응급실을 내원한 65세 이상 노인 환자의 분석

김진년,김태훈,강양욱,오명,김상철,김성훈,권계형,남홍우,이홍순,유형준 대한노인병학회 2001 대한노인병학회지 Vol.5 No.3

간세포암의 십이지장침윤에 의한 상부위장관 출혈 1 예

유태현,한광협,박성하,김형길,문영명,한재호,조상호 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2

Recent advances in both the diagnosis and treatment of hepatocellular carcinoma have improved the prognosis and changed the clinical significance of the recently increasing distant metastases. Distant metastases found after successful treament of the primary lesions are of great clinical significance for the treatment of hepatocellular carcinoma. The duodenum is a rare site of hematogenous metastases or direct invasion from hepatocellular carcinoma. A 23 year old man was admitted with upper gastrointestinal bleeding. He had been diagnosed with hepatocellular carcinoma and treated by a left lobectomy and chemoembolization. The patient was admittted for 12 months after the treatment of the primary tumor. Endoscopic examination revealed a mass in the duodenal bulb that protruded into the lumen. He died due to massive hematemesis. We report on a rare case of hepatocellular carcinoma with duodenal invasion in a 23-year-old male patient.

유기용제에 장기간 폭로된 근로자의 정신의학적 기능과 삶의 질

김석재,강순아,유지숙,국승희,윤진상,문재동,이형영 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

연구목적: 본 연구는 Y공단의 제조공정에서 저농도의 유기용제(solvent)에 장기간 노출된 근로자의 정신의학적 기능과 삶의 질을 평가하고자 하였다. 방법: 총 142명의 남성근로자 중 유기용제에 폭로된 군(이하 폭로군) 82명과 폭로되지 않는 군(이하 비폭로군) 60명에게 간이정신진단검사(Symptom Checklist-90-R, SCL-90-R), 인지 및 정신운동성검사 (Critical Flicker Fusion Threshold. CFFT; Choice Reaction Time, CRT;Compensatory Tracking Task, CTT;Digit-Symbol Substitution, DDS) 및 한국판 스미스클라인 비챰 삶의 질 척도(Korean version of the SmithKline Beecham 'Quality of Life' Scale, KvSBQOL) 등을 적용하였다. 두 군간의 비교는 평가치의 평균에 대해 t-검증을 하였고 또한 연령과 학력을 공변인으로한 공변량분석(ANCOVA)을 하였다. 결과: SCL-90-R의 9개 증상 차원과 3개 전체 지표 점수는 두 군이 각각 정상범위였다. 그러나 신체화 (Somatization, SOM), 우울(Depression, DEP), 적대감(Hostility, HOS), 공포불안(Phobic anx-iety, PHOB)의 증상차원과 전체심도지수(Global Severity Index, GSI), 표출증상합계(Positive Symptom Total, PST)의 전체 지표는 폭로군이 비폭로군보다 유의하게 높았다. 인지 및 정신운동성 검사와 삶의 질은 두 군간에 유의한 차이는 없었다. 결론: 이상의 결과는 유기용제가 허용치 이하일지라도 장기간 폭로되는 경우에는 정신의학적 문제를 다소 일으킬 수 있음을 시사하였다. 중심단어:유기용제·근로자·정신건강·정신운동성 기능·삶의 질. Objectives: The aim of this study was to evaluate the psychiatric function and quality of life of the chemical workers who had been exposed to long-term, low-level organic solvents in the Y industrial complex. Method: A total of 144 male workers, of whom 82 were in the exposed group and 60 in the unexposed-control group, were evaluated by using Symptom Checklist-90-R(SCL-90-R), series of neuropsychological tests(critical flicker fusion threshold, CFFT) ; choice reaction time, CRT ; compensatory tracking task, CTT) ; digit symbol substitution test, DSS), and the Korean version of the SmithKline Beecham Quality Of Life scale(KvSBQOL). For the statistical analyses, comparisons of the means of the two groups were performed for each variable with two-tailed t-test as well as ANCOVA including age and education as covariates. Results: For the SCL-90-R, the nine symptom scales and the three global indices were clinically within normal range in both groups. However, the scores on the symptom scales of 'somatization','depression','hostility' and 'phobic anxiety', and those on the global indices of 'global severity index' and 'positive symptom total', were significantly higher in the exposed group than in the unexposed group. In terms of the neuropsychological function and the quality of life, there wes no significant difference between the two groups. Conclusion: These findings suggested that the long-term eposure to mixed organic solvents, even at the low level below the permissible exposure limit, might induce some psychiatric problems. KEY WORDS: Organic solvent·Worker·Mental health·Psychomotor function·Quality of life.

십이지장 궤양 환자와 만성 위염 환자의 염증 분포의 차이 및 H. pylori 집락도와 염증도의 상관관계

유광하,진춘조,박형석,이재동,김예리,윤성욱,이수인,윤호상 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-

An inflammatory difference between the gastric antrum, body and fundus was studied in 39 H.pylroi positive duodenal ulcer and 29 H. pylori chronic gastritis patients. Also we studied correlation of H. pylori colony count and inflammatory severity. Patients with newly diagnosed duodenal ulcer and chronic gastritis were endoscoped and two biopsy secimens each taken from the antrum, body and fundus. Although intestinal metaplasia in antrum and inflammatory activity in fundus were more severe in chronic gastritis patients. another inflammatory difference was equally likely to be found between two groups. There was no definite histological inflammatory difference between duodenal ulcer and chronic gastritis patients. A positive correlation was found between the number of H. pylori and the severity of inflammation.

삼중시기 나선형 CT를 이용한 간경변증 환자에서의 결절성 간세포암의 조영증강양상

김영화,윤종필,김형환,이상진,이혜경,김일영,장유진 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

We evaluated the contrast enhancement pattern of nodular hepatocelluar carcinoma in liver cirrhosis patients by using three phase spiral CT. We anlayzed 34 nodular hepatocelluar carcinonmas in 11 patients with liver cirrhosis. Three phase spiral CT were obtained at 30(arterial phase), 60(portal phase), 180seconds(delayed phase) after initiation of contrast injection in the rate of 3ml/sec. Nodules are classified according to size, as group A(below 1cm, n=11), group B(1 - 3cm, n=15), group C(above 3cm, n=8). Enhancement pattern of the nodule was analyzed comparing to normal liver parenchyme in each phase., as total high, central high, peripheral high, iso, low, mixed density. We also analyzed the detection rate of the nodules. As a whole the nodules show high density in arterial phase(76%), high density in portal phase(47%) and low density in delayed phase(56%). In group A, the nodules show high(100%) in arterial phase, iso(54%) or high (46%) in portal phase, iso(82%) in delayed phase. In group B, the nodules show high(100%) in arterial phase, high(74%) in portal phase, mixed (60%) in delayed phase. In group C, the nodules show mixed density in all three phase. The most common enhancement pattern in each group was high(arterial phase) - iso(portal phase) - low (delayed phase) in group A(6/11, 54%), high - high - low in group B (5/15, 33%), mixed - mixed - mixed in group C(5/8, 63%). The detection rate of the nodule was highest in arterial phase, and the usefulness of arterial phase comparing to portal or delayed phase was higher in smaller size. In conclusion, hepatocelluar carcinomas show different enhancement pattern according to the size on three phase spiral CT, and this may be helpful in diagnosis of them.

묵은 김치 제조과정에서의 이화학적 및 미생물학적 특성 변화

유맹자,김형량,정희종 한국식생활문화학회 2001 韓國食生活文化學會誌 Vol.16 No.5

To develop the low-temperature and long-term fermented kimchi, kimchi was prepared according to the recipe of a specific ratio of major and minor ingredients and adjusted its salinity to 3.7%. Prepared kimchi fermented at 15±1℃ for 24 hours and transferred and fermented in a refrigerator only used to make low-temperature and long-term fermented kimchi at -1±1℃ for 30 weeks. During 30 weeks of fermentation the changes in physicochemical and microbiological properties of low-temperature and long-term fermented kimchi were studied. The initial pH of 6.47 decreased gradually and dropped to pH 4.0 after 14 weeks of fermentation, and then it maintained at same level. Acidity increased to 0.49% on 2 weeks of fermentation and kept at 0.47∼0.50% during 2 to 30 weeks fermentation. Salinity was slightly increased at early stage and started to decrease on 4 weeks of fermentation, and then it did not change. The change of reducing sugar content was closely related to the trend of pH change with a very high correlation coefficient(r=0.912). Lactic acid, citric acid, malic acid, succinic acid and acetic acid were major organic acids contained in low-temperature and long-term fermented kimchi. Vitamin C content decreased at initial stage of fermentation and then slightly increased up to the maximum of 22.3㎎% on 8 weeks of fermentation. In color measurement, L value continued to increase during the fermentation and reached at the highest of 55.45 on 22 weeks of fermentation, and a and b values of 3.62 and 4.54 also increased to 31.26 and 37.32 on 30 weeks of fermentation, respectively. Total microbial count increased slowly from beginning and was the highest on 4 weeks of fermentation, and then began to decrease slowly. Count of lactobacillus spp. was highest after 6 weeks, but count of Leuconostoc spp. was highest on 2 weeks of fermentation, and then both showed a slow decrease. Yeast count wasn't increased until 4 weeks of fermentation and then increased rapidly to get the highest on 10 weeks of fermentation.

C형 간염의 병리조직학적 고찰

김형준,김재규,김미경,박중원,유병철,박실무 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.2

After the discovery of hepatitis C virus, several reports of histologic charcteristics of hepatitis C have been published. The aim of this study is to evaluate histopathologic features of hepatitis C for diagnostic significance. Needle biopsy specimens obtanied from the liver of 14 patients with hepatitis C were evaluated for the diagnostic significance. All patients had not any evidence of hepatitis B, and autoimmune and alcoholic liver diseases. The specimens were histologically evaluted based on previously reported features of hepatitis C such as bile duct damage, lymphocytes infiltration, steatosis and so on. According to the mode of transmission, sporadic infections were 12 cases, posttransfusion hepatitis and Ⅵ drug abuser was 1 case. The commonst finding was sinusoidal inflammatory cell activation, especially lymphocyte (86%). And lymphoid follicles or lymphocytes aggregates (65%), steatatosis (65%) were found. According to the activity of hepatitis, significant difference of pathologic features could not be proposed, but most histologic features were showned in CAH. In conclusion, all the histologic characteristics of hepatitis C such as sinusoidal cell activation, lymphoid aggregates, steatosis were observed in this study. But the further study of comparative histologic evaluation between hepatitis C and other hepatitis is needed. And also, comparative study with larger subjects for specific histopathologic findings according to the activity of hepatitis and epidemiologic cause in needed.

간척지 호소군의 동물플랑크톤 군집 비교

유형빈,김광수 원광대학교 환경과학연구소 1998 環境科學硏究誌 Vol.7 No.1

蔚山 芳基里 靑銅器時代 聚落址 : 發掘調査 성과를 中心으로

兪炳一,金亨坤 嶺南考古學會 1996 嶺南考古學 Vol.- No.19

간이식 수술 환자의 교육 요구도

유양숙,김형숙 가톨릭대학교간호대학 호스피스교육연구소 2005 호스피스논집 Vol.9 No.-

Liver transplantation is an effective procedure in the treatment of end-stage liver failure in South Korea, where liver disease rates are higher than in western countries. Nevertheless, from the perspective of nursing, the research regarding liver transplantation is not sufficient. The purpose of this study was to investigate need for education related to diseases following liver transplantation. Method: The study consisted of 70 patients who had liver transplantation and saw a doctor regularly at C university K hospital located in Seoul. Data were obtained from a need of education questionnaire related to liver transplantation. With the use of a scale assessing need for education following liver transplantation, patients were asked to indicate their degree of concern on 15 items that used a 4-point Likert scale. A higher score indicated a greater need for education following liver transplantation. Data were analyzed using an SAS program with t-test, ANOVA and Scheffe test. Results: The mean score was 2.79 points. The highest items of need for education were' side effects and medical therapies' and 'cautions of medication, the lowest was 'timing of sexual intercourse'. Patients who are in their 30's had significantly higher scores in educational need than patients who were in their 50's. Conclusions: It is necessary to develop an effective, individualized educational program that can improve adjustment following the liver transplantation.