간세포암환자에서 간동맥 화학 색전술 후 발생한 리피오돌에 의한 폐렴 1예

김소이,김유리,허현미,배서은,이명원,최윤정,김고흔,김태헌,유 권,문일환 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.2

Hepatocellular carcinoma(HCC)is one of common causes of cancer-related death in Korea where the majority of HCC patients were Hepaitc B virus(HBV)carriers and have cirrhosis. Transarterial chemoembolization(TACE)is commonly applied to the treatment of multinodular HCC in Korea and careful selection of candidate is important for the risk of various side effects. Besides common side effects as fever, nausea, abdominal pain and elevation of liver enzyme, TACE may predispose to hepatic failure, ischemic cholecystitis, pulmonary embolism, cerebral embolism and pneumonitis. In previous studies, some cases of pulmonary and cerebral embolism cases were reported but lipiodol pneumonitis after TACE was rarely reported. A 65-year-old woman with a multinodular HCC associated with HBV infection, was treated with TACE. Seven days after the procedure, nonspecific respiratory symptoms such as dyspnea and dry cough developed. Chest X-ray and chest computed tomography showed diffuse ground glass opacities in whole lung fields, suggestive of lipiodol pneumonitis. After several days of supportive care with steroid administration, radiologic abnormalities and subjective symptoms were much improved, considered that the disease was compatible with lipiodol pneumonitis.

입원 중인 베트남 참전 군인의 삶의 만족도와 관련된 요인

김애리,박종,김율,노희송,박광희,김은숙,김형철,홍강식,류소연,강명근,김기순 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background and Objectives: The aim of the study was to identify the factors associated with life satisfaction of hospitalized Vietnam veterans. Material and Methods: The data were collected from 200 hospitalized Vietnam veterans of 5 veterans hospitals in Korea from September 13 to 23, 2004. Information of general characteristics, health behavior, disease history, family function, depression and life satisfaction were collected by structured questionnaire. Results: The mean of life satisfaction was 21.48(±6.03), and the mean of depression was 53.10(±9.64). The prevalence of depression was mild depression 24.0%, moderate depression 43.5% and severe depression 25.0%. Depression was associated with life satisfaction and depression was higher, life satisfaction was lower. Family function and age were positively associated with life satisfaction, Conclusion: Life satisfaction was affected by depression and family function in hospitalized Vietnam veterans. Therefore, it was thought that psychosocial approaches such as improve depression and family function in care of hospitalized Vietnam veterans is required.

Clear Cell 'Sugar' Tumor of the Lung: A Well-Enhanced Mass with an Early Washout Pattern on Dynamic Contrast-Enhanced Computed Tomography

Kim, Woong Ji,Kim, So Ri,Choe, Yeong Hun,Lee, Ka Young,Park, Seoung Ju,Lee, Heung Bum,Chung, Myoung Ja,Jin, Gong Yong,Lee, Yong Chul The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.6

<P>Clear cell tumor of the lung is a rare and very unusual benign pulmonary tumor. As clear cell tumor of the lung contains abundant cytoplasmic glycogen, this tumor is called 'sugar tumor'. We report a case of sugar tumor in a 64-yr-old man presenting as a round pulmonary nodule. On dynamic computed tomography (CT) scans, the solitary pulmonary nodule showed early wash-in enhancement with an early washout pattern like a lung malignancy. The patient underwent wedge resection for the tumor. Pathologic examination, including immunohistochemical studies, revealed that the nodule was a benign clear cell tumor, so-called 'sugar tumor'. Because only a small number of cases have been reported previously, clinical aspects, radiological characteristics on dynamic contrast-enhanced CT, and differential diagnosis of the tumor are not well established. Herein we present a clear cell tumor of the lung and discuss the clinical, radiological, and pathological features of the tumor.</P>

A case of ectopic opening of common bile duct in duodenal bulb

( Ju Ri Kim ),( Hyun Cheol Koo ),( Ji Woong Jang ),( So Hee Chung ),( Min Kyu Kang ),( Jin Young Kim ),( Dong-kyu Lee ),( Jun Hyung Park ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Ectopic opening of common bile duct (CBD) in duodenal bulb is very rare, and it can be missed at endoscopy because of small size of the orifice that lacks typical feature of major duodenal papilla and duodenal deformity that makes endoscopic approach difficult. However, it should not be overlookedbecause of critical complications such as recurrent duodenal ulcer or cholangitis. Here we report one case of ectopic opening of CBD in duodenal bulb which was managed with endoscopic retrograde biliary drainage (ERBD) through endoscopic retrograde cholangiopancreatography (ERCP). The patient visited us for fever and abdominal pain. There were some significant findings in studies, which included stricture of duodenal bulb with ulcer and one loose slit-like opening in duodenoscopy, in addition to the tapered distal CBD with dilated proximal part in abdominal CT and ERCP. He treated with two times of ERBD insertion which improved duodenal ulcer and cholangitis, and discharged without any biliary related symptom. The common feature of ectopic opening of CBD isknown to be the absence of normal sphincteric structure. Since it allows free movement of bile and duodenal contents between CBD and duodenal bulb without sphincteric control, this disease frequently accompanies recurrent duodenal ulcer and cholangitis that can cause irreversible deformity. Another is the tapered distal CBD (so-called “hook shaped CBD” in several reports) with dilated proximal part in imaging studies. This is assumed to contribute to bile stasis that promotes bacterial growth or lithogeniccharacteristics of bile, which can lead to biliary disease. These complications can be managed with conservative way, but sometimes need surgical procedure, then, these situations need further accurate diagnosis because of risk for accidental biliary tract injury during surgery due to abnormal location of bile duct orifice. In conclusion, if we encounter recurrent duodenal ulcer or cholangitis in the field, we have to consider the possibility of ectopic opening of CBD.

일반논문 : 통신자료제공제도(전기통신사업법 제83조 제3항)의 문제점과 개선방안 -ISP에 대한 수사기관의 통신자료제공 요청과 이용자의 정보인권 보장을 중심으로

김소리 ( So Ri Kim ),이수진 ( Su Jin Lee ),임효준 ( Hyo Jun Im ) 서울대학교 BK21 법학연구단 공익인권법연구센터 2013 공익과 인권 Vol.13 No.-

이 연구에서는, 수사기관이 이용자의 인적사항 등을 요청하면 전기통신사업자가 이에 응할 수있도록 한 ‘통신자료제공제도(전기통신사업법 제83조 제3항)’의 문제점과 개선방안에 대해 논한다. 이 제도에 대한 논란은 2010년부터 본격화되기 시작했으며, 2012년에 있었던 헌법재판소 결정과 고등법원 판결로 인해 사회적 이슈로 떠올랐다. 통신자료제공제도의 활용 건수는 매년 큰 폭으로 증가하는 추세이다. 이런 현상의 본질적인 이유는 ISP(인터넷서비스제공자)가 수사기관의 요청에 대해 예외 없이 통신자료를 제공하고 있다는 사실에 있다. 현행법상으로 통신자료제공 여부를 결정하는 주체는 법원이 아닌 ISP다. 그러나 ISP는 이러한 결정을 할 역량이 부족할 뿐더러 거절 시 받게 될 수사기관으로부터의 압박에서 자유롭지 못하다. 이 때문에 통신자료제공제도는 법문상 ‘재량적’으로 규정되어 있음에도 불구하고 사실상 ‘강제적’으로 운용되고 있다. ‘정보의 유통에 대한 개인의 통제권’을 그 주요 내용으로 하는 정보인권은 새로운 영역의 권리를 보편적 권리로 격상시킨 ‘새로운 인권담론’이며, 동시에 기존의 인권담론과 그 맥락을 같이하고 있는 ‘기본적 인권’이다. 특히 정보와 관련된 권리들이 기존의 권력관계와 맞물리며 작동할 수밖에 없다는 점에서 정보인권을 소수자 문제와 연결지어 생각할 필요가 있다. 통신자료제공제도에서 쟁점이 되는 정보인권은 익명표현의 자유와 개인정보자기결정권이다. 우선 통신자료제공제도는 2012년 위헌 결정이 내려진 ‘제한적 본인확인제(일명 인터넷 실명제)’와 마찬가지로 익명 표현의 자유를 침해한다. 이는 익명 표현의 자유라는 이용자의 개인적 권리를 침해하는 것에서 더 나아가 이용자의 자유로운 의사표현을 바탕으로 여론을 형성하는 ISP의 언론의 자유 또한 제한하는 결과를 낳는다. 그 외에도 통신자료제공제도는 개인정보자기결정권을 근본적으로 침해한다. ISP가 제공하는 통신자료는 이용자의 개인정보에 해당한다. 그러나 이를 제공함에 있어 정보주체인 이용자의 동의를 요구하는 등의 사전개입절차가 없고, 사후통지절차 또한 미비하다. 민감한 개인정보에 대하여 그 어떤 통제장치도 마련되고 있지 않은 것은 기타 유사한 제도와 비교해 보았을 때도 불합리한 것으로 평가된다. 그러므로 통신자료제공제도는 폐지 또는 개정되어야 한다. 우선 ‘수사기관의 통신자료 취득행위’를 대상으로 헌법소원심판을 청구함으로써, 부수적 규범통제에 의해 통신자료제공제도 자체에 대한 위헌결정을 받아내는 방법이 있다. 이와 달리 입법론적으로는 이 제도를 삭제하거나 수정하는 방법도 생각해볼 수 있다. 우리가 상정하는 새로운 입법안은 영장주의를 기본원칙으로 채택하고, 이용자의 사전개입절차 및 사후통지절차를 마련하는 것을 그 내용으로 한다. 통신자료제공제도는 어디까지나 ‘통신비밀 누설 금지 원칙’의 예외에 해당한다. 그럼에도 지금과 같이 주객이 전도된 상태가 방치되고 있는 것에는, 정보인권 침해에 대해 미온적인 태도를 보이고 있는 국가의 잘못이 크다. 국가가 나서지 않는다면 이 제도의 잠정적 피해자인 국민들이라도 나서야 한다. 정보인권이야 말로 새로운 민주주의를 위하여 다시 한 번 쟁취해 내야 할 우리의 ‘인권’이기 때문이다. This paper deals with the problems and improvement plans of the Communication Data Provision System(Telecommunications Business Act §83-3) which allows ISP (Internet Service Provider) to provide users` personal data when requested by investigation agencies. The controversy over this system kicked into high gear in 2010 and became a main social issue after the decision of the Constitutional Court and the ruling of the High Court in 2012. The use of the Communication Data Provision System has considerably increased year by year. This trend largely originates from the reality that ISP provides investigation agencies with users` personal data with few exceptions. Under current law, it is not the Court but ISP that decides if providing users` personal data is approved or not. However, ISP does not have enough ability to make such decision; moreover it cannot avoid the pressure that investigation agencies may exert especially when ISP refuses to provide data. Because of this, although the law leaves the provision of user`s personal data ‘to discretion’, the Communication Data Provision System is more likely to be operated ‘by force’. The discourse about information human rights, which defines the individual`s control over the distribution of information as its core content, has contributed to newly raising the status of information human rights up to the stream of the universal rights. Also it has served as the discourse about ‘fundamental human rights’ which extend the realm of the previous human rights discourse. Especially given that information-related rights are not free from the existing power relations, we have to further consider minority-related issues with regard to information human rights. The freedom of anonymous speech and the right to informational self-determination are the two issues mainly discussed about information human rights with regard to the Communication Data Provision System. First, the Communication Data Provision System can infringe the freedom of anonymous speech, similar to the Restrictive Identification System(the so-called Internet Real-name System) which was ruled unconstitutional by the Constitutional Court in 2012. This can breach not only the user`s individual rights, the freedom of anonymous speech, but also ISP`s freedom of speech that makes ISP shape public opinion based on users` free expression of opinion. In addition, the Communication Data Provision System fundamentally infringes the right to informational self-determination. The communication data provided by the ISP is the user`s personal information. However, there is no proceeding for users` prior intervention, such as requesting process for users` consent, nor is there any follow-up proceeding to notify the users. Given the other similar systems, the absence of control system whatsoever on such sensitive personal information can be problematic. Therefore, this paper argues that the Communication Data Provision System should be abolished or revised. The first alternative to the present system is to file a petition in an attempt to get a decision of unconstitutionality on the Communication Data Provision system from the Constitutional Court. By filing a constitutional appeal against the investigation agency`s ‘acquisition’ of communication data, the system can be found unconstitutional through incidental norm control(Incidenter-Kontrolle). Secondly, the statement that this system should be deleted or revised can be supported by the principle of legislation. The new legislation bill projected in this study includes warrant requirement as a basic principle as well as user`s prior intervention proceedings and follow-up notice proceedings. The Communication Data Provision System has been exempted from the basic principle, ‘prohibition of communication secrets` leakage’. The main reason why this preposterous situation still exist is closely related to the lukewarm attitude of the government toward the information of information right. If the government does not take any measures, then at least the citizens, the potential victims of this system, should do so. Information human rights is the ‘human rights’ that we should strive again to achieve for a new democracy.

국내 체중 감량 약물 사용 현황: 자발적으로 온라인에 게시한 처방적 분석

이소영,이지은,김미리,정은아,조은 건강보험심사평가원 2023 HIRA RESEARCH Vol.3 No.2

Background: Multiple medications have been used for weight loss (WL); however, research on the regimens of WL treatment in Korea have been limited. This study aimed to characterize the medications prescribed for WL in real-world settings. Methods: The study sample comprised WL prescriptions (Rxs) shared via a portal site for 1 year (from June 2022 to May 2023). WL drugs were classified into four categories: (1) on-label WL drugs; (2) off-label WL drugs; (3) medication-induced symptom management drugs; (4) dietary supplements and others. We calculated prescribing occurrence rates for each category and drugs. Further, we investigated the usage of off-label and psychotropic drug prescribing. Results: The study sample included 66 Rxs consisting of 63 active ingredients. The average number of medications per Rxs was seven (range, 1–13). Acetaminophen/caffeine/(pseudo)ephedrine (59.1%) and topiramate (54.5%) were the most commonly used medicines. The most frequently prescribed drug regimen involved a combination of on-label WL, off-label WL, and medication-induced symptom management drugs. Conclusion: Psychotropic appetite suppressants have been prescribed with unapproved WL drugs or psychotropic anti-anxiety/hypnotics. Further research is needed to provide evidence on drug combinations to ensure the safety of WL treatments.

매복된 상악 전치의 교정적 치료 : 증례보고

김해리,오소희,김영희 大韓小兒齒科學會 2007 大韓小兒齒科學會誌 Vol.34 No.4

상악 전치의 매복은 제3대구치,상악 견치,상하악 제2소구치에 비해서 드물지만,정중 과잉치,외상,치근만곡 등의 치근형성의 변이가 높은 빈도로 나타나기 때문에 다른 전치부에 비해서는 매복되는 비율이 높고,보통 약 8세 이후의 초기 혼합치열기의 아동에서 관찰된다. 상악 중절치의 매복으로 인한 인접치아의 이동으로 공간상실과 함께 정중선 변이가 나타날 수 있고 낭종 등이 발생할 수 있으므로,정확한 위치를 확인하고 적절한 치료 계획을 세우는 것이 중요하다. 치료 방법으로는 외과적 발거,자발적 맹출의 관찰,교정적 견인 등이 있으나,매복치의 병적 변화가 없고,치근의 발육이 양호하다면 기능과 심미성의 회복을 위해 교정적 견인을 시행한다. 이에 매복된 상악 전치들을 교정적 견인을 통해 정상적인 맹출방향으로 유도하여 양호한 치료결과를 얻었기에 보고하는 바이다. Impaction of maxillary incisor is rare than the third molar and canine, but its rate is higher than the other anterior teeth due to frequent mesiodens, trauma and variation of root formation (root dilaceration etc.). It is often observed in the dental age of about eight years and over. It will be occurred that the space loss, midline deviation and cyst formation due to the impaction of maxillary incisor. So it is important to evaluate the precise location of impacted tooth and to make appropriate treatment plan. Treatment would be surgical extraction or expectation for spontaneous eruption. Ifthe impacted tooth has no pathologic change and development ofthe root is favorable, orthodontic traction is recommended for recovery offunction and esthetics. In these cases, we performed orthodontic traction for the eruption ofimpacted maxillary incisors, and obtained satisfactory results.

젊은 성인에서 발생한 고환주위 횡문근육종 1예

김소리,곽재용,임창열 대한내과학회 2004 대한내과학회지 Vol.66 No.3

저자들은 좌측 음낭 부종을 주소로 내원한 17세 남자 환자에서 고환주위에 발생한 IRS 분류 group Ⅰ, IRS-Ⅳ에 따른 stage 1, 저 위험군의 태생기성 횡문근육종을 서혜부 절개를 통한 근치적 고환 적출술 및 음낭 절제술 후 1년여에 걸쳐 매 9주 마다 5차까지의 VA 항암화학요법으로 치료 완료하였고, 치료 중 추적검사한 복부 컴퓨터 단층 촬영상 진행 소견이나 전이 소견 관찰되지 않았으며, 항암화학요법 종료 후 6개월 후 추적검사 예정으로 현재 항암화학요법 종료 후 4개월까지 특이소견 관찰되지 않고 있다. This paratesticular rhabdomyosarcoma is more frequent in children than in adult. Paratesticular rhabdomyosarcoma accounts for approximately 7% of all rhabdomyosarcomas and is the most common soft tissue sarcoma in childhood, with an annual incidence of four to seven cases per million. The rhabdomyosarcoma originated from paratedsticular region is considered to have a good prognosis in comparison with othe rhabdomyosarcomas, despite of the high frequency of retroperitoneal lymph node invasion. this superficial site allows rapid diagnosis and consequently often complete resection of the tumor. The multidisciplinary treatment of paratesticular rhabdomyosarcoma has improved control of the disease with a 2-year survival of 80%. Especially, The outcome for patients with localized paratesticular rhabdomyosarcoma is excellent with the use of the new regimen rather than traditional regimen composed of alkylating agent: an alkylating-free and anthracycline-free regimen is adequate treatment for low-risk patients. We report a case of paratesticular rhabdomyosarcoma of embryonal type in a 17-year-old male who presented left scrotal swelling without tenderness. The diagnosis was confirmed by biopsy. After left radical orchiectomy and hemiscrotectomy, he received VA (Vincristine/Actinomycin-D) chemotherapy.

외상에 의해 함입된 치아의 교정적 견인을 통한 치험례

김해리,오소희,김영희 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.3

공황장애에서 Paroxetine 단기약물치료가 심리적 상태에 미치는 영향

이소영,김지혜,김율리,강은호,이동수,유범희 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.3

Objectives : This study was designed to evaluate clinical effect of paroxetine treatment and to explore psychological Pre-dictors of treatment response. Methods : Patients (n=26) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by Pa-roxetine for 12 weeks. We assessed symptom improvement using Clinical Global Impression (CGI), and clinical characteristics using Anxiety Sen&itivity Index (ASI), Anxious Thoughts and Tendencies (AT & T), Agoraphobic Cognition Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). T-test, correlation analysis, and stepwise multiple regression analysis were performed. Results : Panic patients showed significant improvement in seventy of illness and each clinical characteristic after 12 weeks of paroxetine treatment. There were significant correlations among severity of illness, anxiety, and depression, and subjective seventy was related with catastrophic thoughts. The more catastrophic thoughts and the higher sensitivity of body sensation, Patients had the worse symptom improvement they shorved. Multiple regression analysis showed that catastrophic thought related to agoraphobia was the best predictor of symptom improvement (22%). Conclusion : This study suggests that short-term treatment of paroxetine is effective in panic disorder with or without ago-raphobia, and that catastrophic thought could be a predictor of poor treatment response. Thus cognitive intervention on Catastro-phic thoughts may play an important role in symptom improvement in panic disorder.