Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

부산지역 무균성 뇌막염 원인 바이러스의 분리 및 동정 : 1998년을 중심으로

김영희,정영기,김기순,지영미,윤재득,김병준,구평태,민상기,정구영,김만수,조경순 동의대학교 기초과학연구소 2000 基礎科學硏究論文集 Vol.10 No.1

The incidence of aseptic meningitis infection is ensuing and threatening the health of children. Enteroviruses are the major agents of aseptic meningitis and identification of virus has been a clue to diagnosis and epidemiology. The outbreak of aseptic meningitis occurred in Pusan, 1998. Patients were concentrated from April through November. Children were more susceptible than adults. Among 306 cases of specimens from stool, throat swab tested, only 7.2% were positive on virus isolation, 12 cases from stool and 10 from throat, respectively. All isolated 7 serotypes of viruses represented cytopathic effect on cultured cells. Three types of echovirus 6, 25, 30 and coxsackievirus B2, B3, B4, B6 were identified by neutralizing anti body test. Isolated coxsackievirus and echovirus were observed by an electron microscope with negative staining.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

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.

당뇨병성 합병증을 가진 환자에서 혈증 Erythropoietin 농도

김동규,유기동,허광식,김상용,윤성호,조영신,권용은,김태원,김건영,정종훈,배학연 조선의대 1998 The Medical Journal of Chosun University Vol.23 No.1

항암제와 Lactobacillus casei HY2782의 병용투여에 의한 항암효과의 증강

윤상군,배형석,김경태,백영진 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.1

S-180 복수암을 유발시킨 생쥐에 대한 BCG, OK-432와 LC2782의 항암효과 비교실험 결과 LC2782를 투여한 생쥐의 평균 생존율은 192%(p<0.001)였으며, OK-432 와 BCG를 투여한 생쥐의 평균 생존율은 각각 141%(p<0.01), 112%였다. 3LL 고형암을 유발시킨 생쥐에 대한 BCG , OK-432와 LC2782의 항암효과 비교실험 결과, LC2782를 투여한 생쥐의 암 억제율은 62%(p<0.05)였으며, OK-432 와 BCG를 투여한 실험군의 암억제율은 90%(p<0.05)와 76.2%(p<0.05)로서 OK-432가 가장 높은 암억제 효과를 나타냈다. 또한 S-180 복수암을 유발시킨 5-Fu와 CP를 단독 투여한 경우의 평균 생존율은 각각 115%와 99%였으나, 5-Fu와 CP를 LC2782 와 병용 투여한 경우의 평균 생존율은 각각 226%(p<0.001)1와 244%(p<0.00)1를 나타내어 단독 투여시보다 2배 이상 생존율이 증가하였다. 3LL 고형암을 유발시킨 생쥐에 5-Fu 와 CP를 LC2782와 병용 투여한 경우의 암억제율은 99.3%(p<0.05)와 73%(p<0.025)였다. Augmentation of antitumor activity of antitumor drugs in combination with Lactobacillus casei Hy2782 (LC2782) was studied against Sarcoma-180 (S-180) and Lewis lung carcinoma (3LL). Antitumor drugs used in this study were 5-fluorouracil (5-Fu) and cyclophosphamide (CP). The prolongation effect of LC2782 on the life span of mouse intraperitoneally implanted with S-180 was stronger than that of OK-432 and BCG, while the inhibitory effect of OK-432 and BCG on the growth of 3LL solid tumor was a little stronger than that of LC2782. Average survival rates of mice administrated LC2782, OK-432 and BCG were 192%, 141%, and 112%, respectively, when that of the control was 100%. Intralesional administration of 5-Fu, CP, 5-Fu+LC2782 and CP+LC2782 resulted in 93%, 69%, 99% and 73% inhibition rates against 3LL solid tumor proliferation. The combination therapy of 5-Fu or Cp with LC2782 significantly prolonged the life span of S-180-inoculated ICR mice. Average survival rates of mice administrated 5-Fu and CP alone were 115% and 99%. Furthermore, survival rates of mice administrated 5-Fu and CP in combination with LC2782 were 226% and 244%, respectively.

통풍성 관절염의 임상적 고찰

윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2

통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.

정신분열병 양성 및 음성증상과 혈소판 Monoamine Oxidase 활성도

윤성환,김영훈,진성태 大韓神經精神醫學會 1991 신경정신의학 Vol.30 No.1

The intention of this study to investigate the relationship between the activity of platelet MAO and positive and negative symptoms in the male chronic schizphrenics by DSM-III. The authors devided the male chronic schizophrenics into positive, mixed and negative subgroups by Andreasen & Olsen Criteria(1982), and also each patient was evaluated in relation with positive and negative symptom scales proposed by Lewin & Meltzer(1984). The authors assayed kinetic constants(Vmax and Km) for platelet MAO from 22 drug-free schizophrenics and 22 normal controls, radioenzymatically using 14C-benzylamine as a substrate. The results were as follows ; 1) Schizophrenic subjects had a lower mean Vmax Value(5.20±1.58 nmoles10(-6) platelets/hr) and Km value(38.92±19.28×10(-6)M) for poatelet MAO than normal controls(8.07±4.54, 49.56±18.48). Authough lower mean Vmax had a statistical significance, Km did not have. 2) In case of paranoid group(n = 6), there were no statistical differences in kinetic constants for platelet MAO compared with non-paranoid group(n = 16). 3) There were no significant differences in kinetic constants for platelet MAO between positive, mixed and negative symptom group. 4) The difference between kinetic constants for platelet MAO and positive symptom scale and negative symptom scale were not significant statistically. 5) Each scale item in the negative symptoms was not significantly different from platelet MAO activity. Finally, we confirmed that activity of platelet MAO was lowered in chronic schizophrenics, but we did not find any possible relationship between the negative symptom of schizophrenia and kinetic constants for platelet MAO.

서울시내 특급호텔 한식당의 현황

윤은숙,나영아,송태희 서울保健大學 1998 論文集 Vol.18 No.1

This study was investigated to the Korean restaurant menus from eight of the first class and five of the second class hotels in Seoul, and attempted to evaluate the restaurant evaluation and cooks job satisfaction with questionnaire surveys. The results were as follows : Korean restaurants of the first class hotel was on sale classified with a large table of food (so called kjo-ja-sang), Korean tabled hotel dinner(chong-sik), a Ia carte (il-pum yori), dessert, and wine with various prices and dishes. The first class hotel sold a lot of a large tables, second class hotel merchandised many Korean tabled hate dinner, both of them served from soup and stew of low price to high class dishes, served rice drink(sik-hei) and ginger tea with dried persimmons (su choung-kwa) with dessert, and served so-ju and bop-ju with Wine. Cooks whose sex were composed of 20% of female and 80% of male, ages were 52% of 20th, most of them graduated from high school or more. They had Korean, Western. Japanese or two or more of cooking license, had engaged in cooking for 5-10 years, worked 8 hours a day, made 1,000,000-1,500,000 won in a month. Most of them were satisfied with their job, possibilities, education training, and salary, whereas they dissatisfied with a cuisine environment such as room temperature, noise, illuminations. Therefore Korean restaurants need improve their working environment. Korean restaurants of the first class hotel had job description. standard cooking recipe, and job planing, hence we know that they were managed with scientific systems. We must attempt to survey menu design of food service system, western and Chinese restaurant as well.

丹溪의 學術思想이 韓方婦人科學에 미친 影響의 考察

윤종원,오규석,홍영욱,이태균 동국대학교 한의학연구소 1997 東國韓醫學硏究所論文集 Vol.6 No.1

金元四大家 중의 한 사람인 朱震亨은 主火論의 영향을 받았지만 독창적인 "相火論"과 "陰不足而陽有餘"하다는 견해를 밝히면서 補驗精而抑相火를 위주로한 治法을 제창하여 後代에 "滋陰派"라고 불리운다. 이러한 丹溪의 醫學思想과 韓方婦人科學과 관련된 이론을 개괄하여 丹溪의 이론과 처방이 우리나라 韓方 婦人科學의 발전과정에 미친 영향을 고찰하였다. 그 결과 첫째, 丹溪의 證治思想의 특징은 祛濕痰, 調氣, 滋陰淸熱의 治法 運用과 禁慾的 攝生을 통한 養生論이었으며, 둘째로 丹溪의 理論과 處方들은 《醫方類聚》와 《東醫寶鑑》에서 《丹溪心法》과 《丹溪心法附餘》의 내용을 대폭 수용함으로써 우리나라 韓方婦人料學 理論의 주요한 부분을 형성하는 계기가 되었으며, 셋째로, 부인과 질환과 관련하여 月經病에 調氣 및 祛濕痰을, 不姙症에는 月經不調와의 關聯性은 물론 體型ㆍ體質別 病機와 治法을 구분하였으며, "産前當淸熱養血" 이론에 의한 黃芩·白朮을 위주로 한 安胎論, "從痰論治"한 惡阻治法, 難産豫防, 産後의 "大補氣血"등의 이론을 제시하여 丹溪의 학술사상이 우리나라 한방부인과학에 미친 영향은 많았던 것으로 사료된다. JuJinHyoung(朱需亨) is a well-known physcian of the four schools in the Jin(金) and Yuan(元) Dynasties. He lived in ZhejiangSheng(浙江省) which located in the southeast region of China. There was humid and heatful climate, this kinds of environments influenced to his medical thoughts. He persisted in the theory that Yang is ever in excess while Yin is ever deficient(陽常有餘陰不足論) and exhorted the therapy of subduing excessive Yang and making up deficient Yin by nourishing it, and he said about the theory of ministerial fire(相火論). So he was regarded as a representative of the nourishing Yin school(濫陰派). And he said that the method of "Clearing away heat and nourishing blood" is suitable in pregnanoy. So Scutellaria Baicalensis GEORGI and Atractylodes macrocephala KOIDZ. Can be apply in case of treatment on Anti-abortion. Thus these theories have influenced on Obstetric & Gynecology in Korea.