위암에서 장화생 발생 양상에 대한 연구

최은정,강상균,김창진 순천향대학교 1994 논문집 Vol.17 No.4

The pathogenic mechanisms of gastric carcinoma, which is the most common malignant tumor in Korea, have not been completely revealed, but several lines of evidence suggest that intestinal metaplasia contributes in some way to the gastric carcinogenesis. Histologically, the gastric carcinoma can be classified into two main types, the expanding type and the infiltrative type. Intestinal metaplasia can be classified into 3 types : type Ⅰ which is complete metaplasia, type Ⅱ and type Ⅲ which are incomplete metaplasia secreting sulphomucin. The expanding type has some correlations with incomplete sulphomucin secreting metaplasia. To investigate the relationship between patterns of intestinal metaplasia, especially sulphomucin producing metaplasia, and histologic types of gastric carcinoma, 80 cases of gastric carcinoma and 10 cases of gastric ulcer were studied histochemically with hematoxylin-eosin, periodic acid-Schiff alcian blue(PAS-AB : pH2.5) and high iron diamine alcian blue (HID-AB : pH2.5) stains. The results were as follows : 1. Of a total of 80 cases of gastric carcinoma, 21 cases(26%) were expanding type and 59 cases(74%) were infiltrative type. 2. Of 21 cases of expanding type, 6 cases(28%), 4 cases(19%) and 5 cases(25%) were type Ⅰ, type Ⅱ and type Ⅲ intestinal, which is higher rate than that of nonsulphomucin secreting type Ⅰ intestinal metaplasia. 3. Of 59 cases of infiltrative type, 18 cases(30%), 8 cases(14%) and 12 cases(20%) were type Ⅰ, type Ⅱ and type Ⅲ intestinal metaplasia respectively. Twenty cases(34%) were sulphomucin secreting type Ⅱ and typeⅢ metaplasia, which is slightly higher rate than that of nonsulphomucin secreting type Ⅰ metaplasia. 4. Non-metaplasia was found in 28% of expanding type, and in 36% of infiltrative type, which suggests that, compared to the expanding type, infiltrative type tends to be associated with non-metaplasia 5. Of 10 cases of gastric ulcer, 6 cases(60%), 2 cases(20%) and 1 case(10%) were type Ⅰ, type Ⅱ and type Ⅲ intestinal metaplasia respectively. Above results suggest that sulphomucin secreting type Ⅱ and Ⅲ intestinal metaplasia have some relationship with gastric carcinogenesis, and that infiltrative type is more frequently associated with non-metaplasia, while non-tumorous gastric lesion as peptic ulcer has frequently associated with type Ⅰ complete intestinal metaplasia. However, further studies on the profiles of mucins secreted by epithelial cells should be done to elucidate the relationships between intestinal metaplasia and gastric carcinogenesis.

상악 전치부 후방 견인 시 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구

정애진,김운수,이수행,강성수,최희인,조진형,김상철 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.2

상악 전치부 후방 견인 시의 이동 양상 및 응력 분포를 건조 두개골을 전산화 단층 촬영에 의해 3차원 영상화한 유한 요소 모델 상에서 알아보고자 하였다. 피질골 절단술의 시행 여부와 고정원, 힘의 작용점을 각기 달리 설정하여 8개의 실험군을 구성하여 비교하였다. 통상적인 T-loop을 이용하여 공간폐쇄를 하는 경우 전치부는 후하방으로 경사이동 하였으며, 구치부에서도 약간 전방 이동하였다. 피질골 절단술을 동반하여 전치부를 견인한 경우, 전치부 골편에서의 응력 분포가 전반적으로 넓게 분포되었으며, 전치부 경사의 정도가 적은 반면에 변위량은 훨씬 더 많았다. 협측에서의 견인 시 상악 협측에 식립된 미니 임플랜트와 견치 power arm간에 견인력을 가한 경우가 미니 임플랜트로 고정원이 강화된 제2소구치와 견치 브라켓 간에 견인력을 가한 경우보다 전치부의 후하방 경사 정도가 적었다. 구개측에서 power arm에 대한 견인 시 정중구개봉합 부위에 식립한 미니 임플랜트로부터 견인력을 가한 경우가 상악 제1, 2대구치 간 구개면에 식립된 미니 임플랜트로부터 견인력을 가한 경우보다 전치부의 후하방 경사 정도가 컸다. 이러한 결과로써 치아이동 시 피질골 절단술의 효과와 저항중심에 대한 교정력 벡터 조정의 의미를 확인할 수 있었다. Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

초음파탐상 PD-RR Test의 통계적 신뢰도 평가 (Ⅲ) : a Round Robin Test Reesult (Part Ⅲ)

박익근,박은수,김현묵,박윤원,강석철,최영환,이진호 한국비파괴검사학회 2003 학술대회 논문집 Vol.- No.1

국내 원전의 건전성 및 안전성 확보에 직결되는 자동 초음파검사의 신뢰도 및 검사시스템의 기량을 평가하기 위해 자동UT-PD RRT를 수행하였다. 수행된 RRT의 조건은 2001년 수동 PD-RRT에 적용된 설계변수와 동일하다. 본 연구에서는 자동 UT의 결함검출확률 및 오판확률과 결함크기측정에 대한 불확도 분석을 이용하여 자동 초음파검사의 통계적인 신뢰도를 평가하고 수동 UT PD-RRT의 결과와 비교하여 기량을 검증하고자 한다. 이러한 연구결과를 토대로 향후 각종 비파괴검사에 대한 RRT를 수행하여 기술수준을 파악하고 비파괴검사기술의 발전을 도모할 수 있을 것으로 판단된다.

저장 온도 및 상대습도가 비타민 정제 중 지용성 비타민 함량의 변화에 미치는 영향

김동섭,이재황,김세곤,이동언,박석준,이진희,이강표,최성원,백무열 경희대학교식량자원개발연구소 2007 硏究論文集 Vol.26 No.1

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade

( Kang-un Choi ),( Byung-jun Kim ),( Hong-ju Kim ),( Jang Won Son ),( Jong-seon Park ),( Dong-gu Shin ),( Young-jo Kim ) 영남대학교 의과대학 2017 Yeungnam University Journal of Medicine Vol.34 No.1

We report on a rare case involving a 23-year-old female patient with mediastinal cystic mass complicated with acute pericarditis and cardiac tamponade. Pericardial fluid demonstrated lymphocyte-predominant exu-date and the level of carcinoembryonic antigen (CEA) was unexpectedly elevated. Successive aspiration of mediastinal cystic mass revealed a very high level of CEA (>100,000 U/mL) and carbohydrate antigen 19-9 (>15,000 ng/mL). This patient was clinically diagnosed as an infected bronchogenic cyst complicated with pericarditis and cardiac tamponade. The treatment resulted in alleviation of her symptoms.

Acute Left Main Coronary Artery Thrombosis As Initial Presentation of Systemic Lupus E rythematosus

( Kang Un Choi ),( Ung Kim ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Acute coronary artery thrombosis in left main is rare in young age and its etiology should be determined. Acute myocardial infarction due to thrombus in left main is rare but results in disastrous outcomes. The incidence of Ischemic heart disease is 8%-16% in SLE patients and Few reports have described acute myocardial infarction as an initial presentation. We present a unique case of a 40-year-old young manpreviously healthy who has an ST-elevation myocardial infarction by total acute thrombosis of the left main coronary artery. He have many features of SLE, including Serositis, Renal involvement, Hemolytic anemia, ANA and low complement. The patient was treated successfully with percutaneous coronary intervention and Steroid therapy. This case highlights the importance of considering thrombotic states such as SLE presenting with acute myocardial infarction caused by an unexplained intracoronary thrombosis. In conclusion, SLE should be considered as differential diagnosis in relatively young patients presented with acute left main thrombosis.

Acute left main coronary artery thrombosis as an initial presentation of systemic lupus erythematosus

( Kang Un Choi ),( Ung Kim ) 영남대학교 의과대학 2018 Yeungnam University Journal of Medicine Vol.35 No.2

Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

Purulent pericarditis: subdiaphragmatic suppurative focus

( Kang-un Choi ),( Chan-hee Lee ) 영남대학교 의과대학 2020 Yeungnam University Journal of Medicine Vol.37 No.1

Purulent pericarditis is defined as a localized pericardial infection with gross pus formation in the pericardial space. Although purulent pericarditis is now rare in the antibiotic era, it may be life-threatening. We describe a rare case of purulent pericarditis that originated from a subdiaphragmatic suppurative focus in an immunocompromised host.

Bronchogenic cyst masquerading as malignant pericardial effusion with tamponade

Choi, Kang-Un,Kim, Byung-Jun,Kim, Hong-Ju,Son, Jang Won,Park, Jong-Seon,Shin, Dong-Gu,Kim, Young-Jo Yeungnam University College of Medicine 2017 Yeungnam University Journal of Medicine Vol.34 No.1

We report on a rare case involving a 23-year-old female patient with mediastinal cystic mass complicated with acute pericarditis and cardiac tamponade. Pericardial fluid demonstrated lymphocyte-predominant exudate and the level of carcinoembryonic antigen (CEA) was unexpectedly elevated. Successive aspiration of mediastinal cystic mass revealed a very high level of CEA (>100,000 U/mL) and carbohydrate antigen 19-9 (>15,000 ng/mL). This patient was clinically diagnosed as an infected bronchogenic cyst complicated with pericarditis and cardiac tamponade. The treatment resulted in alleviation of her symptoms.