복강경 불임시술 후 발생한 자궁외 임신에 관한 임상적 고찰

권선호,김성민,노흥태 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

This study is a clinico-statistical analysis of 19 cases of ectopic pregnancy which developed after laparoscopic tubal sterilization during the period from January 1983 to December 1985 in Chungnam National University Hospital. The results were as follows : 1. Among the 140 cases of ectopic pregnancy during the period, 19 cases(13.6%) were disclosed to occur after laparoscopic tubal sterilization. 2. The most frequent age group was in 26 to 30 years and the mean age was 31.2 years. 3. The average gravidity and number of living children were 4.1 and 2.6, respectively. 4. All patients were easily diagnosed preoperatively by culdocentesis, pregnancy test, diagnostic laparoscopy and sonography. 5. About 74% of the total patients presented themselves within 3 years after tubal sterilization, with shortest interval being 4 months, the longest 12 years, and mean 2 year 5 months. 6. The methods of sterilization was mostly electrocauterization (73.9%) and the rest was silastic band application (26.3%). 7. The average duration from last menstrual period of patients to the diagnosis of ectopic pregnancy was 6.2 weeks. 8. The majority of the patients presented with lower abdominal pain, nausea & vomiting, and bearing down sensation. 9. The most implantation site of ectopic pregnancy was fallopian tube(94.8%). 63.2% of the ectopic gestation was located in the distal of fimbrial segment and 31.6% in the proximal segment. 10. The average amount of intraperitoneal blood loss was 1190ml. 11. 89.6% of total cases was treated by unilateral salpingectomy or unilateral salpingooophorectomy.

결장직장암 환자의 임상적 고찰 : 조선대학교 부속병원의 10년 간의 결과

나은종,문성표,장정환,김권천,민영돈,김성환,조현진,김정용,김경종 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Background and Objectives: The colorectal cancer rates 4th in the total cancer prevalence in Korea. The clinical patient demographics were considered with the incidence rate of the colon and rectal cancer. The clinicopathological factors were analyzed for the 5 year survival rate. Materials Methods: Of the 282 patients who were operated from Jan. 1, 1992 to Dec. 31, 2001 and diagnosed by pathological biopsy as colo-rectal cancer, 234 patients were followed up. The age, sex, location of the cancer, TNM stage, operation method, histopathological classification, metastatic region, complications after operation and the survival rate were investigated. Results: Of the 234 patients, male and female consisted of 120 cases (51.3%) and 114 cases (46.7%), with an average age of 61.6 years. The average follow up period was 52.3 months and the peri operative mortality was 5.6%. The site of the cancer was most frequent at the rectum with 127 cases (54.3%). The patients were classified according to the TNM stages with 38 cases of stage 1 (16.2%), 98 cases of II (41.9%), 72 cases of III (30.8%) and 26 cases of IV (11.1%). The 5 year survival rate in the age group older than 50 was 63.3 % and 73.5% in the group younger than 50. In regard to the operation type, the 5 year survival rate was 65.4% for elective operation and 65.8% for emergency operation. The 5 year survival rate for well differentiated, moderately differentiated, poorly differentiated cancer, and mucinous adenocarcinoma was 73.7%, 60.2%, 58.3%, and 92.6%, respectively. The 5 year survival rate of each of the TNM stage is 81.1%, 74.8%, 57.0%, and 11.5% for Classes I, II, III, and IV, respectively. Conclusion: The clinical factors were analyzed for the 5 year survival rate with no statistical significance for the age, sex, and location of the cancer. The TNM stage and histopathological differentiation were statistically significant. The colon cancer showed better prognosis compared to the rectal cancer.

위암의 근치절제술 후 생존율과 예후인자

차윤정,박진영,장정환,김성환,김권천,조현진,민영돈 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Gastric cancer is still the leading cause of cancer death in Korea, and surgery remains the only method of treatment that offers the potential for a cure. Purpose: The aims of this study are to examine the outcome of the patients with gastric adenocarcinoma who underwent curative resection and to identify the prognostic factors leading to improved survival rates in these patients. Materials and Methods: The medical records of 278 patients with gastric adenocarcinoma, treated curatively at the Chosun University Hospital between January 1990 and December 1994, were reviewed retrospectively from January 2000 to March 2000. Follow-up was obtained for 250 patients(89.9%). The survival rates were calculated by the Kaplan-Meier method, and the significance of differences between patient factors(age and sex), tumor factors(location, size, gross type, tumor depth, lymph node metastasis, and stage) and treatment factors(operation method and reconstruction type) were evaluated statistically by the log-rank test. Results: The overall five-year survival probability was 59.6%. There was no survival difference according to age and sex. The 5-year survival rates according to the tumor depth were 97.0% for Tl, 74.5% for T2, 39.6% for T3, and 23.1% for T4(p=0.0000); to the lymph node metastasis were 81,4% for N0, 51.9% for N1, and 21.2% for N2(p=0.0000); to the TNM stage were 96.7% for stage I a, 79.5% for stage I b, 68.8% for stage II, 52.9% for stage III a, 25.9% for stage III b, and 7.5% for stage IV(p=0.0000). Other statistically significant differences were shown in tumor location, size, gross type, operation method, and reconstruction type after subtotal gastrectomy. Conclusion: The most definitive prognostic factors affecting the survival rate of gastric adenocarcinoma were tumor depth, lymph node metastasis, and tumor stage. The keys to successful outcome includes early diagnosis and curative resection with radical lymph node dissection at early stage as possible.

위장질환에 따른 H.pylori 감염빈도와 검사방법의 비교분석

김대현,조재현,금민수,최성곤,이창형,탁원형,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : H. pylori가 위장관 질환의 병인에 깊은 관련이 있어 이의 적절한 진단 및 치료가 중요하게 대두되고 있다. 이에 저자들은 소화기 증상을 주소로 내원한 환자들을 대상으로 내시경 검사를 실시하여 H. pylori검출을 위한 CLO검사, IgG 항체검사 및 H&E 염색 등을 시행하여 각 질환별로 H. pylori 감염의 양성율을 알아보고 검사법에 따른 민감도 및 특이도를 그 유용성에 대하여 조사하였다. 대상 및 방법 : 1996 4월에서 8월까지 경북대학교병원에 소화기증상을 주소로 내원한 총 313명의 환자를 대상으로 내시경 검사를 실시하여 H. pylori 검출을 위한 CLO 검사, IgG 항체검사, 조직염색 검사를 실시하였다. 결과 : 전체 대상 환자수는 313명이었고 연령별 분포는 16세부터 80세 까지 다양하였으며 그중40대, 50대, 60대가 각각 69예(22%), 73예(23.3%), 65예(20.8%)로 전체 환자중 66%를 차지하였다. 남녀비는 2.07 대 1로 남자가 많았다. 대상환자의 평균나이는 52±15세였고, 전체 대상환자에서 H. pylori 양성군과 음성군의 평균나이는 각각 50±15세, 54±15세 였고, 궤양환자군에서 H. pylori 양성군과 음성군사이의 평균나이는 각각 49±14.8세, 55±13.8세로 나타났다. 각 질환별분포는 위염이 72명(23%), 십이지장 궤양이 85명(27.2%), 위궤양이 80명(25.6%), 위암이 20명(6.4%), 비궤양성 소화불량이 13명(4.2%), 기타가 43명(13.7%)이었으며, H. pylori 감염 양성율은 위염이 71%, 십이지장 궤양이 86.8%, 위궤양이 58.3%, 위암이 75%, 비궤양성 소화불량이 75%였으며 특히 유문륜 궤양에서는 100%의 양성율을 보였다. 소화성 궤양군과 비궤양군에서의 H. pylori 양성율을 비교해 본 결과 궤양군에서는 73.1%, 비궤양군에서는 72%로 통계학적으로 차이는 없었다(P=0.91). 소화성 궤양환자에서 출혈이 동반된 군과 동반되지 않은 군에서의 H. pylori 양성율을 비교해 본 결과 출혈이 동반된 군에서의 양성율은 54.5%였고, 출혈이 동반되지 않은 군에서는 77.5%의 양성율을 보여 출혈이동반되지 않은 군에서 통계학적으로 유의하게 높았다(P=0.014). 나이에 따른 양성율을 알아본 결과 50세 이하에서는 78.5%였고, 50세 이상에서는 67.5%로서 양성율이 낮았으나 통계학적으로 유의성은 없었다(P=0.052). 각 검사법에 따른 민감도 및 특이도는 전체 환자중에서는 CLO검사가 88.9%, 96.1%, IgG항체검사 90.8%, 58.5%, H&E 염색검사 86.9%, 79.2%로서 민감도는 비슷하게 나왔으나 CLO검사는 상대적으로 특이도가 다른 검사법에 비해 높았다. 궤양군에서의 CLO검사의 민감도와 특이도는 92.0%, 95.6%였고, 비궤양군에서의 민감도와 특이도는 84.3%, 96.8%로서 비궤양군에서는 CLO검사의 민감도는 약간 낮았다. 나이에 따른 CLO 검사의 민감도 및 특이도는 50세 이하에서는 91.5%, 93.1% 였고, 50세 이상에서는 86.3%, 97.9%로서 50세 이상에서는 상대적으로 CLO검사의 민감도가 낮았다. 결론 : 본 연구에서는 위장질환에 따른 H. pylori 양성율을 알아보았는데, 다른 보고에서 처럼 높게 나왔으며, 진단 방법으로 사용한 CLO검사, IgG항체 검사, 조직염색검사 등은 모두 비교적 높은 예민도를 나타냈고, 그중 CLO검사가 간편하고 경제적이라는 면에서 임상적으로 유용한 검사로 여겨지나 상대적으로 CLO검사의 민감도가 낮은 비궤양성 질환과 50세 이상의 환자군에서는 CLO검사 외에 다른 검사방법을 병행함으로써 H. pylori의 진단율을 높일 수 있을 것으로 사료된다. Background: Gastric colonization by Helicobacter. pylori is common among patients with peptic ulcer and gastritis. And various diagnostic tests are available in confirming H. pylori infection. The aim of this paper is to estimate the prevalence of H. pylori infection in Gastroduodenal disorders and compare the sensitivity and specificity of the most widely available tests. Methods: A total of 313 patients were tested for H. pylori infection by IgG Ab, CLO test and H&E stains. Results: The prevalence of H. pylori infection was significantly higher in duodenal ulcer(86.8%) than in gastric cancer(75%), gastritis(71%) and gastric ulcer(58.3%)(P=0.009). The sensitivity and specificity of each test was as follows: CLO test(88.9%, 96.1%), IgG Ab test(90.8%, 58.5%), H&E stain(86.9%, 79.2%). Sensitivity of CLO test in peptic group was 92.0%, whereas in non-peptic group, it was 86.3%. Sensitivity of CLO test in age under 50 was 91.5%, that over 50 it was 86.3%. Conculsions: There is a strong association between H. pylori and gastrointestinal disorders. CLO tests have relatively high sensitivity and specificity, especially in peptic group and younger age(below 50 yr)group. But in those patients in which CLO tests are less sensitive (age>50 or non-peptic group), more than one test may be necessary to diagnose the presence of the organism.

Male patients with rheumatoid arthritis have an increased risk of osteoporosis : Frequency and risk factors

Kweon, Seong-Min,Sohn, Dong Hyun,Park, Ji-Heh,Koh, Jung Hee,Park, Eun-Kyoung,Lee, Han-Na,Kim, Keunyoung,Kim, Yunkyung,Kim, Geun-Tae,Lee, Seung-Geun Wolters Kluwer Health 2018 Medicine Vol.97 No.24

<P><B>Abstract</B></P><P>Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA.</P><P>The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA.</P><P>We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a <I>T</I>-score of ≤ −2.5 according to the World Health Organization (WHO) classification.</P><P>The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, <I>P</I> = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm<SUP>2</SUP>, <I>P</I> = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m<SUP>2</SUP>, respectively. In multivariable logistic regression models, BMI ≤ 22 kg/m<SUP>2</SUP> (odds ratio = 3.43, <I>P</I> = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, <I>P</I> = .032) were independent risk factors for osteoporosis at either site in male patients with RA.</P><P>Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.</P>

소아의 흉부 전산화 단층 촬영 검사에서 70 kVp 사용시 Dose 경감율에 관한 연구

최성민(Seong min Choi),권성옥(Seong ohk kweon),한진희(Jin hee Han) 대한전산화단층기술학회 2013 대한CT영상기술학회지 Vol.15 No.1

목적: 소아의 흉부 CT 검사 시 2012년 식품의약품 안전청에서 권고한 CTDIvol 2 mGy를 80 kVp 와 70 kVp 로 검사 하여 Noise 값을 비교 CTDIvol 값을 줄여보고자 하였다. 대상 및 방법: 자체 제작한 체중을 고려한 연령별 평균 Body size의 아크릴 팬텀을 128-slice DSCT로 어린이 CT 영상의학검사의 환자 선량 권고량 가이드 라인에서 제시한 CTDIvol 2 mGy에 맞추어 기존에 가장 낮은 kVp 였던 80 kVp 를 설정하여 반복 촬영, 판독 시의 영상 slice thickness 로 reconstruction 하여 PACS 상에서 그 노이즈 값을 측정하였다. 이 후 70 kVp 를 사용하여 CTDIvol 값이 1~2가 나오도록 설정하여 팬텀을 scan 하여 80 kVp로 scan 했을 때와의 노이즈 값을 비교 하였다. 장비에서 선량표시에 사용되는 팬텀은 32 cm 팬텀을 기준으로 측정하고 16 cm 팬텀 값으로 변환하였다. 결과: 80 kVp, CTDIvol=2 mGy scan 시 노이즈 평균값 8.889, 80 kvp, CTDIvol=1.6 mGy scan 시 노이즈 평균값 9.553, 70 kVp, CTDIvol=2 mGy scan 시 노이즈 평균값 8.546, 70 kvp, CTDIvol=1.6 mGy 노이즈 평균값 9.688, 70 kVp, CTDIvol=1.5 mGy 노이즈 평균값은 10.252. 70 kVp, CTDIvol=1.4 mGy 노이즈 평균값 10.598. 70 kVp, CTDIvol=1.3 mGy 노이즈 평균값 10.694. 70 kVp, CTDIvol=1.2 mGy 노이즈 평균값 11.604. 70 kVp, CTDIvol=1 mGy 노이즈 평균값 12.591. 결론: 70 kVp scan 시 CTDIvol 1.6 mGy 에서 CTDIvol 1.3 mGy 로 낮추어서 검사 할 경우 noise 값은 10% 상승하지만 CTDIvol 값은 18.8%의 감소를 할 수 있기 때문에 판독이 가능하다면 선량을 낮추는 부분은 고려해 볼 만한 사항이라 판단된다. Purpose: The objective of this article is to reduce CTDIvol values by comparing the noise of the 70 kVp inspection with the noise of the 80 kVp inspection, obeying the recommendation of CTDIvol(2 mGy) from the 2012 guideline of the Korea Food & Drug Administration. Materials and methods: We took several CT films of self-produced acrylic phantom, whose size had been considered an average body size by age, using 80 kVp which is the existing minimum dose, with CTDIvol 2 mGy which is obeyed the CT radiology guideline for children. We measured the noise value by reconstruction of slice thickness from evaluation on the PACS. Furthermore, we scanned the phantom with setting of CTDIvol to be 1~2 using 70 kVp, and compared this noise value with 80 kVp. The phantom used as a measuring scale was a 32 cm phantom, and those result conversed for a 16 cm phantom. Result: In 80 kVp, CTDIvol=2 mGy scanning, average noise value is 8.889, in 80 kVp, CTDIvol=1.6 mGy scanning, average noise value is 9.553, in 70 kVp, CTDIvol=2 mGy scanning, average noise value is 8.546, in 70 kVp, CTDIvol=1.6 mGy scanning, average noise value is 9.688, In 70 kVp, CTDIvol=1.5 mGy scanning, average noise value is 은 10.252. In 70 kVp, CTDIvol=1.4 mGy scanning, average noise value is 10.598. In 70 kVp, CTDIvol=1.3 mGy scanning, average noise value is 10.694. In 70 kVp, CTDIvol=1.2 mGy scanning, average noise value is 11.604. In 70 kVp, CTDIvol=1 mGy scanning, average noise value is 12.591. Conclusion: In 70 kVp scanning, if a CTDIvol 1.6 mGy is decreased to 1.3 mGy, although the noise value wⅢ be increase 10%, the CTDIvol value wⅢ be decrease 18.8%, so on the supposition that the CT image is readable, decreasing of CTDIvol is reasonable.

Thyroid dysfunction associated with follicular cell steatosis in obese male mice and humans.

Lee, Min Hee,Lee, Jung Uee,Joung, Kyong Hye,Kim, Yong Kyung,Ryu, Min Jeong,Lee, Seong Eun,Kim, Soung Jung,Chung, Hyo Kyun,Choi, Min Jeong,Chang, Joon Young,Lee, Sang-Hee,Kweon, Gi Ryang,Kim, Hyun Jin The Endocrine Society 2015 Endocrinology Vol.156 No.3

<P>Adult thyroid dysfunction is a common endocrine disorder associated with an increased risk of cardiovascular disease and mortality. A recent epidemiologic study revealed a link between obesity and increased prevalence of hypothyroidism. It is conceivable that excessive adiposity in obesity might lead to expansion of the interfollicular adipose (IFA) depot or steatosis in thyroid follicular cells (thyroid steatosis, TS). In this study, we investigated the morphological and functional changes in thyroid glands of obese humans and animal models, diet-induced obese (DIO), ob/ob, and db/db mice. Expanded IFA depot and TS were observed in obese patients. Furthermore, DIO mice showed increased expression of lipogenesis-regulation genes, such as sterol regulatory element binding protein 1 (SREBP-1), peroxisome proliferator-activated receptor γ (PPARγ), acetyl coenzyme A carboxylase (ACC), and fatty acid synthetase (FASN) in the thyroid gland. Steatosis and ultrastructural changes, including distension of the endoplasmic reticulum (ER) and mitochondrial distortion in thyroid follicular cells, were uniformly observed in DIO mice and genetically obese mouse models, ob/ob and db/db mice. Obese mice displayed a variable degree of primary thyroid hypofunction, which was not corrected by PPARγ agonist administration. We propose that systemically increased adiposity is associated with characteristic IFA depots and TS and may cause or influence the development of primary thyroid failure.</P>

Mitochondrial oxidative phosphorylation reserve is required for hormone- and PPARγ agonist-induced adipogenesis

Ryu, Min Jeong,Kim, Soung Jung,Choi, Min Jeong,Kim, Yong Kyung,Lee, Min Hee,Lee, Seong Eun,Chung, Hyo Kyun,Jung, Saet Byel,Kim, Hyun-Jin,Kim, Koon Soon,Jo, Young Suk,Kweon, Gi Ryang,Lee, Chul-Ho,Shong Springer-Verlag 2013 Molecules and cells Vol.35 No.2

Treatment of Gastric Candidiasis in Patients with Gastric Ulcer Disease: Are Antifungal Agents Necessary?

( Min Kyu Jung ),( Seong Woo Jeon ),( Chang Min Cho ),( Won Young Tak ),( Young Oh Kweon ),( Sung Kook Kim ),( Yong Hwan Choi ) 대한소화기기능성질환·운동학회 2009 Gut and Liver Vol.3 No.1

Background/Aims: The inadequacy of information on the treatment of gastric candidiasis with antifungal agents promoted us to evaluate patients with fungal infections who had gastric ulcers and assess the need for proton-pump inhibitors or antifungal agents. Methods: Sixteen patients were included in the study. The criterion for the diagnosis of candidiasis was finding yeast and hyphae in the tissue or an ulcer on histological sections of biopsy samples. Surface fungi were not considered infections. Results: In all cases with benign ulcers, follow-up endoscopy performed 6 weeks after proton-pump-inhibitor treatment revealed that the ulcer had improved without antifungal medication. However, in patients with malignant ulcers, surgical resection was necessary for a definitive cure. Two patients with lymphoma received combined chemotherapy and a proton-pump inhibitor, which improved their condition. Conclusions: The results of this study suggest that benign ulcers with candidiasis can be effectively treated by a proton-pump inhibitor without antifungal medication. However, surgical resection should be considered for malignant ulcers with candidiasis. (Gut and Liver 2009;3:31-34)

소화성궤양 환자에 있어서 Omeprazole(오엠피®)의 치료효과

권중구,이창형,김영탁,금민수,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1995 慶北醫大誌 Vol.36 No.1

목적 : 소화성궤양 환자의 치료제중 하나인 benzimidazole유도체인 Omeprazole은 강력한 위산분비억제기능을 가지고 있는 것으로 알려져 있다. Omeprazole의 소화성궤양에 대한 치료효과를 관찰하기 위하여 본 연구를 실시하였다. 대상 및 방법 : 1994년 8월부터 12월까지 경북대학교병원 내과를 방문한 환자중 상부소화관내시경 검사로 확진된 위궤양 및 십이지장궤양 15예를 대상으로 omeprazole(OMP®) 20㎎을 1일 1회 투여하고, 4주후에 내시경검사를 실시하고 그 치유효과를 관찰하였다. 결과 : 소화성궤양에 대한 4주후의 내시경상의 치유율이 93.4%(8예 중 8예)였고 완전치유율은 62.5%(8예 중 5예)였다. 소화성궤양에 대한 4주후의 증상의 변화를 보면 저명개선이 66.7%(15예중 10예)였고 개선이 33.3%(15예 중 5예)였다. 4주후에 임상적으로 특기할만한 부작용이 관찰되지 않았다. 결론 : Omeprazole이 소화성궤양에 뚜렷한 효과가 있고 비교적 안전하게 사용할 수 있는 약물로 생각된다. For the evaluation of clinical efficacy of omeprazole in the treatment of patient with gastric and duodenal ulcer, 15 patients with upper GI endoscopically proved active gastric ulcer(14 patients) and duodenal ulcer(1 patient) were admitted to this trial. Omeprazole was administered 20㎎ daily for 4 weeks and then follow up was done by endoscopy. The observed results were as follows: (1) Overall improvement of peptic ulcers by endoscopy was noted in 93.4% of the patients. 7 out of 8 cases of peptic ulcers had been healed up in 4 weeks. The complete healing rates of peptic ulcer by endoscopic examination at 4 weeks were 62.5% of the patients. (2) Clinical manifestations of peptic ulcer had been markedly improved in 10 out of 15 cases (66.7%) after 4 weeks medication with omeprazole and had been improved in 5 out of 15 cases (33.3%) (3) No significant clinical side effects had been noticed with 4 weeks medication. According to this study, omeprazole appears to be fairly effective and safe for the treatment of patient with peptic ulcer-diseases.