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김한겸,양우익 大韓法醫學會 1987 대한법의학회지 Vol.11 No.2
A 21-year-old male, complaining of dyspnea, expired. An autopsy was performed to clarify the cause of death. A huge tan tumor mass, measuring 13×11×7cm, was present at the anterior mediastinum in close anatomic relationship with the thymus. Large vessels around the heart were compressed by the tumor mass and hemopericardium by extensive hemorrhagic necrosis of the tumor was noted. The tumor was diagnosed as choriocarcinoma by histopathologic and immunoperoxidase method using HCG. The cause of death was right heart failure due to compression of large vessels and hemopericardium.
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김한겸,이채원 大韓法醫學會 1986 대한법의학회지 Vol.10 No.1
A 33-year-old male patient expired suddenly, during esophago-gastrofiberscopic examination. Three years before this unexpected fatal accident, he was performed segmental resection of the duodenum and transverse colon due to leiomyosarcoma of the 4th portion of the duodenum and adhesion with transverse colon. The next of kin of the deceased requested an autopsy for the liability for the accident. On postmortem examination, massive hemoperitoneum(about 1,800cc) originated from the ruptured metastatic tumor mass protruding from the lower surface of the left lobe of the liver was seen. And the liver was near totally replaced by several huge metastatic tumor masses. In the lung, tumor emboli were also seen. The cause of death was hypovolemic shock due to massive bleeding by rupture of hematic mass.
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추간판 조직에서 연령 및 퇴행성 변화와 신생혈관과 섬유모세포 성장인자발현에 대한 연구
전창훈,김한겸,강신영 대한척추외과학회 1999 대한척추외과학회지 Vol.6 No.3
연구계획 : 추간판 조직에서 신생혈관의 연구는 탈출된 추간판 조직에서 이루어졌다. 본 연구는 퇴행성 척추질환의 추간판 조직에서 신생혈관과 섬유모세포 성장인자의 발현에 대한 연령 및 퇴행성 변화와의 관계를 연구하고자 한다. 연구목적 : 추간판 조직에서 신생혈관과 섬유모세포 성장인자의 발현을 관찰하고 추간판 조직의 연령 및 퇴행성 변화와의 상관관계를 연구하고자 한다. 대상 및 방법 : 주된 증상이 요통인 퇴행성 척추 질환으로 전방 추체유합술을 시행받고 12개월 이상 추시 가능하 였던 환자의 추간판 조직 30례를 연구대상으로 하였다. 조직학적 관찰은 H-E염색과 혈관내피세포 성장인자와 섬유 모세포 성장인자를 이용한 면역 조직화학염색을 실시하였다. 대조군으로 부검시 채취한 신생아의 추간판 조직 12례를 대상으로 하였다. 결과 : 질환군에서 Hematoxylin - eosine염색 및 혈관내피세포 성장인자와 섬유모세포 성장인자를 이용한 면역 조직 화학염색상 신생혈관과 섬유모세포 성장인자의 발현은 전례에서 섬유륜의 바깥 1/2 층에서 관찰되었으나, 수핵에서는 혈관형성이나, 면역염색상 양성반응을 보이는 세포는 관찰되지 않았다. 대조군 12례의 추간판조직에서 Hematoxylin-eosin염색상 혈관형성이 관찰되었으나, 혈관내피세포 성장인자 항체와 섬유모세포 성장인자를 이용한 면역 염색상 양성 반응을 보이지 않는다. 대조군과 질환군 사이의 신생혈관에 대한 혈관내피세포 성장인자와 섬유 모세포 성장인자의 발현의 차이점은 통계학적으로 의미가 있었다( P<0.05). 질환군 사이의 신생혈관에 대한 혈관내 피세포 성장인자 항체 및 섬유모세포 성장인자의 발현의 차이는 없었다( P>0.05 ) . 결론 : 추간판내의 신생혈관과 섬유모세포 성장인자의 발현은 추간판 조직의 연령 및 퇴행성 변화와 관계가 있다 고 사료되었다. Numerous studies have shown neovascularization and basic fibroblast growth factor(bFGF) expression in herniated nucleus pulposus. It is not clear whether the neovascularization and bFGF expression are due to herniated nucleus pulposus with secondary reaction phenomenon or due to disc aging and degeneration. The purpose of this study is to investigate neovascularization and bFGF expression in both nucleus pulposus and anulus fibrosus tissues from aging and degenerated discs and compare it to neonate intervertebral disc. Thirty disc blocks obtained during anterior interbody fusion of the lumbar spine with degenerative spine disease were studied by immunochemical stains to observe neovascularization with vascular endothelial cell growth factor(VEGF) and bFGF expression. There were 8 disc blocks from the patients with degenerative disc disease, 15 with spondylolytic spondylolisthesis, and 7 with spinal stenosis with instability. For the control group, 12 neonate disc blocks obtained at autopsy. The neovascularization and bFGF expression were observed in the outer one half layer of the anulus fibrosus in the disease group but not in the nucleus pulposus. The neovascularization and bFGF expression were not observed in the control group. There was a statistical significant difference of neovascularization and bFGF expression between the control and disease group(p<0.05). There was no statistical significant difference of neovascularization and bFGF expression among the disease group(p>0.05). The results of this study suggest that neovascularization and bFGF expression are inherently related to aging and degeneration of the intervertebral disc.
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양우익,김한겸 中央醫學社 1987 中央醫學 Vol.52 No.10
A 21-year-old male, complaining of dyspnea, expired. An autopsy was performed to clarify, the cause of death. A huge tan tumor mass, measuring 13 x I1 x 7cm, was present at the anterior mediastinum in close anatomic relationship with the thymus. Large vessels around the heart were compressed by the tumor mass and hemopericardium by extensive hemorrhagic necrosis of the tumor was noted. The tumor was diagnosed as choriocarcinoma by histopathologic and immunoperoxidase method using HCG. The cause of death was right heart failure due to compression of large vessels and hemopericardium.
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이정규,전지현,김민정,이규재,김한겸,조현득,채양석 大韓法醫學會 1999 대한법의학회지 Vol.23 No.2
Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on mediline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
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Effects of social supports on burden in caregivers of people with dementia
Han, Ji Won,Jeong, Hyeon,Park, Jae Young,Kim, Tae Hui,Lee, Dong Young,Lee, Dong Woo,Ryu, Seung-Ho,Kim, Shin-Kyeom,Yoon, Jong Chul,Jhoo, JinHyeong,Kim, Jeong Lan,Lee, Seok Bum,Lee, Jung Jae,Kwak, Kyung Cambridge University Press 2014 INTERNATIONAL PSYCHOGERIATRICS - Vol.26 No.10
<B>ABSTRACT</B><B>Background:</B><P>Social support programs for dementia caregivers were widely used in order to reduce care burden. We investigated which types of social supports can reduce psychological and non-psychological burdens of dementia caregivers, and explored the mechanism of those social supports.</P><B>Methods:</B><P>We evaluated 731 community-dwelling dementia patients and their caregivers from the National Survey of Dementia Care in South Korea. We investigated the five types of social supports (emotional support, informational support, tangible support, positive social interaction, affectionate support) using the Medical Outcomes Study Social Support Survey in each caregiver. The mechanisms of specific types of social support on psychological/non-psychological burden were examined using path analysis.</P><B>Results:</B><P>Positive social interaction and affectionate support reduced psychological burden via direct and indirect paths. Tangible support reduced the non-psychological burden via direct and indirect paths. Informational support and emotional support were not helpful for reducing psychological or non-psychological burden. A maximum of 20% of psychological burden could be relieved by positive social interaction and 10.3% of that could be reduced by affectionate support. Tangible support was associated with a 15.1% maximal improvement in non-psychological burden.</P><B>Conclusions:</B><P>In order to reduce caregiver burden in dementia effectively, psychosocial interventions should be tailored to target type of caregiver burden.</P>
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한형수,정현주,양은경,김인겸 경북대학교 의학연구소 2000 경북대학교병원의학연구소논문집 Vol.4 No.1
Intrinsic differences between vascular smooth muscle cells(VSMC) in normotension and those in genetic hypertension may account for the exaggerated growth response often observed in the hypertensive vasculature. We investigated whether the differences in the growth properties between VSMC from 12 week old male spontaneously hypertensive rats(SHR) and those from normotensive Wistar-Kyoto rats(WKY) are related to the gene expression of c-fns, PDGF-β1, FGF-β, TGF-β1 and angiotensin Ⅱ receptor type 1A(ATIA). Growth stimulation to VSMC was done with angiotensin Ⅱ(1 μM) and mRNA levels for c-fos, PDGF-β, FGF-β, TGF-β1 and AT1A were measured by RT-PCR using each specific cDNA primers. In Angiotensin Ⅱ-untreated cases, VSMC from SHR exhibited higher mRNA leval for c-fos and PDGF-β than those from WKY . Following angiotensin Ⅱ treatment, increase in the level of mRNA for c-fos was more prominent in WKY than SHR. Angiotensin Ⅱ enhanced the gene expression of PDGF-β and FGF-β in both strains and made no change in AT1A and TGF-β1 gene expression. For FGF-β, there was no difference in the mRNA level between SHR and WKY following exposure to angiotensin Ⅱ. We concluded that difference in the growth properties of VSMC between SHR and WKY may be related to gene expression of c-fos and PDGF-β.
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