FORREST II 궤양 출혈의 적절한 치료 유용성 : 전향적 무작위 연구

김성은,이선영,신정은,주미순,전정현,이경은 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

Objectives : This study is to compare the clinical and cost effectiveness of various pharmacologic therapies with of without endoscopic procedure in the Forrest II ulcer. Methods : Between May 2001 and June 2002, total of 58 Forrest II bleeding activity patients (37 cases of NBVV, 6 adherent blood clots, 9 flat red spot, and 6 flat black spot) with gastric ulcer(32 cases) and duodenal ulcer(26 cases) were analyzed. UGI endoscopy was performed within 12 hours of the first bleeding episodes, and underwent repetitive endoscopy after 48h. All the patients were randomly assigned to receive somatostatin(group I), PPI(omeparzole : group II), only H2 blocker (famotidine, group III), or endoscopic injection therapy followed by famotidine (group IV). We compared with rebleeding rates, changes of ulcer size, and modified estimated costs for 3 day-hospital in four groups respectively. Results : 1) Twelve patients experienced rebleeding(20.7%). 2) The rates of rebleeding were 16.6% (2/12) in group I, 28.6%(4/14) in group II, 5.9%(1/17) in group III, 26.7% in group IV. There was no significant difference in rebleeding rate among the groups, but there was low rebleeding tendency in group III, compared with group II(p=0.087).3)Type of stigmata including non-bleeding visible vessels and adherent clots were associated with an increased rate of recurrent bleeding(p=0.01).4) When modified estimated costs were calculated, group III could be treated at the lowest cost(p<0.05). Conclusion : In Forrest II bleeding ulcer, medical therapy, especially famotidine could be suggested prudently as a proper treatment modality for this lesion, considering the cost-effecti-veness. 목적: 위십이지장의 궤양성 출혈은 대부분 특별한 치료없이 보존적인 치료만으로 지혈된다. 그러나 활동성 출혈이 있는 Forrest II 궤양의 경우는 흔히 내시경적인 치료를 하게 되는데 최근 여러 연구에서 약물치료와 비교 연구가 있었으나 다양한 약물들과 내시경 치료의 효과 및 비용-효용성의 비교는 이루어지지 않았다. 방법: 2001년 5월부터 2002년 6월가지 Forrest II 궤양출혈 환자 68명을 전향적으로 포함시켰고 이중 위암으로 진단된 경우와 내시경의 추적 검사를 거부한 경우 또는 다른 중증의 내과적 질환이 동반된 경우를 제외시켜 58명의 환자를 대상으로 하였다. 대상 환자 58명은 위궤양이 32명이고 십이지장 궤양이 26명으로 비출혈성노출 혈관 37명, 신선 부착 혈괴 6명, 적색반 9명, 그리고 흑색반 6명이었다. 초기 상부 위장관 내시경은 내원 후 12시간 이내에 이루어졌고 추적 검사는 48시간 이후에 시행되었다. 치료는 네 개의 군으로 나누어 무작위로 소마토스타틴 투여군(1군), 프로톤펌프 억제제 투여군 (2군), H₂수용체 차단제 투여군(3군), 그리고 내시경적 지혈제 주사군(4군)으로 치료하였고 각 군의 재출혈 여부, 혈압, 수혈, 궤양의 크기, 급성 출혈 흔적 등을 비교 관찰하였고 입원 3일간의 입원치료비용을 계산하였다. 결과: 1) 재출혈은 12명(20.7%) 에서 발생하였다. 2) 각군에서의 재출혈은 제1군이 16.6%(2/12), 제2군에서 28.6%(4/14), 제3군이 5.9%(1/17), 제4군이 26.7%(4/15)로 각 군의 재출혈 빈도는 차이가 없었으나 제3군에서 제2군에 비해 재출혈이 낮은 경향을 보였다.(p=0.087).3) 재출혈에 영향을 미치는 인자는 노출 현환과 신선 혈괴였다(p=0.01). 4)평균 입원치료 비용은 제3군이 가장 적어 높은 치료 비용-효과를 보였다.(p<0.05).

2.9% 과산화수소를 함유한 부착형 미백제의 임상적 효능과 안정성에 관한 연구

박은숙,성소래,홍성태,김지은,이소영,황수연,이신재,진보형,손호현,조병훈 大韓齒科保存學會 2006 Restorative Dentistry & Endodontics Vol.31 No.4

2.9%의 과산화수소를 함유한 시험용 부착형 미백제(Medison dental whitening strip, Samsung medical Co.,Anyang,Korea)를 실험군 피험자 23명, 시험용 미백제에서 과산화수소를 제외한 동일한 제재를 대조약으로 대조군 피험자 24명에게 매일 1시간 30분씩, 2주간 적용하여 임상적 효능과 안전성을 평가하였다. 미백 효과는 Shade Vision, Chroma Mete 및 Vitapan classical shade guide를 이용하여 색변화를 측정하여 다음과 같은 결론을 얻었다. 1. 실험군에서의 전체 치아의 색변화량(ΔE^(*))은 세 가지 측정법에서 모두 대조군에 비해 통계적으로 유의한 차이를 보였고 (p < 0.05). 쉽게 인지할 수 있는 정도였다. 2. 색변화는 색좌표 상에서 명도의 증가와 녹색조 및 청색조로의 변화에 의해 얻어졌다. 3. 치아별로는 어두운 견치의 색변화량이 가장 컸고, 측절치, 중절치 순으로 감소하였다. 4. 47명의 피험자 중 5명이 경도의 과민증을 경험하였으나 곧 완화되었다, 치은염증지수와 전기치수검사 결과 시험 전후에 차이가 없어 안전성을 확인하였다. This study evaluated the effectiveness and safety of an experimental bleaching strip (Medison dental whitening strip, Samsung medical Co., Anyang, Korea) containing 2.9% hydrogen peroxide. Twenty-three volunteers used the bleaching strips for one and a half hour daily for 2 weeks. As control group, the same strips in which hydrogen peroxide was not included were used by 24 volunteers with the same protocol. The shade chang (ΔE^(*), color differnce) of twelve anterior teeth was measured using Shade Vision (X-Rite Inc., S. W. Grandville, MI, USA), Chroma Meter (Minota Co., Ltd. Osaka, Japan) and Vitapan classical shade guide (Vita Zahnfabrik, Germany). The shade change of overall teeth in the experimental group was significantly greater than that in the control group (p < 0.05) and was easily perceivable. The change resulted from the increase of lightness (CIE L^(*) value) and the decrease of redness (CIE a^(*) value) and yellowness (CIE b^(*) value). The shade change of individual tooth was greatest in canine, can smallest in central incisor. The safety of the bleaching strip was also confirmed. 〔J Kor Acad Cons Dent 31(4):269-281, 2006〕

Bortezomib과 Dexamthasone으로 치료한 골수외 형질세포종 4예

백종현,이은영,장리라,손창배,신은경,서정아,이지숙,이호섭,이상민,신성훈,김양수 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Despite the use of aggressive local and systemic treatment including autologous stem cell transplantation in multiple myeloma, extramedullary recurrences are common and the prognosis of these patients is poor. Many novel drugs such as thalidomide, lenalidomide and bortezomib improve the response of treatment of multiple myeloma, but some reports failed to describe thalidomide has effect in extramedullary plasmacytoma. Recent data report on the successful treatment plasmacytomas with bortezomib in patients with advanced multiple myeloma. We treated 4 relapsed or refractory extramedullary plasmacytomas with bortezomib at our institution. We recognized all these extramedullary plasmacytomas decreased and showed more than partial response. This report lends support to the efficacy of bortezomib in the treatment of plasmacytoma and describes the safe use of bortezomib. Responses may, however, be of short duration. Therefore, despite our limited experience, we propose that bortezomib may be considered a therapeutic option for such patients who have risk of radiation therapy

한국 정신장애의 역학 조사 연구[I] : 각 정신장애의 유병률

조맹제,함봉진,김장규,박강규,정은기,서동우,김선욱,조성진,이준영,홍진표,최용성,박종익,이동우,이기철,배재남,신정호,정인원,박종한,배안,이충경 大韓神經精神醫學會 2004 신경정신의학 Vol.43 No.4

Objectives : This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). Methods : Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November30,2001. Results : Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major de-pressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. Conclusion : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

골격성 III급 부정교합자에서 술 전 교정치료 전과 후의 수술계획의 차이

이은주,손우성,박수병,김성식 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.3

본 연구는 술 전 교정치료 전 치아 이동 예측치(initial STO)와 술 전 교정치료 후 실측치에 바탕을 둔 STO (finalSTO)를 비교하고자 시행되었다. 부산대학교병원 치과교정과에 내원하여 교정 및 악교정수술 복합치료를 시행 받은 환자 중 하악만 수술한 환자 40명을 선정하여 상악 제1소구치 발치 여부에 따라 두 그룹(발치 그룹 20명, 비발치그룹 20명)으로 분류하였다. 술 전 교정치료 전의 initial STO, 술 전 교정치료 후의 final STO를 작성하여 각 계측치를 수평, 수직 기준선에 대해 거리를 측정하여 비교하였다. 발치 그룹의 두 STO 비교 시 수직적으로 상악 중절치절단연과 치근단, 상악 제1대구치 협측교두에서, 수평적으로 상악 중절치 절단연, 상악 제1대구치 근심협측교두, 하악 중절치 치근단, 하악 제1대구치 근심면과 근심협측교두에서 차이를 보였으며 비발치 그룹의 경우는 수직적으로 하악 중절치 치근단, 수평적으로 상악 중절치 절단연, 하악 중절치 절단연과 치근단, 하악 제1대구치 근심면에서 차이를 보였다. 두 STO의 차이와 initial STO 수립에 영향을 미칠 수 있는 여러 진단 요소와의 상관성 평가 시 상악 치열궁 공간 부족량이 상악 전치의 수평, 수직 및 제1대구치의 수평 위치 예측에 유의한 상관성을 가졌으며 두 그룹 모두 하악 전치 치축 각도와 하악 치열궁 공간 부족량이 하악 전치의 수평 위치 예측에 유의한 상관성을 보였다. InitialSTO 작성과 술 전 교정 단계에서 이를 고려하여 진행한다면 좀 더 효율적인 치료 계획 수립 및 전체적인 치료 기간을 줄이는 것에도 도움이 될 것이라 생각한다. and final STO in Class III malocclusions and to find which factors are related to the discrepancies. Methods: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks as coordinates of the X and Y axes. Results: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. Conclusions: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.

혈액투석 환자에서 대퇴신경범증으로 발현된 장골근 및 요근 농양 1예

이준상,강동구,신상열,윤재호,조영일,고성은,유영범,전혜정,진춘조,송종오 대한신장학회 2004 대한신장학회잡지 Vol.23 No.1

알파인 스키 국가대표선수와 국가대표 상비군 선수의 요부 및 슬관절의 등속성 근력에 관한 비교 연구

이종희,허승은,이재문 경희대학교 체육과학연구소 2001 體育學論文集 Vol.29 No.-

The current study aims at determining the effect of fitness and suggesting basic information necessary for training the National Alpine ski team through comparing the uniform nature lumbar joint and a knee joint muscular function in 20 Alpine ski racers based on race results. We divided the group into A (National team) and B (National reserve team) groups, and we used the result obtained by a body component analysis programs such as In Body 3.0 and Biodex system 3, which were further examined statistically by SPSS/PC+ program. The difference of uniform nature lumbar joint and a knee joint muscular function from the race in each team was analyzed through Independent Samples t-test, and the results are as follows: 1. The uniform nature the absolute lumbar region of a protractor and the flexor muscular strength in National Alpine ski team was notably higher than that of National reserve team, but there was little difference in relative vague per weight. 2. The uniform nature of lumbar region muscular stamina of National Alpine ski team was comparatively higher than that of the reserve team, but there was little difference in rate of muscle. 3. The average power of uniform lumbar region in National Alpine ski team showed a sizable difference at 60 degrees per second (p〈.01), and at 180 degrees per second there was a sizable difference between groups (p〈.01). 4. The left and right protractor of uniform nature knee joint and maximum muscular strength in National Alpine ski racers was notably high, but there was little difference in relative value per weight. 5. The uniform nature left and right of protractor and muscular stamina flexor knee joint in National Apline ski racers was notably high (p〈.01), but there was little diffrence between groups in muscular stamina of the right flexor. 6. The rate of muscle of uniform nature knee joint and the rate of muscle of both of National Alpine ski racers was not much different from that of National reserve team. 7. The average power of the left and right protractor and the uniform nature knee joint of flexor of National Alpine ski racers at 60 degrees per second was notably high (p〈.01). However, though the average power of the left and right of protractor and the right of flexor was notably high at 180 deg per second (p〈.05) there was little difference in the left flexor.

혈관모세포종의 임상 분석

김은성,강삼석,이정길,김태선,정신,김재휴,김수한,이제혁 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.1

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.

Silver Nitrate가 雄兎의 精巢에 미치는 影響

李殷奉,趙聖均 順天大學校 1983 論文集 Vol.2 No.1

Silver Nitrate 稀釋液(1%, 5%)을 白色 日本系 雄兎를 使用하여(生後 4∼5個月令) 9區로 各 4마리씩 配置하여 總 36마리에 1%, 5% Group에 0.5㎖씩 精巢內에 注入한 結果 다음과 같은 結果를 얻었다. 1. 各 Group間에 體重의 增減의 有差差가 없는 것으로 成長과 增體에는 支障이 없는 것 같다. 2. 外的인 精巢의 變化를 보면 1%, 5% Group 共히 注入後 2日에 膨脹(23.6×10.2mm→34.7×18.1mm)되었다가 다시 收縮되었으며 5% Group은 20日 後에 精巢組織의 壞死로 因하여 消失을 가져와 測定할 수가 없다. 3. 內的인 精巢의 變化를 보면 局部的 또는 全體的 組織의 壞死를 가져와 移動的이 아니라는 것을 알 수 있으며 暗褐黑靑色을 띠었다. 4. 白血球의 數는 S.N의 注入으로 7,000∼11,000(正常値)에서 13,575로 急增加 하였으나 時日이 經過함에 따라 正常으로 復歸가 되었다.(13,575→9,500) 5. 完全去勢보다 部分去勢가 增體에 效果的이라는 것에 一致된 것 같다. To investigate the effect of Silver Nitrate solution on the testis and the body weight in male rabbit, this experiment was carried out and used thirty six White-Japeness Rabbits, which were 4to5 months old, as experimental animal. Those animals were assigned into 9 groups of 4 rabbits, and these groups consited of three control groups and three groups with 1%, three groups with 5% silver nitrate solution which injected 0.5ml into the testis tissue of these male rabbits. The results obtained summarized were as follows; 1. The growth and the body weight gain showed no significant effect in all the groups. 2. In the changes of the external testes, showed expending testes in 2 days after injection and then constructing in all the groups with the exception of control groups. In groups with 5% S.N.solution, however, most of testes were disappeared in 20 days after injection because of necrosis of internal testis tissue. 3. It seemed that the internal testis tissue restored in the groups with 1% S.N.solution as time goes by, but appeared the necrosis of the internal testis tissue in the groups with 5% S.N.solution. 4. Nos. of leucocyte were increased after injection of S.N.solution and then restored with the passage of time. *S.N:Silver Nitrate.