췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

흉선종 제거후에 발생한 재생 불량성 빈혈 : 증례보고

전원선,이상철,김현정,배상병,김찬규,이남수,박노진,이규택,박성규,홍대식,박희숙,원종호 순천향의학연구소 2007 Journal of Soonchunhyang Medical Science Vol.13 No.2

Thymoma is associated with myasthenia gravis, Pure red cell aplasia, and autoimmune diseases such as autoimmune hemolytic anemia, aplastic anemia, and hypogammaglobulinemia. It's association with aplastic anemia is rare and aplastic anemia appearing after surgical removal of thymoma is especially rare. The authors hereby report a case of aplastic anemia occuring in a patient who was diagnosed with thymoma and myasthenia gravis and had the tumor surgically removed. The patient was treated with anti-thymocyte globulin, cyclosporin, and prednisolone, and showed partial remission with hematologic improvements after 12 months.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

기상조절(인공강우와 안개저감)의 경제적 가치 추정 연구

이철규(Chulkyu Lee),장기호(Ki-Ho Chang),차주완(Joo-Wan Cha),정재원(Jae-Won Jung),정진임(Jin-Yim Jeong),양하영(Ha-Young Yang),서성규(Sung-Kyu Seo),배진영(Jin-Young Bae),강선영(Sun-Young Kang),최영진(Young-Jean Choi),조하만(Ha-man Cho) 한국기상학회 2010 대기 Vol.20 No.2

We estimate the economic benefit of weather modification (precipitation enhancement and fog dissipation) by assuming its operation for the considered regions. Based on the statistical data, the economic benefit of the virtually operational precipitation enhancement experiments for the Andong and Imha basins, where the natural precipitation is relatively lack in South Korea, is calculated 348 for the water resources, 22,458 for forest fire prevention, and 28,458 million won/year for the drought relief. The benefit of the fog dissipation operation for the Incheon International Airport is estimated 7,365 million won/year for the flight delay due to fog. The calculated ratio of benefit to cost for precipitation enhancement operation for the basins is 14.07, which is comparable to that conducted in other countries.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

저령차전자탕(猪苓車前子湯)의 기원(基源), 변천과정(變遷過程) 및 구조원리(構成原理)

권오원,김배수,이지원,신승원,이의주,Kwon, Oh-Won,Kim, Bae-Su,Lee, Ji-Won,Shin, Seung-Won,Lee, Eui-Ju 사상체질의학회 2016 사상체질의학회지 Vol.28 No.2

Objectives This paper investigates the origin, the progressive changes and the constructive principles of Jeoryoungchajeonja-tang(猪苓車前子湯).Methods Jeoryoungchajeonja-tang and other related prescriptions were analyzed in terms of their pathological indications, based on previous literature including 『Sanghannon(傷寒論)』, 『Keumkuaeyoryak(金匱要略)』, 『Donguibogam(東醫寶鑑)』, 『Donguisusebowon‧Sasangchobongwon(東醫壽世保元‧四象草本卷)』, 『Donguisusebowon‧Gabogubon(東醫壽世保元‧甲午舊本)』, 『Donguisusebowon‧Sinchukbon(東醫壽世保元‧辛丑本)』Results and Conclusions 1) The origin of Jeoryoungchajeonja-tang is discovered in the prescriptions for Lee-su(利水), that is, Jeoryoung-tang(猪苓湯). 2) Ohryoung-san(五苓散) introduced in 『Donguisusebowon‧Sasangchobongwon(東醫壽世保元‧四象草本卷)』progressively transformed into Shihosaryoung-san(柴胡四苓散)(『Donguisusebowon‧Gabogubon(東醫壽世保元 ‧甲午舊本)』) and ultimately into Jeoryoungchajeonja-tang(『Donguisusebowon‧Sinchukbon(東醫壽世保元‧辛丑本)』), a prescription appropriate for usage in the Mangeum symptomatology(亡陰證). 3) The Jeoryoungchajeonja-tang is composed of 10 herbs. Of these, Notopterygium incisum Ting(羌活), Aralia cordata Thunb.(獨活), Schizonepeta tenuifolia Briq.(荊芥), Saposhnikovia divaricata Schischk.(防風) make the Pyoeum(表陰) drop, and Anemarrhena asphodeloides Bge.(知母), Gypsum fibrosum(石膏) scatter the uihwa(胃火), and Poria cocos Wolf.(茯苓), Alisma canaliculatum(澤瀉), Polyporus umbellatus Fr.(猪苓), Plantago asiatica L.(車前子) facilitate urination.

Genetic Characterization of Haemagglutinin 1 Domain of Influenza B Viruses Isolated in Korea during $1988{\sim}1999$

Shin, Gu-Choul,Na, Byoung-Kuk,Lee, Joo-Yeon,Ahn, Jung-Bae,Park, Jong-Won,Lee, Jin-Soo,Kim, Jee-Hee,Kim, Woo-Joo,Kang, Chun The Korean Society for Microbiology 2003 Journal of Bacteriology and Virology Vol.33 No.4

Although Korean influenza virus isolates have been genetically associated with the vaccine strains of the corresponding year, influenza B viruses have prevailed almost every year in Korea during the past decades. We have 'analyzed the genetic characteristics and evolutionary patterns of the haemagglutinin (HA) 1 domains of influenza B viruses isolated during 1988-1999 using direct RT-PCR and sequencing. Phylogenetic analysis of influenza B viruses isolated in Korea indicated that antigenically and genetically distinguishable strains of the lineage II and lineage III variants had been cocirculated. Variants prevailed in early 1990s are represented in 1996/97 and 1998/99 and some different variants have been co circulated geographically and prevailed concurrently in Korea. All HA1s of Korean isolates have amino acid substitutions mainly in the region between position 124 and 310, which was previously proposed an immunodominant region. Insertion-deletion patterns of the HA gene revealed that Korean influenza B viruses were evolved from Lee40 with different manner between lineage II and III viruses. Lineage III viruses were also divided into two groups as conserved group and inserted group, in relation to Lee40. But lineage II viruses had evolved with directional pattern. Antigenic index proposed that influenza B isolates prevailed since 1996/97 seasons might had emerged from the antigenic variants of a Seo1697-like virus and that new variants might appear from the lineage II viruses resulting in persistent prevalence in Korea.

권역심뇌혈관질환센터 사업의 비용-편익 분석

김병호 ( Byung Ho Kim ),감신 ( Sin Kam ),배상근 ( Sang Geun Bae ),김건엽 ( Keon-yeop Kim ),이원기 ( Won Kee Lee ),홍남수 ( Nam-soo Hong ),박형근 ( Hyeung-keun Park ),이혜진 ( Heyjean Lee ),조은정 ( Eun-jung Cho ),채성철 ( Shung C 한국보건정보통계학회(구 한국보건통계학회) 2017 보건정보통계학회지 Vol.42 No.1

Objectives: This study was conducted to investigate economic feasibility of operating Regional Cardiocerebrovascular Centers using cost-benefit analysis. Methods: The current study assessed cost and benefit data collected from nine hospitals which were designated as Regional Cardiocerebrovascular Centers between 2008 and 2010. Results: The operation of Regional Cardiocerebrovascular Centers reduced mortality rate and length of stay due to acute myocardial infarction and stroke and also decreased disability occurred after stroke. The total calculated cost of operating nine Regional Cardiocerebrovascular Centers was 19.85-22.30 billion won and the minimum benefit calculated was 23.98 billion won. Applying the maximum cost and the minimum benefit, the net benefit was 1.68 billion won, which is estimated to 190 million won per Regional Cardiocerebrovascular Center. Conclusions: The present study revealed that the operation of Regional Cardiocerebrovascular Centers was economically beneficial. The benefit would be larger if intangible benefit such as the long-term effects to community hospitals and enhancement of quality of life of patients and their families are considered.

비커스 압입법에 의한 치과용 세라믹 재료의 균열진전 특성 평가

이용승,최원호,박광선,유창영,배태성 大韓齒科器材學會 2001 대한치과재료학회지 Vol.28 No.1

This study was performed to examine the microstructural aspects of crack propagation under static loading conditions in three dental ceramic materials : A feldspathic porcelain of VMK95, a heat-pressed ceramic of IPS-Empress and an alumina-glass composite of In-Ceram. Disc specimens were prepared to the final dimensions of 12 ㎜ in diameter and 2 ㎜ in thickness. Vickers indentation was made at load range of 2.9∼196.1 N, and the indentation pattern and radial cracks were examined. The results obtained were summarized as follows; 1.The ratios of half-diagonal and indentation load P, 1nc/1nP, were fitted to about 1/2 but showed the increase according to the increase of hardness. 2.The ratios of radial crack length c and indentation load P, 1nc/1nP, were fitted to about 1/2 in semi-elliptical Palmqvist crack but 2/3 in median/half-penny crack. 3.The higher the hardness number is, the longer the radial crack length becornes at the same loading condition. 4.Fracture surfaces of the VMK95 and IPS-Empress showed the toughening mechanism of crack bridging by the dispersed leucite crystals, but In-Ceram showed the frictional interlocking of jogs having the tendency of toughening by crack deflection, rather than by crack bridging.

제한효소인 Sdi Ⅰ을 생성하는 Streptomyces 분리 균주의 수리동정

배무,서원나,송은숙,이계준 이화여자대학교 생명과학연구소 1994 생명과학연구논문집 Vol.5 No.-

제한효소인 Sdi I을 생산하는 한 균주(Streptomyces sp.264)를 토양으로부터 분리하여 형태적 관찰 및 수리동정을 실시하였다. 50여개의 분류 단위 형질을 분석하였고, 이 실험 결과를 TAXON program에 적용하여 종의 수리동정을 실시하였다. 그 결과 분리균 sp.264는 Streptomyces의 제 19주군집에 속하는 Streptomyces diastatochromogenes의 한 균주로 동정되었다. Numerical identification was applied for Streptomyces sp.264, an isolate producing a new restriction endonuclease Sdi I. The restriction enzyme would appear to be an isoschisomer of Xho I. Fifty taxonomic unit characters were tested and the data obtained were analyzed numerically by using the TAXON program. The isolate was identified to be the jamor cluster 19 of Streptomyces and best matched to S. diastatochromogenes. It was, therefore, concluded that the isolate was identified to be a member of Streptomyces diastatochromogenes.