중추신경계에 침범한 속립성 결핵 : 증례보고

이태환,김헌주,허철,한용표,홍순기,변진수,김명순,조미연,김윤미 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.11

in recent times, central nervous system(CNS) tuberculosis has been rare and the prevalence of the focal form, the tuberculoma, varies from 1 per 200 to 1 per 1000. CNS tuberculosis occurs as a result of hematogenous spread from a primary focus. mostly pulmonary tuberculosis. It can be diffuse exudative leptomeningitis or a localized tuberculoma ; the former is more common. We report a case of miliary cerebral tuberculosis in a 24-year-old female who had been having headaches for 4 months. Magnetic resonance imaging showed numerous small round Gadolinium-enhanced supratentorial and infratentorial lesions scattered throughout the brain. Histologic examination confirmed well defined tuberculous granulomas with central caseous necrosis in open biopsy, containing several acid-fast bacilli, the patient was treated with isoniazid, rifampin, ethambutol, pyrazinamide in combination with prednisolone.

Helicobacter pylori 감염에 의한 위점막의 조직 및 전자현미경적 연구

조미연,홍순원,정순희,이동기 연세대학교 원주의과대학 1994 원주의대논문집 Vol.7 No.1

임신성 영양모세포 질환에서 bcl-2 및 p53 단백 발현의 상관성에 관한 면역조직화학적 연구

조미연,송지선,김윤미,이상엽,정순희,이광길 연세대학교 원주의과대학 1999 원주의대논문집 Vol.12 No.1

비호지킨씨 림프종에서 DNA 분석의 의의

정순희,조미연,이광길,장세진,심영학 연세대학교 원주의과대학 1999 원주의대논문집 Vol.12 No.1

일 대학 병원 마취 · 회복실 간호사의 간호활동 분석

강윤경,김경미,김연이,박혜옥,서광희,송숙녀,이현숙,조의영 대한간호행정학회 2006 간호행정학회지 Vol.12 No.1

Purpose: This study was aimed to specify roles of nurses from the anesthesia and recovery room by analyzing nursing activities as well as anesthesia nursing during surgery. Method: The objects were 12 RNs working in the recovery room of a university hospital located in Incheon. Self-report was performed by measuring stop-watch for five days from May 17th to May 21st in 2004. Research method was designed to record the time and frequency of the nursing activity from anesthesia and recovery room based on nurses' statement and other references for five days. The data were analyzed with descriptive statistics, ANOVA, and t-test via SPSS Win 10.0 program. Result: Nursing activities in anesthesia recovery room were classified into two different characteristics such as direct and indirect nursing activity. The activities consisted of 11 direct nursing areas and 39 nursing activities in anesthesia preparation room. The indirect nursing was classified into 8 nursing areas and 32 nursing activities. The direct nursing was classified into 12 nursing areas and 55 nursing activity. Also, the indirect nursing was classified into 7 nursing areas and 21 nursing activities in recovery room. In terms of prevalence of nursing activities in the anesthesia preparation room, observation and cooperation of anesthesia was the most prevalent activity, drug and eqipment management the second prevalent, and drug administration the third. On the other hand, in the recovery room, the most prevalent activity was vital sign checking and observation, the second most prevalent activity informative activity, and the third body temperature control. Nursing activity time was recorded according to the nursing characteristics. In the anesthesia preparation room, the direct nursing spent for 8092.20 minutes was larger than the indirect nursing spent for 7198.50 minutes. Also, in the recovery room, the direct nursing spent for 2361.16 minutes was larger than the indirect nursing spent for 1134.13 minutes. 4. Nursing activity time was compared to duty shifts. In the anesthesia preparation room, the direct nursing was more prevalent on day shift and the indirect nursing was prevalent on evening shift. However, in the recovery room, both direct and indirect nursing activities were prevalent on day shift. Conclusion: The role of anesthesia and recovery room nurses was analysed according to the time, frequency, and its characteristics.

위암종과 Epstein-Barr 바이러스와의 연관성에 대한 연구

심광용,김호영,김효열,백순구,권상옥,조미연,이창훈,이종인 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Objectives: Epstein-Barr virus (EBV) has been known to be linked to a spectrum of neoplastic conditions, including nasopharyngeal carcinoma, Burkitt's lymphoma, peripheral T-cell lymphoma and Hodgkin's disease. This study aims to investigate the association of EBV with gastric carcinoma in Korea. Methods: Fifty-three cases of gastric adenocarcinoma were studied for evidence of EBV infection by EBV-encoded small RNA (EBER) in situ hybridization (ISH) on the paraffin sections and amplifying the EBV genome encoding envelop glycoprotein (gp220) with polymerase chain reaction (PCR) in fresh gastric cancer specimens. Results: EBER was detected in 7 (13.2%) of 53 gastric carcinomas and all cases were male. In 6 (85.7%) of 7 EBER-positive cases, the tumors were located in the upper and middle part of the stomach. EBER ISH study showed strong positivity in all the tumor cells, but negativity in surrouning lymphocytes, stromal cells and normal gastric mucosa. DNA PCR was positive in 23 (43.4%) of 53 gastric carcinomas, including all of 7 EBER-positive cases. Conclusion: We could observe some association of EBV with gastric carcinoma, and our findings about the charateristics of EBV-positive gastric cancers involving sex, site and histological type are similar to those in Japan. However, EBV-positive rate of gastric cancer is higher than in Japan and lower than in Western countries. Further studies to elucidate oncogenic mechanism of EBV in gastric cancer should be performed.

A Standardized Pathology Report for Gastric Cancer: 2nd Edition

Sung Hak Lee,Mee-Yon Cho,Young Soo Park,Myeong-Cherl Kook,Baek-Hui Kim,Hye Seung Lee,Dong-Wook Kang,Mi-Jin Gu,Ok Ran Shin,Younghee Choi,Wonae Lee,Hyunki Kim,In Hye Song,Kyoung-Mee Kim,Hee Sung Kim,Guh 대한위암학회 2023 Journal of gastric cancer Vol.23 No.1

The first edition of ‘A Standardized Pathology Report for Gastric Cancer’ was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements. The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

치료된 증식당뇨망막병증에서 신생혈관녹내장 발생의 예측인자

이지현(Ji Hyun Lee),김은영(Eun Yeong Kim),김태경(Tai Kyong Kim),신혜영(Hye Young Shin),김수영(Su Young Kim),이영춘(Young Chun Lee),이미연(Mee Yon Lee) 대한안과학회 2017 대한안과학회지 Vol.58 No.4

목적: 증식당뇨망막병증 환자에서 신생혈관녹내장으로의 진행에 유의한 인자에 대해 분석하고자 한다. 대상과 방법: 2014년 3월부터 2016년 3월까지 본원에 내원하여 증식당뇨망막병증을 처음 진단 받은 환자 52명의 의무기록을 후향적으로 분석하여 당뇨유병기간, 당화혈색소, 고혈압, 고지혈증, 신장 질환 등의 만성 질환 여부, 인슐린 치료 여부, 혈액 요소질소, 혈액 크레아티닌, 사구체 여과율, 소변 알부민, 투석 여부, 초진 시 교정 시력, 초진 시 안저 소견에서의 견인성 막, 유리체 출혈, 망막앞출혈 여부 등을 각 군에서 비교하여 신생혈관녹내장 발생의 예측인자에 대하여 알아보았다. 결과: 총 52명이 포함되었으며, 홍채신생혈관만 발생한 환자는 12명(23.08%), 신생혈관녹내장까지 발생한 환자는 4명(7.69%)이었다. 당뇨유병기간은 홍채신생혈관 발생군은 10.88 ± 7.14년, 신생혈관녹내장 발생군에서는 11.75 ± 8.61로 홍채신생혈관이 발생하지 않은 대조군의 8.30 ± 5.25년에 비하여 유의하게 길었다(p-value 0.41, 0.032). 당화혈색소는 홍채신생혈관 발생군은 9.59 ± 2.23이었으며 대조군에서는 9.27 ± 2.54로 서로 유의한 차이를 보이지 않았으나(p=0.721), 신생혈관녹내장 발생군에서는 11.55 ± 0.21로 대조군에 비하여 유의하게 높았다(p-value 0.048). 결론: 증식당뇨망막병증 환자에서 오랜 당뇨유병기간 및 높은 당화혈색소 수치는 신생혈관녹내장으로의 진행에 있어 유의한 영향을 미치며 환자의 예후 예측 및 예방에 유용하게 이용될 수 있을 것이다. Purpose: To evaluate the factors that are significant in progression to neovascular glaucoma in patients with proliferative diabetic retinopathy. Methods: In this retrospective analysis, we reviewed the medical records of 52 patients who were first diagnosed with proliferative diabetic retinopathy from March 2014 to March 2016. We compared diabetes mellitus period, HbA1c, chronic diseases such as hypertension, hyperlipidemia, and kidney disease, insulin treatments, blood urea nitrogen, blood creatinine, glomerular filtration rate, urine albumin, dialysis, corrected visual acuity at the first visit, traction membrane sign of the retina at the first visit, vitreous hemorrhage and preretinal hemorrhage in each group and then investigated the prognostic factors of neovascular glaucoma. Results: A total of 52 patients were included in the investigation, 12 patients (23.08%) were diagnosed with iris neovascularization and 4 patients (7.69%) developed neovascular glaucoma. The patients without iris neovascularization were defined as Group I, those with iris neovascularization as Group II, and those with neovascular glaucoma as Group III. The diabetes mellitus period was significantly longer in Group II (10.88 ± 7.14 years) and in Group III (11.75 ± 8.61 years) than Group I (8.30 ± 5.25 years) (p-value 0.41, 0.032, respectively). The HbA1c level was 9.59 ± 2.23 in Group II and 9.27 ± 2.54 in Group I. There was no significant difference between the two groups (p = 0.721). However, HbA1c was significantly higher in Group III (11.55 ± 0.21) than Group I (p-value 0.048). Conclusions: A long diabetes mellitus period and high HbA1c level have a significant effect on the progression to neovascular glaucoma in patients with proliferative diabetic retinopathy. This information could be useful for predicting and preventing the prognosis of patients.

유리체 절제술로 치료한 코우츠 유사 망막색소변성증에 합병된 유리체 출혈 1예

이지현(Ji Hyun Lee),김태경(Tai Kyong Kim),김수영(Su Young Kim),이영춘(Young Chun Lee),이미연(Mee Yon Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.4

목적: 코우츠 유사 망막색소변성증에 합병된 유리체 출혈에 대해 유리체 절제술 및 안내 레이저 광응고술로 치료한 사례를 경험하였기에 이를 보고하고자 한다. 증례요약: 6년 전 망막색소변성증으로 진단 받은 24세 남자가 7개월 전부터 시작된 좌안의 시력저하를 주소로 내원하였다. 망막색소 변성증 가족력 및 기저 질환은 없었다. 내원 시 좌안 교정시력은 0.06으로 측정되었으며 안저검사에서 좌안의 유리체 출혈 소견이 관찰되었고 우안 주변부 망막에서 삼출성 병변 소견을 보였다. 이에 좌안의 코우츠 유사 망막색소변성증에 합병된 유리체 출혈을 의심하여 유리체절제술을 시행하였고 유리체 출혈을 제거한 후 주변부 망막에서 출혈을 야기한 모세혈관 확장 및 삼출성 병변이 관찰되어 안내 레이저 광응고술을 시행하였다. 수술 1개월 후 최대교정시력 좌안 0.2로 개선되었으며 유리체 출혈 및 삼출성 병변은 호전되었다. 결론: 코우츠 유사 망막색소변성증에 합병된 유리체 출혈에서 유리체절제술 및 안내 레이저 광응고술은 유용한 치료 수단으로 고려될 수 있다. Purpose: For vitreous hemorrhage induced by coats-types retinitis pigmentosa, we report a case treated with pars plana vitrectomy and endolaser photocoagulation. Case summary: A 24-year-old male who was diagnosed with retinitis pigmentosa in both eyes 6 years earlier presented with decreased visual acuity in his left eye for the last 7 months. Corrected visual acuity was measured at 0.06 in the left eye and fundus examination revealed a vitreous hemorrhage in the left eye as well as an exudative lesion in the right eye's peripheral retina, which suggested Coats-type retinitis pigmentosa. The left eye was treated with pars plana vitrectomy. After removal of the vitreous hemorrhage, endolaser photocoagulation was performed around the peripheral exudative lesion that caused the vitreous hemorrhage. One month later, the best-corrected visual acuity increased to 0.20 in the left eye, and there was an improvement in the vitreous hemorrhage and the exudative lesion. Conclusions: Pars plana vitrectomy and endolaser can be helpful in vitreous hemorrhage induced by coats-type retinitis pigmentosa.

중심망막정맥폐쇄 환자에서 유리체강내 트리암시놀론 주입술 후 발생한 황반허혈 1예

이재훈(Jae Hoon Lee),김태경(Tai Kyong Kim),이영춘(Young Chun Lee),이미연(Mee Yon Lee) 대한안과학회 2015 대한안과학회지 Vol.56 No.11

증례요약: 우안의 중심망막정맥폐쇄 및 황반허혈 진단하에 정기적인 안저검사를 시행 중이던 75세 남자가 최근 발생한 좌안의 시력저하를 주소로 내원하였다. 기저 질환으로는 당뇨병, 간경화증, 간암이 있었다. 안저검사상 좌안의 망막중심정맥폐쇄 소견 및 빛간섭단 층촬영상 중등도의 황반부종이 관찰되어 유리체강내 트리암시놀론 주입술을 시행하였다. 주입술 1주일 후, 급격한 좌안 시력 저하를 호소하였으며 빛간섭단층촬영상 황반부종은 호전되었으나 형광안저혈관조영에서 좌안의 황반허혈이 발생되었다. 주입술 시행 후 2달 간 경과 관찰하였으며 빛간섭단층촬영상 황반 두께는 정상화되고, 형광안저혈관조영상 누출은 보이지 않았으나 여전히 시력은 호전 되지 않았다. 결론: 중심망막정맥폐쇄에 의한 황반부종이 있는 환자에서 항혈관내피성장인자뿐만 아니라 유리체강내 트리암시놀론 주입술 후에도 황반허혈이 발생할 수 있으므로 특히 망막에 허혈을 일으킬 수 있는 위험 요인이 있는 환자는 주의할 필요가 있다. Purpose: To report a case of macular infarction following intravitreal triamcinolone injection for treatment of central retinal vein occlusion. Case summary: A 75-year-old male visited our clinic for visual disturbance in his left eye and was diagnosed with macular in-farction in his right eye. His medical history included type 2 diabetes, alcoholic liver cirrhosis, and hepatocellular carcinoma. After fundus examination, the patient was diagnosed with central vein occlusion with macular edema and intravitreal triamcinolone was administered to reduce edema. Within 1 week of treatment with the intravitreal injection, the patient experienced a sig-nificant decrease in visual acuity. Fluorescein angiogram showed an enlargement of the foveal avasacular zone, although opti-cal coherence tomography (OCT) showed a decreased macular edema. Despite normalization of macular thickness on OCT and cessation of leakage on angiography, visual acuity remained at the same level during 2 months of follow-up. Conclusions: Intravitreal anti-vascular endothelial growth factor injection as well as intravitreal triamcinolone injection can cause macular ischemia which should be considered with the adopted treatment regimen for patients with ischemic risk factors.