Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

尹草窓의 生涯와 草窓訣에 關한 硏究

金準泰,尹暢烈 대한한의학원전학회 1992 대한한의학원전학회지 Vol.6 No.-

I have studied life of Yoon-Dong-Li(尹東里), who applied Un-Ki(運氣) theory to medicine during Suk-Jong(肅宗) to Jeong-Jo(正祖) in Yi-Dynasty and also studied his existing writings named 《Cho-Chang-kyeol》(草窓訣). The referenced original work prints were based on 1980's pring of Chung-Ku oriental medical society and National Central Library and The academy a korean studies possessed print. Studied with these books, I have concluded as follows. 1. Yoon-Dong-Li(尹東里) courtesy name is Ja-Mi(子美), pen name is Cho-Chang(草窓). He was born in 1705, Suk-Jong(肅宗) 31yrs, and died in 1784, Jeong-Jo(正祖) 3yrs in Yi-Dynasty. He had lineage of third-generationed-doctor and learned medicine from his uncle, Yoon-Woo-Kyo(尹雨敎). His father Yoon-Yi-Kyo(윤이교) gaved him second influence. 2. Confucianal physician in Ming Dynasty You-Bu(劉溥) respected Ju-Ryeom-Kyo(周濂溪), confucianist in Song-Dynasty and You-Bu(劉溥) does not removed grass in front of window (because in chinese, Cho-Chang(草窓) means grass in front of windows), and named himself Cho-Chang(草窓). Yoon-Dong-Li(尹東里) followed this suit so called himself Cho-Chang(草窓). 3. The main contents of 《Cho-Chang-Kyeol》(草窓訣), <Un-Ki-Yeon-Lon>(運氣衍論) was written in 1725, when Yoon-Dong-Li(尹東里) was 21yrs old and printed in 1736. The other part of 《Cho-Chang-Kyeol》(草窓訣), <Yong-Yak-Pyeon>(用藥篇) was written in 1746. These two parts were not written in the same time. The <Un-Ki-Yeon-Lon>(運氣衍論) was written 11years earlier than <Yong-Yak>(用藥). Two parts were combined another day and named 《Cho-Chang-Kyeol》(草窓訣). 4. Existing 《Cho-Chang-Kyeol》(草窓訣) is transcribed printing with the content of "Five elements motion and the six kind of natural factors theory"(五運六氣論). Each edition is generally similar in content, but also has different points each other so naw we hardly finds a complete set of works. 5. 《Cho-Chang-Kyeol》(草窓訣) is a first technical book which treats of Un-Ki(運氣) theory in korea. 6. The contents of <Un-Ki-Yeon-Lon>(運氣衍論) of 《Cho-Chang-Kyeol》(草窓訣) is mechanism of diease according to excess and insuffciency of five elements motion and six kinds of natural factors, and symptoms and priscriptions, includes variated priscriptions. 7. Two parts in <Un-Ki-Yeon-Lon>(運氣衍論) of 《Cho-Chang-Kyeol》(草窓訣), 'Sang-tong'(相通) and 'Kak-Tong'(各通), threats of mechanisim of the disease according to five elements, with the principle of inter-promoting and inter-acting, in the change of ten heavenly stems and five elements motion. 8. In the <Yong-Yak-Pyeon>(用藥篇) of 《Cho-Chang-Kyeol》(草窓訣) describes priscription for clinical application according to Un-Ki(運氣) and also records about misuse of medicine. 9. In the 《Cho-Chang-Kyeol》(草窓訣), most of priscription are common using one, which also found in 《Dong-Ui-Bo-Gam》(東醫寶鑑) and there are few of priscriptions by Yoon-Dong-Li(尹東里).

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

청심연자탕(淸心蓮子湯)으로 호전된 뇌내출혈에 고혈압이 동반된 태음인 환자 치험 1례

오정민,엄태민,최고은,허종원,유호룡,설인찬,김윤식,Oh, Jeong-Min,Eom, Tae-Min,Choi, Ko-Eun,Heo, Jong-Won,Yoo, Ho-Ryong,Seol, In-Chan,Kim, Yoon-Sik 대한중풍순환신경학회 2014 대한중풍.순환신경학회지 Vol.15 No.1

■ Objectives The purpose of this case study is to report that a hypertension with intracerebral hemorrhage of tae-eumin was treated with 'Cheongsim Yeunja-tang' and then the symptoms were improved and blood pressure was decreased. ■ Methods Although the patient who had hypertension with intracerebral hemorrhage took antihypertension drugs, intermittent increase of blood pressure was shown. We diagnosed him as Tae-eumin and treated with Cheongsim Yeunja-tang. We daily checked blood pressure and evaluated the symptoms. ■ Results After the treatment with Cheongsim Yeunja-tang, blood pressure was decreased and symptoms were improved. ■ Conclusion The result shows Cheongsim Yeunja-tang has antihypertensive effect and improve hypertension symptoms of Tae-eumin patient with intracerebral hemorrhage.

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

비혈연간 동종조혈모세포이식의 단일기관성적 : Single Center Experience

김유진,김동욱,이석,이동건,박윤희,김희제,김태규,민우성,김춘추 대한조혈모세포이식학회 2003 대한조혈모세포이식학회지 Vol.8 No.2

연구배경: 비혈연간 조혈모세포이식은 HLA체계에 대한 이해의 증진과 새로운 검사법의 개발, 그리고 기증자 수의 증가에 힘입어 최근 빠르게 증가하고 있다. 방법: 가톨릭조혈모세포이식센터에서 1995년 10월부터 2001년 12월까지 비혈연간 이식을 받은 138명의 성인 환자를 대상으로 후향적 분석을 하였다. 결과: 질환별로 만성골수성백혈병 66예, 급성림프구성백혈병 23예, 급성골수성백혈병 16예, 재생불량성빈혈 21예, 골수이형성증후군 9예, 비호지킨림프종 2예, 그리고 발작성야간혈색소뇨증이 1예였다. 일차 생차부전은 분석가능한 136예 중 4예(2.9%)에서 발생하였다. Ⅱ도 이상의 급성이식편대숙주병의 발생률은 48.1%였고, 만성이식편대숙주병은 49.5%였다. 재발 이외의 사망원인 중 가장 높은 빈도를 보인 것은 폐렴으로, 독성사망 64예 중 36예(52.3%)에서 관찰 되었다. 만성골수성백혈병의 경우(n=66), 무병생존율, 재발률, 비재발성 사망률이 각각 45.7%, 11.4%, 49.2%였다. 무병생존율은 표준위험군이 고위험군에 비해 통계적으로 유의하게 높았다(50.3% vs 32.0%, p=0.03). 급성림프구성백혈병의 경우(n=23), 무병생존율, 재발률, 비재발성 사망률이 각각 30.0%와 49.4%, 44.8%였던 반면, 급성골수성백혈병에서는(n=16) 28.6%, 39.4%, 52.9%였다. 이들 급성백혈병에서는 표준위험군에 비해 고위험군에서 재발률과 비재발성 사망이 모두 높게 관찰되었다. 중증재생불량성빈혈의 경우(n=21), 무병생존율과 비재발성 사망이 37.3%와 62.7%였다. 결론: 본 연구의 결과 비혈연간 이식은 HLA적합 형제가 없는 혈액질환 환자들에게 유용한 치료법의 하나임을 알 수 있었다. 낮은 병기에서의 조기 이식과 분자생물학적 방법을 사용한 HLA 적합도의 개선이 이식관련 사망을 최소화시켜 비혈연간 이식의 효과를 더욱 확대시킬 수 있을 것으로 생각된다. Background: Unrelated allogeneic stem cell transplantation (U-SCT) is recently on a increasing trend supported by better understanding of HLA system, development of new HLA typing, and increase of donor pool. Methods: We retrospectively analyzed 138 adult patients who underwent U-SCT between October 1995 and December 2001 at Catholic Hematopoietic Stem Cell Transplantation Center. Results: Diagnoses were chronic myeloid leukemia (CML, n=66), acute lymphoblastic leukemia (ALL, n=23), acute myeloid leukemia (AML, n=16), severe aplastic anemia (SAA, n=21), myelodysplastic syndrome (MDS, n=9), non-Hodgkin lymphoma (NHL, n=2), and paroxysmal nocturnal hemoglobinuria (PNH, n=1). Primary engraftment failure was observed in 4 (2.9%) of 136 evaluable patients. Acute GVHD (≥grade II) occurred in 48.1% and chronic GVHD occurred in 49.5%. The most common cause of death other than relapse was pneumonia, which occurred 36 (52.3%) of 64 toxic deaths. In CML, disease-free survival (DFS), relapse rate, and non-relapse mortality (NRM) was 45.7%, 11.4%, and 49.2%. DFS of the standard-risk group (SR) was significantly better than that of high- risk group (HR) (50.3% vs 32.0%, P=0.03). In ALL, DFS, relapse rate, and NRM was 30.0%, 49.4%, and 44.8%, whereas corresponding figures for AML were 28.6%, 39.4%, and 52.9%. NRM and relapse rate were higher in HR compared to SR in acute leukemia. In SAA, DFS and NRM was 37.3% and 62.7%. Conclusion: We concluded that U-SCT is a feasible therapeutic option for patients lacking a HLA-matched sibling donor. Transplantation at earlier phase of disease with more accurate HLA matching by molecular typing can minimize treatment-related toxicity and could extend the benefit of U-SCT.

보행 시 노인의 상체 움직임에 대한 3차원적 분석

김희수,윤희중,류지선,김태삼 한국운동역학회 2004 한국운동역학회지 Vol.14 No.3

H. S. KIM, H. J. YOON, J. S. RYU, T. S. KIM. The Three Dimensional Analysis of the Upper Body's Segments of the Elderly during Walking. Korean Journal of Sport Biomechanics, Vol. 14, No. 3, pp. 1-15, 2004. The purpose of this study was to investigate the kinematic variables of the upper part of the body for 8 elderly men during walking. For this study, kinematic data were collected using a six-camera (240Hz) Qualisys ProReflex system. The room coordinate system was right-handed and fixed in space, with righted orthogonal segment coordinate systems defined for the head, trunk, and pelvis. Based on a rigid body model, reflective marker triads were attached on the 3 segments. Three-dimensional Cartesian coordinates for each marker were determined at the time of recording using a nonlinear transformation(NLT) technique with ProReflex software (Qualisys, Inc.). Coordinate data were low-pass filtered using a fourth-order Butterworth with cutoff frequency of 6Hz. Three-dimensional angles of the head, trunk, and pelvis segment were determined using a Cardan method. On the basis of each segment angle, angle-angle plot used to estimated the movement coordinations between segments. The conclusions were as follows; (1) During the support phase of walking, the elderly people generally kept their head the flexional and abductional posture. Particularly, the elderly displayed little internal/external rotation. (2) The elderly people showed extensional and external rotation postures in the trunk movement. Particularly, It showed the change from adduction into abduction at the heel contact event of the stance phase. (3) The elderly people showed almost same pelvis movement from the flexion into extension, from the abduction into adduction, and from internal rotation into external rotation at the mid stance and toe off of the stance phase.

Associations of serotonergic genes with poststroke emotional incontinence

Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

<P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>