유방암의 위와 대장전이

유현아,김은영,서민지,정은,조민정,오현진,장지혜,박지찬,이정의,박석영 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.2

Gastric metastasis from breast cancer is rare and only six cases have been reported in Korea. Colon metastasis is more rare than gastric metastasis. We report a 63-year-old woman with gastric and colon metastases of invasive lobular carcinoma of breast. She was diagnosed as right breast cancer, received right modified radical mastectomy 10 years ago and has been treated with chemotherapy and hormone therapy. Investigating for melena and a small caliber of stool, we found gastric and colon metastases. The diagnosis of metastatic breast cancer was made through gross pathologic and immunohistochemistry staining. We report a case with gastric and colon metastases from breast cancer and a review of the associated six case reports in Korea.

섬유보강에 의한 고강도콘크리트의 내화성능 개선

오상균,김세훈,남지현 동의대학교 산업기술개발연구소 2005 産業技術硏究誌 Vol.19 No.-

Nowadays, it is a requirement to use high strength concrete for skyscrapers. Therefore safety research for high strength concrete is necessary. A fire outbreak in a reinforcement concrete structure looses the organism by the different contraction and expansion of hardened cement pastes and aggregate, and causes crack by thermal stress, leading to the deterioration of the durability. In this study, normal and high strength mortar were exposed to a high temperature environment. And than fundamental data for the character change of concrete heated highly were resented by measuring compressive strength of concrete with PP fiber and vinylon fiber, before and after heating. As the result, it is proven that adding PP fiber and vinylon fiber in high strength concrete for prevents deterioration of durability by fire.

Sol-Gel법으로 제조된 PZT Thin Film

오지현,권근희,김남철 공주대학교 생산기술연구소 2002 論文集 Vol.10 No.-

This paper presents ferroelectric Pb(Zr_0.52Ti_0.48)O_3 (PZT) thin film by sol-gel synthesis with metal-organic precursors. Sol-gel reaction sequences with metal-organic precursors were confirmed through DTA and FT-IR measurements and perovskite phase formation was investigated by rapid thermal annealing technique. The structural and morphological properties of PZT thin film were investigated by XRD and SEM. Perovskite phase PZT single phase was appeared at temperature of 650 ℃ and the second phase, pyrochlore, was decreased as increasing the annealing temperature, which was clearly indicated by investigating the size of 'rosette structure' and pyrochlore phases at different annealing temperatures. The P-E loop measurement indicated the relation of the applied voltage vs. domain alignments in the PZT thin film system.

갑상선 종양에서 thrombin receptor (PAR-1)의 발현 양상

박지영,목지오,김여주,박형규,김철희,변동원,서교일,유명희,조현득,오미혜,김상진 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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SH-SY5Y Human Neuroblastoma Cell에서 에스트로겐의 신경세포 보호효과에 대한 기전

염지현,김희,홍현석,방오영,허균,묵인희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.1

Apoptosis is one major mechanism underlying neuronal cell death in degenerative diseases in the central nervous system. Previous studies have shown that estrogen has neuroprotective effects in several neuronal cell death model systems. In the present study, we established a staurosporine-induced apoptotic neuronal cell death system with human SH-SY5Y cell line. 17b-estradiol(E2) blocked staurosporine-induced apoptosis of SH-SY5Y cells as revealed by MTT as well as LDH assay. The cells showed typical DNA fragmentation at 4 h and 8 h following staurosporine treatment, which was attenuated by E2 pretreatment. Staurosporine-induced chromatin condensation was also reduced by E2 treatment. Because apoptotic stimuli are known to induce caspase-3 activation and PARP cleavage, we examined whether E2 blocks these processes. E2 markedly attenuated staurosporine-induced casapase-3 activation and PARP cleavage. This study shows that E2 blocks staurosporine-induced apoptosis in SH-SY5Y human neuroblastoma cells, suggesting that E2 is a neuroprotective agent that may be used for the treatment of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.

혈액투석 환자에게서 발생한 재생불량성 빈혈 1예

정지용,윤나라,강대웅,오종찬,장재현,선길홍,박경희,정종훈,김현리 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.1

Aplastic anemia is a disease characterized by pancytopenia in the peripheral blood and hypocellular bone marrow with the fatty infiltration. The causes of the acquired aplastic anemia were usually related to drugs and immune-related diseases. A 34-years old man was admitted due to general weakness. He has been going hemodialysis for 2 years because of end stage renal disease (ESRD) due to chronic glomerulonephritis. At admission, laboratory tests showed hemoglobin 6.2 g/dL, hematocrit 18.0 %, WBC 5,710mm (neutrophil 71.8%, lymphocyte 19.1%, monocyte 5.9%), reticulocyte 1.9%, platelet 93,000/mm, Fe 12.8 ug/dL, TIBC 204 ug/dL, ferritin 941.47 ng /ml, haptoglobin 0.72 g/L, vitamin B12 508.17 pmol/L, folate 24 ng/mL, total protein 6.54 g/dL, albumin 3.76 g/dL, Alk. pohsphatase 79 IU/L, AST 30.0 IU/L, ALT 39.7 IU/L, total bilirubin 0.57 mg/dl, BUN 79.4 mg/dl and creatinine 10.18 mg/dl. Peripheral blood smear showed the normocytic normochromic anemia with anisocytosis. Anemia was diagnosed but it was irresponsive to the recombinant human erythropoietin (EPO) and blood transfusion. In the bone marrow aspiration smear were there the hypoplastic myeloid and erythroid precursors. The bone marrow biopsy section showed the hypoplasia of all components (10-20%) and the fatty infiltration. We have experienced one case of the idiopathic aplastic anemia in a patient going through hemodialysis and we just report it with documentary records. 저자들은 혈액 투석 중인 환자에서 약물, 면역계 이상등의 원인을 발견할 수 없었음에도 재생 불량성 빈혈이 발생한 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다.

국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

各種 喀痰消化劑가 抗酸菌死滅에 미치는 影響

權智順,權五溶,崔大卿,白太鉉 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.1

For the isolation of mycobacteria in sputum specimens, it is essential to use the most gentle procedure of digestion system for the survival of organisms. The present studies were undertaken to evaluate and compare the effect of various sputum digestants on the death of Mycobacterium fortuitum and Mycobacterium tuberculosis. The results were summarized as follows: 1. Death rates of M. tuberculosis in a solution of 2% NaOH, 3% NaOH and 4% NaOH digestants after 30 minutes of contact time were 97.1%, 97.6% and 97.9%, respectively. In the digestants of 2% NaOH, 3% NaOH and 4% NaOH solution after 1 hour of contact time, survival rates were less than 2%. 2. Death rates of M. tuberculosis in Zephiran-N-acetyl-L-cysteine digestant after 30 and 60 minutes of contact time were 28.5% and 39.5%, while those of M. fortuitum after the contact time were 74.1% and 81.2%, respectively. 3. Death rates of M. tuberculosis in Zephiran-trisodium phosphate digestant after 30 and 60 minutes of contact time were 36.1% and 40.3%, and those of M. fortuitum after the contact time were 71.6% and 74.2%, respectively. 4. Death rates of M. tuberculosis and M. fortuitum in N-acetyl-L-cysteine-NaOH (2%) digestant were similar to the digestant of 2% NaOH solution.

송도 웰빙센터 건립사업 타당성 조사

윤철현,오세경,강지은 東亞大學校 建設技術硏究所 2008 硏究論文集 Vol.32 No.1

본 과업의 대상지는 송도 초등학교 내에 위치한 관사부지이다. 이곳을 서구청에서 확보한 예산으로써 서구 주민의 복지를 위한 문화체육시설로 개발할 경우, 그 사업의 타당성 여부를 진단하고 분석하는데 과업의 목적을 두었다. 본 과업은 문화체육센터에 대한 주민의식 및 선호도 파악에 우선 관심을 두었고 서구청 공무원을 조사대상으로 한정하였다. 그 까닭은 공무원 집단은 지역사회 전반에 걸쳐 문제의식이 강하고 가치판단기준이 일반 주민들보다 명확하며 도시 내 주요시설에 대한 식견이 비교적 넓기 때문이다. 본 조사에서 나타난 특징은 첫째, 응답자의 약 85%가 문화체육센터의 수적 부족을 인식한 점이고, 둘째, 45%만이 송도초등학교 내 웰빙센터의 건립에 찬성한 점이다. 반대의 대부분은 일반 주민을 위한 시설이 교육기관과 쉽게 양립 할 수 없다는 것이다. 서구의 인구가 감소한다는 것은 특정시설의 시장여건이 불리해진다는 뜻이다. 이 같은 현실 하에 웰빙센터의 경제적 타당성의 진단에서 나타난 분석결과는 B/C가 1보다 낮고(0.866), 내부수익률 역시 (-)값으로 나타난 점이다. 따라서 송도 웰빙센터 건립사업의 경제적 타당성은 매우 취약하다고 판단된다. 또한 교육청 및 학교당국은 학생중심의 시설건립과 시설 건립 후 교육기관에 기부채납을 요구하고 있으므로 이점이 사업의 결정적인 제약이 되고 있다. 공무원 의식조사에서 나타난 바를 참고할 때 웰빙센터와 같은 문화체육시설은 학교 내가 아닌 인접한 다른 장소에서 적극적으로 건립하는 방안을 모색해 볼 필요가 있다.

폐렴 구균(Streptococcus pneumoniae)에 의한 척수 경막외 농양 1예

이지영,위유미,손경목,기현균,문치숙,오원섭,백경란,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

폐렴구균은 보통 폐렴이나 뇌막염을 일으키는 균으로 척수 경막외 농양을 일으키는 경우는 매우 드물다. 본 저자들은 폐렴 구균에 의한 척수 경막 외 농양을 경험하여 보고하는 바이다. 과거 건강했던 36세 남자 환자로 사다리에서 낙상한 후 요통 및 고열, 신경학적 이상으로 내원하여 자기 공명 촬영 결과 척수 경막 외 농양으로 진단받고 항균제 투여와 함께 응급 수술을 시행하였다. 농 배양 결과 페니실린 감수성인 폐렴 구균이 분리 되었고, 수술 요법과 항생제 투여 후 농양은 치유되었으나 신경학적 이상은 호전 없는 상태로 타원으로 전원되었다. Pneumonia and meningitis are the most frequent manifestations of pneumococcal infections. Pneumococcal spinal epidural abscesses have been rarely reported. Spinal epidural abscess by Streptococcus pneumoniae has been diagnosed among the patients with diabetes mellitus, alcoholism, corticosteroid therapy, intravenous drug use, chronic renal failure, AIDS, and history of spinal surgery. Recently, we experienced a case of pneumococcal spinal epidural abscess after spinal trauma. A 36-year-old male patient was admitted with back pain, fever, and paraplegia which occurred 5 days after the trauma. Spine MRI revealed spinal epidural abscess at the level from T2 to T9. He was treated with antimicrobial agents and surgical exploration for spinal epidural abscess. Pus culture grew S. pneumoniae which was susceptible to penicillin. Despite early surgical treatment, neurologic sequelae remained. Considering the high mortality and morbidity of pneumococcal spinal epidural abscess, early diagnosis and aggressive treatment including surgical intervention and antibiotics therapy should be implemented immediately.