Factors associated with the risk of colorectal neoplasia in young adults under age 40

Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.

중증 외상 환자의 골반골절에서 경피적 혈관 색전술과 Young과 Burgess 분류의 상관관계

차용한 ( Yong Han Cha ),설영훈 ( Young Hoon Sul ),김하용 ( Ha Yong Kim ),최원식 ( Won Sik Choy ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.3

Purpose: Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture isn’t an easy task. There have been many trials finding indicators of embolization for patients with pelvic bone fracture. Although Young and Burgess classification is useful in decision making of treatment, it is reported to have little value as indicator of embolization in major trauma patients. The aim of this study is to find out Young and burgess classification on predicting vessel injury by analzyng pelvic radiograph taken from major trauma patients with pelvic bone fracture. Methods: Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 200 patients were found with pelvic bone fracture in trauma series and thus pelvic CT angiography was taken. Setting aside patients with exclusion criteria, 153 patients were enrolled in this study for analysis of Young and Burgess classification. Results: The most common mechanism of injury was lateral compression in both groups. There was no statistical significant difference in Young and Burgess classification (p=0.397). The obturator artery was the most commonly injured artery in both groups. Six patients had more than one site of bleeding. Conclusion: Prediction of transcatheter angiographic embolization using Young and Burgess classification in severe trauma patients is difficult and requires additional studies. [ J Trauma Inj 2015; 28: 144-148 ]

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.

PVA-ECC를 활용한 Half PC 복합체의 역학적 특성에 관한 실험적 연구

김재환,김영덕,김갑수,조봉석,장종호,김무한 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

ECC represents one particular class of HPFRCC, which are defined by an ultimate strength higher than their first cracking strength and the formation of multiple cracking during the inelastic deformation process. This study is to provide the fundamental data for the development of hybrid construction method such as the half PC(Precast concrete) reinforced by PVA-ECC, the mechanical properties of half PC according to the alteration of properties of PVA-ECC in terms of the type of fiber, Vr, S/M, placing height of PVA-ECC, are experimentally investigated. As the results. it is found that the half PCs of PVA-ECC have very higher mechanical performance in terms of yield load, strain capacity beyond yield point and maximum flexural load than that of mortar. Also, flexural crack in the half PCs of PVA-ECC are not localized at first crack and are growed to many micro crack, especially multiple cracking in specimen of P(12)-30-0.1ㆍ3 occurred.

영골(靈骨).강압혈(降壓穴) 자극(刺鍼)이 혈압(血壓)에 미치는 영향(影向)

임영남,심성용,한지완,고호연,박종형,한양희,전찬용,김동우,Yim, Young-Nam,Sim, Sung-Yong,Han, Ji-Wan,Ko, Ho-Yeon,Park, Chong-Hyeong,Han, Yang-Hee,Chun, Chan-Yong,Kim, Dong-Woo 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.2

Objective : The purpose of this study is to evaluate the clinical effect of the non-pharmacological anti-hypertension method, acupuncture, for hypertensive patients. Methods : 26 patients diagnosed with hypertension were each treated by one of three methods: an anti-hypertension drug(adalat soft capsule), venepuncture, and acupuncture. In cases of rising blood pressure, patients were treated by their one of the three methods, and blood pressure was measured at regular intervals. Result : As for the group of acupuncture treated patients on Young-gol(ling-gu) and Gang-ap-hyul(jiang-ya-xue), readings dropped 18.0mmHg in systolic blood pressure and 6.50mmHg in diastolic blood pressure. This was a greater effect than that seen in the venepuncture treated patients. Blood pressure checked one hour after acupuncture treatment showed a greater difference than blood pressure checked after thirty minutes. Conclusion : Safe reductions in blood pressure were observed through the non-pharmacological method of acupuncture on Young-gol(ling-gu) and Gang-ap-hyul(Jiang-ya-xue).

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

초음파 유도하 맘모톰 생검을 이용한 병변의 완전제거 : 6개월 추적 초음파 검사를 통해 알아본 유용성

김혜성,한부경,최연현,김지영,고영혜,양정현,남석진,김정한 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.1

결장 직장암 환자에서 근치적 절제술 후 혈청 CEA치의 변화에 대한 임상적 의의

김영훈,배병노,김기환,한세환,김홍주,김영덕,김홍용 대한대장항문학회 2003 Annals of Coloproctolgy Vol.19 No.6

워크스테이션의 조명성능 평가에 관한 연구

김영민,김한성,김창성,김강수 대한건축학회 2003 대한건축학회논문집 Vol.19 No.10

The purpose of this study was to provide the visual evaluation data in a workstation space when different lighting types were applied. For the performance evaluation, Radiance program was used for simulations, and the mock-up room(15.0×11.6×3m) was used for the actual test. The results of this study were as follows; 1) When the indirect lighting simulation data using Radiance was compared with the actual data in a small workstation space, there was a 6.5% difference. Therefore, Radiance program was proved to be useful for the evaluation of lighting performance. 2) The results show that the straddled layout has higher light levels (higher light ratio (%)) and the centered layout condition has lower light levels (lower light ratio (%)) in most cases. 3) Also, the results show that the indirect luminaires and the straddled layouts provide higher uniformity, whereas the direct luminaires and centered layouts have lower uniformity.

삼출성 늑막액에서 양악성 감별지표로서 CEA, TPA, SCC Ag 측정의 의의

김경찬,김민수,김미정,권두영,한승범,전영준 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.4

상피 세포에서 기원한 대표적인 종양표지자인 carcinoembryonic antigen (이하 CEA로 약함)은 삼출성 늑막액 환자의 양악성 감별에 보고적으로 사용되고 있다. CEA 이외에 혈청에서 양악성감별의 보조적 지표로 알려진 tissue polypeptide antigen (이하 TPA로 약함)과 squamous cell carcinoma antigen (이하 SCC Ag으로 약함)을 혈청과 늑막에서 동시 측정하여 늑막삼출액의 악성 감별에 어느 정도의 임상적인 유용성이 있는지를 알아보기 위하여 이 연구를 시행하였다. 1997년 1월 1일부터 동년 8월 31일까지 계명대학교 동산의료원에 입원한 환자들 중 삼출성늑막액을 가진 61명을 대상으로 하여 혈청과 늑막액에서 CEA, TPA, SCC Ag의 수치를 방사면역법으로 측정하였다. 각각의 조양표지자들은 악성과 양성군으로 구분한 뒤 분석하였으며 악성군이 28례, 양성군이 33례이었다. 그리고 진단양성기준치를 설정한 뒤 종양표지자들의 특이도, 민감도를 산출하였고 상기 지표들을 종양표지자와 늑막액 세포검사르 조합한 경우에도 산출하여 비교 분석하였다. 혈청 CEA 와 TPA는 각각 7.0 ng/ml, 80.0 ng/ml, 늑막액 CEA와 TPA는 각각 50. ng/ml, 4700.0 ng/ml로 진단양성기준치를 설정하였을 때 특이도를 낮추지 않으면서 가장 높은 민감도를 보였다. 늑막액 세포검사와 동시에 혈청 TPA 도는 늑막액 CEA를 측정하였을 때 특이도는 떨어뜨리지 않으면서 민감도를 높이는 좋은 조합인 것으로 나타났으며 혈청 CEA 및 TPA수치를 늑막액 세포검사와 도시에 시행하였을 때 특이도를 떨어뜨리지 않으면서 가장 높은 민감도를 얻었다. 늑막액 세포검사가 음성인 경우에도 혈청 CEA와 TPA를 동시에 측정하여 높은 민감도와 특이도를 얻을 수 있었다. 따라서 CEA와 TPA는 늑막삼출액의 양악성 감별 진단 유용한 보조적 지표로서 사용할 수 있을 것으로 판단된다. Carcinoembryonic antigen(CEA), the most widely used tumor marker was measured in pleural fluid of patients with exudative pleural effusions in order to differentiate malignant from benign effusions. This study was performed to find out if there is any clinical utility in differential diagnosis of malignancy by measuring simultaneously CEA, tissue polypeptide antigen(TPA) and squamous cell carcinoma antigen(SCC Ag) in serum and pleural fluid. The study population was 61 patients with exudative pleural effusions who were admitted to Keimyung University Hospital from January 1 to August 31, 1997. Each CEA, TPA and SCC Ag level in serum and pleural fluid were measured using radioimmunoassay method. These patients were divided to malignant and benign group. Malignant group consists of 28 cases and benign group consists of 33 cases. And the sensitivity and specificity of each tumor marker was obtained using cut-off value and that combining tumor markers and pleural fluid cytology were also obtained and analyzed. When the cut-off value was applied to CEA and TPA in serum using 7.0 ng/ml and 80.0 ng/ml respectively, the highest sensitivity was obtained without specificity being lowered. The same result was obtained when the cut-off value was applied to CEA and TPA in pleural fluid using 5.0 ng/ml and 4700.0 ng/ml respectively. When CEA in pleural fluid or TPA in serum were measured in combining with pleural fluid cytology sensitivity was increased without decreasing specificity than measured in pleural fluid cytology alone. When CEA in serum and TPA in serum were measured in combining with pleural fluid cytology simultaneously, the highest sensitivity was produced without decreasing specificity than measured in any other combinations. In addition, when serum CEA and TPA in serum were measured in the negative group of pleural fluid cytology, high sensitivity and specificity were obtained. These data suggest that CEA and TPA can be used as useful tumor markers for the differential diagnosis of malignancy and benign condition in patients with exudative pleural effusions.