내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

자살 시도의 심각도와 혈청 지질농도의 관련성

이헌정,최낙경,김린,이민수,김용구 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 낮은 혈청 콜레스트롤 농도와 자살과 같은 폭력적 행동에 관한 관련성에 관한 논란이 있어왔다. 본 연구는 자살 시도 후 응급실로 내원한 환자에서 혈청 총 콜레스테롤 농도만이 아닌 전반적인 혈청 지질 농도의 저하 여부를 조사하였으며, 자살 시도 상황을 평가하는 객관적 척도를 통하여 자살 시도 상황에서 자살 시도의 심각도와 혈청 지질 농도의 관계에 대하여 연구하였다. 방 법 : 1998년 7월부터 1999년 6월 사이에 자살 시도후 고려대학교 의료원 응급실로 내원한 50명의 자살 시도자를 연구대상으로 하였다. 이들은 정신과 의사의 면담을 통하여 정신과적 진단을 받았으며 동시에 위험-구조척도(RRR). HDRS, BPRS 등이 평가되었다. 또한 동 기간에 본원 정신과에서 입원 치료를 받은 자살 시도가 없었던 환자중, 대상군과 나이, 성별, 진단을 맞추어서 50명의 환자를 선정하여 정신과 환자 대조군으로 하였다. 자살 시도군과 대조군의 혈청 지질농도가 t-test를 통하여 비교되었으며, RRR점수와 혈청 지질 농도, HDRS,BPRS와의 사이의 연관성 Spearman순위 상관계수로 분석되었다. 결 과 : 자살 시도자중 주요우울증이 29명, 정신분열병이 2명, 인격장애가 19명이었으며, 자살 시도군의 혈청 총 콜레스트롤 농도(t=---3.29, p=.001). 총 지질 농도(t=-2.62, p=.01), LDL농도(t=-2.64, p=.011)가 대조군보다 유의하게 낮았다. 진단별로는 주요우울증에서는 총 콜레스트롤 농도, 총 지질 농도, LDL 농도가 대조군에 비하여 낮았으나, 인격장애에서는 혈청 콜레스트롤 농돤이 대조군보다 낮았다. 자살 시도군에서 RRR 점수는 혈청 콜레스테롤 농도와 부적 상관관계를 보였으나 (γ=.-293,p=.039), BPRS(γ=.544, p<.001)와 HDRS(γ=.488, p=.001)와는 정적 상관관계를 보였다. 결 론 : 자살 시도군에서 혈청 지질 농도 중 총 콜레스테롤, 총 지질, LDL농도가 유의하게 저하되어있음을 확인하였다. 또한 자살의 심각도를 평가한 RRR 정수가 혈청 총 콜레스테롤 농도와 유의하게 상관성이 있음이 확인되었다. 이는 낮은 혈청 총 콜레스테롤 농도가 심각한 자살 시도와 연관이 있음을 보여주는 것이다. Objectives : Many studies have demonstrated that suicide is related to low serum cholesterol level, whereas conflicting results have also reported. The aims of the present study are to determine whether suicidal attempters have low lipid concentration and to identify the relationship between suicidal attempt severity and serum lipid levels. Methods: Subjects were 50 suicidal attempters who visited the emergency room in Korea University Medical Center between July 1998 and June 1999. All subjects had been interviewed by psychiatrist and evaluated with Risk-rescue rating, HDRS and BPRS. They were diagnosed as major depressive disorder(n=29), personality disorder(n=19), and schizophrenia(n-=2). Serum lipid levels in 50 suicidal attempters were compared with those in 50 nonsuicidal psychiatric inpatients corresponding to the age, sex and diagnosis of the suicidal attempters. We also examined the Spearman's rank correlations between serum lipid levels and risk-rescue score. Results : The serum total cholesterol level(t=-3.29, p=.001), total lipid level(t=-2.62, p=.01), and LDL level(t=-2.64, p=.011) in suicidal attempters were significantly lower compared with nonsuicidal controls. In major depressive patients, total cholesterol level, total lipid level, and LDL level in suicidal attempters were significantly lower than those of nonsuicidal controls. In personality disorder patients, however, only serum total cholesterol level was significantly lower. Risk-rescue rating score was negatively correlated with serum total cholesterol level(p=.-293, p=.039), and positively correlated with BPRS(p=.544, p<.001), and HDRS(p=.488, p=.001). Conclusion : The lipid levels in suicidal attempter were significantly lower. Suicidal attempt severity was also significantly correlated with serum total cholesterol level. These findings suggest that low serum cholesterol should be related with severs violent suicidal attempt.

수중 가청음에 의한 쏨벵이의 청각능력 : 2. 청각 임계비

이창헌,박용석,문종욱,강창익,김고환,서두옥 제주대학교 해양연구소 1999 해양자원연구소연구보고 Vol.23 No.-

수중 가청음은 어군의 행동 제어와 해양목장화에서 음향 순치에 많이 이용되고 있다. 수중 가청음에 의한 어류반응 해석을 하기 위해서는 물고기의 청각능력을 정확히 파악할 필요가 있으며,오래전부터 여러물고기의 청각능력을 관련된 연구가 수행되었다.

ROBOT식 多目的 播種機 開發

李鎔國,李大源,黃憲,吳永鎭 成均館大學校 科學技術硏究所 1992 論文集 Vol.43 No.2

Planting, transplanting, and harvesting are important processes for the successful production of farm products in Korea because those require the short term high labor intensity. In the automatic production system of the field or the green house, planting is the first process required to be automated considering subsequent operations such as transpalnting and harvesting. A proto type experimintal robotized seeder was designed and built to handle various sizes and shape of seeds. The developed seeder is automatically controlled with one chip micro-controller. System is composed of the transfer arm, pecker, and the equipments integrated with sensor such as hopper, feeder, counter, and shutter. System allows to control the number of seeds to be planted. Results of the developed experimental robotized seeder are as following : 1. For the adequate feeding and counting of seeds, components such as hopper, feeder, counter, and shutter were designed and built. 2. Kinematic motion of the transfer arm was analyzed and designed. 3. Picker was designed to dig and drop seeds into the soil by the open and close action of the bottom gate controlled by DC solenoid. Digging depth of the pecker was controlled by the transfer arm.

위암 환자에서 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김삼용,김영건 충남대학교 암연구소 1991 癌共同硏究所 硏究誌 Vol.1 No.1

We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly decreased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD_(4) positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

폐쇄성 황달에 대한 내시경적 비 담도 배액법(ENBD)의 효과

이헌영,김남재,정현용 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

To evaluate the clinical effects of ENBD in patients with biliary obstruction, 18 patients were included in this study. The results were as follows ; 1) The causes of obstructive jaundice in 18 patients, with performed ENBD were distal CBD cancer (3 cases), CBD stone with cholangitis (14 cases) and CBD stone without cholangitis (1 case). 2) The duration of ENBD was 12.5 days (8-20 days). 3) The positive results of bacteriologic culture via ENBD tube revealed 8 cases among 13 (61.5%). 4) Amory 15 cases with CBD stones, Basket removal (2 cases) and Mechanical lithotripsy (1 case) perfomed in 3 cases after EST and 4 cases had an operation after ENBD. Three patients with CBD cancer underwent ERBD. In conclusion, ENBD is a safe and effective noninvasive biliary drainage method for initial decompression of malignant or benign biliary obstruction with or without cholangitis (especially with).

괴사후성과 비괴사후성 간경변증에서 원인별 주석교질 (^99mTc-tin colloid) 간스캔의 차이

이헌영,허승식,이강욱,정현용,김삼용,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

The differences of the liver scintigraphic features between postnecrotic and nonpostnecrotic liver cirrhosis were studied for 69 patients. Degrees of mottling and splenomegaly were no different between two groups but shrinked form was more frequent finding in postnecrotic type(23:10), and normal shape & enlarged left lobe with shrinked right lobe were relatively dominant in non-postnecrotic group(15:6, 10:2). Grade of extrahepatic uptake of ^99mTc-tin colloid was significantly higher in Child-Pugh B & C group than A group(p<0.05), but there was no difference between postnecrotic and non-postnecrotic groups. These will be important results on the dicision for the presence of cirrhosis according to the variable causes.

만성 간질환에 대한 DDB(Biphenyl Dimethyl Dicaboxylate)의 임상적 효과

이헌영,임의혁,김성걸,김진희,육은주,성자원,김병호,정형용,강대영,김영건 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

To investigate the effects of short-term administration of DDB(Biphenyl Dimethyl Dicarboxylate) for decreasing elevated serum aminotransferase levels in chronic liver diseases, authors applied 3 capsules of DDB per day at each meal time for 35 patients and compared with 35 patients treated with other conservative management. The following results were obtained. 1. Serum alanine aminotransferase (ALT) levels significantly decreased from 247.1± 180.0 IU/L of pretreatment level to 96.6±126.0 IU/L, 61.1±62.7 IU/L and 38.0±26.8 IU/L after 1, 3 and 6 months of treatment(p<0.05) and effective rates were observed in 60.0%, 71.4% and 88.6% of patients after 1, 3 and 6 months of treatment. 2. Serum aspartate aminotransferase (AST) levels decreased also significantly from 167.8±96.9 IU/L of pretreatment levels to 124.4±155.0 IU/L, 77.9±49.6 IU/L, 60.6± 46.9 IU/L after 1, 3 and 6 months of treatment(p<0.05), but decreasing pattern of serum AST was less significant than that of serum ALT. 3. No significant difference were observed in the serum ALT and AST changes according to the cause and duration of hepatitis. 4. No significant adverse effects were observed in whole patients treated with DDB. It is suggested that small dose administration of DDB is effective for decreasing serum aminotrans ferase levels in chronic liver disease in which other conservative management was not effective.

팥바구미 저항성 녹두의 작물학적 특성

이구환,정승근,박상일,송범헌,조용구,김홍식 忠北大學校 農業科學硏究所 2002 農業科學硏究 Vol.19 No.-