DCT AC계수의 통계적 특성을 이용한 피라미드 벡터양자화에 관한 연구

정경섭(Kyung Sup Chung),정일화(Il Hwa Jung),이대영(Dai Young Lee) 대한전자공학회 1995 대한전자공학회 학술대회 Vol.1995 No.6

재생불량성빈혈 환자에서의 수술 시행예에 대한 고찰

한지숙(Jee Sook Hahn),정경섭(Kyung Sup Chung),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko),조장환(Chang Hwan Cho),박정수(Cheong Soo Park) 대한내과학회 1991 대한내과학회지 Vol.40 No.1

N/A With improved management in the patient of aplastic anemia, complications that require surgical intervention are becoming more frequent. In the past, conventional management of complications that require surgical intervention in patients with pancytopenia were mainly conservative and nonoperative. Because of the presumed high mortality and morbidity, surgery has often been avoided. However, advance in supportive techniques such as transfusion of platelet and leukocyte and introduction of new broad-spectrum antibiotics has made surgical approach possible. Fourteen cases of aplastic anemia who underwent major or minor surgery for surgical complications or diagnostic purpose in the department of internal medicine from December 1972 to February 1989 were evaluated. The results obtained were as follows. 1) The incidence of surgery in 217 cases of aplasic anemia was 6.5 percent. Their median age was 29.5 years with female preponderance (M:F=1:2.5). The severe aplastic anemia (SAA) were 4 cases and non-severe aplastic anemia (non-SAA) 10 cases. 2) Eighteen surgical procedures have been performed, of which the major surgery were 10, and minor surgery 8 cases. Of the major surgery 3 (30%) occasions were undertaken in 2 SAA cases. 3) The types of major surgery included 2 cases of appendectomy, and 1 case of subtotal gastrectomy, cholecystectomy with T-tube drainage, cholecystostomy, hernioplasty, amputation of leg in each, and 3 cases of Cesarean section. Those of minor surgery presented 3 cases of incision and drainage, 1 case of implantation and removal of intravenous injection port, skin biopsy, wound repair, and dilatation and evacuation in each. 4) Of the 10 major surgical procedures, seven were emergent surgery and three elective surgery. The median duration from the diagnosis to the major surgical procedure was 0.5 months (4 days~47.3 months), and the median survival of the surgery was 12.3 months (4 days~38+ months). 5) The mean platelet count before the major surgery was 27,400/㎣ (8,000~94,000/㎣), and it rose to 94,400/㎣ (34,000~166,000/㎣) after average 6.8 units of platelet transfusion. 6) Three surgical complications were encountered in 2 cases, comprising of 1 case of sepsis, and pneumonia, and atelectasis in another 1 without any bleeding complications. The one SAA case complicating the both sepsis and pneumonia was dead within 30 days after surgery. 7) Total 3 cases were dead, whose causes were infection, stomach cancer, and periampullary cancer, respectively. It is concluded that the surgical intervention should be strongly considered in patients with aplastic anemia requiring surgery unless they are terminally ill, which could be attributable to the development of supportive care and would offer enough chance for definite treatment of aplastic anemia and reasultant longer survival. The surgeon and the hematologist must work together to facilitate a major operation when it is indicated.

만성 B형 간염 바이러스 표면항원 보유자의 징병검사 기준에 대한 고찰

이숭환 ( Soong Hwan Lee ),배종엽 ( Jong Yub Bae ),안병철 ( Byeong Cheol Ahn ),배순철 ( Soon Chul Bae ),정경섭 ( Kyung Sup Chung ),손정일 ( Jeong Il Son ),나현재 ( Hyun Jae Na ) 국군의무사령부 2000 대한군진의학학술지 Vol.31 No.1

각종 간질환에 있어서 이상 Prothrombin (des-γ-Carboxyprothrombin)에 관한 연구

이혁우,정경섭,김원호,한광협,정재복,이상인,박인서,최홍재,도윤정,윤홍섭 대한내과학회 1990 대한내과학회지 Vol.38 No.4

The absence of vitamin K or the ingestion of vitamin K antagonists inhibits vitamin K-dependent carboxylase activity in the liver, and an abnormal prothrombin, known as des-y-carboxyprothrombin(DCP) or PIVKA -Ⅱ(a protein induced by vitamin K absence or antagonists-Ⅱ), is released into the blood. In order to evaluate whether abnormal prothrombin levels can be clinically used as an index of hepatocellular dysfunction or as a tumor marker of hepatocellular carcinoma(HHC), DCP levels were determined by a latex agglutination test in 20 normal subjects and in patients with various liver diseases, including 70 hepatocellular carcinoma, sever metastatic liver disease, 45 liver cirrhosis, 13 acute viral hepatitisB, six chronic active hepatitis B, three fatty liver and one liver abscess. The usefulness of the combination assay of DCP and alpha-fetoprotein(AFP) levels to improve the diagnostic value and the effects of vitamin K administration on DCP levels were assessed in the present study. The results obtained were as follows: 1) DCP was detected in 42 out of 70 patients with HCC(60.0%), in three seven patients with metastatic liver disease(42.9%), in 23 out of 45 patients with liver cirrhosis(51.1%), and in one out of six patients with chronic active hepatitisb(16.7%), but there was no detectable DCP among the 20 healthy control subjects or in the 13 acute viral hepatitis B, three fatty liver and one liver abscess cases. 2) The detection rates of DCP according to the size of the HCC were 66.7% in the larger-than 5㎝ size and 44.4% in the 3~5㎝ size, but there was no detection in four patients with smaller-than 3㎝ size. The detection rates of DCP according to Child’s classification of liver cirrhosis were 60% in class C and 25% in class B, but there was no detection in two patients in class A. 3) There was no significant correlation between DCP and AFP levels. However, DCP was also detected 62.5% in less than 400ng/㎖ of AFP, and the positive rates were 91.0% in higher than 400ng/㎖ of AFP or higher than 1:10(+) of DCP in patients with HCC. 4) The detection rate of DCP was 56.8% in liver cirrhosis patients with prolonged prothrombin time(PT). However, 61.4% was detected in HCC patients with normal levels of prothrombin time(PT). 5) On observation of the effectiveness of vitamin K administration on DCP level, are was no effectiveness of vitamin K administration in all patients with 13 HCC, but the DCP level decreased or was not detected in seven out of nine patients with liver cirrhosis after vitamin K administration (p<0.05). Based on these results, DCP determined by a latex agglutination test may be useful as an index of hepatocellular dysfunction. However, due to the lower sensitivity and specificity of the latex agglutination test, it is doubtful whether DCP is a definite tumor marker of HCC. But the combination assay of AFP and DCP is helpful for obtaining an increased diagnostic rate of HCC. We recommended comparison of the effectiveness of vitamin K administration on DCP concentrations during the follow-up observation of chronic liver disease, such as liver cirrhosis, for increasing the diagnostic rate of HCC. Further study utilizing methods such as RIA or ELISA might be needed to evaluate the usefulness of DCP as a tumor marker for HCC.

대뇌 침범이 확인된 Henoch-Schonlein 자반증 1 예

홍천수,최인준,홍순원,한광협,최규헌,허균,정경섭,김경철,조현명 대한내과학회 1991 대한내과학회지 Vol.40 No.3

Henoch-Schonlein purpura is a generalized small vessel vasculitis of the hypersensitivity type characterized by the association of cutaneous lesions with gastrointestinal, joint and/or renal symptoms. The syndrome may occur in infants as well as in adults, but it occurs most commonly in childhood. Neurologic involvement was recognized in 1914 by Osler who described a child with $quot;allergic purpura$quot; associated with a hemiplegia. Since then, relatively little has been written in the medical literature concerning the neurologic manifestations of this illness. The neurologic symptoms and signs may be due to the involvement of the meningeal and cerebral parenchymal vessels by the fibrinoid necrotizing arteriolitis or arteritis of this disease causing the diffuse cerebral ischemia. And it may be aggrevated by a consequence of the hypertension and metabolic derangements that can accompany renal involvement. We report a case of Henoch-Schonlein purpura with neurologic involvement, which was menifestated by typical clinical pictures including severe headache and generalized seizure associated with multifocal low density on computed tomography and abnormal EEG findings.