설 기저부에 발생한 염증성 가성종양 1예

이현섭,허세형,진성민,이상혁,Lee, Hyun-Sub,Huh, Se-Hyung,Jin, Sugn-Min,Lee, Sang-Hyuk 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.1

Inflammatory pseudotumor is characterized by the presence of a mass that may mimic malignancy and is composed of spindle cells mixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells It is benign tumor commonly involves lung and orbit and rarely that occurs in the head and neck The cause and pathogenesis of inflammatory pseudotumor still remain controversial. Some bacterial infection or chronic irritation may have prompted some speculation that an initially reactive process can change into an overt neoplastic disease. It tends to affect children and young adults than old ages. We present a case of inflammatory pseudotumor involving the tongue base, in a 73-year-old patient with repeated oral bleeding that aggravated over a few days. Clinical examination showed angiomatous polyp like findings in oropharynx that easy bleeding tendency. CT images showed well defined soft tissue mass with focal enhancement. After surgery, tumor was finally diagnosed inflammatory pseudotumor by histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues.

내시경적 치료로 제거하지 못한 총담관 결석에서의 복강경 담관 탐색술 성적

이현섭(Hyun Sub Lee),민석기(Seog Ki Min),이선영(Sun Young Yi),이현국(Hyeon Kook Lee) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.3

Purpose: With the advent of endoscopic technology, ERCP (endoscopic retrograde cholangiopancreatography)/ES (endoscopic sphincterotomy) has become the main treatment for CBD stones. However, when ERCP fails to remove CBD stones, it remains unclear whether laparoscopic treatment is an alternative or not. The aim of this study was to investigate the outcome of LCBDE for the management of difficult choledocholithiasis. Methods: This study was a retrospective analysis of 68 LCBDE cases that were performed at the Ewha Womans University School of Medicine, Mokdong Hospital from January, 2000 to March, 2006. Group A was defined that primary LCBDE was performed without ERCP/ES. Group B was defined that secondary LCBDE was performed after ERCP/ES had failed. The operative outcomes and postoperative complications were compared between the two groups. Results: Primary LCBDE was performed for 33 patients (Group A) and secondary LCBDE after failure of ERCP/ES was performed for 35 patients (Group B). No significant differences in gender, mean age and associated diseases were noted between the two groups. The stone clearance rate was 100% for both groups. There were no significant differences between the two groups for the mean operative time (201.5 min for Group A vs 188.7 min for Group B: P=0.415), the open conversion rate (9.1% vs 0%, respectively: P=0.068), the complication rate (12.1% vs 8.6%, respectively: P=0.630) and the duration of the hospital stay (14.3 days vs 11.9 days, respectively: P=0.169). The recurrence rate along with a mean follow-up of 24 months showed no significant difference between the two groups (12.1% vs 2.9%, respectively). Conclusion: When ERCP is impossible or stone retrieval is incomplete, LCBDE is an alternative treatment for difficult CBD stones.

특집 무선랜 보안 정책 : 무선랜 보안에 관한 해외 법제도 현황 조사

이현섭 ( Hyun Sub Lee ) 연세대학교 법학연구원 의료·과학기술과 법센터 2010 연세 의료·과학기술과 법 Vol.1 No.2

The paper analyzes legislation regarding Wireless LAN Security in other countries and draws insights. Then it compares the laws and its enforcement related to illegal access of wireless LAN of a number of countries including US, UK, and Germany, and analyzes trend and effect of punishment for each country. With the number of wireless LAN locations continuing to increase worldwide, every country recognizes its security risks and tries to provide technical solutions. However few country has a law directly dictating wireless security obligations. In U.K., though, the legislation of the Digital Economy Act generated significant controversy as to whether the obligation of enabling security mechanisms has to be levied upon those who provide wireless access to general public like cafe or restaurant owners, ending up with a compromise that the code will only apply to ISPs with over 400,000 subscribers. It is a common theoretical question worldwide whether it is legitimate to apply the existing provisions originally intended to punish hacking into computers to piggybacking open wireless networks.

양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석

이창희,이현섭,진성민,이상혁,Lee, Chang-Hee,Lee, Hyun-Sub,Jin, Sung-Min,Lee, Sang-Hyuk 대한후두음성언어의학회 2012 대한후두음성언어의학회지 Vol.23 No.1

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

통증 조절에 있어서 $Myprodol^{(R)}$의 효과

신상욱,이현섭,김인세,백승완,Shin, Sang-Wook,Lee, Hyun-Sub,Kim, Inn-Se,Baik, Seong-Wan 한국호스피스완화의료학회 2001 한국호스피스.완화의료학회지 Vol.4 No.1

목적 : 경구로 투여되는 진통제 중에서 $Myprodol^{(R)}$은 codeine, ibuprofen과 paracetamol이 복합 처방된 진통제로서 최근에 임상에 사용되기 시작한 약제이다. 본 연구는 실제로 임상에서 $Myprodol^{(R)}$이 사용되고 있는 질환의 종류, 부작용과 진통 효과 등을 알아보기 위하여 수행되었다. 방법 : 부산대학교병원에서 $Myprodol^{(R)}$을 사용한 적이 있는 183명의 환자의 병력기록지를 조사하여 통증의 원인이 된 질환의 종류와 통증의 유형, 병원에 내원하여 최초로 $Myprodol^{(R)}$이 투여되었을 때까지의 통증의 기간 $Myprodol^{(R)}$을 투여한 기간, $Myprodol^{(R)}$의 투여 이후에 나타난 부작용, 통증에 대한 $Myprodol^{(R)}$의 통증 조절 정도를 통증시각등급(VAS)의 변화 등을 분석하였다. 결과 : $Myprodol^{(R)}$을 사용한 환자의 질환은 각종 암성 통증으로 인한 경우가 64.3%이었고, 비암성 통증으로 인한 경우가 35.7%이었다. 투여 중에 나타난 부작용에는 암성 통증 환자에서 메스꺼움, 변비, 전신부종이 있었고, 비암성 통증 환자에서는 위복부통, 변비 등이 있었다. 비암성 통증 관리측면에서 $Myprodol^{(R)}$은 암성 통증 치료에서보다 더 효과가 있었다. 결론 : $Myprodol^{(R)}$은 약한 초기 암성 통증에 비교적 적은 부작용으로 진통효과를 나타내었다. 비암성 통증 환자에서는 흉통, 요통, 치과 수술 후에 주로 사용되었고 적은 부작용으로 진통효과를 나타내었다. Background : Many analgesics are used to relieve the pain of various causes. Among these, $Myprodol^{(R)}$, a combination analgesic with codeine, ibuprofen and paracetamol, was recently used as a new analgesics. This study was performed to survey the kinds of diseases, side effects and pain relief effect of $Myprodol^{(R)}$ in clincal practice. Methods : This retrograde study surveyed the medical records of 183 patients treated with $Myprodol^{(R)}$ at Pain Clinic, Pusan National University Hospital. From medical records, the disease entities, the pain characteristics, duration of $Myprodol^{(R)}$ medication, the analgesic effect and side effects were evaluated. Results : $Myprodol^{(R)}$ is used in the treatment of cancer pain (64.3%) and non-cancer pain (35.7%). Among side effects of $Myprodol^{(R)}$ medication, nausea with vomiting, constipation and generalized edema were common in cancer pain, but epigatric pain was common in non cancer pain. $Myprodol^{(R)}$ was more effective in non cancer pain than cancer pain. Conclusions: $Myprodol^{(R)}$ was used in cancer and non-cancer pain patients. In cancer pain patients, $Myprodol^{(R)}$ was effective in early cancer pain but, not effective in advanced cancer. $Myprodol^{(R)}$ was also used and effective in non-malignant benign chest pain, lumbago, post-operative pain.

보툴리눔 독소의 약리

이상혁,이현섭,진성민,Lee, Sang Hyuk,Lee, Hyun Sub,Jin, Sung Min 대한후두음성언어의학회 2012 대한후두음성언어의학회지 Vol.23 No.2

Botulinum toxins are the most potent toxins known to mankind. Botulinum toxin acts by blocking the cholinergic neuromuscular or the cholinergic autonomic innervation of exocrine glands and smooth muscles. Seven distinct antigenic botulinum toxins (A, B, C, D, E, F and G) produced by different strains of Clostridium botulinum have been described and only A and B type of botulinum toxins were clinically used. Toxins were consisted of a heavy chain with a molecular weight of 100 kD and a light chain with a molecular weight of 50 kD. Toxins are bound with an astounding selectivity to glycoprotein structures located on the cholinergic nerve terminal. Subsequently light chain of toxin is internalized and cleaves different proteins of the acetylcholine transport protein cascade transporting the acetylcholine vesicle from the intracellular space into the synaptic cleft. After a decade of therapeutic application of the toxin, no anaphylaxis or deaths have been reported and systemic adverse effects have not been reported so far. However the toxin's immunologic properties can lead to the stimulation of antibody production, potentially rendering further treatments ineffective. Botulinum toxin is a safe and effective treatment. Use of botulinum toxin in clinical medicine has grown exponentially in recent years, and many parts of the human body are now being targeted for therapeutic purposes.

양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석

이창희,이현섭,진성민,이상혁,Lee, Chang-Hee,Lee, Hyun-Sub,Jin, Sung-Min,Lee, Sang-Hyuk 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.2

Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

하프코스 마라톤 후 체내의 생화학적 변화 및 회복

최창혁,이현섭,서헌석,김상경,신임희,Choi, Chang-Hyuk,Lee, Hyun-Sub,Seo, Hun-Suk,Kim, Sang-Kyung,Shin, Im-Hee 대한정형외과스포츠의학회 2008 대한정형외과스포츠의학회지 Vol.7 No.1

목적: 하프코스 마라톤 달리기 후에 체내의 생리적 변화를 관찰하여 휴식 기간에 따른 회복 양상을 확인하고자 한다. 대상 및 방법: 하프코스 완주자 13명( 남자 12명, 여자 1명)을 대상으로 하였으며, 평균 연령은 44세(범위: $38{\sim}54$)이었으며 신장은 평균 166 cm (표준편차 6.5), 몸무게는 평균 68 kg(표준편차 7.3)이었다. 생화학적 검사항목은 운동 후 근육 및 심장에 영향을 미치는 혈청효소인 aminotransferases (AST, ALT), CK-MB, Troponin-I 그리고 신장 기능 및 체내의 전해질 균형 상태를 확인할 수 있는 BUN, Creatinine, Na, K의 변화를 확인하였으며, 검사 방법은 출발 전, 완주 직후 및 2일 후, 완주 후 2주에 채혈하여 검사치의 변화의 양상을 확인하였다. 결과: 모든 검사 항목에 있어 측정 시점에 따른 측정 결과는 정상범위 내의 변화를 보였다. 측정 시점에 따른 유의한 변화를 보이지 않았던 검사항목은 ALT (p=0.914) 및 Troponin I (p=0.354)이었으며, BUN, Cr. Na. K등 신장 기능 및 체내의 전해질 균형상태를 반영하는 검사는 완주 직후 증가되었다가 2일 째에 출발전의 수치로 회복되었으며, 근육 및 심장에 영향을 주는 AST 및 CK-MB의 경우 완주 직후 증가된 수치가 2일째까지 유지되거나, 더욱 증가되었다가 2주 후 검사 상 출발전의 수치로 회복되는 양상을 보였다. 결론: 장거리 달리기를 한 후 탈수 현상으로 인한 초기 신장 효소 변화는 2일 정도에 회복이 되었으며, 근육 및 심장의 피로 효소는 약 2주 정도의 시간이 지나야 회복되었다. 따라서 하프코스마라톤을 뛴 후 정상적인 회복을 위해서는 음주경력, 흡연경력 및 달리기 경력에 상관없이 약 2주간의 회복기를 거치는 것이 필요할 것으로 생각되었다. Purpose: To evaluate the recovery time of biochemical changes of body after half-course marathon running. Materials and methods: Thirteen amateur half course marathon runners (12 males and 1 females) were studied. Their average age was 44 years old (range: $38{\sim}54$). Biochemical parameters with blood test including AST, ALT, CK-MB, Treponin, BUN, Cr Na, K were evaluated at finish line, 2nd days, 2nd weeks after running. Results: All the biochemical changes were within normal range throughout recovery time, AST reached its maximum level at finish line and continued until 2nd day after running and returned its pre-running level at 2nd week's test. CK-MB reached its maximum level 2nd day after running and recovered at 2nd week's test. Na, K, BUN and Cr reached to the maximum level at finish line, and recovered to pre-running level at 2nd day's test. Conclusion: In case of half-course marathon, the changes of the kidney enzymes due to dehydration were recovered after 2nd day. And the biochemical indicators of muscle fatigue recovered after 2nd week. It needs at least 2 weeks rest after half-course marathon to recover all the biochemical parameter of the body.

강박스 거더의 생애주기비용 최적설계

신영석,박장호,이현섭,안예준,Shin Yung-Seok,Park Jang-Ho,Lee Hyun-Sub,Ahn Ye-Jun 한국전산구조공학회 2005 한국전산구조공학회논문집 Vol.18 No.4

본 논문에서는 강박스 거더의 생애주기비용을 최소화하기 위한 방법을 제시하였다. 본 논문에서 고려된 강박스 거더의 생애주기비용은 초기비용, 유지관리비용 및 보수비용으로 구성되었다. 강재 주형의 상태등급곡선과 안전진단 결과 측정된 내하력을 바탕으로 내하력곡선을 추정하였으며, 이 곡선을 이용하여 생애주비용을 고려한 강박스 거더의 최적설계를 수행하였다. 또한 내하력곡선을 통해 강박스 거더의 공용수명과 보수 보강 시기 및 횟수를 결정하고 초기 내하력에 따른 생애주기 동안 발생하는 연간비용을 비교, 분석하였다. 본 논문에서 제안한 생애주기비용을 고려한 강박스 거더의 최적설계를 통하여 기존의 설계에 비해 보다 경제적이며 안전한 설계를 유도할 수 있으리라 판단된다. This paper presents a design method to minimize Life Cycle Cost (LCC) of steel box girders. The LCC considered in this paper includes initial cost, expected life-cycle maintenance cost and repair cost. A load carrying capacity curve is derived from a condition grade curve of steel girders and load tarrying capacity that is measured in safety diagnostic test. And then, optimal design of steel box girders is performed on the basis of load carrying capacity curve. In this paper time and number of times for repair of steel girders are determined based on the calculated load carrying capacity curve. Also, annual costs considering real discount rate are compared and analyzed in various cases. It is concluded that the optimal design of steel box gilders considering LCC by the presented method will lead to more economical and safer girders than conventional design.

편측 종골 골절의 수술적 치료의 예후 관련 인자

이상욱,고상봉,이현섭,Lee, Sang-Wook,Ko, Sang-Bong,Lee, Hyun-Sub 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2

Purpose: To study prognostic factors of unilateral calcaneus fracture underwent surgery. Materials and Methods: We selected appropriate 60 cases of 236 calcaneus fracture cases between March 1985 and March 2004, and analyzed the correlation between sex, age, smoking, injury mechanism, Essex-Lopresti classification of calcaneus fracture, preoperative Bohler angle, postoperative Bohler angle, postoperative 1 year Bohler angle and Visual Analogue Scale (VAS), P.S. Kerr's Calcaneal Fracture Score (CFSS). The average age was 41.4 and average follow up period was 74 (12 to 240) months. Results: For follow up period, average VAS is 3.43 and CFSS is 81.23. The sex, age, smoking, injury mechanism, and preoperative, postoperative, postoperative 1 year Bohler angle had no correlation with the prognosis. But the Essex-Lopresti classification of calcaneus fracture, tongue type had better prognosis than joint depression type (VAS : p=0.041, CFSS : p=0.021). Conclusion: In unilateral calcaneus fracture, the sex, age, smoking, injury mechanism, preoperative Bohler angle, postoperative Bohler angle, postoperative 1 year Bohler angle had no correlation with the prognosis of fracture, but in Essex-Lopresti classification, the tongue type fracture had better prognosis than the joint depression type.