위장관계 악성종양에서 CA 125 측정의 의미

장우익 ( Jang U Ig ),안강현 ( An Gang Hyeon ),이종인 ( Lee Jong In ),김현수 ( Kim Hyeon Su ),김효열 ( Kim Hyo Yeol ),김수경 ( Kim Su Gyeong ),이동기 ( Lee Dong Gi ),배선우 ( Bae Seon U ),심영학 ( Sim Yeong Hag ),강명서 ( Kang Myeo 대한내과학회 1993 대한내과학회지 Vol.44 No.4

연구배경 : 종양표지자는 암외 진단, 임상적 병기구분 및 치료효과 판정에 유용하며, 위장관암에서 alphafetoprotein, carcinoembryonic antigen, CA 19-9, 및 CA 72-4 등이 중요한 지표로 사용되고 있으나 위암의 경우, 현재까지 만족할 만한 유용성을 가진 종양표지자는 없는 실정이다. 저자등은 위암에 대한 새로운 종양표지자로 CA 125의 역할을 규명하고자 위암을 비롯한 각종 위장관암에서 CA 125와 기존의 종양표지자와의 유용성을 검토하였다. 방법 : 대상은 위장관 악성종양 181예, 위장관 양성질환자 55예를 대상으로 하였으며 CA 72-4는 CIS ELSA CA 72-4 RIA kit, CA 19-9는 Abbott CA 19-9 RIA kit, CEA는 Abbott CEA kit, CA 125는 Centocor CA 125 RIA kit를 사용하여 측정하였으며, 각각의 정상치 한계는 4 U/ml, 37 U/ml, 5ng/ml그리고 35 U/ml로 하였다. 결과 : 1) CA 125는 양성 소화기 질환에서 93%의 높은 특이도를 보였으나 복수가 있는 간경변증의 경우 거의 전예에서 혈중 CA 125값이 증가하여 악성종양군과 감별이 어려웠다. 2) CA 125는 위암에서 민감도가 36%로 CA 72-4와 차이가 없었다. 3) CA 125는 췌담도암에 대한 민감도가 55%로 CA 19-9의 85%에 비해 낮았으며 두 종양표지자를 병합하여 사용한 경우 민감도의 증가(95%)를 볼 수 있었다. 4) 23예의 조기위암 환자에서 CA 125의 민감도는 9%로 낮았다. 5) Conventional image study 상으로 인지되지 않은 복강내 암종증 환자에 대한 CA 125의 민감도는 36%였다. 결론 : CA 125는 위암에서 기존의 종양표지자인 CA 72-4와 유용성의 차이를 보이지 않았으며 전이성 위암에서 높은 민감도를 나타내었다. 혈중 CA 125의 증가는 위장관의 악성 및 양성질환에 관계없이 복수의 유무와 밀접한 연관관계를 가지는 것으로 사료되며 통상적인 영상 진단법상으로 인지되지 않은 복강내 암종중의 예견에 있어서는 유용하지 않을 것으로 생각된다. Background: Detection of tumor markers could offer an accessible method for screening risk groups in order to achieve an early diagnosis of cansers, to contribute to and adequate staging, and to help evaluate effects of therapy. CA 125 is an antigenic determinant defined by murine monoclonal antibody OC 125, and synthesized by coelomic epithelial derivatives such as Mullerian epithelium and mesothelial tissues. CA 125 is regarded as useful tumor marker for non-musinous epithelial ovarian tumors. So we investigated whether CA 125 is reliable tumor marker for gastrointestinal malignancies and especially for detection of intraperitoneal carcinomatosis unrecognized by conventional imaging studies. And we compared CA 125 with other conventional tumor markers in the serodiagnosis of gastrointestinal malignancies. Methods: Serum CA 72-4, CA 19-9, CA 125 and CEA were determined radioimmunologically with monoclonal antibodies. A cut-off value of 4 U/ml, 37 U/ml, 35 U/ml and 5 mg/ml were used respectively. Results: The results are summarized as follows. 1) CA 125 had high specificity (93%) for benign gastrointestinal disease but was not useful to differetiate malignant ascites and benign ascites. 2) In gastric carcinoma, the sensitivity of CA 125 (36%) was not so different to that of CA 72-4(36%). 3) In pancreatobiliary carcinoma, the sensitivity of CA 125(55%) was inferior than that of CA 19-9 (85%), but combined use of these two tumor markers increases sensitivitu(95%) for the diagnosis. 4) The sensitivities of CA 125 for 23 early gastric cancer was 9%. 5) The sensitivities of CA 125 for the intraperitoneal carcinomatosis that was not recognized by conventional imaging studies was 36%. Conclustion: Our data indicates that CA 125 is not better in the serodiagnosis of gastrointestinal malignancies than other conventional tumor markers, and CA 125 has a little predictive value in the diagnosis of intraperitoneal carcinomatosis unrecognized by the conventional imaging studies. Serum CA 125 elevation in benign or malignant diseases closely correlated with the presence of ascites.

하시모토갑상선염에 동반된 골수를 침범한 ( 병기 4E 기 ) 원발성 갑상선 림프종 1 예

이기업,송영기,박중열,김기수,김상희,공경엽,조재근,추윤호,엄완식,지현숙 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.4

Primary lymphoma of the thyroid is a relatively rare malignant tumor of the thyroid. It is known to be frequently associated with Hashimoto's thyroiditis. In Korea, a few cases of primary lymphoma of the thyroid have been reported and most of these cases were in the stage I E or II E. Recently, we experienced a case of the primary thyroid lymphoma, stage IV E associated with Hashimoto's thyroiditis in a 70-year-old woman who presented with dysphagia and dyspnea due to rapidly enlarging neck mass. She was treated with combination chemotherapy(cyclophosphamide, adriamycin, vincristine and methylprednisolone) and local radiotherapy and achieved partial response with resolution of dysphagia and dyspnea(J Kor Soc Endocrinol 9: 390-394, 1994).

산발성 비가족성 저인산염혈증 골연화증

박정식,이기업,조유숙,송영기,김상욱,박중열,김기수,조구영 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.1

Chronic hypophosphatemia caused by decreased intestinal absorption or increased renal clearance, may lead to rickets or osteomalacia independently of other predisposing abnormalities. The conditions commonly associated with increased renal clearance of phosphate are X-linked hypophosphatemic rickets, tumor associated rickets/osteomalacia, RTA and Fanconi syndrome. Recently we experienced 3 men with adult-onset, histologically proven osteomalacia associated with increased renal clearance of phosphate. None of them had a family history of bone disease, tumors or other tubular defects. All of these had remarkable biochemical and clinical improvement with medical treatment such as 1, 25-dihydroxyvitamin D and phosphate supplementation. Although we did not find tumors yet, we could not rule out the possibility of tumor-associated osteomalcia since it often takes several years to make a diagnosis because of small size, benign nature and unusual location of tumors. Thus, careful long-term follow up for tumor occurrence will be maintained in these patients with sporadic nonfamilial hypophosphatemic osteomalacia(J Kor Soc Endocrinol 9:25-31, 1994).

ACTH 분비 뇌하수체 선암에 의한 쿠싱병

이문호,이정교,이기업,송영기,박중열,김기수,조원경,최기영 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.2

Primary carcinoma of the pituitary is only rarely reported. About half of the reported cases are nonfunctional. It is generally agreed that the presence of distant metastasis is required to clearly establish the diagnosis of pituitary carcinoma. We have experienced a case of ACTH-producing pituitary carcinoma causing Cushing's syndrome which could be diagnosed by histologic features only without evidence of distant metastasis. A 35-year-old female with Cushingoid appearance was diagnosed as Cushing's disease after biochemical and neuroradiological evaluation. Near total removal of the pituitary tumor was performed. By histopathologic examination, the tumor revealed evidences of histological malignancy such as prominent nuclear pleomorphism, frequent mitoses and extensive tumor necrosis. Pseudosarcomatous components were also noted. By immunohistochemical studies, the tumor cells expressed ACTH. However, there was no evidence of distant metastasis at the initial operation. She was diagnosed as having ACTH producing pituitary carcinoma by histologic feature only. One month later, she complained progressive nausea and vomiting, and follow-up brain MRI revealed regrowing pituitary mass. She was reoperated and near total tumor bulk was removed again followed by radiotherapy with 5580 rads. Four month after the second operation, she developed generalized tonic clonic seizure. Brain CT showed multiple enhancing nodules on left temporal and frontal lobes, and around falx cerebri. She refused further treatment and was managed only with anticonvalsants. About month after discharge she died at home(J Kor Soc Endocrinol 9:136-140, 1994).

악성빈혈을 동반한 골다공증 1 예

이정신,최승원,이기업,김상욱,박중열,김기수 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.3

A few studies strongly suggest that pernicious anemia is a risk factor for osteoporosis, but the mechanism is unknown. Recently we experienced a 65-year-old female with pernicious anemia and osteoporosis. She had multiple compression fractrues of thoracolumbar vertebrae and low bone mineral density of spine and femur by dual photon absorptiometry. Pernicious anemia was confirmed with low serum vitamin B12 level and characteristic bone marrow findings. She did not have other secondary causes of ostoeporosis other than pernicious anemia. Although we co not believe pernicous anemia is solely responsible for osteoporosis of this patient, it must have contributed some to the development of the disease. In summary; pernicious anemia is a risk factor for osteoporosis and optimal evaluation and management of bone loss should be done in patients with pernicious anemia, especially in postmenopausal state(J Kor Soc Endocrinol 8:351~355, 1993).

과아밀라제혈증을 동반한 갈색세포종

김소양 ( Kim So Yang ),김지훈 ( Kim Ji Hun ),김창환 ( Kim Chang Hwan ),남순우 ( Nam Sun U ),김윤정 ( Kim Yun Jeong ),김진일 ( Kim Jin Il ),박수헌 ( Park Su Heon ),한준열 ( Han Jun Yeol ),김재광 ( Kim Jae Gwang ),정규원 ( Jeong Gyu 대한소화기학회 2003 대한소화기학회지 Vol.42 No.2

Pheochromocytoma, a catecholamine-producing tumor of the chromaffin tissue, may present with various features. Herein, we report case of 66-year-old woman with pheochromocytoma accompanying hyperamylasemia and acute abdomen. She was admitted to another hospital due to myocardial infarction 5 months ago. At that time, pheochromocytoma was suggested on the basis of hormonal studies, but she refused surgical resection. When she came to our hospital, serum amylase level was 703 U/L. Subsequent studies revealed pancreatic type isoenzyme, and elevated lipase level. After normalization of serum amylase level, she undertook laparoscopic adrenalectomy. On pathologic examination, pheochromocytoma was confirmed. There are several cases of pheochromocytoma with hyperamylasemia. In general, the source of hyperamylasemia was thought to be pulmonary endothelial cells under ischemic damage caused by potent vasoconstrictive action of circulating catecholamines. In our case, analysis of isoenzymes and serum lipase level suggest that hyperamylasemia can originate from the pancreas. Thus, pancreatitis also should be considered when serum amylase level is elevated in pheochromocytoma. (Korean J Gastroenterol 2003;42:172-175)

Hepatitis B Reactivation among Chronic Hepatitis C Patients Treated with Direct Acting Antivirals

( Hee Yeon Kim ),( Chang Wook Kim ),( Jin Ah Kim ),( Mi Ju Cheon ),( Chan Ran You ),( Sang Wook Choi ),( Se Hyun Cho ),( Joon-Yeol Han ),( Do Seon Song ),( U Im Chang ),( Jin Mo Yang ),( Sung Won Lee 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: This study aimed to investigate hepatitis B virus (HBV) reactivation among hepatitis C virus (HCV) infected patients treated with oral direct acting antiviral (DAA) therapy in areas endemic for HBV in Korea. Methods: A total of 821 HCV-infected patients receiving oral DAA therapy from March 2015 to November 2016 were evaluated. Serum HBV DNA and HCV RNA was regularly assessed during and after DAA treatment in patients with HBV-HCV coinfection. HBV virological reactivation was defined as a >1 log increase in HBV DNA from baseline or a reappearance of HBV DNA for those with baseline undetectable HBV DNA. Clinical reactivation was defined as a serum alanine aminotransferase level ≥3-fold over the upper limit of normal or > 100 U/L. Results: Prior to DAA therapy 95.8% (787/821) had HBsAg testing and 1.7% (13/787) were positive. HBV virological reactivation was found in 7 (53.8%) of the 13 patients. HBV-related clinical reactivation was not observed in our cohort. Conclusions: For HBV-HCV co-infected patients, the risk of HBV virological reactivation was present after oral DAA treatment for HCV infection. Monitoring the HBV DNA level during oral DAA therapy for HCV infection is warranted.

골반 부전과 요통 발생 위치의 상관 관계에 대한 고찰 -기립위 Pelvis X-ray 분석을 통하여-

배우열 ( U Yeol Bae ),권헌준 ( Hun Joon Kwon ),정종훈 ( Jong Hoon Jung ),이종훈 ( Jong Hoon Lee ),김동섭 ( Dong Sub Kim ),조성우 ( Sung Woo Cho ) 한방재활의학과학회 2013 한방재활의학과학회지 Vol.23 No.3

ObjectivesThe aim of this study was to investigate pelvic insufficiency and its correlation with lumbago side. Methods72 cases of patients who received treatment from March 2010 to February 2013 for lumbago were analyzed. Their pelvic insufficiency parameters were estimated by x-ray analysis and lumbago sides were considered. The data were analyzed to find out correlation of pelvic insufficiency parameters and correlation between parameters and lumbago sides. Pearson correlation and two-by-k cross tabulation analysis were used. Results1) Iliac height difference had significant correlation with femur height difference and the result was alike previous studies` results. 2) Femur height difference and iliac height difference had no significant correlation with iliac width difference. 3) Posterior rotation malposition ilium side and inflare side had no significant correlation with lumbago side. ConclusionsIliac height difference had significant correlation with femur height difference and sides of pelvic insufficiency had no significant correlation with lumbago sides. (J Korean Med Rehab 2013;23(3):79-85) ObjectivesThe aim of this study was to investigate pelvic insufficiency and its correlation with lumbago side. Methods72 cases of patients who received treatment from March 2010 to February 2013 for lumbago were analyzed. Their pelvic insufficiency parameters were estimated by x-ray analysis and lumbago sides were considered. The data were analyzed to find out correlation of pelvic insufficiency parameters and correlation between parameters and lumbago sides. Pearson correlation and two-by-k cross tabulation analysis were used. Results1) Iliac height difference had significant correlation with femur height difference and the result was alike previous studies` results. 2) Femur height difference and iliac height difference had no significant correlation with iliac width difference. 3) Posterior rotation malposition ilium side and inflare side had no significant correlation with lumbago side. ConclusionsIliac height difference had significant correlation with femur height difference and sides of pelvic insufficiency had no significant correlation with lumbago sides. (J Korean Med Rehab 2013;23(3):79-85)

2축 솔라셀 센서모듈을 이용한 태양광 추적시스템의 설계 · 제작

전우열(U-Yeol Jeon),강민정(Min-Jung Gang),이승환(Seung-Hwan Lee),김힘찬(Him-Chan Kim),문동윤(Dong-Youn Moon),김희수(Hee-Su Kim),손민정(Min-Jung Son),이지은(Ji-Eun Lee),이주현(Ju-Hyun Lee),우혁재(Hyeok-Jae Woo),신규재(Kyoo-Jae Shin) 대한전자공학회 2015 대한전자공학회 학술대회 Vol.2015 No.6

Solar tracking system has the asembly of remote servo control and remote monitoring. It is composed of solar illumination of the solar azimuth one solar cell sensor device for detecting a value and integrated control device including the integrated control panel for remote transmission by the wireless communication by the servo control and solar module assembly to follow the sun azimuth in response to the control signal. The proposed algorithm is verified through experimental results.

BIM-Based Simulator for Rebar Placement

Park, U-Yeol The Korean Institute of Building Construction 2012 한국건축시공학회지 Vol.12 No.1

Reinforcing bars (rebar) comprise an integral part of a concrete structure, and play a major role in the safety and durability of the building. However, the actual placement or installation of rebar is not planned and controlled by the detailer. Recently, 4D simulations, using 3D model and scheduling software, have been used to improve the efficiency of the construction phrase. However, 4D simulators have not been introduced at the detailed level of work, such as rebar placement. Therefore, this paper suggests a BIM-based simulator for rebar placement to determine the sequence with which rebar is placed into the form. The system using Autodesk Revit API automatically generates rebar placement plans for a building structure, and labels the placement sequence of each individual bar or set of bars with ascending numbers. The placement sequence is then visualized using Autodesk Revit Structure 2012. This paper provides a short description of a field assessment and limits.