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장리라,최영식,박요한,문대성,김자경,김성은,최인수,유찬희,남성진 고신대학교 의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3
Metastasis to the thyroid gland is usually considered uncommon. The most frequent sites of the primary tumor include the kidney, breast and lung. Its presence often indicates poor prognosis. Metastases represent the advanced stage of the tumors and fine needle aspiration cytology is and important way of diagnosis in thyroid metastasis. we experienced a case of Metastatic Small cell Lung Carcinoma to the Thyroid Gland. A 58-year-old man with Graves' disease diagnosed pulmonary nodule in the left upper lung field on his chest X-ray film. The patient's thyroid gland was diffusely swollen, and elastic to hard. A thyroid ultrasonography showed 1cm sized hypodense nodule on the left thyroid gland. The patient underwent a ultrasonography guided fine needle aspiration cytology of the mass. Cytological diagnosis was a metastatic small cell carcinoma. Then Chemotherapy was administered to the patient. The authors report this rare case of metastatic small cell lung carcinoma to the thyroid with literature review.
Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예
백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2
Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy
( Sung Soo La ),( Dong Woo Kim ),( Ki Chul Shin ),( Se Young Yun ),( Suk Bae Kim ),( Jung Eun Shin ),( Hong Ja Kim ),( Il Han Song ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Serum alanine aminotransferase (ALT) activity, reflecting the degree of hepatic necroinflammation, is one of the most frequently measured liver tests in persons who are suspected to have liver disease. But current upper limit of normal (ULN) of ALT, 40 IU/L, often can not detect the subclinical liver disease with minimal to mild inflammation. We, therefore, evaluated the ULN of ALT of healthy adult subjects in order to assess the necessity of revision for currently accepted reference range of ALT. Methods: 23,898 adult subjects who visited for medical examination at Health Promotion Center, Dankook University Hospital, from January 2005 to December 2006, were retrospectively enrolled in the present study. We excluded the adults who had HBsAg, anti-HCV, anti-HIV, VDRL, history of current medication and alcohol consumption more than 40 g/week, and high risks for liver disease defined as BMI more than 23 kg/m2, serum cholesterol level more than 240 mg/dL, triglyceride more than 200 mg/dL, fasting glucose more than 115 mg/dL, and ultrasonographic liver diseases including fatty change. We defined updated ULN of ALT as activity below 95th percentile for each gender. Results: 5,994 adults (2,983 men, 2,961 women) met the inclusion criteria of this present study. Updated ULN of ALT levels were 38 IU/L in men and 25 IU/L in women. This ALT activity showed a tendency to increase according to age increase, and revealed positive correlation with the ultrasonographic degree of fatty liver. Serum ALT activity below 95th percentile of HBsAg or anti-HCV positive carrier subjects, whose medical conditions were equal to those of enrolled healthy subjects in aspect of biochemical and ultrasonographic finding, were 75 IU/L and 77 IU/L, respectively. Conclusions: Updated ULN of ALT was lower than currently accepted ALT activity. Considering age and gender, current reference range of serum ALT level should be revised for the detection of subclinical liver diseases such as fatty liver.
라성수 ( Sung Soo La ),김소미 ( So Mi Kim ),김도형 ( Doh Hyung Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.5
Unilateral absence of the pulmonary artery (UAPA) is a rare congenital anomaly that occurs in association with other cardiovascular anomalies, such as tetralogy of Fallot or ventricular septal defects. On the other hand, it is less commonly found as an isolated finding without accompanying diseases. Isolated UAPA is a rare cause of hemoptysis, and massive hemoptysis has been reported to occur in approximately 18∼20% of UAPA patients during their clinical course. Even if a lung resection is considered a treatment option to control life-threatening hemoptysis, the procedure is more difficult than an ordinary lung resection because of the excessive collateral vessels from the systemic circulation. We encountered an isolated UAPA occurring in a young male patient suffering from intermittent blood tinged sputum. To our knowledge, only a few cases of isolated UAPA have been reported in Korea. This case is expected to be a good example to help clinicians better understand isolated UAPA as an unusual cause of hemoptysis. (Tuberc Respir Dis 2008;65:430-434)
라성수 ( Sung Soo La ),공재환 ( Jae Hwan Kong ),방창석 ( Chang Seok Bang ),한성환 ( Sung Hwhan Hahn ),명나혜 ( Na Hye Myong ),김도형 ( Doh Hyung Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.5
Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide. (Tuberc Respir Dis 2008;64:387-391)
세월호 사건 후 안산시⋅서울시 고등학생의 간접외상에 따른 우울과 불안
라수정,오상희,전혜수,지현주,박금주 水原大學校 2015 論文集 Vol.29 No.-
The purpose of this study was to compare the degree of indirect post traumatic stress, incident shock, depression and anxiety of high school students in Seoul and Ansan, after sewol ferry disaster. Sample groups consisted of high school students in Seoul and Ansan. The data was collected from July 14, 2014 to August 13, 2014 through the use of mail and firsthand collection 394 copies were collected and available for this study. The data was analyzed using t-test. The result of this study was as follow: A significant difference to the degree of depression only, and not to post traumatic stress, incident shock and anxiety. However, the average score of the four categories were normal in both groups. Therefore, in addition to the results of the present study, more follow-up assessment and group counseling will be needed.
Stress interactions between two asymmetric noncircular tunnels
La, You-Sung,Kim, Bumjoo,Jang, Yeon-Soo,Choi, Won-Hyuk Techno-Press 2018 Geomechanics & engineering Vol.15 No.3
The continually growing demand for underground space in dense urban cities is also driving the demand for underground highways. Building the underground highway tunnel, however, can involve complex design and construction considerations, particularly when there exists divergence or convergence in the tunnel. In this study, interaction between two asymmetric noncircular tunnels-that is, a larger main tunnel and a smaller tunnel diverging from the main tunnel, was investigated by examining the distributions of the principal stresses and the strength/stress ratio for varying geometric conditions between the two tunnels depending on diverging conditions using both numerical analysis and scale model test. The results of numerical analysis indicated that for the $0^{\circ}$, $30^{\circ}$, $60^{\circ}$ diverging directions, the major principal stress showed an initial gradual decrease and then a little steeper increase with the increased distance from the left main tunnel, except for $90^{\circ}$ where a continuous drop occurred, whereas the minor principal stress exhibited an opposite trend with the major principal stresses. The strength/stress ratio showed generally a bell-shaped but little skewed to left distribution over the distance increased from the left larger tunnel, similarly to the variation of the minor principal stress. For the inter-tunnel distance less than 0.5D, the lowest strength/stress ratio values were shown to be below 1.0 for all diverging directions ($0^{\circ}$, $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$). The failure patterns observed from the model test were found to be reasonably consistent with the results of numerical analysis.
Sung, Chang Ohk,Ahn, Geunghwan,Song, Sang Yong,Choi, Yoon-La,Bae, Duk-Soo Ovid Technologies (Wolters Kluwer) - Lippincott Wi 2009 International journal of gynecological pathology Vol.28 No.6
<P>Atypical leiomyomas are characterized by moderately to severely pleomorphic atypical tumor cells with low mitotic counts and no coagulative tumor cell necrosis. Despite the worrisome histologic features, most tumors have shown benign behavior. However, most studied patients had total hysterectomies, and very few patients who had myomectomy alone have had long-term follow-up. The behavior of atypical leiomyomas treated with myomectomy alone is still not known. We present a study of 13 atypical leiomyomas treated with myomectomy alone with long-term follow-up results and immunohistochemical findings for p16 (p16), p53, Ki-67, estrogen receptors, and progesterone receptors. The lengths of the postoperative intervals ranged from 20 to 151 months (mean=76.1 mo). None of the patients had developed a metastasis of her atypical leiomyoma. However, 1 patient showed local recurrence at the past myomectomy site 22 months after initial myomectomy. Immunostaining for p16 showed moderate to strong diffuse immunoreactivity in 11/13 cases (84.6%) of atypical leiomyomas, and 38.5% showed immunoreactivity for p53, including 1 case with strong, diffuse positive p53. When an atypical leiomyoma is discovered in a myomectomy specimen, the patient should be carefully followed up with or hysterectomy could be recommended. Larger numbers of cases and more long-term follow-up studies are needed to confirm the safety of myomectomy for atypical leiomyomas.</P>