위전절제술 후 Kim 's Tie 부근 공장에 국소 재발한 위암환자 1예

배병구,서병조,유항종,강윤경,김진복,Bae Byung-Gu,Suh Byoung-Jo,Yu Hang-Jong,Kang Yun-Kyung,Kim Jin-Pok 대한위암학회 2005 대한위암학회지 Vol.5 No.1

위암은 국내에서 발생 빈도가 가장 높은 암으로서 근치적 절제술 및 확대 영역 림프절 절제술의 도입과 더불어 술후 보조 항암화학요법 및 면역요법 등의 이용으로 최근 치료성적의 향상을 보이고 있다. 그러나 수술적 치료를 포함한 치료법의 발전에도 불구하고 다양한 형태의 재발을 경험하게 되고, 대부분의 재발은 3년 이내에 일어난다. 재발양상으로는 크게 국소재발, 원격재발, 복막재발 등이 있으며, 여러 가지 재발양상이 한꺼번에 보이는 경우도 있다. 이 중 국소재발의 호발 부위로는 림프절($48\%$), 문합부($32\%$, 잔존 위($20\%$)의 순으로 보고되고 있다. 증례: 51세의 여자 환자로 1999년 10월 진행성 위암으로 근치적 위전절제술을 시행 받았고, 당시 병기는 T3N1M0(IIIa,AJCC 1997)이었다. 수술 후 10회의 보조적 정맥 주사용 항암화학요법 및 경구용 항암화학요법을 2년간 실시하였고, 외래를 통한 추적검사상 약 5년간 재발을 보이지 않았으나 2004년 9월 시행한 내시경상 Kim's tie 부근공장에서 궤양성 병변을 발견하고 조직검사를 시행, 병리학적으로 낮은 분화도를 보이는 인환 세포암종 형태의 위선암 재발로 진단하고 수술을 시행하였다. 수술 방법은 Kim's tie 위치를 포함해 근위부 6.5 cm, 원위부 4 cm의 절제연을 두고 공장부분 절제술을 시행하였다. 수술 당시 다른 복부장기로 전이는 없었으며 전이성 복수도 없었다. 수술 후 별다른 합병증 없이 회복하였으며 보조 항암화학요법 제제로써 TS-1을 사용하며 외래 통한 추적검사 중이다. Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly $90\%$ of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, $33\%$ of the recurrences involved locoregional sites, $44\%$ the peritoneum, and $38\%$ distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during sep. 2004, cancer recurrence was found at the Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

인공 대기오염 조건에 의한 종이 시트의 열화 거동

김형진,오정수,조병묵 동국대학교 생명자원과학대학 연습림 2000 연습림논문집 Vol.- No.6

Paper is an important material being considered as a contributor for the development and succession of human culture. With the introduction of mass production system by fourdrinier paper machine, the addition of lots kinds of chemicals and additives is necessarily required for controlling papermaking process. The modern machine-made paper has a irreversible problem for acidification or deterioration of paper before the passage of time around 100 years, due to the chemical additions. The deterioration factors of paper can be divided by several classes, such as factors by raw materials of pulp, by papermaking processes, and by external environment. Among these, some factors occurring aging in paper are temperature, moisture, and air pollutant materials. In particular, air pollution, like SO_2 and NO_2 by industrial and automobile origins has been a topic of focusing attentions for preservation of an old books. In this study, the conditions of artificial air pollutants and heat acceleration were controlled in special gas exposure system and weather-o-meter. The aging treatment was carried out in three kinds of commercial paper prepared with different types of fibrous material. The aging behaviors of paper by the factors of temperature, moisture, sulfur dioxide or nitrogen dioxide were investigated and analyzed from the results in physical and chemical properties of paper.

급성 단핵구성 백혈병에서 발생한 피부 백혈병 1예

김영조,홍문희,정병수 조선의대 1996 The Medical Journal of Chosun University Vol.21 No.2

알코올 의존환자의 인격장애에 관한 연구

김동인,김병조,박유경 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 본 연구의 목적은 알코올 의존이 없는군과 입원한 알코올 의존군 사이의 인격장애의 유벼율을 알아보고, 여러가지의 축Ⅱ 장애의 범위와 중복을 알아보고자 하였다. 방 법 : 대상은 일반군에서 알코올 의존이 없는 87명과 정신병원에 입원된 알코올 의존환자 94명이었다. 알코올 의존은 DSM-IV에 의거하여 미시건 알코올 의존 선별검사로 진단하였고, 정상군과 환자군 모두 PDQ-4+를 시행하였다. 결 과 : 정상군은 52.3%가 적어도 1개 이상의 인격장애를 가지고 있었으며 한 사람당 평균 1.23개였다. 알코올 의존군은 88.3%가 적어도 1개 이상의 인격장애를 가지고 있었으며 한 환자당 평균 4.26개였다. 결 론 : 본 연구에서는 단일의 "알코올성 인격장애"는 없었다. Objectives : The purpose of this study was to examine the prevalence of personality disorders among non-alcoholics and hospitalized alcoholics and the extent and nature of the overlap between different axis Ⅱ disorders. Methods : Subjects were 87 non-alcoholics in the general population group and 94 alcoholics admitted to psychiatric hospital. Alcohol dependence was diagnosed according to DSM-IV by the MAST, and general group and patients were assessed with the PDQ-4+. Results : In the general population group, 52.3% of non-alcoholics had at least one personality disorder and the average number of personality disorders was 1.23 per person. In the alcohol group, 88.3% of the patients had at least on personality disorder and the average number of personality disorders was .426 per patient. Conclusion : In our study, there is no single "alcoholic personality" emerged.

인터넷 의료상담에 관한 분석 및 연구

김영조,박홍표,정병수,최규철 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives: Telemedicine uses computer and telecommunication technologies to provide medical information and services. Telemedicine can be useful in any situation in which there is a physical barrier between the doctor and the patient. We analyzed medical consultations from Chosun University Hospital is home page (http://hosp.chosun.ac.kr) to find problems on the home page and to offer high quality medical information services. Methods : We collected 544 queries of medical consultation on our home page from May 1998 to May 1999. From medical consultation data on the internet web site of Chosun University Hospital, consulted documents were analyzed with regard to medical department, patients’ age, consultation by attorney, and dermatologic consultations. Results : The telemedicine system is a relatively satisfactory method to both patients and physicians due to easier access and almost rea1-time medical consultation through the world wide web. But several problems should be solved to provide a more effective and lawful telemedicine environment. Conclusion : As a consequence to analyzed medical consultations on our home page, there were several problems in our store-and-forwarding system. To establish an effective telemedicine system, we have to prepare protocols to receive sufficient information and patients have to send digital images to make help an accurate diagnosis. Also problems of liability, reimbursement and coordinated national policy need to be solved.

유전체 배리어 방전 플라즈마를 이용한 애시드레드 27 수용액의 색도 제거

조진오,김병남,목영선 제주대학교 공과대학 첨단기술연구소 2006 尖端技術硏究所論文集 Vol.17 No.2

The physicochemical processes of dielectric barrier discharge (DBD) such as in-situ formation of chemically active species and emission of UV light were utilized for the decolorization of an aqueous solution formed with distilled water and an azo dye Acid Red 27. The DBD reactor consisted of two coaxial dielectric tubes with different diameters. Aqueous electrolyte solution was filled in the inner tube, which acted as the discharging electrode. The DBD reactor was submerged in the Acid Red 27 solution that was grounded. In this case, the Acid Red 27 solution acted not only as the counter electrode but also as the cooling medium of the DBD reactor. The DBD reactor with the aqueous discharging electrode was found to be more energy-efficient for the generation of ozone than that with typical metal electrode. The chemically active species (mostly ozone) produced in the DBD reactor were well dispersed in the Acid Red 27 solution using a porous gas diffuser, thereby increasing the gas-liquid contact area available for the decolorization. The results have clearly shown that the DBD reactor system was very effective for decolorizing the Acid Red 27 solution. For the purpose of improving the performance of the DBD reactor system, MnO_(2) catalyst was added to the Acid Red 27 solution. It was found that the catalyst significantly enhanced the decolorization.

製紙工程에서 分離한 슬라임 形成細菌의 最適 生長條件 探索

김은희,조병묵,오정수 동국대학교 생명자원과학대학 연습림 1997 연습림논문집 Vol.- No.5

The eight bacteria isolated from paper­making process were tested under the condition of 30℃, 35℃, 40℃ with pH 5, 7, 9. The growth of Pseudomonas paucimobilis B was the most excellent at 30℃ with pH 7. Staphylococcus sapropyticus was very good at 35℃ with pH 7 and pH 9. Pseuomonas cepacia generally grew well at every pH condition except for 40℃, pH 9. Acinetobactor calcoaceticus was excellent at 35℃ with pH 7 and at 30℃ with pH 9. Actinobacillus capsulatus showed the good growth in every tested condition except for pH 5 of 35℃, 40℃. The unidentified sprain was very good at 35℃ with pH 7 and pH 9. Staphylococcus auricularis had a unique growth pattern at pH 9 at every tested temperature condition. Acidovorax sp. was good at pH 7 and pH 9 of 30℃, 35℃, 40℃. This isolated bacteria generally showed good growth at pH 7 of 35℃, 40℃.

모반세포성 모반과 악성 흑색종의 CD44 발현에 관한 면역조직화학적 연구

김정수,김영조,최규철,정병수 朝鮮大學校 附設 醫學硏究所 1998 The Medical Journal of Chosun University Vol.23 No.1

CD44 is the major human cell surface receptor for hyaluronate and mediate cellmatrix and cell-cell interactions involved in the mechanisms of tumor invasion and metastasis. Typical acquired melanocytic nevi appear to follow a life cycle characterized by active growth, maturation, and progressive involution, In contrast, congenital melanocytic nevi have a different course and prognosis with potential for development of melanoma, and metastatic spread is very common in malignant melanoma. We investigated the expression of CD44 in acquired and congenital melanocytic nevi, and malignant melanoma by immunohistochemical technique. Formalin-fixed and paraffin-embeded tissue from 5 compound nevi, 6 intradermal nevi, 5 congenital melanocytic nevi, and 5 malignant melanoma were immunolabeled with monoclonal antibodies directed against CD44. All acquired melanocytic nevi showed negative or weak staining for CD44. However, all congenital melanocytic nevi exhibited positive staining for CD44 with minimal irregularities according to location. In malignant melanoma, there was variable intensity of staining for CD44 in different areas of the tumor. These findings suggest that the different expression of CD44 in melanocytic nevi may contribute to different biological behavior between acquired and congenital meanocytic nevi. and CD44 seems to be related to metastasis and tumorigenesis of the malignant melanoma.

소아 Henoch-Schonlein 신염의 임상경과와 조직학적 특성 : Renal Outcome and Prognostic Factors

김병목,장창환,조민현,곽정식,고철우,구자훈 대한신장학회 2003 대한신장학회잡지 Vol.22 No.6