수술로 절제된 간의 국소 결절성 증식의 임상적 특징

황남철,최문석,이준혁,고광철,백승운,유병철,이종철,이광웅,조재원,박철근 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.2

목적: 간의 국소 결정성 과형성은 일반적으로 특별한 치료가 필요 없는 양성 종양이다. 그러나 드물지만 합병증이 발생한 경우와 진단이 불확실한 경우에는 수술을 시행하게 된다. 이에 저자들은 간절제술을 시행한 국소 결절성 과형성의 임상적, 영상학적 특징들을 알아보고자 하였다. 대상과 방법: 1995년부터 2003년까지 수술을 시행하여 조직을 확인한 국소 결절성 과형성 환자 10명을 대상으로 연령, 성별, 실험실 검사 및 영상 소견과 조직 소견을 분석하였다. 결과: 연령의 중앙값은 37.5세, 남녀 비는 1.5:1이었다. 5예에서는 간세포선종이나 간세포암종을 감별할 수 없어서 수술을 시행하였으며, 수술 후 우연히 진단된 예는 4예이었다. 간세포암종의 위험 인자를 가지고 있었던 예는 4예(B형 간염 바이러스 보유자 3예, 간경변 2예)이었다. CT검사가 시행되었던 6예 중 5예는 동맥기에서 조영 증강을 보였고 문맥기 및 지연기로 감에 따라 주변과 동일(4예)한 또는 감소(2예)되는 양상을 보여 간세포암종과의 감별이 어려웠다. 크기는 3.2±2.2㎝이었으며 위치는 간우엽의 후하구역(S6)에 가장 많았다(30.0%). 4예에서 수술 전 침생검을 시행하였으나 고분화 간세포암종이나 간세포선종과의 감별이 어려웠다. 결론: 임상상, 영상검사 및 간침생검으로도 간세포암종이나 간세포선종과의 감별이 어려운 경우 수술을 시행하였으며 수술 전에는 발견하지 못하였지만 다른 질환으로 인한 수술시 우연히 발견된 경우도 있어 국소 결절성 과형성의 수술 전 진단이 어려운 경우가 적지 않음을 알 수 있었다. Background/Aims: Focal nodular hyperplasia (FNH) is a benign hepatic tumor with few serious complications and no malignant transformation. However, differential diagnosis between FNH and other liver tumors, especially hepatocellular carcinoma, is often difficult. Methods: Clinical features of surgically resected FNH were reviewed. From January, 1995 to February, 2003, 10 patients with surgically resected FNH were enrolled. Their age, sex, results of laboratory examination, imaging studies and pathologic findings were evaluated. Results: Median age was 37.5 years and sex ratio (male:female) was 1.5:1. In 5 cases, resection to exclude hepatic adenoma or HCC was performed. Four cases were diagnosed incidentally after surgery. Four patients had risk factors for HCC, such as hepatitis B virus infection, liver cirrhosis or both. The size of FNH was 3.2 2.2 cm. The most common site of the tumor was segment 6 (30.0%). Differential diagnosis with HCC was difficult in 5 of six cases in whom CT was performed. Although needle biopsies were performed preoperatively in 4 cases, it was difficult to distinguish FNH from hepatic adenoma or HCC. Conclusions: FNH was resected due to uncertainty of diagnosis, or incidentally during hepatectomy in patients with other liver disease. In the former, differential diagnosis with hepatic adenoma or HCC was a major problem despite extensive work-up including dynamic CT or biopsy. (Korean J Hepatol 2004;10:135-141)

유자액을 이용한 소스의 이화학적 특성 및 저장성

유경미,서우영,서한석,김완수,박재복,황인경 한국조리과학회 2004 한국식품조리과학회지 Vol.20 No.4

The purposes of this study were to investigate the physicochemical characteristics and storage stabilities of various sauces with added Yuza(Citrus Junos). Yuza consisted of three parts: peeled (46.17%), fleshed (43.74%) and seeded (10.09%). Yuza juice revealed 11.33% extraction yield, pH 2.85, 4.18% total acidity, 11° Brix, 1.16% transmittance and 2.63° Brix/acid ratio. Five kinds of sauces with added Yuza juice were Yuza red pepper paste sauce, Yuza soybean sauce for meat, Shahu shabu Yuza sauce, Korean Yuza vegetable sauce and Japanese Yuza soybean sauce. These sauces showed slight changes in pH, total acidity, total bacterial counts and overall sensory characteristics during storage period (60 days). In conclusion, Yuza juice could be applied to various sauces, which remained usable for 60 days.

일산화탄소 중독환자에서 고압산소치료 적응증에 관한 비교평가

유수진,박재황 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study objective: To comparative study the results between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in the these patients, because controversy exists regarding hyperbaric therapy in the drowsy patient with carbon monoxide intoxication. Design: Tetrospective study Setting: The WonKwang university hospital emergency department during january first 1991 through June 31th 1995 Method and result: According to history and carboxyhemoglobin level, we experienced 105 patients of carbon monoxide intoxication admitted to emergency department. Patients intoxicated by other gases and death patients before admission was excluded. According to the indication of the hyperbaric oxygen therapy on carbon monoxide intoxication, 15 patients among 16 patients with coma, semicoma, and stuporous mental state was done. Patient with drowsy mental state was 23 patients, 6 of these patients was done hyperbaric oxygen therapy and remainder was not. Charts of patients with carbon monoxide intoxication including patients with drowsy mental state was reviewed to determine the result between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy. According to clinical features, we found sex ratio(1:1.6), mean age(35.1±19.4years), age range from 1 to 85 years old, 41cases(39%) in 1991, 66cases(62.9%) in alert mental state and 23cases(21.9%) in drowsy mental state The exposure time and time until alert mental status by mental status were 9.5±0.67hours, 18.8±28.3hours in coma mental status. The early laboratory findings were leukocytosis in 39cases(37.1%), increased hematocrit in 20cases(19.1%), increased GOT in 14cases(13.3%), increased GPT in 12cases(11.4%), increased creatinine in 10 cases(9.5%), glucosuria in 17cases(16.2%) and normal arterial blood gas analysis findings except acidemia in drowsy and coma mental status, and most common abnormal findings were seen in stuporous mental status. The exposure time and time until alert mental status by carboxyhemoglobin concentration were no significant statistical result, and time until alert mental status between drowsy and stuporous mental status with hyperbaric oxygen therapy were 3.9±3.04hours. In patients with drowsy mental status, the patients with hyperbaric oxygen therapy that was 3.9±3.04hours in time until alert mental status, 1cases(17%) in carboxyhemoglobin concentration(≥20%), 5cases(83%) in carboxyhemoglobin concentration(< 20%), 1.432.11days in admission period, and patients without hyperbaric oxygen therapy were 9.9±6.04hous in the time until alert mental status. Arterial blood gas analysis between patients with and without hyperbaric oxygen therapy in drowsy mental status were normal findings except acidemia before hyperbaric oxygen therapy. The comparison between hyperbaric oxygen therapy and non-hyperbaric oxygen therapy in patients with drowsy mental status were significant statistical result in time until alert mental status. Conclusion: Although hyperbaric oxygen therapy was done according to the indication in carbon monoxide poisoning, theirs result imply that hyperbaric oxygen therapy is more important than the pure oxygen therapy in patients with drowsy mental status.

두부외상 환자에 관한 임상적 고찰

유수진,박재황 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Retrospective clinical analysis was made on 884 cases of head trauma visited to ER of WonKwang University Hospital and was treated in the Department of Neurosurgery from 1991. 1. 1. to 1001. 12. 31. A clinical analysis of 884 cases was performed and following results were obtained. 1) The peak incidence was at the age of third decade and the sex ratio was 2.1 : 1, predominant in male. 2) The predominant month and seasonal incidence were October and Autumn. 3) Traffic accidents form the largest group(69.8%), and next are, in order of incidence, falldown(12.4%), slipdown(9.5%), human trouble(4.0%), and The kinds of vehicle were private vehicle(31.1%), motorcycle(20.6%), truck(12.9%), taxi(7.2%), bongo(9.2%), bus(4.7%), bicycle(9.2%), and cultivator(1.5%). passenger's traffic accident was more than pedestrian. 4) The regional distribujtion was Iri(53.8%), Iksan(20%), Okgu and Kunsan(10.0%) 5) The percentage of emergency treatment on scene was Iri(2.9%), Iksan(6.7%), Kimje(18%), Buan(92.3%), Kusan and Okgu(52.2%), and Seocheon(100%). 6) The mental states at arrival to Emergency Room was alert(77.7%), and heavy mental state(10.6%). 7) The interval within 30 minutes from injury to Emergency Room was 50.7% and within 3 hours was 86.2% and it was rather faster than expected. 8) The loss of consciousness after trauma was epidural hematoma 75%, and severely injured head trauma patients have negative light reflex and positive babinski's sign. 9) The brain CT was performed in 884 cases. abnormal findings were observed in 32.8%, in cluding epidural hematoma(19.6%), subdural hematoma(18.9%), and intracerebral hemorrhage(12.4%) 10) The operation were carried out in 65 cases and mental states after operation showed alert(41.5%), and heavy mental state(58.5%). 11) Skull facture were 209 cases(23%), and fracture sites were temporoparietal region(23.5%), frontal region(14.5%), and skull base(29.9%). 12) The mortality rate at discharge was 17.6%(51cases). 13) In temporal region 45.6% were found in epidural hematoma, and frontal region were found in subdural hematoma(70.9%) and intracerebral hematoma(55.5%). 14) associated injuries following head trauma were extremity fracture(35.5%), facial fracture(21.9%), rib fracture(9.9%) and spine injury(6.7%) in orders.

응급센터로 내원한 복부자상 환자의 임상적 고찰

유수진,박재황 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Study objective : To refer the management of patients with stab wound to abdomen, because controversy still exists regarding management of patients whenever exploratory laparotomy or selective management. Design : Retrospective study Setting : The WonKwang university hospital emergency department during January lst 1989 through December 31th 1994 Participants : 62 patients was admitted after abdominal stab wound Method and intervention : Charts of all patients with abdominal stab wound was reviewed to determine the result between operative management and non-operative management according to surgical indication, paracentesis, peritoneal lavage or abdominal computerized tomographic scan. Patients was discharged from emergency department or transferred to other hospital was excluded. Measurement : There were 62 patients admission to general surgery after abdominal stab wound. Sixty-one patients were alive and one patient were died. The patients grouped as operative management(A group) and non-operative management(B group). A group was 50 patients(80.6%) according to surgical indication, paracentesis, local wound exploration, or abdominal C-T scan.,B group was 12 patients(19.4%). According to clinical features, we found sex ratio(M : F, 4 : 1), 13cases in 1990, spring in 22cases(35.6%), time of injury from 20hour to next 4hour in 35cases(56.5%), no jab in 18cases(29%), knife in 47 cases(75.8%), epigastrium in 16cases(26%), interval from injury to admission within 30minute in 22cases(35.5%), homicide in 49cases(79.1%). The surgical indication were peritoneal irritation(70.9%), next, in order of incidence, loss of bowel sound(53.3%), shock(32.2%), evisceration(19.4%), and free air(1.6%). In the operative group(A group), we found positive paracentesis in 10cases(83%), positive abdominal C-T finding in 5cases(45.5%), positive peritoneal lavage in 2cases(100%), but in the non-operative group(B group), negative abdominal C-T finding in 2cases(100%) and negative peritoneal lavage in 6cases(100%). The organ which most common injured was small bowel(11cases, 22%) and colon(9cases, 18%). The negative exploration was 15cases(30%) in A group, delayed operation was none. The surgical complication was 12% in A group and no in B group. The average hospital stay were 9.7days in A group and 3.8days in B group. Conclusion : The negative operation ratio was high in operative group. These results imply that must be selective management by physical finding and use of diagnostic method including local wound exploration, diagnostic peritoneal lavage, paracentesis, abdominal sonography and abdominal C-T scan because of higher negative operative ratio.

혈당 측정에 있어서 반사광 비색법과 전기 화학 전극법의 비교

황유성,이도훈,우재근 충북대학교 의과대학 충북대학교 의학연구소 1995 忠北醫大學術誌 Vol.5 No.1

당뇨병환자에서 적절한 혈당을 유지하기 위한 목적으로 시험지봉 검사 방법이 1970년대 초 처음으로 개발된 이후 많은 자가 혈당기들이 고안되어 사용되고 있으며, 대부분이 반사광 비색법을 이용한 자가 혈당 측정기로 현재 국내에는 Glucometer(Ames), Glucoscan(Eiken), One TouchTRM Ⅱ(Lifescan), Accu-check Ⅲ(BM)등이 사용되고 있다. 저자들은 본원에서 이미 사용하고 있었던 반사광 비색법을 이용한 시험지봉으로 LIFESCAN사의 One TouchTM Ⅱ와 전기 화학 전극법을 이용한 Medisense사의 CompanionTM 2에 대하여 정밀도, 직선성, 비교방법과의 상관관계 및 혈액량과 헤마토크리트에 의한 영향, 관찰자간의 변이, 항응고제가 미치는 영향 등 측정에 영향을 미치는 여러 인자들에 대하여 평가를 시행하였다. 검사일내 정밀성(within day precision)은 두 기기 모두 5% 정도이었고, 검사일간 정밀성(day-to-day precision)은 CompanionTM 2가 3.14%∼6.53%, One touchTM Ⅱ가 4.69%∼8.13%의 변이계수를 보였다. 두 기기 모두 직선성이나 비교방법과의 상관관계가 우수하였다. CompanionTM 2와 One touchTM Ⅱ사이의 상관관계는 y=1.040x+21.679, r=0.9716이었다. 두 기기 모두 혈액량, 관찰자, 항응고제에 의해서는 영향을 받지 않았으며, 헤마토크리트에 의해서는 헤마토크리트가 낮을 때는 높은 혈당치를, 헤마토크리트가 높을 때는 낮은 혈당치를 나타냈다. The purpose of this study is to assess two monitors of blood glucose : One touch?? Ⅱ(Lifescan Inc.), which is using reagent strips by reflectance photometry and CompanionTM 2(Medisense Inc.), which is using electrochemical electrode method. Glucose was determined on capillary and venous blood samples from 70 adult diabetics by three different methodologies : One touchTM Ⅱ, CompanionTM 2 portable glucose meters (capillary) and the Hitachi 7150 analyzer(venous), which is using hexokinase method. In within-run precision studies for One touchTM Ⅱ and CompanionTM 2, coefficient variations (CVs, %) were 1.92∼5.09, 2.95∼4.79 at three different levels, respectively. In between-day percision studies for One touchTM Ⅱ and CompanionTM 2, CVs(%) were 4.69∼8.13, 3.14∼6.53 at three different levels, respectively. The linearity studies revealed r=0.9996 in One touch?? Ⅱ, r=0.9977 in CompanionTM 2, which were satisfactory. Correlation equation and coefficient for results by One touchTM Ⅱ and CompanionTM 2 vs those by hexokinase method(x) were : y=0.8087x-8.9566(r=0.9824) for One touchTM Ⅱ, y=0.8885x+4.4992(r=0.9807) for CompanionTM 2, which were satisfactory. The glucose levels were falsely high at low hematocrit concentration and falsely low at high hematocrit concentration in both monitors. The volume of blood applied to the test strips is not critical. We concluded that "One touchTM Ⅱ" using reagent strip by reflectance photometry and "Companion?? 2" using electrochemical electrode method is suitable for self monitoring of blood glucose.

排卵湯이 白鼠의 排卵에 미치는 影響

황태원,박재웅,위석,조한백,유심근 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Baelantang(BLT) is used in female infertility caused by ovulation disorder. An attempt was to evaluate the influences, of BLT on the serum concentrations of FSH, LH, estradiol(E_(2)) and progesterone, the histological and optical changes of ovary, ovary weight of rats. The results of the study were as follows : 1. Blood FSH level increased experimental group as compared with control group on 7th day, which showed no efficacy. 2. Blood LH level increased in experimental group as compared with control group on 7th day and decreased 14th day, which showed no efficacy. 3. Blood E_(2) level decreased in experimental group as compared with control group on 7th day and increased 14th day, which showed no efficacy. 4. Blood progesterone level increased in experimental group as compared with control group on 7th day and decreased 14th day, which showed no efficacy. 5. In histological observations of ovary, ovulation increased in experimental group as compared control group on 7th day and on 14th day, which showed no efficacy. 6. In optically observations of ovary, weight of ovary increased in experimental group as compared with control group on 7th day and 14th day, which showed no efficacy. According to these results, BLT did not influence on the ovulation and ovary of rats.

응급센터로 내원한 두부외상 환자에 관한 임상적 고찰

유수진,박재황 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2

Retrospective clinical analysis was made on 884 cases of head trauma visited to Emergency Center of Wonkwang University Hospital and was treated in the Department of Neurosurgery from 1991. 1. 1 to 1991. 12. 31. A clinical analysis of 884 cases was performed and following results were obtained. 1. The peak incidence of age was third decade and the sex ratio was 2.1 : 1, predominant in male. 2. The predominant month and seasonal incidence were in October and Autumn, respectively. 3. The cause of head trauma were traffic accidents(69.8%), and next, in order of incidence, fall down(12.4%), slip down(9.5%), and human trouble(4.0%). The kinds of traffic accidents were private vehicle(31.1%), motorcycle (20.6%), truck(12.9%), taxi(7.2%). bongo(9.2%), bus(4.7%). bicycle(9.2%). and cultivator(1.5%). pedestrian's traffic accident was common more than that of Passenger. 4. The regional distribution was Iri(53.8%). Iksan(20%), Okgu and Kunsan (10.0%) 5. The percentage of patients received emergency treatment on scene was 2.9% in Iri-city, 6.7% in Iksan, 18% in Kimje. 92.3% in Buan. 52.2% in Kunsan and Okgu, and 100% in Seocheon. 6. The mental states of patients on arrival to Emergency Center was alert (77.7%). and heavy mental state(10.6%). 7. The interval from injuries to arrival of Emergency Center was within 30 minutes in 50.7%, and was within 3 hours in 86.2%. 8. The loss of consciousness after trauma was shown in 75% of epidural hematoma patients, and severely injured head trauma patients had negative light reflex and positive babinski's sign. 9. The brain CT was performed in 884 cases. Abnormal findings were observed in 290 cases(32.8%), including epidural hematoma(57, 19.6%), subdural hematoma(55, 18.9%), and intracerebral hemorrhage(36, 12.4%). 10. The operation were carried out in 65 cases and mental states after operation showed alert(41.5%), and heavy mental stale (58.5%). 11. 209 cases(23%) had skull fracture, and fracture sites were temporo-parietal region(23.5%). frontal region(14.5%). and skull base(29.9%). 12. The mortality rate at discharge was 51cases(17.6%) among 884cases. 13. In location of hematoma, epidural hematoma was found in temporal region (45.6%), and subdural hematomain frontal region(70.9%). and intracerebral hematoma in frontal region(55.5%). 14 Associated injuries following head trauma were extremity fracture(35.5%). facial fracture(21.9%), rib fracture(9.9%) and spine injury(6.7%) in orders.

응급의료체계를 통하여 내원한 응급실 환자에 대한 분석

유인술,박재황 大韓應急醫學會 1992 대한응급의학회지 Vol.3 No.1

We performed a review of 406 patients who visited to ER through the EMS system during the past two years period from July 1990 to June 1992(A) and a statistical analysis of 400 population`s answer about a question of the 129 emergency system.(B) The results were obtained as follows; A. 1) Among the total 406 patients, 267 were male(65.8%) and 139 were female(34.2%). The peak age was 4th decade. 2) The underlying medical disease was the major cause of the transport; 227cases(55.9%). The most predominant delivery time was within 10 to min; 263cases(52.4%). The major transport time was 8:00 PM to 4:00 AM; 193cases(47.5%). 3) Among the transported patients, admission rates were 22.2%(90cases), discharge against advice: 9.1%(37 cases), hopeless discharge; 4.4%(18cases), DOA; 3.2%(13 cases), DAA; 3.2%(13 cases), transfer; 3.2%(13 cases). B. 1) 82%(82 cases) of the total 100 pts, was transported by public and private vehicles. 2) The rates which knows the 129 EMS systm was 38.8%(135 cases) and the method of use; 18.0%(72 cases) 3) 26.7%(80 cases) of the total 300 cases have an experiment of education about the emergency first aid.

서울特別市의 都心構造에 對한 組査

兪在炫,黃仁子 梨花女子大學校 師範大學 社會生活科 1964 綠友硏究論集 Vol.- No.6