動脈硬化性心臟病의 臨床的 觀察

具滋英,李相採,尹炳哲,李相桂 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.1

過去 10年間 慶北醫大 附屬病院 內科에서 診療한 動脈硬化性心臟病患者 143例를 對象으로 觀察, 檢討하였으며 그 主要成績은 다음과 같다. 1) 男女의 比는 3.2:1로 男子에 많았으며 發病年齡은 50代가 가장 많았고(40.6%), 60代(30.8%), 40代(14%), 70代以上(11.2%), 그리고 30代(3.5%)順으로 많았다. 2) 動脈硬化性心臟病에 다른 病症이 同伴된 例는 全例의 58.7%를 차지하였으며 高血壓과 糖尿病이 많았다. 3) 主要 臨床症狀은 胸痛(94.6%), 呼吸困難(57%), 消化不良(13.8%), 기침(12.3%) 및 心悸亢進(7.7%)등이었다. 4) 症狀發作의 誘因은 全例가운데 56.1%에서 찾아 볼 수 있었는데 身體活動, 精神的 Stress 및 食事가 主된 誘因이었고 狹心症의 誘因은 주로 身體活動(53.7%) 및 精神的 Stress(20.9%)의 두 가지였으나 急性心筋梗塞症의 그것은 身體活動(23.7%), 食事(13.6%), 精神的 Stress(6.8%) 및 感染症(5.1%)등 여러 因子가 誘因으로 作用하였다. 5) 發病後 72時間以內에 SGOT値(40單位以上) 및 SGPT値(35單位 以上)의 上昇은 各各 75.6% 및 48.6%에서 나타났으며 發病後 4日以內에 血淸 LDH値의 上昇(400單位以上)을 나타낸 例는 41.6%였다. 血淸 Cholesterol値가 200㎎/100㎖未滿인 例는 38.7%, 200-240㎎/100㎖가 27.0%, 240-280㎎/100㎖가 14.4%였고 19.9%에서는 280㎎/100㎖보다 높았다. 6) 異常心電圖所見으로서 높은 頻度를 보인 것은 左心室肥大所見(41.3%), 左側軸偏位(35.7%), Q-T間隔의 延長(30.7%), 左心房肥大所見(12.6%) 및 QRS波의 低電位(8.4%)등이었다. 그리고 心電圖學的으로 본 心筋梗塞의 部位는 前壁이 58.3%, 後壁이 30.6%, 高 側壁이 2.8%였고 後 側壁이 8.3%였다. 그리고 調律異常 및 傳導障碍는 各各 21.7%, 33.6%에서 觀察되었다. 7) 合倂症은 전예의 37.8%에서 發生하였는데 主된 것은 鬱血性心不全症(24.5%) 및 不整脈(11.9%)였고 心筋梗塞症에서의 合倂症은 狹心症에서의 그것보다 約 2倍나 많이 發生하였으며 특히 前者에서는 不整脈의 發生頻度가 狹心脈의 그것보다 約 3倍에 달하였고 重篇한 合倂症이 많이 發生하였다. A clinical study was made on one hundred and forty-three cases of atherosclerotic heart disease seen at Kyungpook University Hospital during past 10 years, and the following data were obtained. 1. Atherosclerotic heart disease was more common in the male with male to female ratio being 3.2:1. Over two thirds of them, their age was fifth and sixth decades. 2. In 58.7 per cent of all patients there were associated diseases. The two most frequently associated diseases were hypertension and diabetes mellitus, each comprising 31.5 per cent and 7.6 per cent, respectively. 3. The cardinal symptoms were chest pain, dyspnea, indigestion, and palpitation. And the socalled painless myocardial infarction was noted in 7 cases(11.9 per cent). 4. Physical exercise, mental stress, and meal were three major precipiting factors of attacks in all clinical situations. In myocardial infarction single cause triggered the attacks, Whereas, on or more factors played in attacks of angina Pectoris. 5. The common arrhythmias including conduction distrbances and their incidence were: both atrial fibrillation and premature ventricular contraciton, 6.3 per cent, junctional rhythm, 4.2 per cent, first degree atrioventricular block, 8.4 per cent, second degree atrioventricular black, 3.5per cent, complete right bundle branch block, 7.7 per cent, and complete left bundle branch block, 4.9 per cent. Left ventricular hypertrophy pattern and the finding consistent with left atrial enlargement were noted in 41.3 per cent and 12.6 per cent, respectively. Electorcardiographically, anterior wall was the most frequent site of infarction followed by posterior wall,each comprising 58.3 per cent and 30.6 per cent, respectively. 6. Complications were developed in 48.6 per cent of myocardial infarction and in 23.9 per cent of angina pectoris. Congestive heart failure and arrhythmia including heart block were the major in 31.9 per cent and 16.7 per cent, respectively, whereas, in angina pectoris they were noted in 16.4 per cent and 6 per cent, respectively.

대구 경북지역에서 진단된 노령자 폐암의 임상적 특징과 예후

김현숙 ( Hyun Sook Kim ),현대성 ( Dae Sung Hyun ),김경찬 ( Kyung Chan Kim ),이상채 ( Sang Chae Lee ),정태훈 ( Tae Hoon Jung ),박재용 ( Jae Yong Park ),김창호 ( Chang Ho Kim ),차승익 ( Seung Ick Cha ),이관호 ( Kwan Ho Lee ),정진홍 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.1

연구배경: 폐암은 우리나라 암 사망원인 질환의 가장 높은 비율을 차지하는 질환으로 특히 노령 인구에서 증가하는 추세이다. 그러나 노령의 폐암 환자는 동반된 질환, 노령에 따른 장기 기능의 저하 등의 이유로 적절한 치료를 받지못하는 경우가 많다. 이에 70세 이상의 노령 폐암 환자의 임상적 특징과 치료에 따른 생존기간 등을 알아보고자 한다. 방법: 2005년 1월부터 2005년 12월까지 대구, 경북지역에 소재하고 있는 대학병원 및 종합병원(경북대학병원, 구미 순천향병원, 대구가톨릭대학병원, 대구파티마병원, 동산의료원, 영남대학병원)에서 세포학적 혹은 조직학적으로 원발성 폐암을 진단받은 706명의 환자들을 70세 이상 환자군과 70세 미만 환자군으로 나누어 후향적으로 연구하였다. 결과: 전체 환자 중 70세 이상의 환자는273명(38.7%)이었다. 70세 이상의 환자는 70세 미만보다 호흡곤란의 증상이 많았으며(p<0.001), 만성폐쇄성폐질환의 빈도가 높았고(p<0.001), 활동도가 좋은 경우가 적었다(p<0.001). 비소세포폐암 환자의 중앙생존기간은 70세 미만의 환자와 70세 이상의 환자에서 유의한 차이를 보였지만(962일 vs 298일, p=0.001), 한 가지라도 치료를 받았던 환자들을 대상으로 했을 때는 두 군간에 의미 있는 차이가 없었다(1,109일 vs 708일, p=0.14). 결론: 70세 이상의 비소세포폐암 환자에서 환자의 활동도 등을 고려하여 적극적인 치료를 시행하는 것이 바람직할 것으로 생각된다. Background: Lung cancer is the leading cause of cancer death in South Korea since the year 2000 and it is more common in elderly patients, with a peak incidence at around 70∼80 years of age. However, these elderly patients receive treatment less often than do the younger patients because of organ dysfunction related to their age and their comorbidities, and they show poor tolerance to chemotherapy. The aims of this study were to analyze the clinical characteristics and treatment-related survival of elderly patients with lung cancer. Methods: In this retrospective study, we analyzed the clinical data of 706 lung cancer patients who were diagnosed at hospitals in Daegu and Gyeongsangbukdo from January 2005 to December 2005. We compared the clinical characteristics and outcomes of the patients who were aged 70 years and older (elderly patients) with those clinical characteristics and outcomes of the younger individuals. Results: The median age of the patients was 68 years (from 29 to 93) and the elderly patients were 38.7% (n=273) of all the study``s patients. Squamous cell carcinoma was the most common type of lung cancer in both the elderly and younger patient groups. Elderly patients had more symptoms of dyspnea and chronic obstructive pulmonary disease (COPD) than the younger patients (p<0.001 and p<0.001, respectively). A good performance status (ECOG 0-1) was less common for the elderly patients (p<0.001). The median survival of the non-small cell lung cancer (NSCLC) patients was significantly higher in the younger patient group than in the elderly patient group (962 days vs 298 days, respectively, p=0.001). However, the median survival of the NSCLC patients who received any treatment showed no significant difference between the younger patient group and the elderly patient group (1,109 days vs 708 days, respectively, p=0.14). Conclusion: Our data showed that appropriate treatment for selected elderly patients improved the survival of patients with NSCLC. Therefore, elderly NSCLC patients with a good performance status should be encouraged to receive appropriate treatment.

영남문집해제 : 수졸재집

이상채 영남대학교 민족문화연구소 1988 민족문화연구소 자료총서 Vol.4 No.-

各種 刊疾患患者에 있어서의 HBs-Ag, Anti-HBs 및 AFP의 檢出率에 關한 檢討

李相彩,鄭克守 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

우리나라에서 비교적 흔히 관찰되는 급만성 간염 간경변증, 간암 및 기타의 간질환에서 HBV와의 관련성을 조사하는 한 방편으로서 각종 간질환 357례를 대상으로 하여 이들의 혈청 HBs-Ag, Anti HBs 및 AFP을 그 예민도에 있어서 RIA와 대등하다고 알려진 RPHA방법으로서 검사하여 다음과 같은 성적을 얻었다. 1. HBs-Ag의 출현율은 평균 45.1% 였으며, 만성 간염에서 61.4%로 가장 높은 검출율을 보였고, 급성 바이러스성 간염(55.3%), 간암(48.1%), 간경변증(41.2%)의 순서를 나타냈으며, HBV와 무관하다고 생각되는 기타의 간질환의 경우는 5.0%의 성적을 보였다. 또한 생검으로 확진된 예와 임상적으로 진단된 예는 서로 유의한 차이는 없었으나, 생검예에서는 만성 활동성 간질환이 만성 비활동성 간질환에 비하여 고율로 나타났다. 2. AFP의 출현율은 평균 11.5%였으며, 이들중 간암이 대부분으로 42.0%의 출현율을 보였으나 만성 간염(4.5%), 간경변증(2.4%), 급성 바이러스성 간염(2.1%)의 순서로 나타났다. 3. Anti-HBs 검출율은 평균 62.0%였으며 비활동형 간경변증에서 87.5%로 가장 높은 검출율을 보였으며, 급성 바이러스성 간염, 만성 간염, 간암 및 활동형 간경변증의 순서로 나타났으나 HBV의 감염과 특별한 관련성이 없다고 생각되는 기타의 간질환군에서 57.9%의 성적을 보여서 이는 우리나라가 B형 간염이 많이 관찰되는 지역이라는 근거를 제시하고 있다. 4. 간암환자에서 HBs-Ag 양성과 AFP의 양성사이에는 상당한 관계가 있음을 보여 주었다. 5. 이상의 성적으로서 우리나라에서 유행하는 각종 간질환은 HBV와 밀접한 관련성이 있는 질환의 일종으로 생각된다. A study was done in order to evaluate the etiologic correlation between hepatitis B virus and various diseases of the liver, prevalent in Korea, sera from 357 patients with liver diseases were examined for HBs-Ag and AFP by reverse passive hemagglutination assay (RPHA) technique. Among 357 cases, 170 cases were proved by percutaneous needle biopsy or aspiration cytology and 187 cases were diagnosed clinically. Distributions by disease entity showed liver cirrhosis 46.2% (165 cases), hepatocelluar carcinoma 22.7% (81 cases), acute viral hepatitis 13.2% (47 cases), chronic hepatitis 12.3% (44 cases) and miscellaneous liver diseases 5.6% (10 cases) unrelated to hepatitis B virus infection. The results were summarized as followings: 1. The average incidence of HBs-Ag in patients with various diseases of the liver was 45.9%, but the peak incidence of HBs-Ag ranked as 61.4% in chronic hepatitis and the incidence of HBs-Ag in acute viral hepatitis was 55.3%, hepatocellular carcioma 48.1%, liver cirrhosis 41.2% and the miscellaneous diseases of the liver 5.0%. 2. The incidence of AFP in patients with hepatocellular carcinoma was 42.0%, chronic hepatitis 4.5% (2 of 44), liver cirrhosis 2.4% (4 of 165) and acute viral hepatitis 2.1% (1 of 47). 3. The incidence of Anti-HBs in patients with inactive liver cirrhosis was 87.5% and the next ranking showed as acute viral heptitis, chronic hepatitis, hepatocellular carcinoma and active livercirrhosis. But the incidence of Anti-HBs in patients with miscellaneous diseases of the liver that might be thought to be unrelated to hepatitis B virus infection was exceptionally high as 57.9%. This result suggested indirect evidence of the fact that Korea was one of the nations for prevalent hepatitis B virus infection. The average incidence of HBs-Ag in patients with various diseases of the liver was 62.0%. 4. The correlation between of HBs-Ag in positivity and the detectability of AFP in case with hepatocellular carcinoma was closely related significantly. 5. In conclusion, we condsidered the various diseases of the liver which were prevalent in Korea to be closely related to a spectrum of hepatitis B virus.

개원의 연수강좌 2 : 호흡기 질환의 증례와 영상진단 ; 종양성 흉부질환

이상채 대한내과학회 2004 대한내과학회 추계학술대회 Vol.2004 No.2

항결핵제 투여후 중합효소연쇄반응으로 추적한 폐결핵 환자들의 치료반응 관찰

이상채,전창호 대한결핵 및 호흡기학회 1997 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.85 No.0

자율신경실조증에 따른 제증상에 대한 토리잘^(�) Soft Capsule의 임상효과

李相彩 최신의학사 1988 最新醫學 Vol.31 No.8

주민참여형 도시숲 조성 유형 및 특성 분석

이상채,박세영,손학기,한소영,권윤구,김은일 한국경관학회 2020 한국경관학회지 Vol.12 No.1

Urban forests can be an alternative to our society, which needs a community, given that they can be energy that boosts the local economy and communities. In particular, the active demand for people’s direct participation in the creation of urban forests has been increasing recently. However, there are no specific guidelines for this, so there are many difficulties not only for participating citizens but also for the project implementers. Therefore, this study was intended to identify the current status of participating forests created through ‘Jeonnam in the Forest’ and to present the characteristics of each type and the direction of guidance accordingly. The types of participatory forests can be largely divided into living forests, income forests, and other forests, while living forests can be classified into shelter-type and landscape-type again. It is believed that more effective participatory forests can be created if specific guidelines on how to manage and maintain food products are set according to these types. Citizen participation in the creation of urban forests has a great influence on the improvement of urban forest service functions. Therefore, this study has a implication which sought a more efficient way to implement related projects.

토양 및 지하수 오염지역에 대한 전기비저항탐사의 적용성 연구

채승헌 ( Seungheon Chae ),이상은 ( Sangeun Lee ),정교철 ( Gyo-cheol Jeong ) 대한지질공학회 2020 지질공학 Vol.30 No.4

본 연구지역은 피혁 제조공정에서 발생된 고형폐기물, 처리용수 및 유류 저장용기 등이 매립되어 있는 지역이다. 피혁폐기물 매립으로 발생된 침출수에 의한 오염영역을 파악하기 위하여 토양·지하수 오염도 조사 및 전기비저항탐사를 수행하였다. 토양오염 분석 결과 TPH와 아연 항목에서 토양오염 우려기준을 초과하였으며, 침출수 및 지하수의 경우 6가 크롬 항목이 지하수 정화기준을 초과하는 것으로 파악되었다. 전기비저항탐사는 토양 · 지하수 오염특성 및 확산경로를 파악하기 위하여 쌍극자배열법으로 전극간격이 5 m인 총 10개의 측선을 설정하였다. 토양·지하수 오염도 조사의 결과와 저비저항이상대가 비교적 잘 일치하였다. 따라서 본 연구지역과 같이 폐기물 매립에 따른 불규칙한 지층분포와 토양·지하수가 복합적으로 오염된 지역에서 전기비저항탐사를 병행하면 오염원에 의한 수직·수평적인 확산경로, 오염영역 및 향후 오염 예상지역에 대한 모니터링을 계획하는데 있어서 유용한 조사기법으로 사용될 수 있을 것이다. A site containing buried solid waste and treated water and oil storage containers from a leather manufacturing plant was studied through soil and groundwater pollution and electrical resistivity surveys with the aim of identifying areas polluted by leachate generated by landfilling with leather waste and leakage wastewater. It was found that TPH and Zn exceeded environmental standards for soil pollution and, for leachate and groundwater, Cr(VI) concentrations exceeded standard levels for groundwater quality. An electrical resistivity survey was used to elucidate soil and groundwater pollution characteristics and diffusion pathways. Ten survey lines were set up with an electrode spacing of 5 m in a dipole-dipole array. The hydraulic characteristics of soil determined by groundwater contamination surveys matched well the low-resistivity-anomaly zones. Electrical resistivity surveys of areas containing contaminated soil and groundwater that have irregular strata due to waste reclamation are thus useful in highlighting vertical and horizontal pollutant diffusion pathways and in monitoring contaminated and potentially contaminated areas.

胃癌 1,265例에 對한 統計的 考察 : 胃內視鏡 檢査例

金秀祥,李相彩,丁泰勳,鄭俊謨,鄭克守 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.1

1968年 1月부터 1978年 8月까지 約 10年間 慶北醫大 消火器內科 胃鏡室에서 實施된 總 7000例의 胃內視鏡檢査中 胃癌으로 診斷된 1265例를 對象으로 分析한 바 다음과 같은 成績을 얻었다. 1. 總胃內視鏡檢査例中 胃癌의 檢索率은 18.1%였으며 이들중 早期胃癌은 全體胃癌例의 3.1%였으나 手術한 胃癌例의 19.6%에 達하였다. 2. 過去 10年間 各年度別 胃癌頻度의 推移를 보면, 近來 胃內視鏡檢査의 普遍化로 人해 胃癌의 胃內視鏡檢査例에 對한 相對的頻度도는 1975年以後 漸次 減少하는 傾向으로 보이나, 來院患者總數에 對한 胃癌의 頻度는 有意한 差異가 없었다. 3. 胃癌의 男女比는 2.3 : 1로서 男子에서 頻發했고, 年齡別로는 50代에서 가장 頻發했으나 進行胃癌dkp서는 20代와 30代가 13.9%를 차지 했고 早期胃癌에서는 30代가 23.1%를 차지해서 젊은 年齡層에서도 결코 적지않은 頻度를 보였다. 4. 胃癌의 好發部位로서는 進行胃癌에서는 A部位(46.4%), 早期胃癌에서는 M部位(59.5%) 그리고 橫的分布로서는 小彎側이 가장 많았다. 5. 胃癌疾巢의 크기는 胃內視鏡 下 生體觀測한 進行胃癌에서는 2cm 以上의 疾巢만도 56.3%에 達했다. 그러나 手術切除後 新鮮胃標本에서 觀測한 早期胃癌의 境遇에서는 1∼3cm 크기의 疾巢(66.7%)가 가장 많았다. 6. 胃癌의 肉眼的形態分類에서는 Borrmann 氏 分類를 實施한 進行胃癌의 境遇 Ⅲ型(62.2%)이가장 頻發했으며 그다음으로 Ⅱ, Ⅰ, Ⅳ, Ⅴ型의 順序를 보였고, 日本內視鏡學會의 分類를 따른 早期胃癌의 경우는 Ⅱ_e 및 Ⅱ_e 複合型이 71.4%로서 가장 많았다. 大別해보면 早期胃癌이나 進行胃癌에서 모두 陷沒形質變이 顯著하게 많음이 觀察되었다. 7. 早期胃癌의 癌浸潤深度는 m이 18疾巢, sm이 24疾巢였고 周圍淋巴腺轉移는 16.7%에서 觀察되었다. 8. 進行胃癌의 手術切除率은 65.2%였으며, 腫瘤觸知例에서는 59.2%, 腫瘤觸知不能例에서는 71.6%였다. 9. 進行胃癌의 肺結核合倂率은 10%로서 1975年度 韓國全域의 肺結核有疾率 3.3%에 比해 3倍以上이었다. A statistic study was done on 1,265 cases of the gastric cancer, selected from 7,000 cases of gastroscopic examination performed at Gastroscopy Room department of Internal Medicine of Kyungpook National University Hospital, Taegu, Korea, during the last 10years period from Jan. 1968 to Aug. 1978. The results were summarized as follows: 1. The overall incidence of gastric cancer among total gastroscopic examination was 18.1% and the incidence of early cancer among total gastric cancer was 3.1%. Among total 193 cases of gastric cancer on whom surgical resection was performed early cancer occupied 19.6%. 2. Annual incidence of gastric cancer among annual number of gastroscopy showed slight decrease in the period of after 1975, compared with before 1975. But no differences were found in the annual incidence of gastric cancer among total number of patients visited at Department of Internal Medicine and of General Surgery. 3. Age distribution of gastric cancer showed the highest incidence in the age group of 5th group (advanced; 2nd and 3rd decades; 13.9%, early; 3rd decade; 23.1%). Male to female ratio was 2.3:1. 4. The location by CMA classification in advanced stomach cancer showed a predilection in area A, while in early cancer, in area M. The location from the view of transection, the most predilection site was the lesser curvature. 5. The size of the lesion measured in vivo during gastroscopy showed the highest incidence in the size larger than 4cm in diameter (56.3%) in advanced gastric cancer, while the size of the lesion measured in fresh resected stomach of the cases of early cancer showed the highest incidence in the size between 1 to 3cm in diameter. 6. Borrmann type classification of advanced gastric cancer in order of frequency were as follows; Ⅲ(92.2%), Ⅱ(26.7%), Ⅰ(8.6%), Ⅳ(2.4%), Ⅴ(0.1%). In early gastric cancer, the most prevalent type was Ⅱc(35.7%) and its combined type (total 71.4%). 7. Concerning the depth of cancerous infiltration in early cancer, 18 lesions were confined to the mucosa, and 24 to the submucosa. Metastasis of the regional lymph node was determined in 4 out of 24 cases (16.7%) 8. Overall resectability of 198 operated cases of gastric cancer was 65.2%. The resectability of the cases with palpable epigastric mass was 59.2% and without palpable epigastric mass, 71.6%. 9. Complication of pulmonary tuberculosis in advanced gastric cancer revealed 10% of prevalence rate, and this value was 3times higher than that of general population in Korea, 1975.