제 1형 신경섬유종증 환자에서 발생한 위장관 간질종양 1예

원경준,이준,변유미,조민근,한경택,김원,홍란,임성철,김경종,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract, but this tumor is rarely seen in association with type l neurofibromatosis (NFl) Generally, the majority of GISTs are isolated neoplasm and they are sporadically found in the stomach, but the GISTs in NFl patients are usually multiple and usually found in the small intestine. We report a case of multiple GISTs in the jejunum of a 63-year-old woman diagnosed as NFl accompanied by complication of gastrointestinal bleeding, In this case, Patient had multiple cafe-au lait spots and neurofibroma on skin and had freckling on axilla and groin, and then, we made a diagnosis of NFl. Gastrointestinal bleeding is controlled by resection of multiple GISTs. Generally, only 3-5% of all gastrointestinal bleeding comes from the small bowel. Causes of small intestinal bleeding are angiodysplasia, neoplasm, NSAIDs induced ulcer etc. but, If patients have NFl accompanied by complication of gastrointestinal bleeding, GISTs on small bowel must be considered.

좌측흉수로 발현된 Boerhaave 증후군 1예

이준,변유미,조민근,조주연,원경준,김영대,박찬국,김만우,유재근,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

구토 후 발생한 토혈을 주소로 내원한 환자에서 좌측 늑막 삼출 동반 시 식도 파열의 가능성을 고려하여 흉수 천자 및 지속적인 흉부 단순 촬영의 추적관찰이 필요하며 식도 파열이 배제된 후 환자의 생체 징후 및 토혈 양을 파악하여 내시경 검사 시기를 신중히 결정하는 것이 좋을 것으로 생각된다. 본 증례는 토혈을 주소로 내원하여 Mallory-Weiss 증후군 의심 하에 내시경을 통한 치료 시행 후 추적 관찰에 의해 진단된 Boerhaave 증후군을 경험하였기에 보고하는 바이다. Boerhaave's syndrome is a spontaneous perforation of the esophagus most commonly resulting from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure caused by straining or vomiting. Surgery should generally be performed within 24 hours because mortality approached 30 to 50 percent in which surgery was delayed. Therefore, early diagnosis and prompt surgical repair are critical for survival. We have experienced a case of Boerhaave's syndrome in a patient presenting with hematemesis with left pleural effusion without any signs or symptoms of pneumomediastinum or pneumothorax.

몬도씨병 (Mondor's Disease) 1예

김지은,김유진,서성준,홍창권 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.2-3

Mondor's disease is a rare disorder characterized by superficial thrombophlebitis and usually develop in thoracoabdominal wall. It has clinical feature of sudden development of painful cordlike structure. The cause is not determined in about 50-60% but it is suggested that trauma, surgery, exercise, drug abuse are often associated. A 44-year-old woman presented cordlike linear tender lesion on right thoracoabdominal wall and histopathologic examination revealed thrombophlebitis with organized thrombus.

구리 인근 경기 동북 지역에서의 피부질환의 통계적 관찰

이창우,유희준,양홍윤,전재홍 한양대학교 의과대학 1996 한양의대 학술지 Vol.16 No.2

We reviewed 4,173 new out-patients visited dermatology clinic of Hanyan University Kuri Hospital (from November 1995 to October 1996) to study the prevalence of common dermatoses occurring in this region (northeastern area of Kyounggi province) and compared to those of other Korean data. Among 4,173 new out-patient, 1,866(44.7%) were male, and 2,307(55.3%) were female. Fifteen common dermatoses were found to be contact dermatitis(13.0%), dermatophytosis(9.1%), atopic dermatitis(8.4%), seborrheic dermatitis(8.1%), other eczemas(7.8%), urticaria(6.4%), acne vulgaris(4.9%), herpes zoster(3.4%), drug eruption(2.5%), bacterial infection(2.1%), psoriasis(1.9%), verruca(1.8%), vitiligo(1.4%), syphilis(0.5%), and scabies(0.5%) in order of frequency. The most frequently visited age group was those between the age 21 to 30 years old constituting 20.4% of total patients. On monthly visited number of patients, the highest was in January, and the lowest was November. The results suggest that age, sex and monthly distribution patterns in northeastern area of Kyounggi province are similar to those of other epidemiological reports in Korea except for the higher prevalences of contact dermatitis, seborrheic dermatitis and herpes zoster.

中學 科學敎育의 探究學習에 대한 評價問項 開發 (Ⅱ)

閔庚德,楊洪準,李善行,鄭遠佑,이병교,金裕漢,羅長薰 경북대학교 과학교육연구소 1985 科學敎育硏究誌 Vol.9 No.-

This study was accomplished to develope the evaluation items for inquiry learning in the 2nd grade Middle School Science for the consecutive study of the evaluation items for inquiry learning in the 1st grade Middle School Science(U-Hang Ki et al, 1984). In this study, paper and pencil test items and performance test items are made by analyzing the abilities of inquiry according to the contents and four basic experiments from each unit in the 2nd grade Middle school science. These evaluation items were applied to tke five classes of the 2nd grade of middle school to test their validity. It is desirable that performance test schuld be used for the evaluation for the abilities of inquiry which can not be evaluated by paper and pencil test. In the evaluation methods of performance test, tester evaluation, peer evaluation and self-evaluation can be applied to the science class in a multi-student class. In higher grade, however tester evaluation is more desirable than peer and self evaluation. It is found that peer evaluation and self-evaluation make possible the perfect study by feedback.

몬도씨병 (Mondor's Disease) 1예

김지은,김유진,서성준,홍창권 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.3

항정신병약물 사용 중인 정신분열병 환자에서 올란자판으로의 교체 방법에 관한 연구(II) : Comparison of Safety 안전성 비교

안용민,권용실,권준수,민성호,박두병,양문정,소형석,송종호,신윤식,우행원,유범희,이홍석,정한용,한창환,김용식 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

연구목적: 이 다기관 공동임상연구는 사용 중인 항정신병약물을 ’직접 교체 방법’또는 ’시작-감량 교체 방법’중 한 가지 방법으로 올란자핀으로 교체한 후, 안정성 측면에서 두 교체 방법 간의 비교와 교체후의 변화를 관찰하기 위한 것이다. 방법: 국내 13개 병원의 입원 및 외래에 내원한 환자들 중 ICD-10 지단기준으로 정신분열병에 해당되며, 임상적으로 항정신병약물 교체가 필요한 환자를 대상으로 하였다. 두 가지 교체 방법 중 한 가지를 무작위로 피험자에 적용하였으며, ’직접 교체 방법’에 배정된 경우에는 사용중인 항정신병약물을 일시에 중단하고 10㎎의 올란자핀을 바로 투여하였고, ’시작-감량 교체 방법’에 배정된 경우는 10㎎의 올란자핀 투여하고 2주에 걸쳐서 기존 약물을 감량하여 중단하였다. 올란자핀 사용기간은 총 6주이며, 용량은 5∼20㎎ 범위로 제한하였다. 한정성 평가를 위해서 체중, 생명징후, 자발적인 이상반응 복, 실험실 검사 그리고 Simpson-Angus Scale(SAS), Barnes akathisia rating scale(BARS), Abnormal involuntary movement scale(AIMS). Liverpool University neuroleptic side effect rating scale(LUNSERS)등을 이용하였다. 결과: 총 103명의 정신분열병 환자를 대상으로 하였다. 사용한 올란자핀의 용량, 벤조디아제핀의 병용률, 탈락률과 탈락 사유, 자발적인 이상반응 보고, 생명징후, 실험실 검사 그리고 대부분의 부작용 척도 상에서 임상적으로 의미 있는 차이를 두 교체 방법간에 발견하지 못하였다. 다만 AIMS의 감소는 ’직접 교체 방법’군에서 보다 적었고, 항콜린제의 병용률은 ’시작-감량 교체 방법’군에서 보다 많았다. 기저 상태에서 전체 피험자의 SAS와 BARS 점수는 각각 3.5점과 1.8점이었으며 70% 이상의 피험자가 고프로락틴 혈증을 보였다. 올란자핀으로 교체한 후, SAS, BARS, AIMS 점수의 유의한 감소가 있었으며 고프로락틴 혈증을 보인 피험자 분율도 약 30%이하로 감소하였다. 그러나 교체 방법과 상관없이 올란자핀 교체 후 유의한 체중 증가가 있었다. 결론: 이 연구를 통해 교체 방법에 관계없이 비교적 안전하고 용이하게 올란자핀으로 교체 할 수 있음을 알 수 있었다. 그리고 기존 항정신병약물을 올란자핀으로 교체함으로써 일부 부작용들을 줄일 수 있음을 간접적으로 관찰할 수 있었다. 하지만 이 연구는 여러 제한점과 문제점을 지니고 있기 때문에 보다 체계적인 연구를 통해 검정이 필요하리라 생각된다. Objectives: This multicenter clinical trial involving 13 hospital sites compared the safely of switching to olanzapine between ’direct switching method’ and ’start-tapering switching method’. Method: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For ’direct switching method’group, previous antipsychotics were abruptly discontinued and 10㎎ of olanzapine was administered, and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20㎎. The safety of switching to olanzapine was measured with vital sings including body weight, adverse events reported spontaneously, laboratory tests, and various scales such as Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS). Abnormal Involuntary Movement Scale(AIMS), and Liverpool University Neuroleptic Side Effect Rating Scale(LUNSERS). Results: 103 patients were switched to olanzapine in this study. The comparison between two switching methods did not show any significant difference in the dosage of olanzapine used, the concomitant use of benzodiazepine, the rate and reasons of drop-out, the adverse events, vital signs, laboratory tests, and most scales for measuring side-effects. However, the decrease in AIMS scores was significantly lower in ’direct switching method’ group, and the concomitant use of anticholinergics was comparatively greater in ’start-tapering switching method’ group. At baseline, SAS and BARS scores were 3.5 and 1.8 points respectively, and more than 70% of the subjects showed hyperprolactinemia. After switching to olanzapine, SAS, BARS, and AIMS scores were significantly decreased and the proportion of the patients with hyperprolactinemia was also decreased to less than 30%. However significant weight gain after the treatment of olanzapine was observed regardless of switching method. Conclusion: This study may suggest that switching to olanzapine can be done with relatively high safety regardless of switching methods and olanzapine can significantly decrease some side-effects induced by other antipsychotics.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

뇌성마비아의 모발내 중금속 함량 분석

안경희,김희상,유창현,윤동환,홍장혁,유승돈,이준원 경희대학교 2001 慶熙醫學 Vol.17 No.1

자동차용 실리콘 가속도센서의 개발(Ⅱ)

이종현,신장규,이상룡,천희곤,조찬섭,심준환,류인식,박석홍,허정준,박기열 경북대학교 센서기술연구소 1994 연차보고서 Vol.1994 No.-

자동차의 air-bag 장치에 실용될 수 있는 압저항형 단결정 실리콘 가속도센서 칩을 개발하기 위하여 결정 실리콘 미세구조의 제조방법을 확립하고, 단위공정의 검증을 통하여 일괄공정에 의한 PROTO-TYPE 칩을 만드는 기술을 연구하였다. 단결정 실리콘 미세구조는 선택확산법을 이용하여 정확히 선택된 영역에만 air-gap을 형성하여 미세구조의 측면식각을 방지하는 선택확산법에 의한 실리콘 마이크로머시닝 기술로 제조하였다. 일괄공정을 위한 단위공정확립을 위하여 PROTY-TYPE 8빔 브릿지형 가속도 센서를 제조하였다. 제조된 칩의 가속도에 따른 출력전압은 선형성을 나타내고 있으며, 감도는 약 50 ㎶/V·g로 나타났다. 이 감도는 50G용 가속도센서의 사양을 만족하지 못했다. 이는 공정에 의한 문제라기 보다는 가속도센서의 시뮬레이션에 의해 설계한 구조가 이미 원하는 감도에 못 미친다는 것으로 생각된다. 따라서 2차 공정으로 제조될 가속도센서의 파라미터를 SuperSAP 유한요소 패키지를 이용하여 실리콘 미세구조부의 파라미터에 따른 특성을 시뮬레이션하였다. 설계된 50G용 가속도센서의 mass Pad의 반경 및 빔 길이, 빔 폭, 빔 두께, 그리고 mass의 각 파라미터 값은 700 ㎛, 120 ㎛, 5 ㎛, 1.0 ㎎ 이었다. 반도체 공정기술, 관성질량 제조법 및 선택확산을 이용한 마이크로머시닝을 사용하여 일괄공정으로 8빔 브린지형 가속도센서를 제조하였다. We researched the establishment of the silicon microstructure fabrication technique to develop a piezoresistive type silicon acceleration sensor chip and the technique to make a proto-type chip by the verification of the unit-process. Silicon microstructure is fabricated silicon micro-machining by selective diffusion method. This method prevent a side-etching of microstructure because selective diffused region is only formed an air-gap. We fabricated a proto-type 8-beam bridge-type acceleration sensor to establish the unit-process for the batch-process. The output voltage of the chip represented linearity with acceleration, and the sensitivity was about 50 ㎶/V·g. But this sensitivity dosen't satisfy the requirements of a practical acceleration sensor. The cause of this result is assumed not process problem, but the structure designed by simulation isn't suitable already. Threfore, the characteristics of parameters of the acceleration sensor that will be fabricated by 2nd-process is simulated by SuperSAP finite-element package. The determined parameter values of beam length, beam width, beam thickness, mass, and mass radius are 120 ㎛, 5 ㎛, 1.0 ㎎, and 700 ㎛, respectively. We fabricated 8-beam bridge-type acceleration sensor by batch-process using a semiconductor process technique, proof-mass fabrication method, and micromachinig using selective diffusion.