고등급 이형성을 보인 편평톱니샘종

권경주,정성애,심기남,정정화,강석형,송도경,전승정,김혜인 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.1

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed ‘serrated adenomas’. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.

거친 표면을 가진 흡수체와 버퍼의 측면에 의한 극자외선 산란효과

권영근,심상진,김종회,김옥경,오혜근 한양대학교 이학기술연구소 2003 이학기술연구지 Vol.6 No.-

마스크 상의 거친 표면을 정의하기 위해서 Monte-Carlo 방법이 적용되었다. 극자외선 마스크의 거친 표면 함수, 즉 power spectral density 에 의해 표현된 무작위적인 표면의 높이 변화는 상면에서의 전기장을 계산하기 위해서 재정의 되었다. Feynmann의 접근 방식과 유사한 산란에 대한 일반식을 유도하였고, 이는 결상과정에서 마스크의 단차상의 거친 측면에 의한 효과를 알아보기 위해서 적용되어졌다. 거친 표면과 완전히 편평한 표면에 대한 전기장의 위상과 진폭 변화 정도를 비교하기 위해서 다중 산람 문제 또한 여러 다른 패턴에 대하여 이 논문에서 다뤄졌다. The Monte-Carlo Method is adopted to define the roughness of the mask structure. A random surface height variation described by power spectral density for the rough surfaces of an estreme ultraviolet (EUV) mask is to be redefined to calculate the field in the image plane. A general explicit formula of the scattering, which is analogous to Feynman's approach, is derived, and it is adapted to the EUV mask structure to evaluate the effect of the surface roughness of the side wall of the mask topography on the image formation. The multiple random scattering problems are dealt with the different pattern types in order to compare field variations in phase and amplitude with the ideal flat surface.

한국인 주요우울장애 환자에서 혈중 ACTH, Cortisol 농도와 해밀턴 우울 평가 척도의 신체증상 항목과의 상관관계

여혜빈,김린,함병주,심세훈,권영준,정희연,정한용,한상우,이민수,이화영 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:Hypothalamic-Pituitary-Adrenocortical(HPA) system dysregulation plays an important role in the pathophysiology of major depressive disorder. Medically unexplained somatic symptoms comprised the predominant complaints of korean patients with major depressive disorder. It might be related to dysregulation of HPA system and somatic symptoms. The aim of this study was to investigate the association between Hamilton Depression Rating Scale severity and the Plasma Adrenocorticotropic Hormone(ACTH) & Serum Cortisol level in Korean patients with major depressive disorder. Methods:Our study design was prospective. A total 111 hospitalized patients with major depressive disorder (DSM-IV) at Anam Hospital, Korea University Medical Center between Jan 2009 and May 2011 were selected. Hamilton Depression Rating Scale was measured by psychiatrist. Plasma ACTH, Serum Cortisol levels were analyzed at the time of admission. Results:There are significant correlations(p<0.05) between Hamilton Depression Rating Scale of somatic component(HAM-D 11-15 item) and Plasma ACTH and Serum Cortisol level. However, other HAM-D sub items were not significantly correlated with Plasma ACTH and Serum Cortisol level except somatic component. Conclusion:Our Study results suggest that hyperactivity of HPA axis might be correlation with somatic symptoms in korean patients with major depressive disorder.

감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자1례와 축산 부산물 시장에서의 역학조사 : Sero-epidemiology Study on Market, by-product, Stock-raising

정성주,김성범,박대원,정혜원,기세윤,권정아,박만석,박미연,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

브루셀라증은 전 세계적으로 발생하는 인수공통 전염병중에 하나로서, 본 증례는 국내에서 감염된 가축에 대한 노출력이 없는 집단에서 현증 브루셀라증이 발생한 첫 증례이기에 문헌 고찰과 함께 보고한다. 또한 환자가 근무하였던 축산물 부산물 시장에서 역학 조사를 실시하여, 현증환자 및 기감염자를 발견하여 축산물 부산물 시장 근무자에서 현증 브루셀라증이 발생할 위험성을 평가하였다. 역학 조사 결과 축산물 부산물을 다루는 일을 하는 사람들에서 감염된 가축과의 직접 접촉이 없이도 브루셀라증이 발생할 수 있음을 알 수 있었다. Brucellosis is a world-wide zoonotic disease. We report the first case of brucellosis in South Korea that is not related to direct contract with intected cattles. The patient had been working in the market of by-product, stock raising for twenty years and complained of 1-month history of fever, chill, and intermittent epistaxis. We confirmed brucellosis by anti-brucella antibody test and PCR. After 6 weeks' treatment with rifampicin and doxycycline, fever and chilling subsided, and, generalized weakness and oral intake improved. We performed seroepidemiology study against workers who were working in the same market as the patient. However, we couldn't find out other cases with seropositivity. We concluded that although the workers of by-product market have a risk of getting brucellosis, the risk is low.

호산구성 간농양 54예의 임상상

강혜련,권혁수,송우정,이상민,김태범,박혜경,장윤석,김윤근,조상헌,민경업,김유영 대한알레르기학회 2004 천식 및 알레르기 Vol.24 No.2

3D CT를 이용한 파노라마 방사선 사진상 상악 매복 견치 위치 정보의 유용성 평가

김혜정,박효상,권오원 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.4

3D CT를 이용하여 파노라마에서 얻어진 상악 매복 견치 위치 정보의 유용성을 평가하기 위해, 상악 견치 매복을 주소로 경북대학교병원에 내원한 환자를 대상으로 파노라마 방사선 사진과 3D CT에서의 매복 견치의 위치를 평가하였다. 대상은 25명(남자 7명, 여자 18명)으로 평균 나이는 10.9세(범위 : 8.2 - 15.7세)이며, 35개의 상악 매복 견치 증례를 분석하여 다음의 결과를 얻었다. 첫째, 파노라마 방사선 사진은 확대되어 촬영되므로 3D CT의 계측치보다 상악 견치의 tooth length, crown width, vertical distance 그리고 lateral shift값에서 큰 값을 가졌다. 단, angulation to occlusal plane은 파노라마에서 더 작은 값으로 계측되었다. 둘째, 파노라마 방사선 사진상 상악 견치가 구개측으로 매복된 경우, angulation to occlusal plane은 3D CT보다 작게 측정되고 vertical distance는 더 크게 측정되었다. 셋째, 파노라마 방사선 사진에서 상악 매복 견치의 tooth length, crown width 그리고 순측으로 매복된 경우 상악 견치의 angulation to occlusal plane은 3D CT와 근접된 계측치를 가졌다. 또한 CT와 비교하였을 때, 치근 흡수 정도 평가에 대한 파노라마 방사선 사진의 감수성은 33.3%인 것으로 측정되었다. 파노라마 방사선 사진은 협측 매복견치의 위치는 실제와 유사하다고 생각되나 구개측 매복의 경우 3D CT보다 더 높게, 각도는 더 작게 나타나는 등 상당한 차이가 있어 CT를 이용한 추가적인 검사가 필요하다고 생각된다. Objective: The aim of this study was to evaluate the potency of panoramic radiography for the detection of maxillary impacted canines. Methods: Twenty-five patients were selected, comprised of 7 males (mean age: 10.9 years, range: 8.5 - 14.5 years) and 18 females (mean age: 10.9 years, range: 8.2 - 15.7 years). In total, thirty-five maxillary impacted canines were estimated. The position of the canine and root resorption of adjacent teeth were evaluated on panoramic radiography and 3D CT. Results: Except for angulation to the occlusal plane, the other parameters, such as tooth length, crown width, vertical distance and lateral shift showed larger values on panoramic radiography compared to 3D CT. In palatally impacted cases, the angulation of canine was smaller, and the vertical distance to the occlusal place was larger on panoramic radiography than 3D CT. For labially impacted canines, tooth length, crown width, and angulation to the occlusal plane were similar for the two methods. The sensitivity for detecting root resorption on panoramic radiography was calculated as being 33.3% of 3D CT. Conclusions: The position of labially impacted canines can be effectively estimated using panoramic radiography, but palatally impacted canines need further investigation such as 3D CT for proper diagnosis.

성인에서 발생한 발진성 가성 혈관종증

서상희 ( Sang Hee Seo ),장호선 ( Ho Sun Jang ),목혜수 ( Hye Soo Mok ),김성준 ( Sung Jun Kim ),김병수 ( Byung Soo Kim ),김문범 ( Moon Bum Kim ),오창근 ( Chang Keun Oh ),권경술 ( Kyung Sool Kwon ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.8

Background: Eruptive pseudoangiomatosis (EPA) is a rare, benign, spontaneously regressing childhood exanthem. It is characterized by the sudden onset of several bright red angioma-like papules surrounded by pale halos with a distinct histopathology from true angiomas. Objective: This study was performed to evaluate the clinical and histopathologic characteristics of EPA occuring in adults. Methods: Ten adult patients who visited Pusan National University Hospital and Mok Hye-SooㆍJang Ho-Sun Dermatology Clinic from March 2005 to September 2006 were evaluated. We prospectively evaluated the sex, age, onset season, past medical history including immunosuppressive abnormalities, systemic disorders and other diseases including allergies. We also investigated the relations of mosquito biting, patients` occupations and outdoor activities to occurrence of EPA. In addition, simultaneous occurrence in family members, the clinical, histopathologic, laboratory findings, disease courses and responses to treatment were evaluated. Based on medical records, photographs and pathologic slides, we retrospectively diagnosed another 20 EPA patients suspected as insect bite from October 2003 to March 2005. The same questions were inquired as for the 10 patients who prospectively underwent evaluation. Results: In the study, female predominance (76.7%) was observed and the average age of onset was 54.2 years. Interestingly, there was no child patient during the period of study. Multiple, 2∼5 mm sized, red angiomatous papules surrounded by pale halos occurred on exposed areas such as the arms (86.7%), legs (50%), and face (46.7%), although it could also occur to a non-exposed area. EPA occuring in adults usually appeared in summer (80%). The mean disease duration was 3.4 weeks. Although EPA spontaneously regressed, it had the potential of recurrence (46.7%). Histopathologic findings showed dilated dermal blood vessels without the evidence of increase in numbers, and perivascular lymphocytes infiltration. Inside the lumen of dermal blood vessels, plump endothelial cells were found. Conclusion: EPA occuring in adults usually happened to exposed sites in summer, so it can be misdiagnosed as insect bite. We suggest that dermatologists should be concerned about EPA in adults and conduct further investigation to have a better understanding of the disease. (Korean J Dermatol 2007;45(8):797∼803)

치과위생사들의 직무 스트레스와 대처반응에 관한 연구

이성숙,권혜진 중앙대학교 의과대학 간호학과 간호과학연구소 1998 중앙간호논문집 Vol.2 No.1

This study intends to research the job stress dental hygienists have experienced and their reactions upon it. By analyzing and examining the factors of job stress, the management methods to solve their causes and stir up the morale of dental hygienists are tried to be grouped. As the object of this research, dental hygienists who work for dental clinics, dental private hospitals, or dental surgery of university hospitals located in Seoul were selected. As the research instrument to measure dental hygienists' job stress and their reactions upon it, the questionary of Yoon, Dae Ha(1991) was used as modified and supplemented the measurement of the job stress factors was classified on the basis of the theoretical study on job stress of Song, Dae Hyun(1986). The period of materials collection was 30 days from December 4, 1995 to January 5, 1996. The questionaries were distributed and then collected by direct visit or mail. 230 questionaries were collected, but 217 were used in analysis of materials except 13 which are hard to analyze. The materials analysis was computed in the statistics by SPSS after being encoded. The general characteristics of the objects were computed by using real number and percentage, and the differences of job stress according them were analyzed. To analyze the differences of dental hygienists' reactions, average mean points and standard deviations were computed and F certification(ANOVA) were executed. The results obtains through this study are as follows; 1. The results induced through researching general factors of dental hygienists' job stress and analyzing them are as follows; 1) it was showed that among the factors of job stress, the highest mean point was the factor related with job, and the next the factor related with individual, the factor related with Organization, and the physical environment factor in order. 2) In the factors of stress according to working organs, the factor related with individual showed meaningful differences in the statistics(p<0.05). 3) In the factors of stress according to the average of patients in a day, the factor related with Organization showed meaningful differences in the statistics(P<0.05). 4) In the factors of stress according to the number of assistant staffs, the factor related with Organization showed very meaningful differences in the statistics(P<0.0001). 5) In the factors of stress according to division of labor, the factor related with individual and the physical environment factor showed meaningful differences in the statistics(P<0.05, p<0.001). 2. The results induced through researching general reactions upon the factors of dental hygienists' job stress and analyzing them are as follows; 1) The findings compared with the reactions upon the factors of stress according to working organs - in the factor related with individual an event was accepted affirmatively, the impact of the event was controlled, and it was met with confidence - showed meaningful differences in the statistics(p<0.05, p<0.05, p<0.05). 2) The findings compared with the reactions upon the factors of stress according to the average of patients in a day - in the factor related with organization an event was forecasted in advance, it was accepted affirmatively, the impact of the event was controlled, and it was met with confidence - showed meaningful differences in the statistics(p<0.01, p<0.05, p<0.05, p<0.05). 3) The findings compared with the reactions upon the factors of stress according to the number of staffs - in the factor related with organization an event was forecasted in advance, it was accepted affirmatively, the impact of the event was controlled, it was met with confidence, and it was discussed and consulted with others - showed meaningful differences in the statistics(p<0.01, p<0.01, p<0.001, p<0.001, p<0.001). And in the factor related with individual the findings - it was accepted affirmatively, the impact of the event was controlled - showed meaningful differences in the statistics(p<0.05, p<0.05). 4) The findings compared with the reactions upon the factors of stress according to division of labor - in the factor related with individual and the physical environment factor an event was forecasted in advance, it was accepted affirmatively, the impact of the event was controlled, it was met with confidence, and it was discussed and consulted with others - showed very meaningful differences in the statistics(p<0.01, p<0.01, p<0.01, p<0.001, p<0.001). And in the factor related with job the findings - it was accepted affirmatively, the impact of the event was controlled, and it was met with confidence, and it was discussed and consulted with others - showed meaningful differences in the statistics(p<0.01, p<0.05, p<0.01, p<0.05).

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

韓國人 混合齒列期 兒童 및 成人에 관한 頭部放射線學的 計測

徐惠敬,成在鉉,權五源 慶北大學校 齒科大學 1986 慶北齒大論文集 Vol.3 No.1

正常咬合을 가진 混合齒列期 兒童(男子 55名, 女子 46名) 및 成人(男子 41名, 女子 36名)을 對象으로 側貌 頭部放射線規格寫眞上에서 坂本分析法에 의해 頭蓋顔面骨의 成長 變化를 觀察하여 다음과 같은 結論을 얻었다. 9才, 11才, 成人에서 男女別 各 計測項目의 平均値, 標準偏差 및 profilogram을 얻었다. 頭蓋顔面骨의 크기는 深度에서는 9, 11 才에서 男女間 有意差는 거의 나타나지 않았으나, 高徑은 9才에서 男子가 上顔面部 및 下顎部에서 더 크게 나타났으며 11才에서는 N, PTM, PNS를 제외한 全 項目에서 男子가 더 크게 나타났다. 成人에서는 深度에서 GO, 高涇에서 N을 제외한 金 項目에서 男子가 더 크게 나타났다. 9才에서 11才까지의 平均成長量은 上顎 中切齒 및 上下顎 第一大臼齒, 신부에서는 큰 것으로 나타났고 上顔面部, 上顎部에서는 비교적 작은 것으로 나타났으며, 頭蓋顔面骨의 전반적 成長은 S를 中心으로 하였을 때 下方性 長傾向이 優勢한 前下方成長을 하였다. The purpose of this study was to investigate the growth change of craniofacial complex in korean children & adults. The subjects included 55 males and 46 females in children, 41 males and 36 females in adults. A series of 2 lateral cephalometric radiographs obtained from each child at age 9 and 11 and 1 lateral cephalometric radiograph obtained from each adult were analyzed by Sakamoto's coordinate system. The conclusions were as follows : Means, standard deviations and profilograms from measurements were obtained at age 9, 11 and adult. Sexual difference in depth of craniofacial complex was hardly found at age 9 and 11, but in height male was larger than female in upper facial and mandibular portion at age 9 and in all of the items except N, PTM, PNS at age 11. At Adult male was larger than female in all of the items except Go in depth and N in height. Growth increments of upper and lower incisors, upper and lower first molars and chin portion from age 9 to 11 were large, whereas those of upper facial and maxillary portions were relatively small, and the craniofacial complex grew forward and downward, but more downward.