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김번,한민석,조동후,이동준,신혜선,박수정,홍성필,천재희,김태일,김원호 대한장연구학회 2012 Intestinal Research Vol.10 No.4
Background/Aims: Acute hemorrhagic rectal ulcer (AHRU) is an important etiology of lower gastrointestinal bleeding in intensive care unit patients and hospital inpatients. Moreover, with increasing elderly populations, and improved survival in critically ill patients, the incidence of AHRU has increased. The aim of this study is to determine rebleeding risk and prognostic factors of AHRU patients. Methods: We retrospectively reviewed 32 patients with AHRU in Severance Hospital from February 2006 to October 2010, collected clinical data, and analyzed their association with the recurrence of bleeding and mortality of patients. Results: The mean age of patients was 65.5 years, and 27 patients (84.4%) showed Eastern Cooperative Oncology Group performance status 3-4. Nineteen patients (59.4%) had recurrent bleeding. Hypoalbuminemia (≤2.5 g/dL) was a risk factor of rebleeding in univariate and multivariate analysis. For patients with chronic liver disease, hypoalbuminemia (≤2.5 g/dL), renal dysfunction (>2 mg/dL) and thrombocytopenia (<150,000/ՌL) showed relatively earlier rebleeding than those without (P=0.007, P=0.009, P=0.027 and P=0.043, respectively). The endoscopic hemostasis at the first bleeding event was associated with lower early rebleeding rate (P=0.048). In univariate analysis, chronic liver disease, hypoalbuminemia (≤2.5 g/dL) and the prolongation of activated partial thromboplastin time (>40 seconds) increased mortality (P=0.028, P=0.008 and P=0.027, respectively) and the patients with rebleeding showed a tendency toward higher mortality, compared to those without (57.9% vs. 23.1%, P=0.051). Conclusions: In AHRU patients, hypoalbuminemia was a risk factor of rebleeding, and chronic liver disease, hypoalbuminemia, renal dysfunction, thrombocytopenia and no endoscopic treatment at the first bleeding event was correlated with relatively earlier rebleeding. 목적: 급성 출혈성 직장 궤양 환자의 임상적 특징과 입원 기간 중의 재출혈 및 사망의 위험 인자를 알아보고자 하였다. 방법: 세브란스병원에서 2006년 1월 1일부터 2010년 10월 30일 사이에 선혈변을 주소로 대장내시경 또는 직장경을 시행한 환자 116명 중 급성 출혈성 직장 궤양에 합당한 환자 32명을 대상으로 임상적 소견과 입원 기간 중 재출혈 및 사망과 관련된 요인을 후향적으로 분석하였다. 결과: 급성 궤양성 직장 출혈 환자의 평균 연령은 65.5세이고, 평균 1인당 3.4개의 전신 질환을 가지고 있었으며, 27명(84.4%)의 환자가ECOG 3-4의 전신상태를 보였다. 19명(59.4%)의 환자에서 재출혈이 발생하였으며, 재출혈의 관련 위험인자에 대한 단변량 및 다변량 분석에서 저알부민혈증(≤2.5 g/dL)이 유의한 관련인자였다. 만성간질환, 저알부민혈증, 신기능 저하 및 혈소판감소증이 있는 경우 재출혈의 조기발생이 많았고(P =0.007, P =0.009, P =0.027 및 P =0.043), 초출혈 발생 당시 내시경 지혈술을 시행한 경우 의미있게 재출혈의 조기발생이 적었다(P =0.048). 입원기간 중 사망과 관련한 단변량 분석에서는 만성 간질환, 저알부민혈증, aPTT 상승(>40초)이 사망률 증가와 관련된 유의한 인자였으나(P =0.028, P =0.027, P =0.008), 다변량 분석에서는 유의한 관련인자가 없었다. 결론: 급성 출혈성 직장 궤양 환자에서 저알부민혈증이 재출혈에 관련된 유의한 위험인자였으며, 만성간질환, 저알부민혈증, 신기능 저하, 혈소판감소증 및 초출혈에서 내시경 지혈술 시행 여부가 재출혈의 조기발생과 연관성이 있었다.
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인삼모상근의 생장과 Ginsenoside 생합성에 미치는 KH2PO4의 영향
인준교,박동식,이범수,이태후,김세영,노영덕,조동하,김성무,양덕춘 한국약용작물학회 2006 한국약용작물학회지 Vol.14 No.6
To investigate effects on the growth and ginsenosides accumulation in ginseng hairy root, potassium phosphate was supplemented with 1.25, 2.5, and 5.0 mM concentration in 1/2 MS medium, respectively. Potassium phosphate supplement was increased the biomass and ginsenosides accumulation when it was dose at the concentration of 1.25 mM. And the growth rate of hairy root in the light condition was higher than in dark condition. The highest contents and productivity of ginsenosides were observed at the supplement of 1.25 mM potassium phosphate at the 7th day after the culture onset. Ginseng hairy root cultured in 20 L bioreactor supplemented with 1.25 mM KH2PO4 was increased the growth with 1,609 g (F·W) and ginsenosides content with 11.09 mg than those in control.
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Ventricular Tachyarrhythmias in a Patient with Andersen-Tawil Syndrome
표정윤,정보영,박진수,이승준,이한철,김원진,조동후 대한심장학회 2013 Korean Circulation Journal Vol.43 No.1
Andersen-Tawil syndrome (ATS), a rare autosomal dominant disorder, is characterized by periodic paralysis, dysmorphic features and car-diac arrhythmias. This syndrome is caused by mutations of KCNJ2 gene, which encodes inward rectifying potassium channel. Here, we re-port an 18-year-old girl who was presented with life-threatening cardiac arrhythmia and acute respiratory distress. She was diagnosed with ATS, based on dysmorphic features, ventricular arrhythmia, and periodic paralysis. This is the first case to be reported in Korea who experienced a fatal cardiac arrest and respiratory failure caused by ATS.
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증례 : 소화기 ; 재발성 췌장암으로 항암화학요법을 시행한 환자에서 발생한 복부 방선균증
조인래 ( In Rae Cho ),이승우 ( Seung Woo Yi ),조중현 ( Jung Hyun Jo ),조동후 ( Dong Hoo Joh ),한민석 ( Min Seok Han ),박정엽 ( Jeong Youp Park ),송시영 ( Si Young Song ) 대한내과학회 2013 대한내과학회지 Vol.85 No.4
저자들은 재발성 췌장암으로 인해 고식적 항암화학치료를 받고 있던 46세 남자 환자에서 복부 전산화 단층 촬영상 암종의 재발로 의심되는 종괴 형태로 발생한 복부의 방선균증의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. A 46-year-old male patient with recurrent pancreatic cancer was admitted with a newly developed abdominal mass. The patient had a history of diabetes and underwent total pancreatectomy with partial gastrectomy followed by adjuvant concurrent chemoradiation therapy and palliative chemotherapy. Abdominal CT scan during palliative chemotherapy showed an abdominal wall mass. We performed excisional biopsy for diagnosis. Histological examination revealed actinomycosis of the abdominal wall. The patient was treated with penicillin G. This case showed that actinomycosis can occur in a patient receiving chemotherapy and may mimic cancer recurrence. Therefore, when evaluating a newly developed abdominal mass in patients who are receiving chemotherapy or radiotherapy, the probability of actinomycotic infection must also be considered, especially in patients with a history of surgery and diabetes mellitus. (Korean J Med 2013;85:401-405)
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