단일 기관에서 소아 굴곡성 기관지내시경에 대한 임상 경험

안혜성 ( Hye Sung Ahn ),최은정 ( Eun Jeong Choi ),윤현진 ( Hyun Jin Yun ),왕승문 ( Sheng Wen Wang ),권은영 ( Eun Young Kwon ),황규근 ( Kuy Geun Hwang ),이영석 ( Young Seok Lee ),정진아 ( Jin A Jung ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.3

Purpose: This study was performed to investigate the indications, bronchoscopic findings, results of bronchoalveolar lavage, and complications and to report the clinical features of using flexible bronchoscopy for respiratory diseases in children. Methods: We studied 105 patients who underwent flexible bronchoscopy at the Department of Pediatrics, Dong-A University Medical Center from June 2001 to June 2008. A bronchoalveolar lavage (BAL) was performed if need, and the BAL fluid was cultured for bacteria and fungi. We performed an acid-fast bacilli (AFB) smear and culture. Result: The most common indication for flexible bronchoscopy was suspected pulmonary tuberculosis (37 cases, 35.2%). The most common abnormal finding was excessive secretion, which was found in 53 cases (50.4%). BAL bacterial cultures were performed in 10 of 38 cases, and Hemophilus influenza was the most common organism and was found in three cases (7.8%). There were 17 AFB culture-positive cases (49.3%) among the 37 suspected pulmonary tuberculosis cases. Among these 17, the Tb-polymerase chain reaction (Tb-PCR) was conducted for four cases (23.5%) but only two cases (50%) were positive. TB-specific antigen-induced interferon-gamma was performed in four cases (23.5%), and all four cases (100%) were positive. Conclusion: Pediatric flexible bronchoscopy has made it possible to vary the indication and subjects. It was also safe and effective if used carefully. Further study should be conducted to develop safe and useful technology to overcome the limitations. [Pediatr Allergy Respir Dis(Korea) 2011;21:226-233]

서울시 주택 예상투자이익 추정과 영향요인에 대한 시론적 분석 - 2010-2018년 주택 실거래가를 중심으로 -

안혜성(Ahn, Hye-Sung),강창덕(Kang, Chang-Deok) 한국지역학회 2020 지역연구 Vol.36 No.1

이 연구는 투자이론에서 활용되고 있는 토빈의 Q 개념을 적용하여 투자이익을 측정하고 이를 통해 서울 주택시장을 이해하고자 한다. 구체적으로 서울시 아파트와 연립·다세대주택을 대상으로 2010년부터 2018년 까지 투자이익을 추정하고 공간계량모형을 이용하여 투자이익에 영향을 주는 요인들을 살펴보았다. 투자이익은 실거래가격에서 대체비용(토지비용+건축비용)을 빼는 방식과 실거래가격 대비 대체비용의 비율로 각각 추정하였다. 분석결과를 보면, 투자이익은 2018년으로 갈수록 더 커졌고 강남·서초구 및 한강 주변에서 투자이익이 높게 나타났으나 투자이익의 시공간적 변화양상은 아파트의 경우 뚜렷한 반면에 연립·다세대주택은 산발적·국지적으로 나타났다. 공간계량모형 분석결과는 주택유형과 상관없이 고밀·신축개발이 많은 지역에서 투자이익이 높았다. 이 연구의 접근방법과 결과는 향후 주택 공급 정책, 투자이익 환수, 지역 경쟁력 측정, 가격 거품 측정 등에 대한 논의를 위한 기초 자료가 될 것이다. Estimating investment profits of real estate is critical to understand real estate markets and create relevant policy as real estate market and capital market combines closely. Thus, this study applied the concept of Tobin’s Q to estimate investment profits for apartments as well as row-houses and multi-family homes in Seoul from 2010 to 2018. Investment profits were estimated by two approaches: subtracting the replacement cost from the transaction price and calculating ratio of the transaction price to the replacement cost, respectively. The spatio-temporal changes in investment profits were apparent in apartments compared with row-houses and multi-family homes. As a result of analyzing the spatial econometrics models, the investment profit was higher in the area with high density and new developments regardless of the housing types. The framework and key findings would be the effective reference to understand residential investment behavior, create relevant housing policy, introduce value capture of windfall, measure regional competitiveness, and estimate housing bubble.

원발성 십이지장 선암의 수술적 치료 및 성적

안혜성(Hye Seong Ahn),장진영(Jin-Young Jang),이승은(Seung Eun Lee),양성훈(Sung Hoon Yang),이건욱(Khun Uk Lee),김선회(Sun Whe Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.1

Purpose: Because of the rarity of primary duodenal adenocarcinomas, the factors affecting the management and survival of patients with this disease remain controversial. This study analyzed the nineteen-years of experience gained at one institution to define the surgical management and outcomes of patients with primary duodenal adenocarcinomas. Methods: A retrospective review of 77 patients, who underwent surgery for a primary duodenal adenocarcinoma at Seoul National University Hospital, between May 1985 and April 2004, was undertaken. The dermographics symptoms, operative variables, surgical pathology and survival data were analyzed. Results: A curative resection was performed in 40 patients (51.9%); a pancreaticoduodenectomies and/or resection of other organs, pancreas head resection with a duodenal segmentectomy and a segmental duodenectomy and resection of another organ in 37, 2 and 1, respectively. The remaining 37 patients underwent a palliative resection or bypass. The hospital mortality and complication rates were 2.6% (2 patients) and 42.9% (33 patients), respectively. The overall 5-year survival was 26.8%. The 5-year survival for the curative resection group was 42.7%, whereas that for the palliative surgery group was 0%. In a univariate analysis, nodal metastasis was found to have a significant negative impact on survival after a curative resection (P=0.028). The patients’ age, sex, operative procedure, tumor size, histologic type, differentiation and tumor depth had no influence on survival. Conclusion: A curative resection is associated with increased survival in patients with a duodenal adenocarcinoma. Following a curative resection, nodal metastasis is an independent prognostic factor. Therefore, the early diagnosis should be sought to achieve a curative resection and increased survival. As a curative resection, a pancreati-coduodenectomy is usually required, and a segmental duodenal resection may be appropriate in selected patients, especially in early duodenum cancers.

위 절제 수술 전후 빈혈 환자에 있어 철수크로오스의 유효성 및 안전성

유문원,조재진,이인규,안혜성,정상호,이혁준,김형호,이건욱,양한광,Yoo, Moon-Won,Cho, Jae-Jin,Lee, In-Kyu,Ahn, Hye-Seong,Jeong, Sang-Ho,Lee, Hyuk-Joon,Kim, Hyung-Ho,Lee, Kuhn-Uk,Yang, Han-Kwang 대한위암학회 2008 대한위암학회지 Vol.8 No.1

목적: 빈혈을 동반한 위 절제 수술 환자에서 정맥용 철수 크로오스(베노훼럼$^{(R)}$ 투여의 유효성 및 안전성을 평가하고자 하였다. 대상 및 방법: 2006년 9월부터 2007년 2월까지 서울대학교 병원에서 위 질환으로 외과에 입원 또는 외래 치료를 받은 혈색소(Hb)가 7 g/dl 이상 11 g/dl 미만인 환자를 대상으로 수술 $2{\sim}3$주 이전 또는 수술 1개월 이후인 급성출혈의 증거가 없는 환자를 1군으로, 수술 후 1개월 미만으로 생체징후가 안정된 환자를 2군으로 분류하여 나이, 성별, 진단명을 조사하였고, Hb, 적혈구용적률(Hct), 평균적혈구용적(MCV), 혈청페리틴, 총철결합능(TlBC), 혈청철, 망상적혈구수에 대해 철수크로오스 투여 전후를 비교하였고 약물 부작용을 조사하였다. 결과: 대상 환자 수는 1군은 79명, 2군은 46명이었다. 1군에서 약물 투여 전후 비교 시 통계적으로 유의한 증가를 보였던 Hb, Hct, MCV, 혈청페리틴, TIBC, 망상적혈구 각각의 변화량의 평균은 1.3 g/dl, 4.1%, 3.1 fL, 195.0 ng/ml, -86.4 ug/dl, 0.2%였다. 2군에서 통계적으로 유의한 증가를 보였던 Hb, Hct, MCV, 혈청페리틴, 망상적혈구수 각각의 변화량의 평균은 1.8 g/dl, 6.1%, 3.4 fL, 259.6 ng/ml, -0.3%였다. 약물 부작용으로 2명(1.6%)의 환자에게서 국소성 정맥염이 발생하였다. 결론: 빈혈을 동반한 위 절제 수술 환자에서 정맥용 철수 크로오스의 투여는 짧은 시간에 큰 부작용 없이 빈혈 교정에 유효하였다. Purpose: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose ($Venoferrum^{(R)}$) for treating the perioperative anemic gastrectomy patients. Materials and Methods: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl $\leq$ hemoglobin levels (Hb) < 11.0 g/dl) and who were admitted or visited the outpatient clinic of the Department of surgery, were divided into two groups. The preoperative (${\leq}\;2{\sim}3$ weeks before gastrectomy) or postoperative ($\geq$ 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. Results: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1ft, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. Conclusion: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.

위 유암종의 임상병리학적 특징에 대한 후향적 연구

장정문,공성호,윤홍만,안혜성,이혁준,윤원재,김상균,양한광,이건욱,Jang, Jeong-Moon,Kong, Seong-Ho,Yoon, Hong-Man,Ahn, Hye-Seong,Lee, Hyuk-Joon,Yoon, Won-Jae,Kim, Sang-Kyoon,Yang, Han-Kwang,Lee, Kuhn-Uk 대한위암학회 2009 대한위암학회지 Vol.9 No.4

목적: 위 유암종의 임상병리학적 특성과 치료방법 및 예후 등을 분석하였다. 대상 및 방법: 1996년부터 2006년까지 본원에서 치료받았던 18명을 대상으로, 의무기록을 이용한 후향적 연구를 통해 Rindi 분류에 의해 구분하여, 기존의 보고와 임상병리학적 특성 및 치료, 생존율을 비교 분석하였다. 결과: Type I은 8명, type III가 10명이었으며 type II는 없었다. 평균발생 연령은 type I이 47.75세, type III는 57.90세였고, type I은 남자 4명, 여자 4명으로 성비가 1:1이었으나 type III는 남자 7명, 여자 3 명으로 남자에서 많았다. Type I에서도 단발성인 경우가 4예가 있었으며, 1예를 제외하고는 점막 또는 점막하층에 국한되어 있고, 림프절 전이나 원격전이는 없었다. Type III는 병변의 침습성에 관계없이 모두 국소림프절 전이 또는 원격 전이가 있었다. 진단 시 원격전이가 없었던 13명 중 5예에서 내시경적 절제술, 8예에선 수술이 시행되었으며 5년 생존율은 92.3%였다. 원격 전이가 있었던 5예는 평균 생존 기간이 22개월로 이 중 고식적 수술을 시행 받은 3예의 중위 생존 기간은 24개월이었다(95%, ${\pm}6.52$). 결론: 기존의 Rindi 분류법과 비교하여 보았을 때, 본 연구 결과 빈도에 있어서 type III가 type I보다 흔하였다. 또한 type I 유암종에 있어서 평균연령이 낮고, 단발성 종양이 절반 정도를 차지하며, 악성빈혈이 동반되지 않았던 점 등에서 서구와는 다른 특징이 관찰되었다. Purpose: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). Materials and Methods: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. Results: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1:1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, ${\pm}6.52$). Conclusion: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.

반복되는 천명을 주소로 내원한 3세 미만의 환아에서 25-hydroxyvitamin D의 혈청 내 농도와 관련된 인자

최은정 ( Eun Jeong Choi ),박누리 ( Nu Ry Bag ),정진아 ( Jin A Jung ),김대철 ( Dae Cheol Kim ),안혜성 ( Hye Sung Ahn ),윤현진 ( Hyun Jin Yun ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.4

Purpose: We evaluated the relationship between laboratory/clinical factors and vitamin D levels in recurrent wheezers less than 3 years old. Methods: We retrospectively analyzed clinical data and laboratory factors (25-hydroxyvitamin D, complete blood count, C-reactive protein, glutamic oxaloacetic transaminase, glutamyl purovic transaminase, alkaline phosphatase [ALP], eosinophil counts, and serum IgE IgG, IgA, IgM) of 84 children less than 3 years who had experienced wheezing episodes at least 3 times. Results: Children in the normal group (1.4±0.9 years) were younger than those in the deficient (2.2±1.2 years) and insuffient (2.31.0 years) groups (P=0.010). Glutamyl purovic transaminase were higher in the normal group (24.5±19.4 IU/L) than in the deficient (16.0±4.7 IU/L) and insufficient (15.3±4.5 IU/L) groups (P=0.009). ALP were higher in the deficient (791.4±180.8 IU/L) and insufficient (770.4±251.2 IU/L) groups than in the normal group (631.9±127.0 IU/L, P=0.034). Total IgE levels were higher in the deficient group (171.9±212.1 kU/L) than in the normal group (43.7±58.3 kU/L, P<0.05), and the rate of sensitization to aeroallergens was higher in the insufficient group (36.1%) than in the normal group (10%, P<0.05). Conclusion: Among children with recurrent wheezing less than 3 years old, low vitamin D levels may be associated with older age, total IgE, ALP level, glutamic pyruvate transaminase level, and rate of sensitization to aeroallergens.