특발성 자발성 신장 파열 1예

윤재철,김원,조규종,홍정석,이미우,장성은,오세현,임경수 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Primary aldosteronism is a syndrome characterized by hypertension, hypokalemia, suppressed plasma renin activity, and elevated serum aldosterone levels. Conn first described it 1955 in association with adrenal cortical adenoma(Conn's syndrome). Today, it can be divided into at least six distinctive sub-groups. The diagnosis of primary aldosteronism is usually suspected when the patient presents with poorly controlled hypertension with hypokalemia. The main issues in the evaluation of primary aldosteronism are to differentiate an adenoma from hyperplasia and to localize the adenoma. Basic hormonal studies and computed tomographic(CT) scanning can be used effectively for that differentiation. An adenoma is one of a few potentially curable forms of hypertension, and it is best treated by removing the adrenal tumor. We experienced a case of a typical adrenal adenoma. The patient was a 37-year-old male who had experienced in both his legs over a period of several days a weakness due to hypokalemia. He was diagnosed using basic hormonal studies and adrenal CT scanning. After, he received laparoscopic adrenalectomy and was discharged with improved condition.

만성폐쇄성폐질환의 중증도와 폐고혈압 및 폐성심으로 진행과의 상관관계

김형호,박철진,이준,장광표,하성일,이재록,하재화,권세훈,권용운,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background: From many previous studies, Pulmonary hypertension is the known independent predictive factor of the mortality in COPD. Also pulmonary hypertension is the major cardiovascular complication of COPD and is associated with the progression to cor pulmonale and poor prognosis. Author want to analyze the correlation between pulmonary hypertension and the severity of COPD which are classified by forced expiratory volume in one second, and the extent of progression to corpulmonale. Methods: Retrospectively we investigated the medical records of 118 patients with COPD who had pulmonary function test and echocardiogaphy more than one times during one-year follow-up (from June, 2005 to May, 2006) at respiratory division in chosun university hospital, and then 50 patients were enrolled in this study. We classified the severity from FEVl in pulmonary function test based on the GOLD guideline, also this was comparably analyzed with RVSP, RVIDd, Visual Grading from echocardiography. Results: 16 patients out of 50 were classified as moderate severity, 25 patients were severe, and 9 patients were very severe group. RVSP was higher in more severe groups than less severe groups but when it comes to pulmonary hypertension that RVSP is over 35 mmHg, there was no valid difference lies in those groups. As FEVl decreases RVSP and RVIDd increases, and observed relationship between RVSP which was classified as below 35 mm and above 35 mm groups and visual grading which was classified as normal and dilatated groups revealed valid correlation, Conclusion: As pulmonary function decreases, progression to pulmonary hypertension and cor pulmonale increases but there was no remarkable difference of prevalence in above moderate severity groups. 연구배경 폐고혈압은 이전의 많은 연구에서 만성폐쇄성폐질환에서 독립적인 사망의 예측인자로 알려져 있다. 또한 폐고혈압은 만성폐쇄성폐질환의 주요한 심혈관계 합병증이며, 폐성심으로의 진행 및 불량한 예후와도 관련되어 있다. 이에 저자는 폐고혈압과 1초간 노력성호기량으로 분류되는 만성폐쇄성폐질환의 중증도 및 폐성심으로의 진행 정도를 비교 분석하여 이들의 상관관계를 밝혀보고자 한다. 방법 2005년 6월부터 2006년 5월까지 1년 동안 본 병원 호흡기 내과에서 폐기능검사와 심장초음파 검사를 각각 1회 이상 시행한 적이 있는 118명에 한하여 의무기록을 후향적으로 조사하여 이 중에서 50명을 대상으로 하였다. 폐기능검사 시행 결과 얻은 1초간 노력성호기량을 바탕으로 GOLD guideline에 따라 중증도를 분류하였으며 이를 심초음파 시행 결과 얻은 우심실수축기압, 확장기말 우심실내부간격, 시각등급과 비교분석하였다. 결과 대상 환자 50명중 16명은 중등증, 25명은 중증, 9명은 최고중증 그룹으로 분류되었다. 우심실수축기압은 중증도가 높은 그룹에서 낮은 그룹에 비해 더 높게 나타났으나 폐고혈압에 해당하는 우심실수축기압이 35 mmHg이상인 환자에 있어사는 각 그룹간에 유의한 차이를 보이지 않았으며, 확장기말 우심실내부간격, 시각등급 또한 중증도와 유의한 차이를 보이지 안항ㅆ다. 1초간 노력성호기량이 감소함에 따라서는 우심실수축기압, 시각등급은 증가하였으며 우심실수축기압을 35mmHg 미만과 이상인 그룹으로, 시각등급을 정상과 확장이 있는 그룹으로 분류하여 비교한 결과에서는 유의한 상관관계를 나타냈다. 결론 폐기능이 감소할수록 페고혈압 및 폐성심으로의 진행이 증가하였으나 폐기능검사에서 중등도 이상의 그룹에서 유병률의 차이는 크지 않았다.

사람폐암세포주 (PC-14)에서 Cyclosporin A에 의한 Adriamycin 내성의 극복

김영환,홍원선,송재관,강윤구,이진오,강태웅,김건열,한용철 대한내과학회 1990 대한내과학회지 Vol.38 No.3

Cyclosporin A and verapamil were tested using MTT assay to evalute the modification effect on the resistance to adriamycin in a human lung cancer cell line(PC-14) and its resistant subline(PC-14/A). PC-14/A was derived by the continuous exposure of PC-14 to incremental concentrations of adriamycin. PC-14/A was 2.5 times more resistant to adriamycin in terms of ICso than PC-14. Cyclosporin A alone, at a concentration of 2.5㎍/㎖, inhibited the growth of PC-14 to 68.3%. 2.5㎍/ ㎖ and 5.0㎍/㎖ of cyclosporin A showed an increase in the cytotoxicity of adriamycin (p<0.01) with 5.0㎍/㎖ being greater than 2.5㎍/㎖(p<0.01). Excluding the direct cytotoxic effect, however, cyclosporin A did not increase in the sensitivity of PC-14 to adriamycin but only showed an additional cytotoxic effect with adriamycin. Verapamil (up to 6.0㎍/㎖) did not inhibit the growth of PC-14. 3.0㎍/㎖ of verapamil did not increase the cytotoxic effect of adriamycin. The combination of cyclosporin A and verapamil with adriamycin enhanced the cytotoxicity of adriamycin, but the result was similar to that of cyclosporin A with adriamycin. 5.0㎍/㎖ of cyclosporin A modified the adriamycin resistance of PC-14/A(SR, 3.2). However, 3.0㎍/㎖ of verapamil did not significantly reverse the adriamycin resistance of PC-14/A. The modified effect of the combination of 5.0㎍/㎖ of cyclosporin A and 3.0㎍/㎖ of verapamil was similar to that of 5.0㎍/㎖ of cyclosporin A alone in PC-14/A. These results demonstrate that cyclosporin A has an additional cytotoxic effect with adriamycin in PC-14 and PC-14/A and has overcome the acquired resistance to adriamycin in PC-14/A. They also suggest that cyclospoin A may have the therapeutic potential in the treatment of human lung cancer.

Prior Use of Inhaled Corticosteroids and COVID-19 Risk and Mortality: A Nationwide Population-based Cohort Study

( Jae Chol Choi ),( Sun-young Jung ),( Una A. Yoon ),( Seung-hun You ),( Myo-song Kim ),( Moon Seong Baek ),( Jae-Woo Jung ),( Won-young Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background There are concerns that inhaled corticosteroids (ICS) could increase the risk of coronavirus disease 2019 (COVID-19) and experiencing poor outcomes. Methods This nationwide population-based study evaluated 234427 individuals with COVID-19-related claims before May 15, 2020 in the Korean Health Insurance Review and Assessment database. Adjusted odds ratios (ORs) were used to compare the clinical outcomes between ICS users and nonusers. To evaluate susceptibility to COVID-19 among patients with chronic obstructive pulmonary disease (COPD) or asthma, a nested case-control study was performed using the same database to examine the association between ICS use and COVID-19 diagnosis. Results In total, 7341 patients were confirmed to have COVID-19, including 114 ICS users and 7227 nonusers. Among 5910 patients who were hospitalized, death was observed for 9% of ICS users (9/101 patients) and 4% of nonusers (209/5809 patients) (p=0.01). However, this association was not significant when adjusted for age, sex, region, comorbidities, and hospital type (adjusted OR, 0.94; 95% confidence interval [CI], 0.43-2.07; p=0.88). Furthermore, ICS use was not associated with an increased risk of respiratory outcomes (respiratory support and extracorporeal membrane oxygenation). The case-control analysis of COPD compared 640 cases with COVID-19 to 2560 matched controls without COVID-19, and the analysis of asthma compared 90 cases with COVID-19 to 360 matched controls without COVID-19. Use of ICS was not significantly associated with COVID-19 among patients with COPD (adjusted OR, 1.02; 95% CI, 0.46-2.25; p=0.97) or asthma (adjusted OR, 0.38; 95% CI, 0.13-1.17; p=0.09). Conclusions Prior ICS use was not significantly associated with COVID-19 risk in patients with COPD or asthma, nor with mortality and respiratory outcomes among patients with COVID-19. During the COVID-19 pandemic, there is no evidence to support discontinuation of ICS among patients with COPD and asthma.

정상혈압 폐색전증에서 위험도 평가도구로서의 D-dimer의 역할

윤재철 ( Jae Chol Yoon ),김원영 ( Won Young Kim ),최상식 ( Sang Sik Choi ),정상구 ( Sang Ku Jung ),손창환 ( Chang Hwan Sohn ),김원 ( Won Kim ),임경수 ( Kyoung Soo Lim ),정태오 ( Tae O Jeong ),진영호 ( Young Ho Jin ),이재백 ( Jae 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.2

Background: D-dimer testing is widely applied as a first step in the diagnostic work-up of pulmonary embolism (PE). Although this is the most sensitive assay for ruling out PE, the prognostic implications of D-dimer testing in patients with normotensive PE are not well known. The aim of this study was to determine if D-dimer testing on admission predicts major adverse cardiac events (MACE) in patients with normotensive PE. Methods: A total of 180 consecutive patients with normotensive PE admitted between January 2003 and June 2009 were included. The group was divided into quartiles on the basis of their D-dimer levels. We compared the frequency of MACE by quartile of D-dimer level and estimated sensitivity, specificity, and predictive values for MACE in the first and fourth quartile. Results: In the 37 (20.6%) patients with MACEs, the median D-dimer level (7.94 [IQR: 4.03∼18.17] μg/mL) was higher than in patients with a benign course (5.29 [IQR: 2.60∼11.52] μg/mL, p<0.01). The occurrence of MACEs was increased with increasing D-dimer level (p=0.017). In the first quartile (D-Dimer <2.76 μg/mL) sensitivity, specificity, and positive and negative predictive values for predicting MACEs were, respectively, 91.9%, 29.4%, 25.2%, and 93.3%. Conclusion: Patients with D-dimer levels below 2.76 μg/mL have a low risk of MACEs. Our study suggest that D-dimer level may be used to identify low risk patients with normotensive PE.

동중국해 북부해역의 해양환경 장기변동

윤상철(Sang Chol Yoon),윤석현(Suk Hyun Youn),황재동(Jae Dong Whang),서영상(Young Sang Suh),윤이용(Yi Yong Yoon) 한국해양환경·에너지학회 2015 한국해양환경·에너지학회지 Vol.18 No.3

중이 진주종의 면역조직학적 고찰

윤태현,이봉재,이기천,추광철 울산대학교 의과대학 1992 울산의대학술지 Vol.1 No.1

저자들은 진주종조직과 비진주종 조직에서 Langerhans 세포와 T림프구의 아형들의 분포를 면역조직학적 방법에 의해 관찰하고, 임상적으로 이루의 존재 유무와 연관시켜 고찰하여 다음과 같은 결과를 얻었다. 1) 비진주종성 조직 5례에서 Langerhans 세포들은 상피층에 나타나는 빈도가 적고 주로 상피층의 상기저부에 국한되어 있었으며, T림프구는 거의 관찰할 수 없었다. 2) 진주종조직 32례에서 Langerhans 세포들은 상피층에서는 항상 관찰되었으나, 상피하층에서는 25례에서만 관찰되었다. 3) 진주종조직에서 Langerhans 세포들은 상피층에서 상피하층으로 갈수록 분포밀도가 감소하였다. 4) 진주종 조직에서 T림프구의 아형들은 주로 상피하층에서 발견되었고, 조력 T림프구가 억제 T림프구보다 출현 빈도가 많았다. 5) 진주종 환자에서 임상적으로 이루가 있던 경우 Langerhans 세포의 분포밀도가 없던 경우에 비하여 높았으나, T림프구 아형들의 분포는 양군간에 차이가 없었다. The etiopathogenesis of cholesteatoma is still unknown;however, it has been reported that Langerhans' cells and T-lymphocytes play an important role in the pathogenesis of aural cholesteatoma. The authors performed immunohistological study to identify the distribution of the Langerhans' cells and T-lymphocytes in 32 cases of cholesteatoma tissue and in 5 cases of chronic inflammation of aural skin, and to correlate with clinical symptom of otorrhea. CD1 monoclonal antibody was used to demonstrate Langerhans' cells, CD4 for helper T-lymphocytes, and CD8 for suppressor T-lymphocytes. Our results showed that Langerhans' cells and helper T-lymphocytes were found abundantly in the cholesteatoma tissue than in noncholesteatoma skin, and the proportion of Langerhans' cells in cholesteatoma tissue was higher in cases with otorrhea than in cases without otorrhea.

2007년 하계 및 추계 경상북도 후포연안역 물리적 해황특성

황재동 ( Jae Dong Hwang ),이용화 ( Yong Hwa Lee ),심정민 ( Jeong Min Shim ),윤석현 ( Seok Hyun Youn ),진현국 ( Hyun Gook Jin ),김영숙 ( Young Suk Kim ),권기영 ( Kee Young Kwon ),윤상철 ( Sang Chol Yoon ) 한국수산학회 2008 한국수산과학회지 Vol.41 No.6

Mycobacterium tuberculosis 파쇄 추출항원에 대한 단세포군 항체의 생산 및 그 특성에 관한 연구

국윤호 ( Yoon Hoh Kook ),조명제 ( Myung Je Cho ),황응수 ( Eung Soo Hwang ),김익상 ( Ik Sang Kim ),차창룡 ( Chang Yong Cha ),장우현 ( Woo Hyun Chang ),이승훈 ( Seung Hoon Lee ),김상재 ( Sang Jae Kim ),한용철 ( Yong Chol Han ) 대한결핵 및 호흡기학회 1984 Tuberculosis and Respiratory Diseases Vol.31 No.3

응급 안와 전산화 단층촬영을 시행한 안와골절 환자

진재우,김철,김행재,배택환,정윤석 대한외상학회 1998 大韓外傷學會誌 Vol.11 No.1

In the emergency department, orbital wall fracture which is associated with fracture of basal skull or other facial bones is frequently seen. And orbital wall fractures which may produce cosmetic problems and functional orbital damages are increasing in frequency with the rise in number of traffic accidents, assaults and sport activities. Recently, we reviewed medical records of 54 cases which were taken orbital CT scan in emergency department. These cases were analyzed in age and sex distribution, injury causes, physical findings, anatomical locations, other skull and facial fractures, difficulties of diagnosis, and complications. The diagnosis is based on clinical symptoms and signs and radiologic procedures, but it may be difficult to detect fractures with plain X-rays of orbit because of the superimposition of the shadow by other bony structures. It is important to recognize the associated signs and symptoms in order that the diagnosis should not be missed. And emergency physician should show much attention to its anatomical structure, difficulties of diagnosis with plain orbital films and later cosmetic and functional complications.