지주막하 출혈을 동반한 용혈성 요독 증후군 1례

김웅흠,김우택,이창연,김동욱,박성기,장무환 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Hemolytic uremic syndrome is characterized by Coombs-negative microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure in infant and children. At present, E. coli 0157 : H7 and other verotoxin-producing E. coli(VTEC) seem to be a major cause of this illness. The majority of patients have a prodrome of bloody diarrhea, and acute renal failure develops several days to weeks later. Although an optimal treatment remains unknown, the general management of hypertention and renal failure with early and frequent dialysis is the mainatay of treatment, and intravenous administration of immunoglobulin G is like to be effective. We experienced a case composed of bloody diarrhea, seizures, coma, and anuria in 1 year old girl who was diagnosed as HUS and recovered renal function completely with slight impairment of cognitive ability and behavioral function. We presented this case with a review of literatures.

파킨슨씨병 환자에 있어서 자가부신수질 이식술

정상섭,박상근,오성훈,김선호,윤도흠,박정수,양우익,최인준,안영수,김경환,박창일,김진수,이현철 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.6

Recent experimental studies and clinical cases have suggested that grafting tissue from the adrenal medulla into the brain may alleviate the symptoms of Parkinson's disease. Autologous adrenal medullary grafts into the striatum was performed stereotactically in two patients with Parkinson's disease. Both patients were bedridden preoperatively, but 4 months after the surgery both became ambulatory and one was even capable of returning to his job. Even though the number of cases was small⑵ and the follow-up period was short, this study shows that adrenal medullary transplantation into the striatum may have some beneficial effects in patient with Parkinson's disease. Further experimental and clinical trials are necessary to see whether this procedure will be a recommendable surgical treatment for patients suffering from Parkinson's disease.

A comparison between two methods for tumor localization during totally laparoscopic distal gastrectomy in patients with gastric cancer

Chang Min Lee,Sungsoo Park,Seong-Heum Park,You Jin Jang,Seung-Joo Kim,Young-Jae Mok,Chong-Suk Kim,Jong-Han Kim 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.3

Purpose: The aim of this study was to compare two methods of tumor localization during totally laparoscopic distal gastrectomy(TLDG) in patients with gastric cancer. Methods: From March 2014 to November 2014, patients in whom TLDG had been engaged for middle third gastric cancer enrolled in this study. The patients were allocated to either the radiography or endoscopy group based on the type of tumor localization technique. Clinicopathologic outcomes were compared between the 2 groups. Results: The accrual was suspended in November 2014 when 39 patients had been enrolled because a failed localization happened in the radiography group. The radiography and endoscopy groups included 17 (43.6 %) and 22 patients (56.4 %), respectively. Mean length of the proximal resection margin did not differ between the radiography and endoscopy groups (4.0 ± 2.6 and 2.8 ± 1.2 cm, respectively; P = 0.077). Mean localization time was longer in the radiography group than in the endoscopy group (22.7 ± 11.4 and 6.9 ± 1.8 minutes, respectively, P < 0.001). There were no statistically significant differences in the incidence of severe complications between the 2 groups (5.9% and 4.5%, respectively, P = 0.851). Conclusion: As an intraoperative tumor localization for TLDG, radiologic method was unsafe even though other comparable parameters were not different from that of endoscopy group. Moreover, intraoperative endoscopic localization may be advantageous because it is highly accurate and contributes to reducing operation time.

쿠싱병의 임상적 고찰

김태승,이경미,이찬희,김영수,김동익,허갑범,이현철,이은직,김경래,조재식,이규창,정상섭,윤도흠 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.3

Cushing's syndrome caused by ACTH secreting pituitary adenoma or by corticotroph hyperplasia in referred to Cushing's disease. Since the original description of Cushing's disease by Harvey Cushing in 1932, lthere has been marked progression in the etiology, diagnosis and treatment of this disorder. Despite the progression, the diverse clinical, endocrinological and pathological features of Cushing's disease remin incompetely understood and there also remain many problems to be resolved about the diagnosis, treatment, and prognosis of Cushing's disease. Sixteen cases with Cushing's disease were evaluated in this study. The follwing results were obtained. 1) The patients consist of 12 females and 4 males and the age was ranged from 18 to 47 years. 2) Among 16 patients, 14 patients showed central obesity and buffalo hunp, 13 moon face. Among 12 female patients, 10 patients showed abnormalities of menstration. 3) Elevated levels and loss of diurnal variation of the serum cortisol were observed in all patients, and increased 24hr urine free cortisol in 11 out of 12 patients tested. Urinary cortisol excretion was not suppressed by low dose dexamethasone suppression test but suppressed by high dose dexamethasone test. 4) Computed tomogram and MRI revealed that 15 casese were micreadenoma and 1 was macroadenoma. 5) The modalties of treatment were TSA (11 cases), TSA with Radiotherapy (2 cases), and r-knife radiosurgery (3 cases). 6) During the follow up periods(2~31 months), 2 cases were recurred. In conclusion, 15 cases of 16 Cushing's disease were microadenoma. The standard dexamethasone suppression test was useful in the biochemical diagnosis, and inferior petrous venous sampling was also needed to clarify the localization of tumor which was not detected by MRI or CT scan.( J Kor Soc Endocrinol 8: 273~280, 1993).

복강 내 낭종성 림프관종으로 오인된 간내 담관낭선종 1예

김창진,이문수,김홍수,이문호,김선주,박상흠,정일권,윤영근,김상균 대한소화기학회 1999 대한소화기학회지 Vol.34 No.3

Biliary cystadenoma is a rare epithelial neoplasm. The clinical features and optimal surgical management for these lesions have not been defined clearly. It occurs predominantly in female. Abdominal fullness or an abdominal mass was the most common symptom. The site where the tumor occurs most commonly is the right hepatic lobe. It is rare to diagnose the biliary cystadenoma preoperatively, so these tumors are usually found accidentally. The valuable diagnostic methods are ultrasonogram, abdominal CT scan, angiography, endoscopic retrograde cholangiography, percutaneous transhepatic cholangiography. These benign tumors are at the risk of malignant transformation and thus, should be considered to be premalignant. Local surgical excision from the wall of the bile duct is associated with high reccurence. Therefore, complete resection with negative histologic margins followed by bilioenteric reconstruction is recommended. We report a case of biliary cystadenoma which was mistaken for peritoneal cystic lymphangioma with a review of literatures.

Ginsenoside Analysis of Panax ginseng C. A. Meyer Culture Broth in a Bioreactor and Its Application in Inducing Biological Changes in Leafy Vegetables

Chang Heum Kim(김창흠),Eun Soo Seong(성은수),Ji Hye Yoo(유지혜),Jae Geun Lee(이재근),Chang Yeon Yu(유창연) 한국약용작물학회 2020 한국약용작물학회지 Vol.28 No.2

Clonal Variation of Physical Characteristics and Mineral Composition in Acorn of Quercus acutissima and Q. serrata Seed Orchard

Chang-Soo Kim,Du-Hyun Kim,Sang-Urk Han,Tae-Heum Shim 경상대학교 농업생명과학연구원 2011 농업생명과학연구 Vol.45 No.6

This study investigated mineral element concentrations of acorns in Quercus acutissima and Quercus serrata seed orchard, so that to estimate the variation of these species based on the chemical composition in different clones from plus trees. The acorns were collected from ten clones of each species grown in the same clonal seed orchard. The nutritional concentration of acorns was significantly different between the clones and species. The concentration of nutrient for the whole acorn followed in this general sequence: P > K > Na > Mg > Ca > Mn > Fe > Zn > Cu . The mineral concentrations of acorns in clones of Q. acutissima and Q. serrata contained P (494 to 684 and 541 to 672 mg/100 g), K (114 to 569 and 140 to 251 mg/100 g), Na (57 to 121 and 49 to 85 mg/100 g), Mg (29 to 37 and 26 to 42 mg/100 g), Ca (10 to 53 and 26 to 68 mg/100 g), Mn (0.5 to 3.4 and 1.8 to 4.5 mg/100 g), Fe (0.7 to 1.1 and 0.0 to 2.2 mg/100 g), Zn (0.34 to 0.81 and 0.38 to 0.84 mg/100 g), and Cu (0.13 to 0.40 and 0.09 to 0.34 mg/100 g) respectively. Even though acorns of Q. serrata are smaller in size than Q. acutissima, acorns of Q. serrata contained significantly higher concentration of phosphorus, calcium, iron and manganese than Q. acutissima. Based on the mineral composition of the acorns, this study has shown that the clones of Q. acutissima and Q. serrata have different ability to accumulate mineral nutrients which could indicate the variation of Quercus species in terms of mineral acquisition and accumulation.

Stereotactic Radiosurgery for Intracranial Tumors

서창옥 (Chang Ok Suh),정상섭 (Sang Sup Chung),추성실 (Sung Sil Chu),김영수 (Young Soo Kim),윤도흠 (Do Heum Yoon),김선호 (Sun Ho Kim),노준규 (John Juhn Kyu Loh),김귀언 (Gwi Eon Kim) 대한방사선종양학회 1992 Radiation Oncology Journal Vol.10 No.1

연세대학교 의과대학 세브란스병원에서는 1988년 8월 10MV 선형 가속기를 이용한 방사선 뇌수술(radiosurgery, stereotactic external beam irradiation)을 시작한 이래 1991년 12월까지 총 24예의 두개강내 종양에 대하여 방사선 뇌수술을 시행하였다. 대상 환자들의 조직학적 유형은 뇌수막종이 5예, 두개인두종이 3예, 악성임파종이 1예, 전이성 뇌종양이 2예 있었다. 대상환자들은 몇가지 다른 질병상태에서 방사선 뇌수술을 받았는데, 10예는 뇌정위적 생검이나 신경방사선학적 영상만으로 진단을 한 후 일차적인 치료로 방사선 뇌수술을 시행했으며, 9예에서는 수술 후 잔류 종양에 대하여 방사선 뇌수술을 시행하였다. 또 3예에서는 방사선 치료후 재발한 종양에 대해 구제요법으로 시행하였고, 2예에서는 외부 방사선 조사와 함께 추가 방사선조사로써 시행되었다. 6개월 이상 추적 조사된 환자 16명 중에서 7명 (뇌수막종 2예, 신경교종 4예, 악성임파종 1예)이 CT Scan 또는 MRI상 종양의 완전 소멸을 보였고 나머지 9예는 모두 종양 크기의 감소를 보였다. 방사선 수술시 급성 부작용은 없었고 4예에서 만성 합병증이 나타났는데 3예에서 신경학적 증상의 발현과 함께 CT Scan상 뇌부종이 나타났었고 1예의 두개인두종에서는 방사선에 의한 시신경 손상으로 생각되는 시력 소실이 있었다. 저자들의 경험 예들은 조직학적 유형이 다양하고 증례수가 많지 않고 추적 조사 기간이 짧기 때문에 결론을 얻기 어렵지만 정위적 방법으로 종양에 다량의 방사선을 일시에 조사함으로써 완전 관해까지의 우수한 종양 제어효과를 얻을 수 있었다. 그러나 여러 가지 종류의 뇌종양의 치료에 있어서 방사선 뇌수술이 생존율 향상이나 삶의 질의 향상에 기여할 수 있는지를 알기 위해서는 더 많은 증례를 통하여 경험을 축적하여야 할 것이다. Between August 1988 and December 1991, 24 patients with intracranial tumors were treated with stereotactic radiosurgery (RS) using a 10 MV linear accelerator at Severance Hospital. Yonsei University College of Medicine. There were 5 meningiomas. 3 craniopharyngiomas. 9 glial tumors, 2 solitary metastases, 2 acoustic neurinomas, 2 pineal tumors. and 1 non-Hodgkin's lymphoma. Ten patients were treated as primary treatment after diagnosis with stereotactic biopsy or neuroimaglng study, Nine patients underwent RS for post-op. residual tumors and three patients as a salvage treatment for recurrence after external Irradiation, Two patients received RS as a boost followed by fractionated conventional radiotherapy. Among sixteen patients who were followed more than 6 months with neuroimage. seven patients (2 meningiomas, 4 benign glial tumors. one non-Hodgkin's lymphoma) showed complete response on neuroimage after RS and nine patients showed decreased tumor size. There was no acute treatment related side reaction. Late complications include three patients with symptomatic peritumoral brain edema and one craniopharyngioma with optic chiasmal injury. Through this early experience, we conclude that stereotactically directed single high doses of irradiation to the small intracranial tumors is effective for tumor control. However, in order to define the role of radiosurgery in the management of intracranial tumors. we should get the long-term results available to demonstrate the benefits versus potential complications of this therapeutic modality.

우측 관상동맥 폐쇄 환자에서 관상동맥내 Thallium - 201 주사를 이용한 측부 혈행의 의의

박창윤(Chang Yun Park),이도연(Do Yun Lee),이종두(Jong Doo Lee),심원흠(Won Heum Shim),김한수(Han Soo Kim),조승연(Seung Yun Cho),김성순(Sung Soon Kim),정남식(Nam Sik Chung),김용수(Young Soo Kim),하종원(Jong Won Ha),권혁문(Hyuk Moon Kwo 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A To compare the myocardial viability in patients suffering from total occlusion of the right coronary artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) (300∼350 μCi) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA (200-250 μCi) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar & SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 reinjection. Intravenous T1-201 reinjection (six pts) or Tc-99m-MIBI (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201(IV T1-201) images, EGG, and ventriculography. Intracoronary TI-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

터널 붕괴위험도 평가모델 개발을 위한 기초 연구

김정흠(Kim, Jeong Heum),정수매(Zheng, Xiumei),유완규(Yoo, Wan Kyu),김창용(Kim, Chang Yong),이준환(Lee, Jun Hwan) 대한토목학회 2016 대한토목학회 학술대회 Vol.2016 No.10