Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

신경회로망을 이용한 유압모타의 학습적 추종제어

김대영,김영태,김성동 金烏工科大學校 1993 論文集 Vol.14 No.-

Hydraulic systems have a nonlinear property and complex dynamic characteristics. These features make it a tedious job to design a hydraulic control system. The controller design process is more difficult when the desired performance is given as a trajectory of a model response. The neural net theory is applied to the control of hydraulic systems for the purpose of simplicity of design process. The learning feature of the neural net is expected to make the output response trajectory closer and closer to the desired model trajectory as the learning action continues. Experiments for velocity control of a hydraulic motor show the neural net control is very effective in its learning and trajectory tracking.

급성심근경색후 발생한 심실중격결손 2례

김태희,이재호,김애란,허민영,문치숙,정수룡,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Ventricular septal defect remains an infrequent but devastating complication of acute MI. Approximately 1∼3% of cases of acute myocardial infarction are complicated by ventricular septal rupture in the prethrombolytic era and the incidence has decreased to 0.2% with reperfusion therapy. This mechanical complication usually occurs within the first 10 to 14 days when necrotic tissue is most abundant and the collateral coronary circulation is not well developed. This lesion is generally associated with complete coronary obstruction rather than severe stenosis. Rupture of the ventricular septum is a severe mechanical complication of acute myocardial infarction, usually resulting in death unless surgical repair is performed. The bad prognosis of this event within the first 2 weeks indicates the need for early surgical rapair. This complication is more frequent after the first acute myocardial infarction in the elderly and secondary to a transmural myocardial infarction. We report two cases of ventricular septal rupture after acute myocardial infarction.

소아 야뇨증에 대한 임상적 고찰

김승수,곽병곤,김영대,김우경,김영균,이종국 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objectives: The aim of this study was to describe the clinical characteristics of enuretic children and to evaluate the efficacy of treatments. Methods: Our study subjects enrolled were 52 children with nocturnal enuresis, who visited outpatient clinic of pediatrics in Seoul Paik Hospital and Ilsan Paik Hospital, during the period from October 1998 to August 2004. The data of gender, age, family history, symptom, clinical type of enuresis and drug therapy were collected and analyzed retrospectively. Results: The male : female ratio was 2.25 : 1. The mean age at diagnosis was 6.8 years with an age range from 4.3 years to 12.5 years. Fourty five cases(86.5%) were diagnosed as primary enuresis and 7 cases(13.5%) were diagnosed as secondary enuresis. A family history of enuresis was noted in 5 cases(9.6%) including 4 cases with parental enuresis history. The accompanying urinary symptoms were urgency(11.5%), frequency (7.7%), and dysuria(2.0%). Conclusion: We found frequent occurrences of enuresis in boys and primary type and an occasional association with a family history of enuresis. The two main treatment modalities were behavior control with an alarm system and drug therapy with imipramine, desmopressin, or oxybutynin. We recommend continuous drug medications to control nocturnal enuresis along with encouragement.

한국인에서 혈소판 당단백 Ⅲa 유전자 다형성과 급성 관동맥 증후군의 관계

김광일,채인호,김효수,손대원,오병희,이명묵,박영배,최윤식,이영우 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

ZnO:In 가스 감지막의 특성 및 응용

김영범,박종아,김진해,김권태,김정규,마대영,박기철 경상대학교 생산기술연구소 2001 工學硏究院論文集 Vol.1 No.-

The microsensors to detect NH3 gas were fabricated by continous deposition of In film by evaporation and ZnO film by rf magnetron sputtering onto the Si3N4 diaphragm that was prepared by MEMS technology. The sensors were heat-treated to dope In into the ZnO thin film. The electrical characteristics of sensitive films were studied as a function of heat-temperature by 4-point probing method and electrometer. The dependence of the sensitivity, selectivity and time response of sensor on heat-treatment temperature was investigated. The microsensor heat-treated at 400℃ that 3000 A ZnO:In film was chosen as gas sensitive film, showed the highest sensitivity 23% at 350ppm NH3 under 366mW heater power. The time response was 90sec. The sensitivity for CO and NOx was not observed.

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

방사선 조사에 의한 흰주 난포의 퇴축과 난포세포의 방사선 감수성

김수일,한승로,조근자,허대영,이영호,조문준,김무강,김원식 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

The aim of this study were to investigate radiation-induced atresia and radiation susceptibility in the rat ovary morphologically. Female rats (Sprague Dawley strain) of 4 weeks old were irradiated with dose of 4 Gy and 8 Gy, and sacrificed at hour 6, 12, and 24 after radiation. The H & E stain, the TUNEL method (ApopTag kit) and transmission electron microscopy (TEM) were used. In light microscopic observation, the number of atresia of ovarian follicles were increased significantly at 6h after irradiation (p<0.01). There was no significant difference between 4 Gy and 8 Gy irradiated groups. In TEM observation, granulosa cells in radio-sensitive follicles were characterized by several structural features including condensation of nuclear chromatin granules, nuclear fragmentation and apoptotic body formation. An apoptotic cell is observed to have been phagocytosed by a normal granulosa cell. Granulosa cells in radio-resistant follicles were characterized by several structural features including nuclear indentation, partial condensation of chromatin granules, mitochondrial swelling, dilatation of RER cisterns, accumulation of dense irregular masses, accumulation of lipid droplets, and increased lysosomal bodies. Number of gap junctions between granulosa cells were decreased, and intercellular space were widen than that of control animals. These findings were prominent at 6h after irradiation and were diminished at 12h and 24h after irradiation. With these results, it was concluded that radiation-induced follicular cell apoptosis and ovarian follicular atresia in rat ovary increased considerably at 6h after irradiation. Further studies are needed to reveal the more extensive differences between radiosensitive and radioresistant follicular granulosa cells.

관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

치아 수복용 불소함유 glass filler의 제조 및 특성

김대성,최세영,김경남,김광만,김중곤 대한치과기재학회 1998 대한치과재료학회지 Vol.25 No.3

The purpose of this study was the reaching test of restorative glass according to composition. Mixtures of SrF₂, CaF₂and SiO₂were fused in platinum crucible. The glasses were ground and fraction which passed through a 400 mesh (38㎛) sieve were collected. The powder specimens were analyzed by a DTA and XRD. Then powder specimen were inserted to D. I. water with various of dissolution time and composition at 37℃. Fluoride ion, cation release, solubility, and pH change were estimated. It was clear that the glasses were formed except S0.65. In S0.40, Tg, Ts, and Tc were 630, 672, and 813℃ respectively. In initial 0.5 hrs., amounts of released fluoride ion and cation were about 90% of total released amounts and released rate was decreased with dissolution time. Amount of released fluoride ion and cation were increased with decreasing SiO₂ in glass filler. And released rate was decreased rapidly by adding CaF₂. This was caused by structural variation in glass filler. Solubility was similar tendency with ion released. The pH of D.I. water was 4.5. But in intial 0.5 hrs., pH was 8.2∼9.8., and decreased according to dissolution time. This is caused by ionic changing with cation and H* ion.