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신생아 간내 담즙 정체증의 예후 인자: 비가족성, 비대사성, 비증후성 담즙 정체증
김형석,이창훈,김인주,박재홍,Kim, Hyung Suck,Lee, Chang Hoon,Kim, In Ju,Park, Jae Hong 대한소아소화기영양학회 2004 Pediatric gastroenterology, hepatology & nutrition Vol.7 No.2
목적: 신생아 간내 담즙 정체증을 일으키는 질환들은 임상적으로 감별이 용이하지 않으며, 예후와 관련된 인자들에 대한 연구가 부족한 실정이다. 병리 조직 검사, 혈청 생화학 검사, DISIDA 신티그래피 소견들과 예후와의 관련성에 대하여 알아보고자 본 연구를 시행하였다. 방법: 1995년 7월부터 2002년 7월까지의 기간 중 부산대학병원 소아과에 신생아 담즙 정체증으로 내원한 생후 3개월 이내 신생아 및 영아 중 간내 담즙 정체증으로 진단된 32명을 대상으로, 진단 후 6개월 이전에 혈청 ALT치가 정상화 된 환아들을 A군으로, 진단 후 6개월 이상 지속적으로 혈청 ALT치가 증가된 환아들을 B군으로 구분하고, 의무기록을 바탕으로 한 후향적 분석을 하였다. 생화학 검사로는 혈청 ALT치, 총 빌리루빈, 직접형 빌리루빈, alkaline phosphatase의 최고치 등을 비교하였으며, 간 생검에 대한 분석은 담즙관의 증식, 문맥간 가교형성, 다핵 간세포, 간세포 부종, 담세관 마개 5가지 항목에 대한 조직 소견을 정도에 따라 임의로 1점부터 3점까지 점수화하여 조사하였고, DISIDA 신티그래피에서 담낭과 소장이 보인 시간을 두 군에 대하여 비교하였다. 결과: 신생아 간염이 29명, 신생아 간염과 간내 담도 부족증을 동반한 환아가 3명이였다. 간 생검 검사상 예후가 좋지 않은 군에서 담즙관 증식, 문맥간 가교 형성이 심하였으며, 다핵 간세포, 간세포 부종, 담세관 마개의 정도는 예후와 관련성이 없었다. 생화학 검사상 ALT의 최고치가 높은 군에서 예후가 좋지 못하였으며, DISIDA 신티그래피의 담낭과 소장이 보인 시간, 총 빌리루빈, 직접형 빌리루빈, alkaline phosphatase의 최고치는 예후와 관련성이 없었다. 결론: 신생아 간내 담즙 정체증이 있는 환자에서 간 조직 검사상 담즙관 증식과 문맥간 가교 형성이 심하거나 혈청 ALT의 최고치가 높을수록 예후가 나쁘므로 이들에 대한 주의 깊은 관찰 및 검사가 필요할 것으로 생각한다. Purpose: The prognosis of neonates with cholestasis is not clear. Some factors, such as high peak bilirubin levels and liver histologic findings have been claimed to affect the prognosis adversely. Our study aims to define which factors influence the prognosis of neonatal intrahepatic cholestasis. Methods: Retrospective reviews of the medical records were performed in 32 cases with neonatal intrahepatic cholestasis, who were admitted to Department of Pediatrics, Pusan National University Hospital from July 1995 to July 2002. Neonates were classified into 2 groups according to the duration of elevated serum alanine aminotransferase (ALT) levels more or less than 6 months. The data, such as biochemical, histopathologic and radiologic findings, were compared in both groups. Biochemical data included mean peak level of serum ALT, total bilirubin, direct bilirubin, and alkaline phosphatase. Histologic parameters related to lobular architecture, fibrosis, inflammatory infiltration and degenerative features of hepatocytes were arbitrary estimated on a scale of 1 to 3. Results: There were 19 males and 13 females, whose mean age was 48 days (14~77 days). The peak serum ALT levels were higher in the poor outcome group. Ductular proliferation and portoportal bridging were more severe in the poor outcome group. But the degree of multinucleated hepatocytes, hepatocellular swelling and canalicular plug did not appear to be significantly related to the long-term outcome. The DISIDA scintigraphy by visualization time of gall bladder and intestine was not useful in predicting outcome of neonatal intrahepatic cholestasis. Conclusion: Neonates who have intrahepatic cholestasis with high serum ALT levels, severe ductular proliferation and portoportal bridging in the liver biopsy specimen should be carefully followed up because they may have a poor prognosis.
박대성,김광호,김형석,이종철,주흥규,홍사욱 ( Dai Sung Park,Kwang Ho Kim,Hyung Suck Kim,Jong Chul Lee,Heung Kyu Jhoo,Sa Uk Hong ) 한국하천호수학회 1971 생태와 환경 Vol.4 No.3·4
Survey on the treatment of waste water of factories according to the kinds of industries distributed in Yeong Deung Po, Seoul has been investigated. The results of this study were summarized as follows: 1. All of the waste water of factories were over the standard levels in preventive law of public nuisance. 2. Flocculation sedimentation method is most favorable in treatment of waste water from the textile factories. In textile with dyeing factories, it can not be desirable in treatment of waste water by the methods such as sand filtration, sedimentation, flocculation sedimentation and aeration. In the food factories, the methods of flocculation sedimentation followed with aeration can accomplish the object of treatment. In the paper factories, all the methods of sandfiltration, sedimentation and flocculation sedimentation can be applied but the flocculation sedimentation is especially most favorable among them. In the treatment of waste water from the fermentation factories, use of aeration after flocculation sedimentation method can reach the objects of treatment. 3. Degrees of relationships between determined values of treated water were calculated into coefficients of correlationships between each experimental items. Calculating the equations of regression, in the case of necessity, presuming the mean values of other experimental items from a certain experimental item, the range of judgement can be widen to the extent of experimental data of treated water which were experimented in few item and also the random data can be used in the judgement of normal value or not. 4. Instead of the complicated B.O.D., the turbidity of simple experimental items can be applied in food, fermentation, textile, paper and pharmaceutical tries.
Childhood Ataxia with Diffuse Central Nervous System Hypomyelination(CACH) 증후군 1례
김규태(Kyu Tae Kim),김형석(Hyung Suck Kim),남상욱(Sang Ook Nam),김학진(Hak Jin Kim) 대한소아신경학회 2002 대한소아신경학회지 Vol.10 No.2
16개월된 여아로 정상적인 발달을 보이다가 내원 수일 전 돌발진을 앓고 난 후 시작된 기도진전, 운동 조절 실조 및 운동 실조 등 운동 퇴행 증상이 발생하였다가 증상이 호전 된 이후 수두, 폐렴을 앓고 난 뒤에 다시 운동 퇴행 증상과 회복을 보인 CACH 증후군 환아 1례를 문헌 고찰과 함께 보고한다. Childhood ataxia with diffuse central nervous system hypomyelination(CACH) syndrome is a recently described leukodystrophy of unknown etiology. The patients show normal development until the age from 1.5 to 5 years, and sudden deterioration of all motor abilities with irritability is presented after a viral infection or minor head trauma. Brain magnetic resonance imaging(MRI) shows generalized hypointensity of the white matter in T1-weighted image, which turns hyperintense in T2-weighted image, and Proton Magnetic Resonance Spectroscopic Imaging(H-MRSI) shows reduced signal of Nacetylaspartate, choline, and creatine only in white matter. Dementia is not present and peripheral nerves are normal. We report a case of CACH syndrome who was born with no perinatal problem, and showed normal development until the age of 16 months. She suddenly lost all motor abilities after exanthem subitum who recovered fully over two months. At the age of 18 months she experienced similar attack after chicken pox, and developed seizures at age of 18 months.
난소 상피 종양에서 혈관 내피세포 성장 인자 발현 및 미세혈관 밀도와 예후에 관한 연구
최성란 ( Seong Lan Choi ),김지영 ( Ji Young Kim ),박일웅 ( Il Woong Park ),전현철 ( Hyun Chul Jun ),정두석 ( Du Suck Jung ),조중동 ( Joong Dong Cho ),김형석 ( Hyung Seok Kim ),이지신 ( Ji Shin Lee ),정종재 ( Jong Jae Jung ),최호선 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.3
목적 : 종양이 성장하고 전이하기 위해서는 신생 혈관 형성이 필수적인데 혈관 형성 과정에는 많은 인자들이 복잡하게 작용하고있다. 대표적인 혈관 형성 인자로 혈관 내피세포 성장인자 (VEGF)가 있는데 미세혈관 밀도 및 VEGF 발현이 여러 종양에서 예후 인자로서의 가능성이 제시되고 있으나 난소 종양에서는 아직 확실하지가 않다. 이에 저자들은 상피성 난소 종양을 대상으로 미세혈관 밀도와 VEGF 발현을 관찰하여 다른 예후 인자들과의 상관성 및 새로운 예후 Objective : It is still unclear whether angiogenic potential, which is believed to be a prerequisite for tumor development, is an important prognostic factor in ovarian carcinoma. The current study was designed to examine the relationship among Vascular e
서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)
김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2
Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.