서동증과 의지감소증으로 발현한 간성 뇌병증 : 증례보고

문소영,정용,강수진,진주희,나덕렬 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

We report a 70-year-old woman who, without a prior history of liver disease, presented abulia and bradykinesia as the initial symptoms of hepatic encephalopathy (HE). Neurological examination showed bilateral extensor plantar responses in addition to mild parkinsonian features On neuropsychological tests, she was impaired at the attention, visuospatial function, memory, and frontal lobe function. Laboratory tests were remarkable for increased AST and ammonia, and positive igG HbcAb. The results of ultrasonography of the liver were consistent with chronic liver disease. Brain T1 weighted MRI revealed a high signal intensity in bilateral basal ganglia. Brain PET showed diffuse cerebral hypometabolism After treatment with oral lactulose, the above symptoms remained improved for the next 6-month of follow-up From this case, we learned that hepatic encephalopathy could be a reversible cause of dementia plus parkinsonism even in patients without a prior history of chronic liver disease.

肺癌組織에서 Carcinoembryonic Antigen의 免疫組織化學的 檢出에 關한 硏究

蘇文永,金仁仙,白承龍 고려대학교 의과대학 1982 고려대 의대 잡지 Vol.19 No.3

The advent of immunohistochemical technique has allowed the more conventional visualization by light microscopy of antigenic cellular constituents. Carcinoembryonic antigen (CEA), which had been thought to be present in colorectal carcinomas only, was later demonstrated in a variety of malignancies as well as nonmalignant diseases. Using formalin-fixed, paraffin-embedded tissues and immunoperoxidase, the author has attempted to demonstrate CEA in 40 lung cancers and 10 nonmalignant diseases. The results obtained are as follows: 1. Seventeen squamous cell carcinomas among 19, three adenocarcinomas among 4 and only 3 of the 12 small cell carcinomas of the lung were positive for CEA. Two mucoepidermoid tumors and one carcinosarcoma were all positive, whereas one carcinoid tumor and one large cell carcinoma were negative for CEA. 2. In the well differentiated squamous cell carcinoma of the lung it was almost exclusively the more keratinized squamous tumor cells that displayed CEA, whereas in the poorly differentiated squamous cell carcinoma and adenocarcinoma the total cell surfaces demonstrated CEA. In mucoepidermoid tumors, the total cell surfaces and the luminal borders of glandular structures were positive for CEA. The stainability of CEA was weak and focal in small cell carcinoma. The stronger staining of CEA was found in the carcinomatous portion of carcinosarcoma. 3. Except two middle lobe syndromes and one tuberculosis of the lung, 2 bronchiectasis, 2 pneumonias and 3 tuberculosis of the lung were positive for CEA, however the staining was weak and mainly found along the luminal border of the bronchiolar epithelial lining cells. In summary, the findings suggested that the immunohistochemical identification of CEA in tissue section processed for routine histopathology was feasible. This might have diagnostic significance to the histopathologist and provide a basis for use of CEA in the follow-up management of patients with lung cancers.

외과적 정출술을 통한 치은 하방 치경부 파절선이 있는 상악 전치부의 심미 보철 치료

이소진,김유진,박영범,조규성,정문규 大韓齒科補綴學會 2012 대한치과보철학회지 Vol.50 No.3

Surgical extrusion, immediate extrusion following tooth luxation, is a method to preserve one's natural tooth and achieve esthetic restoration without additional periodontal surgery when subgingival dental caries or crown fracture occurs. A 16-year-old male was referred to the clinic from the department of operative dentistry for the esthetic restoration of maxillary left lateral incisor. Due to the crown to root fracture, the tooth was endodontically treated with a buccal crown length of 4 mm. When the palatal flap was elevated, the mesiopalatal cervical fracture area was situated 3 - 4 mm subgingivally. Crown lengthening was achieved through surgical extrusion. After 3 months of clinical observation and provisional restoration, the maxillary left central incisor was restored with all ceramic crown and obtained a satisfactory clinical result. 치은연 하방에 치아 우식증이나 치아 파절이 발생했을 때, 치아를 탈구시켜 즉시 정출시키는 외과적 정출술을 이용한 치관 연장술은 자연치를 보존하고 추가적인 치주적 수술 없이 단기간에 심미적인 보철 치료를 가능하게 한다. 본 환자는 16세 남환으로 본원 보존과로부터 상악 좌측 중절치의 심미 수복을 위해 본원 보철과로 의뢰되었다. 상악 좌측 중절치는 근관치료가 되어 있었으며 치관-치근 파절로 인해 협측 치관 길이는 4 mm였으며 구개측 판막을 열었을 때 근심 구개측 치경부 파절 범위는 치은 하방 3 - 4 mm에 위치하였다. 외과적 정출술을 통한 치관연장술을 시행하였으며 경과 관찰 및 임시 치아의 단계를 거쳐 3개월 후에 전부 도재관으로 수복하여 만족할 만한 임상 결과를 얻을 수 있었다.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

외상 후 뇌 지방색전증 1예

문정미,소정일,김용권,류진호,허탁,서정진,민용일 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Post-traumatic fat embolism was first reported by Zenker in 1862, Von Bergmann reported the first clinical diagnosis of the fat embolism syndrome in 1873. Fat embolism has been associated with traumatic or non-traumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. The diagnosis of fat embolism syndrome is based on the patient's history, is supported by clinical signs of pulmonary, cerebral, and cutaneous dysfunction, and is confirmed by the demonstration of arterial hypoxemia in the abscence of other disorders. Two different mechanisms cause fat to embolize: direct entry of deposit fat into the blood stream and agglutination of endogenous or exogenous plasma fat. MRI can detect a cerebral fat embolism with a higher sensitivity than cerebral CT. We report a case of post-traumatic cerebral fat embolism without pulmonary involvement, and we present a review of the literature. A 16-year girl had a traffic accident and pelvic bone fracture. Forty eight hours later severe trauma become stuporous without a focal neurological deficit. The patient received supportive therapy, and her condition improved throughout her hospital course. She was discharged with good condition after a 30-day hospital stay.

HBx형질전환 생쥐에서 발생한 간세포암종에서 H-ras 및 c-myc의 발현에 관한 연구

문형배,소병준,김학철,윤기중,한원철,조향정,유대열,정영진 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

<연구목적> HBx형질전환 생쥐에서 발생한 간세포암종의 발암과정에 종양유전자(H-rgs, c-myc)의 발현 정도를 조사하고자 하였다. <연구방법> 정상생쥐 12마리(4-18개월) 및 HBx 형질전환 생쥐 44마리(4-18개월)를 대상으로 포르말린에 고정하고 파라핀에 포매한 간 조직을 이용하여 면역조직화학적염색을 실시하였다. 실험군은 정상 부위, 이형성 부위 및 종양 부위로 구분하였으며, 종양 부위는 소결절성병변 부위와 간세 포암종 부위로 구분하였고, 이형성병변 부위는 이형성병변만 발견되는 부위, 소결절성병변과 동반된 이형성병변 부위 및 간세포암종과 동반된 이형성병변 부위로 구분하였다. <연구결과> H-rgs의 발현은 정상 간조직에 비하여 이형성병변 부위(P<0.05) 및 종양 부위(P<0.01)에서 증가하였으며, 소결절성병변 부위과 간세포암종 부위 사이에서는 간세포암종 부위에서 증가된 경향이었으나 통계학적으로 유의한 차이가 없었으며, 각 이형성병변 부위 사이에서도 유의한 차이는 없었다. c-myc의 발현은 정상 간조직 및 이형성병변 부위에 비해 종양 부위에서 증가하였으며(P<0.001), 소결절성병변 부위와 간세포암종 부위에서는 비슷하였고, 각 이형성병변부위 사이에서도 비슷하였다. <결론> HBx형질전환 생쥐에서 발생하는 간세포암종의 발생에 H-rgs는 이형성 변화를 일으키는 시기에 관여하며, c-myc은 이형성병변에서 암으로 이행하는 시기에 관여할 것으로 생각한다. Background: This experiment was designed for the expression of H-ras and c-myc in hepatocarcinogenesis of the HBx transgenic mice. Methods: Immunohistochemical stains in the paraffin embedded tissue of the liver were used for the detection of H-ras and c-myc in the 12 normal mice and 44 HBx transgenic mice of the 4-18 month old. Results: Expression of the H-ras was significantly increased in the dysplastic area (P<0.05) and tumor area (P<0.01) than in the normal liver. But there were no differences of H-ras expression between areas of microscopically identified hepatocellular carcinoma (MI-HCC) and grossly identified hepatocellular carcinoma (GI-HCC) and dysplastic areas among the only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Expression of the c-myc was significantly increased in the tumor area (P<0.001) than in the normal liver and dysplastic area. But there were no differences of c-myc expression between areas of MI-HCC and GI-HCC, and dysplastic areas among only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Conclusions: Our study suggests that H-ras is related to the dysplastic change and c-myc is related to the neoplastic change in the hepatocarcinogenesis of the HBx transgenic mice.

아파트 거주의향 및 선호경향에 관한 연구 : 구미시 중·소형 아파트 구매예정자를 대상으로

신소영,박세문,김익환 금오공과대학교 2005 論文集 Vol.26 No.-

This paper analyzes the living intention and preference tendency of the potential buyers for small and medium sized apartment houses in Gumi. The analysis results are summarized as follows; 1) About 90% of pollees have intention to move into apartment houses, and prefer a subcenter of Gumi city as residence area, which provides convenient living environment and great nature environment. 2) Most of them want to buy aparbnent houses in ordre to own their houses. Thus, they have a strong desire to have their own houses. When buying apartment houses, they consider economic points first such as price and the merits of investment. 3) Most pollees say they think indoor space is more important than outdoor space. Especially, they want storing spaces and a large balcony. 4) Majority of the pollees like a housing complex consisting of around 300 to 1000 houses and high-rise apartment buildings of 11 to 15 stories.

양이온교환수지에 대한 Co(Ⅱ), Ni(Ⅱ), Cr(Ⅲ) 및 Fe(Ⅲ) 이온의 흡착 특성 : 원자로 일차 냉각재 계통내 탈염공정에의 적용 Application to the Demineralizing Process in a Primary Coolant System of PWR

강소영,이병태,이종운,문승현,김경웅 대한방사선 방어학회 2002 방사선방어학회지 Vol.27 No.1

가압경수로 일차냉각수내 탈염공정의 효과적 운용을 위하여 Amberlite IRN-77 양이온 교환수지의 특성 및 Co(II), Ni(II), Cr(III), Fe(III) 이온의 흡착거동을 연구하였다. 용존 금속이온 농도가 약 200 mgL^-1 인 용액 100 mL에 대하여 이온교환수지 투입량은 약 0.6g이 가장 적절하였으며, 이온교환 반응 속도 측정 결과 대부분의 흡착은 반응 1 시간 이내에 신속히 발생하였다. 수지에서의 양이온 교환은 Langmuir 흡착등온선을 잘 따르는 것으로 나타났으나, Fe(III)의 경우, 다른 금속과는 달리 쉽게 평형에 이르지 못하였으며 이는 공기와 오래 접촉한 결과 철산화물 또는 수산화물을 형성하며 용액 중으로부터 침전되기 때문인 것으로 관찰되었다. 전자가가 동일한 Co(II)와 Ni(II)가 동시에 포함된 모의 조제용액에 대하여 흡착실험을 한 결과, 각 이온은 거의 동일한 흡착 거동을 보였다. 그러나 전자가가 큰 Cr(III)이 첨가된 경우, 이들은 기존에 수지에 흡착되어 있던 전자가가 낮은 금속들을 탈착시키고 대신 흡착하는 경향을 보였다. 따라서 이온교환수지를 이용한 효과적인 탈염 공정을 위해서는 용존 금속 상호간의 경쟁적 흡착관계의 규명이 필요한 것으로 여겨진다. Characteristics of Amberlite IRN-77, a cation exchange resin, and the mechanisms of its adsorption equilibria with Co(II), Ni(II), Cr(III) and Fe(III) and Fe(III) ions were investigated for the application of the demineralizing process in the primary coolant system of a pressurized water reactor (PWR). The optimum dosage of the resin for removal of the dissolved metal ions at 200 mgL^-1 was 0.6 g for 100 mL solution. Most of each metal ion was absorbed onto the resin in an hour from the start of the reaction. Each metal adsorption onto the resin could be well represented by Langmuir isotherms. However, in the case of Fe(III) adsorption, continuous formation of Fe-oxide or -hydroxide and its subsequent precipitation inhibited the completion of the equilibrium between the metal and the adsorbent. Cobalt(II) and Ni(II), which have an equivalent electrovalence, were adsorbed to the resin with a similar adsorption amount when they coexisted in the solution. However, Cr(III) added to the solution competitively replaced Co(II) and Ni(II) which were already adsorbed onto the resin, resulting in desorption of these metals into the solution. The result was likely due to a higher adsorption affinity of Cr(III) than Co(II) and Ni(II). This implies that the interactively competitive adsorption of multi-cations onto the resin should be fully considered for an efficient operation of the demineralizing ion exchange process in the primary coolant system.

아파트 주거모델 요구도 평가에 관한 연구 : 구미시 중·소형 아파트 구매예정자를 대상으로(2)

신소영,박세문,김익환 금오공과대학교 2006 論文集 Vol.27 No.-

This paper is analyzed with the living intention, preference tendency and needs of dwelling model of the potential buyers for small and medium sized apartment houses in Gumi. The analysis results are summarized as follows; 1) To see the category of apartment housing model, the need of Apartment & Store, environmentally oriented apartments, well-being apartments is shown to be high. 2) The instruction of the natural-control-system and the recycling system are the top priority of environment-oriented apartments. 3) The need of Automated apartments and Health-oriented apartments is high, as a new housing model. 4) Accordingly, the housing model in the future is concluded with the house with convenience, high technical facilities, and health-oriented apartments.

상아질 삭제기구가 자가부식 접착제의 결합강도에 미치는 효과

이영곤,문소라,조영곤 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.1

이 연구는 다이몬드 포인트와 카바이드 버 및 SiC paper로 삭제한 상아질에 대한 자가부식 프라이머 접착제의 결합강도를 비교하고, 실험실에서 사용하는 SiC paper와 유사한 결합강도를 나타내는 회전용 삭제기구를 알아보기 위하여 시행하였다. 56개의 발거된 대구치 치관의 교합면 상아질을 노출시켜 1.2 mm의 두께의 시편을 제작한 후 8개의 군으로 분류하였다. 1군은 standard diamond point (TF-12), 2군은 fine diamond point (TF-12F). 3군은 extrafine diamond point (TF-12EF), 4군은 cross-cut carbide bur (no. 557), 5군은 plain-cut carbide bur (no. 245), 6군은 P 120-grade SiC paper, 7군은 P 220-grade SiC paper, 8군은 P 800-grade SiC paper를 사용하여 각 시편의 상아질 표면을 약 0.2 mm정도 삭제하였다. 상아질 표면에 Clearfil SE Primer와 Bond를 적용하고 Tygon tube를 이용하여 Clearfil AP-X를 충전하고 40초간 광조사 하였다. 제작된 시편은 만능시험기를 이용하여 를 미세전단 결합강도는 측정한 후, 각 군의 결합강도를 one-way ANOVA와 Tukey검정을 이용하여 분석하여 다음과 같은 결과를 얻었다. 자가부식 프라이머 접착제 사용 시 상아질에 대한 개선된 접착을 위해서는 초미세입자 다이아몬드 포인트의 사용이 추천되며, 실험실적인 연구에서 P 220-grade SiC paper의 사용은 미세입자 다이아몬드 포인트나 카바이드 버로 삭제한 상아질 면과 유사한 결합강도를 나타내었다. The purpose of this study was to compare the microshear bond strength of a self-etching primer adhesive to dentin prepared with different diamond points, carbide burs and SiC papers, and also to determine which SiC paper yield similar strength to that of dentinal surface prepared with points or burs. Fifty-six human molar were sectioned to expose the occlusal dentinal surfaces of crowns and slabs of 1.2 mm thick were made. Dentinal surfaces were removed with three diamond points, two carbide burs, and three SiC papers. They were divided into one of eight equal groups (n = 7); Group 1: standard diamond point(TF-12), Group 2: fine diamond point (TF-12F), Group 3: extrafine diamond point (TF-12EF), Group 4: plain-cut carbide bur (no. 245), Group 5: cross-cut carbide bur (no. 557), Group 6 : P 120-grade SiC paper, Group 7: P 220-grade SiC paper, Group 8: P 800-grade SiC paper. Clearfil SE Bond was applied on dentinal surface and Clearfil AP-X was placed on dentinal surface using Tygon tubes. After the bonded specimens were subjected to uSBS testing, the mean uSBS (n = 20 for each group) was statistically compared using one-way ANOV A and Tukey HSD test. In conclusion, the use of extrafine diamond point is recommended for improved bonding of Clearfil SE Bond to dentin. Also the use of P 220-grade SiC paper in vitro will be yield the results closer to dentinal surface prepared with fine diamond point or carbide burs in vivo.