위선암 중 Signet - ring cell type 의 임상적 연구

허윤(Yoon Huh),정주섭(Ju Sup Jung),윤명순(Meung soon Yoon),박병엽(Byung Yeub Park),김무현(Moo Hyun Kim),나산균(San Gyun Rha) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

To investigate the clinical characteristics about signet-ring cell type of gastric adenoca- rcinoma, the authors has evaluated 176 cases of gastric adenocarcinoma that had been diagnosed by gastrofiberscopic biopsy during 5.5 years. Of these, 21.6%(38/176) were signet-ring cell type. At the time of diagnosis, the average age of patients with signet-ring cell type was younger and the sex ratio showed equal male: female(1.1: 1) distribution. The location of signet-ring cell type was mainly the gastric body 45%(17/38) and more wides- pread 26%(10/38) than non-signet ring cell type 9%(13/138). The macroscopic features pre-dominantly detected in signet-ring cell type. For staging gastric adenocarcinoma preoperati- vely, 63 patients were examined with abdominal Computerized Tomography scan. The group of patients with signet-ring cell type was often composed by stage 4 50%(7/14) that could not be performed with curative surgery. To study the invasiveness of cancer cell, the microscopic examination on the resected margin was designed in 36 specimens that curative operation had been done. Malignant cells were found in 33%(2/6) in the group of signet-ring cell type and this result was statistically significant(p<0.05), as compared with the group of non-signet ring cell type, 3%(1/30). These data suggest that signet-ring cell type of gastric adenocarcinoma may result in a worse outcome.

HBsAg 양성 말기 신부전 환자에서의 신이식

배현호(Hyun Ho Bae),장익득(Ik Deuk Jang),김중경(Joong Kyoung Kim),윤명순(Meung Soon Yoon),이시래(Si Rhae Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.3

N/A Methods: From December 1984 to June 1991, 21 HBsAg positive and 248 HBsAg negative patients underwent living renal transplantation in Kosin Medical College. During follow up period of a mean 32.7 months in HHsAg positive group and 33.0 months in HBsAg negative group, HBsAg, HBsAb and anti HBc examinations were done by radioimmunoasssy and biochemical liver function tests were performed monthly. The liver function abnormality was diagnosed when aminotransferase values were above the normal range(50 I.U./L)in at least two consecutive determinations. The immunosupressant hepatic toxicity was taken into account when amino transferase elevation promptly returned to normal after reducing the drug dosage and was excluded in this study. Differences between HRsAg positive and negative patients were tested for statistical significance by the chi square test. Results: 1) There was no significant difference in patient and graft survival of HBsAg positive and HBsAg negative group and in the incidence of acute rejection in bath groups. 2) The significantly higher incidence of hepatic dysfunction in HBsAg positive group than HBsAg negative group was noted. Excluding chronic active hepatitis and liver cirrhosis from transplantation in HBsAg positive patients, no notable relation between pre-tansplantation histological changes and the patients and graft survival during follow up period of 32.7 months was found. 3) There was slightly better survival rate in HBsAg positive transplants than HBsAg positive hemodialysis patients. Conclusion: The hepatitis B antigenemia is not an absolute contraindication to renal transplantation, We recommend a pre transplantation liver biopsy in HBsAg positive patients, and if the histological findings suggest a benign form of liver disease, we would have no hesitation in providing a renal transplant in spite of an HBsAg positive status. To reduce the mortality from hepatic failure, the doses of immunosuppressive drugs should be lowered or with- drawn in patients who exhibit severe hepatic dysfunction.

지속성 외래 복막투석 ( CAPD ) 환자에서 영양 상태를 반영하는 지표들과 요소 동력학 모형 ( Urea Kinetic Modeling ) 및 크레아티닌 청소율과의 비교 관찰

이종명(Jong Myoung Lee),허동(Dong Hu),정유성(yu Seong Jeong),장익득(Ik Deuk Jang),배현호(Hyun Ho Bae),김지윤(Jee Yoon Kim),김중경(Joong Kyoung Kim),윤명순(Meung Soon Yoon),이시래(Si Rhae Lee) 대한내과학회 1997 대한내과학회지 Vol.52 No.3

N/A Objectives: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. Methods: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. Results: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter- mediate groups. Conclusion: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in mal- nourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross- sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.

만성형의 악성 조직구 증다증- 증례보고-

윤명순,이경호,김영훈,유석동,조군제,나하연,문한규 大韓血液學會 1986 大韓血液學會誌 Vol.21 No.2

약물에 의한 무과립구중에 동반된 급성 맹장염(Acute Typhlitis) 1 예

윤명순,정유성,이시래,배현호,장인득,이종명,허동,홍윤범,허길,이종명 대한내과학회 1997 대한내과학회지 Vol.52 No.5

Increasingly aggressive chemotherapy regimens, advances in transplantation technology, and the acquired immunodeficiency syndrome have resulted in a growing number of immunocompromised patients. Infections are a major cause of morbidity and mortality in this population. One of the most ominous complications is the development of typhlitis in this immunocompromised patients. Treatment of this process is controversial, and no consensus has emerged. We report a case of typhlitis who complicated agranulocytosis after exposure to drugs to treat $quot;flu$quot; like illness and recovered completely after two operations of appendectomy and ileocolectomy. Reviewing articles and this case, the favorable outcome seemed to be related to following three factors recognition of the acute surgical abdomen by abdominal CT scan, a prompt return of normal circulating white cells by the use of Granulocyte Colony Stimulating Factor and discontinuation of causative drugs, and an appropriately timed surgical intervention.

자가면역성 갑상선질환에서 TBII 활성도에 관한 연구

김동수,김인주,김용기,신우원,나산균,배상균,정주섭,윤명순 대한내과학회 1986 대한내과학회지 Vol.30 No.5

To clarify the pathogenetic significance of TBII in the autoimmune thyroid disease, the author assayed TBII using TSH-radioreceptor assay kit (R,S.R, Limited, England) in 10 normal control, 93 patients with Graves' disease, 21 patients with Hashimoto's thyroiditis and 3 patients with Hashitoxicosis. The following results were obtained: 1) The mean value of TBII activity in the normal control, patients with Graves' disease, Hashimoto's thyroiditis and Hashitoxicosis was 2, 6±3.4%, 37.2±26.2%, 3.9±8.4% and 44.0±38.1%, respectively. 2) The range of TBII activity in the normal control was 010% and then TBII positivity was defined to the value over 10% of TBII activity. The prevalence of TBII positivity were O%, 81, 7%, 9.5% and 66.0% respectively, and the activity and prevalence of TBII positivity in the patients with Graves' disease and Hashitoxicosis were significantly higher than the normal control and the patients with Hashimoto's thyroiditis. 3) There was no significant difference in the thyroid function states between TBII positive and TBII negative patients with Graves' disease. 4) There was no significant correlations between TBII activity and thyroid function states in the patients with Graves disease and Hashimoto's thyroiditis. 5) The prevalence of TBII positivity in Graves' disease was highest in fourth decades.