Mo¨nckeberg 중막 석회화로 인해 초기자궁내막암이 진행성 자궁내막암으로 판독되었던 1례

김승만,배철성,김동훈,김정란,이현경,윤혜원 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

Mo¨nckeberg 중막 석회화는 크거나 중간크기의 근육성 동맥(large and medium-sized muscular arteries)의 중막(media)에 노화와 관련되어 퇴행성 과정인 윤상석회화가 특징적으로 나타나는 동맥경화증의 일종으로, 근본적으로 폐쇄성 죽상경화증(occlusive atherosclerosis)과는 다른 과정으로 동맥의 관강(lumen)을 막는 경우는 드물어 상대적으로 임상적 의의는 적거나 거의 없다. 저자들은 Mo¨nckeberg 중막 석회화때문에 초음파 및 컴퓨터 단층촬영에 의한 병기결정에 혼란을 초래하였던 초기 자궁내막암 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The Mo¨nckeberg medial calcification is aging change rather than disease entity. The Mo¨nckeberg medial calcification involve muscular arteries of limb, head, and genital track and cause fibrosis change associated with hyalinization and fine basophilic staining, suggesting early calcification with little or no clinical significance but is demonstrable on roentgenograms as regular and diffuse radiopaque shadow under intima. We experienced one case of mis-staging of early endometrial cancer due to the Mo¨nckeberg medial calcification therefore, we report this case with a brief review of the literature of the Mo¨nckeberg medial calcification.

푸드뱅크 기탁식품의 안전성 확보를 위한 HACCP 제도 적용

김철재,박현신,배현주,이지해,양일선,강혜승 한국식생활문화학회 2002 韓國食生活文化學會誌 Vol.17 No.3

The purpose of this study was to analyze the problems arising from the actual conditions of the Foodbank, and to implement the HACCP system as a solution in terms of increasing the safety of donated food within the Foodbank. In order to apply HACCP system, the entire Foodbank working process such as preparation, collection, transportation, division, and distribution was considered and analyzed to decide the application point for CCPs. Donated foods mainly consisted of processed foods, raw materials, lunch boxes, and cooked foods from mass catering establishments, which dominated over the others in terms of quantity. Cooked foods were divided into three groups based on menu-types and processing methods. Temperature, pH, and aw were measured on cooked foods, and Total Plate Count, Coliforms, E. coli, Salmonella spp., Staphylococcus aureus, Listeria monocytogenes, and E. coli O157:H7 were conducted in order to apply a HACCP plan. Form these experiments, temperature, pH, and aw of donated food were likely contributed to microbial growth. Donated foods before HACCP implementation showed high numbers in terms of total plate count and Coliforms, both well over the acceptable standard levels. By setting the CCPs on maintenance of donated food below 10℃ and using a 75 ℃ reheating method, microbiological hazard levels were able to be controlled and lowered. From these results, it is concluded that in order to guarantee food safety, foods donated to the Foodbank must not only maintain a reasonable level of initial microbiological growth, but also must be handled properly through time and temperature controls within the Foodbank system. Furthermore, in terms of implementing the HACCP plan within the Foodbank management structure, basic food safety and sanitation measures, such as reheating facilities and various cold chain systmes such as refrigerated vehicle for food transportation are importantly needed. The training and education of Foodbank personnel and management in areas such as awareness of hygiene and safe food handling and practice are also required and necessary.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

Poster Session : PS 0693 ; Rheumatology ; Safety of TNF Inhibitor Therapy in Patients Who Have Had a Prior Malignancy

( Seung Hyeon Bae ),( Su Min Ahn ),( Do Ho Yim ),( Seok Chan Hong ),( Yong Gil Kim ),( Chang Keun Lee ),( Bin Yoo ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: According to the 2012 American College of Rheumatology Recommendations, it is possible to start biologic agent in patients who have been treated for solid tumor. But, there is no evidence in patients with history of a solid cancer treatmentwithin the past 5 years. The purpose of this study was to explore the infi uence of TNF inhibitor (TNfi) therapy in this subgroup patients. Methods: The medical records of all patients (n=859) that received TNfi therapy at a single rheumatology clinic between June 2005 and May 2014 were retrospectively reviewed. Among them, data from patients who had a history of solid cancer treatment before TNfi therapy were collected and patient outcomes were evaluated especiallyfor those who have been treated cancer within the last 5 years. Results: Of 859 patients who underwent TNfi therapy, 22 patients had a history of malignancy before initiating TNfi therapy for ankylosing spondylitis (AS) and rheumatoid arthritis (RA) (Table 1). The median AS, RA disease duration was 8 (3. 75-12. 25) years and median time to TNfi therapy after prior cancer treatment was 62. 5 (21. 25- 140. 25) months. Most common site of prior cancer is stomach (36. 4%) and followed by thyroid, colorectum, liver, kidney, and breast. There was no recurrence of previous cancer during 40 (7. 0-50. 75) months of TNfi therapy. Especially, 10 patients started TNfi therapy before 5 years prior cancer treatment (Table 2). All of our 10 cases were limited in an early stage without distant metastasis. When they have been followed for 36 months, recurrence of cancer was not found. Conclusions: Our results suggest that starting TNfi therapy in patients with history of solid cancer in locally limited stage is safe even less than 5 years after prior cancer treatment.

Stents versus coronary-artery bypass grafting for left main coronary artery disease.

Seung, Ki Bae,Park, Duk-Woo,Kim, Young-Hak,Lee, Seung-Whan,Lee, Cheol Whan,Hong, Myeong-Ki,Park, Seong-Wook,Yun, Sung-Cheol,Gwon, Hyeon-Cheol,Jeong, Myung-Ho,Jang, Yangsoo,Kim, Hyo-Soo,Kim, Pum Joon,S Massachusetts Medical Society 2008 The New England journal of medicine Vol.358 No.17

<P>BACKGROUND: Several studies have compared the treatment effects of coronary stenting and coronary-artery bypass grafting (CABG). However, there are limited data regarding the long-term outcomes of these two interventions for patients with unprotected left main coronary artery disease. METHODS: We evaluated 1102 patients with unprotected left main coronary artery disease who underwent stent implantation and 1138 patients who underwent CABG in Korea between January 2000 and June 2006. We compared adverse outcomes (death; a composite outcome of death, Q-wave myocardial infarction, or stroke; and target-vessel revascularization) with the use of propensity-score matching in the overall cohort and in separate subgroups according to type of stent. RESULTS: In the overall matched cohort, there was no significant difference between the stenting and CABG groups in the risk of death (hazard ratio for the stenting group, 1.18; 95% confidence interval [CI], 0.77 to 1.80) or the risk of the composite outcome (hazard ratio for the stenting group, 1.10; 95% CI, 0.75 to 1.62). The rates of target-vessel revascularization were significantly higher in the group that received stents than in the group that underwent CABG (hazard ratio, 4.76; 95% CI, 2.80 to 8.11). Comparisons of the group that received bare-metal stents with the group that underwent CABG and of the group that received drug-eluting stents with the group that underwent CABG produced similar results, although there was a trend toward higher rates of death and the composite end point in the group that received drug-eluting stents. CONCLUSIONS: In a cohort of patients with unprotected left main coronary artery disease, we found no significant difference in rates of death or of the composite end point of death, Q-wave myocardial infarction, or stroke between patients receiving stents and those undergoing CABG. However, stenting, even with drug-eluting stents, was associated with higher rates of target-vessel revascularization than was CABG.</P>

내시경 유두절제술로 제거한 거대 십이지장 주유두의 신경내분비종양

배승현 ( Seung Hyeon Bae ),김진용 ( Jin Yong Kim ),김창래 ( Chang Lae Kim ),최영권 ( Young Kwon Choi ),신보미 ( Bo Mi Shin ),홍승모 ( Seung Mo Hong ),김명환 ( Myung Hwan Kim ) 대한내과학회 2014 대한내과학회지 Vol.86 No.3

Neuroendocrine tumors (NET) of the major duodenal papilla are rare and the natural history of this disease is not clear. We experienced a case in a 31-year-old male. Duodenoscopy revealed an enlarged major duodenal papilla with central umbilication and nodularity. Endoscopic ultrasonography (EUS) demonstrated a 3-cm hypoechoic mass that was confined to the submucosa. A biopsy led to the diagnosis of a grade 1 NET. The patient refused surgery, so we performed an endoscopic papillectomy. The tumor was removed completely. The resected specimen confirmed the diagnosis of a well-differentiated NET and all resection margins were negative. Surgical resection is currently considered to be the gold standard for the treatment of a large NET of the major duodenal papilla; however, endoscopic resection is a possible treatment modality for patients at high surgical risk or who are reluctant to undergo surgery.

대한간학회지 제8차 춘계학술대회 초록집 : 구연 ; 간이식 후 B형 간염 재발방지를 위한 저용량 헤파빅 근주 및 라미부딘 병용효과

배시현 ( Bae Si Hyeon ),조세현 ( Jo Se Hyeon ),윤승규 ( Yun Seung Gyu ),양진모 ( Yang Jin Mo ),한준열 ( Han Jun Yeol ),이창돈 ( Lee Chang Don ),차상복 ( Cha Sang Bog ),정규원 ( Jeong Gyu Won ),선희식 ( Seon Hui Sig ),박두호 ( Park 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.2(S)

제5차 대한간학회 춘계학술대회 초록집 : 만성 B형 간질환 환자에서 Lamivudine-저항성 B형 간염바이러스 출현양상 및 YMDD motif 돌연변이 검출

배시현 ( Bae Si Hyeon ),박영민 ( Park Yeong Min ),강성호 ( Kang Seong Ho ),최종영 ( Choe Jong Yeong ),변병훈 ( Byeon Byeong Hun ),박태욱 ( Park Tae Ug ),조세현 ( Jo Se Hyeon ),윤승규 ( Yun Seung Gyu ),안병민 ( An Byeong Min ),한 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.1(S)

건염의 한의학적 치료에 대한 국내 연구 동향

배영현(Young Hyeon Bae),김해솔(Hae Sol Kim),김호선(Ho Sun Kim),김노현(No Hyeon Kim),서창용(Chang Yong Suh),양규진(Kyu Jin Yang),이기범(Gi Bum Lee),염승철( Seung Chul Yeom),이준석(Joon Seok Lee) 대한스포츠한의학회 2016 대한스포츠한의학회지 Vol.16 No.1

Objectives The purpose of this review is to investigate the trends of traditional Korean medicine treatments on tendinitis. Methods We investigated the studies on traditional Korean medicine treatments for tendinitis via searching 5 Korean web databases. Results Nineteen papers were published since 2004. The studies on traditional Korean medicine treatments about tendinitis were mainly published in the journal of Korean spine & joint. Nineteen papers had been under research. In most of the research, the number of the cases were not enough. In 8 cases of the studies, special methods were used to treat the symptoms. Whereas in 11 cases of the studies, various traditional Korean medicine treatments were used to treat the symptoms. Range of motion(ROM) and visual analogue scale(VAS) were used most frequently as primary assessments. Conclusions In this study, we analyzed the trends of traditional Korean medicine treatments on tendinitis. Reviewing the domestic trends of studies on traditional Korean medicine treatments on tendinitis and examining the strong and weak points of those treatments are essential for the further studies.

성인 여성에서 신체조성, 최대산소섭취량과 안정시 대사량간의 상관성

배영현 ( Young Hyeon Bae ),김열 ( Yeol Kim ),정승현 ( Seung Hyeon Jeong ),이재갑 ( Jae Gap Lee ),김성렬 ( Sung Ryeol Kim ),이석민 ( Suk Min Lee ) 대한스포츠의학회 2008 대한스포츠의학회지 Vol.26 No.2

The purpose of this study was to analyze the correlation between the body composition, maximum oxygen uptake (VO2max) and resting metabolic rate (RMR) of 53 adult females. The RMR and RMR/body weight (BW) were significantly increased in subjects with higher VO2max/BW (p<0.05). It was found that the higher was the body mass index (BMI), the lower was the RMR/BW (p<0.05). The age, BW, BMI, body fat mass, and body fat percentage showed negative correlation with the RMR/BW, while the height and VO2max/BW showed positive one. In conclusion, it seems that, during an evaluation of RMR, the positive effect of lean body mass, muscle mass, VO2max on RMR could be shown more easily by measuring RMR/BW when a subject has higher level of VO2max; the negative effect of BMI, BFM, and BFP on RMR could be excluded more efficiently when the subject has lower level of it.