右側 胸廓을 侵犯한 Leiomyosarcoma의 1例

하해구,김기정 최신의학사 1972 最新醫學 Vol.15 No.9

A 33-year-old Korean male patient with leiomyosarcoma involving the right lateral thoracic wall was reported. Leiomyosarcoma in thoracic wall is extremely rare. This patient's chief complaints were dull pain with slowly growing bulging mass in right lateral thoracic wall for about 2 months duration. Physical examination on admission showed moderately developed and nourished man with a large hard bulging mass (about 1OX15cm in diameter) with severe tenderness around the right subaxillary region. Coughing and deep respiration made severe chest pain. Chest X-ray (P-A and lateral view) showed large diffuse soft tissue mass densities were occupying the entire right lateral thoracic wall and also involving the pleura with destructive bony missing of lateral parts of right 4th, 5th and 6th ribs. All biochemical findings were nonspecific except elevated erythrocyte sedimentation rate (127 nimHr) Biopsy with histopathology revealed malignant mesenchymal tumor of smooth muscle cell origin (Leiomyosarcoma). Surgical treatment was not indicated, and palliative radiotherapy was recommended.

腹部腫瘍(72例)에 있어서의 血管撮影 및 手術所見

河海求,崔斗石,金基延 최신의학사 1973 最新醫學 Vol.16 No.7

Aortography with selective visceral injections has been recognized as highly diagnostic and easy technique for the evaluation of various abdominal mass lesions. At department of Radiology, National Medical Center, Seoul, Korea seventy-two (72) patients whose chief complaints were slowly growing abdominal mass were studied with angiography after conventional examinations (barium study, I. V. P. etc) for last several years(1965-1972). The angiographic patterns were comprehensively analized. Almost cases (about 64 cases) were retroperitoneal expanding lesions which were not well detected with conventional radiological study (barium study, I. V. P. etc). The all expanding lesions were composed of renal expanding lesions(42 cases), other retroperitoneal expanding lesions (17cases), and liver, spleen, pancreatic lesions (13 cases). The angiography with selective visceral injections was the most diagnostic and easy technique without any permament complication than any other conventional studies.

경골 골수정 고정술후 교합나사의 파단

박형빈,강번중,송해룡,구경회,정순택,조세현 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 경골 골절에서 골수정 고정술후 발생하는 교합나사 파단의 빈도와 발생 원인을 밝히고자한다. 대상 및 방법 : 1995년 3월부터 2000년 10월까지 골수정으로 치료하였던 경골 간부골절 82예중 내고정물 파단이 발생하거나 골유합이 이루질 때까지 추시 가능하였던 75예를 대상으로 하였다. 내고정물 파단 빈도와 위치, 골절의 양상, 술후 골절부 신연 및 골유합 이상 여부를 조사하였다. 결 과 : 교합나사 파단은 7예였고 (9.3%), 근위부 두 번째 나사의 파단이 가장 흔하였다. 교합나사으 ㅣ파단은 AO분류 B형과 C형 골절, 술후 골절부가 신연된 경우, 개발성골절, 자연유합 및 불유합의 경우 발생하였다. 결 론 : 교합나사 파단의 주된 요인은 골절부의 골과 골 접촉이 불안정하기 때문이며, 개방성 골절, 지연유합 및 불유합도 교합나사 파단의 위험인자라고 생각한다. 교합나사 파단을 예방하기 위해서는 수술시 골절부 신연을 피해야하며 골절부 골접촉이 불안정한 경우 완전 체중부하를 골유합시까지 제한하여야할 것으로 생각한다. Purpose : The aims of this study were to investigate the prevalence and the causes of crew breakage in tibia nailing. Materials and Methods : Between 1995 and 2000, eighty-two tibial diaphyseal fracture were treated with interlocking nails. The loss of follow-up was 7 cases. We retrospectively reviewed seventy-five cases. We investigated the rate and location of metal failure and evaluated the fracture pattern, the presence of distraction after nailing and union abnormality. Results : Screw breakage was identified in seven cases (9.3%) and most frequently occurred on the second proximal locking screw. Screw breakage occurred in AO type B or C type fractures, fracture site distraction after nailing, open fracture, delayed union and nonunion. Conclusion : The main cause of screw breakage is unstable bone to bone contact on the fracture site caused by comminution of distraction. The open fracture, delayed union, and nonunion also contributing factors for screw breakage. For preventing screw breakage, it is necessary to avoid fracture site distraction and delay full weight bearing in cases having unstable fracture site contact.

산업보건관리자를 위한 소음성 난청 예방지침서의 개발

이원철,유경혜,장성실,이세훈,구정완,김현욱,노영만,이경재,김형아 가톨릭 대학 산업의학 쎈타 산업의학연구소 1996 韓國의 産業醫學 Vol.35 No.1

Occupational hearing loss became the leading occupational disease by constioution 56% of all work-related diseases in Korea. However, the prevalance rates showed wide variations among the specific medical examination providers and were very low(0.8-1.4%) compared with those 8.4% in Japan. The sources of these variations was regarded in the preview study as 1) Employee audometric estings were primarily conducted by nurses and nurse-aids who had no formal training for audiometry; 2) althought audiometric testing equipment used by the spedific medical examination providers, it should be periodically calibrated, a significant number of them were not properly calibrated : 3) Initial audiometric testings were conducted at any available spaces in workplace or at the testing room without considering bachground noise level. One of solutions that can be done for sloving surrent noise related problems is to provide a noise related manual for the occupational health managers including doctors, nurses and hyginests. This study was done to provide such a manual. The main core of the manual was hearing conservation program. And the contents of the manual was the same as the main frame of hearing conservation program such as noise survey, provided of the diagram showing the core contents of each factor of the hearing conservation program. Hopefully, this manual will be the references of the standardized performances of the specific medical examination providers.

운동성 산화 스트레스와 항산화비타민의 보충이 말초단핵세포의 NF-kB 활성에 미치는 영향

진영수,박건구,박준영,김미정,이왕록,김혜영,이한준,박은경 대한스포츠의학회 2000 대한스포츠의학회지 Vol.18 No.2

Reactive oxygen species(ROS) are implicated in the pathogenesis of a wide variety of human diseases. Numerous studies indicate that ROS may serve as common intracellular molecules that contribute to the process of nuclear factor(NF)κB activation in response to a diverse stimuli. In our laboratory, we have demonstrated tat antioxidants could reverse the decline of immune function caused by exercise-induced ROS. Furthermore, it in necessary to understand a mechanism underlying ROS-dependent disorder in biological system. Recent studies have been shown that several gene expression were regulated by oxidants, antioxidants and other determinants of the intracellular reduction-oxidation(redox) state. In this process, NF-κB have been shown to play a important role. The purpose of the present investigation was to evaluate the effect of exercise-induced oxidative stress and antioxidnt supplementation on NF-κB activation in peripheral mononuclear cells. Forty male SD rats(4 weeks old) were randomly divided into noraml diet group and antioxidants(ATO) supplement group, and then ATO groups were treated with antioxidants(VE: 2001U/kg, VC: 50mg/rat, β-carotene: 300mg/kg, vitamin B6: 250㎍/100g, selenomethionine: 0.1mg/kg) for 16 weeks. After 16 weeks breeding at each condition, each group divided into two groups: Control group(CR) fed generally, Exercise group(CE) fed generally and followed by acute exercise 16 weeks later. Antioxidant Antioxidants and Exercise group(AE) fed with antioxidants and followed by acute exercise. The activation of NF-κB binding activity was increased after exhaustive exercise bout in both group. In addition, pretreatment of ATO group with the antioxidants mixture lead to the inhibition of NF-κB binding activity. This results suggest that NF-κB activation should be further studies in response to a variety of exercise.

노인 낮병원의 심리사회적 치료 프로그램이 노인의 신경인지기능과 우울 증상에 미치는 효과

유계준,송정은,오병훈,안석균,이홍식,오희철,구은형,황혜숙,이은철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

노인에게 있어서 신경인지기능의 저하와 우울 증상은 가장 흔한 장애이며 신체적, 정신적인 면에 많은 영향을 미치고 있다. 또한 이러한 장애중 비임상군에서 심리사회적 치료개입의 효과가 보고되고 있다. 이러한 측면에서 지역사회에서 노인에게 제공되는 심리사회적 치료개입의 중요성이 높아지고 있다. 이전의 연구에서는 대상이 특정 집단이거나, 비교군이 없거나, 치료효과에 대한 추적 관찰이 이루어지지 않는 등의 제한점이 있었으며, 현재 국내의 노인 낮병원은 소수에 불과하고 이러한 낮병원의 치료효과에 대한 연구는 거의 없는 실정이다. 따라서 본 연구는 지역사회 정신보건센터에서 운영하는 노인 낮병원에 참가하는 노인들을 대상으로 낮병원의 심리사회적 프로그램이 노인들의 신경인지기능과 우울 증상에 미치는 효과와 이에 대한 유지 효과의 유무를 알아보고자 하였다. 경기도 광주군 정신보건센터의 노인 낮병원에 참여한 노인을 치료군으로, 치료를 거부하거나 치료 중 탈락한 노인을 비교군으로 하여 10주간의 낮병원 치료전후와 치료종결 후 10주에 신경인지기능은 한국형 간이 정신상태검사(이하 MMSE-K)로, 우울 증상은 단축형노인우울척도(이하 SGDS)로 평가하여 두 군을 비교하였고 치료군의 치료 직후와 치료종결 후 10주를 비교하였다. 연구결과 노인 낮병원의 심리사회적 치료가 시간에 따른 SGDS점수 변화에 통계학적으로 유의한 영향을 미쳤으며, MMSE-K점수 변화에는 통계학적으로 유의한 영향을 미치지 않았다. 또한 10주 추시가 가능했던 치료군 중 약 43%가 10주 후 SGDS가 증가하여 호전되었던 우울증상의 악화를 보였다. 본 연구 결과 노인 낮병원의 심리사회적 치료 프로그램 개입은 노인에게 있어서 우울 증상을 호전시키며 신경인지 기능에는 직접적인 영향을 미치지 않는 것을 알 수 있었다. 또한 상당수에서 심리사회적 치료 개입으로 인한 우울 증상의 호전이 유지되지 않음을 알 수 있었다. 이는 노인우울증상의 치료에 낮병원의 심리사회적 치료 프로그램이 효과적일 수 있음과 치료 후 이를 유지하기 위한 부가적인 치료개입의 필요성을 시사한다. Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K), and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS). The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.

미세혈관 협심증 환자의 임상상 및 지표에 관한 연구

박상호,온영근,김현정,이태훈,길효욱,김현건,박수진,송해정,한대희,방덕원,신원용,이내희,김성구,권영주 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background : Microvascular angina or syndrom X is heterogenous and encompasses different pathogenetic entities. Several studies suggest that microvascular angina have good prognosis and occurs predominantly in postmenopausal women. Lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and fibrinogen are the independent risk factor of acute coronary syndrome and are the chief underlying cause of atherosclerosis. We investigated clinical characteristics and markers in patients with microvascular angina. Methods : We studies 23 patients diagnosed with microvascular angina and 16 control group with negative treadmill exercise test and no significant coronary angiogram. We investigated clinical characteristics in patients group and evaluated symptom during a follow-up period of 4.2± 2.5 month. Exercise time in treadmill exercise test was compared between patients and control group. We assessed the level of markers, such as lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, CRP and ESR in two groups. Results : There is no difference in age between two groups. Patients group had a tendency to increase in female, hypertension, DM, and smoking history, but there was no statistical significance difference. Exercise duration time was significantly decreased in patients with microvascular angina (p<0,05). Serum lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholestrol, Triglyceride, ESR, Fibrinogen and Homocystein value were no significant difference between microvascular angina and control group. Only CRP was significantly high in patients with microvascular angina (p<0.05). Conclusion : There was no statistical significance difference in age, sex, hypertension, DM and smoking history between two groups but patients group had a tendency to increase the prevalence in hypertension, DM and smoking history, female. Also, Symptom improvement and disappearance in follow-up was presented in 11 patients of 19(57.9%). Exercise tolerance was worse in patients group than control group. CRP value was significantly higher in patients group than control group. There was no statistical significance difference in lipoprotein (a), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, homocystein, ESR and Fibrinogen between two groups.

CASE REPORT : Mycobacterium abscessus Lung Disease in a Patient with Kartagener Syndrome

( Jung Hoon Kim ),( Won Jun Song ),( Ji Eun Jun ),( Duck Hyun Ryu ),( Ji Eun Lee ),( Ho Jung Jeong ),( Suk Hyeon Jeong ),( Hyung Koo Kang ),( Jung Soo Kim ),( Hyun Lee ),( Hae Ri Chon ),( Kyeong Man J 대한결핵 및 호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.77 No.3

Primary ciliary dyskinesia (PCD) is characterized by the congenital impairment of mucociliary clearance. When accompanied by situs inversus, chronic sinusitis and bronchiectasis, PCD is known as Kartagener syndrome. The main consequence of impaired ciliary function is a reduced mucus clearance from the lungs, and susceptibility to chronic respiratory infections due to opportunistic pathogens, including nontuberculous mycobacteria (NTM). There has been no report of NTM lung disease combined with Kartagener syndrome in Korea. Here, we report an adult patient with Kartagener syndrome complicated with Mycobacterium abscessus lung disease. A 37-year-old female presented to our hospital with chronic cough and sputum. She was ultimately diagnosed with M. abscessus lung disease and Kartagener syndrome. M. abscessus was repeatedly isolated from sputum specimens collected from the patient, despite prolonged antibiotic treatment. The patient’s condition improved and negative sputum culture conversion was achieved after sequential bilateral pulmonary resection.

기상조절 실험을 위한 최신 드론 기술의 개발과 활용 사례

구해정(Hae-Jung Koo),차주완(Joo Wan Cha),Miloslav Belorid,황현준(HyunJune Hwang),김민후(Min-Hoo Kim),김부요(Bu-Yo Kim),장기호(Ki-Ho Chang),이용희(Yong Hee Lee),서성규(Seong-Kyu Seo),정재원(Jae-Won Jung) 한국항공우주학회 2022 한국항공우주학회 학술발표회 논문집 Vol.2022 No.11

남한 지역의 지면 오존 농도 특성과 식생에 대한 임계값 적용 연구

구해정(Hae-Jung Koo),박순웅(Soon-Ung Park) 한국대기환경학회 2008 한국대기환경학회지 Vol.24 No.3