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열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구
배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2
Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.
일차성, 이차성 그리고 삼차성 부갑상선 기능 항진증 환자의 수술 후 임상결과: 서울대학교 병원에서의 14년 경험
최윤석 ( Yun Suk Choi ),이규언 ( Kyu Eun Lee ),박귀원 ( Kwi Won Park ),노동영 ( Dong Young Noh ),오은미 ( Eun Mee Oh ),최준영 ( June Young Choi ),윤여규 ( Yeo Kyu Youn ),오승근 ( Seung Keun Oh ),구도훈 ( Do Hoon Koo ) 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.1
목적: 일차성, 이차성, 삼차성 부갑상선 기능 항진증은 각각 원인과 치료방법 그리고 임상 경과가 서로 다르지만 부갑상선 절제술이 표준치료로 알려져 있다. 본 연구에서는 각각의 부갑상선 항진증의 수술 전후의 임상적 변화를 알아보고 부갑상선 절제술의 의미를 재고 해보고자 하였다. 방법: 1996년부터 2009년까지 총 126명이 서울대학교 병원에서 부갑상선 절제술을 시행 받았으며 각각 일차성 96명, 이차성 24명, 삼차성 6명이었다. 환자들의 나이, 성별, 생화학적 검사, 수술방법, 병리학적 검사 결과를 전자 의무기록을 통해 후향적으로 분석하였다. 결과: 모든 세 군의 환자에서 혈청 칼슘, 부갑상선 호르몬, 이온화 칼슘이 수술 전보다 호전을 보였다. 이차성 환자군은 다른 두 군에 비해 수술 전, 후의 부갑상선 호르몬이 높았으며(p<0.001, p=0.036), 수술 후 지속적인 부갑상선 기능 항진증(30.4%) 및 일과성 저칼슘혈증(87.5%)도 다른 두 군에 비해 많이 발생하였다.(p< 0.001) 일과성 저칼슘혈증의 대부분(90.4%) 은 6개월 이내 회복 되었다. 이차성 환자에서 부갑상선 아전 및 전 절제술을 시행 받은 경우 수술 후 일과성 저칼슘혈증이 많이 나타났으나(71.4%), 제한적 절제술을 시행 받은 경우 지속적 부갑상선 기능항진증이 더 많이 나타났다.(50%) 결론: 부갑상선 절제술은 생화학 검사상의 호전을 위한 치료 방법으로 추천될 수 있으며, 이차성에서는 제한적 절제를 하는 경우 지속적 부갑상선 항진증의 빈도가 더 높으므로 부갑상선 아전 및 전 절제술을 시행해야 한다. Purpose: Primary hyperparathyroidism(PHPT), secondary hyperparathyroidism(SHPT) and tertiary hyperparathyroidism(THPT) are different in the cause, treatment and prognosis. However the parathyroidectomy has been an efficient treatment in all hyperparathyroidism groups. A single institution`s 14 year experience of surgical treatment was analyzed to investigate perioperative changes of clinical characteristics and reconsider the value of parathyroidectomy as the treatment option. Materials and Methods: From 1996 to 2009, 126 patients underwent parathyroidectomy at single institute and the number of patients with PHPT, SHPT and THPT were 96, 24 and 6 retrospectively. The electronic medical records of age, sex, biochemical analysis, operative method, and pathologic results were reviewed retrospectively. Results: Postoperative calcium (Ca), parathyroid hormone (PTH), ionized calcium (iCa) levels were improved definitely than preoperative Ca, PTH, iCa level in all three groups. Pre and postoperative PTH level in SHPT was higher than in PHPT and THPT(p<0.001, p=0.036) and postoperative persistent PTH increased status were more common in SHPT.(30.4%, p<0.001) Postoperative temporary hypocalcemia was more common in SHPT(87.5%, p<0.001), almost of them (90.4%) were recovered in 6 month. In SHPT group, temporary hypocalcemia were more common in subtotal or total parathyroidectomy group than in limited resection group (94.1%) but persistent iPTH increase were more common in limited resection group (50%). . Conclusion: Parathyroidectomy is highly recommended to improve biochemical laboratory findings in patients with hyperparathyroidism. And in SHPT, subtotal or total parathyroidectomy is more appropriate surgical method for reducing the high incidence of persistent hyperparathyroidism.
총수담관 결석의 진단에 있어서 내시경적 역행성 담췌관 조영술과 초음파 내시경의 비교
최윤미(Yun Mee Choi),김해성(Hae Sung Kim),안승익(Seung Ik Ahn),이건영(Keon Young Lee),홍기천(Kee Chun Hong),최선근(Sun Keun Choi),허윤석(Yoon Seok Hur),김세중(Sei Joong Kim),우제홍(Ze Hong Woo),신석환(Seok Hwan Shin),김형길(Hyung Gil 대한외과학회 2003 Annals of Surgical Treatment and Research(ASRT) Vol.64 No.4
대장암에서 림프절 침범과 암의 침윤도가 예후에 미치는 영향
최윤미 ( Yun Mee Choi ),김해성 ( Hae Sung Kim ),최선근 ( Sun Keun Choi ),허윤석 ( Yun Seok Hur ),이건영 ( Kun Yong Lee ),김세중 ( Sei Joong Kim ),안승익 ( Seung Ick Ahn ),홍기천 ( Kee Cheun Hong ),신석환 ( Seok Hwan Shin ),우제홍 대한소화기학회 2002 대한소화기학회지 Vol.40 No.6
Background/Aims: This study was carried out to evaluate prognostic significance of the clinicopathological features in colorectal cancer. Methods: The records of 413 patients who underwent a curative resection of colorectal cancer from June of 1996 to December of 2000 were examined focusing on the clinicopathological factors and difference of survival rates. Results: The numbers of lymph node metastasis were significantly related to age, depth of invasion, histologic differentiation, tumor size, lymphovascular invasion, perineural invasion, and preoperative serum CEA level. In the univariate analysis for 366 patients, the depth of invasion (p=0.0017), histologic differentiation (p=0.0069), lymph node metastasis (p=0.0000), lymphovascular invasion (p=0.0001), perineural invasion (p=0.0008), and preoperative serum CEA level (p=0.0005) turned out to be significant prognostic factors. The histologic differentiation between the primary lesion and the metastatic lymph node was the same in 90.7% of the studied cases. Capsular invasion was found in 92 cases (53.5%), but there was no significant difference in survival rates between the capsular invasion group and non-capsular invasion group (p=0.0510). Conclusions: In this study, the depth of invasion, lymph node metastasis, and the number of lymph node metastasis could be recognized as important prognostic factors for colorectal cancer. However, further follow-up studies are needed to determine the role of the various clinical and pathological factors in colorectal cancer prognosis. (Korean J Gastroenterol 2002;40:371-378)