부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

전측두엽 치매 3례

김이영,김재경,이유리,서만길,우금석,장용이,김지혜,서연림,김상은,김도관 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

전측두엽 치매는 치매의 흔한 원인이며 알쯔하이머병과 구별되는 질환이다. 하지만 임상증상에서 인지기능의 현저한 장애가 나타나기 전에 사회적 기능과 인격의 붕괴가 서서히 일어나기 때문에 다른 정신과 질환으로 진단될 수도 있다. 저자들은 3례 전측두엽 치매를 보고하였다. 이 증례들은 전측두엽 치매를 임상 진단으로 고려할 만한 병력과 증상을 가지고 있고, 신경심리학 검사, 대뇌의 자기공명영상과 18F-FDG양성자방출단층촬영술 등의 검사에서 전형적인 전측두엽 치매의 소견을 보였다. 이러한 병력과 임상양상 그리고 객관적인 소견들은 임상에서 전측두엽 치매에 주의를 기울이고 적절하게 진단하는 데 도움이 될 것으로 생각된다. Frontotemporal dementia is a common cause of dementia and distinguished from Alzheimer`s disease. Because its clinical symptoms are characterized by slow progressive social breakdown and change of personality before cognitive impairments become prominent, it may be diagosed as other psychiatric disease. We have presented three cases of frontotemporal dementia. They had typical clinical histories and symptoms which deserve to be considered frontotemporal dementia. They showed appropriate findings of frontotemporal dementia in the neuropsychological tests and brain imaging study with brain magnetic resonance imaging and 18F-FDGpositron emission tomography. Their clinical histories and findings are thought to be helpful for clinician to give attention to and diagnose frontotemporal dementia.

Case Report : Hepatoid Carcinoma of the Pancreas Combined with Neuroendocrine Carcinoma

( Ji Ye Jung ),( Yoon Jae Kim ),( Hee Man Kim ),( Hong Jeoung Kim ),( Seung Woo Park ),( Si Young Song ),( Jae Bock Chung ),( Chang Moo Kang ),( Joo Yeon Pyo ),( Woo Ick Yang ),( Seung Min Bang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.1

Hepatoid carcinoma is a primary extrahepatic carcinoma whose morphology, immunohistochemistry, and behavior are similar to those of hepatocellular carcinoma. The most common sites of extrahepatic carcinoma are the stomach and ovary, but nine cases of hepatocellular differentiation of the pancreas have been reported in the literature. We report another case of hepatoid carcinoma of the pancreas that was associated with the development of a pancreatic endocrine carcinoma in a 46-year-old man. Serum alpha-fetoprotein (AFP) was elevated to 262.49 IU/mL and radiological examinations revealed a mass measuring 7.5 cm in diameter in the head of the pancreas. He underwent a conventional Whipple operation, and light microscopy showed adenocarcinoma that was immunopositive for AFP, hepatocyte antigen, cytokeratin, chromogranin, synaptophysin, and alpha-1 antichymotrypsin. Although hepatoid differentiation was not shown unequivocally histologically, other immunohistochemistry findings supported the diagnosis of hepatoid carcinoma combined with neuroendocrine carcinoma. The patient was healthy and had no evidence of recurrence at 4 months after the surgery. This report describes why hepatoid carcinoma should be considered as a differential diagnosis of a pancreatic mass, especially when serum AFP is elevated. (Gut Liver 2010;4:98-102)

Incisional Hernia in Adult Liver Transplant Recipients

( Ji Soo Lee ),( Kyeong Sik Kim ),( Chan Woo Cho ),( Kyo Won Lee ),( Gyu-seoung Choi ),( Jong Man Kim ),( Choon Hyuck David Kwon ),( Jae-won Joh ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Incisional hernia is one of the complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing an incisional hernia because of immunosuppression. The purpose of this study is to review incisional hernia cases after liver transplantation and to identify the risk factors for hernia formation. Methods: We retrospectively reviewed and analyzed the medical records of the ninety-four incisional hernia patients after liver transplant recipients from January 2000 to December 2015 in single center institution. Results: 1463 underwent adult liver transplantation during the study period. 94 Incisional hernia patients were found among them. The overall incisional hernia rate was 6.4 %. Mean age was 54 years old and 76.6 % were men. No significant difference was observed for sex, diagnosis, smoking, alcohol, albumin, Child-Pugh score, MELD score, intensive care unit stay, hepatorenal syndrome, ventilator, spontaneous bacterial peritonitis, diabetes, bile leakage, wound problems between patients with incisional hernia and patients without incisional hernia. The characteristics of patients with incisional hernia showed old recipient, more body weight, higher body mass index, living donor recipient compared with patients without incisional hernia. Hypertension, tuberculosis, rejection, postoperative complication event before hernia were significant risk factor (p<0.05). Conclusions: Present study identifies the risk factors for incisional hernia. Surgeons should strive to reduce the risk of incisional hernia after adult liver transplantation.

직장 Dieulafoy 병변으로 다량의 혈변을 보인 1 예

김태영;이상헌;김지현;배영환;정은주;김승만;지삼룡;설상영 인제대학교 2011 仁濟醫學 Vol.32 No.-

Dieulafoy’s lesion is very rare cause of gastrointestinal bleeding, Deiulafoy’s lesion is exposure of non ulcerative, abnormally large tortuous, thick- walled artery in the muscularis mucosa through a small submucosal defect. It is usullay found on stomach antrum and lesser curvature side of the proximal body, and possibly found on any sites throughout whole gastrointestinal tract, but rarely on rectum. The principal of treating Dieulafoy’s lesion was the surgical resection of lesion, but recently remarkable advances in endoscopic technique make endoscopic approach more popular. We report a case of rectal Dieulafoy’s lesion successfully treated with endoscopic hemoclipping in an elderly female patient.

레트로바이러스의 표면단백질 : 인슐린의존형 당뇨병의 동물모델인 NOD 쥐의 혈청과 반응하는 새로운 자가항원 A New Autoantigen Reactive with Non Obese Diabetic (NOD) Mice Sera

김경수,김기환,김현만,윤지원,강엽 아주대학교 1997 아주의학 Vol.2 No.2

IDDM (Insulin dependent diabetes mellitus) is believed to be an autoimmune disease and characterized by the immune activation against insulin-producing pancreatic beta cell. The identification and characterization of new autoantigens reactive with an activated immune System would heip to elucidate the pathogenic mechanism of this disease. Several autoantigens are trying to apply for diagnosis and prevention of IDDM. The NOD (non obese diabetic) mice have been the best model for studying the pathogenesis of human IDDM. To identify new autoantigens reactive with activated humoral immunity of NOD mice, the lambda gt11 cDNA library was constructed from NOD-derived pancreatic beta cell (MIN6N8a: mouse insulinoma cell) and screened with prediabetic NOD sera. Mine positive dones were selected from 2x10^(5) phage plaques. The 5'-end sequencing and homology searching showed that six clones from nine clones had over 98% sequence homolgy with the retroviral envelope gene. Full sequendng reveated that the cloned gene was a fragment of ecotropic retrovirus (emv-3) envelope gene. To confirm the immunoreactivity of doned retroviral envelope protein, the cloned gene fragment was expressed in an E.coli expression vector System. Western blotting showed that the recombinant envelope protein fragment also reacted with prediabetic NOD sera.

인지적 양식 및 스트레스 지각과 월경전기 증상와의 관계

김지웅,이정현,김덕만,이만홍 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 월경전기 증후군의 원인에 관한 많은 가설 중에 여러 인지모델이 제시되어왔다. 즉, 부정적인 인지적 특징을 가진 사람이 월경전기 증상을 더 심하게 겪을 수 있다는 것이다. 본 연구의 목적은 월경전기 증상을 가진 여성에서 인지적 양식 및 스트레스 지각과 월경전기 증상과의 관계를 알아보고자 시행하였다. 방 법 : 18세 이상의 가임기 성인 여성 86명을 대상으로 하여 월경전기 평가서, 역기능적 태도 척도, 자동적 사고척도-부정형, 자동적 사고척도-긍정형, 스트레스 지각 척도를 작성하게 하였다. 이 중 21명은 2개월간의 전향적인 평가를 통해 월경전 불쾌기분장애로 진단하였다. 각 변수들간의 관계는 Pearson 상관계수를 구하여 검증하였다. 결 과 : 월경전불쾌기분 장애군에서 자동적 사고-부정형(r-.65, p<.01)과 스트레스 지각(r=.52)이 월경전기 증상과 유의미한 상관이 있는 것으로 나타났다. 월경전 불쾌기분장애에 해당하지 않는 대상군에서는 자동적 사고-부정형(r=.36, p<.01)이 월경전기 증상과 유의미한 상관이 있었다. 결 론 : 월경전기 증상은 비적응적인 부정적 인지 요소와 유의한 상관 관계를 보였고, 이러한 경향은 특히 월경전 불쾌기분장애 환자들에서 보다 두드러지게 관찰되었다. 이와 같은 결과는 월경전기 증후군 및 월경전 불쾌기분장애에 인지적 요소가 영향을 미침을 시사한다. 또한, 이들 질환의 치료에 있어 인지행동치료가 효과적일 수 있음을 제시한다. Objectives : The cognitive model has been suggested to explain the pathogenesis of premenstrual syndrome. In this model, it is suggested that negative cognitive style may contribute to the experience of severe premenstrual symptoms. We conducted this study to examine the relationship among cognitive style, perceived stress, and premenstrual symptoms. Method : Eighty six reproductive aged women older than 18 years were included in this study, to complete the Premenstrual Assessment form, Korean version of automatic thoughts Ques-tionnaire-Positive, Korean version of Automatic Thoughts Questionnaire-Negative, Korean version of Dysfunctional Attitude Scale, Perceived Stress Questionnaire. Among the subjects, twenty one were diagnosed to have a premenstrual dysphoric disorder which was determined by prospective assessment for two months. The relationships among the variables were analyzed by examining Pearson correlation coefficiency. Results : In the subjects without premenstrual dysphoric disorder, there exist significant correlation between the premenstrual symptom and the score of Korean-version of automatic thoughts Questionnaire-Negative(r=.36, p<.01). In the subjects with premenstrual dysphoric disorder, premenstrual symptoms had significant correlation to automatic thoughts Questionnaire-Negative(r=.65, p<.01) and Perceived Stress Questionnaire(r=.52, p<0.01). Conclusion : Our findings show the significant relationship between negative cognitive style and premenstrual symptoms. This relationship was more prominent in the subjects with premenstrual dysphoric disorder compared to ones without it. Our findings suggest that cognitive style and stress perception may influence on the severity of symptoms of premenstrual syndrome or premenstrual dysphoric disorder, and that cognitive behavior therapy is a possible effective therapeutic strategy for those with severe premenstrual symptoms.

림프절외 림프종의 WHO 분류 : 임상적 및 면역학적인 표현형의 분석 Clinical and Immunophenotypic Analysis

김진만,설지영,강대영 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

The authors retrospectively reviewed extranodal malignant lymphomas which include various distinctive clinicopathologic entities according to the new WHO lymphoma classification system. The aim of this study was to analyze the clinical characteristics of extranodal lymphomas and the relative frequency of the subtypes with immunophenotype in the Daejeon city and Chungcheong province. The authors reviewed 134 cases of extranodal lymphoma out of 220 cases of total non-Hodgkin's lymphoma which was diagnosed during the last 10 years. Among the cases, gastric lymphomas (26.1%) were the most common anatomic site. Nasal and paranasal (14.4%), skin (13.4%), and Waldeyer's tonsillar ring (11.2%) lymphomas were relatively common in order of frequency. The most frequent subtypes of extranodal lymphoma were marginal zone B-cell lymphoma of MALT (31%), diffuse large B-cell lymphoma (20%), peripheral T-cell lymphoma, unspecified (15.7%), and nasal NK/T cell lymphoma (13.4%), in decreasing order. Compared with a previous studies, the relative frequency of nasal NK/T cell lymphoma was much higher in our study than western countries and similiar to East Asia. The immunophenotype of our extranodal lymphomas was mainly B-cell type (68%) and the remaining cases were T- or NK-cell origin. In conclusion, the occurrence rates for various subtypes of extranodal lymphoma in Daejeon and Chungcheong province were distinct from those in western countries and similiar to those in East Asian countries. The most distincitive entities in our study were marginal zone B-cell lymphoma of MALT and nasal NK/T cell lymphoma. It also appears that the frequency of lymphoma subtypes is changing according to the classification system.

林業稅制에 關한 考察 : 韓國, 日本, 美國의 制度에 대하여

金知洪,辛在萬,尹鐘和 江原大學校 森林科學硏究所 1985 Journal of Forest Science Vol.5 No.-

Introduced with a review of general taxation principles in Korea, the article provides details of the main type of tax related to forest resource management. The forest taxation of Japan and the United states is also examined to compare with the Korean legislation. The basic analysis is made upon provisions and interpretation of each tax, its history, and its influence on forest management. For Korean forest taxation, some points to be considered are as follows. 1) Since 500,000 won of special income tax deduction from total forest revenue is not likely to be remaining with its absolute value, it should be variable by socio-economic situation. 2) Income tax exemption from newly reforested land for 40 years may shorten rotation and induce heavy harvest cutting for long-term commercial timber species. 3) With a few exceptions, general forest managers are not offered favors in death tax and property tax for their forest land. Taxes have frequently been called the primary impediment factor for timber production because the effectiveness of incentives of programs has not been provided. Considered to the specific characteristics of forestry and resource conservation, Korean forest taxation should be revised and complemented to encourage forest management or maintenance.