외상 후 뇌 지방색전증 1예

문정미,소정일,김용권,류진호,허탁,서정진,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

서동증과 의지감소증으로 발현한 간성 뇌병증 : 증례보고

문소영,정용,강수진,진주희,나덕렬 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

We report a 70-year-old woman who, without a prior history of liver disease, presented abulia and bradykinesia as the initial symptoms of hepatic encephalopathy (HE). Neurological examination showed bilateral extensor plantar responses in addition to mild parkinsonian features On neuropsychological tests, she was impaired at the attention, visuospatial function, memory, and frontal lobe function. Laboratory tests were remarkable for increased AST and ammonia, and positive igG HbcAb. The results of ultrasonography of the liver were consistent with chronic liver disease. Brain T1 weighted MRI revealed a high signal intensity in bilateral basal ganglia. Brain PET showed diffuse cerebral hypometabolism After treatment with oral lactulose, the above symptoms remained improved for the next 6-month of follow-up From this case, we learned that hepatic encephalopathy could be a reversible cause of dementia plus parkinsonism even in patients without a prior history of chronic liver disease.

외과적 정출술을 통한 치은 하방 치경부 파절선이 있는 상악 전치부의 심미 보철 치료

이소진,김유진,박영범,조규성,정문규 大韓齒科補綴學會 2012 대한치과보철학회지 Vol.50 No.3

Surgical extrusion, immediate extrusion following tooth luxation, is a method to preserve one's natural tooth and achieve esthetic restoration without additional periodontal surgery when subgingival dental caries or crown fracture occurs. A 16-year-old male was referred to the clinic from the department of operative dentistry for the esthetic restoration of maxillary left lateral incisor. Due to the crown to root fracture, the tooth was endodontically treated with a buccal crown length of 4 mm. When the palatal flap was elevated, the mesiopalatal cervical fracture area was situated 3 - 4 mm subgingivally. Crown lengthening was achieved through surgical extrusion. After 3 months of clinical observation and provisional restoration, the maxillary left central incisor was restored with all ceramic crown and obtained a satisfactory clinical result. 치은연 하방에 치아 우식증이나 치아 파절이 발생했을 때, 치아를 탈구시켜 즉시 정출시키는 외과적 정출술을 이용한 치관 연장술은 자연치를 보존하고 추가적인 치주적 수술 없이 단기간에 심미적인 보철 치료를 가능하게 한다. 본 환자는 16세 남환으로 본원 보존과로부터 상악 좌측 중절치의 심미 수복을 위해 본원 보철과로 의뢰되었다. 상악 좌측 중절치는 근관치료가 되어 있었으며 치관-치근 파절로 인해 협측 치관 길이는 4 mm였으며 구개측 판막을 열었을 때 근심 구개측 치경부 파절 범위는 치은 하방 3 - 4 mm에 위치하였다. 외과적 정출술을 통한 치관연장술을 시행하였으며 경과 관찰 및 임시 치아의 단계를 거쳐 3개월 후에 전부 도재관으로 수복하여 만족할 만한 임상 결과를 얻을 수 있었다.

HBx형질전환 생쥐에서 발생한 간세포암종에서 H-ras 및 c-myc의 발현에 관한 연구

문형배,소병준,김학철,윤기중,한원철,조향정,유대열,정영진 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

<연구목적> HBx형질전환 생쥐에서 발생한 간세포암종의 발암과정에 종양유전자(H-rgs, c-myc)의 발현 정도를 조사하고자 하였다. <연구방법> 정상생쥐 12마리(4-18개월) 및 HBx 형질전환 생쥐 44마리(4-18개월)를 대상으로 포르말린에 고정하고 파라핀에 포매한 간 조직을 이용하여 면역조직화학적염색을 실시하였다. 실험군은 정상 부위, 이형성 부위 및 종양 부위로 구분하였으며, 종양 부위는 소결절성병변 부위와 간세 포암종 부위로 구분하였고, 이형성병변 부위는 이형성병변만 발견되는 부위, 소결절성병변과 동반된 이형성병변 부위 및 간세포암종과 동반된 이형성병변 부위로 구분하였다. <연구결과> H-rgs의 발현은 정상 간조직에 비하여 이형성병변 부위(P<0.05) 및 종양 부위(P<0.01)에서 증가하였으며, 소결절성병변 부위과 간세포암종 부위 사이에서는 간세포암종 부위에서 증가된 경향이었으나 통계학적으로 유의한 차이가 없었으며, 각 이형성병변 부위 사이에서도 유의한 차이는 없었다. c-myc의 발현은 정상 간조직 및 이형성병변 부위에 비해 종양 부위에서 증가하였으며(P<0.001), 소결절성병변 부위와 간세포암종 부위에서는 비슷하였고, 각 이형성병변부위 사이에서도 비슷하였다. <결론> HBx형질전환 생쥐에서 발생하는 간세포암종의 발생에 H-rgs는 이형성 변화를 일으키는 시기에 관여하며, c-myc은 이형성병변에서 암으로 이행하는 시기에 관여할 것으로 생각한다. Background: This experiment was designed for the expression of H-ras and c-myc in hepatocarcinogenesis of the HBx transgenic mice. Methods: Immunohistochemical stains in the paraffin embedded tissue of the liver were used for the detection of H-ras and c-myc in the 12 normal mice and 44 HBx transgenic mice of the 4-18 month old. Results: Expression of the H-ras was significantly increased in the dysplastic area (P<0.05) and tumor area (P<0.01) than in the normal liver. But there were no differences of H-ras expression between areas of microscopically identified hepatocellular carcinoma (MI-HCC) and grossly identified hepatocellular carcinoma (GI-HCC) and dysplastic areas among the only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Expression of the c-myc was significantly increased in the tumor area (P<0.001) than in the normal liver and dysplastic area. But there were no differences of c-myc expression between areas of MI-HCC and GI-HCC, and dysplastic areas among only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Conclusions: Our study suggests that H-ras is related to the dysplastic change and c-myc is related to the neoplastic change in the hepatocarcinogenesis of the HBx transgenic mice.

肺癌組織에서 Carcinoembryonic Antigen의 免疫組織化學的 檢出에 關한 硏究

蘇文永,金仁仙,白承龍 고려대학교 의과대학 1982 고려대 의대 잡지 Vol.19 No.3

The advent of immunohistochemical technique has allowed the more conventional visualization by light microscopy of antigenic cellular constituents. Carcinoembryonic antigen (CEA), which had been thought to be present in colorectal carcinomas only, was later demonstrated in a variety of malignancies as well as nonmalignant diseases. Using formalin-fixed, paraffin-embedded tissues and immunoperoxidase, the author has attempted to demonstrate CEA in 40 lung cancers and 10 nonmalignant diseases. The results obtained are as follows: 1. Seventeen squamous cell carcinomas among 19, three adenocarcinomas among 4 and only 3 of the 12 small cell carcinomas of the lung were positive for CEA. Two mucoepidermoid tumors and one carcinosarcoma were all positive, whereas one carcinoid tumor and one large cell carcinoma were negative for CEA. 2. In the well differentiated squamous cell carcinoma of the lung it was almost exclusively the more keratinized squamous tumor cells that displayed CEA, whereas in the poorly differentiated squamous cell carcinoma and adenocarcinoma the total cell surfaces demonstrated CEA. In mucoepidermoid tumors, the total cell surfaces and the luminal borders of glandular structures were positive for CEA. The stainability of CEA was weak and focal in small cell carcinoma. The stronger staining of CEA was found in the carcinomatous portion of carcinosarcoma. 3. Except two middle lobe syndromes and one tuberculosis of the lung, 2 bronchiectasis, 2 pneumonias and 3 tuberculosis of the lung were positive for CEA, however the staining was weak and mainly found along the luminal border of the bronchiolar epithelial lining cells. In summary, the findings suggested that the immunohistochemical identification of CEA in tissue section processed for routine histopathology was feasible. This might have diagnostic significance to the histopathologist and provide a basis for use of CEA in the follow-up management of patients with lung cancers.

아파트 주거모델 요구도 평가에 관한 연구 : 구미시 중·소형 아파트 구매예정자를 대상으로(2)

신소영,박세문,김익환 금오공과대학교 2006 論文集 Vol.27 No.-

This paper is analyzed with the living intention, preference tendency and needs of dwelling model of the potential buyers for small and medium sized apartment houses in Gumi. The analysis results are summarized as follows; 1) To see the category of apartment housing model, the need of Apartment & Store, environmentally oriented apartments, well-being apartments is shown to be high. 2) The instruction of the natural-control-system and the recycling system are the top priority of environment-oriented apartments. 3) The need of Automated apartments and Health-oriented apartments is high, as a new housing model. 4) Accordingly, the housing model in the future is concluded with the house with convenience, high technical facilities, and health-oriented apartments.

아파트 거주의향 및 선호경향에 관한 연구 : 구미시 중·소형 아파트 구매예정자를 대상으로

신소영,박세문,김익환 금오공과대학교 2005 論文集 Vol.26 No.-

This paper analyzes the living intention and preference tendency of the potential buyers for small and medium sized apartment houses in Gumi. The analysis results are summarized as follows; 1) About 90% of pollees have intention to move into apartment houses, and prefer a subcenter of Gumi city as residence area, which provides convenient living environment and great nature environment. 2) Most of them want to buy aparbnent houses in ordre to own their houses. Thus, they have a strong desire to have their own houses. When buying apartment houses, they consider economic points first such as price and the merits of investment. 3) Most pollees say they think indoor space is more important than outdoor space. Especially, they want storing spaces and a large balcony. 4) Majority of the pollees like a housing complex consisting of around 300 to 1000 houses and high-rise apartment buildings of 11 to 15 stories.

Alloxan 유도 당뇨병상태에서 과산화지질생성에 미치는 Brazilin의 효과

안영수,길이룡,소동수,창동신,김진형,박광식,문창규 한국환경독성학회 1996 환경독성보건학회지 Vol.11 No.2

Brazilin was tested for its ability to inhibit alloxan induced lipidperoxidation. Lipid peroxide contents in liver, kidney and serum were measured by the TBA method. ICR mice receiving alloxan at a dose of 43mg/kg via the tail vein after a 24hrs starvation showed significantly increased lipid peroxide contents as compared to untreated control. Lipid peroxide contents in liver, kidney and serum of alloxan-induced diabetic mice were dose-dependently decreased by the treatment of brazilin at a dose of 10mg/kg, 50mg/kg, 100 mg/kg for 5 days.

성인간호학회지 논문(1989-2000)의 내용과 경향 분석

서문자,김소선,송미순,이명선,오의금,신경림,김옥수,이숙자,이영자,오효숙,정재심,김철규 성인간호학회 2001 성인간호학회지 Vol.13 No.4

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows : 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview. physical measurement, observation were used in 22.8%. 8.2% 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.