Surgical resection of stage Ⅲ non-small cell lung cancer after chemotherapy and radiotherapy

Moon, Dong Seok,Lee, Doo Yun 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

1990년 1월부터 1997년 9월까지 연세대학교 의과대학 영동세브란스 병원에 내원한 비소세포성 폐암환자에게 수술 전 항암제 투여, 흑은 방사선 치료와의 병행요법으로 그 효과를 분석할 수 있었던 15명의 환자를 대상으로 수술시 연령, 성별, 수술 방법, 병기 변화, 병용 치료요법에 대한 반응, 수술 후 합병증, 사망원인 등을 조사하였다. 15명 중 처음 진단시 제 IIIA 기는 6명, 제 IIIR 기는 9명이었으며, 편평 상피암 13명 선암 2명이었고 14명이 남자이었다. 이들의 중앙 연령은 56.2세 이었으며 개흉술은 모두에게서 시행되어 졌으며, 병리학적 완전 관해가 3명(20.0%)이었고, 유도요법에 대한 전체 반응률 46.7%이었다. 개흉술 당시 병기절하(Downstaged)는 10명(53.3%)에서 나타났다.

심근경색증의 급성기에 시행한 경피적 관동맥 스텐트 삽입술의 효과

이남호 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

최근 들어 여러 연구보고에서 심근경색증의 급성기에 스텐트 삽입술을 시행하여 풍선확장술만을 시행한 경우에 비해 시술 후 6개월 내의 주요 심장합병증 및 재협착율이 현저하게 감소됨이 보고된바있다. 본 연구에서는 1992년 9일 1일터 1991년 10월 10일까지 세브란스병원 심장내과에 내원하여 심근경색증의 급성기에 경피적 관동맥성형술을 시행받은 38명의 환자들을 대상으로 하여 풍선확장술만 시행한 군과 스텐트를 시술한 군으로 나누어 관동맥조영술 소견 및 임상적 경과 등을 전향적으로 분석하였다. 분석결과 비록 적은 대상환자수로 인하여 통계적 유의성은 관찰되지 않았으나 스텐트 시술군에서 풍선확장군에 비해 관동맥 재협착율이 훨씬 낮은 것을 알수 있었으며 병원내 생존에 유일하게 의미 있는 지표는 경색원인 관동맥의 재관류 여부였다. 따라서 최근의 여러 연결결과 및 본 연구의 결과를 고려할 때 향후 심경색증의 급성기에 스텐트 삽입술이 매우 중요한 치료로서 자리잡을 것으로 사료된다. Primary balloon angioplasty in acute myocardial infarction has been shown to result in lower rates of mortality, recurrent MI, and stroke compared with thrombolysis. However, recurrent ischemia and early reocclusion of the infarct-related vessel occur in 10-15% of patients and late restenosis in the first 6 months remains high. Recently two prospective randomized trials comparing stenting with balloon angioplasty in acute stage of myocardial infarction showed that balloon angioplasty followed electively by coronary stents can be used as the primary modality for acute myocardial infarction, reducing in-hospital adverse events, and improving late outcome compared with balloon angioplasty alone. In this study, we retrospectively reviewed the angiographic findings and clinical outcomes of 38 percents with primary angioplasty in acute myocardial infarction, Although there was no statistical significance due to small study population, restenosis rate in the stent group was lower than in the balloon angioplasty group(18% versus 50%). This study demonstrates that primary stenting in acute stage of myocardial infarction can be applied safely and effectively, resulting in a lower rate of restenosis compared with balloon angioplasty.

Socio-cultural understandings of traditional management of childbirth in korea

Kim, Hae Won 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

모성간호는 간호대상자가 속한 사회 문화적 배경의 특성을 고려하여 제공된다는 입장을 기본 철학으로 삼는다. 생식과 관련된 제반 현상은 모성간호의 오랜 역사를 거쳐 현재까지도 중요한 지식 탐구와 연구 주제의 대상이 되어왔다. 최근에는 특히 분만과 관련된 간호관리가 대상자의 독특한 특성에 따라 어떻게 나타나고, 어떤 사회 문화적 배경이 이에 영향을 미치는 지에 대하여 관심이 증대되고 있다. 따라서 이 글은 한국의 분만과 관련된 간호대상자를 보다 민감하게 이해하고 나아가 개별화된 전문 간호를 제공하기 위하여 전통적인 한국의 분만관리의 특성과 그 사회 문화적 배경을 확인하였다.

A case of herpes zoster that has occurred without chicken pox history in normal early childhood

Cho, Moon Kyun,Lee, Hyun Hee 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

대상 포신은 주로 성인에서 발생되며, 소아에서는 드물게 발생하는 질환이다. 대상포진의 병변은 군집성 발진이 특징적으로 밴드형태의 분포를 보이며 하나 혹은 그이상의 신경절을 침범하는 질환이다. 원인균은 허피스 바이러스군에 속하는 varicella-zoster바이러스(VZV)이다. 발생기전은 수두를 하는 동안 varicella-virus가 피하신경에 들어가 있다가 varicella-virus가 재활성화 되어 발생된다고 하나 그 이유 아직까지 명확하게 알려지지 않지 있다. 재활성화 시키는 요소는 피로, 연령, 면역 억제제, 림프종, 백혈병 등이 관계된다. 소아기에서 대상포진을 면역상태가 좋지 않은 소아, 자궁내 감염이 있었던 경우, 생후 수두를 앓은 경우 발생한다. 정상 소아의 경우 유아기에 후천적으로 varicella-zoster-virus에 감염되면 대상포진의 발생시기가 단축되며, 된 환아의 경우도 후천적으로 수두백신을 생후 13개월에 접종하였고 그후 13 개월 후 발생된 것으로 보인다. 저자들은 수두의 병력 없이 백신접종 후 발생된 것으로 보이는 대상포진을 경험하였기에 보고하는 바이다.

자궁내말암종에서 표피성장인자 수용체의 발현과 DNA량 분석소견

이상엽 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

In endometrial carcinomas, one of the most difficult problems in clinical management has been to identify women with low stage disease who have a substantially increased risk of developing recurrence. Numerous studies to find the prognostic indicator of endometrial carcinomas were performed, but little is known about the relationship between the overexpression of epidermal growth factor receptor(EGFR) and findings of flow cytometric DNA analysis. The immunohistochemical reactivity of antibodies against EGFR and flow cyromertic DNA analysis were examined in 19 endometrial carcinomas, and these finding were compared with histopathological findings and each other. Thirteen of 19 cases were immunohistochemical positive for EGFR(68%). The overexpression of EGFR did not correlate with histological grade, muscle invasion, DNA ploidy, DNA index, S-phase fraction, proliferative index. The cases of high DNA index(1.89 and 1.95) were histological grade 2 and 3 with deep muscle invasion. In this study, the overexpression of EGFR in endometrial carcinomas failed to show correlation with histopathologial findings and results of flow cytometric DNA analysis. But the high content of DNA is related to high histologic grade and deep muscle invasion, therefore it may present important prognostic information especially to patient with low clinical stage.

저산소 스트레스가 마우스의 자연살 세포 분포율에 미치는 영향

강동원 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

To study the nature of differentially manifested adaptive responses of an organism according to the intensities of the stress, the immune effects of different levels of repeated hypoxia were investigated. Four experimental groups (NH. not-handled, 20% : handled, 15 or 10%: exposed to 15% or 10% O_2 with balanced nitrogen, respectively) of mice were exposed to different levels of hypoxia for 60 min/day, 5 days/week and in a repeated and intermittent manner. After 11 weeks' exposure to hypoxic environment, mice were subjected to immunophenotypic analysis. Changes of natural killer (NK) cell subpopulation of spleen cells of mice were studied. Although there were no differences in weight changes among experimental groups during hypoxic exposure, the NK cell subsets pf 15% and 10% group were significantly decreased comparing to that of NK group. These results show that the repeated hypoxic stress decreases the NK cell subpopulation in the spleen of mouse and that NK subpopulation is a sensitive marker of stress effects on this experimental model.

메치실린 내성 포도상구균에 대한 SK-302의 시험관내 및 생체내 효과

박윤선,김수기,신운섭,최선주,정종순,이종수 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

SK-302 is the active compound purified from culture filtrate of a streptomyces species (streptomyces sp. 302). The in vitro and in vivo antibacterial activities of SK-302 were evaluated against 6 clinically isolated MRSA strains and compared with the activities of vancomycin. SK-302 had node in virto antistaphylocoal activity stronger than that of vancomycin exhibiting MIC's, while vancomycin showed very weak 4 to 8fold lower than that of vancomycin. In SK-302 showed killing activity at the MIC, so SK-302 was superior to vancomycin. Furthermore, in acute systemic infections in mice, the ED_50s of SK-302 against infections by high-resistance MRSA were 30 to 40-feold less than that of vancomycin, therefore SK-302 showed potent in vive therapeutic efficacy against MRSA infection, These results suggest that SK-302 has excellent in virto in and in vivo activities against high-resistance MRSA.

복강내 고환에서 발생한 Anaplastic Seminoma 1례

심희영,구자홍,김현정 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

The cryptorchism is a congenital disorder in which a testicle is arrested at some point in its normal descent anywhere. The end of surgical correction by the 2-year-old is to restore the fertility and decrease the malignant chance. The cancer is 35 - 48 times more common in a misplaced testis than in the normally descended organ. Do most authors recommend the orthiectomy as a treatment of the cryptorchism after puberty because of a malignant chance. We experienced the malignant tumor developed in abdominal testis with the radical orchiectomy and radiothererapy. We report a case of anaplastic seminoma in 35 year old male a brief review of the literature.

스트레스 대처행동에 관한 연구 : 간호학생의 무력감 경험 및 정서적지지와 관련하여

최미경 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

This study was designed to investigate the content of stress coping behavior and to examine factors, determining stress coping behavior for nursing students(n= 1.19) in relation to socidemographic variable, the experience of powerlessness, emotional support. Data analysis procedure included factor analysis and stepwise multivariate regressions using stress coping behavior as dependent variables. Analysis showed; 1. As a whole, nursing students showed a tendency of lack in positive stress roping behavior. 2. Contents of stress coping behavior showed that high grade student had more tendency to take stress coping behavior positively than 1ow grade students. 3. Multiple regression analysis revealed that the factors such as grade and religion were to be independently and significantly associated with stress coping behavior: Students who were in high grade and had no religion were tend to take stress coping behavior positively. 4. The experience of powerlessness and emotional support did, inspite of stereotype, poorly impact on stress coping behavior. We tan guess the effect of education indirectively from these findings, but longitudinal studies need to consider the direct effect of education. The results also indicate that the respondents should be on encouraged to take stress coping behavior positively.

간기능 평가에 있어서 개인용 컴퓨터를 이용한 간체적의 산정

김경식 關東大學校醫科大學醫科學硏究所 1998 關東醫大學術誌 Vol.2 No.1

Measurements of the whole liver volume have used for the assessment of preoperative functional reserve in cirrhotic patients. The equipment of personal computer and peripherals have been developed and widely used. We easily calculated pure liver volume excluding tumor volume using program on personal computer and investigated the relationship between pure liver volume the conventional parameters such as Child-Pugh score and IGG R15. The whole liver volume were 1634.3±764.4cm, volume of tumor were 322.7±97.0㎤ and the pure liver volume excluding tumor volume were 1311.7±402.5㎤. The comparison true liver volume with above mentioned two indexes were as follows: (1) The true liver volume were 1389.1±565.6㎤ in patients with Child-Pugh points 5 and 1243.8±196.6㎤ in patients with a value of IGG R15 less than 10% and 1501.8±571.3㎤ in patients with a value of IGG R15 above 10%, respectively. Although there were limitations for using the pure liver volume as index of liver reserve function the measurement for liver volume with this method is simple and accurate and further studies and more cases would be needed.