바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

연마방법에 따른 탄성의치의 표면거칠기와 Candida albicans의 부착율 변화

오주원,서재민,안승근,박주미,강철균,송광엽 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.2

연구 목적: 본 연구는 탄성의치 제작 시 주로 사용되는 polyamide를 수종의 연마방법을 사용하여 처리 후 Candida albicans의 부착정도와 표면거칠기를 비교하고자 하였다. 연구 재료 및 방법: 25×15×2 mm 크기의 polyamide 시편을 4군으로 나누어 연마재를 사용하여 기공용 lathe 연마하는 방법(기공실내 연마방법)과 각기 다른 2종의 실리콘 포인트로 진료실내 연마하는 방법, 그리고 실리콘포인트 연마 후 pumice로 연마하는 방법으로 처리하였다. C. albicans의 부착성을 평가하기 위해 5×106 CFU/ml의 C. albicans 현탁액에 시편을 2시간 동안 침적하였고 5회 수세처리 후 한천배지에서 배양하였다. 그리고 주사전자 현미경(JSM-5900, JEOL LTd., Tokyo, Japan) 촬영을 시행하였다. Profilometer (Surf-pak; Kawasaki, Japan)를 이용하여 표면거칠기를 측정하였고 통계처리를 위하여 SPSS 18.0 프로그램을 사용하였다. 일원변량분석으로 비교 분석하였고 사후검증은 C. albicans의 부착성 검증을 위해 Scheffe test를 시행하였으며 표면조도검증을 위해 Tamhane’s T2 test를 시행하였다(α=.01). 결과: 최대 거칠기 값을 보인 군은 2단계의 연마용 버를 사용한 것으로 0.32 ㎛±0.10 값을 나타냈으며, 가장 낮은 거칠기 값을 보인 것은 tungsten carbide를 사용하지 않고 기공용 lathe로만 연마를 한 군으로 0.02 ㎛±0.00의 거칠기 값을 나타냈다. C. albicans 부착 실험에서는 기공용 lathe만을 이용한 연마방법이 가장 적은 부착수를 보였으며 다른 세 군과 유의한 차이가 발견되었다(P<.01). 결론: 표면거칠기 및 미생물 부착능 실험 결과 기공실 연마만을 시행한 경우 유의하게 낮은 거칠기 값과 부착율을 보였다. Pumice로 추가 연마한 군은 진료실연마를 시행한 군에 비해 낮은 거칠기 값을 보였으나 C. albicans 부착에 있어서는 유의한 차이를 보이지 않았다(P>.01). Purpose: The purpose of this study was to compare the effect of 3 chairside polishing methods and laboratory polishing methods on surface roughness and C. albicans adhesion of polyamide denture base. Materials and methods: Using contact profilometer, the surface of polyamide specimens (25×15×2 mm) was studied after conventional polishing without finishing and after chiarside polishing with 2 chiarside polishing kits and chairside-pumice polishing following finishing with tungsten carbide bur. To evaluate the adhesion of C. albicans, C. albicans suspension was overlayed on the test specimen. And the specimens were incubated for 2 hours. Imprint culture method was achieved and counted the colony on the agar plate. Polished polyamide were evaluated using a scanning electron microscope. The statistics were conducted using one-way ANOVA and in case of difference, Scheffe test and Tamhane’s T2 test were used. Results: Surface roughness (Ra) of surfaces polished with 2 chairside polishing kits had higher than conventional polishing and pumice polishing. The highest roughness value was 0.32 ± 0.10 ㎛, and the lowest was 0.02 ± 0.00 ㎛. The adhesion of C. albicans on the specimens polished with chairside polishing group and pumice polishing group were increased than conventional polishing group (P<.01). Conclusion: Conventional laboratory polishing was found to produce the smoothest surface and the lowest adhesion of C. albicans. Two groups polished with Chairside polishing kits were similar with respect to surface roughness. Surface of the specimen polished with pumice is significantly smoother than 2 chairside polishing groups, but the result of C. albicans adhesion is that group polished with pumice was similar with 2 chairside polishing groups (P>.01).

이하선 종양에 관한 임상적 연구

백승,하주원,오희균,유선열,김원재 大韓顎顔面成形再建外科學會 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.5

This is clinical study on 113 patients who were treated for parotid tumors at Chonnam National University Hospital over a period of 5 years from January 1996 to December 2000. The results were as follows ; The mean ages were 42.6 years old (12∼73 years) for benign parotid tumor patients and 43.9 years old (2∼74 years) for malignant patients. The ratio of male to female was 1:2 in malignant parotid tumors, but there was no difference in benign tumors. There was no difference in mean mass size and duration of illness between benign and malignant tumor patients. The combined usage of fine needle aspiration biopsy and computed tomogram was common as the diagnostic methods of parotid tumor. The parotid tumors were commonly located in the superficial lobe (69%). The ratio of benign and malignant tumors was 4:1. The most common benign tumor was pleomorphic adenoma (72% of benign tumor), followed by Warthin's tumor and monomorphic adenoma. The most common malignant tumor was mucoepidermoid carcinoma (45% of malignant tumor), followed by adenoid cystic carnoma, carcinoma ex pleomorphic adenoma, and adenocarcinoma. The most common operations were superficial parotidectomy (72%) for benign parotid tumor and total parotidectomy (45%) for malignant tumor. The most common postoperative complication was temporary facial nerve weakness (82%), followed by Frey's syndrome (14%) and permanent facial palsy (4%). Postoperative radiation therapy was done in 12 patients (60%) and the mean radiation dose was 5550±620 cGy. Of 113 cases, tumor recurrence developed in 12 cases (10%). These results suggest that the successful management of parotid gland tumors needs adequate surgical treatment on the basis of knowledge of parotid gland anatomy and preoperative diagnosis.

원형구멍이있는 띠모양평판에서의 광탄성 실험법에 의한 應力해석

박세만,박명균,정재진,백범선,김용주 明知大學校 産業技術硏究所 1994 産業技術硏究所論文集 Vol.13 No.-

A stress analysis on a strip with a circular hole was carried out by the computer assisted photoelastic experimental method. A stress concentration phenomenon around the hole of a strip under axial loading was carefully investigated through this study. The result shows that it well agrees with the results of finite element method and photoelasticity. We suggest that computer assisted photoelasticity experiment is very efficient method for data analysis compared to conventional experimental stress analysis method.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

간내 간충병에 대한 간절제술 1예

심민철,김홍진,권광보,노성균,이헌주,이태숙,장재천 영남대학교 의과대학 1990 Yeungnam University Journal of Medicine Vol.7 No.1

영남대학교 의과대학 외과학교실에서는 1989년 11월에 한국에서 발병한 간흡충병의 여섯 번째 증례로, 특히 간내 담관에 발생한 첫 증례를 우측 간엽 절제술 및 담낭 적출술로 좋은 결과를 얻었으며, 간내 담관에 발생한 경우에는 간암과의 구별이 요구되어야 한다는 점을 상기 시키면서 증례보고와 더불어 문헌적 고찰을 하였다. Human Fasciola hepatica infection is a rare entity involving infestation of the liver and biliary tree with adult flukes, which can result in hepatitis, cirrhos is and biliary tract inflammation, obstruction and lithiasis. The patient had the typical diagnostic tetrad of fever, eosinophilic leukocytos is, tender hepatomegaly and fluke ova in the stools. Theatment consistes of Emetine hydrochloride administration for hepatic involvement and common bile duct exploration for removal of flukes, with cholecystectomy for associated cholelithiasis. The combination of medical and surgical therapy cal be expected to produce an arrest of this infection. The removed liver revealed eggs of the fasciols species in the intrahepatic bile duct. The clinical history, pathological findings and treatment of this case were described.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

전신마취 후 발생한 악성고열증 환자의 치료 경험

이근무,정승환,이정한,정순호,최영균,김영재,신치만,박주열,이영민 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Malignant hyperthermia is the disorder of calcium regulation within skeletal muscle associated predominantly with anesthesia. It is triggered by volatile anesthetics and depolarizing neuromuscular blocking agents. We experienced a case of malignant hyperthermia. 50 years old female patient was transferred to our emergency room that she was developed tachyarrhythmia and high fever. She was taken arthroscopic examination under the general anesthesia with enflurane and succinylcholine. We suspected malignant hyperthermia and promptly treated her with dantrolene sodium. She was developed disseminated intravascular coagulopathy and acute renal failure then we were intensive care to her. She was discharged without sequela. We experienced successful management of malignant hyperthermia.

Clinicopathologic Characteristics of Patients with Gastric Carcinoma of the Cardia

Jae Kyun Ju,Hyung Soo Kim,Dong Yi Kim,Seong Yeob Ryu,Young Kyu Park,Young Jin Kim,Shin Kon Kim 대한외과학회 2006 대한외과학회 학술대회 초록집 Vol.2006 No.5

Air Pollution and Hearing Loss

Min Jae Ju(Min Jae Ju),Sung Kyun Park(Sung Kyun Park),Sun-young Kim(Sun-young Kim),Yoon-Hyeong Choi(Yoon-Hyeong Choi) 한국환경보건학회 2022 한국환경보건학회 학술대회 자료집 Vol.2022 No.5