후복막강내 발생한 Castleman병 1례

남성진,이동욱,박찬규,정시욱,김추성,조성래,구본천,양사규,이일웅,박정자 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

Castleman' s disease is a rare, reactive lymphoid proliferation of unknown cause and pathogenesis. Depending on histololgic findings, it has been divided into two distinct histologic subtypes that include hyaline-vascular type(90%) and plasmacell type(10%). This disease occurs most commonly in mediastinal lymph nodes and cervical lymph nodes, inguinal lymph nodes respectively. But occurs rarely in retroperitoneum. We report a case of hyaline-vascular type asymptomatic Castleman' s disease of the retroperitoneum in a 47-year-old man.

기관내 삽관시 Flexiblade 후두경과 Macintosh 형 후두경 사용에 대한 비교

장선영,이상귀,이준례 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Comparison between the Flexiblade Laryngoscope and the Macintosh Blade Laryngoscope in Endortracheal Indubation Sun-Young Jand, M.D., Sang-Kyi Lee, M.D., and Jun-Rae Lee, M.D. Department of Anesthesiology, Chonbuk National University Medical School, Jeonju, Korea Background: The Flexiblade laryngoscope has a unique structure that is composed of a blade and a handle with a trigger. When the trigger of the Flexiblade laryngoscope is squeezed, the hyoepiglottic ligament is depressed, the epiglottis is moved anteriorly, and then the laryngoscopic grade is improved. This study was designed to compare the Flexiblade laryngoscope with the conventional Machintosh blade laryngoscope in the laryngoscopic view in endotracheal intubation. Methods: Following induction of general anesthesia, the laryngoscopic grades of 110 patients were evaluated while five different blade positions of the Flexiblade laryngoscope and a laryngoscopy with the Macintosh blade were performed. The laryngoscopic grades which were described by Cormack and Lehane were classified from 1 to 4. Results: With the Macintosh blade laryngoscope, 98.2% of the patients were grade one and two, and 98.2% of the patients was laryngoscopic grade one and two with partial depression of the trigger of the Flexiblade laryngoscope. The laryngoscopic grade of maximal depression of the Flexiblade trigger had similar results to partial depression of the trigger. However, the partial depression of the Flexiblade laryngoscope showed better laryngoscopic views than the maximal depression of the Flexiblade laryngoscope or the Macintosh blade laryngoscope, respectively. In the overall success rate of endo-tracheal intubation and using the adjusting maneuvers, the Flexiblade laryngoscope was superior to the Macintosh blade laryngoscope. Conclusions: The Flexiblade laryngoscope is comparable to the Macintosh blade laryngoscope for endotracheal intubation, therefore, the Flexiblade laryngoscope can be recommended as the first choice for endotracheal intubation. (Korean J Anesthesiol 2001; 41: 289~296)

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

골다공증의 진단시 파노라마 방사선사진 유용성에 대한 연구

이병도,이상래 대한구강악안면방사선학회 2001 Imaging Science in Dentistry Vol.31 No.2

Purpose : To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. Methods : Mandibular cortical width(MCW), degree of mandibular alveolar bone resorption(ABR) and morphology of mandibular infeprior cortex(MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density(BMD) of lumbar(L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. Results : There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. Conclusion : Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.(Korean J Oral Maxillofac Radiol 2001;31:67-71)

형질변형성장인자가 손상골 재생능에 미치는 영향에 과한 실험적 연구

이병도,황의환,이상래,홍정표 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

The purpose of this study was to observe the effect of TGF-81, which promotes differentiation and proliferation of osteoblasts, on bone regeneration. Experimental bone defects that measured 3 mm in diameter were created on the mandibles of guinea pig by removal of bone with the use of trephine burs. In one side of mandibular body, the experimental groups, bone defects were grafted with Biogran(Orthovita Co., U.S.A.) and TGF 131(R&D System Co., U.S.A.). In the remaining side of the mandiblar body, the control groups, bone defects were grafted with only Biogran. Guinea pigs in the control and experimental groups were serially terminated by fours on the 3 days, the 1 week, the 2 weeks, the 3 weeks, and the 4 weeks after experiment, and both sides of the mandibular bodies were removed and fixed with 10% neutral formalin. They were decalcified and embedded in paraffin as using the usual method. The specimen sectioned and stained with hematoxylin and eosin. Also, they were radiographed with a soft X-ray apparatus. The Obtained results.=were as follows; 1. Hemorrhagic condition, observed in the granulation tissues, disappeared on the 1 week after experiment in both groups, and more prominent in the experimental group. The granulation tissues of the experimental group had larger number of cells than those of the control group. 2. Osteoblastic differentiation in the margin of grafted material and adjacent bone was observed on the 1 week after experiment in both groups. Also, bone formation was observed in immature form on the 1 week after experiment, and more prominent in the experimental group. 3. In the polarizing microscopic examination, bone matrix was very loose on the 1 week after experiment, but increase in density with time, and more prominent in the experimental group. 4. In the microradiographic examination, newly formed bone was observed in the experimental group on the 2 weeks after experiment, and this was observed earlier than in the control group. Newly formed bone was increased with time and defected area was markedly decreased on the 4 weeks after experiment.

방사선조사와 당뇨병이 백서 악하선의 caspase-3 발현에 미치는 영향

이흥기,황의환,이상래 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.3

Purpose : To observe the histopathological changes and caspase-3 expression in the submandibular gland in streptozotocin-induced diabetic rats after irradiation. Materials and Methods : The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups: control, diabetes, irradiation, and diabetes-irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control and irradiation groups were injected with citrate buffer only. After 5 days, rats in irradiation and diabetes-irradiation groups were irradiated with a single absorbed dose of 10 Gy to the head and neck region. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the submandibular gland were sectioned and observed using histopathological and immunohistochemical methods. Results : In the irradiation group, the condensed nucleus, karyolysis, and degeneration of the acinar cells and atrophy of the duct cells were observed in the early experimental phase. However, the acinar cells were found to be normal at 28 days after irradiation. In the diabetes group, the condensed nucleus, karyolysis, atrophy, and degeneration of the acinar cells were observed in the early experimental phase. However, the acinar cells were found to be normal at 21 days after diabetic state induction. In the diabetes-irradiation group, the ductal epithelial cells were predominant in their glandular tissues at 28 days after irradiation. In all of the experimental groups, the most prominent change of the acinar cells and ductal cells were observed at 14 days after diabetic state induction and irradiation. Conclusion : The expression of caspase-3 in the acinar cells and ductal cells of the submandibular gland was weak after irradiation, but that in the acinar cells, ductal cells, and fibrous cells of the submandibular gland was prominent after diabetic state induction.

食用獨活의 生態에 關한 硏究 : 越冬前 地下莖의 芽數와 翌年發生 莖數와의 相關 Correlation between the number of crownbuds in autumn and the number of stalk produced in the following season in chonnam area

李相來,鄭丁采,金鶴鎭 順天大學校 1983 論文集 Vol.2 No.1

全南地方에 있어서 食用獨活의 地下莖에는 翌春에 嫩莖이될 芽(crown bud)가 形成되여 있으나 翌年度에 發芽되는 莖數와의 相互關係를 알고 收穫期間의 決定의 資料를 얻고자 全南地方의 推定 收穫 限界期라고 生覺되는 5月 下旬까지만 莖을 除去하고 그 以後부터서 가을 霜降時까지 그대로 放任한 區와 嫩莖이 發達한 直前의 月末까지(7月末日) 收穫하였다가 그 後 부터서 霜降까지 그대로 放任한 區等의 3個의 試驗區를 亂塊法 三反覆으로 試驗하였으니 그 結果를 要約하면 다음과 같다. 1. 前年度 가을에 芽數와 翌年 發生 莖數와의 높은 相關을 認定할 수 있었다. 2. 收穫 期間이 가장 길었던 7月末 까지의 收穫區는 越冬前 根群을 調査한 結果 根群 發生이 不良하여 減收의 原因이 되였다. 3. 發生 莖數는 越冬前의 芽數와 多小 關係가 있는 것 같으나 收穫期의 長短이 더욱 큰 影響을 주었다. 4. 全南地方의 收穫 限界期는 5月 末日까지로 보는 것이 좋을 것 같다. This experiment was conducted to investigate the ecological characteristics of Japanease udo in Chonnam area. During the summer and autumn poriod after the previous year cutting crownbuds of Japanease udo which is edible spears in the following spring are formed. This study was made to dertimine the relationship between the number of corwnbuds in the previned and the number of ber of stalks produced in the following season. The results obtained were as follows: previous num- 1. There was a highly positive correlation between the sum of spears and stalks produced. 2. The plots harvested until the end of July were caused low yield due to the poor development of root system. 3. The number of stalks produced were slightly correlated with the crownbuds of previous year but the length of the harvesting period were influenced severely. 4. The marginal harvesting period of Japanease udo in Chonnam area were determined to the end of May. previous autumn and the num-

학교체육 활성화 방안에 대한 연구(Ⅰ) : 강원대학교 교양체육 운영방법의 개선을 중심으로

이광재,문병용,노성규,박기동,홍관이,한상준,유옥재,엄기진,정청자,오수일,김윤래,박장평,부기원 江原大學校附設 體育科學硏究所 1986 江原大學校附設體育科學硏究所論文集 Vol.- No.11

Try to find a scheme for activation to College Physical Education, this Report informs the various kinds of Survey and process those were projected for improvement of management methods on Cultural Physical Education in Kang Weon National University. From experimentally carried out "Sports events Choosing System" not as usual be inforced "Total practical Skill System", Following Positive effects and sujestions were Presented; 1. "Sports events choosing system" gave birth to more students' interesting and more voluntary participation to the sports events they chose, and sports skill and instruction level was elevated due to charge of expert according to each sports events. This system would be managed continuously hereafter for it related to life sports. 2. This System needs to closed cooperations between College and Community, for the facilities of community are utilized by college. 3. To complete the plan for activation of college Physical Education, additionally, the successional study ; namely "autonomous extracurricular sports activity" should be excuted hereafter.