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.

고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

간세포암과 하대정맥 막성폐쇄의 치료 후 호전된 백혈구파괴혈관염 1예

이준엽 ( Jun Yeob Lee1 ),이주원 ( Ju Won Lee1 ),이진욱 ( Jin Wook Lee ),박현준 ( Hyun Joon Park ),장국환 ( Gook Hwan Jang ),김다정 ( Da Jung Kim ),김선민 ( Sun Min Kim ),한병훈 ( Byung Hoon Han ),정규식 ( Gyoo Sik Jung ),김근태 ( 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

저자들은 하지 자색반과 고환 통증으로 내원한 알코올성 간경화증 환자에서 LCV의 원인 감별하는 과정에서 HCC와 하대정맥 막성폐쇄를 진단하고 이에 대한 치료 후 LCV의 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature. (J Rheum Dis 2015;22:322-326)

비응축성 기체 존재 시 수직관 외벽에서의 응축 열전달계수 상관식 개발

장영준(Yeong-Jun Jang),최동재(Dong-Jae Choi),김신(Sin Kim),정동욱(Dong Wook Jerng),이연건(Yeon-Gun Lee) 대한기계학회 2018 大韓機械學會論文集B Vol.42 No.3

본 연구에서는 비응축성 기체(공기)가 존재할 때, 10 mm의 직경을 갖는 수직 튜브 외벽에서의 응축 열전달계수를 측정하였다. 압력 2~5 bar, 공기 질량분율 10~75 %의 범위에서 실험을 수행하였다. 응축튜브 직경의 차이가 열전달계수에 미치는 영향을 평가하기 위해 측정 결과를 외경 40 mm의 응축튜브로부터 얻은 Lee의 실험 결과와 비교하였다. 본 연구의 측정결과와 Lee, 그리고 Dehbi의 실험결과를 이용하여 전열관의 직경에 의한 영향을 고려할 수 있는 실험적 상관식을 제안하였다. 제안된 상관식의 검증을 위해 Kawakubo의 실험결과와 예측값을 비교하였고, 평균 표준편차는 약 27 %로 나타났다. In this study, condensation heat transfer coefficients are measured in the presence of noncondensable gas (i.e., air) on a vertical tube with a 10-mm outer diameter. Experiments are conducted at pressures ranging from 2 to 5 bar and an air-mass fraction from 10 to 75 %. The experimental results are compared to the heat transfer coefficients obtained on a 40-mm O.D. tube, researched by Lee et al. Using the consolidated data from this study and Lee"s and Dehbi"s tests, a new empirical correlation for the condensation heat transfer coefficient of an air-steam mixture is developed. The proposed correlation is assessed against Kawakubo"s experimental results, and the mean standard deviation is ~27 %.

40세 이하 관상동맥 질환자에서 장기적 임상 관찰

이승욱,정명호,박종철,박형욱,조상희,김원,김계훈,이상현,강경태,조장현,김남호,김건형,안영근,조정관,박종춘,강정채 全南大醫大 2001 전남의대학술지 Vol.37 No.2

소아 만성 부비동염에서 단순촬영상과 OMU CT상의 비교

이병돈,박상호,김장묵,이승균,장혁순,강주원,김장욱 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

Most commonly and widely used diagnostic tool for chronic paranasal sinusitis in children is plain X-ray check not only because of small radiation dose and easy performance, but because of low cost. However ostiomeatal unit computed tomography(OMU CT) was known to be more accurate and recommended recently by many physicians. The author have studied for both OMU CT and plain X-ray of paranasal sinuses and compaird their findings in 90 chidren(180 sides of sinus) aged from 4 to 14 years who suspected having sinusitis. OMU CT was taken after plain X-ray examination (Caldwell's view, water's view, lateral view), and the time interval betweeen these two examination was O to 14 days (average 4.7 days). The following results were obtained. Considering that OMU CT was accurate, the rate of correspondence in diagnosis of sinus pathology between plain X-ray and OMU CT was 48.3% in the ethmoid sinus, 51.1% in the maxillary sinus, 41.9% in the sphenoid sinus, 43.4% in the frontal sinus. If all OMU CT findings had been accurate, the incidence of false positives according to plain X-ray was 25.5% in the ethmoid sinus, 28.3% in the maxillary sinus, 70.8% in the spenoid sinus and 77.8% in the frontal sinus. While, the incidence of false negatives according to plain X-ray was 85.9% in the ethmoid sinus, 70.5% in the maxillary sinus, 50.0% in sphenoid sinus and 37.5% in the frontal sinus. A routine preoperative OMU CT is recommended, which allows a detailed evaluation of pathologic changes and anatomical relations of the paranasal sinuses before surgical interventiaon for the paranasal sinuses. Considering the above facts, diagnosis of pediatric sinusitis only by plain X-ray was inadequate and OMU CT was necessary.

일본의 노인종합복지관 성공사례의 환경지원성 분석 연구

이연숙,이소영,여욱현,장미선 한국의료복지시설학회 2007 의료·복지 건축 Vol.13 No.1

According to the 2005 Korean census, the 65 and over population now exceeds 9.5% of the total population and is growing rapidly. Meeting elderly environment and care needs of this rapidly growing segment of the population becomes a major challenge for public policies and planners. Since great deal amount of elderly will reside in their houses, aging in place concept becomes important. For the success of aging in place, the quality of individual house unit, community support systems, and/or quality of senior center of the community are crucial. Since elderl environments and facilities serve not only medical and/or care programs but also social activity program in aging society, senior centers need to promote social activities and other care programs. The purpose of this study is to analyze characteristics of environmental affordance of a well received senior center in Tokyo, Japan. In order to analyze the characteristics, Murtha & Lee user benefit criteria and Lawton's environmental affordance approaches were used. As results, design characteristics and interior elements which provide environmental affordance were enumerated by type of space. Based on needs and user benefit criteria, those features were analyzed. This study shows design characteristics, elements, and attributes which are well received and utilized by elderl users.

원격 공동 실험에 관한 연구

李將虎,金東旭,張禪 弘益大學校 科學技術硏究所 2005 科學技術硏究論文集 Vol.16 No.-

The third wave has effected a huge change not only in society but also in the construction industry. In the construction industry, various digital and construction technologies have merged and developed according to the third wave. Such examples include integrated construction system, electronic document system, blueprint management system, and simulation system. As construction structures are developed, they acquire more functions and become bigger and more complicated. Hence, developing these construction core technology is crucial for international competitiveness of the national construction industry. However, it is difficult to build and use a related big experimental facility because it is impossible for one organization to build such facility due to its huge cost. This paper describes the design of effective KOCEDgrid system and shows the implementation of a prototype called the Mini-MOST experiment.

진균성 부비동염의 임상적 고찰

이승원,김장욱,박영진,송태현,이병돈,장혁순 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

The fungal sinusitis is relatively rare and mainly develops in immunocompromised hosts, but is sporadically appears in the immunocompetent patients, where its incidence tends to be increasing. Because the clinical features of this disease are similar to those of chronic suppurative sinusitis, this entity may be overlooked. We analysed thirteen fungal sinusitis from January 1997 through December 1999 based on clinical features, laboratory characteristics and operative findings. The results are as follows. 1)Fungal sinusitis occurred 3.3 times as frequently in female patients as in male patients and the peak age groups are 4th and 5th decades. 2) The time intervals between the onset of symptoms and the first hospital visit were as follows: 5 cases within 3 months, 1 case between 4 and 6 months, 3 cases between 7 and 12 months, and 4 cases over 1 year. 3) The chief complaints were nasal obstruction, postnasal drip, rhinorrhea, cheek pain, headache, ocular pain, sneezing. 4) The characteristic computerized tomographic findings were hyperattenuated lesions in the maxillary sinus and in the nasal cavity near the natural ostium. 5) The most common pathogen was Aspergillus(92.3%) 6) We performed Caldwell-Luc's operation only in 4 cases, Caldwell-Luc's operation with intranasal ethmoidectomy in 3 cases, Caldwell-Luc's operation with endoscopic sinus surgery in 3 cases and endoscopic sinus sugery only in 3 cases. 7) Most of the gross specimens revealed a fungus ball containing a black-brown necrotic debris or caseous material.

치료용 방사선의 입사각에 따른 광섬유 방사선량계의 체렌코프 빛 측정 및 분석

장경원,조동현,유욱재,신상훈,서정기,이봉수,박병기,문주현 제주대학교 방사선응용과학연구소 2008 방사선응용과학연구소논문집 Vol.22 No.-

In this study, we have measured scintillating light generated in a fiber-optic dosimeter by high energy photon and electron beams using a charge-coupled device. The intensity of Cerenkov lights are also measured and characterized as functions of incident angles and energies of the high energy beams from a clinical linear accelerator. To minimize or remove Cerenkov light, a simple subtraction method using a background optical fiber and wavelength discrimination method using optical filters are investigated. Also, the intensities of Cerenkov light induced by high energy photon and electron beams are compared.