소아복벽원심성 지방위축증 2예

윤정빈,허충림,김낙인 경희대학교 1997 慶熙醫學 Vol.13 No.4

기분장애를 주소로 내원한 Binswanger씨 병 1례

채정호,전태연,윤수정,최성빈,김대진,김광수 대한생물치료정신의학회 2000 생물치료정신의학 Vol.6 No.1

We report a 70 year-old man with Binswanger's disease associated with mood symptoms. He was apparently well until 15 years ago when the treatment-resistant atypical mood symptoms had been appeared. He showed a fluctuating course in mental disturbance, such as irritable and labile affect, emotional incontinence, and irritable behavior. Two years ago, he was diagnose as hypertension, renal failure, and heart failure. He was admitted to psychiatric ward due to irritable mood, dysarthria, lack of bladder control, gait disturbance, and impulsive behaviors, which had been aggravated during the last 2 months. In physical examination, he had hypertension and both pretibial pitting edema was revealed, and also in neurological examination, exaggeration of deep tendon reflexes and weakness of extremities were found. On mental status examination, he showed irritable and labile mood with mild cognitive disturbances. Brain MRI demonstrated multifocal high signal intensity in periventricular white matter, both basal ganglia, and thalami on the T2 imaging. These findings were compatible with Binswanger's disease with mood symptoms.

원자력 발전소 저압 터빈 동익 자동 초음파 검사 기술 개발

양승한,이정빈,김영호,윤병식,김용식 한국비파괴검사학회 2004 한국비파괴검사학회지 Vol.24 No.4

원자력 발전소의 터빈에서 운전 연수 증가에 따라 pin finger형 블레이드 루트부에 균열이 발생하는 문제점이 발생되었다. 블레이드 루트부에 대한 비파괴검사는 매 계획 예방 정비기간 동안 수동 초음파 검사를 통하여 수행되어 왔으나, 검사의 신뢰성을 확보하기 위해 해당 설비에 대한 자동 초음파 검사 기술 개발의 필요성이 대두되었으며, 이에 따라 자동 초음파 검사 장비 및 검사 기술을 개발하였다. 개발된 검사 장비의 적용성을 확인하기 위해 계획 예방 정비 기간 중 저압터빈 2,3단 블레이드 루트부에 대한 자동 초음파 검사를 수행하고, 다양한 형태의 터빈 검사에 확대 적용 가능성을 확인하였다. As the turbine running duration in nuclear power plants increases, cracks have been found in the pin finger type blade root area. The nondestructive examination for the blade root area has been carried out by manual ultrasonic examination during the overhaul period, but because of necessity to improve the reliability, we developed an automatic ultrasonic examination system and technique. To demonstrate the performance of the developed automatic ultrasonic examination system, low pressure turbine blades in the 2nd and 3rd stages of nuclear power plants were examined using developed system. Its applicability nuclear power plant turbine roots of various types was also confirmed.

Characterization of the aminopyridine derivative KRC-180 as a JAK2 inhibitor

Yoon, Kyoung Bin,Cho, Sung Yun,An, Su Jin,Park, Kyeong Ryang,Lee, Hyo Jeong,Yoon, Hae Sung,Lee, Sun-Mi,Kim, Yong-Chul,Han, Sun-Young D.A. Spandidos 2017 Oncology letters Vol.14 No.2

<P>Janus kinase 2 (JAK2) is a non-receptor tyrosine kinase that regulates the signal transducer and activator of transcription (STAT) signaling pathway. Deregulation of JAK2 signaling has previously been observed in hematologic malignancies, including erythroleukemia. In the present study, an aminopyridine derivative compound, KRC-180, exhibited direct inhibition of the JAK2 protein at the catalytic site, as demonstrated using <I>in vitro</I> kinase activity assays and docking analyses. In addition, KRC-180 reduced the phosphorylation of STAT3 and STAT5, downstream signaling molecules of JAK2. The growth of HEL92.1.7 erythroleukemia cells harboring a constitutively activated form of JAK2 was suppressed by KRC-180 treatment; KRC-180 induced apoptotic cell death and cell cycle arrest. The results of the present study indicate that KRC-180 is a JAK2 inhibitor with anti-leukemic properties.</P>

Relationship between Timing of Endoscopy and Mortality in Cirrhotic Patient with Variceal Bleeding

( Jeong-ju Yoo ),( Young Chang ),( Eun Ju Cho ),( Sang Gyune Kim ),( Young Seok Kim ),( Yun Bin Lee ),( Jeong-hoon Lee ),( Su Jong Yu ),( Yoon Jun Kim ),( Jung-hwan Yoon ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The optimal timing of emergency endoscopy in patients with variceal bleeding is remains unclear. Most guidelines recommend performing endoscopic evaluation and treatment within 12 hours after patient’s arrival, but there are few related studies. The aim of this study was to examine the association between timing of endoscopy and mortality of esophageal variceal bleeding in cirrhotic patients. Methods: This retrospective study included 274 of consecutive patients admitted to two tertiary hospitals in Korea due to esophageal variceal bleeding. Using descriptive statistics and Kaplan-Meier survival analyses, we analyzed the association between the timing of endoscopy and patients’ mortality. We adjusted confounding factors and balanced the baseline characteristics of the subjected patients using Cox proportional hazards model and inverse probability weighting (IPW) method. Results: A total of 173 patients received endoscopy within 12 hours after admission and 101 patients, after 12 hours. Endoscopy was performed after a median of 7.6 hours (interquartile range [IQR], 2.9-16.5) after admission. The median overall survival (OS) was 8.2 months (IQR, 1.4-25.9) months, and in-hospital mortality was 8.0%. Performing endoscopy within 12 hours was associated with longer OS than performing after 12 hours (33.2 vs. 23.5 months, log-rank P=0.01). Early endoscopy was independently associated with longer OS after adjusting presence of hepatocellular carcinoma, MELD score, and Glasgow-Blatchford score (adjusted hazard ratio [aHR] 1.61, 95% confidence interval [CI]=1.05-2.46, P=0.03). Also, after balancing baseline characteristics using IPW, endoscopy within 12 hours group consistently showed longer OS than endoscopy after 12 hours group (aHR 2.17, 95% CI=1.56-3.03; P=0.03). However, outcomes were not significantly different between the urgent (within 6 hours) and early endoscopy groups. Conclusions: Timing of endoscopy is associated with mortality in patients with esophageal variceal bleeding. It is important to perform emergency endoscopy within 12 hours, especially for high-risk patients.

Entecavir Plus Pegylated Interferon Alfa-2a and Sequential HBV Vaccination Increases the Chance of HBsAg-Seroclearance: A Results from Randomized Controlled E+VIP Trial

( Jeong-hoon Lee ),( Sungwon Chung ),( Min Suk Kim ),( Sung Woong Kim ),( Jun Sik Yoon ),( Young Chang ),( Yun Bin Lee ),( Eun Ju Cho ),( Su Jong Yu ),( Jung-hwan Yoon ),( Yoon Jun Kim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Currently, HBsAg-seroclearance is considered as a functional cure in chronic hepatitis B patients, although it is rarely achievable with oral nucleos(t)ide analogs (NAs) treatment alone. We conducted a randomized controlled trial to evaluate the efficacy on HBsAg-seroclearance and safety of pegylated interferon alfa-2a (Peg-IFN) plus sequential hepatitis B virus (HBV) vaccination in addition to NA treatment. Methods: A total of 111 patients who achieved serum HBV DNA < 20 IU/mL and quantitated HBsAg (qHBsAg) < 3,000 IU/ mL with entecavir (ETV) treatment were enrolled and randomly assigned to the treatment group (ETV + PegIFN [subcutaneous injection of 180 μg every week over 48 weeks] + sequential HBV vaccination [intramuscular injection of recombinant HBV vaccine containing 20 μg of HBsAg, at weeks 48, 52 and 56], N=37), the control group (ETV only, N=37), or the explorative group (ETV + Peg-IFN + concurrent HBV vaccination [at weeks 0, 4, and 8], N=37). The primary endpoint was HBsAg-seroclearance at week 100 and secondary endpoints included change in qHBsAg titer and safety Results: There was no difference in baseline characteristics including qHBsAg, HBV DNA, HBeAg-positivity, and biochemical markers (e.g., ALT, AST, albumin) among three groups. In intention-to-treat analysis, the treatment group showed significantly higher chance of HBsAg-seroclearance at week 100 (16.2% vs 0%, P=0.025 by Fisher’s exact test). However, the explorative group (5.4%) failed to reach significant difference (P=0.49). The changes in median qHBsAg titer from baseline to week 100 was -67.7% in the treatment group and -36.3% in the control group, respectively. Maximal decrease in qHBsAg of each patients are plotted in Figure 1. Adverse events were significantly more frequent in the treatment group (81.1%) than the control group (2.7%) (P<0.0001). However, the frequency of serious adverse events did not differ significantly among groups (2.7% in both treatment and control group, P=1.00). Conclusions: Entecavir plus an additional PegIFN treatment followed by sequential HBV vaccination with intensified schedule significantly increases the chance of HBsAg-seroclearance compared to entecavir alone. ClinicalTrials.gov number: NCT02097004.

[P046] Erythema multiforme with atypical clinical features

( Jeong Won Jo ),( Young Bin Shin ),( Hae Bong Jeong ),( Yun Sun Moon ),( Do Seon Jeong ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Erythema multiforme (EM) is a hypersensitivity reaction characterized by targetoid skin lesions with or without erosions of mucosal surfaces. An acute, self-limiting or episodic course and the presence of targetoid lesions, raised atypical papules or mucosal involvement, are the important clues to diagnose with EM. Laboratory studies and skin biopsies are not required in all cases of EM. EM has been classified into a number of variants, mainly minor and major forms. In the case of general EM major, the mucosal lesions as well as the cutaneous lesions are also more severe and cover a wide range of skin surface. However, we examined a case of EM with atypical clinical features. Unlike general EM major, the cutaneous lesions of our patient were mild and limited to hands and feet that uncommonly involved, although the erosive lesions of oral and genital mucosa were severe. This atypical feature caused misdiagnosis to hand, foot and mouth disease and led to delay proper treatment. In conclusion, we should be recognized that there is a case of EM with atypical clinical features and refer to it when diagnosing.

Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio

( Jeong-ju Yoo ),( Eun Ju Cho ),( Bora Lee ),( Sang Gyune Kim ),( Young Seok Kim ),( Yun Bin Lee ),( Jeong-hoon Lee ),( Su Jong Yu ),( Yoon Jun Kim ),( Jung-hwan Yoon ) 대한소화기학회 2018 Gut and Liver Vol.12 No.6

Background/Aims: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been wellvalidated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. Methods: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. Results: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p< 0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR ( >2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p<0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. Conclusions: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC. (Gut Liver 2018;12:714-721)

[P044] A case of pretibial thyroid dermopathy

( Jeong Won Jo ),( Young Bin Shin ),( Hae Bong Jeong ),( Yun Sun Moon ),( Do Seon Jeong ),( Eui Chang Jung ),( Chi Yeon Kim ),( Tae Jin Yoon ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Pretibial myxedema(PM) is a dermatological manifestation of Graves` disease, which commonly presents as diffuse, non-pitting edema of shins and less often as plaques, nodules, or elephantiasis lesions mimicking lymphedema. Most common site is pretibial area and localized thickening of the pretibial skin causes deposition of acid mucopolysaccharides. There are 7 cases of pretibial myxedema reported in domestic dermatology literature. The only four of cases occurred after treatment of hyperthyroidism like that our case. Herein, we report a case of pretibial myxedema with Grave`s disease and Grave`s ophthalmopathy. A 51-year-old male visited our department with multiple erythematous patches and nodules on Lt. pretibial area. He had been diagnosed with Grave`s disease 6 months ago and Grave`s ophthalmopathy 3 months ago. The incisional biopsy on Lt. pretibial area showed mucinosis in dermis with perivascular lymphocytic infiltration. The lesions improved after steroid intralesional injection. For persisted local lesions despite improvement of systemic symptoms, we propose that the steroid intralesional injection may be an alternative to treatment.

A Case of Crohn`s disease showing a skin Lesion with cobblestone-Like appearance in perianal region

( Jeong Bin Yoon ),( Yang Hoon Cho ),( Hyo Jong Kim ),( Mu Hyoung Lee ) 대한피부과학회 1997 초록집 Vol.35 No.20