Case Report : Improved severe hepatopulmonary syndrome after Liver transplantation in an adolescent with end-stage Liver disease secondary to biliary atresia

( Tae Jun Park ),( Keun Soo Ahn ),( Yong Hoon Kim ),( Hyungseop Kim ),( Ui Jun Park ),( Hyoung Tae Kim ),( Won Hyun Cho1 ),( Woo Hyun Park ),( Koo Jeong Kang ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period. (Clin Mol Hepatol 2014;20:76-80)

골반 내 농양 1예

조인숙,이해혁,김태희,이권해,남계현,이임순,김정식,박성진 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Pelvic inflammatory disease (PID) is a disease that affects young, sexually active, reproductive age women. Most pathogens are Chlamydia trachomatis and Neisseria Gonorrheae transmitted sexually. One of serious acute complication of PID is tubo-ovarian abscess (TOA) that involves the fallopian tube, ovary and adjacent structures (eg, bowel, pelvic peritoneum). The microbiology of TOAs is polymicrobial with anaerobic organisms and causal organisms of PID. Common anaerobic organisms are Peptostretococcus spp, Bacteriodes spp, Prevotella spp, Escherichia coli and aerobic streptococci. Treatment is necessary to admission for intravenous broad-spectrum antibiotics and surgery is often reserved for patients with suspected rupture or patients who fail to respond to antibiotics. So, we reported this case found pelvic abscess due to ruptured tube-ovarian abscess.

정신분열병 환자를 위한 인지재활훈련 프로그램의 개발 : Korean-Cognitive Differentiation Program 한국형 인지분화훈련 프로그램

현명호,안석균,이만홍,조현상,최충식,이연희,송선미,유계준,김장우,김태용,이희상 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구배경 : 정신분열병 환자들은 인지장애를 보이는바, 저자들은 이들을 대상으로 한국형 인지분화훈련 프로그램을 개발하여 정신분열병 환자들을 대상으로 인지재활훈련을 실시한 후 환자들의 인지기능, 정신병리 및 문제해결기술에 미치는 효과를 조사하였다. 방 법 : 28명의 정신분열병 환자를 훈련군(n=14)과 대조군(n=14)으로 나누어 훈련군에게 한국형 인지분화훈련 프로그램을 1회 60분씩, 주당 2회씩, 11주간 총 22회를 실시하였다. 환자들의 인지기능은 K-WAIS의 산수, 빠진곳찾기, 어휘, 공통점찾기 소검사로 측정하였고 정신병리는 양성 및 음성증상 척도로 측정하였으며 문제해결기술은 사회문제해결척도로 평가하였다. 인지재활훈련의 효과를 평가하기 위해 훈련 전후의 인지기능, 정신병리 및 문제해결기술의 변화를 종속변수로 하고 훈련 유무를 독립변수로 하여 반복측정에 의한 변량분석으로 자료를 분석하였다. 결 과 : 한국형 인지분화훈련이 시간에 따른 인지기능검사 중 산수 소검사, 문제해결기술 중 시회문제해결척도의 전체 점수와 문제해결기술 소척도의 점수의 변화에 유의한 영향을 미쳤으나, 시각적 주의력, 개념화 능력 및 정신병리의 점수의 변화에 유의한 영향을 미치지 않았다. 결 론 : 한국형 인지분화훈련 프로그램은 정신분열병 환자에서 청각적 주의력 및 문제해결기술의 호전을 꾀할 가능성이 있음을 시사한다. Objectives : The purpose of this study was to investigate the effects of cognitive differentiation training program- Korean version(a training program of attention and conceptual abilities) on cognitive function, psychopathology and problem solving skills in patients with schizophrenia. Methods : A total of patients diagnosed as schizophrenia using DSM-Ⅳ were randomly assigned to 2 groups. The training group went through a total of 22 sessions of cognitive differentiation training(60 min/ session×2 sessions/wk×11 wks). The attention-placebo control group received psychoeducation program during the same period. Arithmetic, vocabulary, similarities, picture completion of Wechsler Adult Intelligence Scale-Korean version, Positive and Negative Syndrome Scale, and Social Problem Solving Scales were administered to all patients, both before and after the training program. Results : In the arithmetic scores(F=6.35, af=1, p=0.018) of Wechsler Adult Intelligence Scale-Korean version, and total scores(F=6.35, af=1, p=0.018) and problem solving skill scale scores(F=4.88, af=1, p=0.036) of social problem solving scale, interaction effects of training was significant. Conclusion : Our findings suggest that cognitive differentiation training program-Korean version is effective on improving auditory attention and problem solving skills in patients with schizophrenia.

임신 중 발견된 대망 종괴 1례

조인숙,김태의,김정식,이해혁,이권해,김희경,남계현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A case of omental mass during Pregnancy Omental cyst is a rare lesion and occur primarily during childhood and young adulthood. When encountered, most of them are benign and intraabdominal masses. It shows a large mass but not palpable and often asymptomatic. The precise diagnosis is made by most commonly at surgery or during pathologic examination. So, we report this case with brief review of literatures.

우울증 관련 평가도구의 개관

조현주,채정호,전태연 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objective : Since a lot of assessment tools for depression have been developed and used, it is difficult to choose the proper and optimal instruments for the purpose of their usage, In order to maximize the effectiveness of assessment for depression, this paper reviewed the characteristics and specific features of currently using tools. Method : The domestically and internationally using assessment tools for depression were reviewed and classified by litera-hire search and clinical experience. Results : Methods of assessment, selecting guides and characteristics of assessment tools for depression were presented. Conclusion : This paper would provide helpful guidelines for selecting the assessment tools. We suggest that it is needed to develop the assessment tools for depression that reflects Korean specific culture and custom.

상 요추 추간판 탈출증의 수술적 치료

조태현,송준혁,김명현,박향권,김성학,신규만,박동빈 梨花女子大學校 醫科大學 醫科學硏究所 2000 EMJ (Ewha medical journal) Vol.23 No.3

Objectives : Lumbar disc herniations at the L1-L2, L2-L3, and L3-L4 level are rare. The purpose of this study is to observe the variable clinical finding of upper lumbar disc herniations and to provide proper treatment modality. Patients and Methods : Between 1998 Jan. and 1999 Dec., seventeen patients with upper lumbar disc herniations who were undergone surgery in our institute were retrospectively evaluated. Patients were evaluated based on following factors : age, sex, aggravating factor, symptoms and signs type of disc herniation, type of surgery, and outcome of post-surgery. Results : The incidence of lumbar disc herniation at the level of L1-2, L2-3 and L3-4 is 6.1% with declining frequency as the level ascends. The peak age incidence is 6th decade in both sex. Preoperative symptomes and signs are variabe. In sixteen cases, posterior approach was done. In these cases, twelve cases were performed microscopic partial hemilaminectomy, and four cases with spinal stenosis were performed total laminectomy and posterior screw fixation with bone fusion. In one case, lateral extracavitary approach was done. In results of operation, fourteen cases showed more than good grade(82%). Conclusion : The age incidence of lumbar disc herniations at the level of L1-2, L2-3 and L3-4 older than lumbar disc herniations at the lower level of L4-5 and L5-S1. The signs and symptoms are variable. In our cases, most of the patients were performed posterior approach with microscopic partial hemilaminectomy except the patients combined spinal stenosis. One case was performed a lateral extracavitary approach because the risk of the cord and cauda equina injuries. The prognosis of upper lumbar disc herniations after treatment with only microscopic partial hemilaminectomy and diskectomy is comparable with the prognosis of lumbar disc herniations at the lower level.

구치부 인접면 와동에서 유동성 복합레진 이장재의 두께가 치은 변연부 미세누출에 미치는 영향

조윤정,김태완,김현정,김영진,남순현 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.2

This in vitro study aimed to investigate the influence of flowable composite lining with different thicknesses on the marginal quality. One hundred twenty cavities, each preparated with proximal box-type(3mm of bucco-lingual width, 2mm of mesio-distal depth and gingival margin of 1mm supra-CEJ) were randomly dived into four groups. group I : Tetric ceram filling alone (control group) group II: 0.5mm thickness Tetric flow + Tetric ceram filling group III: 1.5mm thickness Tetric flow + Tetric ceram filling group IV: 2.5mm thickness Tetric flow + Tetric ceram filling The followings are the results: 1. Group II showed significantly less microleakage compared to group I(control group)(p<0.05). 2. There was no statistically significant difference between group III, IV and group I(p>0.05). 3. Group II showed significantly less microleakage compared to group III. IV(p<0.05). 4. There was microleakage more or less in all group. It was concluded that 0.5mm flowable composite lining improved cavity adaptation and marginal sealing. 구치부 인접면 와동에서 유동성 복합레진 이장재의 두께가 치은측 변연의 미세누출에 미치는 영향을 평가하기 위하여 발거된 소구치 및 대구치의 근, 원심면에 box 형태의 와동(협설폭경 3mm, 근원심폭경 2mm, 상아법랑경계 상방 1mm에 치은 변연) 120개를 형성한 뒤, 무작위로 30개씩 선정하여 다음과 같은 4개의 군으로 분류하였다. group I- Tetric ceram 충전군(대조군) group II- 0.5mm두께의 Tethc flow + Tetric ceram group III- 1.5mm두께의 Tetric flow + Tetric ceram group IV- 2.5mm두께의 Tetric flow + Tethc ceram 색소침투법으로 치은측 변연부 미세누출을 측정하여 다음과 같은 결론을 얻었다. l. group II는 groupI에 비해 낮은 미세누출을 보였다(p<0.05). 2. group III,IV과 group I 사이에는 통계적으로 유의한 미세누출의 차이가 없었다(p>0.05). 3. group II는 group III, IV에 비해 낮은 미세누출을 보였다(p<0.05). 4. 모든 group에서 정도의 차이는 있으나 치경부에서 미세누출을 보였다. 이상의 결과로, 혼합형 복합레진으로의 구치부 인접면 와동 수복시 0.5mm 두께의 유동성 레진으로의 와동저 이장은 치은측 변연의 봉쇄능을 향상시켜 변연부 미세누출을 감소시킬 수 있는 방법으로 사료된다.

公州 錦江 流域의 청둥오리 Anas platyrhynchos 와 쇠오리 Anas crecca의 行動 樣式 比較

趙三來,金賢泰 공주대학교 사범대학 과학교육연구소 1992 과학교육연구 Vol.23 No.1

Mallards(Anas platyrhynchos) and Green-Winged Teal(anas crecca) were studied at Kum River, Kongju, Korea, from 29, December, 1990 to 5, Janury, 1991. There was a wide difference between Mallards(Anas platyrhynchos) and Green-Winged Teal(Anas crecca) in body length but used to same Resting or Feeding area. Resting time was the major activity of mallards(43-45%) and Feeding time was the major activity of Green-Winged Teal(30-34%). Both species increased Resting time as approach of sunset but Locomotion and Comfort decreased. Locomotion(22-24% and 16-24%) and Comfort(16-21% and 14-22%) also were dominant behavioral activities of Mallards and Green-Winged Teal, respectively. Total time spent in Alert, Courtship and Agnoistics behavior was low for both species(>3%). Mallards and Green-Winged Teal rested most on sand bar in River side, while paddy fields were used most for feeding area.

심실중격결손증-치험 1예-

조광현,우종수,황윤호,이양행,박철호,김종성,김철호,이경순,조영일,박태인 인제대학교 1985 仁濟醫學 Vol.6 No.4

A successful treatment of infants and children with congenital heart defects depends upon several factors: diagnosis must be accurate, the operative technique, including techniques of perfusion and myocardial preservation, must be suited to the needs of patients and intensive cares, including accurate anesthesia, must be applied through all stages of investigation and treatment, i.e. before, during and after the operation. Recently we performed a open heart surgery successfully for a six-years old girl who had suffered from frequent upper respiratory tract infection and mild to moderate exertional dyspnea with congenital heart defects (ventricular septal defect, Kirklin type II, with patent foramen ovale). The operation and postoperative course were very smooth. And now we report this with review of literatures.

경기종목의 특성에 따른 유·무산소성 대사능력 및 무산소성 파워에 관한 실험적 연구

조현철,송순천,김학렬,손태열 成均館大學校 科學技術硏究所 1989 論文集 Vol.40 No.2

This experimental study was designed, 1) to observe maximal oxygen uptake and anaerobic threshold during incremental loading treadmill exercise by 2-min interval. 2) to determine the anaerobic power in the wingate test during bicycle ergometer work with toe-stirrups. The subject were 16 college elite boxing player, 10 college elite soccer player The results were as -follows: 1. The means±SD of maximal oxygen uptake and maximal oxygen uptake per kg body weight were 4.06±0.66l/min, 4.27±0.46l/min, and 60.58±7.61ml/kg/min 63.05±3.41ml/kg/min, respectively. also maximal heart rate were 187.88±9.44 beats/min, 185.40±6.57 beats/min. respectively. 2. The means±SD of maximal oxygen uptake and maximal oxygen uptake per kg body weight at anaerobic threshold was 2.93±0.5l/min, 3.23±0.47l/min (AT-VO2. l/min), and 43.70±6.97ml/kg/min, 47.71±4.99ml/kg/min (AT-VO2. ml/kg/min), respectively. also Anaerobic Treshold level (AT-% VO2max) was about 72.49±4.37% VO2max, 75.37±8.8% VO2max, and AT-% HRmax was about 86.07±5.97% HRmax, 87.84±6.25% HRmax, respectively. 3. The means ±SD of Anaerobic Power in the wingate test was 592.50±65.42 Wattes, 588.00±46.30 Wattes, respectively. The results of this study indicated that boxing players are incresed training program and exercise prescription for anaerobic metabolic process, soccer players are done training program for aerobic metabolic process, because of decresed maximal oxygen uptake and anaerobic threshold level.