갑상선 결절에 동반된 퇴행성 낭종의 재발과 낭액내 VEGF의 관련성

조은호,박희붕,김현만<SUP>1<.SUP>,이관우<SUP>1<.SUP>,정윤석<SUP>1<.SUP>,소의영,Eun Ho Cho,M.D.,Hee Boong Park,K.D.,Hyun Man Kim,M.D.<SUP>1<.SUP>,Kwan Woo Lee,M.D.<SUP>1<.SUP>,Yun Suk Jung,M.D.<SUP>1<.SUP> and Euy Young 대한갑상선-내분비외과학회 2002 The Koreran journal of Endocrine Surgery Vol.2 No.1

Purpose: VEGF, a potent angiogenic factor, increases vascular permeability and induces the fluid accumulation in the peritoneal and pleural cavities. This study is designed to know whether the VEGF concentration are associated with the formation of cystic fluid of thyroid nodules and the results of treatment. Methods: To know whether thyroid follicular cells produce VEGF, we measured the VEGF concentration in the conditioned medium after primary culture of the normal thyroid follicular cells (NT 1.0). Thirty seven patients, who had visited Ajou University Medical Center, were divided into two groups; group A (n=19) is patients whose cystic nodules disappeared completely with 1 or 2 times fine needle aspirations. In Group B (n=18), the cystic nodules recurred rapidly and required aspiration more than 3 times. Clinical records of patients were analyzed and compared with TSH and VEGF levels in cystic fluids. Results: The VEGF concentration in basal conditioned medium were 8.2⁑1.2 ng/ml in NT 1.0 and 8.2⁑0.6 ng/ml in thyroid cancer cell line (FTC-133). NT 1.0 was not affected by TSH stimulation. Mean concentration of TSH of all cystic fluids was 4.36μIU/ml (0.13∼21.7) and there was no difference between 2 groups. Mean concentration of VEGF of all cystic fluids was 140.7 ng/ml (11.1∼688.8). The VEGF concentration (287.9⁑289.6 ng/ml) in group B was significantly higher than that (104.2⁑97.1 ng/ml) in group A (P<0.05). Conclusion: This study suggests that thyroid follicular cells produce and secrete VEGF, and VEGF is related with the accumulation of cystic fluid in degenerative cysts of thyroid. Cysts with high VEGF concentration promote rapid reaccumulation of the cystic fluid and possibly necessitate operation in selected patients. (Korean J Endocrine Surg 2002;2:25- 30)

Case Reports : A Case of Rheumatoid Arthritis Presenting as an Intra-articular Mass of the Wrist Joint in a Patient with Chronic Monoarthritis

( Eun Jung Park ),( Young Uck Kim ),( Jiyoung Kim ),( Chang Lim Hyun ),( Kyung Ryeol Lee ),( Jinseok Kim1 ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

Rheumatoid arthritis (RA) mainly affects polyarticular joints and is characterized by inflammation of the synovial membrane leading to joint destruction. We report on an unusual case of RA presenting as an intra-articular mass invading bone of the wrist joint in a patient with chronic monoarthritis. A 43-year-old man presented with left wrist joint pain and swelling lasting several years. A plain radiograph showed a non-specific osteolytic lesion in the distal ulna but a magnetic resonance image demonstrated an intra-articular irregular mass-like lesion with eccentric bone erosion the distal radioulnar joint. Synovial biopsy detected hyperplasia of the synovial lining cell layer and finger-like protrusions of inflamed and edematous fibrovascular stroma containing dense inflammatory infiltrates, mainly plasma cells, B cells, and CD4+ T cells. Rheumatoid factor and anti-citrullinated protein antibody were highly positive. The patient was diagnosed with RA and treated with disease-modifying anti-rheumatic drugs, showing a good response on further follow-up. (J Rheum Dis 2015;22:298-302)

Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation

Eun-Do Kim,Jin-Kwon Lee,Jin-Kyu Cho,Jae-Myung Kim,Ji-Ho Park,Ju-Yeon Kim,Sang-Ho Jeong,Young-Tae Ju,Chi-Young Jeong,Eun-Jung Jung,Young-Joon Lee1,Soon-Chan Hong,곽승진 대한종양외과학회 2019 Korean Journal of Clinical Oncology Vol.15 No.2

Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H

B16 멜라닌 세포에서 해양소재 추출물의 멜라닌 생성 저해 효과

이찬 ( Chan Lee1 ),장정희 ( Jung Hee Jang ),안은미 ( Eun Mi Ahn ),박찬익 ( Chan Ik Park ) 대한본초학회 2012 大韓本草學會誌 Vol.27 No.4

Objectives : Under normal condition melanin protects the skin from extracellular stimuli including ultraviolet (UV)-induced oxidative skin damages, but excess production and accumulation of melanin can induce hyperpigmentation causing esthetic problems. Therefore, in this study we tried to search for natural skin whitening materials from marine natural resources. Methods : Water and ethanol extracts of marine natural resources were prepared from Porphyra thalli (PT), Laminariae thallus (LT), Ostreae concha (OC), Sargassum thallus (ST), Undaria thallus (UT), Codium thalli (CT), Enteromorpha thalli (ET), Syngnathoides biaculeatus (SB), and Hippocampus coronatus (Hc). Their effects against UVB and α-melanocyte stimulating hormone (α-MSH)-induced melanogenesis were investigated based on melanin formation in B16 mouse melanoma cells. The mRNA and protein expression of enzymes involved in the melanogenic process were further examined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot analysis, respectively. Results : Water extract of Ostreae concha (OCW/E) effectively inhibited UVB and α-MSH-induced melanin production in B16 melanocytes, which seemed to be mediated by inhibition of mRNA expression of tyrosinase and tyrosinase-related protein 1 (TRP-1). In another experiment, ethanol extracts from Porphyra thalli (PTE/E), Laminariae thallus (LTE/E), Sargassum thallus (STE/E), Undaria thallus (UTE/E), Codium thalli (CTE/E), Syngnathoides biaculeatus (SBE/E), and Hippocampus coronatus (HcE/E) significantly suppressed UVB and α-MSH-induced melanin formation. Furthermore, ethylacetate fraction isolated form LTE/E (LTE/EEt) decreased UVB and α-MSH-elevated extracellular melanin levels via inhibition of tyrosinase protein expression. Conclutions : These results suggest that marine natural resources such as Porphyra thalli, Laminariae thallus, Ostreae concha, Sargassum thallus, Undaria thallus, Codium thalli, Syngnathoides biaculeatus and Hippocampus coronatus have anti-melanogenic effects, thereby exhibiting high potentials to be utilized as one of the ingredients for the development of new whitening functional cosmetics.

Increased Sclerostin Levels after Further Ablation of Remnant Estrogen by Aromatase Inhibitors

김원진,Yoon Jung Chung,Se Hwa Kim,Sehee Park1,Jae Hyun Bae,Gyuri Kim1,Su Jin Lee1,Jo Eun Kim1,박병우,임승길,이유미 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.1

Background: Sclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs), which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI. Methods: We included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years) treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years). The subjects were randomly assigned to take either 5 mg alendronate with 0.5 μg calcitriol (n=46), or placebo (n=44) for 6 months. Results: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P<0.05). Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively). Serum sclerostin levels increased by 39.9%±10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%±10.2% vs. 55.9%±9.13%, P>0.05). Conclusion: Serum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.

LC, Acute : PE-120 ; Clinical severity according to age groups and risk factors for complicated hepatitis in patients with acute hepatitis A virus infection

( Byung Jun Jeon ),( Bum Su Choung ),( In Hee Kim ),( Dae Ghon Kim ),( Soo Teik Lee ),( Eun Young Cho1 ),( Gum Mo Jung ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Symptomatic acute hepatitis A virus (HAV) infection in adulthood is increasing in Korea recently. The aim of this study was to analyze the clinical severity according to age groups in patients with acute hepatic A and to investigate factors associated with complicated hepatitis A. Methods: We performed a retrospective analysis of 726 patients who were diagnosed with acute viral hepatitis A from January 2005 to September 2011 at three tertiary hospitals at Jeonbuk Province. We analyzed the clinical severity according to age groups, <20 year (n=84), 21-39 years (n=546), ≥40 years (n= 96). Complicated hepatitis was defined as hepatitis combined with one of three major complications, such as severe jaundice (peak total bilirubin level ≥15 mg/dL), acute renal failure, acute liver failure. Results: Of total 726 patients, mean age was 30.1 years, 453 (62.4%) were male, HBsAg was positive in 33 (4.5%). Severe jaundice occurred in 43 (5.95%), acute renal injury occurred in 16 (2.2%), and acute liver failure occurred in 24 (3.3%). The incidence of acute renal insufficiency was significantly increased according to the aging groups were <20: 1.2%(1/84); 21-39: 1.8% (10/546); ≥40: 5.4%(5/96) (p=0.032).The incidence of severe jaundice and hepatic failure were also significantly increased according to the aging groups [<20: 3.7% (3/84); 21-39: 5.2% (27/546); ≥40: 15.6%(13/96), p=0.003, and <20: 0.0% (0/84); 21-39: 3.6% (19/546); ≥40: 5.4% (5/96), p=0.045]. Multivariate analysis showed that old age (≥40years) (p=0.006), female (p=0.002), and HBsAg positivity (p=0.013) were significant risk factors for complicated hepatitis A. Conclusions: Old age group (≥40 years) showed more likely complicated with severe hepatitis A compared to younger age groups. In addition, female and HBsAg positivity were also significantly associated with complicated hepatitis A.

배양중인 심장내피세포에서 인삼사포닌의 항산화 효과

신현종,권영무,정태은,이동협,이정철,한승세,김홍태,박정현,성언기,이융창 대한해부학회 2000 Anatomy & Cell Biology Vol.33 No.1

Primary Hepatosplenic Tuberculosis in an Immunocompetent Adult and Domestic Literature Review

Se Yoon Park,Eun Jung Lee1,Tae Hyong Kim,Jae Young Jang,Min Huok Jeon,Eun Ju Choo,So Young Jin 순천향대학교 순천향의학연구소 2012 Journal of Soonchunhyang Medical Science Vol.18 No.2

Hepatic or splenic involvement of tuberculosis without other disseminated lesions is a very uncommon form of extrapulmonary tuberculosis, especially in an immunocompetent adult. We report a case of a 25 year-old-man who developed primary hepatosplenic tuberculosis not associated with the lung or other distant organs. He was initially diagnosed with esophageal candidiasis in local clinic. A computed tomographic scan of the abdomen showed hepatosplenomegaly and multiple microabscesses in the spleen. Our initial diagnosis, based on the clinical feature and radiologic findings, was hepatosplenic candidiasis. However, histopathology of the liver specimens revealed chronic granuloma with central caseous necrosis, strongly suggestive of tuberculosis. Although rare, splenic tuberculosis should be considered in the differential diagnosis of splenic abscess, especially in countries where tuberculosis is endemic.

Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution

Min Jhi Kim,Eun Jeong Ban,Soo Jung Jung,Hai Young Son1,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4

Purpose: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. Methods: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. Results: The median age of the 32 patients at diagnosis was 42.25 years (range 3∼81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8∼20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85±24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18±5.5 months). Conclusion: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.

암 병동 간호사의 통증관리에 대한 지식과 태도

공성화,방찌야,서민숙,현신숙,김희정,이미애1,이미애2,유현희,허재경,김은애,박경숙 성인간호학회 2004 성인간호학회지 Vol.16 No.1

Purpose: The purpose of this study is to evaluate the knowledge and attitudes of oncology ward nurses toward cancer pain management and to find ways to improve the educational program for nurses. Method: A total of 209 nurses working at the oncology ward of three hospitals in Seoul and a Gyenggi Province. The survey instrument used was the 32-item scale for evaluating nurses knowledge and attitudes originally developed by McCaffery and Ferrell'(1990). that was by Kim'(1997). Result: In terms of the nurses knowledge of pain management. the result showed that the nurses scored an average of 67.8 out of 100 for phamacokinetics of opioids. 84.8 for classification of analgesics, 60.1 for pain assessment, and 70.7 for drug administration. 18.2% of the nurses hesitate to inject the narcotic agent because of concerns regarding the drug's potential side effects. there was significant difference in the knowledge of pain management according to the general characteristics of pain in terms of the nurses age(p=.001), position (p=.016). years of experiences(p=.002), experience of cancer pain education(p= .001). Conclusion: The also showed that nurses working at cancer ward lack knowledge. It is important to provide intensive education to nurses about cancer pain management.