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.

순수수학과 응용수학의 본질에 관한 소고

이건창 東新大學校 工業技術硏究所 2001 工業技術硏究 Vol.7 No.-

The aim of this paper is to outline a philosophy of pure and applied mathematics up to the point at which its main theses can be clearly grasped and compared with other philosophical positions.

치성감염에 의해 발생된 후측인두부 및 종격동 농양

이승호,정종철,김건중,정주성,유선열,박문성,김창룡 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

Odontogenic infections are usually locally confined, self-limiting processes. However, under certain circumstances, they may break through the bony, muscular, and mucosal barriers and spread into contiguous fascial spaces or planes far from the initial site of involvement, resulting in severn life-threatening complications, such as retropharyngeal spread, suppurative mediastinal extension, airway obstruction, pleuropulmonary suppuration, and hematogenous dissemination to distant organs. The mortality arte for mediastinitis from odontogenic infection ranges from 40% to 60%. Therefore rapid evalution and treatment is essential with a combination of life support, antibiotic therapy, and surgical intervention. Recently, we experienced three cases of retropharyngeal and mediastinal abscesses secondary to odonogenic infections. In all patients, early diagnosis was possible by CT scanning and physical examination. The prognosis was good in all patients by using urgent aggressive surgical and antibiotic therapy.

뇌 동맥류 수술을 위한 Isoflurane 마취시 Sodium Nitroprusside 가 혈소판 응집기능에 미치는 영향

김건식,이희주,손창호,강화자,최영규,신광일 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.2

Background: The intravenous infusion of sodium nitroprusside is widely used as a means of producing deliberate hypotension in a variety of clinical situations. However, sodium nitroprusside reported to inhibit platelet aggregation. So we studied the effects of sodium nitroprusside on platelet function in patients undergoing intracranial aneurysm surgery with isoflurane anesthesia. Methods: Platelet rich plasma from the patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated from the samples collected at pre-sodium nitroprusside infusion, 30min and 90min after sodium nitroprusside infusion, respectively. At the same time, bleeding time was measured. Results: The mean maximum aggregation rate of adenosine diphosphate, epinephrine and collagen at pre-sodium nitroprusside infusion decreased significantly 30min and 90min after sodium nitroprusside infusion, respectively(P$lt;0.05). But the maximum aggregation time showed no significant change. Prolongation of bleeding time was not observed after sodium nitroprusside infusion. Correlation between the total sodium nitroprusside dose delivered and the maximum aggregation rate of adenosine diphosphate, epinephrine and collagen were significant (r=0.797(P$lt;0.05), r=0.732(P$lt;0.05) and r 0.737(P$lt;0.05)). Conclusions: In situation where sodium nitroprusside is administered for deliberate hypotensive anesthesia during intracranial aneurysm operation, the platelet aggregation was inhibited by sodium nitroprusside. However, bleeding time was not prolonged.

구강 편평세포암종에서 E-cadherin 및 β-catenin 발현의 변화 : Correlation with Histologic Features and p53 Expression

서진건,권창석,박진배,윤혜경,김우형,이희철 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Altered expression of cell adheion molecules is associated with biologic behavior of tumor. The aim of this study is to evaluate the expression pattern of E-cadherin, β-catenin and p53 protein according to histologic grade and invasion pattern of squamous cell carcinoma of the oral cavity and the relationship between E-cadherin, β-catenin and p53 protein expression. Methods and Material : The materials were fifty seven cses of squamous cell carcinoma, and clinicl parameers such as age, sex, tumor location, stage and recurrence were recorded. Histologic review was done based on histologic grade and invasion pattern(nodular vs infiltrative). Immunohistochemical stains for E-cadherin and β-ca tenin were interpreted based on staining pattern as los of membranous expression and cytoplasmic expression and p53 protein expression was defined as positive if more than 10% of nuclei were reactive. Statistical analysis between E-cadherin, β-catenin and p53 protein expressions and histologic grade and invasion pattern and the relationship between E-cdherin, β-catenin and p53 protein expressions were perfomed. Results : There wa positive correlation between higher histologic grade and infiltrative pattern. Loss of membranous expression and cytoplasmic expression of E-cadherin were noted in 33.3% and 57.9%, respectively, and loss of membranous expression of E-cadherin showed increaing tendency in poorly differentiated carcinomas, however, there was no significant difference of cytoplasmic expression rate of E-cadherin according to histoogic grade. Altered expression of E-cadherin was more frequent in poorly differentiated carcinomas. Loss of membranous expression and cytoplasmic expression of E-cadherin were more frequent in carinomas with infiltrative pattern than in carcinomas with nodular pattern, but their diferences were not significant, Loss of membranous expression and cytoplasmic expression of β-catenin were observed in 19.3% and 80.7%, respectively. Loss of membranous expression of β-catenin howed no positive correlation according to histologic grade and invasion pattern, but cytoplasmic expression rate of β-catenin was higher in poorly differentiated carcinomas and in carcinomas with infiltrative pettern. p53 protein expression rate was 45.6%, and showed invreasing tendency in poorly differentiated carcinomas, but no significant relationship with invasion pattern. There was an inverse relationship of loss of membranous expression and cytoplasmic expression of E-cadherin and β-catenin. Altered expression of E-cadherin was related to cytoplasmic expression of β-catenin, however, there were no significant relationship between altered expressions of E-cadherin and β-catenin and p53 protein expression. Conclusion : In squamous cell carcinomas of the oral cavity, altered expression of E-cadherin and β-catenin was more frequent in poorly differentiated carcinomas and in carcinomas with infiltrative pattern and there was positive correlation betwween altered expression of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cadherin and β-catenin may have a role in the development of squamous cell carcinomas with aggressive biologic behavior. but altered explosions of E-cadherin and β-catenin. These findings suggest that altered expressions of E-cdherin and β-catenin my have a role in the development of squmaous cell carcinomas with aggressive biologic behavior. But altered expression of E-cadherin and β-catenin might not be related to p53 protein expression. Further study on genetic mutation related to altered expression of E-cadherin and β-catenin will be needed

내분비기관으로서의 심방의 형태학적 특징에 관한 연구 - Ⅱ. 흰쥐의 심방 내강 및 내표면 구조

이무삼,두홍서,고병문,강경진,정우송,박병건,이창현 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.2

HLA-DR2 陽性 反應을 보인 嗜眠病 1례

반건호,이기철,장환일 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.5

The authors experienced a 28 year old male narcoleptic patient who revealed narcoleptic tetrad ; sleep attack, cataplexy, sleep paralysis, and hypnagogic hallucination lasted for about 3 years. The patient has a history of poliomyelitis in early childhood and has sustained head trauma just before the onset of narcolepsy. And also HLA-DR2, DQwl, and DR4 positive reaction was confirmed with the method of microcytotoxicity using Terasaki HLA-ABC and HLA-DR tissure typing trays. Sleep attack was somewhat controlled with methylphenidate and cataplexy with imipramine, and other symptoms were also improved followed by the improvement of sleep attack and cataplexy. With this case report, aspect of biologic etiologies of narcolepsy were reviewed.

신경세포이주장애질환을 가진 간질환자에 대한 수술 체험

황승균,정천기,오창완,이상건,지제근,김현집,한대희,이상복 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.3

Neuronal migration disorders(NMD's) are a rare group of development structural lesions characterized by disorganization of cortical architecture with aberrant columnar and laminar neuronal arrangement, often causing intractable seizures. During September 1994 to February 1995, we operated on six patients with NMD to treat intractable seizures. Male to female ratio of these 6 patients was 2 : 4, and mean age at seizure onset was 14 years old(range 6-28 years), indicating early onset of epilepsy. Mean age at seizure surgery was 29 years old(range 23-41 years), and mean follow-up duration after operation was 4 months(range 3-6 months). In their past medical history, three patients had experienced febrile seizure at pediatric age, and one of them had a history of anoxic damage during delivery. Following preoperative localization, the lesion was removed completely in five patients. In the other one patient, part of the lesion was located in the speech and motor area, leading to partial removal. On histologic examination two of them showed cortical dysplasia and the other four revealed microdysgenesis. During follow-up for six months, five patients were free of seizure and in the other one patient, whose lesion was removed incompletely, the frequency of seizure decreased by 95%.

Seismic stratigraphic reconstruction of Plio-Quaternary depositional sequences on the continental shelf of Korea Strait

Yoo, Dong-Geun,Kim, Kyoung-Jin,Lee, Gwang-Soo,Kang, Nyeon-Keon,Yi, Bo-Yeon,Kim, Gil-Young,Chang, Se-Won,Kim, Han-Joon Elsevier 2017 Quaternary international Vol.459 No.-

<P><B>Abstract</B></P> <P>The Korea Strait is a seaway connecting the East Sea with the East China Sea. The Plio-Quaternary stratigraphy and sedimentation on the Korea Strait shelf was studied using a dense network of high-resolution, single-channel seismic reflection profiles. The shelf sequences above the acoustic basement consist of seven depositional sequences separated by erosional unconformities corresponding to falls in sea level. Individual sequences are characterized by well-stratified and complex sigmoid-oblique prograding reflection configurations, reflecting a history of upbuilding and outbuilding in response to repetitive transgressive and regressive events driven by sea level changes. During the regression to lowstand of sea level, lowstand prograding wedges were formed seaward along the present shelf margin, whereas during the highstand of sea level, as in the present condition, highstand deposits were deposited in the inner shelf along the coast. However, as the subsequent regression began, the inner-shelf highstand deposits were severely eroded out and/or formed a condensed section. Volumetrically, the forced regressive and lowstand systems tracts are the most important components of the Korea Strait. Consequently, the Plio-Quaternary sequence in this area consists of a succession of stacked progradational lowstand wedges, mainly formed during the regression and lowstand of sea level.</P>

지체장애 아동의 놀이 환경 기본 계획에 관한 연구

김영은,강병근,성기창,이건하 한국의료복지시설학회 2003 의료·복지 건축 Vol.9 No.2

The elements of a medium for gathering the able bodied and the disable bodied children are examined within the scope of this study. Starting from the importance of play for the children, the characteristics and the properties of middle childhood are closen as domain. This study showed that though most of the playground sites were accessible to Physically disabled Children, and were safety. For Physically disabled Children. the opportunities to play in a play area depend largely on the accessibility of the facilities. this study also explored the play experience of children with disability. The play spaces and the playgrounds including the equipment are examined. The results of study suggest there be creatived planning items in terms of accessibility and domain, which in detail. are summarized in following six points: Accessibility. Barrier-free. convenience, movement, safety. domain. A guideline on the design of an accessible & safety playground for Physically disabled Children should be made.