세탁소를 운영하는 부부에서 동시에 발생한 담낭암 담낭암과 벤젠과의 연관성

심광연 ( Kwang Yeun Shim ),차상우 ( Sang Woo Cha ),엄욱현 ( Wook Hyun Um ),전창균 ( Chang Gyun Chun ),정승원 ( Soung Won Jeong ),장재영 ( Jae Young Jang ),조영덕 ( Young Deok Cho ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

Gallbladder (GB) cancer occurs predominately as a biliary tract malignant tumor. It generally has a very poor prognosis, and early detection is often difficult. A variety of carcinogens have been implicated as an important cause for GB cancer. Benzene is a well-known carcinogen for hematologic malignancy, and its casual relationship with GB cancer has been suggested. We report a case of two patients who had operated a laundry cleaning facility together and later simultaneously got GB cancer after prolonged benzene exposure.

Poster Session : PS 1403 ; Hemato-Oncology(Hematology) : A Retrospective Study on Elderly Patients with Lymphoma in Wonju Severance Christian Severance Hospital

( Yeun Seoung Choi ),( Hyun Sung Pack ),( Shin Young Hyun ),( Kwang Yong Shim ),( Chong In Lee ),( Jee Hyun Kong ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Age is an adverse prognostic factor in lymphoma. In general, elderly patients` medical conditionis poor and they receive subsequently reduced dosages of chemotherapy agents. Therefore, we evaluated the treatment patterns and clinical outcomes in elderly patients with lymphoma in Wonju Severance Christian Hospital (WCH). Methods: We retrospectively reviewed the medical records of elderly patients (=65 years ) who were diagnosed with lymphoma at WCH from January 2010 to December 2013. For this study, we checked the treatment medication, dosage, frequency, response and survival. Results: A total of 55 patients were identified and were followed up for a median of 7(0-43) months. The median age was 71(65-89) years and there were 27 male and 28 female. fifty three patients presented with Non-Hodgkin`s lymphoma (94.6%) and 32 of them were diffuse large B cell lymphoma. Chemotherapy was performed in 46 (83.6%) patients. Eighteen patients went through full cycles and 6 patients received the full dose of chemotherapy. However, neither the cycle nor the mean dosage of chemotherapy made significant differences on responses. The median survival of patients with chemotherapy seemed to be longer than that of those with conservative care only, but it was not statistically significant (8 (0-43) months vs. 1.5 months (0- 40 months), p=0.281). Neither chemotherapy cycle, dosages, stage, LDH nor a bulky disease made any difference regarding survival, but a poor performance, the presence of an extranodal disease and T cell histology showed poor survival. Conclusion: Chemotherapy seemed to improve the survival in elderly lymphoma patients, but without clinical significance. However, this study included only 55 patients with heterogenous histology. Therefore, further prospectivetrials with a larger number of patients and a longer monitoring period are warranted to determine the best treatment strategy in elderly lymphoma patients.

의사결정나무를 이용한 방문학습지사의 고객세분화에 관한 연구

서광규(Seo Kwang-Kyu),오은주(Oh Yeun-Joo),한영규(Han Young-Kyu),심현정(Shim Hyun-Jeong) 한국산학기술학회 2004 한국산학기술학회 학술대회 Vol.- No.-

Due to keen competition among companies, companies have segmented customers and they are trying to offer specially targeted customer by means of the distinguished method. In accordance, data mining techniques are noted as the effective method that extracts useful information. This paper explores customer segmentation of the home study company using data mining. The purposes of this paper are especially competitor churn in the recent home study market, to understand the characteristics of the customer group who are expected churn in case competing companies do aggressive sales promotion. In addition, this paper aims to find the influential factors of their breakaway, and to prepare practical marketing strategy to keep the existing customers. The study of churn in the home study market is conducted and the model using decision tree to predict and select valuable customer. Finally, this paper presents how the results can be incorporated and measured as a part of an overall marketing campaign process.

Web 양상으로 발현한 외상성 기관지 파열

심재정 ( Jae Jeong Shim ),한승환 ( Seung Hwan Han ),이진구 ( Jin Goo Lee ),조재연 ( Jae Yeun Cho ),인광호 ( Kwang Ho In ),김광택 ( Kwang Taek Kim ),유세화 ( Sae Hwa Yoo ),강경호 ( Kyung Ho Kang ) 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.5

산화질소 ( Nitric Oxide ) 의 기도내 신경성 염증 조절에 관한 연구

심재정(Jae Jeong Shim),박상면(Sang Myun Park),이진구(Jin Goo Lee),조재연(Jae Yeun Cho),인광호(Kwang Ho In),유세화(Se Hwa Yoo),강경호(Kyung Ho Kang),김철환(Chul Hwan Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.4

N/A Baekground: Asthma is classified as an inflammatory disease because there are inflammatory changes in the asthmatic airways. There are many evidences that sensory neuropeptides are involved in these inflammatory responses. Neurogenic inflammation is caused by the antidromic nonadrenergic noncholinergic (NANC) release of neuropeptides from vagal nerves. Recently nitric oxide (NO) has received considerable attention as a messenger molecule in the peripheral nervous system and relaxes airway smooth muscle. Also NO is a potent vasodilator and involved in plasma exudation from airway vessels, To investigate the role of nitric oxide in neurogenic inflammation, neurogenic inflammatory responses in rat airways according to duration of NANC stimuation and effects of NO were evaluated, Method: Neurogenic inflammation was produced in rat airways of 2 experimental groups of 1 min and 2 min stimulation with 5V, 1mSec, 5Hz after cholinergic and adrenergic blockade and compared with sham NANC, The magnitude of airway microvascular leakages was checked in the trachea, main bronchus, peripheral bronchus, and lung parenchyme and the leakeage was measured by Evans blue dye extravasation. NW-nitro-L-arginine (L-NNA, 5 mg/kg iv), L-NNA and L-arginine (50 mg/kg iv) were given 15 min before 2 min stimulation on 3 separate groups for evaluation of NO effects, and microvascular leakage was compared with 2 min NANC stimulation group. Results: 1) Vascular permeability of 1 min NANC stimulation group was increased trachea (208.2%, p<0.05), main bronchus (169.4%, p<0.05), and peripheral bronchus (123.6, p=0.18) compared with sham NANC group. 2) There was about l.5 times increase of vascular permeability in 2 min stimulation group compared with 1 min stimulation group (p<0,05), but not significantly increased permeability of lung parenchyme in both groups. 3) In L-NNA pretreated stimulation oup, there was increased vascular permeability of the trachea (133.3%, p<0.05), main bronchus (167.4%, p<0.05), and peripheral bronchus (197.1%, p<0.05) compared with 2 min stimulation group. 4) L-NNA and L-arginine pretreated stimulation group revealed suppressed vascular permeability com- pared with L-NNA pretreated stimulation group. Conclusion: These results revealed that neurogenic inflammation in the rat airway increases inflammatory responses according to duration of stimulation and blocking of NO synthetase increases neurogenic inflammation. These results provide that nitric oxide modulates inflammatory response of NANC stimulation of the vagal nerves in the rat airways.

비노출형 유두부암

백순구,심광용,김준명,박의련,권상옥,이동기,정필호,조도연 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background: Ampullary cancer is a malignant lesion in the pancreatobiliary system with a relatively good prognosis because of its slow growth, early appearance of symptoms and high resectability. Hndoscopic retrograde cholangiopancreaticography(ERCP) is an important and useful method in the diagnosis of ampullary cancer because it identifies the location of lesions endoseopically and by opacification of the bilio-pancreatic ducts and allows confirmation by biopsy, But the diagnostic accuracy of endoscopic forcep biopsy was variable according to the macroscopic appearance of ampullary cancer. In unexposed type ampullary cancer, biopsy after endoscopic sphincterotomy or intraluminal cannulatian biopsy has been recommended because the cancer tissue was either not visible at all or barely visible from the lumen of the duodenum. The purpose of this study was to evaluate the contribution of endoscopic sphincterotomy to the diagnosis of ampullary cancer and to compare the clinical eharasteristics of unexposed type ampullary cancer with those of exposed type ampullary cancer. Method: Thirty-one cases of the ampullary cancers over the past 5 years were reviewed. Macroscopically, thirty one ampullary cancers were classified into two types. The unexposed type ampullary cancer was defined normal ampullary mucosa with or without protruding. The exposed type ampullary cancer was defined abnormal ampullary mucosa including nodular, ulcerative, nodulo-ulcerative and polypoid appearance. Ampullary cancers were diagnosed preoperatively by forcep biopsy, biopsy after endoscopic sphincterotomy, or brushing cytology. Result: The proportion of unexposed type in ampullary cancer was 29%(9 cases). There were no differences of age, sex, diagnostic clue, distal common bile duct(CBD) shape and CBD dilatation by ERCP between unexposed and exposed type ampullary cancers. The serum bilirubin, alkaline phosphotase and GGT were lower in unexposed type comparing with exposed type. The unexposed ampullary cancers could be diagnosed with biopsy after endoscopic sphincterotomy except one case. Biopsy samples were successfully obtained immediately after spltincterotomy in 3 patients and a few days(3day later-lmonth later) after sphincterotorny in 5 patients. Conclusion: We consider the possibility of unexposed amullary cancer in cases of jaundice or duct dilatation with normal ampulla mucosa and should perform biopsy after endoscopic sphincterotomy.

ORiginal Article : Practical Effect of Sorafenib Monotherapy on Advanced Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis

( Soung Won Jeong ),( Jae Young Jang ),( Kwang Yeun Shim ),( Sae Hwan Lee ),( Sang Gyune Kim ),( Sang Woo Cha ),( Young Seok Kim ),( Young Deok Cho ),( Hong Soo Kim ),( Boo Sung Kim ),( Kyoung Ha Kim The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6

Background/Aims: We investigated the effects of sorafenib monotherapy on advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in a clinical setting. Methods: In total, 143 consecutive patients with unresect-able HCC were treated with sorafenib. Among these patients, 30 patients with advanced HCC and PVTT (Vp3 or 4) were treated with sorafenib monotherapy. Results: All patients had a performance status of 1 to 2 (Eastern Cooperative On-cology Group 1/2, 20/10) and Child-Pugh class A or B (A/B, 17/13). Eleven patients had modified Union for International Cancer Control stage IVA tumors, whereas 19 had stage IVB tumors. All patients had PVTT (Vp3, 6; Vp4, 24). Following sorafenib monotherapy, three patients (10.0%) had a partial response with PVTT revascularization, and nine (30.0%) had stable disease, with a disease control rate of 33.3%. The median overall survival was 3.1 months (95% confidence interval [CI], 2.70 to 3.50), and the median progression-free survival was 2.0 months (95% CI, 1.96 to 2.05). Fatigue and hand-foot skin reactions were the most troublesome side effects. Conclusions: A limited proportion of patients with advanced HCC and PVTT exhibited a remarkable outcome af-ter sorafenib monotherapy, although the treatment results in this type of patient is extremely poor. Further studies to pre-dict good responders to personalized therapy are warranted. (Gut Liver 2013;7:696-703)

Effects of Yukmijihwang-tang Derivatives (YMJd) on Ibotenic Acid-Induced Amnesia in the Rat

Kang, Moonkyu,Kim, Ji-Hyun,Cho, Chongwoon,Lee, Kwang-Yeun,Shin, Minkyu,Hong, Moochang,Shim, Insop,Bae, Hyunsu Pharmaceutical Society of Japan 2006 Biological & pharmaceutical bulletin Vol.29 No.7

<P>The present study investigates the effects of Yukmijihwang-tang Derivatives (YMJd) on learning and memory through the Morris water maze task and the central cholinergic system of rats with excitotoxic medial septum (MS) lesion. In the water maze test, the animals were trained to find a platform in a fixed position for 6 d and then received a 60-s probe trial in which the platform was removed from the pool on the 7th day. Ibotenic lesion of the MS showed the impaired performance in the Morris water maze test and severe cell losses in the MS, as indicated by decreased choline acetyltransferase-immunoreactivity in the medial septum. Daily administrations of YMJd (100 mg/kg, i.p.) for 21 consecutive days produced significant reversals of ibotenic acid-induced deficit in learning and memory. These treatments also reduced the loss of choline acetyltransferase (ChAT) immunoreactivity in the MS induced by ibotenic acid. These results suggest that impairments of spatial learning and memory might be attributable to the degeneration of septohippocampal cholinergic (SHC) neurons and that YMJd treatment ameliorated learning and memory deficits partly due through neuroprotective effects on the central acetylcholine system. Our studies suggest that YMJd might be useful in the treatment of Alzheimer's disease.</P>

만성 B형 간염 환자에서 간세포암종으로 오인되었던 1 cm 크기의 간내담관상피암종

복진현 ( Gene Hyun Bok ),정승원 ( Soung Won Jeong ),장재영 ( Jae Young Jang ),심광연 ( Kwang Yeun Shim ),이세환 ( Sae Hwan Lee ),김상균 ( Sang Gyune Kim ),김영석 ( Young Seok Kim ),김홍수 ( Hong Soo Kim ),김부성 ( Boo Sung Kim 대한간암학회 2012 대한간암학회지 Vol.12 No.1

Morphologically, intrahepatic cholangiocarcinoma (ICC) presents as a parenchymal mass, and it is occasionally resectable and potentially curable. In some cases, differentiation from other hepatic neoplasms such as metastatic lesions and hepatocellular carcinoma (HCC) can be extremely difficult, both clinically and histologically, and definitive diagnosis often needs correlation with clinical and radiologic finding.Contrasted computed tomography (CT) is useful in the diagnosis of ICC and in determining the extent of tumor involvement. Although the majority of liver tumors can be diagnosed by modern imaging modalities such as contrast CT, some cases of ICC show tumor enhancement in the arterial phase the same as that in HCC, or a biliary dilatation without stenosis by intraductal tumor growth. Differences in these patterns of tumor enhancement and status of the bile ducts in ICC may also reflect differences in cellular characteristics, clinical features, and prognosis after treatment. We present a case of a small ICC showing similar clinical and radiologic characteristics to HCC.

Clinically Useful Diagnostic Tool of Contrast Enhanced Ultrasonography for Focal Liver Masses: Comparison to Computed Tomography and Magnetic Resonance Imaging

( Sung Woo Ryu ),( Gene Hyun Bok ),( Jae Young Jang ),( Soung Won Jeong ),( Nam Seok Ham ),( Ji Hye Kim ),( Eui Ju Park ),( Jin Nyoung Kim ),( Woong Cheul Lee ),( Kwang Yeun Shim ),( Sae Hwan Lee ),( 대한소화기학회 2014 Gut and Liver Vol.8 No.3

Background/Aims: To evaluate the diagnostic value of contrast (SonoVue®) enhancement ultrasonography (CEUS) and to compare this method with computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating liver masses. Methods: CEUS (n=50), CT (n=47), and MRI (n=43) were performed on 50 liver masses in 48 patients for baseline mass characterization. The most likely impression for each modality and the final diagnosis, based on the combined biopsy results (n=14), angiography findings (n=36), and clinical course, were determined. The diagnostic value of CEUS was compared to those of CT and MRI. Results: The final diagnosis of the masses was hepatocellular carcinoma (n=43), hemangioma (n=3), benign adenoma (n=2), eosinophilic abscess (n=1), and liver metastasis (n=1). The overall diagnostic agreement with the final diagnosis was substantial for CEUS, CT, and MRI, with κ values of 0.621, 0.763, and 0.784, respectively. The sensitivity, specificity, and accuracy were 83.3%, 87.5%, and 84.0%, respectively, for CEUS; 95.0%, 87.5%, and 93.8%, respectively, for CT; and 94.6%, 83.3%, and 93.0%, respectively for MRI. After excluding the lesions with poor acoustic sonographic windows, the sensitivity, specificity, and accuracy for CEUS were 94.6%, 87.5%, and 93.3%, respectively, with a κ value of 0.765. Conclusions: If an appropriate acoustic window is available, CEUS is comparable to CT and MRI for the diagnosis of liver masses.