대장직장종양에 있어서 Hand-Assisted Laparoscopic Surgery (HALS)의 초기 경험

조호영,최선근,구지회,허윤석,이건영,김세중,조영업,안승익,홍기천,신석환,김경래,우제홍 대한내시경복강경외과학회 2003 대한내시경복강경외과학회지 Vol.6 No.-

Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

설계빈도의 지속시간별 강우강도를 고려한 침수피해 특성

송영석(Song Young-Seok),이희섭(Lee Hee-Sup),이정민(Lee Jung-Min),박무종(Park Moo-Jong) 한국방재학회 2018 한국방재학회논문집 Vol.18 No.2

최근 기후변화에 따른 강우의 증가는 설계빈도를 초과하는 강우발생으로 수공구조물 및 사회기반시설의 침수피해를 발생시킨다. 강우사상에 대한 규모를 확인하는 방법으로는 설계빈도와 강우강도가 제시되고 있다. 그러나, 이러한 단편적인 설계빈도 및 강우강도의 제시는 하천 및 하수관거 등에서 설계빈도를 초과하는 강우발생시 침수피해에 대한 정량적인 크기를 확인할 수 없다. 설계빈도 및 강우강도의 기준으로 침수피해의 규모나 범위를 단정 짓기에는 복합적인 원인으로 피해의 양상이 발생하기 때문이다. 본 연구에서는 2016년 태풍 차바 내습시 침수피해가 발생한 울산광역시 중구를 대상으로 지속시간별 강우강도와 설계빈도를 산정하였다. 침수피해지역 인근에 위치한 하천 및 우수관거의 설계빈도, 태풍 차바의 설계빈도와 강우강도를 비교하여 침수피해와 지속시간별 강우강도 및 설계빈도의 관계를 분석하였다. Rainfall events that exceed the design frequency of the latest climate change cause flood damage on hand structures and infrastructure. When describing the magnitude of typhoon or extreme rainfall events, the magnitude of rainfall event is shown through design frequency. However, presenting these short design frequencies is a value that exceeds the design frequency of rivers and drains and can not identify quantitative sizes or risks. In this study, rainfall intensity was calculated by calculating the design frequency of continuous time in Jung-gu, Ulsan, where flood damage occurred during the typhoon Chaba. The Ulsan Rainfall Observatory analyzed the relationship with flood damage by reviewing the difference in rainfall intensity by duration compared with the previously estimated rainfall intensity by design frequency.

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.

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

회맹장 판막에 발생한 아니사키스증 1례

이재익,박정하,김준영,조영완,진한영,강명주,정은욱,박석주,양성연 인제대학교 2006 仁濟醫學 Vol.27 No.-

Anisakiasis refers to parasitic infestation by nematode larvae that belongs to the subfamily Anisakinae, and this condition is seen in people who eat inadequately prepared or raw salt-water fish. While gastric anisakiasis is commonly diagnosed by endoscopic technique, intestinal anisakiasis is rare because it is less common and the clinical and radiologic features are poorly understood. The authors report a case of human anisakiasis involving the ileocecal valve in 62-year-old man who had the history of eating raw cuttlefish.

만성 B형 간염에서 라미부딘 치료중 발생한 Viral Breakthrough 예의 임상 결과

안수현,장윤정,오성남,최도원,백수정,정원석,최창원,김경오,임형준,조남영,박종재,김재선,박영태,이명석,연종은,변관수,이창홍 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

목적: 만성 B형 간염의 치료 중 발생하는 약제 내성 변이종은 임상적으로는 치료 중 음전되었던 혈청 HBV DNA가 다시 양전되는 viral breakthrough 로 진단할 수 있다. 현재 약제 내성 변이종이 발생했을 경우라도 라미부딘 치료를 계속 유지하는 것을 권장하고 있으나, viral breakthrough 발생 예들의 장기적 임상경과가 아직도 불명확하여 이것을 일반화하기는 어려운 상황이다. 이에 라미부딘 사용 중 viral breakthrough 가 발생한 예들을 대상으로 그 임상경과를 알아보고자 하였다. 대상과 방법: 9개월 이상 라미부딘을 투약한 만성 B형 간염 환자로 viral breakthrough가 발생한 74명을 대상으로 하였다(남/여 54/20, 평균연령 42세). Viral breakthrough 후 혈청 ALT치, 총 빌리루빈치, HBV DNA 역가, HBeAg, anti-HBe를 정기적으로 검사하면서 임상경과를 관찰하였다. Viral breakthrough 후 라미부딘의 투약기간은 평균 13개 월(1-41개월)이었다. 결과: Viral breakthrough 발생후 혈청 ALT치가 정상으로 유지되었던 환자는 8예(11%)에 불과했고 나머지 66예(89%)에서는 ALT치가 증가하였으며, 이중 30예(41%)에서 급성 악화(ALT 정상 상한치의 5배 이상 상승)를 보였다. 급성악화는 viral breakthrough 후 3개월 내에 19예 (63%)에서 발생하여 3개월 내에 발생한 예가 많았으나 12개월 이상 지나서 나타나는 예도 약 20%에서 있었다. 비대상성 악화는 6예에서 관찰되었다. Viral breakthrough 후 급성악화가 일어난 예와 없었던 예의 비교에서 급성악화를 예측할 수 있는 인자는 발견할 수 없었다. Viral breakthrough 후 발견할 수 없었다. Viral breakthrough 후 HBeAg이 음전된 예는 8예(11%)였으나 그 임상경과는 양호하지 않았다. 결론: 만성 B형 간염 환자 에서 라미부딘 투여 중 발생한 viral breakthrough 예 중 상당수에서 급성악화가 발생하였으며, HBeAg 이 소실되더라도 그 임상경과는 양호하지만은 않았다. Viral breakthrough 발생 후 주의 깊은 임상경과 의 관찰이 요구되며, 앞으로 viral breakthrough 후 급성악화 예에 대한 대규모 연구와 적절한 치료방향의 제시가 이루어져야 할 것으로 생각된다. Background/Aims: Long-term lamivudine therapy can induce the emergence of lamivudine resistant hepatitis B virus (HBV) mutants. Clinically emergence of the mutant is expressed by the reappearance of disappeared HBV DNA in serum. Continued lamivudine treatment has been usually recommended in cases of viral breakthrough. However, the clinical outcome in patients with viral breakthrough is not clear. The aim of this study was to investigate the clinical course of chronic hepatitis B patients after viral breakthrough during lamivudine therapy. Methods: A total of 74 patients with chronic hepatitis B who showed viral breakthrough after at least 6 months of lamivudine treatment were included in this study. They had positive HBeAg and HBV DNA before treatment. The median follow-up duration after breakthrough was 13 months. Results: After viral breakthrough, only 8 patients (11%) maintained normal ALT levels and 66 patients (89%) showed elevation of ALT. 30 patients (41%) showed acute exacerbation of hepatitis (ALT increase over five-times upper normal limit). These acute exacerbations occurred within three months after breakthrough in 19 patients (63%). In the cases of acute exacerbation, 6 patients showed decompensated progression such as elevation of serum total bilirubin. One of them died of hepatic failure. A predictive factor for acute exacerbation was not found. HBeAg seroconversion occurred in 8 patients after viral breakthrough but their clinical course was highly variable. Conclusions: Chronic hepatitis B patients who had viral breakthrough during lamivudine therapy should be followed carefully and regularly in mind of potential clinical deterioration. New strategies are needed to manage the cases of acute exacerbation after viral breakthrough.(Korean J Hepatol 2002;8:389-396)

크론병에 대한 CoPPLX의 방어효과에 대한 연구

이호학,김유림,문창기,이재일,양병윤,김종수,이정민,정재혁,안석진,박상준,김윤권,김소연,김영중,조민구,최영자,장성조 圓光大學校 醫科學硏究所 2005 圓光醫科學 Vol.20 No.1

경골 원위부 골절 고정용 혼성 외고정 장치의 생역학적 분석 : 유한요소 방법을 이용한 연구

정덕영,김봉주,유석배,오종건 대한골절학회 2004 대한골절학회지 Vol.17 No.2

電子産業의 實態分析 및 競爭力 提高戰略

鄭俊秀,尹英得,方鎬烈,金基錫,金正敎 釜山大學校 經營 經濟 硏究所 1990 經營 經濟 硏究 Vol.9 No.1