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간세포암환자에서 간동맥 화학 색전술 후 발생한 리피오돌에 의한 폐렴 1예
김소이,김유리,허현미,배서은,이명원,최윤정,김고흔,김태헌,유 권,문일환 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.2
Hepatocellular carcinoma(HCC)is one of common causes of cancer-related death in Korea where the majority of HCC patients were Hepaitc B virus(HBV)carriers and have cirrhosis. Transarterial chemoembolization(TACE)is commonly applied to the treatment of multinodular HCC in Korea and careful selection of candidate is important for the risk of various side effects. Besides common side effects as fever, nausea, abdominal pain and elevation of liver enzyme, TACE may predispose to hepatic failure, ischemic cholecystitis, pulmonary embolism, cerebral embolism and pneumonitis. In previous studies, some cases of pulmonary and cerebral embolism cases were reported but lipiodol pneumonitis after TACE was rarely reported. A 65-year-old woman with a multinodular HCC associated with HBV infection, was treated with TACE. Seven days after the procedure, nonspecific respiratory symptoms such as dyspnea and dry cough developed. Chest X-ray and chest computed tomography showed diffuse ground glass opacities in whole lung fields, suggestive of lipiodol pneumonitis. After several days of supportive care with steroid administration, radiologic abnormalities and subjective symptoms were much improved, considered that the disease was compatible with lipiodol pneumonitis.
위전절제술 후 Kim 's Tie 부근 공장에 국소 재발한 위암환자 1예
배병구,서병조,유항종,강윤경,김진복,Bae Byung-Gu,Suh Byoung-Jo,Yu Hang-Jong,Kang Yun-Kyung,Kim Jin-Pok 대한위암학회 2005 대한위암학회지 Vol.5 No.1
위암은 국내에서 발생 빈도가 가장 높은 암으로서 근치적 절제술 및 확대 영역 림프절 절제술의 도입과 더불어 술후 보조 항암화학요법 및 면역요법 등의 이용으로 최근 치료성적의 향상을 보이고 있다. 그러나 수술적 치료를 포함한 치료법의 발전에도 불구하고 다양한 형태의 재발을 경험하게 되고, 대부분의 재발은 3년 이내에 일어난다. 재발양상으로는 크게 국소재발, 원격재발, 복막재발 등이 있으며, 여러 가지 재발양상이 한꺼번에 보이는 경우도 있다. 이 중 국소재발의 호발 부위로는 림프절($48\%$), 문합부($32\%$, 잔존 위($20\%$)의 순으로 보고되고 있다. 증례: 51세의 여자 환자로 1999년 10월 진행성 위암으로 근치적 위전절제술을 시행 받았고, 당시 병기는 T3N1M0(IIIa,AJCC 1997)이었다. 수술 후 10회의 보조적 정맥 주사용 항암화학요법 및 경구용 항암화학요법을 2년간 실시하였고, 외래를 통한 추적검사상 약 5년간 재발을 보이지 않았으나 2004년 9월 시행한 내시경상 Kim's tie 부근공장에서 궤양성 병변을 발견하고 조직검사를 시행, 병리학적으로 낮은 분화도를 보이는 인환 세포암종 형태의 위선암 재발로 진단하고 수술을 시행하였다. 수술 방법은 Kim's tie 위치를 포함해 근위부 6.5 cm, 원위부 4 cm의 절제연을 두고 공장부분 절제술을 시행하였다. 수술 당시 다른 복부장기로 전이는 없었으며 전이성 복수도 없었다. 수술 후 별다른 합병증 없이 회복하였으며 보조 항암화학요법 제제로써 TS-1을 사용하며 외래 통한 추적검사 중이다. Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.
산전 태아사망 환자에서의 Mycoplasma hominis와 Viridans streptococcus감염 1예
김윤숙,문성택,전섭,김종수,최승도,선우재근,배동한 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.1
Mycoplasma hominis was isolated from a Bartholin's gland abscess 70 years ago, and ureaplasmas were isolated from the genital tract about 20 years later. Subsequently, reports incriminating mycoplasmas in the known adverse outcomes of pregnancy have been reported. Without doubt these genital mycoplasmas are able to invoke an inflammatory response and take part in the cascade of events that culminate in preterm birth. Amniotic fluid infection results in considerable pregnancy wastage in the pregnancy. In these cases Gram-positive organisms, especially group B streptococcus and Streptococcus viridans were the most common pathogens isolated. In our case, the patient has fever and vaginal discharge at 14+4 weeks gestation and two days after intrauterine fetal death was seen. The vaginal culture and sensitivity shown Mycoplasma hominis and Vihdans streptococcus. We experienced a case of Mycoplasma hominis and Viridans streptococcus infection in a patient with intrautehne fetal death and report with a brief review of literatures.
김정념,이숭환,김정식,김진호,배윤오,박성규,윤상정,한현영,이헌영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1
Omental infarction, the end result of impaired perfusion to the greater omentum, is a rare benign self-limiting clinical entity. The main clinical symptom is non-specific localized abdominal pain with a moderately raised white blood cell and erythrocyte sedimentation rate. These findings often mimic an abdominal surgical emergency. This condition is often misdiagnosed as acute appendicitis or cholecystitis. The characteristic feature of CT scan and ultrasonography provide non-invasive diagnosis in most patients with omental infarction. We report a case of patient whose CT scan showed the characteristic finding of omental infarction. The patient was improved spontaneously only with conservative care.
Roxythromycin-tylosin-furaltadone 합제의 닭 유래 세균에 대한 시험관내 항균효과
김지영,채미경,윤효인,서상희,박배근,김현수,전무형 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-
In vitro antimicrobial susceptibility of roxythromycin (Rx), tylosin (Tyl), erythromycin (EM) and furaltadone (Fur) was studied, either by the single type or the combinated type of Rx-Tyl-Fur (RTF) against E. co1i (30 strains), Staph. aureus (20 strains) and Mycoplasma gallisepticum (5 strains) that are the major pathogens in poultry farm. The paper disk diffusion and MIC tests were applied. In screening test by paper disk diffusion method, the single types of antibiotics showed the sensitivity against 55 strains of bacteria in order of Fur, EM, Rx and Tyl. The combinated RTF showed the higher rate of sensitivity (80∼83.3% at 64㎍/disk, 60-75% at 32㎍/disk) and wider range of growth inhibiting zone (19.6±3.7-24.8±4.7mm) than those of the single drugs. In MIC test, the sensitivity against the 55 strains appeared in order of Fur. EM, Rx and Tyl as similar to those of paper disk diffusion method. The MIC ranges of RTF were 0.125∼16㎍/ml for E. coli, 0.25∼16㎍/ml for Staph. aureus and 1-8㎍/ml for Myco. gallisepticum, showing evidently lower than those of the single types. The MIC_(50) and MIC_(90) of RTF were estimated l∼4㎍/ml and 8∼16㎍/ml, respectively, and remarkably lower than those of the single drugs.
김계현,이윤석,배준호,지상철,박은석 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-
ABSTRACT-A self-microemulsifying drug delivery system (SMEDDS) was developed to enhance the solubility and dissolution rate of poorly water soluble drug, biphenyl dimethyl dicarboxylate, DDB. The system was optimized by evaluating the solubility of DDB and the microemulsion existence range after the preparation of microemulsions with varying compositions of triacetin and surfactant-cosurfactant mixtures (Labrasol as surfactant (S) and the combination of Transcutol, Cremophor RH 40 and Plurol oleique as cosurfactant (CoS)). SMEDDS in this study markedly improved the solubility of DDB in water up to 10 mg/ml and the size of the o/w microemulsion droplets measured by dynamic light scattering showed a narrow monodisperse size distribution with an average diameter less than 50nm. The microemulsion existing range is increased proportional to the ration of S/CoS, however, it decreased remarkably as the oil content was more than 20%. In vitro dissolution study of SMEDDS showed a significantly increased dissolution rate of DDB in water (>12 fold over DDB powder), and SMEDDS also had significantly greater permeability of DDB in Caco-2 cell compared to powders.