기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

東醫壽世保元 臟腑論에 대한 考察

李敬愛,朴性植,李源哲 동국대학교 한의학연구소 1995 東國韓醫學硏究所論文集 Vol.4 No.-

The purpose of this study is to understand a term of 'Jangbu theory 臟腑論' in 'Dong-Eui-Su-Se-Bo-Won 東醫壽世保元' . The conclusion would be summerized as follows. 1.'Jangbu theory 臟腑論' of 'Sa-Sang medicine 四象醫學' is based on 'Sa-Sang structure 四象構造' . 2.'Mind 心' of 'Sa-Sang medicine 四象醫學' is recognised as the Lord of body. 3.'four-Jang 四臟' and 'four-Bu 四腑' constitute 'Sa-Sang structure 四象構造' which is based on the deviation of 'vital energy 氣', and 'four-Jang 四贓' plays a loading role. 4.'Sacho 四焦' explaine the whole function of human body including one's heart's desire, physical constitution and the visceral physiology. 5.'ear-eye-nose-mouth 耳 目 鼻 口' is connected with 'the profound secrets of nature 天機' and also has a close relation with creation of 'spirit-vital energy-blood-essence 神氣血精' and spiritual function. 6.'SaHae theory 四海論' of 'Dong Mu 東武' is philosophical concept set on the basis of 'nature 天性' and 'life 入命'. 7.'spirit-vital energy-blood-essence 神氣血精' doesn't have the relation of mutual transformation. It's creation and consumption lies on 'the power of ear-eye-nose-mouth 耳目鼻口之力'. 8.'Sa-Sang medicine 四象醫學' expands its theory centering on the deviation of 'vital energry 氣'and the transversaa circulation of 'SaHae 四海'. According to the above result, 'Jangbu theory 臟腑論' in 'Dong-Hui-Su-Se-Bo-Won 東醫壽世保元' should be understood on the basis of' Sacho 四焦' and 'SaHae 四海' according to 'Sa-Sang structure 四象構造' , accompanying philosophical thinking focused on human and society, the centural concept of 'Jangbu theory 臟腑論' could be said as' Mind 心' to be the Lord of body.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

흉선종 제거후에 발생한 재생 불량성 빈혈 : 증례보고

전원선,이상철,김현정,배상병,김찬규,이남수,박노진,이규택,박성규,홍대식,박희숙,원종호 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

Thymoma is associated with myasthenia gravis, Pure red cell aplasia, and autoimmune diseases such as autoimmune hemolytic anemia, aplastic anemia, and hypogammaglobulinemia. It's association with aplastic anemia is rare and aplastic anemia appearing after surgical removal of thymoma is especially rare. The authors hereby report a case of aplastic anemia occuring in a patient who was diagnosed with thymoma and myasthenia gravis and had the tumor surgically removed. The patient was treated with anti-thymocyte globulin, cyclosporin, and prednisolone, and showed partial remission with hematologic improvements after 12 months.

신축 공공도서관의 지위적 역할에 따른 규모와 지역 특성에 따른 건립공사비 기준에 관한 연구

이철재(Lee, Chul-Jae),윤지원(Yun, Ji-Won),이민(Lee, Min) 한국실내디자인학회 2017 한국실내디자인학회논문집 Vol.26 No.3

As the functions and roles of public libraries expand, it is time for qualitative growth. In order to improve the quality of public libraries, it is important to plan actual construction costs through systematic feasibility study. Therefore, the purpose of this study is to present the guideline of construction costs considering the size and regional characteristics according to the status role of the new public libraries. The construction costs are based on actual data. The results of the study are as follows. First, we derived the analysis framework according to the size and regional characteristics. The status role of the public libraries was considered theoretically. The size was classified according to status role of the public libraries. Regional characteristics were classified through literature review. Through this, an analysis framework was derived according to size and region. Second, the actual data on construction costs of the new public libraries were examined and analyzed. Basic factors, size, area, and construction costs were analyzed for 285 libraries nationwide that opened from 2010 to 2016. The data of 129 newly opened public libraries were classified. To present construction costs depending on price fluctuation, construction cost index was analyzed as of September 2016. Third, a guideline of construction costs for new public libraries was suggested. The construction cost per 1㎡ of building area was analyzed. By multiplying 116.70(p), the construction cost index, the construction cost per 1㎡ of total building area was calculated to be 2,472,350 won. When applying the research result, construction costs can be gained by adding construction cost index of the month.

난소 및 난소 종양 염전의 초음파 소견

오연희,이현경,이원재,이성우,박수성,윤혜원,임문환,심재철,김용탁,김성숙,김정란 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Acute torsion of the ovary and ovarian mass is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. The sonographic findings in 14 cases of surgically proven torsion of the ovary and ovarian mass are described. Mostly cystic ovarian mass, engorged vessel, dilated uterine tube, beak-like echo(torsion site), smooth mass wall thickening an free-fluid collection in cul-de-sac are described. More significant in terms of specificity were the demonstration in 6 cases(42.9%) of the smooth mass wall thickening and in 8 cases(57.1%) of a free fluid in the cul-de-sac. We report the sonographic findings of ovary and ovarian mass torsion that may suggest the preoperative diagnosis of this condition.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

위암발증 원인에 대한 생활습관 및 영양섭취에 있어서 농촌지역 주민 조사 : 강원도 화천군 주민의 Helicobacter pylori 감염률을 중심으로 Infection of Helicobacter pylori in Whachon Area, Kang-Won Do

권태봉,이정선,우영국,이명헌,정철원,주진순 한국식품영양학회 1999 韓國食品營養學會誌 Vol.12 No.1

위암발증의 원인을 밝히기 위하여 설문조사를 통하여 강원도 화천군에 거주하는 주민들의 일반사항, 생활습관 및 영양섭취실태와, ELISA법으로 Helicobacter pylori 감염률을 조사하였다. 조사 대상자는 40∼69세까지의 지역주민 169명으로 남자 79명, 여자 90명이었으며 그 결과는 다음과 같다. 조사 대상자의 학력은 65.7%가 초등학교 이하였으며, 월수입은 60%가 50만원 이하였다. 대상자의 62.7%가 농업에 종사하였고 자녀수는 64.3%가 3∼5명이었으며 대상자의 34.5%가 흡연을 하고 있었고 68.4%가 음주를 한다고 대답하였다. 대상자의 전체 평균신장은 156.7㎝로 여자는 150.1㎝, 남자는 164.4㎝ 이었다. 평균체중은 61.1㎏으로 여자의 체중은 57㎏, 남자는 65.7㎏이었으며 BMI는 전체 평균 25.5%로 여자는 24.8%, 남자는 20.1%이었다. Helicobacter pylori의 감염률은 전체 조사대상자의 66.3%이었으며, 여자의 67.7%, 남자의 64.6%가 감염되었고 연령별로는 40대의 70%, 50대의 62.2%, 60대의 69.4%가 각각 감염된 것으로 나타났다. 일상 생활 요인에 따른 Helicobacter pylori의 감염률은 흡연의 정도가 심하고 학력이 낮으며 월수입이 낮을수록 높은 경향을 보였다. Helicobacter pylori의 감염여부에 따라 감염자와 비감염자의 영양섭취량을 조사해 본 결과 비감염자는 감염자와 비교해서 에너지, 총단백질, 동물성 단백질, 칼슘, 비타민 C 섭취량이 높은 경향을 보였으며 철분과 niacin의 섭취량은 낮은 경향을 보였다. To examine the relationship between the casual infection of gastric cancer and lifestyle and nutritional status, we surveyed 169 persons, 90 females and 79 males, aged 40∼69 years from June 7 to June 14, 1997, in Whachon area, Kang-Won Do, Korea. For this purpose, we investigated Helicobacter pylori infection and identified the effect of sex, age, smoking, alcohol consumption, economic status, occupation, life-style and food intake on Helicobacter pylori infection. Helicobacter pylori status was evaluated using an enzyme-linked immunosorbant assay(ELISA) for anti-Helicobacter pylori immunoglobulin G(IgG). Helicobacter pylori infection was present in 66.3% of total subjects, namely, 67.7% of female and 64.6% of male and its prevalence increased with smoking, low education level and low monthly income. Energy, total protein, calcium and vitamin C intakes in the negative Helicobacter pylori infection group were higher than those in positive Helicobacter pylori infection group. However iron and niacin intakes were lower in the Helicobacter pylori negative group than in the positive group.

치과기공사의 스트레스 증상 관련 요인분석

김지환,이원철,이강숙,이철,진기남 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.4

목 적 : 치과기공사에서의 직무 스트레스 증상과 관련된 요인을 알아보기 위하여 본 연구를 수행하였다. 방 법 : 전국에 등록되어 있는 치과기공사 4861명중 786명을 대상으로 생활습관, 직무에서 오는 스트레스, 사회적 지원, 자아 존중감, 성격 및 스트레스증상 평가를 위한 설문조사를 시행하였다. 결 과 : 스트레스 증상지수는 80 percentile을 기준으로 하위척도들의 절단점을 선정하였으며, Receiver Operating Chacteristic Curve를 그려 민감도 81.5 %, 특이도 86.1 % 되는 55점을 절단점으로 선정하였다. 생활습관 및 상태 항목으로는 흡연자에서 OR=1.49(1.11-2.00), 주관적 건강상태가 좋지 않은 군에서 OR=1,53(1.06-2.21)로 유의하게 스트레스 증상이 높았다. 직업관련 스트레서(stressor)로는 역할 과부하 (OR=6.69, 4.74-9.44), 작업 요구(OR=8.34, 5.82-11.97), 작업과정(OR=9.89, 6.76-14.94), 작업환경(OR=8.27, 5.80-11.79), 대인관계(OR=5.82, 4.04-8.39), 직업갈등(OR=8.34, 5.82-11.97), 봉급(OR=5.70, 4.04-8.04), 역할갈등(OR=7.58, 5.37-10.71) 등이 높은군에서 스트레스 증상이 높았으며, 사회적 지원이 높은 군에서 OR꼰.39(0.27-0.57), 자아 존중감이 높은 군에서 OR=0.41(0.290.60)로 스트레스 증상이 유의하게 낮았다. 결 론 : 직업관련 스트레스 경험을 많이 한 사람일수록 직업성 스트레스 증상의 정도도 높았으며, 사회적 지원을 많이 받고 자아존중감이 높은 사람일수록 스트레스 증상을 느끼는 정도가 낮았다. 직장 내에서는 스트레스를 감소시킬 수 있는 다양한 대처 전략 프로그램의 개발과 개인을 위한 스트레스 관리교육이 필요하며, 전문화된 직장 내에서 근로자가 도움을 받을 수 있는 정보체계와 직장내의 지원이 필요함을 제시하고 있다. Objectives To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. Methods : We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. Results We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. Conclusions : Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.

톨루엔 노출 근로자에서 유전자적 요인, 생활습관 및 식이가 요중 마뇨산 배설에 미치는 영향

임현우,박정일,노영만,이강숙,이정민,이원철,이세훈,정치경 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.3

목 적 : 본 연구는 생물학적 지표 특성 연구를 위한 단면조사 연구로서 톨루엔 노출과 톨루엔의 생물학적 모니터링으로 이용되는 요중 마뇨산 농도간의 양-반응 관계에서 효과 변경인자로서 작용하는 유전자 ALDH2, CYPIAI, CYP2El의 다양성 분포를 조사하고, 이들 유전자가 요중 마뇨산 배설 농도에 미치는 영향을 알아보고자 하였다. 방 법 : 연구대상자는 경인지역에 위치한 22개의 사업체에서 페인트 제조 72명, 제조업에서 도장작업 50명, 인쇄업 12명, 접착작업 12명, 벽지의 코팅작업 14명등 160명의 근로자이었다. 성, 연령, 유기용제 작업장 근무경력, 흡연습관, 음주습관, 검사일 이전 밤에 음주 여부, 시료 채취전 6시간 이내에 섭취한 식품조사, 측정일 개인보호구의 착용 여부에 대하여 설문조사를 시행하였다. 톨루엔에 대한 개인노출량은 passive air sampler로 측정하였고, 요중 마뇨산은 요중 크레아틴으로 보정하여 측정하였다. 또한 aldehyde dehydrogenase 2 (ALDH2) , cytochrome P45O IAI(CYPIAI), 그리고 cytochrome P45O 2El(CYPfEl)의 유전적 다양성은 혈액으로부터 백혈구의 DNA를 추출하여 제한 효소 절단 길이 다양성 (restiction fragment length polymorphism, RFLP)법으로 검사하여 다음의 결과를 얻었다. 결 과 : 연구대상자의 요중 마뇨산 농도의 기하평균은 0.44g/g creatinine, 기하표준편차 2.80이었다. 톨루엔 노출 농도, 개인 보호구 착용여부, 안식향산이 함유된 식품의 섭취여부중 요중 마뇨산 배설농도에 영향을 미치는 인자는 톨루엔 노출 농도뿐이었다. ALDH2, CYPIAI, CYPfEl, 연령, 흡연, 근무기간에서 회귀계수간에 차이를 보이는 경향이 있었다. 요중 마뇨산 농도에 대한 다중회귀분석에서 톨루엔, ALDH2, CYPIAI, CYP2El유전자형의 회귀계수가 통계적으로 유의하였다. 결 론 : 톨루엔 노출로 인한 요중 마뇨산 배설 농도는 ALDH2, CYPIAI, CYP2El유전자 다양성에 의해 영향을 받기 때문에, 유전자형의 대사능의 차이를 고려하여 마뇨산 기준 농도를 찾는 연구가 이루어져야 하겠다. Objectives The purpose was to investigate the distributions and the effects of genetic polymorphism of aldehyde dehydrogenase 2(ALDH2), cytochrome P45O IAI (CYPIAI), and cytochrome P45O 2El (CYPfEl) on the toluene metabolism. Methods : The subacts consisted of 160 workers who were exposed to toluene in different industries such as paint manufacturing, painting on steel and wood products, printing, bonding, and coating. The exposed toluene level was monitored by passive air sam paler, and the questionnaire variables were age, sex, smoking, drinking, previous night's drinking, use of personal protectlve equipment, work duration, and taking benzoic acid containing food. The urinary hippurric acid collected in the end of shift was corrected by urinary creatinine concentration. The genotypes of ALDH2, CYPIAI, and CYP2El were investigated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods with DNA extracted from venous blood. Results'The geometric mean and the geometric standard deviation of urinary hippuric acid concentration were 0.44 g/g creatinine and 2.80. The urinary hippuric acid concentration was significantly related to personal exposed toluene level among personal exposed toluene level, use of personal protective equipment, and benzoic acid containing food diet. The slope differences of the regression for ALDH2, CYPIAI, and CYP2E1 genetic polymorphism, age, smoking, and work duration tended to be significant. In multiple regression analysis, the regression coefficient of toluene, ALDH2, 7YPIAl, CYP2E1 genetic polymorphism were significant. Conclusions : From the above results, urinary hippuric acid level after toluene exposure was significantly affected by the genetic polymorphism of ALDH2, CYPIAI, CYPfEl. It is needed further investigation of the urinary hippuric acid level considering the effect of genetic polymorphism.