미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자에서 혈장 Endothelin의 변화

서예경,정상원,남직화,신병호,전종민,김정국,김동희,하승우,김보완 慶北大學校 醫科大學 1996 慶北醫大誌 Vol.37 No.3

목적 : 혈관내피세포에서 생성되는 endothelin(ET)는 강력한 혈관수축작용을 가진 펩타이드로 당뇨병 환자에서 혈관내피세포의 손상여부에 따라 혈중 농도가 증가할 수 있으며 혈관합병증과 관련이 있다는 보고가 있다. 그러나. 혈중 ET치의 상승과 당뇨병성 합병증의 상관성에 대해서는 논란이 많다. 이에 저자들은 인슐린 비의존성 당뇨병 환자에서 미세알부민뇨의 동반유무에 따른 혈중 ET치의 변화 및 혈장 ET치와 요중 알부민 배설률과의 상관성을 검토하였다. 대상 및 방법 : 인슐린 비의존성 당뇨병 환자중 미세알부민뇨를 보인 22명과 정상알부민뇨를 보인 43명을 대상으로 하였으며 혈장 ET를 측정하여 요중 알부민 배설률, 당뇨병성 망막증 및 당뇨병 관련인자들과의 관계를 비교하였다. 결과 : 당뇨병성 망막증이 합병된 군에서 망막증이 합병되지 않은 군에 비하여 혈장 ET치가 유의하게 높았던 반면 (각각 1.9±0.66, 1.5±0.76pg/㎖, p<0.05) 미세알부민뇨를 보인 군과 정상알부민뇨를 보인 군사이에 혈장 ET치는 통계학적으로 유의한 차이가 없었다(각각 1.9±1.14, 1.7±0.69pg/㎖). 또한 요중 알부민 배설률과 혈장 ET치 사이에 유의한 상관관계는 없었으며 미세알부민뇨를 동반한 인슐린 비의존성 당뇨병 환자군에서 혈장 ET치는 당뇨병의 관련인자들과도 유의한 상관관계가 없었다. 결론 : 인슐린 비의존 당뇨병 환자에서 혈장 ET치가 초기 당뇨병성 신증의 합병여부나 미세알부민뇨의 정도를 반영하기는 어려울 것임을 시사한다. Background : Endothelin(ET), a potent vasoconstritor peptide released from vascular endothelial cells, is known to be increased in diabetic patients with vascular damage and related with diabetic angiopathy. However, whether plasma ET levels may be related to diabetic complications is controversial. We studied the change of ET levels in non-insulin dependent diabetics with microalbuminuria and relation between ET and urinary albumin excretion rate. Methods : Plasma ET levels of 22 non-insulin dependent diabetics with microalbuminuria and 43 patients with normoalbuminuria were measured and relations of plasma ET to diabetic complications such as urinary albumin excretion rate, retinopathy and other associated factors were studied. Results : Plasma ET levels were significantly higher in patients with diabetic retinopathy than those without retinopathy(1.9 ± 0.66 vs 1.5 ± 0.76 pg/㎖. p<0.05). The difference, however, between diabetics with and without microalbuminuria was not significant(1.9 ± 1.14 vs 1.7 ± 0.69 pg/㎖). There were no correlations of plasma ET to urinary albumin excretion rate and to the other associated factors in non-insulin dependent diabetics. Conclusion : These results suggest that plasma ET levels may not seem to act as a predictor of diabetic nephropathy or microalbuminuria in non-insulin dependent diabetics.

성인 음낭수종의 치료로서 Window Operation의 효용성

서병욱,박영호,이남규,전윤수,김민의,김영호,송윤섭,구자현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

We intended to determine the usefulness of window operation for adult hydrocele repair. We reviewed medical records of 132 patients from January 1995 to June 1998 with primary hydrocele and evaluated complications and recurrence rates of eversion and/or excision, plication, and internal drainage technique. Recurrence rate was highest in internal drainage technique as 85.2%, and those of eversion and/or excision and plication technique were 1.3% and 4%, respectively. Complication rate was highest in eversion and/or excision technique, and lowest in internal drainage technique. Although complication rate was lowest in window operation, this operation could not be successful due to high recurrence, and we suggest that this operation should be abandoned for hydrocele repair.

백서 척수후근절로부터 슈반세포의 효과적인 체외 배양법

김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.

Goretex를 이용한 융비술

최진영,민철기,명훈,황순정,서병무,이종호,정필순,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

융비술시 실리콘 고무는 다루기 쉽고 조직 반응이 적어 현대 많이 돌출의 합병증이 생길 수 있다. 저자등은 이러한 실리콘의 단점을 보완할 수 있는 goretex를 사용하여 융비술을 시행하고 비첨에 대해서 자가연골을 이식하여 만족할 만한 결과를 얻었기에 goretex가 안면부 연조직의 증강을 위한 이식재료로 적합하다고 생각되어 문헌고찰과 함께 보고하는 바이다. Many different materials have been used to provide augmentation of the nasal dorsum. this include both autogenous and homogenous materials,as well as allografts. Silicone among the artificial materials has been most widely used. The silicone has some advantages and disadvantages. Goretex(expanded polytetra-fluoroethylene) which has widely used in vascular surgery and abdominal surgery can be used for facial soft tissue augmentation. The author presemts 2 cases of nasal augmentaion using goretex with literature review.

무증상의 현미경적 혈뇨의 비뇨기과적 고찰

구자현,서병욱,김영호,송윤섭,전윤수,김민의,이남규,박영호 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

We intended to know whether all of the patients with asymptomatic microscopic hematuria should be urologically investigated routinely. We reviewed the medical records with asmptomatic microscopic hematuria from January 1995 to December 1997. Urological studies included intravenous urography or ultrasonography, urine cytology, cystoscopy and biopsy, urine AFB smear and culture and urine PCR for AFB. The age with patients ranged from 9 to 74 years(mean age: 39.7 years). Benign diseases were found in elderly patients and patients with high degree of hematuria, but there was no patients who had urological malignant disease. According to the results, we suggest that follow-up with urine cytology is sufficient to younger patients or low degree of hematuria with asymptomatic microscopic hematuria.

무증상 대퇴골두 무혈성 괴사의 증상발현

원중희,김용민,최의성,이호승,서중배,배병권 대한고관절학회 2001 Hip and Pelvis Vol.13 No.1

급성 골수성 백혈병 환자에서 관해 유도 항암 화학요법 후 발생한 베르니케 뇌증

황진원,정재현,서광원,최병진,송영진,김종윤,이은지,임홍규,이상민 인제대학교 2009 仁濟醫學 Vol.30 No.-

Wernicke's encephalopathy is characterized by the triad of ocular symptoms, ataxia, and mental confusion and neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, hyperemesis gravidarum, anorexia nervosa, hemodialysis, uremia, and acquired immunodeficiency syndrome(AIDS). Chemotherapy in patient with malignanacy and long term total parenteral nutrition following bone marrow transplantation are related with Wernicke's encephalopathy. A 48-year-old woman had been treated with Daunorubicin and Cytarabine for remission induction chemotherapy of acute myeloblastic leukemia and intravenous hyperalimentation due to persistent hematochezia and ileus caused by infiltration of leukemic cell in terminal ileum. She suddenly complained of diplopia, tremor, and mental confusion at 32th day after chemotherapy and generalized tonic-clonic seizure at 34th day after chemotherapy. The diagnosis of Wernicke's encephalopathy was made with clinical presentations and brain MRI. Brain MR T2-weighted & Flair image revealed a high signal intensity lesions bilaterally at the medial thalamus and peri-acueductal grey matter of the midbrain. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after remission induction chemotherapy followed by intravenous hyperalirnentation in a patient with acute myeloblastic leukemia.

주요우울증이 근로자의 생산성에 미치는 영향 : WHO-HPQ(Health and Work Performance Questionnaire)를 이용한 예비연구

김원,황태연,함병주,이준석,최병휘,김세주,서용진,강은호,우종민 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Major depressive disorder (MDD) causes patients' distress and makes socioeconomic burden, both directly and indirectly. We used the concept of lost productive time (LPT) to estimate the indirect costs and calculated both absenteeism and presenteeism among workers with MDD. Mcthods : Depression group was recruited from workers visiting psychiatric outpatient clinic who had MDD without major physical or mental disorders (N= 106). Age and sex matched healthy control group was also recruited through advertisement (M=100). All participants completed a interview using WHO Health and Work Performance Questionnaire (HPQ), Job Stress Measurement Scale for Korean Employees, and Hamilton Rating Scale for Depression. Statistical analysis was performed with independent t-test or χ² test as characteristics of values (p=0.05). Results : The number of absence (0.94-day/month vs. 0.10-day/month, P=0.015) andthe numberofearly leaving (2.56-day/month vs. 0.24-day/month, P<0.001) were significantly higher in the depression group. Depression group evaluated their Perfor-mance level much lower than controls with significant value (5.16 vs. 7.62, P<0.001). In addition, depression group estimated their performance level during the last 4 weeks lower compared to the level of past 1-year (5.16 vs 6.63, P<0.001). The estimated costs of absenteeism in depression group were higher than controls by 2,520,000 Korean Won per year, and those of presenteeism were also higher by 4,880,000 Korean Won per year. The total costs of LPT in depression group were higher than controls by 7,400,000 Korean Won, which corresponds to 26% ofmean annual salary. In addition, the level of occupational stress, such as high demand and interpersonal conflict, was higher in the depression group. Conclusion : Major depressive disorder costs substantial productivity loss to workers and their company. Presenteeism imposes more time cost than absenteeism. Effectiveness trials are needed to devise cost-effective programs for the early detection and treatment of depression at the workplace.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

여성 하부요관석환자에서 무마취하 요관경하 배석술

박영호,송윤섭,임용순,김영호,이남규,구자현,서병욱,김민의,전윤수 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Although ureteroscopy(URS) has been used widely to remove ureteral calculi, there is an argument against the belief that anesthesia or admission is needed for URS. We evaluated the experience of URS without anesthesia in female patients. From September 1997 to July 1998, URS was performed in 31 female patients without anesthesia. EHL(Electrohydraulic Lithotripsy) was used in 21 patients with impacted or large stone over 5mm. All patients were given oral antibiotics for 3 days and follow-up KUB was taken to confirm successful removal of the stone one week after the procedure. Successful treatment was defined as complete removal of the stone or residual fragments less than 2mm. Overall success rate was 96.7%(30 cases among 31 cases). All but one patient tolerated with analgesia through the entire procedures. There were only minimal complications such as mild flank pain and hematuria. So, we recommend that non-anesthetic ureteroscopic removal of stone as the first choice for treatment of lower ureteral stones in female based on the minimal morbidity, high success rate and low cost.