지연성으로 발생한 외상성 횡격막 파열의 임상적 고찰

이정희,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Background: Diaphragmatic rupture may occur from blunt or penetrating thoracoabdominal trauma, which may be undiagnosed initially in the acute trauma, work-up and may remain unrecognized. Delayed traumatic diaphragmatic rupture is reported with increasing frequency and is associated with high morbidity and mortality. The purpose of this study was to present our experience and found out early diagnostic method, clinical presentation and management. Matehals and Methods: From March 1998 to February 2004, the 6 patients of delayed diaphragmatic rupture in our hospital were operated. We reviewed the diagnostic interval, symptom, diagnostic method, operative method and complication. Resutt: They were 3 men and 3 women. Mean age was 56.8:t15.8 years(range 29-69). Most common symptom was dyspnea. Delayed diaphragmatic rupture was right-sided in 4 patients, left-sided in 2. The average operative interval of delayed diaphragmatic rupture was 18.8 months(range 5-48). The diagnosis was chest x-ray and thoracic CT. Operative approach were only thorax in 4 patients and both thorax and abdomen in 2. Postoperative complication were observed in 4 patients, and the overall mortality was none. Conclusion: The delayed case of traumatic diaphragmatic rupture tends to be overlooked without suspicion, In all patients with thoracoabdominal blunt injury a rupture of the diaphragm must be suspected. With a high suspicion, a thorough physical examination and diagnostic method is recommended in order to avoid early or late complications.

특수형 방사성 동위원소 운반캡슐의 안정성 평가

이주찬,서기석,구정회,방경식,한현수,박성원 대한방사선 방어학회 2001 방사선방어학회지 Vol.26 No.1

특수형 방사성물질 운반캡슐은 국내외의 수송관련 법규에 규정된 기술기준을 만족하도록 설계, 제작되어야 한다. 본 연구의 목적은 하나로에서 생산된 192Ir 특수형 동위원소 운반캡슐의 건전성을 평가하는데 있다. 법규에서 규정된 낙하시험, 타격시험, 굽힘시헝 및 가열시험조건에 대한 안전성 시험을 수행하였으며, 각각의 시험 전후에 누설시험을 수행하였다. 또한, 안전성시험과 더불어 컴퓨터코드를 이용한 전산해석을 수행하여 안전성시험 전에 시험결과에 대한 예측자료로 활용되었다. 낙하시험 및 가열시험 결과 캡슐 표면에서 약간의 흠집과 변형이 발생하였으나, 각각의 시험에서 평가기준이 되는 캡슐의 손상이나 용융 등은 발생하지 않았다. 또한 각 시험 후 수행한 누설시험 결과 누설이 발생하지 않았다. 따라서 특수형 방사성물질 운반캡슐은 법규에서 규정하는 기술기준을 만족하도록 설계, 제작되었음이 입증되었다. All of sealing capsules to transport a special form radioactive material should be designed and fabricated in accordance with the design criteria prescribed in IAEA standards and domestic regulations. The objective of this study is to demonstrate the safety of a shipping capsule for 192Ir special form radioisotope which produceed in the HANARO. The safety tests were carried out for the impact, percussion, bending and heat test conditions. And leakage tests were carried out before and after the each test. Also, the safety analyses were performed using computer codes in order to verify the test results. The capsule showed slight scratches and deformation, and maintained its structural and thermal integrities in all tests without any severe damage or melting. It also met the allowable limits of leakage rate after earth test. Therefore, it has been verified that the capsule was designed and fabricated to meet all requirements for the special form.

폐모세포종 : 1례보고 A Case Report

최영호,서홍주,임영혁,김정중,박성강,이석기,임진수,김은규 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pulmonary blastoma is a very rare primary neoplasm of the lung. We experienced a case of pulmonary blastoma in a 40 years old man. The mediobasal segmentectomy of the right lower lobe was performed. The patient was discharge on the postoperative days 6. There is no evidence of recurrence or metastasis on followup study during 7 months period after operation.

개심술(開心術)의 임상적 고찰 : 치험 200예 200 Cases

최형호,서홍주,임영혁,김정중,배대양,이석기,임진수 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Background and Objectives: Two hundred cases of the open heart surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 2001. Material and Methods: The number of congenital heart disease was 132 cases. 68 cases were acquired heart disease. 'The age of the congenital heart disease was from 22 days to 45 years. In the acquired heart disease, the age was from 14 to 72 years. Result: Congenital heart disease consisted of 113 congenital acyanotic heart disease, 19 congenital cyanotic heart disease. Corrective operation was done for congenital heart disease with 4. 5 % operative mortality. Of 68 cases acquired heart disease, 44 patients were valvular heart disease, 3 cardiac tumors, 9 ischemic heart diseases, 12 aortic dissections and etc. The operative mortality was 13%. Conclusion: The postoperative complications were appeared in 68 cases and the complications were wound infection, occipital alopecia, low cardiac output syndrome, arrhythmia, septicemia etc. The mortality after open heart surgery was 15 cases and the causes of death were low cardiac output syndrome, septicemia, respiratory failure and left ventricle rupture.

그레이브스 병 치료 후 재발 위험 인자에 관한 연구

이영창,유명희,윤석기,변동원,서교일,김극배 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

연구 배경 : 그레이브스 병에 대한 항갑상선제 치료후 적절한 치료 여부 평가 및 재발 위험성을 예측하기 위하여 여러 가지 예후 판정 인자들이 연구되어 왔으며, 이러한 인자들 중 TRH(thyrotropin-releasing hormone) 자극 시험이 가장 믿을 만한 검사중에 하나로 알려져 있다. 그러나 TRH 자극 검사가 정상으로 나와도 재발하는 경우가 많으며, 현재로는 이러한 경우에 재발을 예측하는 예후 인자에 대한 연구는 전무한 실정이다. 금번 연구에서는 TRH 자극 시험 후 TSH(thyroid stimulating hormone)가 정상적인 반응을 보인 환자를 대상으로 재발 및 관해여부를 예측할 수 있는 인자들을 찾고자 하였다. 대상 및 방법 : 항갑상선제제 치료 종료후 TRH 자극 시험을 시행하였던 그레이브스 병 환자 총 84명 중, 정상적인 TSH 반응을 보이면서 1년 이상 추적 관찰이 가능하였던 32명의 환자를 대상으로 하였다. 처음 진단 시와 치료 종료 시에 T3(triiodothyronine), T4(thyroxine), T3/T4 비, TSH, TRAb, Anti-TPO Ab(anti-thyroperoxidase antibody)를 측정하였으며, 치료 종료 2개월후에는 TRH 자극 검사를 하여 TSH 증가폭(△TSH) 및 유리 T_(3) 증가폭(△FT_(3))을 구하였다. 모든 측정치는 평균±표준편차로 표시하였으며, SPSS software를 이용하여 Student's paired t-test, chi-square test, Wilcoxon signed ranks test를 시행하였고, 유의 수준 0.05 이하를 통계적으로 유의하다고 판단하였다. 결과 1) 총 32명의 환자 중 재발한 환자(Group Ⅰ)는 22명(69%) 이었으며, 재발한 환자(Group Ⅱ)는 10명(31%) 이었다. 2) 진단 초기 총T3 치는 Ⅰ 군에서 342.0±126.2ng/dl, Ⅱ 군에서 493.0 ±142.2 ng/dl로 Ⅱ군에 비해 유의하게 증가되었다(p<0.05). 3) Anti-TPO Ab는 Ⅰ군에서 2.9±4.4, Ⅱ군에서 22.3±22.3 U/mL로 나타나 Ⅱ군에서 유의하게 증가되었다.(p<0.05) 4) 양군에서 치료 종료후 재발시 대부분의 환자가 1년 이내에 재발하였다. 5) TRH 자극· 검사후 유리 T3 증가폭 및 TSH 증가폭은 양군간에 차이가 업ㅅ었다(1.5±0.9 vs 1.2±1.0 pmol/L, 12.54±7.56 vs 11.23±4.21 mU/L, p>0.05) 결론 : TRH 자극 검사후 정상적인 TSH 반응을 보인 환자에서 재발 및 관해여부를 치료 초기 T3 및 치료 종료시 Anti-TPO Ab로 예측할 수 있었으며, 이들 측정치가 증가해 있을수록 재발의 가능성이 많음을 알 수 있었다. 또한 투약 중단후 초기 12개원의 추적기간 동안 관해가 유지되면 그 이후엔 재발의 가능성이 현저히 줄어 들었으며, 이 후 좀더 많은 환자들을 대상으로 하는 장기적인 추적연구가 진행 되어야 할 것으로 사료된다. Background : Many studies were undertaken to find parameters that could predict the clinical course of patients with Graves' disease after withdrawal of antithyroid drugs. In many parameters, TRH (thyrotropin-releasing hormone) stimulation test and T3 suppression test were considered to be one of the most reliable for predicting remission. But recently, some studies showed that the measurement of free T3 and FT3 are to be a more accurate than other thyroid function test. In this study, we measured T_(3), T_(4), T_(3)/T_(4), TSH (thyroid stimulating hormone), TRAb (TSH receptor antibody), FT3 and other known useful parameters to compare the factors influencing the relapse of Graves disease after antithyroid medication. Patients and methods : Among the 84 Graves' disease patients who had done the TRH stimulation test after withdrawal of antithyroid medication, we examined 32 patients who showed normal TSH response and followed up more than one year. T_(3), T_(4), T_(3)/T_(4), TSH and TRAb levels were measured at the time of diagnosis and at the end of therapy. Serum TSH and FT_(3) levels were measured after TRH stimulation, after two months of withdrawal of medication. Statistical evaluation was Performed by SPSS software in combination with Student's Paired t-test, chi-square test, Wlicoxon signed-ranks test. p-value less than 0.05 was considered to be significant. Results 1. In the 32 patients with Graves disease, 10 patients(31%) relapsed(Group Ⅰ) and 22 Patients(69%) remained in remission(Group Ⅱ). 2. Initial serum T3 level was significantly higher in group Ⅰ than group Ⅱ(342.0 ±126.2 vs. 493.0±142.2 ng/dl, p<0.05). 3. Anti-TPO Ab level was significantly higher in group Ⅰ than group Ⅱ(22.3±22.3 vs 2.9±4.4 U/mL, p<0.05). 4. In group Ⅰ and Ⅱ most patients showed relapse within 1 year after antithyroid medication. 5. After TRH stimulation test, serum FT_(3), and TSH level were not significantly different between group I and Ⅱ(p>0.05). 6. Serum T_(4), T_(3)/T_(4), TSH, TRAb levels were not significantly different from group Ⅰ and Ⅱ. Conclusion : In this study, we found increased relapse rate in the patients with Graves' disease whose initial serum T3 and anti-TPO Ab levels were high, so these parameters could be used to predict the relapse of Graves' disease. In the case of more than 12 months remission period after withdrawal of antithyroid medication, no relapse wsa observed in this study, but study should be done in the large population of patients with Graves' disease.

[Free Paper] Clinical Outcome of Differentiated Thyroid Carcinoma Presenting With Distant Metastasis

Sang Beom Seo,Jung Min Lee,You Jin Lee,Eun Kyung Lee,Yuh-Seog Jung,Jun Sun Ryu,Seog-Yun Park,Tae Hyun Kim,Seok-Ki Kim,Tae-Sung Kim,Ki-Wook Chung 대한외과학회 2011 대한외과학회 학술대회 초록집 Vol.2011 No.11

Adenocarcinoma of Unknown Primary Site

( Seo Young Song ),( Won Seog Kim ),( Hye Ran Lee ),( Hyun Sik Jung ),( Sung Yong Oh ),( Ji Hyang Kim ),( Ki Hyun Kim ),( Eun Mi Nam ),( Chul Won Jung ),( Sung Soo Yoon ),( Young Hyuck Im ) 대한내과학회 2002 The Korean Journal of Internal Medicine Vol.17 No.4

Background: Metastatic cancer of unknown primary site occupies 0.5~10% of all diagnosed cancer patients and includes various tumors with diverse responses to systemic chemotherapy. Adenocarcinoma of unknown primary site (ACUPS), the most common subtype, h

위에 발생된 편평세포암종 1례

서검정,김진아,김용석,유경훈,최석채,김학철,나용호,윤기중 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2

Squamous cell carcinoma of the stomach is a rare lesion. The pathogenesis of this neoplasm remains obscue and controversial. Several possible mechanisms have been postulated to explain its occurance and location. Tumor masses were located in the mid-esophagus and cardiac portion of the stomach. Simple Borrmann's macroscopic classification was applicable to type III. Microscopically was composed of pure squamous cell carcinoma. Growth pattern and surrounding mucosal changes as with older age prevalence of these tumors might express the biological behavior of intestinal type of gastric carcinoma. With respest to the prognosis, patients with SCC of the stomach reportedly had a somewhat poor prognosis than those with gastric adenocarcinoma, because of aggressive metastasis to the liver, lymph node, & other organ. A case of the squamous cell carcinoma of the stomach is presents with brief review of the literatures.

Case Report : Esophageal Bezoar in a Patient with Achalasia: Case Report and Literature Review

( Ki Hoon Kim ),( Suck Chei Choi ),( Geom Seog Seo ),( Yong Sung Kim ),( Chang Soo Choi ),( Chong Ju Im ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.1

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders. (Gut Liver 2010;4:106-109)

Inhibition of p65 Nuclear Translocation by Baicalein

Seo, Min-Bum,Lee, Seog-Ki,Jeon, Young-Jin,Im, Jin-Su Korean Society of ToxicologyKorea Environmental Mu 2011 Toxicological Research Vol.28 No.2

We demonstrate that baicalein, a bioactive flavonoid originally isolated from Scutellaria baicalensis, inhibits LPS-induced expression of iNOS gene in RAW 264.7 cells. Treatment of peritoneal macrophages and RAW 264.7 cells with baicalein inhibited LPS-stimulated nitric oxide production in a dose-related manner. Immunohistochemical staining of iNOS and RT-PCR analysis showed that the decrease of NO was due to the inhibition of iNOS gene expression in RAW 264.7 cells. Immunostaining of p65, EMSA, and reporter gene assay showed that baicalein inhibited NF-${\kappa}$B nuclear translocation, DNA binding, and transcriptional activation, respectively. Collectively, these series of experiments indicate that baicalein inhibits iNOS gene expression by blocking NF-${\kappa}$B nuclear translocation. Due to the critical role that NO release plays in mediating inflammatory responses, the inhibitory effects of baicalein on iNOS suggest that baicalein may represent a useful anti-inflammatory agent.