고빌리루빈혈증을 동반한 자가면역성 간염 1례

서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

經皮經肝膽湃液術의 放射線學的 考察

全石吉,朱亮求,金洪,禹聖龜,徐修之,金玉培,許定旭 啓明大學校 醫科大學 1987 계명의대학술지 Vol.6 No.1

Percutaneous transhepatic biliary drainage(PTBD) was performed 40 times in 38 patients with obstructive jaundice, from January, 1986 to May at Department of Radiology, Keimyung University School of Medicine. The PTBD is to decrease serum bilirubin level, promote liver function, effectively decompress the severely obstructed biliary tree prior to surgery and palliates the clinical problems in patient with non-operable malignant obstruction and control sepsis effectively. The results were as follow: The cause of obstructive jaundice included 35 malignant diseases and 3 benign diseases. Malignant disease were 23 cases of bile duct carcinoma, 5 cases of hepatoma, 5 cases of pancreas carcinoma and 2 cases of metastasis. The most common level of obstruction was distal common bile duct in 13 cases. The most common indication of PTBD was palliative drainage of obstruction secondary to malignant tumor in 26 cases. The drainage type was internal i 12 cases and external in 24 cases. The most common complication was high fever in 7 cases. The successful drainage with effective decrease in the level of serum bilirubin was observed in 30 cases, ineffective drainage in 4 cases.

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.

알칼리용액으로 처리된 폐피혁 분이 석고-피혁 복합체의 물성에 미치는 영향

조헌영,서정목,전기석,이기환 공주대학교 생산기술연구소 2001 論文集 Vol.9 No.-

Gypsum material has strong compressive strength and excellent resistance against fire. But, these material has some demerits ; weak water-resistance, heavy specific gravity and low physical properties in flexural and tensile strengths. While, leather shaving dust(LSD) which is much produced from leather manufacturing company in waste has strong tear and tensile strengths, the properties of the high hygroscopic and the superior thermal insulation. In this research, gypsum-leather composites were made with gypsum and LSD. And the physical properties of those were tested. The optimum dosage of LSD for gypsum-leather composite was decided to 1~5%(w/w) of the gypsum. In that case, the composit which has compressive strength: 147~272 kg_(f)/cm^(2), flexural strength: 66~87kg_(f)/cm^(2), specific gravity: 1.11~1.29 is made.

피혁 분으로 변성된 석고계 재료의 물성

조헌영,서정목,전기석,이기환 공주대학교 생산기술연구소 2000 論文集 Vol.8 No.-

Gypsum materials have strong mechanical strengths and great resistance to fire. Also these one are very cheap because of the gypsum is a byproduct from chemical plants. But, these materials have some demerits ; weak water-resistance, heavy specific gravity and low physical properties in bending and tensile strengths. While, leather shaving dust(LSD) is very much produced from leather manufacturing process. The LSD is composed of collagen fibers which is a kind of protein. This one has strong tear and tensile strengths because of the collagen fibers are cross linked during the tanning process of leather. Also the dust has the properties of the high hygroscopic and the superior thermal insulation, but is not degraded any more in neutral condition such as gypsum slurry. In this paper, we have reinforced the physical properties of gypsum with LSD as a filler. From this research, it is decided that the optimum dosage of LSD to gypsum is below 5%(w/w) of the gypsum, and the specific gravity of LSD-gypsum mixture is reduced to 30% relative to gypsum alone.

방향족 화합물의 할로 메칠화 반응

박정서,김신종,백운필,이현주,송윤석,장정민 明知大學校 自然科學硏究所 1997 자연과학논문집 Vol.15 No.-

Biphenyl의 para position에 methylene group을 도입 시키는 방법으로 paraformaldehyde와 dimethylamine을 반응시켜 Mannich Base인 (1,1'-biphenyl-4,4'-dimethyl)-dimethli amine을 합성해 보았으나, 전혀 반응이 진행되지 않았다. 즉 , Biphenyl에 강한 activating group이 없으므로 Mannich Base을 사용한 방법은 효과적이 못된다. 따라서, 다른 방법으로 biphenyl에 bromomethylation을 진행 시켜서, 두 개의 methylene group을 도입시켰다. Bromomethylation은 다음과 같이 사용하는 시약 및 실험 방법 등을 고려하여 3가지 방법으로 시도 하였다. 1)1,3,5-trioxane + HBr in AcOH + paraformaldehyde 사용법, 2)Hbr in AcOH + paraformaldehyde 사용법, 3) NaBr + H₂SO₄+paraformaldehyde 사용법, 이상의 3가지 방법 중에서 NaBr+ H₂SO₄+ paraformaldehyde 사용법이 가장 좋은 결과를 얻었다. 이러한 system에서 반응을 진행시킨 결과 69% 의 높은 수율 (87%의 purity)로 4,4'-dibromomethylbiphenyl 합성에 성공할 수 있었다. The synthetic method for the induction of methylene group on the para position of arenes is of importance. Since the weak activation effect of phenyl group on the electrophilic substitution reaction, the induction of methylene group by way of Mannich base using paraformaldehyde and dimethylamine was unsuccessful. It was found that halomethylation of byphenyl is only the way for the preparation of di-p-methylenebiphenyl. Especially, bromomethylation was turn out to be more reliable synthetic method than chloromethylation. Herein, we developed 3 protocols for the synthesis of 4,4'-dibromomethylbiphenyl. In addition, the best result was obtained using NaBr + H₂SO₄paraformaldehyde protocol in 69% yield.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

관상동맥 내 빛간섭단층촬영술을 활용한 관상동맥 내 석회화 병변의 중재시술 후 경과 예측: 전향적 관찰 연구

장지홍,강시혁,조영석,신은석,서정원 순천향대학교 순천향의학연구소 2021 Journal of Soonchunhyang Medical Science Vol.27 No.1

Objective Imaging modalities such as intravascular ultrasonography or computed tomography or angiography have shown limitations in assessing coronary calcification. In this study, we investigated whether quantitative indices of optical coherence tomography (OCT) in calcified lesions are correlated with the late outcome of a coronary stent. Methods We consecutively enrolled patients who had more than grade 2 coronary calcification on fluoroscopy. OCT was performed at baseline, immediately after stenting, and at 9 months after stenting. We analyzed qualitative and quantitative characteristics of plaque, calcification, and stent-related indices. Results All images of 3-time points were available in a total of 10 patients. Calcified lesions were frequently associated with thin cap fibroatheroma (100%), plaque erosion (20%), or rupture (20%) before the procedure. Thrombus was found in 100% of cases in the OCT immediately after stenting. Maximal calcium area before stenting was strongly correlated with late luminal loss assessed by 9-month follow-up OCT (r= 0.766, P= 0.01). Conclusion Preprocedural OCT assessment on calcified coronary lesion may predict high-risk procedure and late stent outcome. Further studies are warranted to confirm these findings.

인체 유방암종에서 Cyclic-Dependent Kinase Inhibitor, p27^Kip1 발현의 의의

송상용,김덕환,서연림,고영혜,김대식,남석진,양정현 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

공원묘지 유실에 의한 대량재해의 개인식별

강신몽,이한영,윤중진,이원태,김종열,이영석,서재관,최득린,서지석,이혜경 大韓法醫學會 1992 대한법의학회지 Vol.16 No.1

Individual identification of severely decomposed or skeletonized bodies is an important part in medicolegal field. 142 bodies were torn up and carried away by flood in a park cemetry, Kwang-Ju, Kyunggi province, Korea at Sept., 10, 1990. The authors examed the 56 bodies, which were gained, through medical, anthropological, odontological, radiological methods, and superimposition for individual identification. Among them, 41 cases were successfully identified, and remaining 15 cases were not identified because of sever destruction and no adequate information.