불완전하게 결찰된 뇌동맥류의 혈관내치료 - 증 례 보 고 -

임동준,정용구,조태형,이훈갑,김세훈,김근회,권택현,정흥섭,박정율,박윤관,이기찬,서중근,Lim, Dong-Jun,Lee, Hoon-Kap,Cho, Tae-Hyoung,Chung, Yong-Gu,Kim, Se-Hoon,Kim, Keun-Hoe,Kwon, Taek-Hyun,Chung, Heung-Seob,Park, Jung-Yul,Park, Youn-Kwan,L 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Residual aneurysm is a challenging problem after clipping procedure for the aneurysms. The anthors describe one patient in whom endovascular treatment was sucessfully done to treat residual aneurysm after surgical clipping. We discussed the role of endovascular coil occlusion in case of incomplete surgical obliteration of aneurysms.

허혈성 뇌혈관질환에서 자기공명혈관조영술의 가치에 대한 임상연구

임동준,조태형,정용구,김백현,김근회,김세훈,권택현,정흥섭,박정율,박윤관,이훈갑,이기찬,서중근,Lim, Dong-Jun,Cho, Tae-Hyoung,Chung, Yong-Gu,Kim, Baek-Hyun,Kim, Keun-Hoe,Kim, Se-Hoon,Kwon, Taek-Hyun,Chung, Heung-Seob,Park, Jung-Yul,Park, Youn-K 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

췌도 미세캡슐의 최적화

임동준 ( Dong Jun Lim ),조재형 ( Jae Hyoung Cho ),최윤희 ( Yoon Hee Choi ),박헌석 ( Heon Seok Park ),홍옥기 ( Oak Kee Hong ),권혁상 ( Hyuk Sang Kwon ),손호영 ( Ho Young Son ),윤건호 ( Kun Ho Yoon ) 한국조직공학과 재생의학회 2005 조직공학과 재생의학 Vol.2 No.3

Using an air-driven droplet generator, we investigated to establish an ideal condition of microencapsulation of rat islets by simple alginate-barium microcapsules and to access viability of islets in capsules. We made empty microcapsules by changing an alginate density from 1.0% to 3.0%, an alginate infusion rate from 10 to 70 mL/hr and a CO2 flow rate from 1.0 to 7.0 L/min and decided the optimal condition in making the optimal sized capsules with less than 5% fragmented microcapsules. The adequate microcapsules sized 700-800 μm were produced at an alginate density of 1.5% (P<0.05), at an alginate infusion rate of 40 mL/hr (P<0.05), and at an air flow rate of 4.0 L/min under the minimum of fragmented microcapsules. Isolated 4000 rat islets were microencapsulated according to the above condition. There was no difference of the capsule size between the islets-encapsulated microcapsules and that of empty ones (750.5±31.3 μm vs. 826.1±31.9 μm). We compared the insulin secretion of islets encapsulated by alginate-barium microcapsule with that of naked islets (control group) through the measurement of glucose-stimulated insulin secretion at 3.3 mM glucose and at 16.7 mM glucose. Insulin secretion of microencapsulated islets had no difference from that of control group at 3.3 mM glucose but was 42% lower than that of control group at 16.7 mM glucose during 45 min incubation. Here we established the optimal conditions for microencapsulation of isolated islets, which would overcome the immunorejection in allo- and xeno-islet transplantation in diabetes patients.

Contrastive Learning 기반 네트워크 침입 탐지 성능 평가

임동준(Dong-Jun Lim),장지호(Ji-Ho Jang),정윤경(Yun-Gyung Cheong) 한국정보과학회 2022 한국정보과학회 학술발표논문집 Vol.2022 No.12

서울,경기 지역의 의료기관별로 관찰한 당뇨병 환자의 임상적 특징

임동준 ( Dong Jun Lim ),권혁상 ( Hyuk Sang Kwon ),김희수 ( Hee Soo Kim ),이진희 ( Jin Hee Lee ),고승현 ( Seung Hyun Ko ),이정민 ( Jung Min Lee ),김성래 ( Sung Rae Kim ),이원철 ( Won Chul Lee ),손현식 ( Hyun Sik Son ),차봉연 ( Bong 대한내과학회 2006 대한내과학회지 Vol.71 No.2

목적: 다양한 의료기관에 의한 관리에도 불구하고 많은 당뇨병 환자들이 적절히 치료받지 못하고 있는 것이 현실이다. 저자들은 우리나라 당뇨병 환자들의 혈당조절 정도, 치료방법, 고혈압 및 고지혈증의 빈도와 관리실태 등을 파악하여 앞으로 우리나라의 의료기관별 당뇨관리 지침 개발을 위한 기초자료로 이용하고자 하였다. 방법: 2000년 12월부터 2001년 2월까지 3개월 동안1 차 의료기관 7곳, 2차 의료기관 3곳, 3차 의료기관은 2곳에서 각각 조사를 실시하였다. 모든 정보는 환자의무기록, 면담, 검사실 소견을 바탕으로 기록되었고 설문조사는 1. 인구통계학적 정보(성별, 연령, 체중, 신장, 당뇨병 이환기간), 2. 생화학검사(당화혈색소, 공복혈당, 식후 2시간 혈당, 혈청지질농도), 3. 병용약제(당뇨병치료제, 항고혈압제, 항고지혈증제 및 기타 병용약제)를 포함하였다. 모든 조사가 완성된 사람은 각각 1차 의료기관 321명, 2차 의료기관 343명, 3차 의료기관 1,830명이었다. 결과: 각 의료기관별로 연령이나 성별 분포는 차이 가 없었다. 이환기간은 3차 의료기관에 다니는 환자들이 9.7±7.3년으로 1, 2차 의료기관에 다니는 환자들보다 더 길었고(각각 6.6±4.5, 6.2±5.2년), 체질량지수는 2, 3차 기관의 환자가 각각 24.5±3.0, 24.1±3.1 kg/m2으로 1차 의료기관의 환자(25.2±2.7)보다 더 낮았으나 통계학적 유의성은 없었다. 공복혈당의 경우 2차 의료기관의 환자들이, 식후 2시간 혈당은 1차 의료기관에 다니는 환자들이 가장 높았다(각각 p<0.01, p<0.01). 평균 당화혈색소는 3차 의료기관 8.0±1.8%, 2차 의료기관 8.3±2.1%, 1차 의료기관 8.7±1.8%로 상위 의료기관으로 갈수록 더 낮았다(p<0.01). 혈청지질농도의 경우 3차 의료기관이 총 콜레스테롤, 중성지방, LDL-C 모두 가장 낮고, HDL-C이 가장 높았으며(모두 p<0.01), 총 콜레스테롤과 HDL-C은 1, 2차 의료기관간 차이가 없었다(각각 p>0.01, p>0.01). 전체 조사환자 중 고혈압은 각각 1차 의료기관 49.5%, 2차 58.1%, 3차 43.8%에서 동반되었으며(p<0.001), 항고혈압제를 복용하는 환자들 중 혈압조절의 목표인 130/85 mmHg 미만으로 조절되는 환자는 1차 의료기관 33.3%, 2차 의료기관 22.7%, 3차 43.2%이었다(p=0.003). 총 콜레스테롤이 200 mg/dL 이상이거나 항고지혈증제를 복용 중인 환자는 1차 의료기관 60.1%, 2차 54.6%, 3차 41.6%이었고(p<0.001), 항고지혈증제를 복용 중인 환자 중 총 콜레스테롤이 200 mg/dL 미만인 환자는 1차 의료기관 17.0%, 2차 20.9%, 3차 56.5%이었다. LDL-C이 100 mg/dL으로 유지되는 환자는 1차 의료기관 16.9%, 2차 29.9%, 35.7%이며(p<0.001), HbA1c가 7% 미만으로 유지되는 환자는 1차 의료기관 17.5%, 2차 28.9%, 3차 30.9%에 불과하였다. 관상동맥 질환의 경우 세 의료기관별 차이를 보이지 않았으며(p=0.70), 2차 의료기관에서 뇌혈관 질환의 빈도가 높았다(7.6%, p<0.001). 당뇨병성 말초신경병증은 2, 1, 3 의료기관순으로 빈도가 증가하였으며, 당뇨병성 비증식성 망막병증은 상위 의료기관으로 갈수록 증가하였고(p<0.001), 증식성 망막병증은 3차 의료기관에서만 관찰되었다. 결론: 각 의료기관에 대한 제한된 자료임에도 불구하고, 의료기관별로 관찰한 우리나라 당뇨병 환자의 혈당, 혈압 그리고 고지혈증 조절 실태는 전반적으로 불량하였다. 당뇨병 환자에 대한 효율적인 관리를 위해 의료기관별 표준 관리지침과 의사 교육 프로그램 개발 등 좀 더 많은 노력이 필요할 것으로 보인다. Background: In spite of various types of medical supports, many diabetic patients have not been cared adequately. This study was performed to investigate the clinical characteristics and the patterns of management according to the types of the medical institutions. Methods: Seven private clinics as primary care institutions, 3 hospitals as secondary care institutions, and 2 medical centers as the tertiary care institutions located in Seoul and Gyeonggi province were the targets of investigation for three months from December 2000 to February 2001. The survey included demographic information, biochemical tests and the pharmacological agents used concomitantly. The subjects who have completed the entire tests were respectively 321, 343 and 1830 patients in the primary, secondary and tertiary care centers. Results: There were no significant differences in age and sex distribution among the study groups. The fasting and postprandial blood glucose levels were highest in secondary and primary institutions, respectively. The glycated hemoglobin levels were higher in primary care institutions than in others. In tertiary care institutions, blood pressure and lipid profile (total cholesterol, triglyceride and HDL-cholesterol) were better controlled compared with the other study groups. Conclusions: In spite of the limited data from the selected medical institutions, the overall status of the blood glucose, hypertension and hyperlipidemia management for the diabetic patients in Korea were inadequate in all types of medical institutions. For the better management of the diabetic patients, more efforts will be required including the standard management protocol as well as the education program for the primary physicians.(Korean J Med 71:173-181, 2006)

강바닥판 교량의 U리브 간격이 교면포장 종방향 균열에 미치는 영향에 관한 수치해석적 연구

임동준(Lim Dong Jun),김영필(Kim Young Phil),김문영(Kim Moon Young) 대한토목학회 2009 대한토목학회 학술대회 Vol.2009 No.10

간낭종으로 오인한 Pancreatic Pseudocyst Rupture로 발생한 Pseudocyst 1예 보고

임동준(Dong Jeon Lim),소병준(Byung Jun So),채권묵(Kwon Mook Chae) 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.53 No.5

당뇨 환자에서 경막외 농양과의 감별을 요한 원발성 척추 경막외 임파종 - 증례보고 -

김세훈,임동준,조태형,정용구,이훈갑,이기찬,서중근,Kim, Se Hoon,Lim, Dong Jun,Cho, Tai Hyoung,Chung, Yong Gu,Lee, Hoon Kap,Lee, Ki Chan,Suh, Jung Keun The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.3

척추 경막외 임파종은 전체 임파종의 7%정도를 차지하며, 가장 흔한 증상으로 척수 압박 증세를 유발하는 것으로 알려져 있다. 그 중에서도 원발성 척추 경막외 임파종, 즉 다른 장기의 침범 소견 없이 척추에만 국한되어 나타난 임파종은, 당뇨병 환자에서 급성 척수 압박 증상으로 나타났을 때, 척추 경막외 농양과의 감별을 요한다. 저자들은 48세의 여자 당뇨 환자에서 흉추부의 통증으로 내원 1개월 전까지 여러 차례 침술치료를 받고 난 후 통증이 악화되고 급성 하반신 부전마비와 배뇨 장애 및 감염 징후가 있어 본원에 내원하여, 병력과 제반 검사상 수술전에 척추 경막외 농양으로 진단되었던 원발성 척추 경막외 임파종 1례를 수술 치험하고 보고하는 바이다. Primary spinal epidural lymphoma(SEL), i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, is an unusual cause of spinal cord compression. The authors report a 48-year-old, diabetic woman presented with back pain followed by acute paraparesis and voiding difficulty. She had been treated with acupunctures on her back before admission, and complete blood count showed leukocytosis with neutrophilia and increased erythrocyte sedimentation rate(ESR). Thoracic spine magnetic resonance imaging(MRI) revealed an epidural mass extending from T5 to T8 with compression of the spinal cord. Emergency decompressive laminectomy was performed with a tentative diagnosis of spinal epidural abscess, but a B-cell lymphoma was final pathologic diagnosis. Further staging showed no other sites of lymphoma, and the spinal lesion was treated by chemotherapy and radiotherapy. The authors stress that primary SEL can mimic spinal epidural abscess(SEA) in the diabetic patient and should be a diagnostic consideration in patients with a syndrome of acute spinal cord compression manifested by a prodrome of back pain and neuroimaging consistent with an epidural compressive lesion, especially in a diabetic.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation

김세훈,임동준,조태형,박정율,정용구,이훈갑,이기찬,서중근,Kim, Se Hoon,Lim, Dong Jun,Cho, Tai Hyoung,Park, Jung Yul,Chung, Yong Gu,Lee, Hoon Kap,Lee, Ki Chan,Suh, Jung Keun The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.10

악성 임파종중에서 Non-Hodgkin 임파종이 척수 압박 증상을 일으키는 경우는 0.1~10.2%정도로 알려져 있으며, 이러한 척수 압박 증세가 임파종의 초기 증상으로 나타나는 경우는 특히 드문 것으로 알려져 있다. 척수 압박은 척추관내에 국한되어 있는 임파종에 의하거나 주변 임파절이나 척추로부터 전이된 경우에 발생하며, 다른 장기로의 침범 소견이 없는 원발성 척수 경막외 임파종의 경우, 조기에 외과적 감압이 이루어지고 보조요법으로 항암 치료 및 방사선 치료가 행해진다면 그 경과가 비교적 양호한 것으로 알려져 있다. 저자들은 요통을 전구 증상으로, 급성 하반신 부전마비 및 배뇨 장애 소견을 보여 본원에 내원후, 응급 감압술 및 조직병리검사 결과 B-세포성 Non-Hodgkin 임파종으로 확인된 두 명의 여자환자를 경험하였다. 수술후 두 환자의 증세는 모두 회복되었으며, 항암 치료 및 방사선 치료후 현재까지 추적 조사중이다. 이에 저자들은 초기 증상으로 경막외 척수 압박을 보인 원발성 Non-Hodgkin 임파종에 관해 문헌 고찰과 함께 보고하는 바이다. Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

유증상성 터어키안 내 지주막 낭종의 수술적 치험 -증례보고-

박동혁 ( Dong Hyuk Park ),정용구 ( Yong Gu Chung ),임동준 ( Dong Jun Lim ),조태형 ( Tai Hyeung Cho ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.2

We report the presentation and surgical management of one case with symptomatic intrasellar arachnoid cyst. A 37-year-old female presented with a 2-month history of headache. On neurological examination and preoperative hormonal evaluation, she had no abnormalities. The preoperative magnetic resonance images revealed a intrasellar mass which was hyperintense on T1-weighted image without enhancement after Gd-DTPA administration, and hypointense on T2-weighted image. She underwent transsphenoidal surgery. The cystic lesion was incised, and the colorless cystic fluid like CSF was drained without any solid portion. Postoperative course was uneventful. With regards to intraoperative findings, this lesion was diagnosed as arachnoid cyst.