국내에서 분리된 Esherichia Coli 와 Klebsiella pneumoniae의 CTX-M형 Extended-Spectrum β-Lactamase 생성 현황

배일권,우건조,정석훈,박광옥,조병규,김둘만,권수봉,김현주,강현경 대한임상미샐물학회 2004 Annals of clinical microbiology Vol.7 No.1

심혈관계질환으로 사망한 성인형다낭신 3예 보고

양경무,권일훈,조갑래,서중석 大韓法醫學會 1999 대한법의학회지 Vol.23 No.1

Adult polycystic kidney disease is a genetic disease characterized by bilateral multiple renal cysts and is transmitted as an autosomal dominant traits. The disease usually manifests in the fourth decade of life. The affected patients usually die with end stage renal failure, cardiovascular assaults and infection etc. Cardiovascular assaults include ruptured berry aneurysm, spontaneous intracranial hemorrhage, acute myocardial infarction, dissecting aortic aneurysm and hypertensive heart failure. Fatal intracranial hemorrhage and hypertensive heart failure occur in 15% and 2% of patients, respectively. Genetically-dater-mined structural weakness in the arterial wall have been suggested as a possible factor in the genesis of berry aneurysm. We have experienced three autopsy cases with cardiovascular causes of sudden death. Two cases have intracranial hemorrahage (1 berry aneurysm and 1 intracerebral hemorrhage) and the remaining one is dead with hypertensive cardiomyopathy. All of them are aged over 40 years and associated with polycystic liver disease. Histologically, myriad cysts of enlarged bilateral kidney are lined by single layer of cuboidal cells with focal hyperplastic epithelial configuration. Diffusely scattered liver cysts are also lined by flat to cuboidal epithelium and often associated with portal fibrosis.

우심방과 우심실의 거대 심장 혈관종 1예

김제열,조상호,김건일,허경림,김현숙,조구영,최영진,이원용,임종윤 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Cardiac tumors, especially the primary tumors involving any part of the heart are extremely rare and its relative incidence has been reported to be approximately 0.02%. We report a patient with huge cardiac hemangioma who complained of shortness of breath, general weakness, and dizziness, Imaging study by echocardiography and computed tomography of thorax revealed a huge lobulating mass like a bunch of grapes in the right chamber of heart. The surgical exploration of thorax was performed and a histological diagnosis of spindle cell hemangioma was obtained by microscopy. The patient was treated by surgical resection of the tumor and doing well after surgery. Our experience indicated that prompt diagnosis and treatment of cardiac hemangioma is imperative for patients' prognosis.

응급실에 내원한 환자에서 어지럼증의 원인과 임상양상의 분석

문원식,정경운,위준선,문정미,전병조,김용권,소정일,류진호,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of elderly population and senile disease. The differentiation of dizzy patients is not familiar to most emergency physicians. This study was designed to differentiate true vertigo and to investigate the clinical difference among central vertigo, peripheral vertigo, and other causes of dizziness. Methods: The authors analyzed the cases of 237 dizzy patients who visited the emergency department of Chonnam University Hospital during the recent 2 years. For the base of dizziness, associated past illnesses, severity, nystagmus type, and the causes of central and peripheral vertigo. Results: Female patients were 142(59.9%) and male patients were 95(40.1%). The most common age group was the 6th decade. The origin of dizziness was classified as peripheral cause(25.3%), central cause(32.9%), and others(41.8%). As to nature of the dizziness, the rotatory sense was dominant in peripheral vertigo and the floating sense and blurred vision in central vertigo. Peripheral vertigo was triggered by position change of head and body, and central vertigo by the eye movement. Audiograms I showed that most patients with central vertigo had normal hearing, but 46.7% of thoswith peripheral vertigo had an abnormal hearing disturbance. Nystagmus was more prevalent in peripheral vertigo Conclusion: History taking and physical examination played an important role in the diagnosis of dizzy patients. An important part of the diagnosis of a dizzy patient could be to evaluate the peripheral origin, the central origin and others causes. Because central vertigo may be associated with a significant neurological pathology, spectral radiological studies, including MRI and CT, are mandatory to rule out a devastating brain lesion.

3차 병원의 병동에서 시행된 심폐소생술의 분석

류진호,정경운,위준선,문정미,전병조,문원식,김용권,소정일,허탁,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. Methods: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. Results: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. Conclusion: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.

사지 체벽 복합기형 1례

우종진,조석재,박소정,박재복,김용진,조경일,이헌수 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

Limb body wall complex(LBWC) has been included in the spectrum of defects seen in early amnion rupture sequence. LBWC is a complicated fetal malformation with essential features of exencephaly or encephaloceles associated with facial clefts, lateral body wall defects with evisceration of organs, and limb defects. Our case is characterized by the absence of craniofacial anomalies and normal development of urogenital system comparing with other repoerted cases. We present a case of LBWC with a brief review of the literatures.

The Anti -allergic Effects of Taraxaci Herba(蒲公英) on the RBL-2H3 Cells

조주흠,류지효,김철홍,강경화,윤화정,이승연,고우신,김원일,Jo, Ju-Heum,Lyu, Ji-Hyo,Kim, Cheol-Hong,Kang, Kyung-Hwa,Yoon, Hwa-Jung,Lee, Seung-Yeon,Ko, Woo-Shin,Kim, Won-Il The Society of Korean Medicine Ophthalmology 2007 한방안이비인후피부과학회지 Vol.20 No.1

청열해독(淸熱解毒) 작용을 하는 포공영의 항알러지 효과를 알아보기 위하여 RBL-2H3 cell line에 PMA와 A23187을 자극한 후 RBL-2H3 cell내 과립의 degranulation의 억제정도를 살펴보기 위하여 ${\beta}-Hexosaminidase$의 누출량의 억제 정도를 살펴본 결과 포공영은 농도 의존적으로 현저하게 degranulation을 억제하였다. 알러지 반응 시 세포내에서 분비되어 중요한 작용을 하는 것으로 알려진 사이토카인인 $TNF-{\alpha}$, IL-4의 합성조절 정+도를 살펴본 결과, $TNF-{\alpha}$, IL-4의 mRNA 수준에서의 발현의 조절을 통한 합성도 억제하였다. 이 결과로 보아 포공영은 알레르기와 관련된 질환에 치료약물로서 응용이 가능할 것으로 사료된다.

심실중격결손증-치험 1예-

조광현,우종수,황윤호,이양행,박철호,김종성,김철호,이경순,조영일,박태인 인제대학교 1985 仁濟醫學 Vol.6 No.4

A successful treatment of infants and children with congenital heart defects depends upon several factors: diagnosis must be accurate, the operative technique, including techniques of perfusion and myocardial preservation, must be suited to the needs of patients and intensive cares, including accurate anesthesia, must be applied through all stages of investigation and treatment, i.e. before, during and after the operation. Recently we performed a open heart surgery successfully for a six-years old girl who had suffered from frequent upper respiratory tract infection and mild to moderate exertional dyspnea with congenital heart defects (ventricular septal defect, Kirklin type II, with patent foramen ovale). The operation and postoperative course were very smooth. And now we report this with review of literatures.

Leptomeningeal seeding in patients with brain metastases treated by gamma knife radiosurgery.

Jo, Kyung-Il,Lim, Do-Hoon,Kim, Sung-Tae,Im, Yong-Seok,Kong, Doo Sik,Seol, Ho Jun,Nam, Do-Hyun,Lee, Jung-Il M. Nijhoff ; Kluwer Academic Publishers 2012 Journal of neuro-oncology Vol.109 No.2

<P>To characterize the development of leptomeningeal seeding (LMS) in patients with brain metastases after gamma knife radiosurgery (GKRS). Eight hundred and twenty-seven patients that underwent GKRS as a part of an initial treatment plan for brain metastases between January 2002 and December 2010 were included in the study. Six hundred and fifty patients were treated with GKRS alone and 177 patients received GKRS combined with upfront whole brain radiation therapy (WBRT). Actuarial curves for overall survival (OS) and the development of LMS were plotted using the Kaplan-Meier method. Median overall survival for all patients was 55 weeks (95 % CI, 47.8-62.2), and the overall incidence of LMS was 5.3 %. The actuarial rates for LMS at 6 and 12 months were 3.1 and 5.8, respectively. Uni- and multivariate analysis suggested that breast cancer and a large number of metastases (n 4) are significant risk factors of LMS (P < 0.05). Regarding treatment modalities, the addition of WBRT was found to have a significant impact on lowering the risk of LMS by multivariate analysis (P = 0.045). LMS is an important pattern of CNS failure. The risk of LMS following GKRS may be associated with multiple lesions, breast cancer, and the omission of WBRT. Additional data from large-scale, randomized controlled trials are required to identify risk factors associated with the LMS more accurately.</P>

Gamma Knife Radiosurgery for Brain Metastases from Breast Cancer

Jo, Kyung Il,Im, Young-Hyuck,Kong, Doo Sik,Seol, Ho Jun,Nam, Do-Hyun,Lee, Jung-Il The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.5

Objective : The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods : Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan- Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results : Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) ${\geq}70$ (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were $89.5{\pm}4.5%$ and $70.5{\pm}6.9%$ at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (${\leq}3$) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion : The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery.