육안으로 정상적인 파터 팽대부암의 감별진단과 예후

정지봉,김용태,정용진,김지원,김병관,이국래,류지곤,윤용범 대한소화기내시경학회 2008 Clinical Endoscopy Vol.37 No.3

목적: 육안으로 정상적인 파터 팽대부 협착이 있는 경우 양성 또는 악성 여부에 따라 치료방법이 달라질 수 있고 환자의 예후가 다르므로 감별진단이 중요하다. 본 연구는 육안으로 정상적인 파터 팽대부 악성협착 감별진단에 유용한 위험인자, 조직 생검의 진단적 정확도, 그리고 예후를 알아보고자 하였다. 대상 및 방법: 육안으로 정상적인 파터 팽대부 국소협착을 가진 환자를 대상으로 의무기록과 내시경적 역행성 담도조영술을 후향적으로 분석하였다. 악성협착 감별진단에 유용한 위험인자를 알아보고자 임상소견, 검사실소견, 총담관 직경 등을 비교하였다. 파터 팽대부 악성협착 환자에서 조직 생검의 정확도를 알아보았다. 또한, 추적 관찰을 통해 생존율 등을 조사하였다. 결과: 9명의 환자가 양성협착이었고 15명의 환자가 파터 팽대부암이었다. 혈청 빌리루빈, 알칼리성 포스파테이즈, 그리고 ALT 수치는 양성협착 환자보다 파터 팽대부암 환자에서 높았다(p<0.05). 악성협착에 대한 조직 생검 민감도와 특이도는 각각 73.3%와 88.9%였다. 파터 팽대부암으로 수술받은 환자 중 13예가 제I, II 병기였으며 평균 50개월 추적기간 동안 모든 환자가 생존하였다. 결론: 육안상 정상적이면서 팽대부에 국소협착을 동반한 파터 팽대부암의 감별진단에는 간기능 검사와 파터 팽대부 조직 생검이 유용하였다. 또한, 이들 환자에서 조기암이 많았으며 치료는 수술이 효과적이었고, 양·악성 감별진단을 위하여 적극적인 파터 팽대부의 조직 생검과 간기능 소견의 면밀한 검토가 중요하다고 생각한다.

강화되는 수질환경오염규제와 주정산업의 변화

정지봉,Jeong, Ji-Bong 한국주류산업협회 1991 주류산업 Vol.11 No.1

산업폐수처리시설설치 및 운영에 관한 비용분석

정지봉,정용 한국물환경학회 1987 한국물환경학회지 Vol.3 No.1

1985년 1월부터 12월까지 조사한 전국 436개 각종 산업체의 폐수처리시설 설치 및 운영에 관한 비용을 분석하여 다음과 같은 결과를 얻었다. 1 . 폐수처리방법의 선택은 미생물에 의해 분해가 용이한 유기물질이 많은 음식료품 제조업에서는 생물학적 처리 방법을, 고농도의 유기물이나 오염물질의 성상이 다양한 업종은 종합처리를, 미생물에 의한 분해가 어려운 오염 물질과 중금속을 함유하는 오염물질을 배출하는 업소는 화학적 처리방법을 택하였다. 2 . 폐수처리시설 설치비용은 시설규모와 BOD농도의 역대수함수로서 Y_J = -1836.183 1/log_(l0) BOD + 2094.022 1/log_(l0) S(㎥·일) 나타나며 , 폐수처리시설 운영비용은 폐수량과 BOD농도의 역대수함수로서 Y_p = -1739.335 1/log_(l0) BOD + 3082.159 1/log_(l0) W(㎥·일) 로 나타난다. 3 . 폐수처리비용의 구성은, 가장 높은 구성비율을 갖는 부분으로 화학적 처리방법에서는 약품비가 43%, 활성오니법에서는 전력비가 33%, 산화조처리에서는 전력비가 42%, 종합처리에서는 전력비와 감가상각비30%로 나타났다. 4 . 산업폐수처리 계획에 따른 비용추계에서는 1991년도 우리나라의 산업폐수 배출량을 4298천㎥ ·일로 추정치 처리시설의 규모를 20,000㎥ ·일 정도의 종말처리시설이 현행의 각자 처리시설보다 운영비면에서 약468억 원의 절감 가능액으로 나타나고 있다. 위의 결과로 보아, 본 연구결과가 산업폐수 처리시설의 설치 및 운영시에 참고될 수 있으며 종말처리시설 설치로서 설치비 및 운영비 절감에 큰 역할을 할 것으로 사료된다. As regards to the cost on installation and operation of the waste water treatment facilities, the objective 436 companies from 34 kinds industries registered to Environment Administration, the Government Office of Korea from 1984 to 1985, were analyzed. The results were as follows: 1. The biological treatment method was applied to about 80% in the food and food products industries, the chemical treatment about 90% in metal machinery, plating, chemical products manufactures, and the consolidated treatment about 90% in the leather, paper and textile industries. 2. Average cost of the installation for the waste water treatments required US$ 979.11 per ㎥ of facility for the capacity of treatment plant less than 100 ㎥/day, US$ 299.79 per ㎥ for the capacity of treatment plant less than 1,000 ㎥/day, and US$ 56.14 per ㎥ for the capacity of treatment plant less than 10,000 ㎥/day, respectively. It was shown that the greater the capacity of treatment required, the less the installation cost per the unit facility capacity. The installation cost can be expressed as a function of the concentration of BOD and scale of treatment facilities. Formula was as follows; Y_J = -1836.183 1/log_(l0) BOD + 2094.022 1/log_(l0) S where, Y_J : installation cost, 10³ Won/㎥ -day S : capacity of facilities, ㎥ -day

급성 담석성 췌장염에서 내시경 유두 괄약근절개술 및 담낭절제술의 역할

정지봉,류지곤,박주경,윤원재,이상협,황진혁,이준규,김용태,윤용범 대한소화기내시경학회 2006 Clinical Endoscopy Vol.33 No.3

Background/Aims: Stone removal can prevent recurrence of acute biliary pancreatitis. This study examined the natural course of acute biliary pancreatitis and compared the results obtained using endoscopic sphincterotomy (EST) and cholecystectomy. In addition, the incidence and risk factors associated with acute cholecystitis were estimated when a cholecystectomy had not been performed. Methods: The medical records of 113 patients diagnosed with acute biliary pancreatitis in Seoul National University Hospital from January 1990 to April 2005 were reviewed retrospectively. Results: Twenty-five patients received no specific treatment of which 15 (60.0%) experienced a recurrence during a mean follow-up period of 36.0 months. Fifty-two patients received EST only and did not experience a recurrence during a mean follow-up of 29.8 months. Thirty-six patients underwent a cholecystectomy, and 1 (2.8%) patient experienced a second attack during a follow-up of 35.2 months. The clinical factors predictive of pancreatitis recurrence in patients without treatment could not be identified. Acute cholecystitis developed in 7 out of 77 (9.1%) patients who did not receive a cholecystectomy during a mean follow-up period of 33.3 months, and patients with both gallbladdor and common bile duct stones were found to be more prone to a recurrence. Conclusions: Sixty percent of patients with acute biliary pancreatitis without treatment experienced a second attack, which could be prevented by EST. A cholecystectomy is not always necessary as a routine treatment after EST for preventing pancreatitis, and is recommended for patients with both visible gallbladdor and common bile duct stones at the time of the first attack. (Korean J Gastrointest Endosc 2006;33:152-158) 목적: 급성 담석성 췌장염 재발은 담석을 제거하면 예방할 수 있다고 알려져 있다. 본 연구는 급성 담석성 췌장염의 자연 경과와 내시경 유두 괄약근절개술(endoscopic sphincterotomy, EST) 또는 담낭절제술 후 임상 경과를 비교하였다. 또한, 담낭절제술을 시행하지 않았을 때 급성 담낭염 발생률과 위험인자를 알아보고자 하였다. 대상 및 방법: 1990년 1월부터 2005년 4월까지 서울대학교병원에서 급성 담석성 췌장염으로 진단된 113명의 의무기록을 후향적으로 분석하였다. 결과: 특별한 치료를 시행하지 않은 25명에서는 평균 36개월 추적관찰기간 동안 15명(60%)에서 췌장염이 재발하였으며, EST만 시행한 52명에서는 평균 29.8개월 동안 재발이 없었다. 담낭절제술을 시행한 36명에서는 평균 35.2개월 동안 1명에서 재발하였다. 특별한 치료를 시행하지 않은 환자군에서 췌장염 재발을 예견할 수 있는 위험인자는 찾을 수 없었다. 급성 담낭염은 평균 33.3개월 동안 담낭절제술을 시행하지 않은 환자 77명 중 7명(9.1%)에서 발생하였으며, 담낭담석과 총담관석을 동시에 갖고 있는 환자에서 좀 더 발생하는 경향이 있었다. 결론: 특별한 치료를 하지 않는 경우 급성 담석성 췌장염 환자의 60%에서 재발을 경험하였고 EST가 췌장염 재발을 예방할 수가 있었다. 담낭절제술은 췌장염 재발 방지를 위하여 EST 후 항상 필요하지 않으며 담낭염 예방을 위하여 첫 발현 시 담낭담석과 총담관석을 동시에 가지고 있는 환자에서 권장된다.

원격제어 이동로봇의 효율적 주행제어

정지봉,이상식,신위재,Jung Ji bong,Lee Sang-sik,Shin Wee-jae 한국융합신호처리학회 2000 융합신호처리학회 논문지 (JISPS) Vol.1 No.2

In this paper, we study how the remote controllable mobile robot which could come to many via points with FLC(Fuzzy Logic Control) efficiently. The fabricated robot stop after the movement of single path method by four kinds of commands (forward, backward, turn left, turn right). To reduce disadvantages of this driving type, this paper reduce via points to goal position base on map which get from senor, let robot drive via point to via point on optimized path. An algorithm for the avoidance of unexpected obstacles by FLC is developed. And these algorithms are confirmed by computer simulations

악성 대장 폐쇄 환자에서 고식적 치료로서 자가 팽창성 금속 스텐트의 임상적 유용성

정지봉 ( Ji Bong Jeong ),이국래 ( Kook Lae Lee ),권순범 ( Soon Beom Kwon ),김준석 ( Joon Suk Kim ),이재경 ( Jae Kyung Lee ),김원 ( Won Kim ),정용진 ( Yong Jin Jung ),김지원 ( Ji Won Kim ),김병관 ( Byeong Gwan Kim ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2

Background/Aims: This study was designed to evaluate the outcomes of self-expanding metal stents (SEMS) as palliative treatment for malignant obstruction of the colon and rectum. Methods: From January 2003 to September 2009, 28 patients (12 men and 16 women) with malignant colorectal obstruction received placement of uncovered or covered stents for palliative purposes under endoscopic or fluoroscopic guidance. The rates of technical success, clinical success, and the complications associated with stent insertion, patient survival, and long-term stent patency were evaluated. Results: The technical and clinical success rates were 100% (28/28) and 89.3% (25/28), respectively. Among the 25 patients with technical and clinical success, seven patients (28%) experienced complications: A case of perforation (n=1) was managed by surgical intervention, cases of tumor ingrowth (n=4), tumor ingrowth and overgrowth (n=1), and tumor overgrowth (n=1) were managed successfully with an additional stent. The median survival duration was 128.0±54.8 days. The median stent patency duration was 93.0±29.1 days, and the patency rates at 30, 90, and 180 days were 92%, 52%, and 25%, respectively. Conclusions: The placement of a self-expanding metal stent was safe and effective palliative treatment for malignant colorectal obstruction. Stent-associated complications can be managed with the placement of additional stents in the majority of the patients and long-term stent patency is favorable. (Intest Res 2010;8:135-141)

담관낭종이 동반된 췌담관 합류 이상에서 췌장염 발생의 위험 인자 분석

정지봉 ( Ji Bong Jeong ),김용태 ( Yong Tae Kim ),윤용범 ( Yong Bum Yoon ),황진혁 ( Jin Hyeok Hwang ),김정룡 ( Chung Yong Kim ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.4

Background/Aims: The clinical features of pancreatitis in patients with anomalous union of pancreatobiliary duct (AUPBD) are not known well. We analyzed the pathogenic mechanisms, risk factors, and clinical courses after treatment in patients with AUPBD. Methods: We retrospectively reviewed the medical records and cholangio-pancreatograms of 58 patients with AUPBD and choledochal cyst diagnosed in Seoul National University Hospital between 1982 and 2001. Results: The incidence of pancreatitis was significantly higher in patients with a long common channel length (>21 mm), wide common channel diameter (>5 mm), wide diameter of proximal pancreatic duct (>2.5 mm), filling defect in the common channel, and pancretic duct anomaly. However, age, sex, type of choledochal cyst, type of AUPBD, diameter of the bile duct, angle between the pancreatic duct and bile duct, biliary stone, and pancreticobiliary malignancy were not associated with the risk of pancreatitis. Patients underwent cyst excision (n=9), choledochocystojejunostomy (n=1), pancreas head resection (n=3), or conservative management only (n=3). Pancreatitis recurred in 3 of the 16 patients treated during a mean follow-up of 37.5 months. Bile reflux to the pancreatitc duct seems to be the main mechanism of pancreatitis in AUPBD, considering the fact that choledochal cyst excision prevented pancreatitis recurrence. Conclusions: Morphological characteristics of the common channel and pancreatic duct contribute to the development pancreatitis in patients with AUPBD and choledochal cyst probably due to the bile reflux into the pancreatic duct. (Korean J Gastroenterol 2003;41:309-315)

최신 연구 소개 : 혈액요소질소(BUN) 수치의 초기 변화가 급성 췌장염 환자의 사망을 예측할 수 있는가?

정지봉 ( Ji Bong Jeong ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.3

과민성 장증후군 환자에서 식후 대장내압검사

정지봉(Ji Bong Jeong),양용모(Youg Mo Yang),전원중(Won Joong Jeon),서정철(Jeong Chul Seo),이경수,이현희(Hyun Hee Lee),고병성(Byeong Seong Ko),채희복(Hee Bok Chae),박선미(Seon Mee Park),윤세진(Sei Jin Youn) 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.1

N/A Background/Aims: The purpose of this study was to discover the physiologic difference of a postprandial motor response in different segments of the colon between patients with irritable bowel syndrome and healthy subjects. Methods: Irritable bowel syndrome patients are categorized into three groups according to their main symptoms; loose stool-dominant (A, n=5), abdominal pain-dominant (B, n=5), constipation-dominant (C, n=6) and the normal control group (n=5). The intraluminal pressure activity was measured with a colonoscopically positioned multilumen manometric catheter. The change of the colonic motility index (MI) is presented as a percent change (mean±SE%) over the basal period in response to a meal. Results: 1) In the transverse, descending and sigmoid colon of healthy subjects, the percentage changes in the basal Ml during the first 30 min after the meal are significantly increased (p<0.05-0.01). 2) In the sigmoid colon, the percentage changes in the basal MI during the first 30 min after the meal were 62±18 in A, 29±18 in B, 12±8 in C and 306±l02% in heathy subjects respectively, which shows a significant difference between the MI of control and healthy subjects (p<0.05). 3) In B and C, the percentage changes in the l MI during the first 30 min after the meal in the descending colon were 105±38, 11±7, respectively, which shows a significant difference between the two groups (p<0.05). In A and C, the percentage changes in the basal MI during the first 30 min after the meal in the sigmoid colon was 62±18, 12±8, respectively, which shows a significant change between the two groups (p<0.05). Conclusion: This study suggests that postprandial intraluminal pressure differences play a role in the pathophysiology of irritable bowel syndrome. (Korean Journal of Gastrointestinal Motility 2(00;6:20-31)

김치 유산균 Starter 를 이용한 김치의 발효 특성 및 기능성 증진 효과

봉연주 ( Yeon Ju Bong ),정지강 ( Ji Kang Jeong ),박건영 ( Kun Young Park ) 부산대학교 김치연구소 2013 김치의 과학과 기술 Vol.16 No.-

chi by inoculating kimchi lactic acid bacteria (LAB) starters were studied. We manufactured single LAB starter kimchi (Lactobacillus plantarum pnuK, Lactobacillus plantarum 3099K, Leuconostoc mesenteroides pnuK), mixed LAB starter kimchi (Lb. plantarum pnu/Leu. mesenteroides pnuK, Lb. plantarum 3099/Leu. mesenteroides pnuK) with inoculum size of 106 CFU/g, as well as naturally fermented kimchi (NK), and fermented them for 6 days at 15°C. The pH and acidity of the early phase of fermentation were not different, but kimchi with the starters showed rapid changes in the pH and acidity from 2 days of fermentation. As the fermentation progressed, the level of total aerobic bacteria and Lactobacillus sp. increased similarly with or without Lb. plantarum (LP) inoculation. However, the level of Leuconostoc sp. was high in kimchi inoculated with Leuconostoc sp. starter. In the sensory evaluation test, kimchi with starters received higher overall acceptability scores than those of NK; mixed starter added kimchi earned the highest score. In DPPH and hydroxyl radical scavenging activity, kimchi with the starters exhibited higher activity than that of NK. In the MTT assay of HCT-116 and HT-29 human colon cancer cells, NK showed inhibition rates of 63.4 and 51.9%, but LPpnuK achieved 77.1 and 68.8%, respectively. This study showed that inoculating starters in kimchi increased in vitro antioxidant and anticancer activities, and single starter (LP) added kimchi revealed higher functionality than the kimchi with mixed starter. Kimchis with the starters effectively up-regulated the gene expressions of the pro-apoptotic gene of Bax, but down-regulated Bcl-2. They promoted expressions of p53 and p21, and suppressed expressions of inflammation-related genes, iNOS and COX-2, compared with NK. Taken together, it is expected that using starters may help manufacture kimchi with improved sensory quality and health functionality.