국내에서 보고된 간세포 선종에 대한 임상적 고찰

최남수(Nam Soo Choi),김병호(Byung Ho Kim),이성배(Sung Bae Lee),정일우(Il Woo Jung),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),장영운(Young Woon Jang),이정일(Joung Il Lee),장린(Rin Chang),홍성화(Sung Hwa Hong) 대한내과학회 1998 대한내과학회지 Vol.54 No.5

N/A Objectives: Hepatic adenoma is a rare benign tumor, occuring in women of child-bearing age and it is known that hepatic adenoma is associated with history of oral contraceptive use in about 90% of cases, rarely with type I glycogen storage disease or anabolic steroids. There have been five cases of hepatic adenoma reported in Korea and three cases have been confirmed in our hospital. We examined the clinical findings of these eight cases and compare them with those of hepatic adenoma reported in western countries. Methods: We reviewed five cases published in medical literature of Korea and three cases confirmed in our hospital, The clinical, laboratory, and radiological features of the eight cases were examined and all were pathologically proven cases as hepatic adenoma. Results: Six cases were male and two cases were female. Mean age of them were 37±6 years old which ranged from 24 to 45 years old. Two cases of female did not have history of ingestion of oral contraceptives and six cases of male did not have history of having anabolic steroids. The associated diseases were chronic hepatitis B in two cases, glycogen storage disease type I in one case, and ovarian mucinous cystadenoma in one case. The presenting symptoms we upper abdominal discomfort in five cases, chronic fatigue in one case and two cases had no symptom Hepatic adenomas were single mass in seven cases and only one case suspected of having glycogen storage disease showed six nodules. The mean diameter of the eight hepatic adenoma was 7.7±3.7cm which range from 2.0cm to 15cm 5even of the eight cases were larger than 5cm in diameter. but there was no case of intraperitoneal bleeding. In laboratory studies, AST/ALT was elevated (81/84IU/L, normal range less than 40lU/L) in one case which was suspected of glycogen storage disease. Alkaline phosphatase were elevated in four cases and elevated α-FP was not found in any case. Hepatic adenoma was shown as hyperechoic mass with indistinct margin by ultrasonography and hypodense mass with contrast enhancement by computed tomography. Hepatic adenoma showed isodense or low signal intensity in T1WI, and low or high signal intensity in T2WI. Hepatic angiography showed hypervascular mass in six cases but avascular mass in two cases. Conclusion: The reported cases of hepatic adenoma were predominant in men, associated with chronic hepatitis B in two cases, and females with hepatic adenoma had no history of having oral contraceptive. Despite the large size of hepatic adenoma, there was no case accompanied by peritoneal bleeding. These findings contrasts with these of hepatic adenoma reported in western countries. Therefore the pathogenesis and clinical course of hepatic adenoma in Korea may be different with those of hepatic adenoma occurring in western countries and further studies are needed,

지반침하 방지를 위한 고효율 수압식 충전 현장실험에 관한 연구

양인재(In-Jae Yang),최남수(Nam-Soo Choi),전철수(Chul-Soo Jeon),이상은(Sang-Eun Lee),신동춘(Dong-Choon Shin) 한국암반공학회 2014 터널과지하공간 Vol.24 No.5

최근 국내에서는 폐광산 지반보강공사를 실시함에 있어 수압식 충전법을 적용하는 사례가 증가하고 있으나 효율적인 충전법 적용을 위한 다양한 연구가 미흡한 실정이다. 본 연구에서는 수압식 충전공법의 충전효율 개선을 위한 충전재료의 입도, 충전관의 형태 및 충전관 직경을 변경해 가면서 현장실험을 실시하였다. No.100체 통과백분율이 16.3% 인 모래를 이용하여 수직관 및 이경티관의 종류에 따른 충전량을 실험결과, 수직관을 이용하여 수로관에 충전한 경우 모래 충전량이 28.84 ton이였고, 100 mm 이경티관을 사용하여 충전한 경우 모래 충전량이 42.62 ton, 80 mm 이경티관을 사용하여 충전한 경우 모래 충전량이 53.33 ton, 50 mm 이경티관을 사용하여 충전한 경우 모래 충전량이 63.33 ton으로 각각 약 47.8%, 84.9%, 119.6% 증가하는 것을 확인할 수 있었다. 이는 단순 충전관의 형태만 변경해도 충전 효과를 극대화 할 수 있을 것으로 기대된다. Hydraulic filling methods are widely applied to suppress the land subsidence recently. But the research on high-efficiency hydraulic filling to protect the land subsidence is rare. In this study, field experiments to improve the efficiency of the hydraulic filling method are performed by changing the property, specification of the filling material and injection pipe. The filling amounts using vertical injection pipe, reducing tee (ø100 mm) pipe, reducing tee (ø80 mm) pipe and reducing tee (ø50 mm) pipe showed 28.84 ton, 42.62 ton, 53.33 ton, and 63.33 ton respectively. The filling rates using reducing tee (ø100 mm) pipe, reducing tee (ø80 mm) pipe and reducing tee (ø50 mm) pipe showed 47.8%, 84.9% and 119.6% respectively. Filling efficiency can be incresed by using reducing tee. This study shows that simply changing the type of injection pipe is expected to increase the hydraulic filling rate.

해설 : 유발지진 관측과 활용

강태섭 ( Tae Seob Kang ),이준기 ( Jun Kee Rhie ),최남수 ( Nam Soo Choi ) 한국지구물리·물리탐사학회 2015 지구물리와 물리탐사 Vol.18 No.1

유발지진은 인류에 의한 수많은 영향 및 다양한 지질학적 조건과 연관되어서 지난 수십 년 동안 관측되어 왔다. 이 논문에서는 다양한 유발지진을 고찰하고 자연적인 조구조 지진뿐만 아니라 유발지진의 종류에 따라 서로 비교한다. 수압파쇄는 암석층에서 새로운 균열을 통해 투수성을 높이는데 보편적으로 사용된다. 이 과정에서 유발지진이 발생하는데, 이 지진은 단열망과 석유/가스의 이동에 관한 중요한 정보를 제공한다. 유사한 방식으로 탄화수소 생산과정이나, 댐 저수지, 채광 활동 또는 폐수 주입 등의 과정에서도 의도하지 않은 유발지진이 발생하며, 이를 이용하여 다양한 수리역학적인 과정과 다양한 규모에서 저류층 특성의 변화를 파악할 수 있다. 일반적인 결론으로 지금까지 알려진 유발지진에 대한 불확실성과 지식의 한계를 요약하고 향후 연구에서 다루어야 할 몇 가지 주제를 제시한다. Induced seismicity has been observed in the relation with lots of anthropogenic influence and at variety of geological conditions over the last several decades. This paper reviews those induced earthquakes and compares with each other as well as with natural tectonic earthquakes. Hydraulic fracturing is commonly used to enhance the permeability through new cracks in the rock formation. The process triggers the induced seismicity, which can give crucial information on the fracture network and oil/gas migration. In the similar way, unintentionally induced events during the production procedure of the field, dam reservoir, minig activity, or wastewater injection can be used to give insight into various hydrodynamic processes and changes of reservoir properties at a various scales. The general conclusion summarizes the uncertainty or limitations of knowledge up to date and presents some issues to be dealt with in the future research.

성인 국소성 분절성 사구체 경화증의 임상경과 및 치료반응

홍화정(Hwa Jeong Hong),임천규(Chun Gyoo Ihm),최태진(Tae Jin Choi),이성배(Sung Bae Lee),최남수(Nam Soo Choi),홍성표(Sung Pyo Hong),이태원(Tae Won Lee),김명재(Myung Jae Kim),양문호(Mun Ho Yang) 대한내과학회 1998 대한내과학회지 Vol.54 No.2

N/A Background: The response to therapy in adult patients with nephrotic syndrome caused by primary focal segmental glomerulosclerosis (FSGS) was discouraging, but recent reports have shown high remission rate. Of these patients in remission, few progressed to end stage renal disease. Methods : we analyzed author's experiences in 42 Korean adults with primary FSGS between January 1986 and December 1995 in attempt to know the response to therapy and outcome. Results: 1) Twenty-six of 42 patients(62%) had nephrotir range proteinuria, and renal insufficiency (serum creatinine>1.4 mg/dL ) was present in 14 patients(34%). Nephrotic patients had higher serum level of creatinine than that of nonnephrotic patients, and there was no difference between the two groups in blood pressure, age, and hematuria. 2) Twenty-six patients with nephrotic range proteinuria received combined treatment with prednisolone and cyclophosphamide. Complete remission (proteinuria≤300 mg/d) was observed in 10 cases(39%), and partial remission(≤2.50g/d) in 10 cases(42%), with mean remission time of 4.1±2.2 months after initiation of treatment. They had remission within 6 months of therapy except one. Relapse was noticed in 11 cases (52%) during follow-up. 3) None of responder group progressed to ESRD, while two of 5 non-responders progressed to ESBD, but there was no significant difference in slope of inverse creatinine between two groups. 4) The degree of proteinuria, initial serum creatinine, age, and sex did not affect the patient's response to therapy 5) The risk factors related to progression of renal failure were the initial serum creatinine level and degree of proteinuria. Conclusion: Nephrotic adult patients with primary FSGS may benefit from a more prolonged course of therapy with prednisolone and cyclophosphamide.

Depletion Syndrome 을 동반한 직장 융모성 선종

이승호,김병호,이정일,김효종,장린,장영운,이정환,동석호,박종오,최남수,이원욱 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.1

Massive secretory diarrhea with pre-renal insufficiency, hyponatremia, hypokalemia and metabolic alkalosis or acidosis is associated with some large villous adenomas of the rectum and is called with depletion syndrome. This characteristic fluid and electrolyte depletion syndrome is caused by secretion of sodium, potassium, and fluid from the tumor. PGE2 formation in the villous adenoma appears to be the cause of fluid secretion by the abnormal tumor epithelium. Surgical removal of villous adenoma is the only promising therapy, In case of inoperability, denial of surgical intervention or just for palliative treatment prior to surgery, the use of PG synthetase inhibitors may facilitate the correction of severe fluid-electrolyte deficits. We reported a case of large villous adenoma of the rectum with depletion syndrome aceompanied by secretory diarrhea and fluid and electrolyte depletion with metabolic alkalosis due to severe vomiting.