급성 췌장염의 시대적 변화

김배영(Bai Young Kim),김효종(Hyo Jong Kim),정형근(Hyung Keun Chung),김영관(Young Kwan Kim),동석호(Seok Ho Dong),김병호(Byung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: According to the rapid changes in social environment such as increasing alcohol consumption and the marked improvement in diagnostic technique, we expect that there have been major changes in various aspects of acute pancreatitis during the recent 12 years in Korea. Methods: The medical records of 317 patients with acute pancreatitis diagnosed from 1980 through 1992 were reviewed about clinical, laboratory and radiological findings in the three different time period. Results: 1) There has been an increasing incidence in male sex about three folds. 2) There has been an increasing trends in the duration of hospitalization. 3) A significant increase was observed in the proportion of patients with alcoholic pancreatitis in the three different time period; 26.9%, 45.7%, 50.7% respectively. 4) The complication rates have been slightly increased in the three different time period; 46.3%, 47.1%, 59.1% respectively. But, the type of complications has not been changed. 5) There is increasing severity in non-gallstone group, but no significant differences in gallstone group. There is a declining trends in the number of patients with muld severity index, but increasing trend in the number of patients with moderate severity index in non-gallstone group. 6) There was no significant differences in mortality rate. Conclusions: There has been major changes in the etiology ans severity of acute pancreatitis from 1980 through 1992. Especially, significant increase in the proportion of patients with alcoholic pancreatitis was observed in the three differnt time period. These results might be due to socioeconomic changes.

흰쥐에서 사염화 탄소(CCl4)에 의한 간섬유화의 유도

김병호,이정일,김효종,김영관,장린,동석호,장영운,송일한 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6

Experimental model of hepatic fibrosis is importent contributions to the understanding of cellular and molecular mechanisms underlying excessive accumulation of extracellular matrix in the liver. Carbon tetrachloride (CCl₄) is one of the oldest and most widely used toxin for experimental induction of hepatic fibrosis in laboratory animals. In this study, We intended to induce the hepatic fibrosis in the rat by the intragastric CCl₄/ phenobarbtal treatment once a week for 12 weeks and the administration dosage of CCl₄ in each week was determined by the daily body weight change. Liver function and histologic change were examined just after 12-week treatment in group Ia (9 rats, Phenobarbital treatment only) and II (18 rats, CCl₄/phenobarbital treatment), and liver function and the irreversibility o histologic change were examined 12 weeks after 12-week treatment in group Ib (9 rats, phenobarbital treatment only) and III (18 rats, CCl₄/phenobarbital treatment). 1) Death rate after 12-week treatment was 11% in group Ⅰ, 56% in group Ⅱ and 50% in group Ⅲ. and the highest rate was at 1 week. that is 33 o each in group Ⅱ and Ⅲ. 2) Tatal protein, alkaline phosphatase, alanine aminotransferase and portal venous pressure were significantly increased in group Ⅱ compared with that in group Ⅰa, but it was only portal venous pressure that was increased in group Ⅲ than in group Ⅰb, 3) The gross finding of micronodular change was shown in 88% of group Ⅱ, 71% of group Ⅲ, but none of group Ⅰ. The microscopic finding of hepatic fibrosis was found in all of group Ⅱ and Ⅲ, but none of group Ⅰ. The severe form of hepatic fibrosis suggesting cirrhosis was found in group Ⅱ and Ⅲ, 12% and 29% respectively. In our study, mortality rate was high within 1 week after CCl₄ treatment, which resulted in half survival rate after 12-week treatment. We also experienced the loin rate of severe fibrotic changes in surviving rats. In the future, in order to produce a severe irreversible fibrotic change with low mortality in inducing hepatic fibrosis with CCl₄/phenobarbital treatment in the rat, adequate detemination of the initial dose of CCl₄ and appropriate choice of administration route of CCl₄ were thought to be needed.

1990년대 간경변증의 원인, 합병증, 사망원인의 변화에 관한 고찰

김병호,김경진,김효종,장린,이정일,동석호,이동근,한요셉,장영운,백일현 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 우리나라에서 간경변증의 가장 중요한 원인은 B형 간염이지만 최근 C형 간염에 의한 경우가 늘고 있으며, 알코올성 간경변증은 드문 것으로 알려져 있으나 음주 인구 및 음주량의 증가로 빈도가 증가되었을 것으로 추측된다. 또한 진단 기술의 발달, 정맥류 출혈 치료의 발전, 간세포암의 조기진단 및 치료법의 발달로 간경변의 진단 시기 및 사망원인 등에도 변화가 있을 것으로 생각된다. 이에 연자 등은 C형 간염 진단이 가능하게 된 1991년 이후의 환자를 대상으로 간경변증의 원인, 진단 시기, 합병증 및 사망원인의 변화 등을 조사하여 비교, 분석하였다. 대상과 방법: 1991년부터 1998년까지 경희대학교 병원에 입원하여 간경변증으로 진단된 1157명의 환자를 대상으로 원인, 합병증의 발생빈도, 사망원인에 대하여 병력기록을 후향적으로 분석하였으며, 이들 결과를 전ㆍ후반기로 나누어 비교하였다. 결과: 간경변증 환자 1157명 중 남자가 848명(73.3%)으로 많았으며, 전ㆍ후반기의 차이는 없었다. 환자의 연령은 전반기 51.4±11.1세, 후반기 51.2±11.2세로 차이가 없었으며, B형 간염이나 알코올에 의한 경우도 유사한 양상이었다. 그러나 C형 간염에 의한 경우는 약 10세 높은 연령), 알코올(12.7%, 20.0%), C형 간염(8.5%, 17.5%) 순으로 후반기에 알코올이나 C형 간염에 의한 경우가 증가하였으나 통계학적 차이는 없었다. 사망환자 249명의 원인 분석에서 전ㆍ후반기 모두 간부전(38.7%, 40.2%)이 가장 많았고, 그 이외 전반기는 정맥류 출혈(20.0%), 간암(18.7%), 간신증후군 순(11.3%)이었고 후반기는 간신증후군(19.2%), 정맥류 출혈(16.2%), 간암(11.2%) 순으로 간신증후군은 증가하고 정맥류출혈은 감소하는 경향이었으나 통계학적 차이는 없었다. 결론: 1990년대 간경변증의 원인은 과거와 마찬가지로 B형 바이러스 감염이 가장 많았지만, 알코올성 간경변증의 빈도가 약 30%로 과거에 비하여 증가한 것으로 생각되었다. C형 간염바이러스 감염에 의한 경우는 빈도의 변화 없이 약 10세 높은 연령에서 진단되었다. 간경변증의 진단은 점차 간경변 초기에 진단되는 경우가 증가하였다. 간경변증의 사망원인 중 정맥류 출혈은 점차 감소한 반면 간경변증 말기에 나타나는 간신증후군에 의한 경우가 증가하는 경향을 보였다$quot;. $quot;Background: Alcoholic liver disease has increased. The causes of death in liver cirrhosis have changed. The author tried to categorize the etiology and complications of liver cirrhosis and analyze the causes of death in the 1990s. Method: The author retrospectively reviewed medical records of 1,175 patients diagnosed as having liver cirrhosis at Kyung Hee University Hospital from January 1991 through December 1998. The etiology, complications and the cause of death were compared between the early (1991-1994) and the late (1995-1998) periods. Results: The proportion of male patients (73.3%) was still about 3 times that of female patients. There was no difference in age at the time of diagnosis between early and late periods (51.4 11.1 and 51.2 11.2 years respectively). Hepatitis B virus (HBV) infection was still the most common cause of liver cirrhosis (57.0%) and alcohol was the next (31.1%). The complications of liver cirrhosis at the time of diagnosis were, in order: esophageal varices, ascites, and variceal bleeding. But there was no significant difference between the periods. The proportion of Child grade B was the most common at the time of diagnosis in both periods, but Child grade A increased in the late period. The most common cause of death was liver failure and the next cause was variceal bleeding in the early period. Hepatorenal syndrome was the second most common cause in the late period. Conclusion: There was no change in the etiology between early and late periods. HBV infection was still the most common etiology but the incidence of alcoholic liver cirrhosis might have increased in the 1990s. The proportion of the Child B at initial diagnosis was the highest (around 50%) but that of Child A increased in the late period. Among the causes of death, liver failure and hepatorenal syndrome had a tendency to increase in the late period$quot;.

SV40 T 항원의 온도조건부 변이형 유전자가 포함된 Amphotropic Retrovirus 에 의한 사람 태아 간세포의 불멸화

이정일(Joung Il Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),장린(Rin Chang),성세라(Se Ra Seong),박재경(Jae Kyung Park),김승보(Seung Bo Kim),이상목(Sang Mok Lee) 대한내과학회 1999 대한내과학회지 Vol.57 No.1

N/A Human cells are almost never spontaneously immortalized in vitro. We tried to immortalize human fetal hepatocytes (h-FH) and evaluate the differentiational status and its change. Methods : Hepatocytes were isolated from a liver fragment of 20 week old fetus and infected with amphotropic recombinant retrovirus containing a temperature- sensitive mutant of SV40 large T antigen and neomycin phosphotransferase gene. G418 resistant colonies were cloned and expanded. The cells which were able to divide more than 30 times were used to analyze various functions. Results : The immortalization rate was 3.3 x 10-8 and two cell lines (C11, D21) were established. C11-60, C11-80, D21-30 and D21-60 (suffix number means the cell division counts) were evaluated. D21-30 was thougt to be imcompletely immortalized because a considerable portion of cells died during culture. The morphology was similar to that of epithelial cells except for D21-30 which looked like fibroblast. The cells grew rapidly at 33oC but stopped growing at 39oC. T antigen and p53 was expressed at 33oC but disappeared at 39oC, which suggest that T antigen binds to p53. Chromosomal changes were so marked that it was impossible to discriminate exact number. Albumin was secreted as about 1/10 as that of h-FH, but alpha-fetoprotein secretion stopped after immortalization. Telomerase was activated in both cell lines except for the incompletely immortalized cells D21-30. Telomere was elongated in competely immortalized cell lines, but it was rather shortened in D21-30 compared to that of h-FH. Macroscopic colonies did not develop in soft agar assay. Conclusions : We successfully immortalized human fetal hepatocytes. Although the cells are not likely to have oncogenicity, the functions are not so good, possibly due to marked chromosomal changes which are thought to occur before telomerase is activated during immortalization step.

십이지장 결핵 2예의 내시경적 고찰

장린,박충기,민영일,장영운,우정택,방익수,최학림,장주희 대한소화기내시경학회 1985 Clinical Endoscopy Vol.5 No.1

Today, the duodenal tuberculosis is a very rare disease. Final diagnosis of duodenal tuberculosis is difficult due to inconsistent symptoms and nonspecific duodenal lesions. We found 2 cases of duodenal tuberculosis by gastrascopy. In gastroscopic findings, there were undetermined ulcers and irregular nodular mucosal changes.

교권침해를 경험한 초등학교 교사의 회복과정에 대한 자문화기술지

장세린(Chang, Se rin),정윤경(Chung, Yun-kyoung) 한국질적탐구학회 2021 질적탐구 Vol.7 No.3

본 연구의 목적은 한 초등학교 교사의 교권침해 경험과 그 회복과정을 조명하는 것이다. 이를 위하여 교권침해 교사의 경험을 통해 교권침해 문제해결을 어렵게 하는 학교의 구조적 메커니즘을 분석하고, 공론화를 통해 학교 차원에서 교권침해 문제를 해결해 가는 과정을 서술하였다. 연구방법은 경험 당사자의 목소리를 효과적으로 들려줄 수 있는 자문화기술지를 사용하였다. 연구 결과는 크게 침해경험과 회복과정으로 나누어 서술하였다. 침해경험은 교권침해 문제 해결을 어렵게 하는 학교 시스템의 구조적인 문제점을 보여주고, 학부모와 학생에 의한 교권침해 경험을 보여준다. 교권침해로부터 회복하는 과정은 첫째, 관리자 교체와 더불어 공론화를 위한 연구자의 노력으로 학교 차원의 연대 형성이 가능했고, 둘째, 학부모와 관계 회복 셋째, 교사로서의 권위와 수업권 회복이 필요했음을 시사한다. 연구 결과가 주는 시사점은 다음과 같다. 첫째, 교권침해 문제를 공론화하고 학교 차원에서 해결하기 위해서는 변혁적 리더십을 가진 관리자가필요하다. 둘째, 암묵적 능력주의에 젖은 교직 사회의 분위기와 교사들의 인식이 변화할 필요가있다. 셋째, 교권 보호를 위한 절차 중심의 해결 방식이 수정되어야 한다. 마지막으로 교권 회복의 최종 목표는 수업의 정상화이며, 교사의 원활한 수업을 위해 어떤 지원이 필요한지 고민해 볼필요가 있다 This papers aims to shed light on an elementary school teacher’s experience of infringement on teachers rights and its recovery process. For this purpose it analyzed the structural mechanisms of schools that make it difficult to solve problems of teachers’ rights infringement through the experience of teachers’ rights violations, and described the process of solving problems at the school level through public discussion, not by individual teachers. For the research method, autoethnography was adopted as it could effectively speak the voices of experienced parties. The results of this study were largely described as damage experiences and recovery processes. The damage experience shows the structural problems of the school system that make it difficult to solve the problem of infringement on teachers’ rights, and shows experience of infringement on teachers’ rights by parents and students. The process of recovering from the challenge against teaching authority implicated first, it was possible to form a solidarity at the school level with researchers’ efforts to make public discussions along with the replacement of managers, second, restore relationships with parents, and third, recover the authority and teaching rights of teachers. The implications of this study are as follows: First, a manager with transformative leadership is needed to have public discussion on and resolve the issue at school level. Second, the attitude relying on implicit competence in teaching society and the perception of teachers need to change. Third, procedure-oriented solutions to protect teaching rights should be revised. Lastly, the final goal of restoring teachers’ rights is normalization of classes, and it is necessary to figure out what support is needed to help teachers lead their classes seamlessly

속박 (束縛) 과 침수 (浸水) 로 유도된 흰쥐의 스트레스성 급성 (急性) 위점막병변 (胃粘膜病變) 발생에 있어서 위산분비의 (胃酸分泌) 역할

민영일(Young Il Min),박충기(Choong Kee Park),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Jung Il Lee),박승준(Seung Joon Park),정주호(Joo Ho chung),정지창(Jee Chang Jung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1

N/A The possible roles of gastric acid secretion in the pathogenesis of stress ulcers induced by restraint with water-immersion for 7 hours in pylorus-ligated rats were investigated. Control rats with pylorus-ligation only did not show any gastric mucosa} lesion, and their mean gastric acid output was 449.2 ± 36.1 umol/rat. In contrast, the stressed rats, group II, showed multiple, punctate and hemorrhagic erosions in gastric mucosa, and mean gastric acid output was decreased to the level of 253.7 ± 27.3 umol/rat. Subcutaneous administration of histamine(40 mg/kg every 2.5 h for a total three times) to stressed rats augmented the lesion with severe multiple, linear and hemorrhagic erosions and mean acid output increased significantly (328.1 ± 31.5 umol/, p<0.005) compared with group II. Pretreatment with rantidine(20 mg/kg) or prostaglandin E2 (30 ug/kg) before exposure to stress reduced gastric lesion formation slightly with no significance. In ranitidine pretreated rats, mean gastric acid output was decreased significantly (120.1 ± 15.3 umol/rat, p<0.005) compared with group II. However, in prostaglandin pretreated rats, mean gastric acid output showed no significant changes. Therefore, it is suggested that increased gastric acid secretion seems to be an aggravating or a permissive factor rather than a major factor in the pathogenesis of stress-induced gastric mucosal lesions.

제주형 작물재배용 비닐하우스의 모델개발 : 풍하중에 대한 수치해석

권기린,김용호,민창식 제주대학교 환경연구소 1998 환경연구논문집 : 제주대 Vol.6 No.-

An elastic analysis under wind load is performed for the double layered plastic greenhouse model developed particularly for minimizing damages under typhoons at Cheju Citrus Research Institute in Chejudo. General EVA frlm is used for the inner covering and for the outer covering the developed special film whch would break the wind pressure down is used. Based on the wind tunnel test. this special film will reduce effectively the wind speed by up to 86 to 98% under very controlled situation. Many more tests need to be performed to adopt the results to greenhouse analysis. Based on the elastic analysis performed in the study, the behavior of the greenhouse is changed dramatically due to the boundary conditions. Not like other researchers before we applied dead load of the concrete support at the ground pipe and fixed support boundary conditions at the 4 corner pipes. The analysis shows that the greenhouse is lifted and pulled the pipe out of the ground due to the sucking wind pressure. The behavior of the greenhouse is very much similar to that one real greenhouse failure. Therefore, not only we need to find the realistic boundary conditions for the supports, but also need to perform many more researches to find how to rest the pipe supports on the ground without losing economy.

原發成肺癌 100例에 對한 X線學的 考察

咸蒼谷,金基廷,姜錫麟 대한의학협회 1971 대한의학협회지 Vol.14 No.12

Sarcoidosis Presenting with Multiple Lung Parenchymal Nodules

Hyung-Jun Kim,Jimyung Park,Jee Min Kim,Ye Jin Lee,Hye-Rin Kang,Chang-Hoon Lee 이화여자대학교 의과학연구소 2016 EMJ (Ewha medical journal) Vol.39 No.2

Sarcoidosis is a multi-organ disease with various clinical manifestations. The lung is the most common site of manifestation; however, unusual findings may delay the correct diagnosis of sarcoidosis. Here we report a case of 32-year-old man with 4-month history of neck mass. Radiological findings revealed multiple pulmonary parenchymal nodules, with initial biopsy results of his neck lymph node showing chronic granuloma with focal necrosis. The patient was treated with anti-tuberculosis medications, but the size of the nodules did not change. Biopsy was performed from one of his pulmonary nodules, which revealed chronic granuloma without necrosis. Therefore, the patient was diagnosed with sarcoidosis. We present a case of sarcoidosis with multiple lung parenchymal nodules that is uncommon in Korea, with an aim to alert physicians of such unusual presentations.