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.

노화가 인체 중간엽 줄기세포로부터 조골세포로의 증식 및 분화에 미치는 영향

백기현,태현정,오기원,이원영,조정기,권순용,강무일,차봉연,이광우,손호영,강성구,김춘추 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3

연구배경: 일반적으로 골다공증과 연관된 위험인자로는 연령, 폐경, 약물, 불충분한 칼슘섭취, 만성질환 및 운동부족 등이 있는데, 특히 노화가 진행할수록 골밀도가 감소하는 것은 잘 알려져 있다. 노화와 관련하여 진행되는 골소실은 조골세포 및 전구조골세포의 기능적 결핍에 의한 골형성의 감소가 주요한 요인으로 여겨지고 있다. 그 동안 연령이 조골모 세포의 양과 조골모 세포로부터 성숙조골세포로의 분화 및 증식에 미치는 영향에 대한 일부 보고들이 있었으나 아직 일치된 견해는 없는 형편이다. 방법: 다양한 연령의 사람으로부터 골수를 채취, 중간엽 줄기세포가 포함된 단핵세포를 분리한 후 조골세포로 분화하기 좋은 조건하에서 배양하였다. 대상군은다시 젊은군과 노령군으로 구분하여 다양한 변수를 비교 분석하였다. 일차배양에서는 CFU-F를 계수하여 골수내 중간엽 줄기세포의 수를 추산하였고, 칼슘측정을 통하여 기질의 무기화 정도를 비교하였다. 계대배양후 이차배양에서는 시기별로 알카리성 포스파타제 활성도를 측정하고 오스테오칼신 mRNA의 발현을 관찰하여 젊은군과 노령군 사이의 증식능 차이를 비교하였다. 또한 이차배양 시기별로 MTT 측정을 하여 양군간에 증식능 차이가 있는지 알아보았다. 결과: 1. 일차배양 15일째에 평균 CFU-F의 수는 젊은군에서 유의하게 많았다(젊은군 148.3±28.9, 노령군 54.3±9.1, p=0.02). CFU-F의 평균면적은 젊은군에서 넓은 경향을 보였으나 통계적으로 유의하지는 않았다. 2. 일차배양 17일 경과 후 양군간에 기질 칼슘 침착정도는 유의한 차이를 보이지 않았다(젊은군 103.6±50.6, 노령군: 114.0±56.5, p=NS). 3. 이차배양 10일째에 젊은군에서 알카리성 포스파타제 활성도가 고령군에 비해 유의하게 높았다(젊은군: 935.5±115.0 U/mg, 노령군: 578.4±115.7U/mg,p.0.05). 고령군에서는 시간 경과에 따른 변화가 미약했으며 전반적으로 알카리성 포스파타제의 활성도가 젊은군에 비해 낮았다. 4. 이차배양도중 오스테오칼신 mRNA의 발현은 배양시기별로 젊은군에 비해 고령군에서 더 낮은 경향을 관찰할 수 있었다. 5. 이차배양 10일과 15일에 젊은군에서 노령군보다세포증식이 유의하게 증가된 양상을 보였다(10앓 젊은군 0.73±0.05, 노령군 0.58±0.04, p=0.05, 15일; 젊은군 0.80±0.05, 노령군 0.70±0.03, p=0.05).결론: 이상의 연구에서 저자들은 노령군에서 젊은군보다 골수 내 중간엽줄기세포의 수가 적고, 노령군에서 유래한 전구조골세포의 성숙조골세포로의 증식 및 분화가 젊은군 보다 감소해 있는 것을 관찰할 수 있었다. Background: Osteoblasts originate from osteoprogenitor cells in bone marrow stroma, termed mesenchymal stem cells (MSCs) or bone marrow stromal cells. Each MSC forms colonies (colony forming units-fibroblasts [CFL-Fs]) when cultured ex vivo. There are some reports about the age-related changes of the number and osteogenic potential of osteoprogenitor cells, but any relationship has not been clearly established in humans. In this study, we counted MSCs using CFU-Fs count and examined the proliferative capacity and differentiation potential of osteoprogenitor cells. Finally, we analyzed how these parameters varied with donor age. Methods: Bone marrow was obtained from the iliac crest of young (n=6, 27.2±8.6 years old) and old (n= 10, 57.4k6.7 years old) healthy donors. Mononuclear cells, including MSCs, were isolated and cultured in osteogenic medium. In primary culture, we compared the colony-forming efficiency of MSCs between the two groups and determined the matrix calcification. When primary culture showed near confluence, the cells were subcultured. Alkaline phosphatase activity, osteocalcin expression by RT-PCR and proliferative potential by MTT assay were examined by the time course of secondary culture. Results: At the 15th day of primary culture, the mean number of CFU-Fs was significantly higher in the younger donors (young: 148.3±28.9, old: 54.3±9.1, p=0.02) and the mean size of CFL-Fs was also larger in the younger donors than the older donors. However, matrix calcification was not different between the two groups (young: 103.6±50.6, old: 114.0±56.5, p=NS). In secondary culture, alkaline phosphatase activities were significantly lower in the older donors. The younger donors showed peak alkaline phosphatase activity at day 10, while the older donors didn't showed a remarkable peak (young: 935.5±115.OU/mg, old: 578.4±115.7U/mg, p<0.05). Total cell number as a proliferative index increased progressively during the secondary culture and a significantly greater cell number was noted in the younger donors. Osteocalcin expression was generally upregulated in the younger donors, but this was not statistically significant. Conclusion: Our study shows that the number of osteoprogenitor cells is decreased during aging and that the proliferative capacity and differentiation potential of osteoprogenitor cells seem to be reduced during aging (J Kor SOC Endocrinol 18:296-305, 2003).

半夏白朮天麻湯과 半夏白朮天麻湯加味方의 抗癌效果와 免疫反應에 關한 實驗的 硏究

白泰鉉,柳逢夏,朴東源,柳基遠 대한한방종양학회 1995 대한한방종양학회지 Vol.1 No.1

In order to investigate the effects of Banhabaekchulcheonmatang and Banhabaekchulcheon-matanggamibang on antitumor effects after Sarcoma -180 cells transplantation into the peritoneal cavity or left groin in mice, and immune responses in mice induced by methotrexate, the extracts of its herbal medicines were orally administered for 14 or 21 days. Experimental studies were performed for measurance of mean survival days, tumor and body weight for antitumor effects, and delayed type hypersensitivity, hemaglutinin titer, hemolysin titer, rosette forming cells, natural killer cell activity and phagocytic activity for immune responses in ICR mice. Following results were obtained : 1. Mean survival time in Banhabaekchulcheonmatang and Banhabaekchulcheonmatanggamibang -treated group was significantly prolonged, as compared with the control group (P<0.010, P<0.005). 2. Tumor weight in Banhabaekchulcheonmatang and Banhabaekchulcheonmatanggamibang-treated group was significantly depressed, as compared with the control group(P<0.050, P<0.050). 3. Body weight in Banhabaekchulcheonmatang-treated group was significantly increased(P<0.050), but in Banhabaekchulcheonmatanggamibang-treated group was slightly increased with no effectiveness, as compared with the control group. 4. Delayed type hypersensitivity in Banhabaekchulcheonmatang and Banhaekchulcheonmatanggamibang-treated group was significantly increased, as compared with the control group(P<0.010, P<0.050). 5. HemagglutinintiterinBanhabaekchulcheonmatangandbanhabaekchulcheonmatanggamibang-treated group was significantly increased, as compared with the control group(P<0.050, P<0.050. 6. Hemolysin titer in Banhabaekchulcheonmatanggamibanga-treated group was significantly increased(P<0.050), but in Banhabaekchulcheonmatang-treated group was slightly increased with no effectiveness, as compared with the control group. 7. Rosette forming cells in Banhabaekchulcheonmatang and Banhaekchulcheonmatanggamibang-treated group was slightly increased with no effectiveness, as compared with the control group. 8. Natural Killer cell activity in Banhabaekchulcheonmatang and Banhabaekchulcheonmatanggamibang-treated group was slightly increased with no effectiveness, as compared with the control group. 9. Phagocytic activity in Banhabaekchulcheonmatang-treated group group was significantly increased(P<0.050), but in Banhabaekchulcheonmatanggamibang-treated group was increased with no effectiveness, as compared with the control group. According to the above results, it could be suggested that Banhabaekchulcheonmatang and Banhabaekchulcheonmatanggamibang have prominent antitumor effects, and enhance both cellular and humoral immunity.

비강비호즈킨 림프종의 전산화단층촬영 소견 : CT Features

노태연,백호길,원종부,박성호,박오봉,백승국,신미정,김봉기,최한용 침례병원 1998 浸禮病院學術誌 Vol.14 No.-

급성 림프구성 백혈병 환자에서 아스페르길루스 감염을 동반한 호중구감소성 소장결장염에 의한 작은창자 천공

강동백,임태수,박원철,윤기중,이정균 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

저자들은 급성 림프구성 백혈병 치료 도중 아스페르길루스 감염을 동반한 호중구감소성 소장결장염에 의한 작은창자 천공을 경험하였다. 급성 림프구성 백혈병의 항암화학치료 중 발생 할 수 있는 호중구감소성 소장결장염은 다양한 위장관 증상을 보일 수 있으며, 이에 대한 발생 가능성을 고려하여 적극적인 조 기진단과 이에 대한 적극적 치료가 필요하며, 면역기능의 저하로 아스페르길루스 등의 진균 감염이 발생할 수 있으므로 호중구감소성 소장결장염의 치료에 증상의 호전이 없을 때 항진균제를 포함한 광범위한 치료가 고려되어야 한다. Though advancesin imumosuppressive therapy or chemotherapy which have lead to increased survival of leukemia and transplant patient, but the risk of infectious complication has been increasing. Neutropenic enterocolitis is a life threatening complication of chemotherapy for malignancies such as leukemia or lymphoma. Symptoms of neutropenic enterocolitis are nonspecific and it may rapidly lead to intestinal peforation. Aspergilus infection could involve the gastrointestinal tract as a result of neutropenia and mucosal injury after imumosuppressive therapy, chemoetherapy, or antibiotics use, but rarely reported a small bowel perforation combined aspergillus and neutropenic enterocolitis. We present a rare case of ileal perforation caused by neutropenic enterocolitis combined with aspergillus infection during chemotherapy for acute lymphocytic leukemia with a review of the literature.

냉기치료후 슬관절강내의 온도변화

백승석,최기섭,박시복,이상건,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

漸進的·急進的 運動負荷가 血液의 pH, Sugar 및 Lactate에 미치는 影響

姜炯基,辛元太,白永守,殷熙寬,宋基成,河哲秀 漢陽大學校 體育科學硏究所 1986 體育科學 Vol.6 No.6

The purpose of this study is to in-vestigate the effects of gradual and radical exercise load on the treadmill for PH, Sugar and Lactate in Blood by selecting 14 subjects in H university, All subjects began exercise by 6mPH for 4 minutes at start and increased exercise speed up to HR 140 by increasing every minute as gradual load. And subjects began exercise by 9mPH at first and increased load up to HR 140 as radical exercise load. The results are as follows: (1) In PH in Blood, gradual exercise load is lower than radical training in all subjects. (p<0.05) (2) In Sugar in Blood, radical exercise load is higher than gradual exercise load in all subjects. (p<0.05) (3) In Lactic Acid in Blood, gradual training is higher than radical exercise load in all subjects. (p<0.01) (4) In Lactic Acid, all subjects showed high value and its is also in Sugar, than the method of exercise load is according to anaerobic energy metabolism.

師範系 體育敎育科 志望生의 一般運動能力檢査 基準値 設定에 關한 硏究

梁點紅,高基俊,黃喆文,金泰運,金重雄,白永鎬,表內淑,黃太相,徐國雄 釜山大學校 附設 體育科學硏究所 1989 體育科學硏究所 論文集 Vol.5 No.-

This study was analyzed the validity and the reliability of evaluation norm. which was used in choosing and grading events of the General Motor Ability Test. The General Motor Ability Test has been done for applicants for entrance to the department of physical education, college of education, Pusan National University. The subjects of this study were 433 applicants(men :387, women :46) for three years. They were tested in seven events : 1) 100m Dash, 2) 1500m Run(man), 800m Run (woman), 3) Throwing Hand-Ball, 4) Broad Jump, 5) Chinning(man), Flexed-Arm Hang(woman), 6) Zig-Zag Run, 7) Trunk Flexion. The results could be summerized as follows ; 1. In 100m Dash, 1500m Run, and Throwing Hand-Ball, man's average records were shown normal distribution which was inclined toward low ll grade. Therefore, the interval size of those three events must be regulated to lower. 2. Average records of Broad Jump in man were distributed into high (1) grade. So, the interval size must be adjusted to higher. 3. In Chinning, Zig-Zag Run, ad Trunk Flexion, man's average records were shawn normal distribution, and the interval size was similar to present records. 4. For woman, it was impossible to analyze correctly in all seven events because of the small number of subjects. So, it was for the sake of the reference. 5. The record of applicants for three years were operated to the variable quantity analysis. And the restults were these ; 100m Dash was F=3.0865(p<0.05), Chinning F=3.9309(p<0.05), Broad Jump F=14.7338(p<0.001), Throwing Hand-Ball F=4.9716(p<0.01), and Zig-Zag Run F=6.8297(p<0.001). Then, it was shown statistical meaningful difference in three groups. 6. In investigating the validity in choosing seven events, it was concluded that the events have been chosen reasonably. Because all events except for 100m Dash, and Zig-Zag Run in man were independent. From the analysis of the General Motor Ability Test, we could realized the necessity of regulating the standard and the interval size in several events. Then, we proposed the new evaluation norm which was suitable to present situation.

임상교정 교육용 멀티미디어 데이터베이스 웹서버 구축에 관한 연구

박재우,이종기,장영일,남동석,김명기,양원식,김태우,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

본 연구는 인터넷상의 가상공간에 다양한 자료로 구성된 환자 증례를 통해, 교정을 배우고자 하는 임상의나 학생들의 교육에 필요한 멀티미디어 데이터베이스를 구축하기 위한 것이다. 이러한 시스템을 구현하기 위해서는 이미지 자료의 처리, computer network를 통한 빠른 정보처리 기능, 진단 분석법의 개발, 데이터베이스의 구축 기술, 데이터베이스와 인터넷과의 연계, 증례를 통한 교육방법론과 같은 기술적 문제점들이 있다. 진단과 치료계획을 위한 분석은 모델 분석과 두부방사선 사진분석으로 나누어 제공하였다. 모델분석법은 arch length discrepancy와 Bolton tooth ratio를 환자 정보란에 제공하였다. 두부방사선 사진분석은 초진란에 제공하였다. Cephalometric analysis ver 2.0과 Power Ceph pro 3.3.5를 이용하여 Tweed, Steiner, Jarabak분석법 등을 제공하였으나, 본문에서는 주로 Kim's analysis와 몇 가지 계측치를 추가하여 설명하였고, 나머지는 tracing란에서 제시하였다. 또한 치료 종료 후나 보정란에서 치료 전, 후의 두부방사선 사진을 중첩해서 보여줌으로써 치료에 의한 효과를 직접 볼 수 있도록 하였다. The Objective of this research was to construct the multimedia database system that was necessary for the education of the practitioners and the students. To establish this system, there were technical problems as follows : 1) The processing of the images, 2) The rapid processing of the information with the computer network, 3) The development of diagnosis tools, 4) The technique to establish the database system, 5) The link between the database system and the internet, and 6) The method to educate through many cases. The analysis for diagnosis and treatment planning were provided as two parts : model analysis and cephalometric analysis. As a model analysis, arch length discrepancy and Bolton tooth ratio were provided for the part of patient information. Cephalometric analyses were provided in the part of initial diagnosis. The Cephalometric analysis ver 2.0 and the PowerCeph pro 3.3.5 were used to show Tweed, Steiner and Jarabak analysis. In the main part, Kim's analysis and some measurements were added. In the post-treatment or retention part, we show the superimposition of the cephalometrics with which you can find the effectiveness of the various orthodontic treatment. The address of this home page is "http://damis.snu.ac.kr/orthodontics"

뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 ^(18)F-FDG Positron Emission Tomography의 유용성

김남돈,박연희,기승석,박용진,김형준,류백렬,김흥태,김성은,천기정,최창운,임상무 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절의 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로, 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다. Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose (^(18)FFDG)PET uptake diminished more rapidly following therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT. It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with ymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on ^(18)FFDGPET while CT showed persistent destructive bone lesion. Thus, ^(18)FFDGPET study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.