WDHA(Watery diarrhea, Hypokalemia, Achlorhydria) syndrome 1예

박기룡,김현영,김지혜,임영찬,최영식,박요한,최경현,이재화,장희경 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1

저자들은 부갑상선절제술 이후에도 교정되지 않는 고칼슘혈증과 계속된 수양성 설사로 인한 하지마비 및 전신쇠약을 주소로 내원한 70세 남자환자에서 일반 화학검사, 호르몬 건사, 방사선 검사 등으로 VIPoma와 동반된 MEN Ⅰ으로 진단하여 외과적 절제술 후 수양성설사, 저칼슘혈증 및 고칼슘혈증이 호전된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Multiple endocrine neoplasia I (MEN Ⅰ) is a genetic disorder that consists of neoplasia of neuroendocrine type in the parathyroid glands, in the islets of Langerhans in the pancreas, and in the anterior pituitary gland. Primary hyperparathyroidism is most common feature of the MEN I and occurs is approximately 95% of patients. Pancreatic islet cell tumors occur in 40% of MEN I patients. Most of these tumors produce excessive amounts of hormone, such as gastrin, insulin, glucagon and vasoactive intestinal polypeptide (VIP). VIP-producing pancreatic tumors (VIPoma) associated with MEN I are rare and there was only one case report in Korea so far. Recently we experienced a case of MEN I, especially VIPoma presented in a 70 year old man. He got subtotal parathyroidectomy for hyperparathyroidism 5 months ago, but his symptoms of watery diarrhea, severe general weakness and paralysis of lower limbs were not improved and hypercalcemia, hypokalemia were persisted. On computerized tomography scan of abdomen, demonstrated a mass of 3㎝ in diameter at the tail of pancreas. Serum level of VIP hormone was 250pg/㎖ (normal range : 0∼23pg/㎖). After partial pancreatectomy, his symptoms were improved dramatically and biochemical parameters such as, serum potassium, calcium, and VIP returned to the normal ranges.

말초혈액에서 Tg mRNA에 대한 역전사 중합효소 연쇄 반응법의 갑상선 재발암의 분자생물학적 진단

권성일,박기룡,김현영,신채희,임영찬,최영식,박요한,이강대,장희경,이재화,염하용 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 갑상선암은 다른 조직에 발생한 암에 비해 비교적 천천히 자라므로 대부분 예후가 양호하지만, 일부에서는 주위 조직으로 침윤하거나 혹은 원격 전이로 인하여 치명적인 결과를 초래할 수 있다. 갑상선전절제술 및 131^I 제거술 후 경과 관찰시 갑상선암의 재발과 전이의 진단에 있어 131^I 스캔과 혈청 Tg의 측정이 현재 임상에서 가장 많이 이용되고 있으나 이 방법에는 여러 가지의 결점이 있다. 최근 Tg mRNA에 대한 RT-PCR법을 이용한 여러 연구결과는 131^I 스캔과 혈청 Tg 측정의 결점을 보완할 수 있는 좋은 보조적인 진단법으로 이용할 수 있을 가능성을 제시하였다. 이에 말초혈액에서 측정한 Tg mRNA에 대한 RT-PCR법이 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무의 진단에 유용한가를 알아보고자 이 연구 시행하였다. 방법: 분화된 갑상선암으로 진단된 후 갑상선전절제술을 시행받고 방사성요드 치료를 받은 환자 중 현재까지 한차례에 이상 추적 방사성요드 전신 스캔을 시행하고 추적관찰이 가능했던 유두선암 35예, 여포선암 5예를 대상으로 연구를 시행하였다. 대상군은 131^I 스캔 소견상 음성인 군(Group Ⅰ), 잔여조직이 있는 군(Group Ⅱ), 국소전이가 있는 군(Group Ⅲ), 및 원격전이 군(Group Ⅳ)으로 구분하였다. 정상 대조군은 갑상선질환이 없는 10예의 건강인으로 하였다. 대상환자의 말초혈액을 이용한 Tg mRNA에 대해 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행하였다. 결과: 본 연구 결과는 다음과 같다. 1) 131^I 스캔 소견상 음성인 군 21예 중 1예에서 Tg가 양성소견을 보였다. Anti Tg Ab가 양성인 4예 모두 Tg가 음성을 보였다. 잔여조직이 있거나 국소전이 및 원격전이를 보인 군 19예 중 Tg가 양성인 경우는 4예였으나, Tg mRNA는 전예에서 양성이었다. 2) 131^I 스캔에서 국소 및 원격전이 소견을 보인 8예 중 4예에서 Tg가 음성으로 131^I 스캔과 혈청 Tg 사이에 불일치 소견을 보였다. 3) 말초혈액에서 특이적인 primer를 이용하여 RT-PCR 및 nested RT-PCR을 시행한 결과 대상군 40예 및 정상 대조군 10예 모두에서 Tg mRNA가 양성을 보였다. 결론: 본 연구에서 갑상선 절제술 및 방사성요드 치료 후 갑상선암의 재발 및 전이 유무를 평가함에 있어 역전사 중합효소 연쇄 반응법을 이용한 Tg mRNA 측정의 의의는 재평가되어야 한다고 생각된다. Background: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyriod ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluated the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. Methods: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. Results: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131^I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. Conclusion: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications (J Kor Soc Endocrinol 17:501∼513, 2002).

濟州道에서 Feijoa(Feijoa sellowiana Berg.)의 果實發育에 關한 硏究

白子勳,朴才昊,韓海龍 濟州大學校 亞熱帶農業硏究所 1992 亞熱帶農業硏究 Vol.9 No.-

濟州道 地方에서 feijoa (Feijoa sellowiana Berg.)의 經濟的 果實 生産 可能性에 關한 基礎資料를 얻기 위하여 'Mammoth', 'Triumph', 'Robert' 및 'Coolidge' 品種에 대하여 9月 下旬부터 11月 上旬까지 果實의 外的, 內的, 發育 狀態를 調査한 結果는 다음과 같다. 增加倍數 收穫時 結果 從徑 1.62~1.7 48.35~51.84㎜ 橫徑 1.77~1.8 38.85~40.97㎜ 果重 4.73~6.59 41.54~50.85g 果肉重 6.17~9.69 8.35~11.06g 果肉步合比 1.31~1.71 20.79~22.45% 果皮두께 1.49~1.66 7.28~7.45㎜ 糖度 1.35~1.74 12.65~15.11。Brix This study was conducted to obtain the data for feijoa (Feijoa sellowiana Berg.) production in Cheju. Four feijoa cultivars-Mammoth, Triumph, Robert and Coolidge-were compared in development of fruits harvested at different maturing stages. Increasing rate of fruit size (fruit length, width and weight) and fruit quality (pulp weight, pulp content, skin thickness and soluble solids) were examined from Oct. 26 to Nov. 5 (90~130 days after anthesis) in 1990. The results obtained are summerized as follow. Increasing rate Fruit size and quality (Nov.5) Fruit length 1.62~1.7 48.35~51.84mm Fruit width 1.77~1.8 38.85~40.97mm Fruit weight 4.73~6.59 41.54~50.85g Pulp weight 6.17~9.69 8.35~11.06g Pulp content 1.31~1.71 20.79~22.45% Skin thickness 1.49~1.66 7.28~7.45mm Soluble solids 1.35~1.74 12.65~15.11。Brix

矮化劑 處理가 바나나의 生育 및 收量에 미치는 影響

李宗錫,姜榮吉,朴才昊,韓海龍,文斗吉,金龍湖 濟州大學校 亞熱帶農業硏究所 1990 亞熱帶農業硏究 Vol.7 No.-

바나나에 알맞은 矮化劑를 選拔하고자 몇종의 矮化劑를 Dwarf Cavendish에 처리하였던 결과를 요약하면 다음과 같다. 1. 주당 80mg 이하의 paclobutrazol 土壤灌注 처리는 草長, 莖葉特性, 果實收量, 果實特性 등에 영향을 주지 않았다. 200mg 이상 처리구에서는 草長과 假莖長이 단축되는 경향을 보였고 果梗長은 유의성 있게 단축되었으나 다른 莖葉特性이나 果實收量, 果實特性은 무처리구와 큰 차이가 없었다. 2. 주당 20mg의 ancymidol 土壤灌注에 의해서 草長과 假莖長이 단축되는 경향이나 다른 莖葉特性이나 果實收量, 果實特性은 무처리구와 큰 차이가 없었다. 3. 5000ppm의 chlormequat 수용액 2회 葉面撤布區에서는 草長, 莖葉特性, 果實收量, 果實特性 등이 무처리구와 비슷하였다. 4. 草長과 假莖을 현저히 단축시키는 藥量의 矮化劑를 처리할 때 果梗이 假莖에서 빠져나오지 못할 것으로 보여 바나나에 있어서 矮化劑의 실용성은 없을 것 같다. This study was conducted to select growth retardants for bananas grown in a plastic greenhouse. The various rates of paclobutrazol(40, 80, 200 and 400mg/plant) and 20mg/plant of ancymidol were soil drenched and 5000ppm solution of chlormequat was foliarly sprayed twice. Application of less than 80mg of paclobutrazol did not affect plant height, pseudostem and leaf characteristics fruit yield and fruit characteristics. Application of 200 or 400mg of paclobutrazol tended to reduce plant height and pseudostem length and significantly shortened fruit stalk but did not affect the other characteristics. Application of 20mg of ancymidol tended to reduce plant height and pseudostem length but did not influence the other characteristics. Foliar spray of 5000ppm solution of chlormequat did not influence any measured plant traits. Application of growth retardants to bananas grown in a plastic greenhouse may not be beneficial because growth retardant rates to reduce plant height and pseudostem length significantly appear to prevent fruit stalks from fully emerging.

간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

척수 외상의 자기공명영상 및 신경학적 소견 : Delayed MR Image and Correlated Neurology

박용규,정진명,김은상,김재일,송해룡,한종우,신형진 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11

19 patients with traumatic spinal cord injuries and associated neurological deficit were examined by delayed(> 1 month) magnetic resonance imaging(MRI), the result of which were correlated with neurologic and somatosensory evoked potential(SSEP) findings. 5 different MRI patterns were observed in these patients : (1) normal signal intensity(SI) on T1-and T2-weighted images(WI)(pattern N/N, n=6), (2) normal SI on T1-WI and high SI on T2-WI(pattern N/Hi, n=3). (3) low SI on T1-WI and high SI on T2-WI(pattern Lo/Hi, n=6), (4) syrinx(n=2), and (5) cord transection(n=2). The neurologic state was determined using Frankel's classification at admission and MRI time. Pattern N/Hi had best neurologic state except pattern N/N, and pattern Lo/Hi showed worst prognosis except pattern transection. SSEP findings relatively well correlated with neurologic findings, but did not exactly. The cause is probably that SSEP shows predominantly the function of ascending sensory systems of the cord, do not reveal motor pathways, directly or indirectly.

약물치료에 가역적 회복을 보인 갈색세포종에 동반된 확장성 심근증 1례

홍숙경,최현,이승철,천경일,김영철,한재룡,김미숙,정경태,박순창 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

Outcomes of liver resection in patients with colorectal liver metastases by laparoscopic or open surgery

Jae-Ryong Shim,Seung Duk Lee,Hyung-Min Park,Eung-Chang Lee,Boram Park,Sung-Sik Han,Seong Hoon Kim,Sang Jae Park 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.3

Backgrounds/Aims: Colorectal cancer is found with liver metastases about 20-25% due to characteristics of cancer itself. Approximately 20% of liver metastases are found to be resectable. The objective of this study was to evaluate short-term outcomes of patients who received liver resection with colorectal cancer operation in our center by laparoscopic surgery or open surgery. Methods: Short-term outcomes of laparoscopic surgery of liver resection (LSLR) group who underwent liver resection for colorectal liver metastases (CRLM) at a single institute from 2013 to 2016 were compared to those of open surgery of liver resection (OSLR) group. Results: A total of 123 patients underwent liver resection for CRLM, including 101 (82.1%) patients in the OSLR group and 22 (17.9%) patients in the LSLR group. There were significant differences in tumor characteristics between the two groups, including synchronous and metachronous (p=0.004), tumor number (p<0.001), and tumor margin (p=0.002). For postoperative outcomes, only the length of hospital stay (LOS) was significantly different between the two groups (8.5 days in LSLR vs. 11 days in OSLR, p<0.001). There was no significant difference in overall rate of postoperative complications between the two groups (9.1% in LSLR vs. 23.8% in OSLR, p=0.158). Conclusions: There are no significant differences in postoperative outcomes between LSLR and OSLR except LOS, liver metastasis number, and resection margin. LSLR may be favorable for highly selected patients with CRLM.

Are you prepared for pancreas bifidum? A case report

Jae Ryong Shim,Sang-Jae Park,Hyung Min Park,Eung Chang Lee,Sung-Sik Han 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.94 No.1

Two cases of bronchobiliary fistula

Jae Ryong Shim,Sung-Sik Han,Hyung Min Park,Eung Chang Lee,Sang-Jae Park,Joong-Won Park 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.2

A bronchobiliary fistula, or a biliobronchial fistula (BBF), is a rare condition. It results from an abnormal connection between the biliary and bronchial trees, and is characterized by pathognomonic bilious sputum with suspicious pneumonia. Traditionally, an infectious disease, such as a hydatid infection, has been known to cause a BBF, but BBFs have recently become associated with tumors. In every case, procedures and treatments differ between centers, from simple conservative management to invasive surgical procedures. This case report presents two patients who had BBF after liver resection. Symptoms of each patients were treated and controlled successfully by percutaneous transhepatic biliary drainage tube insertion. We hope that this report helps in the management of BBF in other cases.