간세포암과 감별이 어려웠던 악성중피종 치험 1예

김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

조기 위암의 조직 분화도에 따른 내시경적 육안 소견

김남재,이경태,김진희,송규상,이승민,정현용,김석현,노승무,이병석,조준식 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.2

Background/Aims : The aim of this study was to investigate the endoscopic findings of early gastric cancer according to histological differentiation. Methods : One hundred eight cases of early gastric cancer (EGC) which had been confirmed surgically over a 1 year and 7 month period, were studied to assess the relationship between histological differentiation and endoscopic findings. Results : All elevated types of EGC (41 cases) were found to be differentiated carcinoma. 48.2% (30/67 cases) of the depressed type EGC was determined to be differentiated carcinoma, while the others (51.8%) were undifferentiated carcinoma. Twenty-four of thirty cases with differentiated depressed type EGC showed a reddish discolored surface (80%), and the others manifested a whitish or mixed colored surface of red and white. In the undifferentiated depressed type EGC, 73% (27/37 cases) revealed a whitish or mixed colored surface, while the others (27%) showed a reddish discoloration. In the differentiated depressed type EGC, the character of the depressed surface was mainly regular and soft or fine granular (77%), while that of the undifferentiated cases appeared as uneven large granules (43.2%) or fine granules (43.2%), sclerotic (2.8%) and/or elevated (10.8%). The margin of the depressed type EGC with differentiated carcinoma was mainly of a shoaling beach type (83.3%), and that of the undifferentiated carcinoma was not uniform and existed as a cliff type (60%), Riasis coast type (11.4%) and shoaling beach type (28.6%). Conclusions : All elevated types of EGC showed differentiated types, and histological differentiation of depressed type EGC was macroscopically determined by the size of lesions, color, and character of the depressed surface and margin of the depression.

측두엽 간질에서 F-18-FDG PET에 나타난 측두엽 내외측 부위별 대사의 차이

이명철,이동수,정준기,김현집,송호천,이상건,여정석 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.1

Purpose: We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. Materials and Methods: We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral-contralateral)/(ipsilateral+ contralateral)]×200. Results: ASI of medial and lateral lobes of mesial TLE was decreased (-16.4±8.3 and -12.7±5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8±4.7), whereas that of medial temporal lobe was not decreased (-4.6±6.3). ASI of medial lobe of lesional lateral TLE was -7.3±9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic d or decrease (ASI: -22±10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Conclusion: Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral.

비심장 수술 환자에서 수술 전후 심장사건의 위험도 평가를 위한 심근관류 SPECT 의 유용성

이명철,임석태,이동수,강원준,정준기 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.3

Purpose: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. Materials and Methods: 118 patients (M: F=66:52, 62.7±10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6±5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Results: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reveible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. Conclusion: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.

편측하지의 대퇴골 및 경골골절에 대한 임상적 고찰

이준규,김석범 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

The fracture of the ipsilateral femur and tibia is ususlly produced by violent external forces. It has many problems in the treatment, and may produce many complications. There are no many literatures about the method of treatment, and it may produce variable prognosis with different treatment. The most important objectives of the treatment is the restoration of the function. It can be obtained by early exercise therough the rigid fixation of the both fractures. The authors reviewed 18 cases of fracture of the ,ipsilateral femur and tibia treated at the department of orthopaedic surgery CNUH. and compared the results according to the method of treatment. The results were as follows: 1. Fifteen patients were male, and three patients were female. Of the eighteen patients, eleven patients were at their third and fourth decades. 2. The causes of the injury were traffic accident in fifteen cases, and industrial injuries in three cases. 3. The femoral fractures were open in five cases, and in twelve cases of the tibial fractures. 4. The femur fractures wer treated by internal fixation in sixteen cases, and by conservative treatmentin two cases. 5 The tibial fractures were treated by internal fixation in eight cases, by external fixtion in eight cases, and by conservative treatment in two case. 6. After follow up, the restoration of the function was maximum in the group of femoral internal fixation and tibial internal fixation, and the restoration of the function was minimum in the group of conservative treatment of the femur fractures. 7. The most important point of the treatment was early exercise through the rigid fixatioo of the both fractures.

홍요추 이행부 골절에 대한 임상적 연구

이준규,이호석 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

We have treated 38 cases of the injuries of the Thoracolumbar spine (T11 to L2) by short segment pedicular screw fixation using C-D instrumentation during the period from May. 1989 to June, 1993. The results were obtained as follows. 1. The Correction after short segment fixation was satisfying as follows : Ant. wedging angle, 11.3 degrees. Local Kyphosis angle, 11.1 degrees. Ant. vertebral height, 31.7%. Post. vertebral height, 6.6%. 2. The maintaing of correction appeared to be satistying as well, correction loss was follows : Ant. wedging angle, 2.2 degrees. Local kyphosis angle, 1.7 degreees. Ant. vertebral height, 6.2%. Post. vertebral height, 1.8%. 3. The short segment fixation with CD instrumentation was effective in correction, its maintance and no neurologic deterioration

류마티스성 관절염 및 퇴행성 골관절염에 있어서의 Tenoxicam ^� 제제의 임상적 연구

이준규,임현수,이정웅,김석범 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.1

The authors have conducted a clinical study to evaluate the efficacy, tolerance and safety with newly developed Tenoxicam^ⓡ to thirty-four cases of the patient of Rheumatoid arthritis and Degenerative osteoarthritis during 4 months from January 1988 to April 1988. Treatment for the patient was done with one tablet of Tenoxicam^ⓡ (20mg) per oral once a day for 4 weeks. The evaluation of the patient was done at second and fourth week after initial administration of the drug. Results were as follows: 1. Out of 34 cases, male were 4(11.8%), female were 30(88.2%), and predominent age group was 40-59 years old 17(50.0%). 2. The diagnosis of these patients were Rheumatoid arthritis 22(64. 7%) and Degenerative osteoarthritis 12(35.3%). 3. Overall efficacy, there was marked improvement in global condition, pain on movement, pain at night and stiffness. 4. Side effects were seen in 4 patients such as 2 case of heartburn, 1 case of nausea and vomiting and 1 case of diarrhea. 5. There were no significant difference between pre-and post-treatment laboratory check. 6. Conclusion: The oral Tenoxicam^ⓡ was very effective for the treatment of Rheumatoid arthritis and Degenerative osteoarthritis, and side effects were few and generally mild.

류마티스성 관절염 및 퇴행성 골관절염에 있어서의 Tenoxicam(Tilcotil^(�))제제의 임상적 연구

이준규,임현수,이정웅,김석범 최신의학사 1988 最新醫學 Vol.31 No.6

Eisenmenger씨 증후군을 동반한 충수돌기염 천공에 의한 복막염 환자의 마취경험 : 증례보고

천경석,박천희,이철승,이철,안용미,최준석 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Eisenmenger's syndrome includes any condition in which communication between the pulmonary and systemic circulation gives rise to pulmonary vascular disease causing a right to left shunt with peripheral cyanosis, It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. We report a case of a 58-year-old woman with an emergency operation for peritonitis due to appendiceal perforation and Eisenmenger's syndrome secondary to large ventricular septal defect. We carefully performed balanced anesthesia with air-O₂-desflurane-remifentanil. She was transferred to the intensive care unit in intubated state postoperatively and discharged two weeks later without any complications.

NK/T 세포 림프종 환자에서 시행된 비골수제거성 조혈모세포이식

정준원,김진석,장준호,서형찬,이승태,김현옥,양우익,민유홍,한지숙,고윤웅 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.2

저자 등은 맹장, 충수돌기 및 흉막을 침범한 고위험군 NK/T 세포 림프종 환자에서 비골수제거 조혈모세포이식을 시행한 후 이식연관 합병증 없이 무병생존하였기에 보고하는 바이다. NK/T cell lymphoma is a rare type of non-Hodgkin"s lymphomas. It has the histological features of angiocentric lymphoma characterized by prominent angio-invasion by tumor cells, and commonly presents in nasal and paranasal structures. Non-nasal form of NK/T cell lymphoma involves skin, gastrointestinal tract, or liver. With conventional chemotherapy and/or radiotherapy, NK/T cell lymphoma shows poor response rate and seldom results in long term survival. Especially, non-nasal form has more aggressive clinical manifestations and grave outcome than nasal form. We report a case of NK/T cell lymphoma presenting with small bowel perforation and malignant pleural effusion due to lymphoma infiltration, transplanted with allogeneic peripheral blood stem cells from HLA identical sibling donor after fludarabine-based nonmyeloablative chemotherapy. After transplantation, the patient achieved an enduring tri-lineage hematological complete response without any evidence of relapse for 10 months.