단기간 동안 갑자기 성장한 조기대장암 1예

이보인 ( Bo In Lee ),최규용 ( Kyu Yong Choi ),김병욱 ( Byung Wook Kim ),최황 ( Hwang Choi ),조세현 ( Se Hyun Cho ),정우철 ( Woo Chul Chung ),이강문 ( Kang Moon Lee ),박수헌 ( Soo Heon Park ),채현석 ( Hyun Suk Chae ),최명규 ( Myun 대한장연구학회 2003 Intestinal Research Vol.1 No.1

Retrospective studies report that doubling time of early colorectal cancer is 26 months. Recently we experienced a case of early colorectal cancer which increased over twofold in a size in only 13 days. (Intestinal Research 2003;1:64-67)

Billoth 2 수술 후 반복적인 부종과 저단백혈증을 일으킨 세균과다증식증후군 1예

이보인 ( Bo In Lee ),최규용 ( Kyu Yong Choi ),김병욱 ( Byung Wook Kim ),최황 ( Hwang Choi ),조세현 ( Se Hyun Cho ),정우철 ( Woo Chul Chung ),이강문 ( Kang Moon Lee ),박수헌 ( Soo Heon Park ),채현석 ( Hyun Suk Chae ),최명규 ( Myun 대한장연구학회 2003 Intestinal Research Vol.1 No.2

저자들은 Billoth II 수술을 받은 75세 남자에서 상부위장관 내시경 및 멸균카테터를 통한 공장흡인액 배양으로 세균과다증식 증후군을 진단하고 항생제 치료로 호전을 보인 증례를 경험하여 보고하는 바이다. 세균과다증식이 있으나 선별검사 대상의 요건에 맞지 않는 증례가 있고 선별검사의 상당수가 국내에서 용이하지 않은 점을 고려할 때 Billoth-II 수술 상태와 같이 소장접근이 용이한 경우에는 임상적으로 의심되면 곧바로 상부위장관내시경을 이용한 세균배양검사를 시행해 볼 수 있다. Recently, we experienced a case of bacterial overgrowth syndrome with recurrent edema, hypoproteinemia and normal serum cobalamine level after Billoth II subtotal gastrectomy, which was diagnosed by jejunal aspirates culture and antibiotics treatment. When predisposition and clinical suspicion were present, jejunal culture might be preferable especially in case of post-Billoth II operation status because jejunal approach is easy, screening tests are negative in certain cases and some screening tests are not available in Korea. (Intestinal Research 2003;2:197-200)

딥러닝 첫걸음

문지호(서평자) 한국강구조학회 2021 韓國鋼構造學會誌 Vol.33 No.5

대장암 선별과 대장폴립 진단검사 가이드라인

이보인 ( Bo In Lee ),홍성필 ( Sung Pil Hong ),김성은 ( Seong Eun Kim ),김세형 ( Se Hyung Kim ),김현수 ( Hyun Soo Kim ),홍성노 ( Sung Noh Hong ),양동훈 ( Dong Hoon Yang ),신성재 ( Sung Jae Shin ),이석호 ( Suck Ho Lee ),김영호 ( You 대한소화기학회 2012 대한소화기학회지 Vol.59 No.2

1. 한국에서 대장암과 대장샘종의 역학 (1) 한국에서 대장암의 발생률은 증가하고 있다. (2) 한국에서 대장샘종의 발생률은 증가하고 있다. 2. 대장암 선별과 대장폴립 진단검사 가이드라인 1) 선별검사 시행 시기 (1) 평균위험군에서 대장암 선별과 대장샘종 진단검사는 50세부터 시작하는 것을 권고한다. 단, 대장암 증상이나 징후가 있는 경우 50세 이전에 시행할 수 있다. 2) 대변잠혈검사 (1) 50세 이상의 평균위험군에서 대변잠혈검사는 대장암으로 인한 사망률을 유의하게 감소시키므로 대규모 인구집단에서 대장암의 선별검사로 권고한다. 이는 검사 양성일 때 대장내시경검사가 수행되어야 함을 전제로 한다. (2) 50세 이상의 평균위험군에서 대장암의 선별검사로 기존의 guaiac 대변잠혈검사에 비해 대변 면역화학검사를 우선적으로 권고한다. 3) CT 대장조영술 (1) 50세 이상의 평균위험군에서 CT 대장조영술을 대장암 선별과 대장폴립 진단검사 중 하나로 권고한다. (2) CT 대장조영술에서 6 mm 이상의 폴립이 발견된 경우 대장내시경검사를 권고한다. 4) 이중조영바륨관장술 (1) 50세 이상의 평균위험군에서 이중조영바륨관장술을 대장암 선별검사 중 하나로 권고한다. (2) 이중조영바륨관장술에서 6 mm 이상의 폴립이 발견된 경우 대장내시경검사를 권고한다. 5) 대장내시경검사 (1) 50세 이상 평균위험군에서 대장암 선별과 대장샘종 진단검사로 대장내시경검사를 우선적으로 권고한다. (2) 50세 이상 평균위험군에서 첫 선별대장내시경검사가 일정 질 수준 이상으로 이루어졌다면 대장암이나 대장샘종이 발견되지 않은 경우 5년 이후 추적대장내시경검사를 권고한다. 단, 대장암 경고증상이 새롭게 발생한 환자를 포함하여 추적기간 내 중간암의 우려가 있다고 의사가 판단하는 경우 5년 이내라도 추적검사를 시행할 수 있다. Colorectal cancer is the second most common cancer in males and the fourth most common in females in Korea. Since the most of colorectal cancer occur through the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. Korean Multi-Society Take Force developed the guidelines with evidence-based methods, Parts of the statements drawn by systematic reviews and meta-analyses. Herein we discussed the epidemiology of colorectal cancers and adenomas in Korea, optimal screening methods for colorectal cancer, and detection for adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

이중화 구조를 가진 변전소자동화시스템의 개발

우천희(Chun-Hee Woo),이보인(Bo-In Lee) 대한전기학회 2010 전기학회논문지 P Vol.59 No.3

In order to improve the quality of electricity in large scale power systems, stability of power system has to be achieved. This can be done by the means of preventative diagnosis of power equipments and protection, monitoring and control of the power system. Since the recent adoption of digital controllers, an improvement in stability was observed; in particular, IED, which contained self-diagnostic abilities such as fault tolerance, allowed for automatic recovery via redundancy or switching-over functions should there be faults with the equipments. Furthermore, communication lines have been hugely simplified, thus adding to the improvement in stability significantly. Taking these error reports and forecasting emergency reports and by effectively responding to them in the overiding controlling systems, high levels of system stability can be obtained. Power Management System that is being applied to automated power sub-stations, takes the IEC61850 international standard as its specification. In this paper, additional research into achieving stability of already developed PMS system and also the stability of the overall system was carried out, and the results of development of communication servers, which play a pivotal role in connecting systems, are stated.

크론병 환자에서 의사별 치료 행태의 차이

최황 ( Hwang Choi ),김상우 ( Sang Woo Kim ),이강문 ( Kang Moon Lee ),이보인 ( Bo In Lee ),정대영 ( Dae Young Cheung ),김민국 ( Min Kuk Kim ),정현정 ( Hyun Jung Jung ),김형근 ( Hyung Keun Kim ),지정선 ( Jeong Seon Ji ),박수헌 ( So 대한장연구학회 2009 Intestinal Research Vol.7 No.1

Background/Aims: The incidence and prevalence of Crohn’s disease are increasing in Korea. However, the guidelines for the management of Crohn``s disease have not been established in Korea. In the current study we determined the difference in the treatment methods between physicians in Korea for Crohn’s disease. Methods: We retrospectively analyzed the use of medical and surgical treatment modalities in 92 patients with newly diagnosed Crohn``s disease. We compared the treatment strategies among 4 physicians at 3 different institutions. Results: Prednisone, 5-aminosalicylates, antibiotics, immunomodulators, infliximab, and surgery were prescribed or preformed in 64%, 92%, 24%, 35%, 9%, and 22% of the patients, respectively. The surgical procedures included 12 bowel resections and 8 fistulectomies. The prescription rates for 5-aminosalicylates, prednisone, antibiotics, and infliximab did not differ, but of the use of immunomodulators was significantly different between physicians (p=0.012). The mean interval between diagnosis and the start of immunomodulators was 14 months, and was not different between physicians. The median dosage of immunomodulators was 50 mg per day, and was not different between physicians. Conclusions: A difference in medical treatment strategies for Crohn’s disease between physicians exists in Korea. Specifically, there was a significant difference in the use of immunodulators between physicians. The development of treatment guidelines for Crohn’s disease, together with efforts to decrease the inter-physician difference for treating Crohn’s disease are needed. (Intest Res 2009;7:41-46)

초고압 가스절연개폐기의 베이 컨트롤러 개발 및 성능시험

우천희(Chun-Hee Woo),이보인(Bo-In Lee) 대한전기학회 2010 전기학회논문지 P Vol.59 No.2

The digital substation automation system has contributed hugely to increasing the stability of power systems by providing not only protection and control of power systems but diagnostic features alongside them. Digital substation automation systems in the scale of substations consist of integrated operation systems and intelligent electronic devices. The main intelligent electronic devices currently in use are digital protection relays and the bay controllers in Gas insulated switchgears. Proficiently accomplishing the coordination of protection within the power system as a means of ensuring reliability and contriving for the stability of power supply through connection of function, the application of bay controllers is crucial, which collectively manage the protection relay at the bay level in order to achieve both. In this research, the bay controllers to be used in high-voltage Gas insulated switchgear has been localized, and in particular, the logic function and editor required in order to minimize the complicated hardware-like cable connections in the local panel have been developed. In addition, to ensure the strength and reliability of the bay controller hardware developed herein, the type tests from KERI have been successfully completed.

한국인 바렛식도에서 p53과 Ki-67 단백의 면역조직화학 발현

김창환 ( Chang Whan Kim ),이보인 ( Bo In Lee ),김병욱 ( Beung Wook Kim ),김진일 ( Jin Il Kim ),박수헌 ( Soo Heon Park ),김재광 ( Jae Kwang Kim ),한석원 ( Sok Won Han ),정인식 ( In Sik Jung ),선희식 ( Hee Sik Sun ),이아원 ( A Won L 대한소화기학회 2005 대한소화기학회지 Vol.46 No.3

목적: 바렛식도는 식도선암의 전구병변으로 원주상피로 치환된 식도상피의 특수장상피화생에서 이형성이 존재할 경우 식도선암의 발생과 관련이 깊다. 최근 한국에서 역류 식도질환이 증가하고 있지만 아직 바렛식도와 식도선암의 유병률은 서구에 비해 현저히 낮다. 이에 저자들은 바렛식도의 암성 변화의 예측에 유용한 p53과 Ki-67단백의 면역조직화학 발현 양상을 알아보고자 하였다. 대상 및 방법: 상부위장관 내시경검사에서 원주상피로 치환된 식도상피의 변화가 관찰되어 바렛식도의 확진을 위해 식도 조직검사를 시행한 95명을 대상으로 하였다. 특수장상피화생의 진단을 위해 모든 생검 예에서 alcian blue 염색(pH 2.5)을 시행하였고, 장형화생의 유무를 관찰하기 위해 high ion diamine 염색을 하였다. 그리고 전 예에서 p53과 Ki-67 면역조직화학 검사를 시행하였다. 결과: 내시경검사에서 바렛식도가 의심되었던 95명 중 55명(57.9%)에서 특수장상피화생이 관찰되었고 전 예에서 이형성은 없었다. 이들 55명 중 31명(56.4%)에서 sulfomucin 양성인 장형화생이 관찰되었다. 바렛식도로 조직 진단을 받은 55명 중 6명(10.9%)에서 p53 단백질의 핵내 침윤소견이 관찰되었고 이들 6명 모두에서 장형화생이 존재하였다. Ki-67 표지지수는 특수장상피화생이 있거나 p53 양성일 때 상대적으로 높게 나타났으나 유의성은 없었다. 결론: 바렛식도 환자에서 p53 단백질이 발현된 경우는 10.9%로 이들 모두에서 장형화생을 동반하고 있어 한국인에서도 바렛식도는 이형성의 발생이나 암성변화의 위험도가 높은 전암병소이며 향후 이들에 대한 추적 검사가 필요하다. Background/Aims: Barrett`s esophagus is a premalignant lesion of the esophagus in which normal squamous epithelium is replaced by intestinalized columnar epithelium. In Korea, adenocarcinoma associated with Barrett`s esophagus is rare compared with that of Western country. The purpose of this study was to investigate the immunohistochemical expression of p53 and Ki-67 in Barrett`s esophagus which had predictive value for cancer risk in Korea. Methods: Ninety five patients (43 male and 52 female, median age 44, range 21-75) who have been suspected to have Barrett`s esophagus by endoscopic assessment were enrolled in this study. Alcian blue (pH 2.5) and high ion diamine stain for the evaluation of specialized intestinal metaplasia (SIM) and immunohistochemical stain for p53 and Ki-67 were done. Results: 57.9% (55/95) of biopsies from the columnar lined esophagus showed SIM, but no dyspalsia. 56.4% (31/55) of Barrett`s esophagus showed sulfomucin positive colonic metaplasia. The p53 expression was observed in 10.9% (6/55) of the patients of Barrett`s esophagus and all of them showed colonic metaplasia. Ki-67 labeling index showed no difference significantly. Conclusions: In Korea, 10.9% of Barrett`s esophagus had p53 mutation and moreover all of them had colonic metaplasia. Consequently, we expect that these patients have high risk of developing dysplasia and adenocarcinoma and need careful follow-up. (Korean J Gastroenterol 2005;46:189-195)

대량의 위궤양 출혈을 일으킨 정상 신생아

박영실 ( Young Sil Park ),정우철 ( Woo Chul Chung ),이강문 ( Kang Moon Lee ),이보인 ( Bo In Lee ),천지성 ( Ji Sung Chun ),장우임 ( U Im Chang ),양진모 ( Jin Mo Yang ),최규용 ( Kyu Yong Choi ),정인식 ( In Sik Chung ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.3

Gastric ulcer bleeding in neonatal period, mainly in preterm newborn babies or in neonates treated in intensive care units, is relatively frequent, However the occurrence of significant gastric ulcer bleeding in healthy full term infants is unusual. We experienced a case of massive upper gastrointestinal (GI) bleeding in a 3-day-old healthy full term infant. Endoscopic examination confirmed the presence of gastric ulcerations. Treatment was initiated with transfusion and histamine 2 receptor antagonist, and the clinical signs resolved. Mother`s serum antibody to Helicobacter pylori (H. pylori) was positive. We collected stool of the patient including other 17 infants in the intensive care unit. A highly sensitive semi-nested PCR for H. pylori DNA was performed, but all infants including the patient revealed negative. H. pylori infection is not related with upper GI bleeding in healthy full term infants. In conclusion, the diagnosis of upper GI bleeding in infant can be easily made by means of pediatric endoscopy, which is a simple and a well tolerated examination. (Korean J Gastroenterol 2006;48:210-214)

IEC61850용 게이트웨이 개발 및 성능시험

우천희(Chun-Hee Woo),이보인(Bo-In Lee) 대한전기학회 2010 전기학회논문지 P Vol.59 No.1

The IT project for power plants initiated domestically in 2005 necessitates the power equipment facility and the controllers for those to be sufficiently adaptable for automation system for power substations. This implies that the power plants using power equipments must be developed to satisfy the IEC61850 standards. The IEC61850 communication standards that all power equipment and facility and controllers installed in automation system for power substations must follow has had its Parts 3 and Part 4 established as international standard in January 2002 and Part 10 in May 2005, the last to become international standard. Hence all separate parts of the original IEC61850 standard came to be established as international standards. As a consequence, after 2005, in most power substations around the world the IEC61850 standard is being applied and the prominent makers are geared towards manufacturing products to the IEC61850 standard. The IEC61850 is being recognized as an essential standard that must be applied to not only power substations but for automation of power systems and communication systems. In this research, the Gateway device that connects current SCADA system and IEC61580 based system has been domesticated with Korea’s own technology and extensive testing was carried out in order to obtain confidence in its performance.