췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

농촌지역 노인들의 우울증상에 관련된 요인들의 특성

송미숙,전기홍,송현종,김정은,박승구,신상건,이동훈,정성현,최연주,최완철,최민규,황재철,홍지만 아주대학교 1997 아주의학 Vol.2 No.2

This study was performed to identify risk factors for depression among the elderly in a rural area. A survey was done for the elderly living in Gosam-myenn, Ansung-kun during the period of July 28, 1997 and July 30, 1997. Demographic and sodoeconornic characteristics, and functional and health Status were assessed using a structured questionnaire, and the level of depression was measured by GDS score. The data obtained were analyzed by frequencies, percentage, t-test, ANOVA, and multiple regression, and the results were as follows: 1. The total sample consisted of 133 elderly. Of them, 47 elderly (35.4%) showed significant depressive Symptoms. 2. The GDS score was the highest for the group over 85 years of age (p < 0.05). Those living alone or widowed showed lower GDS score than those living with someone or married (p < 0.05). 3. The GDS score was the highest in the absolutely dependent group, followed by the partially dependent group, and the independent group (p < 0.01). The elderly who perceived their health Status as excellent showed the lowest GDS score. In contrast, those who had more than five chronic diseases showed the highest GDS score. 4. The elderly receiving financial and emotional support from their family or friends showed lower GDS score compared to those without any support. 5. The economically dependent group showed higher GDS score than that of independent group. 6. The elderly who involved in leisure activities showed lower GDS score than those without any involvement. 7. In terms of risk factors for depression, we found that perceived health Status, subjective economic Status, leisure activities, living arrangement and financial support were inversely associated with GDS score, whereas labor support was positively associated with GDS score. Based upon the above findings, this study suggests that these risk factors for depression in the elderly should be taken into consideration for a comprehensive mental health program for the elderly living in the rural area.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

상분리법을 통하여 제조된 새로운 개념의 지지형 액막의 기체투과특성

최평호,김범식,이정민,김철웅,구기갑,이상학 한국공업화학회 2004 공업화학 Vol.15 No.1

새로운 지지형 액막(SLM)을 용매 증발에 따른 1차, 2차 상분리법으로 3성분 고분자 용액으로부터 제조하였다. 액막재로 이온액인 BMIBF_(4) (BMI+ =1-(1-butyl)-3-methylimidazolium, BF_(4)=tetra-fluoro boratr)와 매트릭스 고분자로 polyvinylidenefluoride(PVDF)가 사용되었다. 이 고정화 액막의 O_(2), N_(2) 그리고 CO_(2) 기체 투과특성을 여러 조작 조건에서 조사하였다. SLM은 가혹한 조건에서 조작하였음에도 불구하고 오랜 시간동안 높은 CO_(2) 투과도 및 선택성을 유지하였다. 투과거동을 나타내는 인자인 투과도, 확산도, 그리고 용해도를 연속 측정 장치를 통하여 구함으로써 특성을 관찰하였다. SLM은 다른 기체에 비하여 CO_(2)에 대해서 높은 투과도와 선택도를 갖고 있었다. 특히, 막내 CO_(2)의 용해도는 다른 기체들에 비하여 매우 높은 반면 확산도는 큰 차이를 보이지 않았다. 또한 막내 이온액의 조성은 CO_(2) 용해도에 영향을 관찰할 수 있었다. 막내 이온액의 조성이 증가함에 따라서 CO_(2) 의 투과도 및 선택도가 극격히 증가하였다. 이는 SLM를 통한 기체 투과에 있어서 용해도가 주인자로 큰 영향을 끼침으로써 막내 이온액 조성 증가 SLM의 투과에 큰 영향을 미침을 확인하였다. The new supported liquid membranes (SLMs) were fabricated from ternary polymer solution contained ionic liquid in which primary and secondary phase separations were induced by the solvent by the solvent evaporaton. The used ionic liquid and polymer matrix were BMBF_(4) (BMI+=-(1-butyl)-3-methylimidazolium, BF_(4)-tetra-fluoro boratel and polyvinylidene fluoride (PVDF). Gas permeation properties of the SLM to O_(2), N_(2) and CO_(2) were studied at various operating conditions. Although the SLM were operated under severe operating condition, it maintained high CO_(2) permeability and selectivity for quite long time. The solubility coefficient of CO_(2) in the membrace was very high in comparison with those of other gases; whereas there was no big difference in the diffusivity between CO and other gases. Moreover, in the permeation of pure gases, it is observed that the ionic liquid content in the membrane affected the solubility of CO_(2) in the memhranc. With increasing ionic liquid content in the membrane, the permeability and selectivity of CO_(2) increase significantly. There fore, in the permeation of gases through SLM, the overall permeation performances weir affected mainly by solubility coefficient. This observation can be discussed in terms of the influence of solubility coefficient with ionic liquid content in the membrane.

정신분열병환자와 기질성뇌증후군환자에 있어서 KWIS 하위검사들의 비교

최영택,박영남,정철호 大韓神經精神醫學會 1989 신경정신의학 Vol.28 No.3

In order to compare the cognitive functions between schizophrenia and organic brain syndrome, the authors performed Korean Wechsler Intelligence Scale(KWIS) for 30 schizophrenics and 30 patients with organic brain syndrome. Schizophrenics had significantly higher scores than patients with organic brain syndrome on the subscales of 'information', 'similarities' and 'block design' of KWIS, but no significantly differences were found between the two groups on the subscales of 'comprehension','arithmetic' and 'picture arrangement' of KWIS. These findings suggest that schizophrenics might be less impaired than patients with organic brain syndrome in the cognitive functions which required only simple memory or spontaneous visuomotor task, but there seemed to be no differences between two groups in those cognitive functions which required more complex, abstract and logical thinking or sustained attention.

하지방사통을 동반한 성인 협부결손성 요추전방전위증의 후방요추간유합술 및 추경나사고정술후 추적결과

최철,김근수,최하영,김철진,김형일,이정청 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.4

복합레진의 수리 시 표면처리가 결합강도에 미치는 영향

최정인,김영재,김정욱,이상훈,김종철,한세현,장기택 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

본 연구의 목적은 표면처리가 기존의 레진과 새로운 레진 사이의 전단결합강도에 미치는 영향을 평가하는 것이다. 준비된 레진 시편을 6군으로 임의로 배분하여 각각의 표면처리를 한 후 수리용 레진을 축조하였다. 일주일간 보관 후 전단결합강도를 측정하였고 일원분산 분석법으로 통계처리하여 다음과 같은 결과를 얻었다. 1. 3군과 4군(air abrasion)은 1군(산부식)에 비해 전단결합강도가 유의하게 높게 나타났다(p<0.005). 5군과 6군(diamond bur)은 1군(산부식)에 비해 높은 전단결합강도를 나타냈으나 통계적으로 유의하지 않았다(p<0.005). 2. 2군(자가부식 접착제)은 1군(산부식)에 비해 전단결합강도가 낮게 나타났으나 유의한 차이는 없었다(p<0.005). 3. 3군(air abrasion)과 4군(air abrasion +산부식)에서 전단결합강도의 차이는 유의하지 않았다(p<0.005). 4. 5군(diamond bur)과 6군(diamond bur+산부식)에서 전단결합강도의 차이는 유의하지 않았다(p<0.005). 결론적으로,복합레진의 수리 시 air abrasion으로 표면처리를 했을 때의 결합강도가 가장 높았고,산부식 방법과 처리여부는 수리강도에 유의한 영향을 미치지 않았다. The purpose of this study was to evaluate the effect of surface treatment on the shear bond strength between new and old composite resin. The prepared resin specimens were separated 6 groups, and each group then received a different surface treatment. Then the repair material was added. Shear bond strengths for repair were measured after 7 days and the results were analyzed by using one way ANOVA. The results were as follows ; 1. Group 3, 4(air abrasion) showed significantly higher shear bond strength than Group l (phosphoric acid)(p<0.05). Group 5, 6(diamond bur) showed higher bond strength than Group l(phosphoric acid) but not significantly different(p<0.05). 2. Group 2(self-etching adhesive) showed lower shear bond strength than Group 1 (phosphoric acid) but not significantly different (p<0.05). 3. There was no statistically significant difference between Group 3 (air abrasion) and Group 4(air abrasion + etching). 4. There was no statistically significant difference between Group 5(diamond bur) and Group 6(diamond bur+etching). In conclusion, the surface treatment with air abrasion resulted in higher repair bond strength than other methods. Repair bond strength was not significantly affected by acid etching.

출산후 여성의 우울성향과 영아 기질, 양육 스트레스 및 대처방식과의 연관성

최영민,이승휘,김영미,이정호,전성일,이기철 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

목 적 : 산후우울증의 발생은 출산 직후부터 1년까지 지속될 수 있고 출산 이후에도 오랜 기간동안 발생 가능성이 있으며, 산후우울증을 단순히 선행하는 감정적 문제, 통제 소재, 사회적지지, 출산과 동반된 생리적 변인만으로 설명할 수 없다. 그러므로 산후우울증은 출산후 산모-영아 상호관계에서 겪게되는 어려운 영아의 기질, 산모가 영아를 양육하면서 겪게되는 양육 스트레스, 그리고 산모의 대처 방식과 연관이 있을 것이다. 본 연구는 산후우울증과 영아 기질, 양육 스트레스, 대처방식을 변인으로 하여 산후우울증과의 연관성을 평가하기위해 산후의 우울성향과 각 변인의 관계를 연구하였다. 방 법 : 연구의 대상은 1996년 7월 16일부터 8월 27일까지 인제 대학교 의과대학 부속 상계백병원 소아과 외래에 예방 접종을 위해 내원한 4개월에서 12개월 사이의 영아를 둔 산모 105명을 대상으로 하였다. Beck우울척도(BDI), 영아기질척도(EAS), 부모 양육스트레스 목록표(PSI), 대처방식척도(WCC)를 사용하여 산후의 우울성향과 이들 변인과의 연관성을 평가하여 다음과 같은 결과를 얻었다. 결 과 : 1) 어머니의 우울성향 점수는 영아의 기질중 부정적 정서성(r=.26 p<0.05), 과도한 활동성(r=.22 p<0.05)과 유의미한 상관 관계를 보였다. 영아의 사회성 척도와는 부적 상관이 있었으나 통계적으로 유의미하지는 않았다. 2) 어머니의 우울성향 점수는 양육 스트레스와는 정적 상관관계가 있었다(r=.44 p<0.001). 3) 어머니의 우울성향 점수와 대처방식과 유의미한 상관관계를 보이지 않았다. 4) 영아의 부정적 정서성과 양육 스트레스는 정적 상관관계가 있었으나(r=.49 p<0.001) 사회성, 활동성과의 상관관계는 유의미하지 않았다. 양육 스트레스와 대처방식과도 통계적으로 유의미한 상관관계를 보이지 않았다. 결 론 : 본 연구 결과, 산모의 산후 우울성향과 첫째, 영아 기질 중 정서성과 활동성이 연관관계가 있고 둘째, 양육스트레스와 연관이 있으나 세째, 대처방식과는 연관이 없었다. 이런 결과는 산후의 우울성향과 각 요인과의 연관성을 살펴볼 때 산후우울증에 더 중요한 영향을 미치는 것은 산모의 대처 방식이라는 어머니 측의 변인보다는 출산과 동반된 양육 스트레스 혹은 영아의 어려운 기질일 것이라고 추론할 수 있다. Objectives : This Study examined the relationship of depressive tendency in postpartum women with psychosocial factors such as infant temperament, parental stress and coping style. Methods : The subjects consisted of 05 postpartum women, each of whom had an infant aged 4 to 12 months. They were assessed on demographic variables and on measures of the depressive symptomatology, infant temperament, parental stress and the coping style using Beck Depression Inventory(BDI), the EAS temperamental survey, Parenting Stress Index(PSI), the Way of Coping Checklist(WCC). And then we assessed the relationship of depressive tendency in postpartum women with psychosocial factors. Results : The results were as follows : 1) Depressive tendency in postpartum women had significant relationship with emotionality(r=.26 p<0.05) and activity(r=.22 p<0.05) of infant temperament. 2) Depressive tendency in postpartum women had significant relationship with parenting stress(r=.44 p<0.001). 3) Depressive tendency in postpartum women had no significant relationship with coping style. 4) Parental stress had significant relationship with emotionality(r=.49 p<0.001) but did not have any relationship with sociability and activity of infant temperament. Parenting stress had no significant relationship with coping style. Conclusion : These results suggest that depressive tendency in postpartum women correlated with emotionality and activity of infant temperament correlated with parenting stress but not correlated with coping style. Infant temperament and parenting stress to child rearing are more significantly correlated with depressive tendency in postpartum women than coping style of postpartum women.

Multiple miliary osteoma에 관한 증례 보고

최갑식,유정수,최순철 大韓顎顔面 放射線學會 1985 Imaging Science in Dentistry Vol.15 No.1

The authers observed a multiple miliary osteoma which was found in the 70-year-old male patient at routine dental examination and obtained the following features; 1. The osteomas are situated in the buccal cheeks of both side, but overlying skin shows normal. 2. The small osteomas range from 0.5mm to 2.0mm in diameter. 3. The osteomas appeared in proximity to the surface at a special radiograph which made with the tube directed parallel to the surface of the face when the cheek is being blown outwardly. 4. Each osteoma appears as a small doughnut shaped shadow with a radiolucent center.