열공성 뇌경색과 뇌내출혈의 위험인자 비교

이장준,이현아,최종환,이형,임정근,이상도,박영춘 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.2

Cerebral small vessel disease is the most important cause of lacunar infarction (LI) and intracerebral hemorrhage (ICH). It is generally postulated that, in its early stages, the vascular lesion engenders vessel wall fragility and ICH. But if rupture dose not occur, segmental vessel occlusion evolves, producing LI. It may be a common aging phenomenon that is exacerbated by hypertension and diabetes mellitus. This study was performed to evaluate risk factors of LI and ICH. We reviewed retrospectively the medical records of 690 patients (254 LI, 436 ICH) with stroke who were admitted to Keimyung University Dongsan Medical Center from January 1995 to December 1998. The major risk factors including age, sex, hypertension, diabetes mellitus and several minor risk factors were analyzed in these patients. Older age (p<0.01), male sex(p<0.01), hypertension with treatment(p<0.01), hypertension with long duration(p<0.01) and hypertriglyceridemia(p<0.01), cigarette smoking(p<0.01) were significantly more frequent in LI. Younger age(p<0.01), female sex(p<0.01) and hypertension without treatment(p<0.01), hypertension with short duration(p<0.01) were more frequent in ICH. The prevalence, duration and treatment of diabetes mellitus were not different between these two groups. This study show that the age, sex, treatment of hypertension, duration of hypertension and cigarette smoking seem to be significant risk factors between LI and ICH.

골형성부전증 10예의 임상적 특징

이형숙,김현주,조재현,이승원,김현아,최준혁,송영준,김대중,이관우,정윤석 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.5

연구배경 및 방법: 골형성부전증은 비교적 희귀한 유전병으로 교원질 대사 장애로 인한 골의 취약성과 다발성 골절 및 척추측만증 등을 특징으로 한다. 유전방식과 표현형의 발현 정도에 따라 다양한 임상 양상을 보이며, 임상적 중증도에 따라 4가지 형태로 분류된다. 지금까지 국내 보고는 분만과정이나 태아 진찰시 골격이상으로 발견된 증례보고가 주였다. 저자들은 비교적 경미한 임상 양상을 보이는 예를 포함한 다수의 골형성부전증 환자들의 전반적인 임상적 특징에 대해 보고하는 바이다. 결과: 2001년 6월부터 2003년 2월까지 골형성부전증으로 진단받은 6 가계, 10예를 대상으로 하였다. 평균 나이는 27.3(5∼56)세였고 소아가 2예였다. 모두 상염색체 우성으로 유전되었으며, 제 I형이 4예, 제 III형이 4예, 그리고 제 IV형이 2예였다. 전 예에서 다수의 골절 경험이 있었고, 골밀도 저하와 골피질 두께 감소 소견이 관찰되었다. 전신의 평균 골밀도는 0.690(0.421∼1.039) g/cm²였다. 골형성지표로 측정된 sAlk는 소아의 경우만 증가되어 있었고, 골흡수지표로 측정된 uDPD의 평균치는 12.9(4.4∼36.3) nM/mM Cr으로 증가된 소견을 보였다. mobility score는 대부분 3,4단계에 속해 있었다. 중증형일수록 진단 시의 mobility score가 낮은 경향을 보였다. 결론: 한국인 골형성부전증 환자의 임상적 특징을 살펴본 결과 기존의 보고된 II형 외에도 I, III, IV형이 다양하게 존재함을 알 수 있었으며, 모든 예에서 상염색체 우성으로 유전됨을 확인할 수 있었다. 또한 모든 예에서 증가된 골흡수로 인한 골밀도 저하와 골절을 확인할 수 있었다. Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis (J Kor Soc Endocrinol 18:496∼503, 2003).

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

Shift of Colorimetric Values in Ishihara Pseudoisochromatic Plates with Plate Aging

( Joon Young Hyon ),( Jin Hak Lee ),( Won Ryang Wee ) 대한안과학회 2005 Korean Journal of Ophthalmology Vol.19 No.2

Purpose: This study aimed to quantify the shift of colorimetric values in the Ishihara pseudoisochromatic test with aging of the plates. Methods: Three sets of Ishihara pseudoisochromatic plates with different published dates (printed in 1971, 1983 and 2001) were tested. Positions matching 32 dots with 13 colors were chosen from each set and the colorimetric values with the CIELAB and HSB/HLS color systems were measured with a spectrophotometer. Lightness (L*), red-green (a*), blue-yellow (b*), chroma, red hue, yellow hue, and green hue values from each set were compared. Results: L* and chroma values were significantly higher in the older versions. The a* values shifted to red (increased a*) and the b* values shifted to yellow (increased b*) with plate aging. Conclusions: Our results showed that the pseudoisochromatic plates had significant changes in color values and a directional shift with aging.

Eyelid Tattooing Induces Meibomian Gland Loss and Tear Film Instability

Lee, Young Bok,Kim, Jin Joo,Hyon, Joon Young,Wee, Won Ryang,Shin, Young Joo Masson Pub. USA 2015 Cornea Vol.34 No.7

PURPOSE:: To investigate the changes of meibomian gland (MG) and tear film stability in subjects with eyelid tattoos. METHODS:: Forty female subjects were recruited. Ten subjects had eyelid tattoos and 30 subjects did not (control group). Tear film break-up time (TBUT) measurement and fluorescein staining were performed to evaluate the tear film. Distances between the eyelid tattoo and the MGs were measured and used to assign a tattoo score. The overall tattoo score, defined as the sum of upper and lower lid tattoo scores, was determined for each eye. MG loss was scored for each eyelid and added together to obtain the total “meiboscore” for each eye using meibography. Values between the tattoo and control groups were examined and compared. RESULTS:: The TBUT in the tattoo group (4.3 ± 0.9 seconds) was shorter than that in the control group (11.0 ± 4.3 seconds; P < 0.001). Corneal erosion, measured with fluorescein staining, was more severe in the tattoo group (1.6 ± 0.5) than that in the control group (0.2 ± 0.2; P < 0.001). MG loss was also more severe in the tattoo group (3.4 ± 1.5) than that in the control group (0.9 ± 0.6; P < 0.001). The total tattoo score was correlated with the total meiboscore (r = 0.852, P < 0.001, Spearman correlation coefficient). CONCLUSIONS:: Eyelid tattooing shortened TBUT, increased fluorescein staining, and induced MG loss. Therefore, eyelid tattooing increases tear film instability through MG disturbance, and patients could have exacerbated signs and symptoms of ocular surface disease.

말초혈액단핵구와 화학적으로 손상된 각막세포의 혼합반응에 대한 시스테아민의 효과

이영복(Young Bok Lee, MD),현준영(Joon Young Hyon, MD, PhD),위원량(Won Ryang Wee, MD, PhD),정태영(Tae Young Chung, MD, PhD),정의상(Eui Sang Chung, MD, PhD),이가영(Ka Young Yi, MD, PhD),신영주(Young Joo Shin, MD, PhD) 대한안과학회 2015 대한안과학회지 Vol.56 No.10

목적: 말초혈액단핵구와 화학적으로 손상된 각막세포의 혼합반응에 대한 시스테아민의 효과를 알아보고자 하였다. 대상과 방법: 사람각막간질세포를 0.05 N NaOH로 60초간 처리하여 화학적으로 손상시킨 후 말초혈액단핵구자극 검사를 시행하였다. 혼합 말초혈액단핵구-각막세포반응은 이후 다양한 농도의 시스테아민(0-10 mM)으로 처리되었다. 세포 내 활성산소물질 형성 정도는 산화에 민감한 형광탐침자인 2′,7′-dichlorofluorescein diacetate (DCF-DA)를 사용하여 측정되었다. NaOH로 처리된 각막세포에 의해 촉진된 말초혈액단핵구의 증식 속도와 염증성 사이토카인 분비는 각각 bromodeoxyuridine 증식분석검사와 효소결합 면역흡수분석법으로 측정하였다. 결과: 말초혈액단핵구 증식은 시스테아민의 농도에 비례하여 억제되었다(p=0.019). DCF-DA 형광은 시스테아민 농도에 비례하여 감소하였다(p<0.001). 시스테아민의 농도에 비례하여 기질분해효소-9 (matrix metalloprotease-9, MMP-9), 인터류킨-6 (interleukin-6, IL-6), 형질전환성장인자-베타1 (transforming growth factor-beta 1, TGF-β1)은 억제되었고(p<0.05), 대식세포이동저해인자(macrophage migration inhibitory factor, MIF)는 증가하였다(p=0.008). 결론: 시스테아민이 활성산소물질의 억제를 통하여 화학적으로 손상된 각막세포에 의해 유발된 말초혈액단핵구의 증식과 염증 사이토카인의 분비를 억제하였다. 따라서 시스테아민이 화학적 각막손상 환자에서 치료제로 사용될 수 있을 것으로 기대된다. Purpose: To investigate the effect of cysteamine on mixed peripheral blood mononuclear cells (PBMCs)-chemically injured keratocytes reaction (mixed lymphocyte-keratocyte reaction; MLKR). Methods: PBMC stimulation assay was performed after keratocytes were chemically injured with 0.05 N NaOH for 60 seconds. MLKR was treated with various concentrations of cysteamine (0-10 mM). Intracellular reactive oxygen species (ROS) formation was measured using the oxidation-sensitive fluorescent probe, 2′7′-dichlorofluorescein diacetate (DCF-DA). Proliferation rate of PBMCs stimulated by NaOH-treated keratocytes and secretion profiles of matrix metalloprotease-9 (MMP-9), transforming growth factor-beta1 (TGF-β1), interleukin-6 (IL-6), and macrophage migration inhibitory factor (MIF) were determined using the bromodeoxyuridine proliferation assay and enzyme-linked immunosorbent assay, respectively. Results: Proliferation rate of PMBCs was suppressed by cysteamine in a dose-dependent manner (p = 0.019). Fluorescence of DCF-DA decreased depending on cysteamine concentration (p < 0.001). MMP-9, IL-6 and TGF-β1 levels were suppressed by cysteamine in a dose-dependent manner (p < 0.05), whereas MIF levels increased with cysteamine concentration of 0.5-10 mM (p = 0.008). Conclusions: These study results indicate that cysteamine induced the ROS-mediated inhibition of inflammatory cytokine release and proliferation of PBMCs stimulated by chemically injured keratocytes. Thus, cysteamine can be used in the treatment of chemical corneal burns.

소아의 눈물기관폐쇄에서 단누소관을 통한 눈물관의 실리콘관삽입술

현준영(Joon Young Hyon),곽상인(Sang In Khwarg),장봉린(Bong Leen Chang),위원량(Won Ryang Wee),이진학(Jin Hak Lee) 대한안과학회 2001 대한안과학회지 Vol.42 No.4

이중샤임플러그 전안부분석기를 이용한 백내장 수술 시 인공수정체 도수 계산

이영복(Young Bok Lee),이가영(Ka Young Yi),배소현(So Hyun Bae),김하경(Ha Kyoung Kim),현준영(Joon Young Hyon),위원량(Won Ryang Wee),신영주(Young Joo Shin) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 백내장 수술 환자에서 이중샤임플러그 전안부분석기(dual Scheimpflug analyzer, DSA; Galilei G2)로 측정한 생체계측값과 예측굴절력을 기존 방식과 비교하고 DSA의 simulated keratometry (simK)를 이용한 인공수정체 계산공식들의 예측오차를 알아보고자 하였다. 대상과 방법: 백내장 환자 총 39명을 대상으로 초음파계측기, 자동각막굴절계, 부분결합간섭계(IOL master??), DSA로 생체계측을 하였다. 수술 전 자동각막굴절계의 auto-keratometry (Auto-K), 부분결합간섭계의 mean K, DSA의 simK와 총각막굴절력(total corneal power, TCP)을 측정하고 4가지 각막굴절값을 이용하여 예상굴절력을 계산하였다. 또한 DSA의 simK를 Sanders-Retzlaff-Kraff (SRK)-II, SRK-T, Holladay II, Haigis, Hoffer-Q 공식에 대입하여 얻은 예상굴절력을 비교하였다. 수술 후 1, 3, 6개월에 측정한 구면렌즈대응치와 예상굴절력의 차이를 평균예측오차로, 그 절대값을 절대예측오차로 정의하여 그 값을 비교하였다. 결과: DSA의 TCP는 simK, mean K, Auto-K에 비해 유의하게 낮았다(p〈0.05). 수술 후 1개월에 평균예측오차는 simK, mean K와 Auto-K 사이에 차이가 없었고, TCP를 사용한 경우에는 다른 각막굴절력을 사용한 경우보다 평균예측오차가 컸다(p〈0.05). 수술 후 6개월에 simK와 TCP를 사용하여 계산된 평균예측오차는 유의한 차이를 보였다(p〈0.05). DSA의 simK를 5가지 인공수정체 계산공식에 대입하여 계산된 평균예측오차는 SRK-T 공식에서 가장 작았다. 결론: 정상각막을 가진 백내장 환자에서 인공수정체 도수 계산 시, DSA의 TCP보다 simK와 SRK-T 공식을 사용하는 것이 유용할 것으로 생각된다. Purpose: To investigate the accuracy of intraocular lens power calculations using simulated keratometry (simK) of dual Scheimpflug analyzer and 5 types of formulas in cataract patients. Methods: The keratometry (K), axial length (AXL) and anterior chamber depth (ACD) were measured using ultrasound biometry (USB) combined with auto-keratometry (Auto-K), parital coherence interferometry (PCI; IOL master??) and dual Scheimpflug analyzer (DSA; Galilei??) in 39 eyes of 39 patients. Predicted refraction was calculated using Auto-K, mean K of PCI, and simK and total corneal power (TCP) of DSA in the Sanders-Retzlaff-Kraff (SRK-T) formula. The SRK-II, SRK-T, Holladay II, Haigis, and Hoffer-Q formula were used to calculate predicted refraction with the simK of DSA and AXL of USB. Manifest refraction, mean numerical error (MNE) and mean absolute error were evaluated 1, 3 and 6 months after cataract surgery. Results: TCP of DSA was lower compared with other keratometric values (p 〈 0.05). The MNE was not different among Auto-K, mean K and simK. The MNE using TCP was larger compared with Auto-K, mean K and simK at 1 month after surgery (p 〈 0.05). There was a difference in MNE between simK and TCP of DSA at 6 months after surgery (p 〈 0.05). The MNE of SRK-T formula was the smallest in the intraocular lens (IOL) power calculation using the simK of DSA. Conclusions: We suggest using IOL power calculations with simK of DSA and SRK-T formula rather than TCP of DSA in cataract patients with normal corneas.

췌장암 환자의 근치적 절제후 생존과 재발 재발 양상

박영수,서정훈,정재복,송시영,황영웅,장혁재,이준규,이진헌,이세준,정준표,강진경 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4

Background/Aims: The only hope for the cure of pancreatic adenocarcinoma is curative resection. However, the rate of recurrence after curative resection is higher than 50%. The aim, of this study were to analyze survival and the factors influencing survival and to evaluate the recurrence rate and pattern after curative resection of pancreatic adenocarcinoma. Methods: The records of 250 patients who were diagnosed as pancreatic cancer were reviewed retrospectively. We classified the patients into 3 groups (curative resection, non-curative resection, and conservative treatment) and analyzed the factors influencing survival, recurrence rate, and recurrence pattern after curative resection. Results: Curative resection were performed in 31 (12.4%) of 250 cases. The patients with curative resection was significantly prolonged median survival time than those without non-curative resection or with conservative treatment. The factors influencing survival rate after curative resection were age, lymph node involvement, and disease status. Twenty-five of the 31 cases with curative resection had recurrences after 10 months. Local retroperitoneal recurrence was 69%. Liver metastasis and lymph node metastasis were occurred in 61% and 54%, respectively. Conclusions: The survival time of the patients with pancreatic adenocarcinoma was prolonged in the cases of curative resection compared with the cases of non-curative resection or conservative treatment. However, most cases after curative resection showed recurrence. Thus, early diagnosis and early treatment should be needed to prolong the survival time of the patients with pancreatic adenocarcinoma.

A Rare Case of Transitional Meningioma

Kim, Joon Hyon,Kim, Young Joon,Kim, Hoon,Nam, Sang Hyun,Choi, Young Woong Korean Society of Plastic and Reconstructive Surge 2015 Archives of Plastic Surgery Vol.42 No.3