췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

論文(론문) : 大腸正格證(대장정격증)과 장누수증후군(Leaky Gut Syndrome)과의 관계 考察(고찰)

이진철 ( Jin Cheoul Lee ),박상균 ( Sang Kyun Park ),방정균 ( Jung Kyun Bang ) 대한한의학원전학회(구 대한원전의사학회) 2013 대한한의학원전학회지 Vol.26 No.4

A Study on the Relationship between Dae-Jang-Jung-Gyeok(大腸正格) and Leaky Gut Syndrome Lee Jin-Cheoul1·Park Sang-Kyun2·Bang Jung-kyun3 *1Dept. of Medical History, College of Korean Medicine, Kyunghee University 2Dept. of Meridian, College of Korean Medicine, Sangji University 3Dept. of Korean Medical Classics and History, College of Korean Medicine, Sangji University Objective: If the penetration ratio of the intestinal mucosa is increased, the toxic or unhealthy materials - which should not be absorbed into our bodies - will be come into our bodies. They cause a sort of anti-toxic response or confusion of the immune system, and ultimately bring various types of diseases. This syndrome is related "Poison in Excrement" or "Internal Damage(內傷發□)" and Leaky Gut Syndrome, so I will study on the relationship between them. Method: Study on the relationship between Dae-Jang-Jung-gyeok and Leaky Gut Syndrome. Result: Korean doctors in ancient times called this syndrome "Poison in Excrement" or "Internal Damage(內傷發□)" and treated it with "Dae-Jang-Jung-Gyeok(大腸正格)". Leaky Gut Syndrome is a sort of clinical lesion, which allows foreign and harmful toxins in and results in a disorder of the immune system due to the leaking intestinal mucosa. Conclusion: Based upon the analyses, Dae-Jang-Jung-Gyeok and Leaky Gut Syndrome are closely related. Therefore diseases caused by the Leaky Gut Syndrome might be expected to be cured by Dae-Jang-Jung-Gyeok. Particularly the use of treatments for self-immune diseases and allergic diseases such as atopyic dermatitis and articular rheumatism should be expected to reveal a new path of treatment for other disorders such as Leaky Gut Syndrome. Key Words: Poison in Excrement, Internal Damage(內傷發□), Dae-Jang-Jung-Gyeok(大腸正格), Leaky Gut Syndrome

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

동종골수이식 후의 이식편대숙주 질환의 빈도와 임상양상 : 단일 병원 치료 경험 A Single Institution Experience

이규형,이제환,이정신,서철원,김상위,김성배,김정균,김신,김우건,김상희 대한조혈모세포이식학회 1997 대한조혈모세포이식학회지 Vol.2 No.1

배경: 이식편대숙주 질환은 동종골수 이식후 발생할 수 있는 가장 중요한 합병증의 하나이다. 일반적으로 이식편대숙주 질환이 서구에 비하여 한국을 비롯한 아시아 국가에서 드물다고 알려져 있다. 방법: 저자들은 1993년 12월부터 1997년 6월까지 동종골수이식을 받은 전체 44명의 환자를 대상으로 급성 및 만성 이식편대숙주 질환의 빈도와 임상 양상을 조사하여 분석하였다. 대상환자중 남자가 27명 (61%) 이었고, 여자가 17명 (39%)이었다. 중앙연령은 33.5세 (범위, 16-47세)였다. 17명은 급성골수성 백혈병, 6명은 급성림프구성백혈병, 11명은 만성골수성백혈병, 8명은 중증재생불량성빈혈, 1명은 골수이형성증후군, 그리고 나머지 1명은 신경아세포종(neuroblastoma) 환자였다. 이식편대숙주 질환 예방으로 methodtrexate와 cyclosporine복합요법을 시행하였다. 결과: 3명에서 급성 이식편대숙주 질환이 이식후 18일에서 48일 사이에 관찰되었다(빈도, 7%). 급성 이식편대숙주 질환정도는 3도, 2도 그리고 1도가 각 한명씩이었다. 4도 급성 이식편대숙주 질환은 관찰되지 않았다. 13명의 환자가 만성 이식편대숙주 질환을 경험하였다(30%). 이들 중 10예는 제한성 병변이었고 3예는 전신성 병변이었다. 만성 이식편대숙주 질환의 주된 발병 증상 또는 징후는 황달/간기능 이상(8예)과 구강점막병변(4예)이었다. 한 명의 환자가 이식 후 107일에 간 이식편대숙주 질환에 의한 간부전으로 사망하였다. 결론: 한국인 환자에서는 동종골수이식 후 급성 및 만성 이식편대숙주 질환의 빈도가 구미의 환자에 비하여 상대적으로 낮고 그 정도도 덜한 것으로 보인다. 한국인 환자에 가장 적합한 이식편대숙주 질환 예방 방법의 정립을 위한 계속적인 연구가 필요하다고 사료된다. Background: Graft-versus-host (GVHD) disease is one of the most important complications after allogeneic bone marrow transplantation (BMT). Generally, it has been known that graft-versus-host disease is less frequent after allogeneic BMT in Asian countries including Korea when compared to western countries. Methods: We investigated the frequency and clinical pattern of acute and chronic GVHD in 44 consecutive patients who underwent allogeneic BMT between December 1993 and June 1997. There were 27 male (61%) and 17 female (39%) patients with median age of 33.5 years (range, 16-47). Seventeen patients had acute myelocytic leukemia (AML), 6 acute lymphocytic leukemia (ALL), 11 chronic myelocytic leukemia (CML), 8 severe aplastic anemia (SAA), 1 myelodysplastic syndrome, and 1 neuroblastoma. Methotrexate/cyclosporine combination was given for acute GVHD prophylaxis. Results: There patients (7%) developed acute GVHD median 31 days (range, 18-48) after BMT. There were one grade 3 acute GVHD involving the liver. There was no patient with grade 4 acute GVHD. Thirteen patients (30%) developed chronic GVHD median 100 day (range, 53-266) after BMT. Ten cases were limited stage and 3 were extensive stage. Frequent initial manifestations of chronic GVHD were jaundice/liver function abnormality in 8 cases and oral mucosal lesion in 4 cases. One patient died due to liver failure which were felt to be seconday to chronic GVHD 107 days after BMT. Conclusion: Acute and chronic GVHD are less frequent in Korean patients after allogeneic BMT when compared to historical data from patients from western Europe or United States. In cases of chronic GVHD, mild forms of disease predominate. Optimal strategy for GVHD prophylaxis in Korean patients remains to be defined.

한국에서의 간질의 사회적 낙인

이상암,유희정,허경,박형국,신동진,송홍기,정원영,권오영,이성수,김요식,김성은,이병인 대한간질학회 2002 대한간질학회지 Vol.6 No.2

THE VARIATIONS OF JAPANESE APRICOT (PRUNUS MUME) CULTIVATED AROUND IN MTS. JIRI.

Lee,Jun-Ki,Hyun,Sang-Ki,Lee,Sang-Sun,Chai,Jung-Ki 한국자원식물학회 2002 Plant Resources Vol.5 No.1

Twenty-three plants of Japanese apricot (Prunus mume) were collected from several sites around Mountains JIRI in Korea. Japanese apricots having the different morphological features were evenly distributed in the groups made from the cluster analysis, indicating no geographic distributions but artificial vegetations in Korea. Japanese apricots were, as based on the PCR-RAPD techniques, clustered into the three groups; a group (prototype) having the five white petals with the five red sepals, a group (green type) having the five white petals with the five green sepals, and a group (hybrid type) having the more than five red petals with various colored sepals. The prototype apricots showed higher toxicities than other type apricot against bacteria and production of less compounds in TLC plates. The polypetal types of Japanes apricot were related to those of p. armebiaca in the characteristics of seed (the ruggedness), but also to be closed to those of p. armebiaca in PCR-RAPD analysis. The cluster analysis of the twenty three apricots and its related species calculated from the two primers were shown to distinguish relationships of cultivars within species, or of individual plants within cultivars, but also to display the two overlapping bands resulted from PCR-RAPD technique.

새로운 연노출의 효과지표로서의 혈장 δ-aminolevulinic acid 측정의 유용성

이금원,황보영,김용배,리갑수,이성수,장봉기,함정오,안규동,이병국 순천향대학교 산업의학연구소 2001 순천향산업의학 Vol.7 No.1

To evaluate the usefulness of the measurement of plasma δ - aminolevulinic acid (ALAP) as a new effect indicator of lead exposure, the association of ALAP with blood lead, DMSA chelatable lead and bone lead with a special emphasis of genetic interaction of ALAD polymorphism was studied with 419 lead exposed workers and 85 non-lead exposed workers. Lead workers were recruited from storage battery industries, secondary smelting industries and other lead using industries and non-lead workers selected from electronic refrigerator manufacturing industry. Blood lead, DMSA chelatable lead and bone lead were chosen for parameters of lead exposure. Plasma and urinary ALA were selected for the effect parameter of lead intoxication. Information for age, smoking, drinking habit and body mass index were also obtained. Job duration for lead workers was also collected. The overall prevalence of the variant allele, ALAD type 1-2 or 2-2(ALAD2) in lead exposed workers was 10.0% (42 out of 419 lead workers) which was not differed from control workers (9.4% : 8 out of 85). The means blood lead and DMSA chelatable lead of lead workers with ALAD 1(ALAD type 1-1) were lower than those of lead workers with ALAD2, but the differences were not statistically significant. On the other hand, the mean of tibia lead of lead workers with ALADI was higher than that of lead workers with ALAD2, but the difference was not statistically significant. DMSA chelatable lead showed highest correlation with log transformed plasma ALA(LALAP)(r=0.682) and blood lead and tibia lead had r=0.650, r=0,402 correlation coefficient with LALAP respectively On the other hand. log transformed urinary ALA(LALAU) had lower correlation coefficient with all three parameters of lead exposure than LALAP. The equation of robustic simple linear regression of blood lead on LALAP was LALAP=2.0439+0.0165PbB in ALADI lead workers and LALAP=2.031+0.0121PbB in ALAD2 lead workers. ALAD genotype in the multiple regression analysis of blood lead with LALAP after adjusting for possible confounders(sex, ago, BMI, smoking and drinking status and job duration) showed significant main effect on LALAP resulting lower LALAP in ALAD2 lead workers than ALADI lead workers. On the other hand, effect modification of ALAD genotype was observed in the multiple regression analysis of tibia lead with LALAP after adjusting for possible confounders, but there was no significant effect of ALAD genotype in the multiple regression analysis of DMSA chelatable lead with LALAP after covariate adjustment. With above results, plasma ALA was found to be a useful effect parameter of lead exposure compared with urinary ALA. It was also observed that ALAD polymorphism made significant effect on the association of blood and tibia lead with ALAP. Thc lower plasma ALA in ALAD2 lead workers suggested supportive effect of ALAD2 in lead exposure.

경북 최초의 신장이식 1례

이중현,김용섭,이정호,이창우,김상욱,이문섭,오민구,하달봉,이경섭 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

신장이식은 환자의 삶의 질을 높이고 거의 정상적인 사회생활을 가능하게 함으로써 말기신부전 환자의 3가지 신대체 요법(혈액투석, 복막투석, 신장이식) 중에 가장 효과적이고 각광받는 치료법이라 할 수 있다. 최근 들어 의료기술과 의학의 발달로 신장이식의 성공률은 과거에 비해 비약적으로 높아지고 있으며 국내에서도 점차 신장이식수술을 받는 환자가 증가하고 있으나 서울이나 다른 대도시에 비해 의료환경이 열악한 중소도시나 지방의 병원에서는 아직도 시행하지 못하고 있는 형편이다. 이에 저자들은 경북 최초로 자체 의료진에 의해 고혈압과 말기 신부전으로 동국대 포항병원에서 혈액투석을 받고 있던 32세의 남자환자에게 부인으로부터 신장을 제공받아 신장이식을 성공적으로 시행하였기에 문헌고찰과 함께 보고하고자 한다. Kidney transplantation is the preferred treatment modality for many patients with end-stage renal disease (ESRD), because it offers improved quality of life over both hemodialysis and peritoneal dialysis. Patients who do well after transplantation generally report improvement in vitality and freedom to return to the style of life that they experienced before their progression to ESRD. Recently, the success rate of kidney transplantation is greatly being increased as the surgical technique and immunosuppressive drugs are developed. Kidney transplantation is also popular in Korea which has good result. But, until now the general hospitals which are located at small city can't try the kidney transplantation because they don't have proper facilities and experts. We firstly experienced a case of kidney transplantation in a 32 years old man with hypertension and chronic renal failure at KyoungBuk province. So we report this case with references.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.