캡슐내시경과 단일풍선 소장내시경으로 진단된 공장의 간질종양 1예

송도경,심기남,태정현,김경진,송명은,송하응,윤혜원,정가영,정정화 이화여자대학교 의과학연구소 2012 EMJ (Ewha medical journal) Vol.35 No.2

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4×2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.

자궁경부암 선별검진을 위한 PapSure 검사에서 Spiral Brush의 유용성에 관한 연구

송언호,김어진,명나혜,박충학 대한부인종양 콜포스코피학회 2002 Journal of Gynecologic Oncology Vol.13 No.4

2001년 12월 1일부터 2002년 6월 30일까지 만 7개월 간 단국대학교의료원 산부인과 부인종양 Clinic에서 자궁경부암 선별검진을 위한 PapSure 검사를 시행한 환자 중 SpiraBrush Cx_® 검사를 실시한 33예를 대상으로 하여, 기존의 Papanicolaou 세포진 검사의 진단과 SPiraBrush Cx_®)에 의한 Papanicolaou 세포진 검사의 진단 및 최종적인 병리조직학적 진단을 비교, 분석하여 SpiraBrush Cx_®에 의한 세포진 검사가 생검에 의한 조직검사를 대체할만한 유용성이 있는지 그 여부를 조사하기 위하여 본 연구를 시행하여 다음과 같은 결과를 얻었다. 1. 환자의 연령별 분포는 21세에서 70세까지였으며 40-49세 군이 42%로 가장 많은 분포를 보였고, 평균 연령은 45.7세였다. 2. 환자의 평균 임신횟수는 3.6회였으며, 평균 출산횟수는 2.0회였다. 3. 기존의 자궁경부 세포진 검사(Conventional Papanicolaou cytology)상 진단이 음성으로 나온 경우가 19예(57.6%)였고, ASC를 포함하여 양성으로 나온 경우가 14예(42.4%)였다. 자궁경부 형광경진 검사(Speculoscopy)에서는 음성이 13예(39.4%)였고, Suspicious 진단을 포함하여 양성으로 나온 경우가 20예(60.6%)였다. SpiraBrush Cx®에 의한 세포진 검사(SpiraBrush Cx_® Papanicolaou cytology)에서는 진단이 음성인 경우가 8예(24.2%)였고, ASC를 포함하여 양성으로 나온 경우가 25예(75.8%)였다. 4. 병리조직학적 검사의 진단은 음성 12예(52.2%), 저등급 편평상피내병변(Low-grade Squamous Intraepithelial Lesion: 이하 LSIL이라 함) 2예(8.7%), 고등급 편평상피내병변(High-grade Squamous Intraepithelial lesoin: 이하 HSIL이라 함) 3예(13.0%), 편평세포암(Squamous Cell Carcinoma: 이하 SCC라 함) 6예(26.1%)였다. 5. 검사 결과의 양성판정 기준을 세포진 검사의 경우는 ASC 이상으로 하고 조직학적 검사의 경우는 LSIL이상으로 정할 경우, 기존의 Papanicolaou 세포진 검사의 민감도는 63.6%이고 특이도는 66.7%였으며, SpiraBrush Cx_®세포진 검사의 민감도는 90.9%이고 특이도는 33.3%였다. 이상의 결과로 미루어 볼 때 연구 대상의 숫자가 적어서 통계학적인 유의성은 찾을 수 없으나 SpiraBrush Cx_®가 자궁경부암 선별검진에서 생검에 의한 자궁경부의 조직학적 진단을 대체하지는 않는다고 판단된다. 그러나 기존의 Papanicolaou 세포진 검사의 민감도가 63.6%인데 반하여 SpiraBrush Cx_® 세포진 검사의 민감도는 90.9%로 훨씬 더 높았으며 이로 인해 SpiraBrush Cx_® 세포진 검사의 특이도는 33.3%로 훨씬 낮았는데 이는 매우 흥미있는 사실로서 향후 많은 Data로 더욱 연구하여 진위를 구분함이 필요하리라 사료된다. 또한 본 연구에서는 SpiraBrush Cx_® 기구의 강모들이 단단하고 날카로워서 기저막층까지의 조직과 상피층 세포들을 탈락시키면서 많은 출혈을 초래하여 슬라이드 판독에 어려움을 주었고 이는 연구 결과에 지대한 영향을 미쳤으리라고 생각되는 바, 이러한 출혈로 인한 요인을 최대한 배제하기 위하며 향후 SpiraBrush Cx_® 세포를 채취한 후 최신의 자궁경부 세포진 검사법인 ThinPrep Pap Test를 이용하거나 조직표본을 만들기 위한 Cellblock 기법을 사용하여야 한다고 판단된다. Objective : The purpose of this study was to investigate the clinical efficacy of a new stiff bristled spiral shaped brush (SpiraBrush Cx_(??))∼in) PapSure Test for cervical cancer screening, by comparing SpiraBrush Cx_(??) cytologic diagnoses with conventional Papanicolaou cytologic diagnoses and final histologic diagnoses. Methods : This study was performed in Gynecologic Oncology Clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from December I, 2001 to June 30, 2002. Thirty three cases who underwent PapSure Test (Pap cytology t Speculoscopy) were analyzed. SpiraBrush Cx_(??) Papanicolaou cytologic diagnoses were compared with conventional Papanicolaou cytologic diagnoses and histologic diagnoses as a reference standard. Results : Followings are the results summarized. 1. Age distribution was between 21 and 70. The mean age was 45.7 years. 2. The mean gravidity was 3.6 and the mean parity was 2.0. 3. There were 19 (57.6%) conventional Papanicolaou cytologic diagnoses of Negative, and 14 (42.4%) of Positive including ASC. There were 13 (39.4%) Speculoscopy diagnoses of Negative, and 20 (60.6%) of Positive including Suspicious. There were 8 (24.2%) SpiraBrush Cx_(??) cytologic diagnoses of Negative and 25 (75.8%) of Positive including ASC. 4. There were 12 (52.2%) histologic diagnoses of Negative, 2 (8.7%) of LSIL, 3 (13.0%) of HSIL, and 6 (26.1%) of SCC, according to the criteria of TBS, 2001. 5. For detecting LSIL or worse lesions, conventional Papanicolaou cytologic test yielded sensitivity of 63.6% and specificity of 66.7%. On the other hand, SpiraBrush Cx_(??) cytologic test yielded sensitivity of 90.9% and specificity of 33.3%. Conclusion : SpiraBrush Cx_(??) cytologic diagnosis does not seem to have clinical efficacy replacing the histologic diagnosis by punch biopsy in cervical cancer screening in this study. But further studies using ThinPrep Pap Test or Cellblock techniques with large data will be required and anticipated.

갑상선기능저하증 이환견에 대한 치료 증례

김혜원,이선희,임수정,박형진,김태신,송은식,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 10-year-old, male, poodle dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University because of continuous cough and cardiomegaly. Weight gain, lethargy, unwillingness to exercise and decreased activity was revealed on history. Obesty and alopecia was also observed on physical examination. Hypercholesterolemia and increased ALP was revealed on blood exam. So, evaluation of thyroid gland function was performed and cTSH concentration was increased. tT4 and fT4 concentrations was decreased. Results of a history, physical examination, blood exam, and thyroid gland fuction test support a diagnosis of hypothyroidism. Initial therapy with sodium levothyroxine was indicated. On 32 days after treatment of hypothyroidism, clinical signs was relieved and cTSH concentration was decreased, tT4 and fT4 concenctrations was increased.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

장기 이식 환자에서 Voriconazole 과 Cyclosporine 또는 Tacrolimus의 상호작용

한혜원,김재연,송영천,김승은,유성길 한국병원약사회 2009 병원약사회지 Vol.26 No.1

Abstract: In organ transplant patients, the opportunity of fungi infections such as invasive aspergillosis increase by use of immunosuppresant drugs and voriconazole is recommended as primary treatment drug. When voriconazole is administered with cyclosporine(CsA) or tacrolimus(FK506), caution about increment of blood CsA or FK506 concentrations that caused by the change of CYP3A4 activity is required but few domestic cases of interaction were reported yet, The purpose of this study was to assess the effect of voriconazole on the blood CsA or FK506 concentrations in transplant recipients and the factors of recipients that have an effect on the results. 25 transplant recipients who were administered voriconazole with CsA or FK506 from January 1 of 2006 to August 17 of 2008 in Asan Medical Center were objects (12 patients on CsA coadministration arm - 9 males, 3 females; 41~62years;2 liver, 2 kidney, 3 bone marrow, 5 heart transplant recipients, and 13 on FK506 coadministration arm - 7 males, 6 females;26~65years; 10 liver, 2 kidney, 1 heart transplant recipients). Blood CsA or FK506 concentrations before and after coadministration of voriconazole, and maximum concentration in one month from the first day of coadministration were monitored retrospectively. In most cases CsA or FK506 were administered as recommended doses regardless of coadministration of voriconazole, and blood concentration increased from 239.42±126. 77ng/ml to maximum 411.92±225. 76ng/ml in CsA coadministration arm(p=0.003), and from 7.72±2.79ng/ml to maximum 19.16±9.35ng/ml in FK506 coadministration arm(p=0.003). Gender, age, and the kind of transplant organ did not affect to the change of blood concentration in both two arms. In consequences, administration of voriconazole could affect on the blood CsA or FK506 concentration, and in cases of administra tion of voriconazole in transplant recipients treated with CsA or FK506, close monitoring and dose adjustment is needed.

A rare case of extensive papillary muscle calcification in senile cardiac calcification syndrome

김은진;송봉근;강민호;손형래;홍수민;박동원;허승혜;김계연;최석구 인제대학교 2011 仁濟醫學 Vol.32 No.-

광범위 유두근 석회화는 흔하지 앉으며, 원인과 임상적 중요성에 관한 문헌만 드물게 찾아볼 수 있다. 반면에 작은 석회 침착은 노인에서 흔하며 심장 첨부에 주로 나타난다. 유두근 석회화는 관상동맥질환, 확장성 심근병증, 승모관 질환, 고칼슘혈증, 그리고 말기신부전에서 인산칼슘의 중가와 연관성이 있다. 저자는 심장초옴파와 MDCT를 통해 진단된 전외측 유두근의 광범위 석회화의 드문 사례가 있어 보고한다.

새로운 반복단위에 의한 GABARB1 유전좌의 염기서열다형성과 한국인에서 대립 유전자의 빈도

이혜린,이혜승,송은섭,한길로,황적준 大韓法醫學會 1998 대한법의학회지 Vol.22 No.2

To determine allele frequency of GABARB1 Jcus in Korean, first, we sequenced each allele, which was amplified with primers that published before. We found mismatching between allele number and size of each allele when 'GATA' repeats are counted. The sequence revealed new 'GATA' repeat. So we had made new allele designation with total number of in 176 Korean people. The heterozygosity this locus was 0.716 and mean exclusion chance (MEC) and power of discrimination (PD) were 0.433 and 0.845, respectively. In this study, we emphasized necessity of sequencing of 2-3 alleles, which have same size before setting up allelic ladder.

유용성 도료와 수용성 도료의 유해성 비교에 관한 연구 : 자동차 보수용 도료를 중심으로

권은혜,김광식,오정룡,최정근,정윤석,이유진,김은아,송세욱,정호근 한국산업위생학회 2001 한국산업보건학회지 Vol.11 No.1

The purpose of this study is to substitute water-based painting materials for the current solvent-based ones used in motor-repairing process to minimize the exposure of organic solvents to the painters. This study assessed the exposure of organic solvents to the painters using water-based and solvent-based painting materials and compared compositions, painting processes and the health hazards of the application of these alternative painting materials. The results of this study are as follows. 1. solvent-based painting materials used in motor-repairing process consist of various organic solvents, which consist primarily of toluene, xylene, ethyl benzene, ethyl methyl bezene, trimethyl bezene, ethyl acetate, butyl acetate, methyl isobutyl ketone, 2-ethoxy ethanol, 2-ethoxy ethyl acetate and toluene-2.4-diisocianate and the others. These organic solvents are know as health-hazardous substances. But water-based painting materials are high-solid, low-solvent ones and consist of such two organic solvents as 2-butoxy ethanol and 2-heptanone and the others. 2. The painters using solvent-based painting materials in motor-repairing process are exposed to various organic acetate, methyl isobutyl ketone, trimethyl benzene, 2-ethoxy ethanol, and 2-ethoxy ethyl acetate. But the painters using solvent-based ones are only exposed to 2-butoxy ethanol and 2-heptanone. 3. By using water-based painting materials in stead of solvent-based painting materials containing health-hazardous organic solvents, the exposure of such organic solvents in the painter's breathing zone can be largely prevented. 4. This study recommends water-based painting materials as substitutes for the current solvent-based ones used in motor-repairing process to minimize the exposure of organic solvents to the painters.

중환자실 병원감염에 대한 다기관 공동 조사연구

박은숙,박미라,진혜영,김정은,최정실,송영구,최영화,이위교,홍성관,허애정,양동규,김준명 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

입력성형기법을 이용한 변위증폭형 마이크로스테이지 잔류진동제어

배규현,송은혜,강중옥,홍성욱 한국공작기계학회 2009 한국공작기계학회 춘계학술대회논문집 Vol.2009 No.-

This paper presents a result of application of input shaping to a micro-stage with a displacement amplification mechanism. The stage considered in this study is subjected to severe residual vibration in its lever mechanism to amplify displacement. The system dynamics exhibit some nonlinear nature due to the hysteresis of the PZT actuator. Input shaping method is successfully applied to the system so as to eliminate residual vibration from the system. The experimental study also shows that staircase input is useful to avoid the performance degrade by the nonlinear characteristics.