위암 환자에서 절제된 림프절 수의 차이와 관련이 있는 인자

정귀애,박정희,변익건,김경종,장정환,김권천,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Purpose: By the definition of UICC TNM classification (fifth edition), the nodal stage of gastric cancer is based on the number of metastatic lymph nodes, which is influenced by the number of resected lymph nodes. And individual differences in the number of resected lymph nodes had been observed in patients with gastric cancer. The aim of this study is to verify the factors which are associated with the difference in the number of resected lymph nodes in patients with gastric cancer. Methods: We reviewed 613 patients with gastric cancer who underwent curative resection and D2 lymph node dissection with 15 or more resected lymph nodes. The number of resected lymph nodes was analyzed according to the characteristics of patients, the types of operation and prognostic factors of gastric cancer. Results: The mean number of resected lymph nodes per patient was 33.0 (median: 31.0, range: 15-88). The number of resected lymph nodes was significantly associated with the types of operation, the location and size of tumor, macroscopic types, depth of tumor invasion and the number of metastatic lymph nodes. Patient's age, gender and the histopathological finding's had no relationship with the number of resected lymph nodes. Conclusions: The number of resected lymph nodes from gastric cancer was different in each patient despite of same D2 lymph node dissection and it was associated with several prognostic factors of gastric cancer.

3차 병원의 병동에서 시행된 심폐소생술의 분석

류진호,정경운,위준선,문정미,전병조,문원식,김용권,소정일,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.

응급실에 내원한 환자에서 어지럼증의 원인과 임상양상의 분석

문원식,정경운,위준선,문정미,전병조,김용권,소정일,류진호,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of elderly population and senile disease. The differentiation of dizzy patients is not familiar to most emergency physicians. This study was designed to differentiate true vertigo and to investigate the clinical difference among central vertigo, peripheral vertigo, and other causes of dizziness. Methods: The authors analyzed the cases of 237 dizzy patients who visited the emergency department of Chonnam University Hospital during the recent 2 years. For the base of dizziness, associated past illnesses, severity, nystagmus type, and the causes of central and peripheral vertigo. Results: Female patients were 142(59.9%) and male patients were 95(40.1%). The most common age group was the 6th decade. The origin of dizziness was classified as peripheral cause(25.3%), central cause(32.9%), and others(41.8%). As to nature of the dizziness, the rotatory sense was dominant in peripheral vertigo and the floating sense and blurred vision in central vertigo. Peripheral vertigo was triggered by position change of head and body, and central vertigo by the eye movement. Audiograms I showed that most patients with central vertigo had normal hearing, but 46.7% of thoswith peripheral vertigo had an abnormal hearing disturbance. Nystagmus was more prevalent in peripheral vertigo Conclusion: History taking and physical examination played an important role in the diagnosis of dizzy patients. An important part of the diagnosis of a dizzy patient could be to evaluate the peripheral origin, the central origin and others causes. Because central vertigo may be associated with a significant neurological pathology, spectral radiological studies, including MRI and CT, are mandatory to rule out a devastating brain lesion.

유방통을 호소하는 한국 여성에서 Gamma Linolenic acid의 임상적인 효과

정재헌,김권천,조현진,민영돈,김성환,김정용,장정환 조선대학교 부설 의학연구소 2000 The Medical Journal of Chosun University Vol.25 No.1

Background and Objectives : Recently, the incidence of breast cancer is gradually increasing in korea. Many patients visit the hospital with a fear of breast cancer, if she had the pain in her breast. But Breast pain is not a cardinal sign of breast cancer. Only 7% of patient in breast cancer has breast pain. Materials and Method : To know the clinical effects of gamma-linolenic acid(GLA), we analyzed the medical records of 55 cases with breast pain, who visited the outpatient clinic of Chosun university hospital, between July of 1999 to December of 1999. Of the 55cases of breast pain, we analyzed 26 cases of patient with breast pain who was treated with GLA for 2 month and we excluded patients of breast pain who had breast mass or were treated with other drug. Results : 2 Patients we are dropped out because nausea and vomiting were developed, 4 Patient with breast pain were treated with GLA for 1 month, and relieved completely from mastalgia and 8 patients with breast pain were treated with GLA for 2 months and breast pain was relieved completelys. 4 patient had treatment for 2 months, were relieved slightly. But 8 patients with breast pain didn't reveal the relief of symptom after the intake of GLA. Conclusion : We conclude that GLA could be considered a first line drug in patients with mastalgia.

조기위암의 형태학적인 분류에 따른 임파절 전이 양상

최은서,강길,박정희,장정환,김권천,김경종,민영돈 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Currently, in the limited cases of early gastric cancer (EGC), endoscopic mucosal resection (EMR) is used for curative treatment. However, its completeness is still controversial. The purpose of this study was to review the suggested indications of EMR. We retrospectively analyzed 234 patients with EGC who underwent curative (RO) gastrectomy. The enrolled cases were further classified into mucosal and submucosal types, and mucosal EGC were further classified according to the size, gross type and histologic pattern. 133 patients had mucosal cancers and 101 patients submucosal. The overall incidence of positive lymph node was 14.1% (33/234), the incidence of mucosal cancer was 8. 3% (11/133), which was significantly lower than that of submucosal, 22% (22/101). Of 133 patients with mucosal EGC, 90 were smaller than 2㎝ in size and the incidence of lymph node metastasis was 5.6% (5/90), compared to 43 of larger than 2㎝ with the incidence of 14% (6/43). According to the gross type classification of mucosal cancer, incidence of lymph node metastasis in protruded type (EGC type Ⅰ, Ⅱa, Ⅰ+Ⅱa) was 15.4% (4/26), nat type(EGC type Ⅱb) 2. 9% (1/35), depressed type (EGC type Ⅱc, Ⅲ) 8.3% (6/72). Lymph node metastasis in differentiated type of mucosal cancer was 6.9% (5/72) and undifferentiatcd type 9.8% (6/61). In this study, there was no single indication free from lymph node metastasis, It is thought that the selection of EMR for the curative treatment of EGC should be considered carefully and more clinical studies with long-term follow up are necessary for EMR to be generally acceptable.

외상 후 뇌 지방색전증 1예

문정미,소정일,김용권,류진호,허탁,서정진,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.

위암의 근치절제술 후 생존율과 예후인자

차윤정,박진영,장정환,김성환,김권천,조현진,민영돈 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Gastric cancer is still the leading cause of cancer death in Korea, and surgery remains the only method of treatment that offers the potential for a cure. Purpose: The aims of this study are to examine the outcome of the patients with gastric adenocarcinoma who underwent curative resection and to identify the prognostic factors leading to improved survival rates in these patients. Materials and Methods: The medical records of 278 patients with gastric adenocarcinoma, treated curatively at the Chosun University Hospital between January 1990 and December 1994, were reviewed retrospectively from January 2000 to March 2000. Follow-up was obtained for 250 patients(89.9%). The survival rates were calculated by the Kaplan-Meier method, and the significance of differences between patient factors(age and sex), tumor factors(location, size, gross type, tumor depth, lymph node metastasis, and stage) and treatment factors(operation method and reconstruction type) were evaluated statistically by the log-rank test. Results: The overall five-year survival probability was 59.6%. There was no survival difference according to age and sex. The 5-year survival rates according to the tumor depth were 97.0% for Tl, 74.5% for T2, 39.6% for T3, and 23.1% for T4(p=0.0000); to the lymph node metastasis were 81,4% for N0, 51.9% for N1, and 21.2% for N2(p=0.0000); to the TNM stage were 96.7% for stage I a, 79.5% for stage I b, 68.8% for stage II, 52.9% for stage III a, 25.9% for stage III b, and 7.5% for stage IV(p=0.0000). Other statistically significant differences were shown in tumor location, size, gross type, operation method, and reconstruction type after subtotal gastrectomy. Conclusion: The most definitive prognostic factors affecting the survival rate of gastric adenocarcinoma were tumor depth, lymph node metastasis, and tumor stage. The keys to successful outcome includes early diagnosis and curative resection with radical lymph node dissection at early stage as possible.

결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과

나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.

Mitochondrial oxidative phosphorylation reserve is required for hormone- and PPARγ agonist-induced adipogenesis

Ryu, Min Jeong,Kim, Soung Jung,Choi, Min Jeong,Kim, Yong Kyung,Lee, Min Hee,Lee, Seong Eun,Chung, Hyo Kyun,Jung, Saet Byel,Kim, Hyun-Jin,Kim, Koon Soon,Jo, Young Suk,Kweon, Gi Ryang,Lee, Chul-Ho,Shong Springer-Verlag 2013 Molecules and cells Vol.35 No.2

파력발전장치 설계를 위한후포 연안의 파랑 분석 및 스펙트럼 추정

권혁민(Kweon, Hyuck-Min),조홍연(Cho, Hongyeon),정원무(Jeong, Weon-Mu) 한국해안해양공학회 2013 한국해안해양공학회 논문집 Vol.25 No.3

파력변환장치에는 여러 가지 형식이 있으며 지점흡수식이 가장 많이 연구되고 있다. 하지만, 국내외적으로 진동형 전력부이 형식의 설계를 위한 계통적 실측자료 분석 예는 찾기가 어렵다. 본 연구는 권 등(2010)에 의해 제안된 지점흡수식인 공진형 파동에너지 추출시스템에 작용하는 파랑외력을 산정하고자 한다. 본 연구는 경북 동해안에 위치한 후 포항 북방파제 전면수역에서 수압식 파고계를 이용하여 약 3년동안 관측한 자료(2002년 5월 1일~2005년 3월 29일)를 대상으로 시계열 스펙트럼을 분석하였다. 분석결과, 월별주기변동과 파고변동이 뚜렷하게 나타나며 월별 파력이 년 간 불균등하게 분포함을 알았다. 상시파랑의 평균 파형경사는 풍파영역인 0.02-0.04보다 작은 0.01이였다. 년 중 파의 평균주기의 최빈값은 5.31 sec 이며 본 주기에 해당하는 파고 중 최빈 파고는 0.32m이다. 첨두 주기의 발생확률은 이산형(bi-modal)으로 나타나며 4.47 sec와 6.78 sec에서 mode값을 보인다. 설계주기는 이러한 4개의 값으로부터 선택할 수 있다. 파고는 1m 이하가 약 95%를 차지하고 있다. 본 연구를 통하여 파력이 미약한 해역에서는 공진형 파력 시스템이 필요하며 파력의 월별 불균등 분포를 극복하기 위한 최적설계가 전력생산단지(Wave Energy Farm) 형성을 위한 주요한 과제임을 알았다. 본 연구는 상시파랑의 평균스펙트럼에 대하여 표준스펙트럼으로 표현이 불가능하여 3개의 매개변수로 표현이 가능한 새로운 스펙트럼형을 제안하였으며 파력부이에 의한 전력생산 예측과 피로해석을 위한 기본 자료를 제공할 수 있다. There exist various types of the WEC (Wave Energy Converter), and among them, the point absorber is the most popularly investigated type. However, it is difficult to find examples of systematically measured data analysis for the design of the point absorber type of power buoy in the world. The study investigates the wave load acting on the point absorber type resonance power buoy wave energy extraction system proposed by Kweon et al. (2010). This study analyzes the time series spectra with respect to the three-year wave data (2002.05.01~2005.03.29) measured using the pressure type wave gage at the seaside of north breakwater of Hupo harbor located in the east coast of the Korean peninsula. From the analysis results, it could be deduced that monthly wave period and wave height variations were apparent and that monthly wave powers were unevenly distributed annually. The average wave steepness of the usual wave was 0.01, lower than that of the wind wave range of 0.02-0.04. The mode of the average wave period has the value of 5.31 sec, while mode of the wave height of the applicable period has the value of 0.29 m. The occurrence probability of the peak period is a bi-modal type, with a mode value between 4.47 sec and 6.78 sec. The design wave period can be selected from the above four values of 0.01, 5.31, 4.47, 6.78. About 95% of measured wave heights are below 1 m. Through this study, it was found that a resonance power buoy system is necessary in coastal areas with low wave energy and that the optimal design for overcoming the uneven monthly distribution of wave power is a major task in the development of a WEF (Wave Energy Farm). Finding it impossible to express the average spectrum of the usual wave in terms of the standard spectrum equation, this study proposes a new spectrum equation with three parameters, with which basic data for the prediction of the power production using wave power buoy and the fatigue analysis of the system can be given.