임신 중기 급성 A형 간염의 치료 1예

김미영,문성택,김윤숙,전섭,최승도,선우재근,배동한 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

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위암 환자에서 위절제술후 나타나는 담도확장의 임상적 의의: 추적 CT 소견을 중심으로

윤구섭,백승연,이문규,김영환,오용호 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.1

A retrospective review of consecutive 35 patients'pre and post operative abdominal computed tomography was performed to determine frequency and degree of bile duct dilatation following Billroth Ⅱ operation for stomach cancer and it's clinical significance. Degree of intrahepatic biliary dilatation was classified as mild, moderate, marked according to the extension into central, middle and peripheral zone of liver, respectively. Three specialists on the abdominal image participated in analysis of those findings without prior information of the patients. Intrahepatic biliary dilatation was seen in 22 patients(63%) analysed by at least one radiologist, in 13 patients(37%) by at least two radiologists. Bile duct dilatation on CT was common finding and not necessarily meant tumor recurrence. Vagotomy and afferent loop resulted form Billroth Ⅱ were one of possible causes of bile duct dilatation. This study showed in the cases of bile duct dilatation without clinical and other radiological evidence of recurrence, no further study are needed and only enough to follow up study.

뇌손상 후 인지기능장애에 대한 메칠페니데이트의 효과-이중맹검 위약대조 연구-

김연희,나승용,신용일,서정환 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.4

거대 관동맥류에 병발한 급성 심근 경색증 1예

윤혁준,김기식,허승호,박남희,조용원 대한순환기학회 2002 Korean Circulation Journal Vol.32 No.8

내시경역행성담췌관조영술 후 발생한 종격동기종, 피하공기증, 긴장성 기흉 1예

조용건,이현승,권균홍,김자영,김봉진,김지연,배용목,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

However, Endoscopic retrograde cholangiopancreatography (ERCP) is still helpful procedure for the diagonosis of the pancreatobiliary disease and treatment through endoscopic sphinterectomy (EST) is relatively safe, these have possiblity of complications such as hemorrhage, infection, panceatitis, and perforation. ERCP related perforation was rarely reported in 0.3 to 1.1% of previous study, but most serious complication. A report of Pneumomediastinum, Tension Pneumothorax complicating perforation after ERCP and EST is very uncommon. In our hospital, we experienced case of pneumomediastinum, subcutaneous emphysema, and tension pneumothorax after ERCP and EST, and the patient (a 58 years old female with suspicious common bile duct stone) was treated successfully with conservative treatment.

시골 지역 청원에서 관측한 이산화황 농도의 변동 경향 특성

남윤희,정용승 한국교원대학교 환경과학연구소 2004 환경연구논문집 Vol.- No.8

We analyzed hourly integrated measurements of SO₂ concentrations obtained from a rural monitoring site located in Chongwon, Korea to investigate the characteristics of temporal variations during the period from 1994 to 2001. The annual, seasonal, and diumal variations of observed SO₂ concentrations are discussed and the characteristics of rural concentration variations are addressed associated with the effects of meteorological variables such as wind speed, wind directions and temperature. The results indicate that the annual variation of mean SO₂ concentrations show a significantly decreasing trend and the amplitude of monthly variations are also found to decrease with time. The diumal variations of SO₂ concentrations show maximum in the morning around at 0800-1000 LST and secondary maximum at around 1900-2100 LST, but the amplitude of diumal variation of SO₂ concentration has decreased. Although the urban and industrial cities such as Chongju are located in the eastern part of Khangnae, Chongwon, the analyzed result in association with wind directions shows that relatively lower SO₂ concentrations are found in the directions of ENE rather than WSW cases. This is implying the importance of topography located in south-north direction over the eastern Chongwon area where a blocking of air pollutants from the eastern emission area plays a certain role on the characteristics of SO₂ levels in Chongwon. On the other hand the SO₂ concentrations from the WSW-W area (i.e., Daejun and Chochiwon) are found to be relatively higher than from other directions due to more effective medium and large scale transport of pollutions from upstream regions.

국내 검정콩 육성품종의 종자특성

주용하,박재훈,윤승길,김영호,김성민,정길웅 한국국제농업개발학회 2002 韓國國際農業開發學會誌 Vol.14 No.4

1. 수분흡수율이 가장 높은 시간은 다원콩(침지 후 4시간)을 제외한 모든 품종이 침지후 2시간이었으며, 둔화되기 시작한 시간은 침지후 약 10시간이었고, 평형에 도달한 시간은 침지후 약 16시간이었다. 2. 수분흡수율은 품종간에 차이가 있었는데 가장 높은 수분흡수율을 보인 품종은 검정콩2호이었으며, 가장 낮은 품종은 다원콩이었다. 3. 발아율의 범위는 28이었으며, 평균발아율은 93.9%이었고, 가장 높은 품종은 청자콩과 흑청콩이었다. 4. 발아세의 범위는 52이었으며, 평균발아세는 81.9%이었고, 가장 높은 품종은 흑청콩이었다. 5. 평균발아일수와 T_50의 범위는 모두 2이었으며, 평균은 각각 2.6과 2.3이었고, 품종간에는 선흑콩이 가장 길었다. 6. 발아균일도의 범위는 3.1이었으며, 평균은 1.3이었고, 높은 그룹(흑청콩·청자콩·검정콩2호·다원콩·검정올콩)과 낮은 그룹(검정콩1호·일품검정콩·선흑콩)으로 분류되었다. 7. 알칼리붕괴도는 공시품종의 평균이 4.65이었으며 등급은 4∼5등급을 나타내었다. 붕괴도가 가장 높고 우수한 품종은 검정콩1호였으며 가장 낮은 품종은 선흑콩이었다. The water absorption rate after soaking of seeds was the highest at 2 hours in all varieties except Dawonkong(4 hours after soaking), and became slowed down at 10 hours, and reached moisture equilibrium in stopping almost at 16 hours. The water absorption rate was different among varieties, the highest variety was Geomjeongkong #2 whereas the lowest variety was Dawonkong. The range of germination percentage was 28, and average value 93.9%, and the highest varieties were Cheongjakong and Heukcheongkong. The range of germination speed was 52. average value 81.9%, and the highest variety was Heukcheongkong. The range of average days to germination and T_50 were all two days and these average was 2.6 and 2.3, respectively. Seonheukkong among varieties was very long in average days to germination and T_50. The range of germination uniformity was 3.1 and average was 1.3 and divide into two groups such as high group(Heukcheongkong, Cheongjakong, Gemjeongkong #2, Dawonkong, Geomjeongolkong) and low group(Geomjeongkong #1, llpumgeomjeongkong, Seonheukkong). Varietal mean of alkali digestibility value was 4.65 belong to 4∼5 class, the highest variety was Geomjeongkong #1 whereas Seonheukkong was very low among varieties.

거대적아구성빈혈의 임상적 고찰

곽승근,천재민,박남숙,박상은,박수진,윤환중,김삼용,조덕연 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Megaloblastic anemias are disorders caused by impaired DNA synthesis and chara-cterized by the presence of megaloblastic cells. Clinical data on these disorders in Korea are limited. The aim of this study was to analyze clinical characteristics of megaloblastic anemias caused by vitamin B12 deficiency. We identified 40 cases who were diagnosed as megaloblastic anemia from January 1993 to December 2002 in a retrospective study on the basis of chart review. We investigated the annual distribution of diagnosed patients, clinical manifestations and response to treatment. 19 cases were complicated with a previous total gastrectomy(gastrectomy group) and 21 cases had no history of surgical operation(non-gastrectomy group). The most common presenting complaint was generalized weakness. The median age at diagnosis was 7(range: 38-79) years in non-gastrectomy group. The mean pos-toperative duration was 7(range: 4-25)years in group of total gastrectomy and mean level of serum vitamin B12 was lower than 100 pg/mL in both group. Peripheral blood revealed thrombocy-topenia, macrocytic anemia and hypersegmented neutrophil in all cases. After treatment of pareliteral vitamin B12, Their clinical symptoms and hematologic findings improved except two patients who had bone marrow with lower cellularity. Cobalamin replacement after total gastrectomy is still missing. Diagnoses are made too late in a population of patients, resulting in irreversible neurological sequale, and we suggest that Pernicious anemia seems not to be very rare in Korea.

미만성 대형 B-세포 림프종에서의 예후인자에 관한 연구

김삼용,곽승근,박상은,윤환중,조덕연,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

미만성 대형 B-세포 림프종은 가장 흔한 악성 림프종의 한 종류로서 우리나라에서는 전체 비호지킨 림프종의 50%를 차지한다. 비호지킨 림프종에서 병기는 호지킨병과는 달리 예후 인자로서의 유용성이 적다. 따라서 병기만을 예후 인자로서 평가하는 한계를 극복하기 위해 국제예후지표(International Prognostic Index)가 도입되었다. 특정 환자에서 IPI 점수와 함께 그 환자의 림프종의 생물학적 특성을 분석한다면 예후 예측에서 정확도가 높아질 것이다. 본 연구에서는 미만성 대형 B-세포 림프종에서 국제예후지표의 유용성을 확인하고자 하였으며, 각종 생물학적 지표의 면역화학염색을 통하여 이들을 배세포 중심 아형(germinal center subgroup : 이하 GC양 아형으로 약함)과 활성화 B-세포 아형(post-germinal center subgroup; 이후 pGC양 아형으로 약함)으로 분류하고 이들의 예후 예측에 대한 적절성을 평가하였다. 결과는 다음과 같다. 1. 연령분포는 37세에서 69세로 중앙치는 56세이었으며, 남자는 17예(65.4%), 여자가 9예(34.6%)였다. 병기는 Ⅰ, Ⅱ, Ⅲ, Ⅳ기가 각각 2예(7.7%), 11예 (42.3%), 5예(19.2%), 8예(30.8%)였다. 'B'증상은 5예(19.2%)에서 양성이었다. 진단 당시 혈청 LDH치가 상승한 경우가 11예(42.3%)였고, 거대종양(직경이 10㎝이상)을 갖는 경우가 5예(19.2%)이었다. ECOG 수행등급은 0이 2예(7.7%), 1이 18예(69.2%), 2가 5예(19.2%), 3이 1예(3.8%)이었다. 2. 면역조직화학염색 상 bcl-2의 양성은 17예(65.4%), bcl-6의 양성이 20예(76.9%)이었다. CD10이 양성인 경우가 5예(19.2%)이었다. IRF-4가 양성인 경우는 8예(30.8%)였다. 26명의 환자에서 bcl-6, CD10과 IRF-4를 이용하여 GC양 아형과 pGC양 아형으로 분류 하였는데, GC양 아형은 14예(53.8%)이었고, pGC양 아형은 7예(26.9%), 분류가 되지 않는 경우가 5예(19.3%)이었다. 3. 평균 48개월 동안 추적한 결과 중앙생존기간은 44개월이었고 생존기간은 1~100+개월에 분포하였다. Kaplan-Meier법에 의한 5년 누적 생존률은 32%이었다. 4. 병기, 'B' 증상, 혈청 LDH 농도, ECOG 수행등급, 거대종양유무가 통계학적으로 의미있는 임상적 예후 인자였다. 5. 면연조직화학염색에서는 bcl-2만이 통계학적으로 유의한 예후인자였다. 6. GC양 아형은 pGC양 아형에 비해 생존기간은 좋았으나, 통계학적 유의성은 없었다. 7. 다변량 분석결과 bcl-2 발현과 혈청 LDH치만이 예후에 영향을 미쳤다. Clinical Significanceof Expression of Biomarkers in Patients with Diffuse Large B-cell Lymphoma Diffuse large B-cell lymphoma(DLBL) is the most common type of lymphoma in Korea, representing about 50% of non-Hodgkin's Lymphomas. Although DLBL is usually considered as a specific category, the diversity in clinical presentation, morphology, genetic and molecular alterations strongly suggest that these tumors represent a heterogeneous group of neoplasia rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embraces patients with heterogeneous prognoses. It is likely that the prognostic assessment of patients with DLBL might be improved by using biological features. During the last decade, most studies dealing with the heterogeneity of DLBL have focused on individual protein expression and molecular alterations. The expression of individual antigens related to different stages of B-cell differentiation, including CD10, bcl-6, and IRF-4, may help to define groups of tumors with different clinical and pathological characteristics. To determine the clinical significance and prognostic value of individual biomarker expression and the biomarker expression patterns according to germinal center subgroup or post-germinal center subgroup of DLBL as defined by a relatively small number of single antigens, we studied 26 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for CD10, bcl-6, IRF-4, bcl-2 antigens. Two immunophenotyping profiles were distinguished according to the pattern of differentiation; germinal center(GC;CD10/Bcl-6+/IRF-4-) subgroup or postgerminal center (pGC ; CD10/bcl-6/IRF4+) subgroup. The results are as follows; 1) Baseline characteristics of patients were ; median age of patients was 56(range ; 37-69). 17 patients(65.4%) were male. 5 patients(l9.2%) had 'B' symptoms. Stages were as follows ; stage Ⅰ2 patients(7.7%), stage Ⅱ 11 patients(42.3%), stage Ⅲ 5 patients(l9.2%), stage Ⅳ 8 patients(30.8%). 11 patients (42.3%) had elevated LDH levels. 25 patients(96.2%) had ECOG performance grade 0-Ⅱ and 1 patient had grade Ⅲ. 5 patients(l9.2%) bad bulky disease. 2) The results of immunohistochemical study were as follows ; positive bcl-2 staining in 17 patients(65.4%), positive bcl-6 in 20 patients(76.1%), positive CD10 in 5 patients(l9.2%), positive IRF-4 staining in 8 patients (30.8%). 3) After a median follow up duration of 48 months, the median survival duration was 44 months with a range of survival of 1-100+ months. 5-year overall survival rate was 32% by Kaplan-Meier method. 4) The clinical factors affecting survival were elevated serum LDH level, B symptoms, bulky disease, stage at diagnosis and ECOG performance status 5) Among the biomarkers, only bcl-2 expression affected survival of DLBL patients 6) The germinal center like subgroup had superior survival than post-germinal center like subgroup but had no statistical significance. 7) Multivariate analysis showed that bcl-2 and serum LDH level had siginificance on survival Conclusion In addition to the known clinical prognostic factors, immunohistochemically defined characteristics such as bcl-2 expressionin DLBL is important and subgroups(germinal center or post-germinal center subgroup) of DLBL may have importance in predicting prognosis of DLBL patients

석청(Mad-honey) 복용 후 유발된 부정맥 1예

김용철,김남호,김승환,최준호,박은미,이상재,이은미,유남진,윤경호,오석규,정진원 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2

석청에 포함된 grayanotoxin에 의해 독성 작용이 나올 수 있으며, 이러한 독성 작용은 일반적으로 24시간 이내 저절로 회복된다. 최근에 본 저자들은 석청 복용 후 발생한 심실빈맥을 경험하였기에 보고하는 바이다. 49세 남자가 호흡곤란으로 내원하였으며, 내원당시 분당 40회 정도의 동성 서맥이 관찰되었고, 수액을 투여하던 중 심실 빈맥이 발생하였다. 항부정맥제를 투여 후 정상 동율동으로 전환되었으며, 특별한 이상 없이 4일 후 퇴원하였다. Mad-honey intoxication caused by the consumption of honey producted from the nectar of rhododendrons. The grayanotoxins cause the intoxication. The toxic effects of mad-honey poisoning are rarely fatal and generally last for no more than 24 hours. We experienced one case, a 49 years-old man who presented with dyspnea after ingestion of mad-honey. He showed marked sinus bradycardia with < 40 beats per minute on admission. The cardiac rhythm was changed to ventricular tachycardia immediately. These features resolved completely in 24 hours with continuous infusion of amiodarone(600 mg per day) and fluids. We report the case of intoxication of mad-honey as a presentation of fatal cardiac arrhythmia.