진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

정신분열병 환자 가족을 위한 한 정신교육적 가족치료 모형의 효과

이영호,심주철,이상경,서영수,김용관,김규수,김영훈 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.3

연구목적 : 본 교실에서 정신분열병 환자 가족을 대상으로 시행 중인 장기 정신교육적 가족치료모형을 소개하고, 이모형이 가족의 대처방식과 우울증상, 환자가 자각하는 가족의 정서적 지지와 우울증상, 재입원율 및 사회재활상태에 미치는 영향을 평가하였다. 방 법 : 연구대상은 DSM-IV 진단기준에 의해 정신분열병으로 진단받고 외래 통원치료를 받고 있는 환자와 그 보호자였다. 교육군은 전체 19회 교육 중 최소 ⅔이상 참여한 11명의 환자와 가족이었고 비교육군은 부산소재의 종합병원에서 가족교육을 받지 않고 통원치료만을 받았던 11명의 환자와 가족이었다. 정신교육적 가족치료 모형의 효과는 가족의 대처방식과 우울증상, 환자가 자각하는 가족의 정서적 지지와 우울증상, 재입원율, 사호재활 실태로 나누어 평가했다. 평가도구는 The Ways of Coping Checklist의 국내번안용, Family Emotional Support Questionnaire for Transaction. Beck Depression Inventory를 이용했다. 재입원율 및 사회재활 실태에 대한 평가는 환자 및 가족과의 면담을 통해 조사했다. 결 과 : 본 연구의 정신교육적 가족치료 모형 실시 후 가족의 대처방식 중 적극적 대처는 교육군운 의미있게 증가한 반면 비교육군에서는 변화가 없었다. 소극적 대처 교육군은 의미있게 감소했으나 비교육군에서는 변화가 없었다. 가족치료모형 실시 전 가족들은 양군 모두 심한 우울증상을 갖고 있었다. 가족치료모형 실시 후 가족의 우울증상은 교육군에서 감소, 비교육군은 증가를 보였으나 통계적 유의성은 없었다. 환자가 지각하는 가족의 정서적 지지 평가척도점수는 교육군은 의미있는 증가를 보였으나 비교육군에서는 변화가 없었다. 환자의 우울증상의 교육군에서는 현저한 감소를 보인 반면 비교육군은 상반되게 증가했다. 가족의 적극적 대처가 환자가 자각하는 정서적 지지의 증가 및 우울증상 감소와 의미있는 상관관계를 나타냈다. 또한 교육군의 환자들이 비교육군의 환자들보다 장기가족교육 종료시점과 9개월 경과 후의 추적 평가에서 재입원율이 현저히 낮았고, 사회재활상태도 좋았다. 결 론 : 본 연구에서 실시된 장기 가족교육모형은 가족의 대처방식을 향상시키고, 우울증상의 감소를 가져오며, 환자가 자각하는 가족의 정서적 지지 향상 및 우울증상의 호전을 가져오고, 재입원율의 저하 및 사회재활의 향상을 보이는 것으로 나타났다. Objectives : This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods : Subjects were schizophrenic out-patients, who fufilled DSM-IV diagnostic criteria, and their families. The members of "education group" were 11 families and patients who participated in more than two thirds of 19 sessions of the program. The members of "non-education group" were 11 families and patients who had no experience of family education and were treated in a general hospital in Pusan. Clinical ratings were performed using by The Ways of Coping Checklist, Family Emotional Support Questionnaire for Transactions, and Beck Depression Inventory. Results : Coping style was changed positively, in education group but not in non-education group. The depressive symptoms of families were decreased in educated group and increased in non-educated group, although there were no statistical significance. In education group, patients felt much better emotional support by their families than patients in non-education group did. At the same time, their depressive symptoms were significantly reduced. The patients from education group were on more successful rehabilitation than those from non-education group were. Conclusion : Our results suggest that this psychoeducational family therapy model would be helpful to induce the positive changes in coping styles and reduce the depressive symptoms of family members, and it could also induce the reduction of depressive symptoms of schizophrenic patients and help their rehabilitation.

인터넷 중독 청소년들의 정신병리 및 대처 방식

안영균(Young Kyun Ahn),신영철(Young Chul Shin),고복자(Bok Ja Koh),심진현(Jin Hyun Shim),김범조(Bum Jo Kim),이승민(Seung Min Lee),이길홍(Kil Hong Lee) 한국중독정신의학회 2005 중독정신의학 Vol.9 No.1

This study was conducted to investigate the differences in psychopathology and coping strategies among internet addictors, over users and non addictors in high school students. Subjects were 273 high school students in Seoul city. Self rating questionnaires included demographic data, Young’s Internet Addiction Scale, SCL-90-R, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and The Way of Coping Strategy. Subjects were classified into 3 groups (addiction, over use, non addiction) by Internet Addiction Scale score. Prevalence of internet addiction was 4.3% and male adolescents were more addictive than female. Students who were mainly involved with internet chatting or game showed higher internet addiction score. The addiction group and over use group showed higher level of somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, and paranoia than non-addicted group. Addiction group and over use group used passive coping strategies more frequently in the stressful situation than nonaddicted group. Also, the regression analysis for finding out causal factors that predicts internet addiction showed that emotion relieving strategy were important variable which predict internet addiction. Interpersonal sensitivity and emotion relieving coping strategy was important to predict addiction. This study showed that problematic internet use was closely associated with psychopathology and psychiatric comorbidity. And high interpersonal sensitivity and emotion relieving coping strategy were related with internet addiction in adolescence.

Borrmann 4형으로 진단된 진행성 위암환자의 임상적 검토

천영국,김영태,홍수진,김진오,조주영,이문성,심찬섭 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background/Aim: It is difficult to dignosis of Borrmann type 4 gastric cancer at the early stage, because of its special morphology. Most of the cases have been detected at the advanced stage with poor survival rate. We reviewed patients with advanced gastric cancer, to define clinicopathologic characteristics of Borrmann type 4 gastric cancer comparing other types of gastric cancer. Methods: 1033 patients with advanced gastric cancer were divided into two groups, consisting of 50 patients with Borrmann type 4 gastric cancer, and the remaining 983 patients with all other types of gastric cancer, which were then compared clinicopatologically. Results: The proportion of Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer were composed 20 males and 30 males and revealed the highest frequency 3rd decade (24.0%) in age (range 26-78). In giant folds group (n=27), the number of poorly differentiated cell type, lymph node metastasis, peritoneal seeding were 20 (74.1%), 17 (63,0%), 12 (44.4%). In non-giant folds group (n=23), the number of poorly differentiated type, lymph node metastasis, peritoneal seeding were 17 (73.9%), 15 (65.2%), 6 (26.1%). Rate of tumor invasion in serosa and beyound serosa was 88.9% in giant fold group, 63.0% in non-giant fold group. Surgery was performed in only 32% as a modality of treatment (vs. 82.5%). Characteristics findings of Borrmann type 4 gastric cancer in EUS showed a thickening of the third (submucosa) and fourth (muscularis propria) layers in 72% of 50 patients, and a well preserved five-layered gastric wall structure in 33 patients. Conclusions: We concluded that Borrmann type 4 gastric cancer was diagnosed more in females, as a more advanced disease, early detection was needed. And endoscopic ultrasonography is useful for diagnosis of Borrmann type 4 gastric cancer in the cases of suspicious results of gastroscopy.

Articulation Patterns of Children who Developed Articulation Disorders Associated with Ankyloglossia

박선영(Sun-Young Park),심선희(Sun-Hee Shim),장은실(Eun-Sil Jang),엄태훈(Tae-Hoon Eom),김영훈(Young-Hoon Kim),이순주(Soon-Ju Lee) 대한소아신경학회 2013 대한소아신경학회지 Vol.21 No.3

목 적 : 설소대와 조음장애의 관련성과 설소대 환아에서 조음장애 유무를 감별하는데 필요한 임상지침을 제시하기 위해 조음장애를 동반한 설소대 환아의 조음양상의 특징을 알아보고자 하였다. 방 법: 2002년 1월부터 2012년 12월까지 의정부성모병원 소아청소년과 외래를 방문한 124명의 환아 중 설소대를 제외한 다른 조음기관의 해부학적 이상, 신경학적 질환이나 발달/언어지연을 가진 46명의 환아를 제외한 총 78명을 설소대 유무에 따라 각각 환자군 23명과 대조군 55명으로 나누어 그림자음검사를 통해 조음양상을 비교분석하였다. 결 과 : 두 군에서 조음오류를 보인 자음유형에 따라 집계한 각 환자수는 연구개비음의 경우에만 차이를 보였다. 하지만 자음유형에 따른 조음오류의 환자별 관찰빈도수의 총합은 양순파열음, 연구개파열음과 연구개비음에서 유의한 차이를 보였다. 조음오류의 변화유형에 따라 집계한 환자수는 두 군에서 차이를 보이지 않았다. 하지만 조음변화 유형에 따른 환자별 관찰빈도수의 총합은 환자군에서 전설음화와 마찰음화가 낮게 관찰되었고, 경음화와 격음화과 높게 관찰되었다. 결 론 : 본 연구를 통해 설소대를 동반한 조음장애 환아의 일부에서 해부학적 이상을 동반하지 않은 기능적 조음장애 환아와 구별되는 특징을 보이는 결과를 관찰할 수 있었지만, 이를 설소대를 동반한 모든 조음장애 환아로 일반화할 수는 없었다. 따라서 설소대와 조음장애의 관련성은 여전히 논란의 여지가 있으며, 또한 수술적 치료를 포함한 설소대 치료를 결정하는데 주의를 기울여야 할 것으로 사료된다. Purpose : We investigated articulation patterns in children with ankyloglossia who developed articulation disorders in order to determine the relationship between ankyloglossia and articulation disorders, and to clinically detect children who have articulation disorders associated with ankyloglossia. Methods : The participants of this study were 23 children with articulation disorders that accompanied ankyloglossia and 55 controls with functional articulation disorders independent of anatomical problems, who were admitted to our hospital from January 1, 2002 to December 31, 2012. All children underwent speech-language pathologic evaluation using the Picture Consonant Articulation Test (PCAT; Young-Tae Kim, 1994). We retrospectively compared collected data between the subject and control groups using Fisher's exact test and odds ratio tests with a 95% confidential interval for categorical variables and the independent Mann-Whitney U-test for continuous variables. Results : The number of patients with articulation errors in the velar nasal was lower significantly only in the subject group (P =0.038). The total numbers of articulation errors in the bilabial plosive, velar plosive and velar nasal also were lower (P=0.007, P˂0.001, and P=0.034, respectively). There were no differences in the numbers of patients with articulation errors according to phonological changes between the two groups. However, the total numbers of fronting and frication were lower in the subject group (both P˂0.001), but the total numbers of plosivation and tensing were higher (P =0.002 and P =0.008, respectively). Conclusion : This study showed that the relationship between an articulation disorder and ankyloglossia is doubtful, although some results suggest that ankyloglossia may cause articulation errors only in certain individuals. Therefore, clinicians should be careful when determining the relationship between ankyloglossia and articulation disorders and use caution when making a treatment decision.

S-21 Usefulness of Anchoring Technique for Prevention of Stent Migration in Esophagorespiratory Fistula

( Hyoung Joon Shim ),( Tae Yoon Lee ),( Young Koog Cheon ),( Chan Sup Shim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Background:?Coated SEMS (self-expandable metal stent) placement is the preferred therapy for malignant esophagorespiratory fistula (ERF) at present. Migration is more frequent in coated stent than uncoated stent. Migration can occur immediately after stent placement and is likely secondary to malpositioning, inadequate anchoring, soft nonconstricting tumors, or complete coating of the stent. The overall risk of migration is approximately 10%. To prevent migration, we have used the anchoring technique, called Shim’s technique in Korea, connecting stent to ear with silk thread.?Patients and Methods:?Seven patients with malignant ERF were included. ERF conditions liable to migration of stent were selected. The selection criteria were ERFs without stricture (3 cases), with short length of stenosis (2 cases), and with soft consistency around fistula (2 cases). The anchoring method was designed to hang stent to ear lobe. Auricle was used for a post to suspend stent by a thread until the fixation of stent on the esophageal wall. The coated stent was specially designed for antimigration which has small circumferential uncoated portion on proximal flange part of stent for fixation. After 5 days of stenting, we removed the anchoring silk from the stent. Sealing of fistula were assessed with clinical improvement and esophagogram.?Results:?There were no migrations after stent placement in all 7 cases. Symptoms of aspiration were improved in all 7 cases.?Conclusions:?The anchoring technique was useful for the prevention of stent migration in esophagorespiratory (ERF) cases, especially in the conditions that stent are apt to be migrated.

에드워드 증후군에서 선천성 심질환 수술로 교정한 1례

송진영,문윤희,장기영,이재영,김수진,심우섭,김웅한 대한소아과학회 2004 小兒科 Vol.47 No.4

보충원으로서의 과일

심영현 서울여자대학교 1980 서울여자대학논문집 Vol.- No.9

肺結核患者의 難治化에 미치는 要因에 關한 調査硏究

沈雲澤,李棟培,曺永釵 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

To find out the factors affecting to the intractability of pulmonary tuberculosis, we analyzed the 1,047 pulmonary tuberculosis patients, registered and treated at the Clinic of Chungnam Branch of Korean National Tuberculosis Association for entire 8 years from January 1st, 1978 to the December 31st, 1985. Following variables were find out to be the affecting factors to the intractability of pulomonary tuberculosis. 1. General characteristics : age of patient, residential area, education, occupation, marital status and smoking status; above 30 years of age, rural area, low educational background, physical workers and heavy smokers were more apt to be intractable pulmonary tuberculosis patient. 2. Laboratory findings : chest P-A, direct sputum smear and culture, and rate of antituberculous drug resistance; moderately advanced and far advanced, smear and culture highly positive and higher occurrence rate of antituberculotic resistance. 3. Medical facility they treated : primary and retreatment; the patient who treated at the drug store and health center were find out: more easily become intractable pulmonary tuberculosis patient.

造景樹木의 VA內生菌根에 관한 硏究

沈慶久,李景俊,安永熙,劉鍾勳 成均館大學校 科學技術硏究所 1985 論文集 Vol.36 No.2

The beneficial role of Vesicular-Arbuscular Mycorrhizae (VAM) for growth of woody landscape plants has already been well demonstrated in many countries, but little has been studied about VAM in Korea. So far, researches concerning physiological aspects of VAM have been abundant compared to researches on the ecological sides in woody landscape plants. Especially, the study about VA mycorrhizal fungi indigenous to threeflower maple (Acer triflorum), Korean mountain-ash. (Sorbus alnifolia), and European bird cherry (Prunus padus) have been less studied. The studies described here were undertaken to identify the genera of VAM fungi living in the soil wherein threeflower maple, Korean mountain-ash, and European bird cherry rooted, to observe infected root of host plants, and to compare mycorrhizal colonization related to soil factors. The results obtained were as follows. Ornamental trees roots infected by VAM fungi were observed and identified genera of the fungi investigated in the rhizosphere soil were Glomus sp. The VAM fungi of threeflower maple and Korean mountain-ash showed a circular form, but spore of European bird cherry showed a ellipsoidal form. Vesicle diameter of landscape plants were found from 25.21㎛ to 50.43㎛. Mycorrhizal colonization of threeflower maple, Korean mountain-ash, and European bird cherry were respectively 46.7, 33.3, and 20.0%. Soil pH of landscape trees were slightly acid, and available soil phosphate in the rhizosphere soil showed lower than normal soils. Rhizosphere soil moisture content were 22.90-29.38%.