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SJO¨GREN'S SYNDROME 환자에게 즉시 임프란트 술식을 행한 치험례
최정환,손동석,이지연,이윤서,안선희,이재목 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5
The old edentulous patients experience xerostomia commonly. They have considerable difficulty in wearing tissue-supported prosthesis and high risk rate of caries. One of them is Sj□gren's syndrome patient. Sj□gren's syndrome is a chronic inflammatory autoimmune disorder that results in a lymphocyte-mediated destruction of exocrine glands. We planned to place implants immediately after extraction in this case of autoimmune disease. The advantages of immediate implant placement include considerable decrease in time from tooth extraction to placement of the final prosthesis, fewer surgical procedures, and better acceptance of the overall treatment plan. We present a case of Sj□gren's syndrome patient treated with immediate implant placement & immediate loading in anterior region and immediate implant placement in posterior region.
정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1
목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.
김이영,김재경,이유리,서만길,우금석,장용이,김지혜,서연림,김상은,김도관 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6
전측두엽 치매는 치매의 흔한 원인이며 알쯔하이머병과 구별되는 질환이다. 하지만 임상증상에서 인지기능의 현저한 장애가 나타나기 전에 사회적 기능과 인격의 붕괴가 서서히 일어나기 때문에 다른 정신과 질환으로 진단될 수도 있다. 저자들은 3례 전측두엽 치매를 보고하였다. 이 증례들은 전측두엽 치매를 임상 진단으로 고려할 만한 병력과 증상을 가지고 있고, 신경심리학 검사, 대뇌의 자기공명영상과 18F-FDG양성자방출단층촬영술 등의 검사에서 전형적인 전측두엽 치매의 소견을 보였다. 이러한 병력과 임상양상 그리고 객관적인 소견들은 임상에서 전측두엽 치매에 주의를 기울이고 적절하게 진단하는 데 도움이 될 것으로 생각된다. Frontotemporal dementia is a common cause of dementia and distinguished from Alzheimer`s disease. Because its clinical symptoms are characterized by slow progressive social breakdown and change of personality before cognitive impairments become prominent, it may be diagosed as other psychiatric disease. We have presented three cases of frontotemporal dementia. They had typical clinical histories and symptoms which deserve to be considered frontotemporal dementia. They showed appropriate findings of frontotemporal dementia in the neuropsychological tests and brain imaging study with brain magnetic resonance imaging and 18F-FDGpositron emission tomography. Their clinical histories and findings are thought to be helpful for clinician to give attention to and diagnose frontotemporal dementia.
( Ji Hye Je ),( Ji Hoon Kim ),( Yang Jae Yoo ),( Sung Hee Kang ),( Hae Rim Kim ),( Sang Jun Suh ),( Young Kul Jung ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Kwan Soo Byun ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Several staging systems for hepatocellular carcinoma (HCC) have been purposed but there is no worldwide consensus which staging system is best. We identifi ed the best staging system evaluating the predictive ability for outcome in patients with hepatocellular carcinoma in Korea. Methods: Between January 2004 and December 2009, total of 875 patients with HCC who were diagnosed and treated at the Korea University Guro hospital were enrolled. They were followed up till April 2014. All patients were classifi ed by modifi ed UICC, Barcelona-Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Chinese University Prognostic Index (CUPI), Japan Integrated Staging (JIS), Tokyo score. The demographic data, clinical variables, tumor characters, residual liver function and initial treatment modalities were reviewed. The discriminatory ability of staging system was quantifi ed using C-index. And the homogeneity and monotonicity of staging system was assessed using likelihood ratio χ2 test correlated with a Cox`s regression model neutralized by Akaike information criterion (AIC). Results: 654 (74. 7%) patients died and the median survival time was 25 months. The 5-years survival was 28. 1%. There were significant differences between all stage in modifi ed UICC, BCLC, CLIP, CUPI, JIS, Tokyo score. In the overall group of patients, CLIP stage had higher discrimination ability (C-index 0. 76) and the best monotonicity of gradient and homogeneity ability (LR χ2 test : 319. 541, P < 0. 008, AIC : 7789. 566). Also JIS system had higher discrimination ability (C-index 0. 75) and higher monotonicity of gradient and homogeneity ability (LR χ2 test : 320. 356, P<. 0001, AIC : 7792. 751). Conclusions: The CLIP and JIS stage systems showed the best prognostic stratifi cation in HCC patients of Korea.
Doubling Time of Serum Tumor Marker in HCC Patients Predicts Recurrence after Curative Treatment
( Ji Hye Je ),( Yang Jae Yoo ),( Young-sun Lee ),( Sang Jun Suh ),( Young Kul Jung ),( Ji Hoon Kim ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Jong Eun Yeon ),( Kwan Soo Byun ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Alpha-fetoprotein (AFP) and protein-induced vitamin K absence (PIVKA-II) have been used as a marker for hepatocellular carcinoma (HCC). We aimed to investigate the correlation of doubling time (DT) of tumor markers (AFP, PIVKA-II) after curative treatment with recurrence of HCC. Methods: Between January 2005 and December 2013, total of 451 patients were enrolled. After excluding the patient with loss to follow- up, tumor remnant and absence of repeated tumor marker, 213 patients who received curative treatment were analyzed (Liver transplantation, surgical resection, radiofrequency ablation, percutaneous ethanol injection). Serum AFP and PIVKA II levels before and after the curative treatment were collected and used for analysis. Tumor marker DT was calculated as DT=t log 2/(log (marker 2nd)-log (marker 1st)) where t was the time interval between from nadir level after treatment to level at recurrence or 2 years later after treatment. Results: Mean age was 56 years. HBV infection was the most common etiology of HCC (78.4%), and most of the patients were in BCLC stage 0 and A (77.9%). During the follow up, 127 of 213 patients (59.6%) were recurred. Median DT of AFP and PIVKA-II was 20months and 18.7months. In comparing the HCC patients with or without early recurrence, DT was significantly lower in the early recurrence group (AFP and PIVKA II: 10.4 vs 26.78 months; P<0.001 and 8.75 vs 24.67 months; P<0.001, respectively). In univariate analysis, BCLC stage, tumor size, PIVKA-II level at diagnosis, AFP DT and PIVKA-II DT were significantly related to recurrence rate. In multivariate analysis, AFP DT and PIVKA-II DT and BCLC stage at diagnosis were only independent predictor of recurrence after curative treatment on HCC. Conclusions: In HCC patients with curative treatment, the DT of AFP and PIVKA-II from nadir level after the treatment is useful tools to predict early recurrence.
Seung-Yeon Lee,Gil-Yong Suh,Soo-Yeon Park,Yeon-Su Kim,Jong-Hyun Nam,Seung-Hyun Yu,Ji-Hoon Park,Sang-Jik Kim,Yong-Sun Kim,Sun-Yong Park,Ja-Young Yun,Yu-Jin Jang,Se-Won Min,So-Jung Noh,Sung-Chul Kim,Kyo 한국토양비료학회 2018 한국토양비료학회지 Vol.51 No.1
To predict the influence of volcano eruption on agriculture in South Korea we evaluated the dispersal ranges of the volcanic ashes toward the South Korea based on the possibilities of volcano eruption in Mt. Baekdu. The possibilities of volcano eruption in Mt. Baekdu have been still being intensified by the signals including magmatic unrest of the volcano and the frequency of volcanic earthquakes swarm, the horizontal displacement and vertical uplift around the Mt. Baekdu, the temperature rises of hot springs, high ratios of N₂/O₂ and ₃He/₄He in volcanic gases. The dispersal direction and ranges and the predicted amount of volcanic ash can be significantly influenced by Volcanic Explosivity Index (VEI) and the trend of seasonal wind. The prediction of volcanic ash dispersion by the model showed that the ash cloud extended to Ulleung Island and Japan within 9 hours and 24 hours by the northwestern monsoon wind in winter while the ash cloud extended to northern side by the south-east monsoon wind during June and September. However, the ash cloud may extent to Seoul and southwest coast within 9 hours and 15 hours by northern wind in winter, leading to severe ash deposits over the whole area of South Korea, although the thickness of the ash deposits generally decreases exponentially with increasing distance from a volcano. In case of VEI 7, the ash deposits of Daejeon and Gangneung are 1.31 × 10<SUP>4</SUP> g m<SUP>-2</SUP> and 1.80 × 10<SUP>5</SUP> g m<SUP>-2</SUP>, respectively. In addition, ash particles may compact close together after they fall to the ground, resulting in increase of the bulk density that can alter the soil physical and chemical properties detrimental to agricultural practices and crop growth.