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.

한국 민주주의의 이행과 공고화 과정 분석

김영태(Kim Young-Tae) 동국대학교 사회과학연구원 2006 사회과학연구 Vol.13 No.1

This paper studies the process of democratic consolidation in Korea since 1987's democratic transition toward civic government and shows the lessons of consolidation for new leap of Korean democracy. The way of democratizing Korean politics is that (l) 'Democratization by agreement between military and democratization influence and (2) economic success was democratization that occur from 'Crisis of success' that bring critical condition of political power of an authority. Roh Tae-Woo government that centralizes power continuously in pro-democracy fight corresponds to transition period by democracy. Kim Young-Sam's civilian government sailing is left perfectly at power center since military party was withdrawn perfectly from centralize power. South Korea has succeeded in democratization transition without cutting or danger of system collapse. It is because it had more profitable condition at democracy consolidation flowing when character of transition period looks back upon historic experience that acted by important variable in unfolding process of hereafter. However, Kim Dae-Jung government as people's government that and Kim Young-Sam government as civilian government speak that failed passing over boundary of negative consolidation and advances active consolidation in Korea's democracy. Korean democracy has achieved some success in procedural and formal side of democratic consolidation since civilian government departure, but democracy is not institutionalized and internalized in virtual side yet. Achieve Korean democracy Consolidation overcoming instability and fluidity of democratization process successfully in circumstance that outside condition of democracy changes rapidly by North Korea nucleus problem, democratic citizen relationship's development and change of politics culture for voluntary politics participation are essential. Citizen relationship and politics culture are expected that is evolved and need considerable time though sweep away remnants with authoritarian culture. Stable society, new democracy welfare society that democracy consolidation is done and institutionalize is achieved, and role division between political society and civic society are achieved properly, and restraint and balance are made together and active interest of people total and continuous effort will have to be redoubled to do it so that democracy consolidation may be deepened still more, and necessity to grope structural innovation plan within synthetic system that is hereafter, country-politics society-civic society will be brought.

太谿穴의 臨床 活用에 대한 文獻考察

구성태,송문영,강정묵,김용명,박보라,이은석,홍정아,김경식,손인철 한국전통의학연구소 2003 한국전통의학지 Vol.13 No.1

Literally, the mean of Tae-gye is highest brook. And on the basis of the acupuncture theory, Tae-gye point is the Soo earth point and source point of the Kidney Channel as well. In addition, Tae-gye point is one of the Yang-Returning Nine points. We were trying to study bibliographically on the Tae-gye point because Tae-gye point can be used very broadly across the symptoms in the theoretical aspect described above. As a results, we found out that according to the classical books of acupuncture, Tae-gye point is entering point of the Meridian Water as a source point and can be used at both Kidney-Sufficient Syndrom and Kidney-Deficient Syndrom. And Tae-gye can be applied to the disease of kidney or bladder that is urogenital symtoms, Also, Tae-gye is an useful option of tooth-ache, asthma, indigestion, constipation, edema etc whose cause is related with decrease of Kidney ki.

맨드라미(Celosia cristata L.) 꽃 메탄올 추출물로부터 용매분획된 분획물의 항산화활성

김현영(Hyun Young Kim),고지연(Jee Yeon Ko),송석보(Seuk Bo Song),김정인(Jung In Kim),서혜인(Hye In Seo),이재생(Jae Saeng Lee),곽도연(Do Yeon Kwak),정태욱(Tae Wook Jung),김기영(Ki Young Kim),오인석(In Seok Oh),정헌상(Heon Sang Jeong),우 한국식품영양과학회 2012 한국식품영양과학회지 Vol.41 No.11

맨드라미꽃의 식품학적 이용가능성을 확인해 보고자 항산화성분 및 항산화활성에 대해 검토하였다. 맨드라미꽃의 항산화성분과 활성은 메탄올 추출물과 순차적 용매분획물에 대해 측정하였으며, 메탄올 추출물과 hexane, chloroform, ethyl acetate, butanol 및 물 분획물의 추출수율은 각각 23.33, 10.27, 20.00, 13.63, 17.55 및 38.54%였다. 맨드라미 꽃 메탄올 추출물의 총 polyphenol, flavonoid 및 tannin 함량은 각각 6.80 ㎎ GAE/g ME, 2.34 ㎎ CE/g ME 및 6.23 ㎎ TAE/g ME였다. 순차적 용매분획물 중 butanol 분획에서 각각 14.92 ㎎ GAE/g SF, 5.44 ㎎ CE/g SF 및 13.38 ㎎ TAE/g SF로 함량이 높았다. 총 proanthocyanidin 함량은 44.72 ㎍ CE/g ME였고 순차적 용매분획물은 각각 42.47, 44.43, 50.03, 49.12 및 41.80 ㎍ CE/g ER로 용매간 유의적인 차이를 보이지 않았다. 맨드라미꽃의 메탄올 추출물의 DPPH 및 ABTS radical 소거활성은 각각 5.24 및 10.70 ㎎ TE/g ME였고 butanol 분획에서 각각 12.53 및 21.09 ㎎ TE/g SF로 활성이 높았다. 메탄올 추출물의 SOD 유사활성은 7.96 unit/mL로 나타났고 hexane, chloroform, ethyl acetate, butanol 및 물 분획물은 각각 4.56, 6.15, 8.07, 12.36 및 5.21 unit/mL로 butanol 분획의 활성이 높았다. 맨드라미꽃 추출물의 항산화성분과 항산화활성 간에 높은 정의 상관관계를 보였고 맨드라미꽃 추출물이 체내 및 식품에서 유익한 도움을 줄 수 있을 것으로 생각된다. The purpose of this study was to evaluate the antioxidant contents and activities of solvent fractions from methanolic extracts of cockscome flowers. The yield of methanolic extracts from cockscome flowers was 23.33%, whereas those of its solvent fractions (hexane, chloroform, ethyl acetate, butanol, and water) were 10.27, 20.00, 13.63, 17.55, and 38.54%, respectively. Total polyphenolic, flavonoid, tannin, and proanthocyanidin contents of methanolic extracts (ME) were 6.80 ㎎ gallic acid equivalent (GAE)/g ME, 2.34 ㎎ catechin equivalent (CE)/g ME, 6.23 ㎎ tannic acid equivalent (TAE)/g ME, and 44.72 ㎍ CE/g ME, respectively. The highest total polyphenolic, flavonoid, and tannin contents of solvent fractions were 14.92 ㎎ GAE/g solvent fraction (SF), 5.44 ㎎ CE/g SF, and 13.38 ㎎ TAE/g SF in the butanol fraction, respectively. The total proanthocyanidin contents were 42.47, 44.43, 50.03, 49.12, and 41.80 ㎍ CE/g SF, respectively. The DPPH and ABTS radical scavenging activities from cockscome flowers were 5.24 and 10.70 ㎎ Trolox equivalent (TE)/g ME, respectively. The highest DPPH and ABTS radical scavenging activities of the solvent fractions were 12.53 and 21.09 ㎎ TE/g SF in the butanol fraction, respectively. SOD-like activities of methanolic extracts from cockscome flowers were 7.96 units/mL, whereas those of its solvent fractions were 4.56, 6.15, 8.07, 12.36, and 5.21 units/mL, respectively. The results of this study show that notable antioxidant activities in cockscome flowers have significant health benefits.

Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim`s technique and comparison to laparotomy

( Jeong Sook Kim ),( In Ok Lee ),( Kyung Jin Eoh ),( Young Shin Chung ),( Inha Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Young Tae Kim ),( Sang Wun Kim ) 대한산부인과학회 2017 Obstetrics & Gynecology Science Vol.60 No.2

Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim`s technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim`s technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim`s technique could be a feasible solution to removing huge ovarian tumors.

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.

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.

18–30세 사이에 발생하는 뇌경색의 특징, 다기관 레지스트리 연구

장윤경,송태진,김용재,허지회,이경열,김영은,장민욱,조수진,강석윤 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3

Objectives: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. Methods: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. Results: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). Conclusion: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1994)

김재홍,안진균,정성재,김영태,김중환,김시영,이석종,이홍렬,서호석,김경훈,권혁진,정우권,고우석,이용석,안필수,오준규,오용섭 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.1

Background : In recent years gonorrhoea has been panendemic and remains one of the most common Sexually Transmitted Diseases in the world, especially in developing countries. Objective & Method : For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria Gonorrhoeae(PPNG), Ive have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1994, 168 strains of N. gonorrhoeae were isolated, among which 109 (64,9% ) were PPNG. Conclustion : Our results suggests that the prevalence of PPNG in Seoul is still increasing.