골반골절 환자에서 출혈의 정도를 반영하는 분류

황태식,손대곤,김인병,장석준 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

The causes of death of pelvic bone fracture are hemorrhage, associated internal organ injuries, sepsis, and multi-organ failure, among which hemorrhage still remains as the leading cause of death. While previous classification for pelvic bone fracture was focused on orthopedic treatment, Pennel & Sutherland suggested a new classification according to the pelvis AP film took in the emergency room. Since this classification supposedly evaluates hemorrhage from pelvic bone fracture, we are reporting on the efficiency of this classification. Out of all the 150 patients admitted to Yong Dong Severance Hospital Emergency Room from 1992, Jan. through 1994, Dec. due to pelvic bone fracture, 18 people with incomplete medical record and X-ray film excluded from the study. The study was done Cohort method and t-test was used. According to the new classification, the unstable fracture had a much more bleeding amount regardless of the type, and type I stable fracture bled more than all the other stable fracture. These were statistically meaningful. Also, there was no differences in the type of fracture when ISS(Injury Severity Scale), GCS(Glasgow Coma Scale), and associated injury were compared. In conclusion, previous classification was done according to orthopedic treatment and this classification could be done only after pelvis X-ray series and pelvic bone CT was performed. Therefore much more time is consumed, more stress is put upon the patient and no comparisons can be made in performing emergency care. On the other hand, modified Pennel &-Sutherl`s classification can be simply classified in the emergency room by taking pelvis AP film only and the bleeding amount can be measured according to the type. Therefore, this classification can be helpful in performing emergency care.

알코올성 치매의 신경심리학적 소견

김태유,김지원,김상윤,김준모,이동기,연권인,김민정,이은아,손정은 대한노인병학회 2004 대한노인병학회지 Vol.8 No.1

대장선암 조직의 CEA에 관한 면역조직학적 고찰

권오준,신현호,서인수,손태중 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4

The autors immunohistochemically studied 63 cases of colorectal adenocarcinoma to evaluate clinical significance of histologic pattern of tissue CEA. Immunohistochemical stain of cancerous tissues was performed by ABC method, and then light and electron microscopy were carried out. On light microscopic studies, CEA was mainly distributed on apical and lateral surface of normal and cancer cells and weakly positive in the cytoplasm of cancer cells. On electron microscopic studies, CEA was strongly positive along the apical and lateral borders of cancer cells and weakly positive in the cytoplasm as a pattern of fine granules. The statistical studies revealed such a data that high preoperative serum CEA level was shown in cases of tumor necrosis. Also in groups of surrounding invasion, well differentiation, and distant metastasis of the cancer, preoperative serum CEA levels were significantly increased. Thus, the evaluatin of CEA serologically and immunocytochemically in cases of colorectal adenocarcinoma may significantly inform in diagnosis or postoperative treatment and follow-up.

비기능성 부신피질암 1례

하달봉,이경섭,손형규,이준희,원유홍,김동훈,장태정 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

비기능성 부신피질암은 발생 빈도가 극히 드문 악성 종양이며, 내분비학적 임상증상이 없어 주로 복부 종물에 의해 우연히 발견된다. 그래서 대부분 종양의 크기가 거대하고 전이로 진행된 경우가 흔하며, 절제술만으로는 치유 불가능한 경우가 많아 예후가 불량한다. 최근 저자들은 약 10년간 간헐적인 좌측 측복통과 흉부 압박감으로 내원하여, 이학적 검사 및 방사선학적 검사상 복부 종물이 확인되고 생화학적 검사에서 비기능성으로 판명된 52세 남자 환자에서 근치적 신절제술을 시행하여 병리조직검사상 비기능성 부신피질암으로 진단되었기에 문헌 고찰과 함께 보고하는 바이다. Nonfunctioning adrenocortical carcinoma is extremely rare, which is diagnosed most often in older man because of mass effect. Most tumors are discovered too late for curative resection, and advanced tumors are associated with a poor prognosis. Herein we report on a 52-year-old man with nonfunctioning adrenocortical carcinoma, treated by radical nephrectomy.

알쯔하이머형 치매 환자에서 우울증의 유무에 따른 인지기능과 일상생활 수행능력의 차이

김승민,최태규,안석균,손석한,유계준,오병훈,오희철 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 알쯔하이머형 치매 환자에게 있어서 중요한 행동증상중의 한가지인 우울증의 다양한 범위로 보고되고 있으며 우울증과 인지능력 및 기능적 능력과의 관계에 대한 연구가 매우 중요하게 부각되고 있다. 본 연구의 목적은 지역사회에 거주하는 경도 및 중등도의 알쯔하이머형 치매 환자를 대상으로 우울증이 일상생활 수행능력과 인지기능의 특정 영역과 연관이 있는지의 여부를 알아보기 위함이다. 방 법 : 본 연구대상은 경기도 광주군에 거주하는 65세 이상의 알쯔하이머형 치매 노인 48명이며, 한국판 Mini-Mental State Examination(이하 MMSE-K), 한국어판 신경행동학적 인지상태 검사(이하 한국어판 NCSE), 한국형 노인우울검사(이하 KGDS), 기본적인 일상생활 수행정도(이하 ADL), 그리고 도구적인 일상생활 수행정도(이하 IADL)를 연구도구로 하여 이들로부터 자료를 수집 조사하였다. 연구대상은 KGDS에 의해 우울 치매군과 비우울치매군으로 분류하였으며 두 군간의 상기 척도에 의해서 얻어진 결과를 χ²test 및 independent t-test를 이용하여 분석하였다. 결 과 : 우울 치매군과 비우울 치매군은 성별, 연령, 교육수준 및 MMSE-K 점수의 유의한 차이가 없었다. 우울 치매군은 비우울 치매군보다 ADL의 한 항목인 목욕하기에서 유의한 저하를 보였다. 우울 치매군은 비우울 치매군보다 IADL의 총점 및 식품점에 가서 장보기, 집안일(청소나 정리정돈), 금전 관리의 3개 항목에서 유의한 저하를 보였다. 그러나 우울 치매군은 비우울 치매군은 한국어판 NCSE를 이용한 인지기능의 영역별 비교에서는 유의한 차이를 보이지 않았다. 결 론 : 이상의 결과로 미루어 볼 때 알쯔하이머형 치매 환자에서의 우울증은 기본적인 일상생활 기능의 일부와 도구적인 일상생활 기능의 저하와 상당한 관련 있고, 이러한 우울증에 동반된 일상생활 기능의 저하는 인지기능의 영향에 기인하지 않는 것임을 시사된다. Objectives : Coexistence of depression is one of the important behavioral symptoms in patients with dementia of Alzheimer type. The study on the relationship between depression and cognitive abilities and /or functional abilities emerges as very important one. The aim of this study was to investigate whether depression is related to the impairment of daily activities and to certain areas of cognitive function in mild to moderate dementia of Alzheimer type. Methods : In this study, 48 patients with dementia of Alzheimer type among elderly community-residents in Kwangju, Kyunggi province, age 65 and older, were finally included. We examined their demographics and administered Korean Version of the Mini-Mental State Examination(MMSE-K). Korean Version of the Neurobehavioral Cognitive Status Examination (Korean version of NCSE), Korean Form of Geriatric Depression Scale(KGDS), Activities of Daily Living(ADL), and Instrumental Activities of Daily Living(IADL) to the subjects. We classified the subjects into two groups, dementia with and without depression on the basis of KGDS scores. The two groups were compared using χ²test and independent t-test. Results : The results show that the two groups did not differ in sex, age, education, and scores of MMSE-K. The depressed dementia group showed significantly poorer performance in bathing, one item of ADL, than the non-depressed dementia group. The depressed dementia group showed significantly more impairment in total scores of IADL and each score of three item(shopping, housework, handling finances) than the non-depressed dementia group. However, the two groups showed no significant difference in five major cognitive ability areas of Korean version of NCSE. Conclusion : These results suggest that depression in patients with dementia of Alzheimer type is highly related to the functional impairments, instrumental activities of daily living and part of activities of daily living, beyond the effects of cognitive impairments.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Clinical characteristics of acute appendiceal diverticulitis

Tae Joon Sohn,Yeon Soo Chang,Jae Hee Kang,Dong Hee Kim,Tae Seok Lee,Joon Kil Han,Seong Hwan Kim,Young Ok Hong 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.84 No.1

Purpose: Diverticulitis of vermiform appendix is known as a rare cause of acute appendicitis, most of which are diagnosed after surgery. We compared appendiceal diverticulitis with acute appendicitis to study the clinical characteristics of appendiceal diverticulitis. Methods: Among 1,029 patients who received appendectomy from January 2009 to May 2011, 38 patients with appendiceal diverticulitis (diverticulitis group) were compared with 98 randomly collected patients with acute appendicitis (appendicitis group) during the same period. Patients’" characteristics, clinical features, laboratory findings, operative findings, and postoperative course were compared between the two groups. Results: Thirty-eight patients (3.7%) were pathologically diagnosed with acute appendiceal diverticulitis among 1,029 cases of appendectomy. The mean age of patients in the diverticulitis group was significantly older than that of the appendicitis group (49.0 ± 15.2 years vs. 25.4 ± 14.2 years, P 〈0.05). Mean duration of preoperative symptoms was longer in the diverticulitis group (3.6 ± 3.8 days vs. 1.8 ± 3.2 days, P 〈0.05). The site of abdominal pain, fever, signs of localized peritonitis, accompanying gastrointestinal symptoms, and white blood cell count showed no differences between the two groups. Twenty-five patients (65.8%) of the diverticulitis group and 10 patients (10.2%) of the appendicitis group showed perforation of appendix (P 〈 0.05). Mean operating time and postoperative hospital stay were longer in the diverticulitis group (55.3 ± 28.8 minutes vs. 41.4 ± 17.8 minutes, 6.8 ± 3.4 days vs. 4.9 ± 1.5 days, P 〈 0.05). Conclusion: Acute diverticulitis of the appendix can be classified into quite different disease entities compared with acute appendicitis. Regarding high rates of perforation, immediate surgical treatment is needed for patients with a high index of suspicion of acute diverticulitis of the appendix.

Clinical Application of Targeted Deep Sequencing in Solid‐Cancer Patients and Utility for Biomarker‐Selected Clinical Trials

Kim, Seung Tae,Kim, Kyoung‐,Mee,Kim, Nayoung K.D.,Park, Joon Oh,Ahn, Soomin,Yun, Jae‐,Won,Kim, Kyu‐,Tae,Park, Se Hoon,Park, Peter J.,Kim, Hee Cheol,Sohn, Tae Sung,Choi, Dong Il,Cho, AlphaMed Press 2017 The oncologist Vol.22 No.10

<P>Molecular profiling of actionable mutations in refractory cancer patients has the potential to enable 'precision medicine,' wherein individualized therapies are guided based on genomic profiling. The molecular-screening program was intended to route participants to different candidate drugs in trials based on clinical-sequencing reports. In this screening program, we used a custom target-enrichment panel consisting of cancer-related genes to interrogate single-nucleotide variants, insertions and deletions, copy number variants, and a subset of gene fusions. From August 2014 through April 2015, 654 patients consented to participate in the program at Samsung Medical Center. Of these patients, 588 passed the quality control process for the 381-gene cancer-panel test, and 418 patients were included in the final analysis as being eligible for any anticancer treatment (127 gastric cancer, 122 colorectal cancer, 62 pancreatic/biliary tract cancer, 67 sarcoma/other cancer, and 40 genitourinary cancer patients). Of the 418 patients, 55 (12%) harbored a biomarker that guided them to a biomarker-selected clinical trial, and 184 (44%) patients harbored at least one genomic alteration that was potentially targetable. This study demonstrated that the panel-based sequencing program resulted in an increased rate of trial enrollment of metastatic cancer patients into biomarker-selected clinical trials. Given the expanding list of biomarker-selected trials, the guidance percentage to matched trials is anticipated to increase.</P>

The Mortality According to Hepatic Venous Pressure Gradient in Korean Patients with Portal Hypertension

Tae Yeob Kim,Ki Tae Suk,Jae Young Jang,Moon Young Kim,Soung Won Jeong,Eui Ju Park,Dong Joon Kim,Joo Hyun Sohn,Soon Koo Baik,Woo Kyoung Jeong,EunHee Choi 한국간담췌외과학회 2014 한국간담췌외과학회 학술대회지 Vol.2014 No.4

우유와 두유를 혼합한 이유보충음료의 개발

손경희,윤선,이민준,김순영,김용태,장동훈,강석필 연세대학교 생활과학연구소 2001 生活科學論集 Vol.10 No.1

The purpose of this study is to develop an infant supplement composed of cow and soy milk which has acceptable taste and digestability and meets nutritional needs of the infants. Even though soy milk is and excellent source of protein for infants who are allergic to dairy products, its protein quality is still lower than that of regular milk. Therefore in the present study the development of sow-soy milk infant formula was attempted. To make the formula equal amount of cow and soy milk were mixed and supplemented with vitamins and minerals to meet the nutritional standards of breast milk, CODEX and recommended dietary allowances for Korean infants. In animal experimental study, the weight gain rate of weaning rats was highest in the order of 100% milk, cow-soy milk, control, soy milk, commercial soy infant milk group. Feed efficiency ratio(FER) were not significantly different among control, 100% milk and cow-soy milk groups. However, commercialized soy infant milk group showed significantly lower FER than other groups. When the cow-soy milk formula was fed to infant in the age of 5 month to 25 months, it did not show any unsatisfactory results in acceptability and bowel movements of the subjects. Since the cow-soy milk formula has not only all the nutrients for the physical growth of infants but also contains valuable physiological functional ingredients, it is expected to be a good choice of supplements for infants.