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이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2
구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.
고석태,윤재경,유강준 朝鮮大學校 1997 藥學硏究誌 Vol.18 No.2
Vasopression which is antidiuretic hormone in human body produced the diuretic action in dog. This atudy was investigated in order to certify the diuretic action and to search out the mechanism of the action on the vasopression. Vasopressin, when given in a dose of 10.0mU/㎏, bolus+1.0mU/㎏/min intravenously, exhibited the increase of urine flow(Vol), renal plasma flow(RPF), osmolar clearance(Cosm) and amounts of sodium and potassium excreated in urine(E_Na, E_K), the decrease of reabosorption rate of sodium and potassium in renal tubules(R_Na, R_K), and then elevated the mean arterial pressure(MAP). Vasopressin given in a increased dose to 30.0 mU/㎏,bolus+1.0mU/㎏/min intravenously elicited the same aspect with that exhibited by a small dose in changes of Vol. and all reansl fuction and potentiated the change rates, whereas this time MAP did not change at all when compared with control value. Vasopressin, when adminstered into a renal artery, but increased slightly the Vol, glomeruler filtration rate(GFR). E_Na and E_K excepted the no change of R_Na and R_K in the control (not administered)kidney. Vasopressin. when infused into carotid artery, showed the increase of Vol. GFR,E_Na, E_K and no change of R_Na and R_K in a dose of 1/5 of intravenouse dose. Diuretic action of vasopressin administewred into carotid artery was not influenced by renal denervation. Above results suggest that vasopressin produces diuretic action by hemodynamic changes in dog. These hemodynamic changes may be mediated by central endogenous substances not associated with renal nerve.
다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도
주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.
A novel prognostic factor for hepatocellular carcinoma: protein disulfide isomerase
Yu, Su Jong,Won, Jae-Kyung,Ryu, Han Suk,Choi, Won-Mook,Cho, Hyeki,Cho, Eun-Ju,Lee, Jeong-Hoon,Kim, Yoon Jun,Suh, Kyung-Suk,Jang, Ja-June,Kim, Chung Yong,Lee, Hyo-Suk,Yoon, Jung-Hwan,Cho, Kwang-Hyun The Korean Association of Internal Medicine 2014 The Korean Journal of Internal Medicine Vol.29 No.5
<P><B>Background/Aims</B></P><P>Protein disulfide isomerase (PDI) has been implicated in the survival and progression of some cancer cells, by compensating for endoplasmic reticulum stress by upregulating the protein-folding capacity. However, its prognostic role in patients with hepatocellular carcinoma (HCC) has not been investigated.</P><P><B>Methods</B></P><P>We collected HCC tissues from 83 HCC patients who underwent surgical resection for an immunohistochemical study of PDI. Overall survival (OS) was measured from the date of surgical resection until the date of death from any cause. Radiological progression was evaluated using the modified Response Evaluation Criteria in Solid Tumors in an independent radiological assessment.</P><P><B>Results</B></P><P>PDI expression was found to be increased in human HCC compared to adjacent nontumor tissues. Increased immunopositivity for PDI was associated with a high Edmondson-Steiner grade (<I>p</I> = 0.028). Univariate analysis of patients who had undergone surgical resection for HCC showed that tumor PDI upregulation is a significant risk factor for poor OS (<I>p</I> = 0.016; hazard ratio [HR], 1.980) and time to progression (TTP; <I>p</I> = 0.007; HR, 1.971). Multivariate analyses revealed that high PDI expression was an independent predictor of a shorter TTP (<I>p</I> = 0.015; HR, 1.865) and poor OS (<I>p</I> = 0.012; HR, 2.069).</P><P><B>Conclusions</B></P><P>Upregulated PDI expression is associated with aggressive clinicopathological features of HCC; thus, PDI might serve as an independent prognostic factor and a potential therapeutic target for HCC patients.</P>
자성홀소자를 이용한 집게형 맥진기의 유효성 평가를 위한 허맥과 실맥 로지스틱 회귀식 탐색
유준상 ( Jun-sang Yu ),장세진 ( Sei-jin Chang ),선승호 ( Seung-ho Sun ),홍유식 ( Yu-sik Hong ),이상석 ( Sang-suk Lee ) 대한한의진단학회 2013 大韓韓醫診斷學會誌 Vol.17 No.1
The aims of this study are to investigate a logisitic regression equation of the vacuous pulse and the replete pulse for efficacy evaluation of clip-type pulsimeter by using magnetic Hall device. To evaluate the efficacy of clip-type pulsimeter by using magnetic Hall device as sensing the minute movement of a radial artery, one research clinical trial have been performed. The number of subject was 120, the clinical data of patients did treated with a normal statistical method. The systolic peak amplitude, the reflective peak amplitude and time, and the notch peak amplitude and time are analyzed major efficacy parameters to discern the vacuous pulse and the replete pulse. The equations included of five parameters such as systolic peak amplitude, the reflective peak amplitude and time, and the notch peak amplitude and notch amplitude time for determination of the vacuous pulse and the replete pulse were deducted by statistical logistic regression method. It suggests that the logistic regression equations are possible to develop the oriental algorithm for pulse diagnosis.
S-584 The optimal dosage of dexamethasone in moderately emetogenic chemotherapy
( Yu Hyun Nam ),( Young Jun Yang ),( Ji Chan Park ),( In Sung Cho ),( Suk Young Park ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Purpose:?The purpose of this study was to evaluate the dosage of dexamethasone in combination with a 5-HT3 antagonist when used for the prevention of acute and delayed nausea and vomiting in patients receiving moderately emetogenic chemotherapy.?Patients and Methods:?This was a multicenter, randomized, single-blind and crossover study. Seventy patients received the two consecutive cycles of moderately emetogenic chemotherapy. Using a computer-generated random numbers, patients randomly received one of the following doses and schedules of antiemetics in each cycles of chemotherapy. The standard-dose schedules(SD) consisted of intravenous administration of dexamethasone 12 mg on day 1 and 8 mg on days 2∼3. The low-dose schedules(LD) consisted of intravenous administration of dexamethasone 8 mg on day 1 and 4 mg on days 2∼3. Both schedules received ramosetron 0.3 mg IV on day 1, followed by ramosetron 0.1 mg tablet on day 2 and 3. The antiemetic effects were evaluated by recording the intensity of nausea and the frequency of vomiting in the acute and delayed phases and were assessed by paired t test.?Results:?The rate of complete response from acute vomiting and nausea, respectively, was not significantly different among the two schedules (SD 100% and LD 98.5% in acute vomiting[p=0.321], SD 87.1% and LD 85.7% in acute nausea[p=0.784]), nor was the rate of complete response from delayed vomiting and nausea, respectively (SD 97.1% and LD 94.2% in delayed vomiting[p=0.321], SD 50.0% and LD 55.7% in delayed nausea[p=0.228]).?Conclusions:?Low-dose schedules of Dexamethasone(8 mg-4mg-4mg) in combination with a 5-HT3 antagonist was no different from current standard dose dexamethasone(12 mg - 8 mg - 8 mg) in the acute and delayed antiemetic effects against moderately emetogenic chemotherapy.