췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

Clostridium difficile 장염에 의한 속발성 유전분증에서 발현된 독성 장염

조형원,정혜경,강현주,이윤표,강혜원,심기남,정성애 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

Amyloidosis is characterized by extracellular deposition of protein fibrils in one or multiple organs. AA amyloidosis is secondarily occurred to be related with chronic infections or inflammatory diseases. We report a 67-year-old man suffered from secondary AA amyloidosis related with chronic Clostridium difficile colitis after repeated total hip replacement surgery. Infection control is the most important treatment of AA amyloidosis secondary to chronic infection. However, the patient’s C. difficile colitis was not controlled well, eventually toxic megacolon with sepsis was developed. Consequently, he had to take total colectomy, but he expired with multi-organ failures. We suggested that early surgical procedure might be one option for intractable C. difficile colitis complicated with secondary amyloidosis.

신촌 연세로 대중교통전용지구는 어떻게 성공적으로 도입되었는가?

김혜원(Kim, Hye Won),이정욱(Lee, Jung Wook) 한국지방정부학회 2018 지방정부연구 Vol.21 No.4

대중교통전용지구는 교통수요관리와 상권 활성화를 통해 도시의 지속가능성을 제고할 수 있으나 승용차 통행을 제한해 사업을 추진하려는 정부당국과 지역주민 간 갈등이 첨예하여 시행이 어려운 사업이다. 그러나 신촌 연세로 대중 교통전용지구의 경우 사업추진과정과 효과 모두 성공적이라고 평가된다. 그렇다면 연세로 대중교통전용지구의 성공적 도입은 어떻게 설명할 수 있는가? 이와 관련하여 본 연구는 Kingdon(2011)의 다중흐름모형과 Moore(1995)의 정치적 관리를 결합한 분석틀을 활용하였다. 다중흐름모형은 정책이 채택되는 환경적 맥락을, 정치적 관리 전략은 이러한 맥락 속에서 정책을 성공적으로 추진하기 위한 구체적인 실천전략을 제시한다. 분석 결과 연세로의 교통정체와 상권 침체를 해결하기 위해 ‘차 없는 거리’ 등의 대안이 존재했으나 박원순 서울시장이 당선되면서 정책의 창이 열리 고대중교통전용지구라는 정책대안에 대한 논의가 본격화되었다. 서대문구는 개방적 의사결정, 논리적인 협상, 공적 숙의, 공공부문 마케팅 등의 정치적 관리 전략을 통해 지역상인과 유관기관으로부터 정책에 대한 정당성과 지지를 확보하였다. 본 연구는 갈등적인 지역사업을 성공적으로 추진하기 위한 관리적 함의를 제공한다. Transit malls are a means to ensure the sustainability and revitalization of local commercial districts by allowing only public transport and pedestrians to use the roads. Efforts by localities to introduce a transit mall often meet with intense opposition from conflicting interests, which makes it very challenging to put this policy idea successfully into action. The case of Sinchon Yonsei Road, however, is considered an exception: the process in which it was officially designated as a transit mall, as well as the positive outcomes such a decision brought about, makes the case clearly distinguished from other similar attempts. What explains the successful introduction of the Yonsei Road transit mall? To answer this question, the present study took an analytical approach that integrated Kingdon’s(2011) multiple streams framework and Moore’s(1995) political management perspective: the former is instrumental in understanding the context in which policies come to be adopted, while the latter allows assessing the effectiveness of the strategies policy entrepreneurs employ in that process. The analysis shows that the election of Park Won-sun as the Mayor of Seoul opened up the policy window where the idea of converting Yonsei Road into a transit mall began to gain serious attention as a viable policy alternative; it also reveals that Seodaemun-gu - the policy entrepreneur in this case - effectively engaged in a series of policy management strategies, which collectively helped to reach a consensus in a relatively short time span. This successful policy adoption case provides managerial implications for local initiatives that involve a complex array of conflicting interests.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계

강혜영,강대룡,장영화,박성은,최원정,문성환,양규현,Kang, Hye-Young,Kang, Dae-Ryong,Jang, Young-Hwa,Park, Sung-Eun,Choi, Won-Jung,Moon, Seong-Hwan,Yang, Kyu-Hyun 대한예방의학회 2008 예방의학회지 Vol.41 No.5

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

Insulin resistance mediates high-fat diet-induced pulmonary fibrosis and airway hyperresponsiveness through the TGF-β1 pathway

Park, Yoon Hee,Oh, Eun Yi,Han, Heejae,Yang, Misuk,Park, Hye Jung,Park, Kyung Hee,Lee, Jae-Hyun,Park, Jung-Won Nature Publishing Group UK 2019 Experimental and molecular medicine Vol.51 No.5

<▼1><P>Prior studies have reported the presence of lung fibrosis and enhanced airway hyperresponsiveness (AHR) in mice with high-fat-diet (HFD)-induced obesity. This study evaluated the role of TGF-β1 in HFD-induced AHR and lung fibrosis in a murine model. We generated HFD-induced obesity mice and performed glucose and insulin tolerance tests. HFD mice with or without ovalbumin sensitization and challenge were also treated with an anti-TGF-β1 neutralizing antibody. AHR to methacholine, inflammatory cells in the bronchoalveolar lavage fluid (BALF), and histological features were evaluated. Insulin was intranasally administered to normal diet (ND) mice, and in vitro insulin stimulation of BEAS-2b cells was performed. HFD-induced obesity mice had increased insulin resistance, enhanced AHR, peribronchial and perivascular fibrosis, and increased numbers of macrophages in the BALF. However, they did not have meaningful eosinophilic or neutrophilic inflammation in the lungs compared with ND mice. The HFD enhanced TGF-β1 expression in the bronchial epithelium, but we found no differences in the expression of interleukin (IL)−4 or IL-5 in lung homogenates. Administration of the anti-TGF-β1 antibody attenuated HFD-induced AHR and lung fibrosis. It also attenuated goblet cell hyperplasia, but did not affect the AHR and inflammatory cell infiltration induced by OVA challenge. The intranasal administration of insulin enhanced TGF-β1 expression in the bronchial epithelium and lung fibrosis. Stimulating BEAS-2b cells with insulin also increased TGF-β1 production by 24 h. We concluded that HFD-induced obesity-associated insulin resistance enhances TGF-β1 expression in the bronchial epithelium, which may play an important role in the development of lung fibrosis and AHR in obesity.</P></▼1><▼2><P><B>Obesity: A trigger for asthma onset</B></P><P>Insulin resistance may be an important causative factor underlying the increased risk of asthma and other respiratory issues in obese individuals. Obesity doubles the likelihood of developing asthma, with symptoms that are more difficult to control than in non-obese patients. The connection between these conditions is poorly understood, but researchers led by Jung-Won Park, Yonsei University College of Medicine, Seoul, South Korea, have identified a potential mechanism. They demonstrated that a signaling molecule called TGF-β1 contributes to airway sensitivity and tissue scarring in a mouse model of diet-induced obesity. Subsequent experiments showed that treatment with insulin also gives rise to increased TGF-β1 production in the mouse lung. Since insulin resistance is a common feature of obesity, resulting in abnormally high levels of circulating insulin, this could also account for the increased risk of respiratory problems.</P></▼2>

여성주의 관점에서 본 Medea

정혜원 서울여자대학교 여성연구소 2002 여성연구논총 Vol.17 No.-

Medea is a woman who was betrayed by her husband. For him she abandoned all her past relationships by killing her own brother and deceiving her father. Here again she is criticized for killing her own children. However, many critics comment that is a real figure of a wife who is deserted by an unfaithful husband. She gives her reason for killing her children: it is because they will be killed by her enemies if she leaves her children. Although she seems cruel and harsh, her passion tn the very situation is truth and reality. This is an admirable characterization and Medea is a great creation of Euripides. 《Media》 accounts for the resistance of the women and the foreigners who were the weaker sides in Greek.

갑상선기능저하증 이환견에 대한 치료 증례

김혜원,이선희,임수정,박형진,김태신,송은식,송근호 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2009 動物醫科學硏究誌 Vol.16 No.1

A 10-year-old, male, poodle dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University because of continuous cough and cardiomegaly. Weight gain, lethargy, unwillingness to exercise and decreased activity was revealed on history. Obesty and alopecia was also observed on physical examination. Hypercholesterolemia and increased ALP was revealed on blood exam. So, evaluation of thyroid gland function was performed and cTSH concentration was increased. tT4 and fT4 concentrations was decreased. Results of a history, physical examination, blood exam, and thyroid gland fuction test support a diagnosis of hypothyroidism. Initial therapy with sodium levothyroxine was indicated. On 32 days after treatment of hypothyroidism, clinical signs was relieved and cTSH concentration was decreased, tT4 and fT4 concenctrations was increased.

대형 사무소건물의 열원설비 교체를 위한 최적 냉난방 시스템 제안 연구

정연욱,이은혜,홍원화 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1

The old equipments can be a factor of increase in the cost of fuel and electric power, and a loss of energy. So, We have to improve technical problems to save energy and build an efficient system. Therefore, in this study, a process of maintaining and repairing old equipments in big office buildings, we surveyed the plans of diagnosis on the main equipments and the measures against malfunction, and suggested some solutions when considered, altering the equipments of heat sources. In addition to analyze the advantages and disadvantages of those systems, and compare initial investment and annual operational costs according to classification of heat sources, we will provide evaluation data for selecting the most efficient and economic system.