고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

무보수 호흡용 보호구 착용이 2차 제련 연작업자들의 연폭로지표에 미치는 영향

이영구,황보영,리갑수,이성수,안규동,이병국 순천향대학교 산업의학연구소 1997 순천향산업의학 Vol.3 No.1

It is often impossible to improve working condition in small scaled lead industries due to inherent old work process and lack of capital to improve it. This is particularly true in secondary smelting industries in Korea. Alternative ways to protect workers in these industries are respiratory protection and job shift if at all possible to less harmful workplace. This study intended to evaluate the effect of maintenance free respirator and job shift of lead workers to other non-lead workplace on the level of lead exposure of workers in terms of blood zinc protoporphyrin as an index of lead absorption and intoxication of lead workers. Seventy three workers of one secondary smelting industry whose work duration was more than 4 months were studied. All workers were classified into 4 groups such as managemental workers(8), non-lead workers(14), lead workers(44) and shift workers(7). Personal data such as age and work duration were collected and air concentration of lead in each workplace were also measured. Blood ZPP was chosen as an index of biological monitoring and was measured regularly once a month for 5 months study period. The results obtained were as follows: 1. There were no significant differences of mean blood ZPP during 5 months study period in management workers and non-lead workers showing the range of 23.1-26.5 ㎍/100ml and 22.2-24.2 ㎍/100ml respectively. 2. Rapid reduction of mean blood ZPP from first month (203.0 ± 106.7 ㎍/ 100ml) to third month (128.4 ± 75.1 ㎍/100ml) was noticed and after 3 months period there was no further reduction of blood ZPP in lead workers. 3. The initial mean blood ZPP of shift workers who moved to non-lead workplace was 394.3 ± 114.9 ㎍/100ml and their mean blood ZPP were steadily decreased every month from 344.3 ± 98.4 ㎍/100ml of first month to129.9 ± 33.5 ㎍/100ml of 4th month). 4. The average reduction rate of blood ZPP based on initial blood ZPP was 37.0% in lead workers for 3 months period and 67.1% in shift workers for 4 months period. With above results it was observed that respiratory protection and work shift could protect lead workers from lead exposure by reducing lead exposure in secondary smelting industry which had fairly bad working condition. But for a complete prevention of lead poisoning, it has certain limitation and should be used as an interim method until fundamental engineering control of workplace.

Plenary Session 2 : PS-2-1 ; Outcomes of hepatitis B virus recurrence after liver transplantation: a multicenter analysis in Korea

( Hee Yeon Kim ),( Jong Young Choi ),( Dong Goo Kim ),( Myoung Soo Kim ),( Soon Il Kim ),( Shin Hwang ),( Sung Gyu Lee ),( Kwang Woong Lee ),( Kyung Suk Suh ),( Young Seok Han ),( Dong Lak Choi ),( Se 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: The outcome of hepatitis B virus (HBV) infection after liver transplantation (LT) was improved by hepatitis B immunoglobulin (HBIG) and nucles(t)ide analogue (NUA). However, HBV recurrence after LT is critical because the recurrence is occasionally accompanied by a progressive destruction of graft and poor survival. The aims of this study were to investigate the significance HBV recurrence and identity factors associated with HBV recurrence. Methods: From October 1999 to February 2011, a total of 2684 consecutive LT recipients who underwent HBV-associated LT were retrospectively enrolled from 7 transplantation centers in Korea. Results: Prophylaxis regimens were HBIG monotherapy (67.7%) or a combination of HBIG with NUA (22.3%). The recurrence rate of HBV was 6.1% (164 recipients) during mean follow-up duration of 10.9 years. The median time from transplantation to recurrence was 2.1 years (0.1-7.9 years). Of the 1,071 patients with hepatocellular carcinoma (HCC) prior to LT, 155 patients (14.5%) had HCC recurrence after transplantation, and 48 patients (31.0%) had HBV recurrence. Of the 48 patients with recurrence of both HBV and HCC, 25 patients (52.1%) experienced HBV recurrence after HCC recurrence. In the multivariate analysis, pretransplant HCC, pretransplant HBV DNA above 5.5 log copies/mL was independent clinical factors influencing HBV recurrence after LT. The mortality rate among the recipients with HBV recurrence was 34.1% (56 recipients). Mean overall survival was 6.4 years in the HBV-recurrence group and 9.9 years in the HBV-nonrecurrence group (p<0.001). HBV recurrence was not an independent prognostic factor for overall survival. HCC recurrence was the most important factor for overall survival. Conclusions: The overall outcome of LT in HBV-related liver disease was excellent with the current prophylaxis regimen Choon Hyuck David Kwon,8 Suk-Koo Lee8 Pretransplant HBV DNA and HCC were important factors for HBV recurrence. HBV recurrence after LT did not significantly influence on the overall survival without combining of HCC recurrence.

대전·충남지역 고등학교 1학년생의 풍진 항체보유율과 백신접종 후의 항체형성률

오성균,김수영,여경오,김윤태,최명한,이석구,조영채,이동배,이태용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

For the purpose of investigating the positive rate of rubella antibody and sero-conversion rate after rubella vaccination, 863 high school students of the two regions were studied from April 21st, 1996 to September 20th, 1996. The main results were as follows; 1. Positive rate of IgG in male was higher than in female, and the rate of IgM was also higher in male than in female. 2. Positive rate of IgG by blood type was similar, but positive rate of IgM was higher in AB type than the others. 3. Positive rate of IgG by vaccination was similar to all groups, but positive rate of IgM was higher in which was not vaccinated group. 4. Positive rate of IgG and IgM, having vaccination card, was less than which was not having vaccination card. 5. Those who were vaccinated acquired IgG(+) regardless of an existence of IgG antibody, and 28.3% of IgG(-), IgM(+) male who was not vaccinated became IgM(+), IgG(+) after 3months later. As a result positive rate of male was higher than female. The author conclude that vaccination is necessary to prevent from rubella for them.

내시경적 점막절제술로 치험한 식도 과립상 세포종 1례

강혁주,김성욱,최석진,이중현,장재식,서영범,윤병구,박건욱,김성자,김용섭,강승완,이구,양창헌,이창우,김욱년,이광헌,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

과립상 세포종은 Schwann 세포 기원으로 생각되며 인체에 비교적 드물게 발생한다. 과립상 세포종은 전신 어느 곳에서나 발견될 수 있으나 주로 혀, 구강, 피부 혹은 유방 등에서 호발하며 드물게 위장관에서 발견된다. 위장관에서는 식도에서 가장 호발하며 다음으로 위, 대장 순이다. 과립상 세포종은 대부분, 특히 위장관에서는 양성이며 소수의 악성 병변이 보고되었다. 이러한 이유와 함께 수술 전의 진단이 어렵기 때문에 과립상 세포종에 대한 근본적인 치료는 현재까지 외과적 절제술이다. 최근에 시도되는 치료방법들로는 내시경적 레이저 치료, 용종절제술, 내시경적 점막 절제술 등이 있다. 저자들은 상부 소화관 내시경검사를 시행하여 식도 과립상 세포종을 진단하고 내시경적 점막 절제술을 시행하여 합병증 없이 퇴원하여 현재 재발없이 경과 관찰중인 1례를 경험하였기에 보고하는 바이다. Granular cell tumors, which occur infrequently, are probably of Schwann cell origin. They can occur almost anywhere in the body but usually affect the tongue, oral cavity, skin, or breasts and are rarely found in the gastrointestinal tracts. The esophagus is the most frequent gastrointestinal site, followed by the stomach and the colon. Granular cell tumors are generally benign, especially in the gastrointestinal tract, some malignant lesions have been reported. For this reason, and also because preoperative diagnosis is difficult, the standard treatment for granular cell tumor has until now been surgical excision. In recent years, other therapeutic methods is endoscopic laser therapy (ELT), polypectiomy, endoscopic mucosal resection (EMR). We report a case of esophageal granular cell tumor which was diagnosed by an endoscopy and managed using an endoscopic mucosal resection without complication.

사적정보 하의 최적사전계약의 특성

이영구 서강대학교 경제학연구원 2002 시장경제연구 Vol.31 No.2

This paper analyzes the characteristics of the optimal pre-commitment contract under private information by using a simple partial equilibrium model. It shows that if the maximum fine is not binding at the optimal solution under public information then the optimal pre-commitment contract under private information can achieve the optimal solution under public information. If the maximum fine is binding, then the optimal pre-commitment contract under private information can not achieve the optimal solution under public information, yet improves the situation under the standard capital control. It also analyzes the characteristics of the pre-commitment contract relative to the optimal solution under public information, in the case of the maximum fine being binding. Ⅰ. 머리 글 Ⅱ. 모형 Ⅲ. 최적계약의 특성 Ⅳ. 예증(例證) Ⅴ. 맺는 글

다이아몬드 기구로 삭제한 와동에서 2단계 접착제의 미세누출 비교

이명구,조권환,조영곤 대한치과보존학회 2007 Restorative Dentistry & Endodontics Vol.32 No.5

인슐린의존형 당뇨병환자에서 임신중 병발한 당뇨병성 케톤산증 1예

이성근,신영구,이성규,정윤석,이관우,김현만,김행수 아주대학교 1997 아주의학 Vol.2 No.2

저자등은 인슐린의존형 당뇨병환자에서 임신중에 병발한 당뇨병성 케톤산증을 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. IDDM is an autoimmune disease resulted from beta cell destruction and insulin deficiency, and developed mostly in children and puberty. Ketoaddosis remains one of the most senous complications that can occur in the pregnant diabetic. A 26-year-old woman, gravida 1, para 0, was admitted at 32 weeks gestation because of fever lasted for 6 days. She had been treated with insulin pump during the pregnancy. Blood sugar was well controlled before admission, and the etiology of her ketoacidosis was urinary tract infection and no insulin-intake. DKA was treated with fluids and intravenous insulin. Urinary tract infection was treated with antibiotics, based on culture test. Healthy newbom was later delivered by cesarean section due to fetal distress. We experienced a case of DKA in pregnant woman and report it with a review on literature.

기능성 소화불량증환자에서 Winstal® 투여에 관한 임상경험

이창형,김영탁,금민수,권중구,안병철,윤영미,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.3

목적 : 기능성 소화불량증은 소화, 흡수등 장관의 기능적인 이상과 관련되어 있을 것으로 생각되며 복합소화효소제(Winstal®)를 투여하여 그 임상효과를 평가하고자 본 연구를 실시하였다. 대상 및 방법 : 1994년 3월 부터 6월까지 경북대학교병원 내과를 방문한 기능성 소화불량증을 호소하는 환자 20명을 대상으로 Winstal®을 1회 1정씩, 1일 3회 식후 30분내에 경구로 2주간 투여하였다. 결과 : 소화불량증의 증상은 복부불쾌감, 복부팽만감, 식욕부진 및 오심, 복부동통, 공기연하증, 고창 및 구토순이었으며, 증상의 개선은 복부불쾌감이 76.4%(13/17)로 가장 높았으며, 그 다음으로 복부팽만감 및 공기연하증이 66.5%(10/15, 6/9)이었고, 오심 61.5%(8/13), 식욕부진 53.8%(7/13), 복부동통 41.6%(5/12), 고창 37.5%(3/8)이었다. 각 환자별 종합적인 증상의 개선도는 현저한 개선이 2예(10%), 중등도 개선이 3예(15%), 약간개선이 11예(55%), 불변이 4예(20%)이었으며 종합적인 유효율은 80%(16/20)이었다. 부작용은 한 예에서도 관찰되지 않았다. 결론 : 본 제제는 기능성 소화불량증 환자의 증상개선에 추천할 만한 유효한 약제로 생각된다. Dyspepsia is a common symptom in gastroenterologic practice and trigger for numerous consultations with physician. The treatment of chronic functional dyspesia is unsatisfactory. This study was performed to evaluate the efficacy of the digestive compound (Winstal®) on 20 functional dyspepsia patients. On open trial, all patients were given 6 tablets daily for 2 weeks and we evaluated the efficacy of this preparation according to the degree of the improvement. The improvement of symptoms was 76.4%(13/17) in abdominal discomfort, 66.5%(10/15, 6/9) in abdominal distension and aerophagia, 61.5%(8/13) in nausea, 53.8%(7/13) in abdominal pain, and 37.5% (5/12) in flatulence, respectively. Overall effectiveness of subjective symptoms was 80% (16/20) and there were no untoward effects of the preparations during this study. As a result, We think that this preparation is an effective one to relieve symptoms of functional dyspepsia.

대학 건축공학과의 실습학기제에 관한 연구

이승준,한인웅,정구용,조방현,한기원,박재호,김진원 三陟大學校 2000 論文集 Vol.33 No.2

In order to solidify the architectural education in university, we should enlarge the opportunity of field training and develop the field training course system as a part of industry-scholastic cooperation. And we should develop new educational process to bring up potent engineers adaptable to the training affairs, faithful to the educational object of the industrial university.