반복적인 급성 신부전을 유발한 호산구성 장염 1 예

정혜진;김현태;김유선;정현걸;강윤경;문정섭 인제대학교 2011 仁濟醫學 Vol.32 No.-

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by presence of gastrointestinal symptoms, eosinophilic infiltratio n of one or more parts of gastrointestinal tract without involvement of other organs and absence of parasitic infestation. The clinical presentation depends on the extents and depths of eosinophilic infiltration. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. We report a case of eosinophilic enterocolitis in a 55-year-old female presented with abdominal pain and watery diarrhea resulting in recurrent acute renal failure.

중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예

강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

판막 질환에서의 심근 섬유화 : 심근 조직을 이용한 형태학적 연구 및 혈청 생화학적 지표의 분석

강수진,박덕우,송재관,박경민,송종민,강덕현,한기훈,송현,이재원,주석중,송명근,김정선 대한순환기학회 2004 Korean Circulation Journal Vol.34 No.2

원위 대퇴골의 고립성 골연골종에서 발생한 속발성 연골 육종 1례 보고

정필현,황장수,강석,김용민,오형호,채동주,김종필 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

연골육종은 비교적 서서히 자라며 늦게 전이하는 악성 연골 종양으로 알려져 있다. 골 연골종에서 발생한 속발성 연골육종은 발생빈도는 드물며 타부위로의 전이가 적고 악성도가 낮은 경우가 많아 적합한 수술적 치료로서 좋은 예후를 보이는 것으로 보고되고 있다. 본 동국대학교 정형외과학 교실에서는 우측 대퇴골 원위부 골간단부에 생긴 고립성 골 연골종에서 이차적으로 발생한 연골육종을 치험한 바 문헌고찰과 함께 보고하는 바이다. A case of Secondary Chondrosarcoma Arising from Solitary Osteochondroma of the Distal Femur Department of Orthopaedic Surgery, College of Medicine, DongGuk University Phil Hyun Chung M.D., Jung Su Hwang M.D., Suk Kang M.D., Yang Mln Kim M.D., Hyung Ho Oh M.D., Dong Ju Chae M.D., Jong Pil Kim M.D. Chondrpsarcoma is a malignant cartilage-forming tumor that grows slowly and metastasis of this tumor occurs in late stage. Secondary chondrosarcomas arising from a solitary osteocartilaginous exostosis are rare and those have a better prognosis than other chondrosarcomas, and they rarely metastasize. We present our experience with a case of secondary chondrpsarcoma arising in solitary osteochondroma of distal metaphysis of right femur with clinical details.

위암 환자의 복강내 투여를 위한 Activated Charcoal-Alginate Bead 제형으로부터 Mitomycin C의 용출 거동

이진호,최선웅,서중기,김동민,정경수,오정연,김진향,노승무,민병무,김용백,김창식,박근성,강대영,송규상,양준묵,조준식,정현용,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherapy seems a logical choice for cancer chemotherapy. In this study, Mitomycin C (MMC)-activated charcoal (CH)-alginate (ALG) beads were prepared by the mixtures of CH particles adsorbed with MMC as an anti-cancer drug and aqueous alginate solution. The alginate is recognized as biodegradable, nontoxic, and biocompatible. The release of MMC from the beads in 0.1 M Tris buffer was stable and continuous until about 1 week. The MMC-CH-ALG beads can be applied in the peritoneal cavity for intraperitoneal chemotherapy since they provide a good adhesiveness on the tissue and controlled release pattern of the drugs.

외상으로 실활된 미성숙 영구치에서의 계속된 치근 형성

강유진,김혜영,김영진,김현정,남순현 大韓小兒齒科學會 2009 大韓小兒齒科學會誌 Vol.36 No.4

치아에 외상을 받은 경우 치수 생활력의 상실은 흔한 일이다. 치수 생활력을 검사하는 방법으로는 임상적, 방사선학적으로 여러 가지가 있지만, 미성숙 외상치의 경우 일시적 현상과 가성 반응이 나타날 수 있으므로 치수 괴사에 대한 정확한 진단은 매우 어렵다. 생활력을 상실한 치아는 염증성 치근흡수, 치근단 낭종 등의 발생을 방지하기 위하여 치수 치료를 시행한다. 그러나 미성숙 영구치의 경우, 치수 치료를 시행 후 치근 성장이 정지될 수 있어 결과적으로 얇고 짧은 치근이 형성되어 장기적인 예후는 좋지 않다. 본 임상 증례에서는 외상으로 인하여 실활된 초기 영구치에서 치근단부의 최소한의 침습적 치근단 형성술로 계속된 치근 형성을 보여 이에 보고하는 바이다. In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

안구의 비색소성 모양체 상피에서 발생한 유두상 선암종 -1예 보고-

최현주,최영진,이연수,이은정,강석진,김병기,심상인 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

위암에서 p53 유전자의 변이에 대한 연구

강현욱,김창진,정문석 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

The pathogenic mechanisms of gastric carcinoma, which is the most common malignant tumor in Korea, have not been completely elucidated. Recently the carcinogenic mechanisms have been explored in depth of genetic mutations. Several lines of evidence showed that oncogenes and anti-oncogenes played some roles in the pathogenesis of human malignant tumors. Among several anti-oncogenes, p53 is the most commonly mutated in varoius human malignat tumors. This study is conducted to see the rate of p53 gene nutation in gastric carcinoma by the loss of heterozygosity(LOH). The DNA is extracted from the cells harvested from paraffin block sections. The exon 4 of p53 is amplified by polymerase chain reaction(PCR) and the product is digested with Tha I endonuclease. Among 20 informative cases, 7 (35%) revealed loss of heterozygosity. Among 14 cases of well differentiated carcinoma and 6 cases of poorly differentiated carcinoma, LOH was observed in 5 cases (36%)and 2 cases (33%) respectively. The above results revealed that p53 mutation plays some roles in the pathogenesis of gastric carcinoma. But to elucidate the roles genetic mutaton in the pathogenesis of gastric carcinoma, more numbers of different exons should be searched.

저가 후막 EL소자 제조 및 신뢰성 평가

강계원,김대연,이영훈,강봉석,박정현,최병호 금오공과대학교 산업기술개발연구원 2000 産業技術開發硏究 Vol.16 No.-

AC powder electroluminescence(EL) device consists of seven layers : PET substrate, transparent electrode, phosphor layer, dielectric layer, two layer metal electrodes and protective layer. Etch layer needs to control to improve electrical and optical properties. Both phosphor and dielectric layer among them is more important to increase its properties. For long-time reliability, proper choices of passivation and sealing material are essential. In this paper, influence of phosphor and dielectric layer thickness on EL performance is studied. Type of cellulos is selected as a sealing material to avoid moisture. To add two type of plasticizer to resin improves flexibility and passivation of EL devices. Through this experiments, technologies of fabrication low-cost thick film EL device can be established.