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최근 5년간(1996-2000) 부산지역 소아 백혈병 환자에 대한 역학적 연구
문재훈,이순용,신종범,박재선,이영호,임영탁,박수은,Moon, Jae Hoon,Lee, Soon Yong,Sinn, Jong Beom,Park, Jae Sun,Lee, Young Ho,Lim, Young Tak,Park, Su Eun 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.10
목 적 : 소아 백혈병은 소아 악성종양 중 빈도가 가장 높으며 타 질환에 비하면 아직도 사망률이 높기 때문에 발생률에 대한 기초자료는 대단히 중요하다. 저자들은 1996년부터 2000년까지 5년 동안 부산지역에서 발생한 소아 백혈병 환자들에 대한 역학적 연구를 시도하였다. 방 법 : 해당기간 동안 부산시내 4개 대학병원과 11개 종합병원의 소아 입원 환자들 중에서 백혈병으로 최초 진단된 133명(남아 87명, 여아 46명)에 대하여 역학적인 조사를 하여 시행하였다. 결 과 : 1) 1996-2000년의 5년 동안 부산지역에서 발생한 소아 백혈병 환자수는 총 133명이며 연간 환자수는 20-33명의 범위였고 연평균 26.6명(남아 17.4명, 여아 9.2명)이었다. 남녀 성비를 보면 1.89 : 1로 남아가 훨씬 많았다. 2) 이 기간 동안 15세 이하의 부산시 소아인구 100,000명당 연령 및 성별 정정 연간 발생률을 보면 2.37-4.53의 범위로 평균 3.29이었으며 남아의 경우는 2.47-5.29의 범위로 평균 4.05이었고 여아는 0.76-3.36의 범위로 평균 2.43이었다. 3) 연령 특정 연간 발생률은 0-4세군이 3.78, 5-9세군이 3.08, 10-14세군이 3.08로 0-4세군에서 가장 높았다. 4) 소아 백혈병의 병형별 분포는 ALL이 71.4%, AML이 23.3%, CML이 4.5%이었고, 병형별 남녀 성비를 보면, ALL에서는 1.97 : 1로 남아가 거의 두 배나 많았고 AML에서는 1.21 : 1로 남아가 약간 많았다. CML은 6명 전원이 남아였다. 5) 연령군에 따른 소아 백혈병의 병형 분포를 보면, 급성 림프구성 백혈병은 5-9세 군에서, 급성 골수성 백혈병은 0-4세군과 10-14세군에서 공히 가장 많았다. 6) 백혈병의 병형별 남녀 성비를 보면, 급성 림프구성 백혈병은 1.97 : 1, 급성 골수성 백혈병은 1.2 : 1이었으며 만성 골수성 백혈병은 전원 남아였다. 결 론: 1996-2000년의 5년 동안 부산지역에서 발생한 소아 백혈병 환자들의 연령 및 성별 조정 연간 발생률은 평균 3.29였다. 저자들의 이와 같은 성적은, 이와 관련된 문헌들과 비교해 볼 때, 부산지역 소아 백혈병의 발생률이 1981년부터 지난 20년간 완만하게 증가되었음 시사하였다. Purpose : For the control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. The authors analyzed the data from 133 new patients with childhood leukemia between 1996-2000 in Busan, Korea. Methods : The data were obtained from 133 new cases(87 males and 46 females from 0 to 15 years old) of childhood leukemia who were residents of Busan and who were admitted to the 4 university hospitals and 11 general hospitals from 1996 to 2000. Results : The total number of the new childhood leukemia patients was 133 between 1996-2000; the average annual number of new patients was 26.6. The age-and-sex adjusted annual incidence rate (/100,000) was in the range of 2.37-4.53(male 2.47-5.29, female 0.76-3.36) with an average of 3.29 (male 4.05, female 2.43). Age-specific annual incidence rate(/100,000) was 3.78 in the 0-4 year age group, 3.51 in the 5-9 year age group and 3.08 in the 10-14 year age group. Of the major types of childhood leukemia, the distribution of ALL was average 71.4%, of AML 23.3%, and of CML 4.5%. Of the major types of leukemia by age range, ALL showed highest in the 5-9 year age group, while AML in 0-4 and 10-14 year age groups. Sex-ratio(male to female) of major type of leukemia was 1.97 : 1 and 1.21 : 1, in ALL and AML groups, respectively, while all were male in CML. Conclusion : The average age-and-sex adjusted annual incidence rate(/100,000) of childhood leukemia in Busan from 1996 to 2000 was 3.29. Compared to data in related articles, this data suggests a steady increase in the incidence of childhood leukemia in the Busan area over the last 20 years since 1981.
소아기 류마티스 관절염 환아에서 발생한 이차성 신유전분증 1 례
문재훈,이숙진,강미선,정우영,Moon Jae-Hoon,Lee Suk-Jin,Kang Mi-Seon,Chung Woo-Yeong 대한소아신장학회 2002 Childhood kidney diseases Vol.6 No.2
저자들은 소아기 류마티스 관절염으로 진단되어 간헐적으로 NSAID를 투여 받아 오던 중학교 신체검사에서 우연히 발견된 단백뇨와 혈뇨를 주소로 내원하였던 12세 여아에서 신생검상 신장의 아밀로이드의 침착을 확인하여 이차성 유전분증으로 진단된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Amyloidosis comprises a diverse group of systemic and local diseases characterized by organ involvement by the extracellular deposition of fibrils composed of subunits of a variety of normal serum proteins. Secondary amyloidosis is caused by the deposition of amyloid A(AA) protein in chronic inflammatory disease. Juvenile rheumatoid arthritis(JRA) has been known to be the most common cause of secondary amyloidosis. We experienced one case of secondary renal amyloidosis in a 12-year-old girl who had suffered from JRA for several years who had visited our renal clinic to evaluate the proteinuria with microscopic hematuria which was detected by chance at school urine screening examination. Apple green birefringence was observed under polarized light with Congo red stain at)d characteristic electron microscopic findings was also noted in renal tissues which was obtained by percutaneous renal biopsy. In our knowledge, this is the first case report of secondary renal amyloidosis developed in pediatric age in Korea.
막증식성 사구체신염 제 II 형(Dense-Deposit Disease) 1례
이숙진,문재훈,강미선,송민섭,정우영,Lee Suk-Jin,Moon Jae-Hoon,Kang Mi-Seon,Song Min-Seob,Chung Woo-Yeong 대한소아신장학회 2003 Childhood kidney diseases Vol.7 No.2
막증식성 사구체 신염은 Berger와 Galle에 의해 처음 기술되어졌고, 전자 현미경상 고밀도로 보이는 물질들이 치밀층에 침착된 것을 특징으로 하므로, dense deposit disease라고 명명하기도 한다. 비록 원인과 병리기전에 대해서는 잘 알려져 있지 않지만, 보체의 대체경로를 활성화시켜 저보체혈증이 일어나는 임상양상으로 미루어 볼 때 이와 연관된 병의 발생기전이 보고되어 있다. 이 질환은 다른 신염에 비해 말기 신부전으로 진행하는 비율이 높아 그 중요성이 있으나 정립된 치료법이 없어 다양한 노력이 시도 중이며 그 효과에 대해서는 아직까지 논란이 있다. 저자들은 내원 3년 전부터 나타난 지속적 반복적 육안적 혈뇨와 단백뇨, 지속적인 보체 감소증이 있었으나 상실성 빈맥증(paroxysmal supraventricular tachycardia) 때문에 신조직 검사를 지연시켜오던 환아에서 2년 정도의 digoxin 복용 후 실시한 7세 여아의 조직검사에서 제 2형 막증식성 사구 체신염으로 진단된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Membranoproliferative glomerulonephritis type II(MPGN II), also called dense deposit disease, was first described by Berger and Galle in 1963. The diagnosis of MPGN II is based on electron-microscopic finding of an intensely electron-dense substance which replaces the lamina densa of the glomerular basement membrane. Although the etiology and pathogenesis of MPGN II are unknown, it frequently progresses to end-stage renal failure. Typically in MPGN II, hypocomplementemia due to activation of the alternative complement pathway is present. In addition, the association of MPGN II with partial lipodystrophy and complement abnormalities is well documented. The relationship between these associated features and the patient's renal functional outcome is not clear. With respect to the therapy for MPGN II, an alternate-day prednisolone regimen was shown to be effective. Various treatment modalities, including immunosuppression with corticosteroids, cytotoxic drugs and cyclosporin A, anticoagulants and antiplatelet therapies are used, either alone or in combination, with varying degrees of success. The purpose of this paper is to present a case of MPGN II from a 7 years old girl with paroxysmal supraventricular tachycardia(PSVT).
증례 : 내분비-대사; 갑상선암과 자궁내막암에서 동시에 전이된 경부림프절에 관한 증례
박경선 ( Kyeong Seon Park ),박효진 ( Hyo Jin Park ),홍아람 ( A Ram Hong ),김영기 ( Yeong Gi Kim ),문재훈 ( Jae Hoon Moon ),박영주 ( Young Joo Park ) 대한내과학회 2014 대한내과학회지 Vol.86 No.3
A 54-year-old woman presenting with dizziness was diagnosed with a metastatic brain tumor. Imaging studies to identify the primary cancer revealed endometrial thickening with a left adnexal mass, enlarged bilateral external iliac lymph nodes, and multiple attenuated nodules in both lobes of the thyroid gland with enlarged central neck nodes. After curettage of the uterine endometrium and ultrasonography-guided gun biopsy of the thyroid gland to confirm uterine and thyroid cancers, respectively, total abdominal hysterectomy with bilateral salpingo-oophorectomy and total thyroidectomy with bilateral central neck dissection were performed. Histopathologic examination of the removed tissues demonstrated both endometrial carcinoma metastasis to the thyroid gland and primary thyroid cancer with synchronous central neck node metastasis originating in the endometrium and thyroid. Three of the four right central lymph nodes were positive for metastatic papillary carcinoma; on the other hand, the remaining right central lymph node and one of the two left central lymph nodes were confirmed to be positive for metastatic endometrial carcinoma.
文載薰,車喆煥 고려대학교 의과대학 1976 고려대 의대 잡지 Vol.13 No.1
Although carbon monoxide poisoning of pregnant woman was reported in 1859, very little has written about the effect of carbon monoxide on the fetus in uterus. Furthermore in this country, the major heat sources in private houses are coal products and this matter has given special emphasis on the pregnant women spending most of their lives in kitchens in which the air is easily and frequently polluted with carbon monoxide. With the reasons, the primary trial to prove the pathogenesis of fetal carbon monoxide poisoning was carried out using 38 pregnant rats of Sprague-Dawley species with 37 fetuses. As for the methodology, the rats were devided into two groups of control and exposure group. The latter was exposed to 500ppm of carbon monoxide through Douglas bag for 4 hours per day for 20 days continuously. And then, the fetuses were examined. The results of the experiment were as follows; 1. The abortion rate of exposure group was 44.6% by average showing significant relative risk of 3.3 comparing with 13.4% of the rate of control group. (p<0.005) 2. The fetuses of the exposure group were significantly lighter than those of control group showing difference of 0.57 gm by average, that is, 3.91±0.08 gm of exposure group and 4.48±0.14 gm of control group. (P<0.001) 3. The brains of fetuses of exposure group were significantly ligher than ones of control group showing difference of 17.6 ㎎ by average. (P<0.05) 4. The fetuses of the exposure group are shorter in length by 0.13㎝ by average, however, the difference is not significant statistically. (p<0.1)