내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

Optogenetic control of body movements via flexible vertical light-emitting diodes on brain surface

Lee, Seung Hyun,Kim, Jeongjin,Shin, Jung Ho,Lee, Han Eol,Kang, Il-Suk,Gwak, Kiuk,Kim, Dae-Shik,Kim, Daesoo,Lee, Keon Jae Elsevier 2018 Nano energy Vol.44 No.-

<P><B>Abstract</B></P> <P>The microstimulation of specific neural populations of the brain is one of the facile and reliable methods used in neuroscience for deduction of functional movement, complex behavior and even long-range connectivity. Recent advanced biomedical tools now employ flexible optoelectronic devices combined with optogenetic mouse models to induce high spatiotemporal modulation of specific brain activity. However, most current applications are limited to activation of small functional regions using blue-light driven channelrhodopsin. In this report, we introduce flexible AlGaInP vertical light-emitting diodes (VLEDs) for perturbation of specific functional areas of mouse cortex. Micro-scaled LEDs effectively compress the conductive balls dispersed in anisotropic conductive film (ACF) resulting red light emissions with high optical power density, capable of stimulating motor neurons deep below layer III from the brain surface. Selective operation of pulsed red light from f-VLEDs induces mouse body movements and synchronized electromyogram (EMG) signals. The expression of chrimson, red-shifted channelrhodopsin, enables red-light excitation of targeted functional area of motor cortex. This demonstration opens new opportunities for entire cortical mapping, to explore the connectivity between undefined motor areas in the mouse brain.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The flexible vertical light-emitting diodes (f-VLEDs) were fabricated by an anisotropic conductive film (ACF). </LI> <LI> The f-VLEDs showed the optical power density more than 25mW/mm<SUP>2</SUP>, enough to stimulate the motor neurons below layer III. </LI> <LI> The f-VLEDs illuminated the frontal motor cortex of the mouse to control the body movements with minimal tissue damage. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

培養 脊髓 運動神經細胞에서 메틸수은에 對한 Vitamin E의 影響에 關한 硏究

李建穆,趙廷九,金仁淑,朴承澤,洪起年,螢根寧,李廷憲,徐銀俄,石勝瀚,趙光皓,崔珉圭,李昊燮,田炳薰,禹元洪,李康昌 대한동의병리학회 2000 동의생리병리학회지 Vol.14 No.1

메틸수은의 신경독성을 조사하기 의하여 생쥐의 배양 척수 운동신경세포를 여러 농도의 메틸수은에서 24시간 동안 배양한 후 MTT 분석법과 신경세사효소면역분석법으로 세독성을 분석하였으며, 또한 메틸수은에 신경세포에 대한 항산화제인 vitamin E의 방어효과를 조사하였다. 메틸수은은 처리한 농도와 시간에 비례하여 척수 운동세포의 생존율을 현저히 감소시켰다. 항산화제의 방어효과에 있어서는 vitamin E가 메틸수은에 의해서 유도된 신경독성을 방어하였다. 위의 결과로부터 메틸수은은 생쥐의 배양 척수 운동신경세포에 신경독성을 나타냈으며 vitamin E와 같은 선택적인 항산화제가 메틸수은의 독성을 방어하는데 매우 효과적이다. In order to evaluate the neurotoxic effect of methylmercuric chloride(MMC) on cultured mouse spinal motor neurons. cytotoxic effect was measured by MTT assay and neurofilament enzymeimmunoassay(EIA) after cultured mouse spinal motor neurons were incubated with various concentrations of MMC for 24 hours. The neuroprotective effect of antioxidant, vitamin E against MMC-mediated nurotoxicity was also examined in these cultures. MMC decreased cell viability of cultured mouse spinal motor neurons remarkably in a dose-and time-dependent manners. In protective effect of antioxidant, vitamin E was remarkably effective in blocking the neurotoxicity induced by MMC in MTT assay and neurofilament enzymeimmunoassay. From these results, it is regarded that MMC induce neurotoxicity, and the selective antioxidant such as vitamin E is very effective in blocking MMC-mediated neurotoxicity on cultured mouse spinal motor neurons

Prophylactic Perihepatic Lymphadenectomy in Patients with Colorectal Cancer with Liver Metastasis

Won-Suk Lee,Jung Nam Lee,Keon Kuk Kim,Jeong-Heum Baek 대한종양외과학회 2014 대한임상종양학회 학술대회지 Vol.2014 No.3

통합적 교육프로그램이 진단 직후 유방암 환자의 지식, 자기효능감 및 대응방식에 미치는 효과

이건숙(Lee Keon Suk),이란(Lee Ran),김동미(Kim Dong Mi),김수현(Kim Soo Hyun) 대한종양간호학회 2012 Asian Oncology Nursing Vol.12 No.1

Purpose: The purpose of the study was to identify the effect of a comprehensive education program on knowledge, self-efficacy for self-management, and coping style among newly diagnosed patients with breast cancer. Methods: This study used a one group pretest-posttest design. Data were collected from April to September, 2010 at a cancer-specific hospital in Goyang, Korea. One hundred forty three women received a comprehensive education program consisting of 3 sessions composed of 8 themes was conducted by several experts (nurses, doctors, dietitians and clinical psychologists) for 3.5 hours a day for 3 days (1 day before and 2 days after the operation). Results: This study showed that knowledge and self-efficacy for self-management significantly increased after education (p<.001). In terms of coping style, however, only the subscale, 'anxious preoccupation', significantly improved (p=.001) among 5 sub-scales of coping style after education. Conclusion: A comprehensive education program for newly diagnosed patients with breast cancer was effective for increasing the knowledge and self-efficacy for self-management of breast cancer, in addition to decreasing the coping style of 'anxious preoccupation'. However, it did not improve other coping style. Therefore, other strategies for improving coping style are needed.

환자교육을 위한 유방암 환자의 지식측정 도구개발

이건숙(Lee Keon-Suk),이란(Lee Ran),김수현(Kim Soo-Hyun) 대한종양간호학회 2010 Asian Oncology Nursing Vol.10 No.1

Purpose: The purpose of this study was the development and validation of knowledge scale for patients with breast cancer (KS-Br) in Korea. Methods: The process included the construction of a conceptual framework, generation of preliminary items, and the test of validity and reliability of the scale. Thirty-seven items were developed through an evaluation process by 10 experts and 24 items were finally confirmed through item analysis. Psychometric testing was performed with a convenient sample of 303 women with breast cancer. The data was analyzed using independent t-test, Pearson’s correlation, and calculation of KR-20. Results: Participants averaged 70.8% correct on the test. The KS-Br has 24 items consisting of 5 categories: incidence of breast cancer, diagnosis and treatment, symptom management, sexuality, and maintenance of daily life. Validity was supported by the use of content validity, known-group technique, and criterion-related validity. Women who had undergone education intervention scored significantly higher than women who had not (p<.001). KS-Br scores were significantly correlated with those of Mishel’s Illness Uncertainty Scale (r=-.214, p<.001). Internal consistency of the KS-Br was appropriate (KR20=.805). Conclusion: This study reveals that the KS-Br is reliable and valid scale to measure the knowledge of breast cancer. Therefore, this scale can be effectively utilized to assess the knowledge of patients with breast cancer regarding their disease.

쯔쯔가무시병에 동반된 간질성 폐렴에 관한 연구

이현숙(Hyeon Suk Lee),김대수(Dae Soo Kim),진영주(Young Joo Chin),김성진(Seong Jin Kim),송형근(Hyeong Keon Song),성노현(No Hyeon Seong),이상도(Sang Do Lee),김명수(Myeong Su Kim) 대한내과학회 1996 대한내과학회지 Vol.50 No.1

N/A Objectives: Interstitial penumonia is a major cause of death in scrub typhus but little is known about its pathology and pathogenesis. To study the clinical findings, pathology and pathogenesis of interstitial pneumonia in scrub typhus, we performed this study. Methods: We performed clinical evaluation, laboratory tests, radiological evaluation including high resolution CT and pulmonary function tests in 53 scrub typhus patients. Bronchoalveolar lavage(BAL) and transbronchial lung biopsy(TBLB) were done in patients with interstitial pneumonia and electron microscopic examination and immunofluorescence study including monoclonal antibody against Rickettsia tsutsugamushi were done. Results: 1) Interstitial pneumonia was found in 13(26%) patients. 2) Radiological findings: High-resolution CT showed diffuse ground glass opacity, thickening of bronchovascular bundie and prominent central core of secondary pulmonary lobule with minimal thickening of interlobular septum and there were no findings suggesting vasculitis 3) Cells in HAL fluid: total cell count, (46±9)×104/ml, alveolar macrophage, 68±17%, lymphocyte, 28±15% and neutrophil, 5±3% Pathologic finding(TBLH): 4) Light microscope: interstitial edema with mononuclear cell infiltration, mainly lymphocyte, without any evidence of vasculitis or perivasculitis 5) Immunofluorescence and eletron microscope ' IF study, using anti-Ig G,A,M, anti-Cg, anti-fibrinogen and anti-rickettsial Ab, revealed negative reaction. Electron photomicrograph revealed no rickettsial organism. Conclusion: In interstital pneumonia associated with scrub typhus we noted lymphocytosis in BAL fluid and interstitial inflammation in histopathology without any evidence of vasculitis. Thus vasculitis is not the only main pathology but other mechanism including immunopathogenesis may operate in the pathogenesis of intersititial pneumonia in scrub typhus

S-589 Comparison of of three-weekly versus weekly cisplatin in concurrent chemoradiation for LA-HNSCC

( So Yeon Lee ),( Yoon Seok Choi ),( Bhum-suk Keam ),( Keon-uk Park ),( Ki-hyeong Lee ),( Ihn-seong Jo ),( Eun-kee Song ),( Sang-gon Park ),( Ik-chan Song ),( Hyo Jin Lee ),( Deog Yeon Jo ),( Samyong 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Introduction: Standard treatment for locally advanced (stage III-IV) head and neck squamous cell cancer (LA-HNSCC) is concurrent chemoradiation therapy (CCRT) with cisplatin 100mg/m2 every three weeks. For medically unfit patients susceptible to treatment-related adverse events, low-dose weekly cisplatin can be used as an alternative. In previous studies, weekly cisplatin-based regimen showed fair efficacy and tolerable toxicity profiles. In this study, we retrospectively compared the therapeutic outcomes of low-dose weekly cisplatin regimen and standard regimen in CCRT for LA-HNSCC.?Methods: The medical records of histologically confirmed LA-HNSCC patients were retrospectively reviewed from Jan 1, 2007 to Dec 31, 2012. 224 patients who were treated with CCRT as initial treatment were enrolled. Among them, 155 patients were treated with low-dose (30 mg/m2) weekly cisplatin and 69 patients were treated with standard-dose (100 mg/m2) three-weekly. Dose intensity of cisplatin in each group was calculated as proportion of delivered dose in full regimen dosage.?Results: Baseline characteristics of both groups did not differ significantly, except that standard-dose group contained more larynx cancer patients. Although dose intensity of standard-dose cisplatin group (84%) were lower than low-dose weekly cisplatin group (91%), difference in median progression free survival (31.2 month vs 26.3 month; p=0.469) and overall survival (36.6 month vs 31.6 month; p=0.439) was not statistically significant between standard-dose group and low-dose group.?Conclusions: In the present study, low-dose weekly cisplatin was not inferior to standard-dose cisplatin in terms of survival outcomes. Prospective comparison of standard-dose three-weekly and low-dose weekly cisplatin is warranted.

A case of infective endocarditis in pregnancy complicated by cerebral infarction (초)

( Kang Hyu Lee ),( Min Ju Song ),( Sun Hwa Lee ),( Sang Rok Lee ),( Kyoung Suk Rhee ),( Jei Keon Chae ),( Won BHo Kim ),( Jae Ki Ko ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

Clinical profiles of patients with surgically resected pheochromocytoma and paraganglioma

Sun Hwa Lee,Jae-Hyeong Park,Ja-Yeon Lee,Sang-Rok Lee,Kyoung-Suk Rhee,Jei-Keon Chae,Won-Ho Kim,Ji-Young Sul,Jin Kyung Oh,Hee-Jin Kwon,Jae-Hwan Lee,In-Whan Seong 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.2

Background/Aims: Pheochromocytoma and paraganglioma (PPGL) are catecholamine- producing tumors that can cause blood pressure (BP) elevation and cardiovascular complications. Clinical presentation of these tumors may be changed through widespread use of imaging studies, which enables detection of PPGLs before onset of symptoms. We investigated clinical profiles of patients with surgically resected PPGLs. Methods: From 2005 to 2017, 111 consecutive patients with surgically resected PPGLs in two tertiary hospitals in Korea were studied. Results: Mean age was 52 ± 16 years, 57 patients (51.4%) were male and 54 (48.6%) were hypertensive. Twenty-nine PPGLs (26.1%) were extra-adrenal paragangliomas. Sixteen (14.4%) and seven patients (6.3%) (Group 1, n = 23) were diagnosed during work-up of hypertension and transient cardiomyopathy respectively, and the remainder (Group 2, n = 88) were incidentalomas detected during routine abdominal imaging. Patients in the Group 1 were younger and more frequently symptomatic, and had higher BPs, heart rates and levels of urinary catecholamines than those in the Group 2. Paragangliomas were less frequent and secretion of epinephrine and metanephrine was more predominant in the Group 1 than in Group 2. After the surgical resections, 18.2% of patients still needed antihypertensive medications. Conclusions: Out of 111 patients with surgically resected PPGLs, 88 (79.3%) were diagnosed as incidentalomas. Seven patients presented with transient cardiomyopathy and 16 with hypertension. Tumor location and secretion of catecholamine may vary depending on the presence of symptoms.