췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

고령자 급성 췌장염의 임상적 고찰

이진헌,강진경,박인서,송건훈,정재복,백용한,송시영,서정훈 대한소화기학회 1998 대한소화기학회지 Vol.32 No.3

Background/Aims: Inflammatory diseasas of the pancreas are not uncommon. The advanced age is one of the significant factors in assessing the severity of acute pancreatitis. It has been shown that the biliary tract disease is a more frequent cause of acute pancreatitis in the elderly than in the young. With the increased life span, the elderly are comprising a large proportion of the population. As a result, physicians are more often being faced with acute pancreatitis in the elderly. The purpose af this study was to evaluate clinical features of acute panereatitis in the elderly. Methods: A total of 188 patients with acute pancreatitis were reviewed. We investigated the differences of clinical characteristics between the elderly patients aged over 60 and the young patients aged under 60. Results: The sex distribution showed male preponderance in the young patients (M:F=2.4:1), but was nearly equal in the elderly patients (M:F=1.1:1). The most common cause of acute pancreatitis in the elderly was biliary tract disease (52.5%), while alcohol abuse was the most common cause in the young patients (38.8%), Local complications of acute pancreatitis, such as psuedocyst, necrosis, abscesses were not differently shown between the elderly (16.9%) and the young (20.2%) patients. Systemic complications including acute puhnonary failure occurred more frequently in the elderly patients than the young patients. The mortality rate of the elderly patients (5.1%) was not significantly different from that of the young patients (3.1%). Conclusions: To detect correctable underlying bihary tract diseases the elderly patients with acute pancreatitis should be completely investigated using endoscopic retrograde cholangiopancreatography (ERCP). In addition, the patient should be closely monitored for the development of the systemic complications during the disease process.

고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

지난 2년간의 학회지 "신경정신의학" 심사 평가보고

김찬형,김세주,김도관,김성곤,박원명,송동호,박용천,이영문,오강섭,정영철,이상열,김주한,이동영,이헌정,함병주,김율리,김문두,김정진,이강욱,천근아,김재진,홍진표,홍승철 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Gilbert 증후군에서 열량 제한 시험과 Phenobarbital 자극 시험의 의의(14예)

이헌영,채경훈,정재훈,강윤세,김연수,문희석,박기오,이엄석,김선문,김석현,성재규,이병석,이강욱 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Gilbert 증후군은 인구의 7%에서까지 나타날 수 있는 매우 흔한 증후군으로서 비진행성인 양성의 만성적 경과를 치하며, 간질환의 증상과 징후가 없는 경한 비포합형 고빌리루빈혈증이 특징인 일종의 체질적인 증상으로서 혈장 빌리루빈 농도에 대한 사춘기의 영향 때문에 10대와 20대에 자주 진단이 된다. 따라서 임상적인 중요성은 미약하지만 높은 빈도가 예상되는 점에 그 중요성이 부여되어야 할 것이다. 따라서 적정한 임상적 진단법으로 기왕에 소개된 열량제한 시험과 phenobarbital 유도 시험을 시행하고 이들의 진단적 가치를 알아보기 위하여 본 연구를 시행하였다. 1990년 7월부터 1999년 4월까지 충남대학교병원에 내원하여 HBsAg, IgG anti-HBc 및 anti-HCV가 음성이고, 간 초음파 스캔에서 이상이 없으며, 혈청 AST, ALT 및 AP가 정상인 비음주자에서 경한 비포합형 고빌리루빈혈증이 있는 14예의 환자들을 대상으로 ^(99m)Tc-DISID 스캔을 시행하였으며, 기저 치 총빌리루빈 및 포합형 빌리루빈 치를 측정한 다음에 하루에 400Kcal로 48시간동안 제한한 열량 제한 시험을 시행하였고, phenobarbital을 하루 60mg씩 5일간 투여한 후에도 각각 총빌리루빈과 포합형 빌리루빈 치를 검사하여 비포합형을 구하였다. 대상 환자들은 모두 14예로서 남자가 11예(78.6%)였고 여자가 3예(21.4%)여서 3.7:1로 남자에서 많았으며, 20대가 6예(42.9%), 30대가 역시 6예(42.9%) 및 40대가 2예(14.2%)로서 2,30대가 대부분(85.8%)이었다. 열량 제한 시험 후의 총빌리루빈 치, 비포합형 및 포합형 빌리루빈 치들은 평균 각각 5.5±2.7, 4.2±2.3 및 1.3±10mg/dL 로서, 시험 전 치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg/dL 보다 유의하게(p=0.001, p=0.001, p=0.023) 상승하였다. 포합형 빌리루빈 치도 유의하게 상승하였으나 비포합형의 상승보다는 훨씬 낮아서 주로 비포합형이 증가하였다. phenobarbital 투여 중 설사가 발생하여 중단한 1예를 제외한 13예에서 열량 제한 시험 후에 상승하였던 총, 비포합형 및 포합형 빌리루빈 치가 phenobarbital 유도 시험후에는 2.0±1.1, 1.5±0.8 및 0.5±0.4mg/dL로서 열량 제한 시험 결과보다 유의하게 낮아졌고(p=0.00, p=0.000, p=0.001), 열량 제한 시험 전의 기초치들인 3.0±0.8, 2.2±0.8 및 0.7±0.4mg.dL 보다도 더욱 낮아졌으며 유의한 차이(p=0.001, p=0.02, p=0.005)를 나타내었다. 14예에서 시행한 ^(99m)-Tc DISIDA 스캔에서 9예(64.3%)가 정상이었고, 5예(35.7%)에서는 심장 및 신장으로의 간외 섭취가 3예였고, 60분까지 소장 배출이 없는 배설 지연 예와 담낭 수축 불량 예가 각각 1예 씩 발견되었다. Phenobarbital 투여시험에서 민감도가 열량제한시험에 비해 더 높았다(92.3%와 50.0%). Gilbert 증후군에서 1일 400 Kcal로 48시간의 열량제한 시험과 1일 60mg의 phenobarbital을 5일간 투여하는 유도 시험은 편리하고 유용한 임상적인 진단법으로 이용할 수 있다고 생각된다. 그러나 열량 제한 시험에서는 증가 기준의 통일이 필요하다고 유추되며 phenobarbital 유도 시험이 민감도가 더 높은 것으로 생각된다. Gilbert's syndrome is very frequent and benign chronic process characterized by mild, intermittent, unconjugated hyperbilirubinemia without any symptom and sign of liver disease. Previously intoduced caloric restriction test and phenobarbital stimulation test as two appropriate clinical tests had been examined and their diagnostic values were reevaluated. Fourteen patients with mild, persistent, unconjugated hyperbilirubinemia were included. Subsequently caloric restriction has been applicated by 400 Kcal/day for 48 hours and phenobarbital has been prescribed by 60 mg/day for 5 days. Therafter serum levels of total and direct bilirubin were measured. Most of the patients were third and fourth decade(85.8%) and male predominant. Each basal serum levels of total, indirect and direct bilirubin were 3.0±0.8, 2.2±0.8 and 0.7±0.4 mg/dL. After caloric restriction test, each levels were increased significantly to 5.5±2.7, 4.2±2.3 and 1.3±1.0 mg/dL(p=0.001, p=0.001, p=0.023). After phenobarbital stimulation test for 13 patients had been practiced, increased levels of each bilirubin after caloric restriction test were decreased significantly to 2.0±1.0, 1.5±0.8 and 0.5±0.4 mg/dL(p=0.000, p=0.000, p=0.001) and these levels were significantly lower than basal levels(p=0.001, p=0.02, p=0.005). The sensitivities of caloric restriction test were 85.7%, 50.0%, and 71.4%, 35.7%(1.0, 1.5 mg increase of total bilirubin and 1.0, 1.5 mg/dL increase of indirect bilirubin). The sensitivities of phenobarbital stimulation test were 93.2% and 92.3% at criteria of 1.5 mg/dL increase of total bilirubin and indirect bilirubin. On the diagnosis of Gilbert syndrome, caloric restriction test and phenobarbital stimulation test are convenient and useful diagnostic tools in clinical face. And also phenobarbital stimulation test has higher sensitivity than caloric restriction test. Furthermore, standardization of bilirubin increment would be necessary in caloric restriction test.

Contribution of stress and coping strategies to problematic Internet use in patients with schizophrenia spectrum disorders

Lee, Ju-Yeon,Chung, Young-Chul,Song, Je-Heon,Lee, Yo-Han,Kim, Jae-Min,Shin, Il-Seon,Yoon, Jin-Sang,Kim, Sung-Wan Elsevier 2018 Comprehensive psychiatry Vol.87 No.-

<P><B>Abstract</B></P> <P><B>Introduction</B></P> <P>Internet use is already high and increasing rapidly among people with psychotic disorders, but there have been few studies on problematic Internet use (PIU) among patients with schizophrenia spectrum disorders. This study aimed to measure the prevalence of PIU and identify the factors associated with PIU among patients with schizophrenia spectrum disorders.</P> <P><B>Methods</B></P> <P>A cross-sectional survey was performed that included 368 outpatients with schizophrenia spectrum disorders: 317 with schizophrenia, 22 with schizoaffective disorder, 9 with schizophreniform disorder, and 20 with other schizophrenia spectrum and psychotic disorders. The severity of psychotic symptoms and levels of personal and social functioning were assessed by the Clinician-rated Dimensions of Psychosis Symptom Severity (CRDPSS) scale and the Personal and Social Performance (PSP) scale, respectively. PIU was evaluated using Young's Internet Addiction Test (IAT). Additionally, the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Rosenberg Selfesteem Scale (RSES), and Brief Coping Orientation to Problems Experienced (COPE) Inventory were administered.</P> <P><B>Results</B></P> <P>PIU was identified in 81 (22.0%) of the 368 patients with schizophrenia spectrum disorders. Subjects with PIU were significantly younger and more likely to be male. Scores on the HADS, PSS, and dysfunctional coping dimension of the Brief COPE Inventory were significantly higher, and RSES scores were significantly lower, in the PIU group. Logistic regression analysis indicated that PIU in patients was significantly associated with scores on the PSS and dysfunctional coping dimension of the Brief COPE Inventory.</P> <P><B>Conclusions</B></P> <P>Patients with schizophrenia spectrum disorders and PIU were significantly more likely to have high levels of perceived stress and dysfunctional coping strategies. Patients with schizophrenia spectrum disorders who also engage in PIU may benefit from interventions that help them to develop appropriate skills for coping with stress.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Patients with schizophrenia spectrum disorders showed a high prevalence (22.0%) of problematic internet use (PIU). </LI> <LI> High levels of perceived stress rather than psychopathology itself contributes to the development of PIU in stabilized patients with schizophrenia. </LI> <LI> Our results indicate that managing stress and developing coping strategies are important for the prevention of PIU among this group of patients. </LI> </UL> </P>

B형 만성 활동성 간염 환자에서 Prednisolone 단기이탈 및 Alpha Interferon 병합요법의 효과

이종선,김병호,성자원,허승식,이기천,정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To evaluate the safety and efficacy of Pd withdrawal followed by recombinant alpha- Interferon 2b therapy. Nine patients were given a single daily subcutaneous injection of ^α-Interferon at a dose of 3 x 10 exp(6) units/day for first weeks and thrice weekly for next 15 weeks (maintenance) after pd tappered over 6 weeks. To evaluate the efficacy of therapy, we measured serum aminotransferase activities monthly during and after therapy, and also measured serm HBsAg, HBeAg and DNA probe before and after therapy. To evaluate the safety of therapy, all patients checked peripheral blood WBC, Hemoglobin, Platelet, BUN and Creatinine. The results were as follows : 1. In control group, the normalization of s-AST & ALT level, negative seroconversion of DNA probe & HBeAg were observed in 1/12(8%) & 7/10(17%), 0/10(0%) & 0/12(0%) at 6 months later, and maintained response in 1/11(9%) & 1/11(9%), 2/9(22%) & 2/11(18%) until 1 years later. 2. In treatment group, Serum AST and ALT returned to normal in 8/9 & 8/9 cases (89%) after 1 montns Tx. (mean serum AST : 33±8, ALT : 34±12 IU/ml) and maintained to normal response in 5/9(56%) & 6/9 cases(67%)after 6 months Tx. (mean s-AST : 55±43, ALT : 66±84 IU/ml), 3/9(33%) & 4/9 cases(44%) after 1 years Tx. It was statistically significant reponse except s-AST of after 1 years Tx. 3. In treatment group, s- HBeAg returned to normal in 3/9 cases(33%) after 1 months Tx., and maintained to normal response in 1/7 & 1/4 cases among follow up patients in after 6 & 12 months Tx. Serm DNA probe level were observed significantly negative seroconversion in 8/9 cases(89%) after 1 months Tx. (p<0.003), and maintained to negative response in 2/6 & 1/3 cases after 6 & 12 months Tx. 4. Serum AST, ALT, HBeAg and DNA probe were not significantly correlated with therapeutic response in relation to histologic diagnosis. 5. Fever and myalgia were noted in 9(100%) & 6(67%) cases. Headache, mild hair loss, anorexia, nausea, facial flushing & diarrhea were noted in few cases. Peripheral WBC(3cases) & platelet counts(3cases) were decreased transiently. This study shows that Pd withdrawal followed by recombinant alpha Interferon 2b therapy may be safe and effective in decrease the level of s-DNA probe, transaminase activity, loss of HBeAg and less adverse effect of clinical and hematologic examinations in patients with CAH type B. But it was necessary for study with large number of patients, more prolonged follow up duration and more strict control study.

폐암과 동반되어 나타난 기관기관지병증 골연골형성증 1예

이영진,전현수,박시형,김모세,김현주,이승헌,이영민,이현욱,이현경 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Tracheobronchopathia osteochondroplastica (TPO) is a rare benign disease of unknown etiology characterized by multiple cartilaginous or bony submucosal nodules, which project into the tracheobronchial lumen. Although some disorders were reported combined with TPO, these seemed to be considered casual. We report a case of TPO that combined with adenocarcinoma of lung. She was 50-year-old non smoking woman presented with chronic cough with right chest pain. Lung mass on right lower lobe was found on chest x-ray, so lung cancer was suspected. Multiple scattered whitish small elevations from trachea to bronchial trees were found on bronchoscopic exam. We mistook these lesions for metastases from lung cancer and biopsies of these lesions were done. Transbronchial biopsy for right lower lobe mass lesion was also done. But biopsies from trachea and bronchus revealed TPO rather than lung cancer. Transbronchial lung biopsy of right lower lobe mass was diagnosed adenocarcinoma of lung. So TPO combined with adenocarcinoma of lung was diagnosed.

위암 환자에게 세포성 면역 기능에 관한 연구

이재익,윤일국,이종선,김종완,장준,안정기,송민호,정현용,이헌영,김상용,김영건 忠南大學校 癌共同硏究所 1991 癌共同硏究所 硏究誌 Vol.1991 No.-

만성활동성간염과 간경변에서의 고-Alpha Fetoprotein 혈증의 의의(Ⅰ)

이현영,이종선,정현용,이복희 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

Ten patients with chronic liver disease, whose serum levels of AFP were markedly increased, were detected from Jan. 1985 to Sep. 1990. The clinical and laboratory findings were examined and the results were as follows. 1. The objective patients were 4 males and 6 females, and their mean age was 40.2 years old. Five cases were chronic active hepatitis-B, and the other 5 cases were liver cirrhosis. 2. At the time of first examination, the mean level of serum AFP was 499ng/ml and this initial level of AFP declined to 10.4ng/ml after 5.1 monthes. 3. Initially the mean levels of serum AST, ALT and ALP were 271.7, 299.1 and 177.1 IU/L, and after 5.1 monthes these levels were changed to 61.0, 53.6 and 72.1 IU/L.