뇌혈관질환 환자의 후유증의 개선에 대한 Propentofylline(HWA 285)의 임상 연구

최영빈,박정욱,한시령,양동원,나정호,김범생 최신의학사 1994 最新醫學 Vol.37 No.6

Coexistence of classic lichen planus and lichen planus pigmentosus-inversus: resistant to both tacrolimus and clobetasol propionate ointments

Kim, BS,Aum, JA,Kim, HS,Kim, SJ,Kim, MB,Oh, CK,Kwon, YW,Kwon, KS Blackwell Publishing Ltd 2008 Journal of the European Academy of Dermatology and Vol.22 No.1

Krukenberg 종양 32예의 임상병리학적 연구

김종혁,남주현,나준희,김봉희,김병식,허주령,김용만,김영탁,목정은 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.4

목적 1989년 6월부터 1998년 5월까지 울산의대 서울중앙병원 산부인과 및 일반 외과에서 진단 받고 치료받은 Krukenberg 종양 환자 32예의 임상병리학적 분석을 하기 위함이다. 연구방법 진단 당시의 연령, 임상 증상 및 증후, 암의 원발 장소, 원발암 진단과 Krukenberg 종양의 진단까지의 기간, 병리적 소견, 치료법 및 생존 기간을 후향적으로 분석하였다. 결과 연구 기간 중 본원에서의 전체 난소의 악성 종양 중 Krukenberg 종양이 차지하는 비율은 10.7%로 나타났다. 환자들의 연령은 23∼55까지의 분포를 보였으며 평균 연령은 39.9[±8.0]세 이었고 약 반수의 환자가 40세 미만이었다. 복통이 가장 흔한 주소였으며 복부 종괴 촉지 혹은 복부 팽만이 다음으로 많은 주소로 나타났다. 원발암의 장소로는 위가 30예로 대부분을 차지하였으며 나머지 2예에서는 원발 병소를 찾지 못하였다. 46.9%의 환자에서는 Krukenberg 종양의 진단 전에 원발 병소의 진단이 가능하였다. 육안적으로 대부분의 종양은 큰 종괴를 형성하는 양상을 보였으며 평균 최대 직경은 10.4 cm에 해당되었고 59.4%의 환자에서 양측성의 발생을 보였다. 현미경적으로 모든 종양은 특징적인 signet-ring 세포를 포함하고 이들의 광범위한 기질 침윤을 나타내는 양상을 보였다. 대다수의 환자에서 전자궁적출술 및 양측 부속기 절제술을 포함하는 종양 감축술을 시행되었으며 19명[59.4%]의 환자에서 PF[cisplatin 5-FU], EF[etoposide 5-FU], PEF[cisplatin epirubicin 5-FU] or EAP[etoposide adriamycin cisplatin]의 항암화학요법이 추가로 실시되었다. 환자들의 중간 생존 기간은 14.7개월이었으며 1년 생존율은 51.5%[survival standard error ; 0.099], 2년 생존율은 27.8%[survival standard error ; 0.132]로 나타났다. 결론 Krukenberg 종양은 난소로의 전이성 종양의 희귀한 한 형태로 알려져 있으나 본원에서 전체 악성 난소 종양 중 차지하는 비율이 10% 이상으로서 서양과 비교하여 높은 것으로 나타났다. 원발 장소로는 위가 대다수이었으며 수술적 요법과 항암화학요법에도 불구하고 생존율이 불량한 것으로 나타났다. Objective The aim of this study was to evaluate the clinicopathologic characteristics of 32 patients with Krukenberg tumor diagnosed and treated in Asan Medical Center, College of Medicine, University of Ulsan from June 1989 to May 1998. Methods Age distribution, symptoms and signs, primary site of tumor, pathologic findings, mode of therapy and survival of patients were analyzed. Results The patients with Krukenburg tumor constituted 10.7% of all ovarian malignancy patients encountered during this period. The patient`s age ranged from 23 to 55 years[mean±S.D. ; 39.9±8.0] and about half of patients were younger than 40. Abdominal pain was the most frequently presenting symptom, palpable mass or abdominal distension being the second. Tumors tended to be large with maximal diameter of 10.4 cm[mean] and showed 59.4% of bilaterality. In 30 cases, the stomach was the primary site and that could not be identified in the other 2 cases. Fifteen[46.9%] were known to have [primary] tumors before they presented with ovarian metastasis. Microscopically, all tumors were of classic type characterized by the presence of the signet-ring cells and a diffuse stromal reaction. Most patients were treated by surgical debulking including total hysterectomy and bilateral salpingoophorectomy with or without omentectomy. Nineteen[59.4%] patients received chemotherapy with regimens such as PF[cisplatin 5-FU], EF[etoposide 5-FU], PEF[cisplatin epirubicin 5-FU] or EAP[etoposide adriamycin cisplatin]. The estimated two-year survival rate was 27.8%. Conclusion Krukenberg tumor is known to be a variant of metastatic ovarian carcinoma. However, the proportion of this tumor to all ovarian malignancies was over 10% in our institute and the prognosis remains extremely poor despite of surgery and chemotherapy.

제2형 당뇨병 환자에서 당화혈색소와 가장 좋은 상관성을 보이는 일종 혈당치의 비교

김형진,이태희,최성희,김수경,김대중,이유미,김세화,안철우,차봉수,송영득,임승길,김경래,이현철,허갑범 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.1

연구배경 : 제2형 당뇨병 환자의 혈당조절을 평가하는데 하루 중 어느 시간의 혈당 측정치가 가장 의미 있는지를 평가하기위해 혈당이 안정화된 당뇨병 환자에서 하루동안 4차례 혈당을 측정하여 당화혈색소와 비교하였다. 방법 : 연세의료원 당뇨병센터에서 혈당을 관리하는 제2형 당뇨병 환자 118명이 실험에 참여하였다. 검사 3개월전에 환자의 식습관을 검토하였고 환자는 검사기간동안 평상시의 식사를 유지하게 하였다. 6시에 아침 공복혈당을, 정오에 점심 식전 혈당을, 오후 5시에 저녁 식전 혈당을, 밤 10시에 자기전 혈당을 측정하였다. 혈당은 모세혈관 전혈로 간이혈당측정기인 Surestep을 이용해 측정하였다. 당화혈색소는 high pressure liquid chromatography assay (VARIANTⅡ, BIORAD)로 측정하였다. 일원배치 분산분석으로 각군 간 혈당치의 차이를 조사하였고 단순회귀분석을 사용하여 혈당과 당화혈색소의 관계를 조사 하였으며 다중회귀분석을 이용하여 다양한 시간대의 혈당중 어느 것이 당화혈색소를 의미있고 독립적으로 예측할 수 있는 지를 조사하였다. 결과 : 당화혈색소에 따라 대상자들을 세 군으로 나누었을 때 오전 6시 혈당은 각 군간에 의미있는 차이를 보였으나 다른 시간대의 혈당은 일부 군들 사이에서만 의미있는 차이를 보였다. 선형회귀분석상 오전 6시 혈당, 정오 혈당, 오후 5시 혈당, 오후 10시 혈당 각각의 결정계수(Rsquare)가 0.187 (p<0.001), 0.035 (p=0.43), 0.116 (p<0.001), 0.108 (p<0.001)이어서 정오 혈당을 제외한 오전 6시 혈당, 오후 5시 혈당, 오후 10시 혈당은 모두 통계적으로 의미있게 당화혈색소를 예측할 수 있었다. 다중회귀분석상 오전 6시 혈당, 정오 혈당, 오후 5시 혈당, 오후 10시 혈당의 회귀계수가 각각 0.348 (p<0.05), -0.091(p=0.369), 0.168 (p=0.148), 0.103 (p=0.338)로 오전 6시 혈당만이 당화혈색소에 유의한 영향을 주는 것으로 나왔다. 결론 : 이상의 결과로 당뇨병 환자의 혈당관리에 있어서 당화혈색소와 가장 우수한 상관성을 보이는 혈당은 공복혈당이며 다른 시간대의 혈당보다 더 좋은 혈당조절의 예측자인 것으로 밝혀졌다. Background: We have designed a study to evaluate the relative value of Capillary blood glucose measurement at different times of the day in comparison with HbA1c measurement in a ssessing the mean glycemic control of type 2 diabetic patients. Methods: The 118 patients with type 2 diabetes, all of whom very regular visitors of the outpatient clinic of the Diabetic Center of the YonseiUniversity Hospital, were entered consecutively into the study. Three months before enrollment, the dietary habits of each participant were checked, and the patients received recommendations for continuing their usual diet throughout the entire period of the study. The first sample was examined before breakfat at 6:00 A.M. (prebreakfa stglucose and HbA_(1c) ); the second, at noon (prelunch glucose); and the third, at 5:00 P.M. (presupper glucose). The last sample was examined at 10:00 P.M. (bedtime glucose). The capillary whole blood glucose was used to determine blood glucose concentrations (by Surestep). A high-pressure liquid chromatography assay (VARIANTⅡ, BIO-RAD) was used to make all determinations of HbA_(1c) (normal range, 4~6%). Simple linear regression a nalysis was used to examine the relationship between capillary blood glucose and HbA1c at each time point. Multip le linear regression analysis was performed to determine which of the values of va rious capillary blood glucoses were significant and independent predictors of HbA1c. Results : Mean concentration of capillary blood glucose at 6 A.M. is significantly different between three groups classified by levels of HaA1c , but not at othertimes. Simple line arregression analysis demonstrated that R-squares between the blood glucose and HbA1c were 0.187 (6:00 A.M.), 0.035 (noon), 0.116 (5:00 P.M.), and 0.108 (10:00 P.M.). Levels of the blood glucose at 6:00 A.M.; 5:00 P.M.; and 10:00 P.M. were correlated with HbA1c , but that at noon was not. Multiple regression analysis demonstrated that the standardized coefficients (β ) of the glucose levels at 6:00 A.M.; noon; 5:00 P.M.; and 10:00 P.M. were 0.348 (P<0.05), -0.09 1(P=0.369), 0.168 (P=0.148), and 0.103 (P=0.338), respectively. Only, the blood glucose at 6:00 A.M. influenced to HbA1c . Conclusions: In type 2 diabetes, the blood glucose at 6:00 A.M. have most strong correlation with HbA_(1c) , and is better predictor of glycemic control than those of other times.

고콜레스테롤혈증 환자에 대한 아토바스타틴의 효과와 안전성을 검토하기 위한 다기관 공동 임상 연구

배종화,최경훈,전재은,박의현,김권배,김기식,이재우,이원로,박정의,최윤식,권영주,강정채,김종준,문용,홍순표,김태호,김영조,심봉섭,박승정,정진원,이건주,최규보,임종윤,이방헌 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.4

導入 機器의 效率的 活用을 위한 敎授-學習 敎材의 開發 : 8 個 學科 共同 硏究

李昌甲,孟琦錫,李載元,朴萬植,廷吉煥,金鍾悟,朴景采,李英浩,李東周,邕章祐,柳盛淵,趙澤東,姜理錫,李殷雄,李興浩,金健中,韓相玉,金良模,張錫明,朴俊灝,洪鳳植,金太均,金再韓,宋海永,盧載星 충남대학교 공업교육연구소 1982 論文集 Vol.5 No.1

In this study, through the combined effort and collaboration of 8 engineering education departments, teaching-learning processes and models were reviewed, and printed and bound student manuals developed on 120 different tasks and subjects. Audio-visual supportive material, already in use in laboratories, was added to form a complete teaching-learning package. In addition to promoting the maximum use of the newly acquired equipment, this study will also contribute to the development of laboratory practice, the in-service training of technical high schools teachers and help in the development of their own instructional program.

자궁경부의 인유두종 바이러스 감염 양성인 여성에서 바이러스 성상 및 부하에 관한 연구

김병기,박상윤,김종훈,유상영,이경희,이의돈,이은희,김병섭,윤창범,성정희 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

Objective: This study was performed to determine the frequency of viral integration and viral load in women with positive HPV type 16 infection, and showing normal findings, CIN, and cervical cancer. Methods: Total 75 (normal, 15; CIN Ⅰ, 20; CIN Ⅲ, 20; cervical cancer, 20) cervical swab specimens were used. HPV detection, typing, and viral load was determined by PCR method. Results: Seventy of 75 (93.3%) of cervical swab specimens showed same results with hybrid capture assay and PCR method for detecting HPV DNA. HPV type 16 DNA was identified more frequently with progression from normal to cervical cancer (normal, 13%; CIN Ⅰ, 15%; CIN Ⅲ, 40%; cervical cancer, 55%). The frequency of HPV type 16 DNA integration also increased with grade of the lesion (normal, 0%; CIN Ⅰ, 33%; CIN Ⅲ, 87%; cervical cancer, 91%) suggesting most of HPV type 16 present as integration forms in the cells. In addition, high-level of HPV 16 viral load also was found more frequently in CIN Ⅲ and cervical cancer, (normal, 0%; CIN Ⅰ, 0%; CIN Ⅲ, 87%; cervical cancer, 100%). Conclusion: These results suggest that viral integration and high-level of viral load may play an important role in cervical carcinogenesis.

태아 심에코로 진단한 심실중격결손이 없는 대혈관 전위 2 례

김인규,조진호,김경률,김병성,이경술,서동만 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.9

Transposition of the great arteries with intact ventricular septum (TGA IVS) is a cyanotic congenital heart disease with high neonatal mortality without early diagnosis. But TGA IVS is known to have good prognosis if treated by arterial switch operation (ASO) within 2 weeks after birth with early diagnosis. We diagnosed two cases of TGA IVS prenatally by fetal echocardiography. A case was diagnosed at 26th weeks of gestation, and the mother was transferred to a cardiac center for planned delivery. The baby had received ASO on postpartum 7th day, but he died of right ventricular failure on postoperative 8th day. The second case was diagnosed at 37th gestational weeks and was transferred to Asan medical center immediately after birth. And he is doing well without any treatment after ASO.

재발성 자궁경부암 환자의 임상적 특성에 관한 후향적 연구

김병기,박상윤,김종훈,유상영,이경희,이의돈,이은희,김병섭,윤창범,성정희 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

Objective: This study was performed to evaluate the survival and clinical characteristics of recurrent cervical carcinoma following initial treatment. Methods: From Jan. 1994 to Dec. 1994, total 79 patients were identified to have recurrence by physical examination, Pap smear, radiologic studies (chest PA, CT/MRI) or/and PCNA (percutaneous needle aspiration cytology). Their medical records and cytologic slides were reviewed. The information about survival and disease status was obtained from the last follow-up date in medical records or from interview via telephone. Results: For the initial FIGO stage of recurrent cervical carcinoma, 18 patients (22.8%) were stage Ⅰ; 38 patients (48.1%), stage Ⅱ; 21 patients (26.6%), stage Ⅲ; 2 patients (2.5%), stage Ⅳ. The recurrent sites in patients with recurrent carcinoma were classified into central pelvic, lateral pelvic, and distant metastasis, and 24 patients (30.4%) showed central pelvic recurrence; 7 patients (8.9%), lateral pelvic recurrence; 48 patients (60.7%), distant metastasis. The most frequent metastatic site was paraaortic LN. For the detection of recurrent tumor, 33 of 79 patients (41.0%) were detected by symtoms and signs; 12 patients (17.0%), by Pap smear; 3 patients (3.1%), by chest PA; 16 patients (20.0%), by routine CT or MRI; 15 patients (18.9%), by PCNA. In these patients, the intervals from completion of initial treatment to recurrence were as follows: within 12 months, 15 patients (18.9%); from 12 months to 24 months, 31 patients (39.3%); from 24 to 36 months, 11 patients (13.9%); above 36 months, 22 patients (27.9%). The median survival of the patients studied was 38 months from the time of the diagnosis of recurrence. Conclusion: These results suggested that the regular follow-up at least 3 years should be made because more than 3/4 of the recurrence developed within 3 years. In addition,the routine diagnostic work-up to detect distant metastasis should be included at appropriate interval in this period. The strategy may improve the survival of the patients with recurrent cervical cancer.

Purification and Identification of Human Recombinant Cathepsin P As A Novel Cysteine Proteinase

Kim MK,Park BS,Son MH,Bae EJ,Kim SH,Kim WB,Lee CH,Lee BY,Lee JW 대한약학회 2000 大韓藥學會 總會 및 學術大會 Vol.49 No.-