간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

자연언어를 이용한 질의응답시스템의 문맥처리부 설계 : 생략, 대용 및 화제처리를 중심으로

강석훈,박수현 東西大學校 1997 동서논문집 Vol.3 No.1

본 논문에서는 자연언어를 이용한 질의응답 시스템에서 사용자의 입력문에 따라 시스템이 능동적으로 응답할 수 있도록 문장을 처리할 수 있는 모듈 가운데 문맥처리부를 설계한다. 질의응답 시스템이 사용자의 입력문에 응답하려면 먼저 입력문을 분석할 수 있어야 하며, 이를 위해서는 기존의 언어해석 뿐만 아니라 문장간의 해석이 필요하다. 따라서 본 논문에서는 이를 위해 생략, 대용 및 화제처리를 중심으로 문맥에 대한 처리를 논하고자 한다.

AFB 공정을 이용한 양돈폐수의 혐기성전처리에 관한 연구

강호,김종원,송석헌,이현규,장제헌 忠南大學校 環境問題硏究所 2003 環境硏究 Vol.21 No.-

This research was performed to optimize the anaerobic pretreatment of slurry type swine wastewater for the subsequent nitrogen and phophorus removal. Step-wise increases in Organic Loading Rate(OLR) and decreases in Hydraulic Retention Time(HRT) were utilized in Upflow Anaerobic Fixed Bed(AFB) reactor at mesophilic temperature(35℃). The maximum methane prodution rates of 1.16 v/v-d was observed at an HRT of 12 hours. TCOD removal efficiency of 75% at an HRT of 2 days and 41% at an HRT of 12 hours were obtained respectively. It is likely that the influent COD concentration of 3,000 mg/L for the subsequent biological nutrient removal system could be supplied from the anaerobic pretreatments operated at an HRT of 12 hours(OLR 12g CODL-day). During AFB operation alkalinity showed 800- 1,500mg/L as CaCO_(3) at all HRTs. It could play an important role for compensating pH drop caused by nitrification. The COD/TKN ratio of 6-14 at all HRTs, COD/TP ratio of 30-50 at an HRT of 1 day and proper buffering capacity and pH of the effluent from the anaerobic fixed bed could be adequate substrate condition in the following nitrogen and phosphorus removal. In conclusion, when AFB was operated at an HRT less than 1 day, the system could be optimized to reach an efficient anaerobic pretreatment for swine wastewater and the subsequent biological nutrient removal.

算數·自然 統合敎科 分析 및 指導硏究

姜錫虞,成濟鉉,徐成輔,朴成澤 부산교육대학교 과학교육연구소 1982 科學敎育硏究 Vol.7 No.-

This study is an analysis and a plan for the improvement on a teaching method, a development of the teaching instruments in integrated subject of mathematics and natural science called "Inquiring Life". Thus this study is summarized as follows: (1) An analysis of the integrated textbook. ① The proportion of the time required for teaching mathematics and natural science is 2:1 in our curriculum. However, in the practical guide book of the Inquiring Life, it has been investigated that the time allotted for mathematics is 12 periods more than the time allotted for natural science, furthermore its significant difference is to appear in x^2=3.86 (p<0.05). ② It has been found that there is a meaning of the integration in the first-term text-book, because the quantity of the contents which is integrated in it is 48.7% of the whole. But there is a problem which must be corrected in the second-term textbook, because such quantity is merely 25.6% of the whole. ③ The time required for teaching a field "figures" was 12 periods (9.2%) of the whole in the textbook of the third revised curriculum (1973). However, since the time required for it in the new textbook is only 2.5 periods (2.0%), this is to show a significant difference in x^2=4.62 (p<0.05). ④ It is because of a emphasis on the problem-solving that the time required for teaching the field "relations" has increased more than that of the preceding textbook. ⑤ There is some resistance in "a reclassification of the shaped boards" and "a learning for preservation of a quantity" to construct a possibility of the learning achievment. ⑥ It is found that the contents and the expressions of the integrated textbook is suitable for our pupils, because, in a questionary investigation for their appropriateness, a significant difference is to appear in x^2=9.49 (p<0.05). (2) The teaching method of the integrated textbook. The integrated teaching method is verified to be effective for a group of the dull pupils by showing a significant difference with CR_M=1.99 (p<0.05). (3) A development of the teaching instruments in the integrated textbook. The integrated teaching instruments that are considered to be a interest of pupils, a acceleration of thoughts, a economic condition, a exactness, a convenience, a firmness and anewness, are efficient for our pupils. (4) An estimation for the integrated textbook. An integration of the curriculum and the revision of the form the pupils' cumulative records are demanded in order to get the good estimations for the integrated concepts.

수화동영상 전송 시스템의 개발 및 구현

강석훈,김열광,박수현 東西大學校 1999 동서논문집 Vol.5 No.-

본 논문에서는 JAVA를 이용한 수화 동영상 전송 시스템을 설계및 구현한다. 일반적인 형식의 동영상 전송기법은 서버 측의 동영상 데이터가 사용자에게 노출될수 있거나 고가의 인코더를 이용해야 하는 등 보안과 유지에 적지 않은 문제점을 가지고 있다. 본 논문에서 구현하는 시스템은 100% 순수 JAVA로 구현되어, JAVA환경만 갖추어져 있으면 일반 Web Browser 로도 데이터의 전송이 가능하며, 서버측의 멀티미디어 데이터 파일이 사용자로부터 보호될수 있는 특징을 가지고 있다. 따라서 이 시스템은 수화를 비롯한 각종 멀티미디어 교육 시스템에서 데이터 전송 모듈로 적합하며 손쉽게 다른 서버 시스템으로 이식이 가능하다.

항원의 말단 아미노산이 T 임파구 자극에 미치는 영향의 분석

강현석,장용석 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3

Immune responsiveness has been known to be determined by the type of individual's major histocompatibiiity complex (MHC). For example, H-2k or H-2a haplotype-bearing mice are high-responders to hen egg-white lysozyme (HEL) antigen, while H-2b or H-2d haplotype-bearing mice are low- or non-responders to HEL. When HEL is injected to the high-responder C3H (H-2k) mice, most of the T lymphocytes recognize the HEL 46-61 epitope region. However, HEL 46-61 specific T lymphocytes are hardly detected in HEL injected low-responder C57BL/6 (H-2') mice. Previously, as an initial step to understand the mechanisms involved in unresponsiveness of HEL low-responder mice to an HEL 46-61 epitope, the antigen recognition pattern of an HEL 46-61 region specific T hybridoma clone originated from C57BL/6 mice was analyzed. The minimal epitope region recognized by the T hybridoma clone was HEL 51-60 and shifted one amino acid from that of high-responder C3H mice. In addition, the arginine at position 61 has an inhibitory effect for T hybridoma cell stimulation by. inhibiting the binding of the epitope peptide with MHC class-II molecules mainly due to the large size of the side chain of the amino acid. In this study, we found that the same characteristics of the arginine are essential for stimulation of C3H T hybridoma clone, 3A9. In order to confirm the influence of arginine on T cell stimulation in T lymphocyte population of HEL high- and low-responder mice, we performed the lymph node cell proliferation assay after HEL injection. In low-responder C57BL/6 mice, the presence of arginine exerts the similar influence on T cell stimulation as shown in T hybridoma cell stimulation experiment. Interestingly however, patterns of lymph node cell proliferation assay in HEL high-responder C3H mice are somewhat different from those of T hybridoma cell stimulation experiment. For example, all the peptides containing the substitutions at position 61 with various amino acids is able to stimulate the T lymphocytes efficiently, although the peptide containing tryptophan at position 61 is the most efficient for T lymphocyte stimulation. Based on these results, possible mechanisms involved in low-responsiveness of C57BL/6 mice to an HEL 46-61 epitope region is discussed.

안구의 비색소성 모양체 상피에서 발생한 유두상 선암종 -1예 보고-

최현주,최영진,이연수,이은정,강석진,김병기,심상인 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

뇌간을 침범한 고혈압성 뇌병증 1예

박강민,양현우,이성훈,배종석 인제대학교 2008 仁濟醫學 Vol.29 No.-

Hypertensive encephalopathy is a medical emergency of which clinical manifestations are associated with bilateral posterior cerebral lesions. However, neuroimaging findings have been reported in only a few cases. We describe a case of hypertensive encephalopathy in which high blood pressure was accompanied by headache, generalized seizure and mental deterioration and T2 weighted magnetic resonance images showed hyperintense lesions in the pons and left occipital lobe. The lesions were nearly disappeared after stabilization of blood pressure, suggesting that induced edema could be the main cause of the MR imaging-observed hyperintensity.

상악동에 발생한 국균증 2례

조용석,김경원,박현진,강지연,이건국,신향미 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.1

국균증은 토양, 유기체 그리고 모든 형태의 유기물 잔사에 광범위하게 존재하는 국균 (Aspergillus) 속에 의하여 발병한다.이 균의 포자는 공기 중에서 전염될 수 있으므로 가장 흔한 감염 진균 중 하나이다.부비동에 발생한 국균증은 초기 임상 증상이 만성 부비동염과 유사하며, 방사선 사진 등을 이용한 검사상도 일반 세균성 감염과 구별하기가 매우 어렵다.대개는 병리조직학적 검사로 국균을 확인해서 확진을 내리게된다.국균증의 치료는 외과적으로 상악동내의 병소를 완전히 제거하고 비강에로 충분한 공기를 통기시키는 것이 가장 중요하며 보조적으로 전신적인 항진균제를 사용해야한다. 증례는 40세와 24세인 여자 환자들로서 전신적으로는 건강했으며 임상적 방사선적으로 만성 상악동 증세를 보였다.상악동 근치술을 시행하면서 국균종으로 여겨지는 암갈색 덩어리들이 관찰되었고 술 후 병리조직검사상 국균증으로 진단되었다.국균증으로 진단 후 보조적으로 전신적 항진균제를 투약하였으며 재발없이 치유되었다. Aspergillus is a fungus of the Acetomyces class that is most commonly encountered in the human environment.Aspergillosis of the maxillary sinus is not common and it requires special consideration to diagnose and eradicate. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. Generally the diagnosis of sinus aspergillosis can be confirmed by histologic examination, however, characteristic radiographic appearance such as coherene of radiodense sinus concretions can be found by careful examination of the radiograms. The choice of treatment of maxillary sinus aspergillosis is radical surgery with adjunctive systemic antifungal therapy. We experienced two cases of maxillary sinus aspergillosis, which initially diagnosed as chronic maxillary sinusitis and showed a necrotic mass intraoperatively and histologically diagnosed as aspergillosis.We reports theses cases with review of literature.