암환자에서 다른 신경학적 증상이 동반되지 않는 두통 : 예비 보고

이성형,안미영,백신혜,이형석,신동익,이상수 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

연구목적 : 암환자에서 신경학적 결손이나 발작 등이 동반되지 않는 두통의 원인과 이런 경우 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견의 진단적 유용성을 알아보고자 하였다. 대상 및 방법 : 2005년 10월부터 2009년 1월까지 신경학적 결손이나 발작을 동반하지 않는 두통이 발생한 71명의 암환자를 대상으로 하였다. 자세한 병력을 청취하고 신경학적 검사를 하였으며, 환자의 상황에 따라 적절한 조합의 뇌MRI, 뇌CT, 및 뇌척수액 검사를 시행하였고, 최소한 3개월 이상 추적 관찰하였다. 이 소견을 종합하여 두통의 국제분류 기준(The International Classification of Headache Disorders, second edition) 에 따라 두통을 진단하였다. 또한 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견인 있는 환자군과 없는 환자군 사이에 중추신경계로의 전이빈도가 차이가 나는지 알아보았다. 결과 : 71명 중에 8.5%인 6명에서 중추신경계로의 전이가 관찰되었는데 심각한 두개내 질환에 의한 이차두통을 의삼할 수 있는 소견이 있었던 18명 중에 4명(22.2%), 이런 소견이 없었던 53명 중에 2명(3.8%)이었다. (상대위험도 5.89, 95% 신뢰구간 1.18-29.49). 두통의 다른 원인으로는 지주막하 출혈이 1명, 중추신경계 이외의 감염에 의한 두통이 6명, 항암제에 의한 두통이 1명, 고혈압성 두통이 1명, 방사선 치료와 관련된 두통이 1명, 원발성 찌름두통이 3명, 긴장성 두통이 51명이었다. 결론 : 심각한 두개내 질환에 의한 이차두통을 의심할 수 있는 소견의 유무가 암환자에서 발생하는 두통의 감별진단에 유용하며, 이러한 소견이 동반되지 않는 경우의 두통은 대부분 양성이다. 하지만 이러한 결론을 바탕으로 향후 보다 많은 대상 환자군을 통한 연구가 필요할 것이다. Purpose: Headache in patients with systemic malignancy is a great concern to neurologists. We performed this study to investigate the frequency of metastasis as the cause of headache in the patients with systemic malignancy and the usefulness of symptoms suggesting underlying serious pathologies especially when headaches do not accompany any other neurological symptoms. Materials and Methods: From October 2005 to January 2009, we prospectively collected 71 patients with systemic malignancy complaining headache but not having any other accompanying neurological symptoms. After thorough history taking and neurological examination, we performed a neuroimaging (MRI or CT) and CSF study according to the clinical situations of individual patients and followed them at least 3 months and diagnosed headaches according to The International Classification of Headache Disorders, second edition (ICHD-II). We compared the incidence of intracranial metastasis between headaches with symptoms suggesting underlying serious illness and those without. Results: Six (8.5%) out of 71 patients had intracranial metastasis: 4(22.2%) out of 18 patients with symptoms suggesting underlying serious illness, 2(3.8%) out of 53 patients without them (relative risk 5.89, 95% confidence interval 1.18-29.49). Other causes included subarachnoid hemorrhage (1 patient), headache attributed to infection (6), headache attributed to drug (2), hypertensive headache (1), headache attributed to radiotherapy (1), primary stabbing headache (3), and tension headache (51). Conclusion: This study suggests that headache symptoms suggesting underlying serious disorder are valuable in differentiating the causes of headache without any other accompanying neurological symptoms in patients with systemic malignancy and headaches without those symptoms might be usually benign. However, more broad study should be made for these value and relationship.

Exercise Training suppresses vascular fibrosis in aging obesity induced rats

( Shin Young Kim ),( Jin Lee ) 한국운동영양학회 2014 Physical Activity and Nutrition (Phys Act Nutr) Vol.18 No.2

Shin Young Kim and Jin Lee. Exercise Training suppresses vascular fibrosis in aging obesity induced rats. JENB., Vol. 18, No. 2, pp.175-180, 2014 [Purpose] The aim of this study was to investigate the effects of exercise training (ET) on vascular fibrosisin aging model rats with diet-induced obesity. [Methods] Twenty-four male Sprague-Dawley rats were divided into 3 groups: Aging control (A-C), A-C with high fat diet (AHF), AHF with ET (AHF + ET). Aging was induced by D-galactose (D-gal) and obesity was induced by HFD (60% fat) for 9 weeks. The experimental rats performed swimming (60 min/day, 5 days/week) for8 weeks. All rat aorta samples were harvested for RT-PCR and morphologic analyses. [Results] The exercise training significantly decreased levels of AT-1, TGF-ß and Coll-1 gene expression compared to AHF group. The AHF + ET group showed a reduced collagen accumulation in the aorta media compared to AHF group. [Conclusion] These results suggest that ET could protect the aging obesity aorta against down-regulation of fibrotic factors (AT-1, TGF-ß and Coll-1 gene) and fibrosis by inhibition of collagen accumulation in the aorta media. [Keyword] Exercise training, vascular fibrosis

개에서 결직장 연접부의 림프종 1례

이재일,이수진,김영석,김명진,조성환,신상태,이영원,김명철 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-

A five years old female Shih-tzu was referred to the veterinary medical teaching hospital at Chungnam national university with soft bloody diarrhea and tenesmus. On rectal palpation, solid mass was palpated in colorectal region. In radiographs, small intestine was deviated cranially, descending colon and rectal junction were deviated caudoventrally in lateral projection of the abdomen. In ultrasonographs, hypoechoic nodulation of mesenteric lymph node in colorectal junction, mixed echoic thickening of colorectal wall and irregular margination were observed. Rectal endoscopy revealed that colorectal men was partially obstructed due to compression of the mass. Also, severe ulceration, inflammation and hemorrhage were also observed in descending colon. The mass was resected through the laparotomy. In histopathology, it was diagnosis of lymphoma in the colorectal junction.

영·유아 언어, 인지, 사회·정서 발달 평가도구 문항 개발을 위한 예비연구

이종숙,신은수,박은혜,김영태,유영의,최일선,유흥옥 이화여자대학교 교육과학연구소 2009 교육과학연구 Vol.40 No.3

본 연구는 만 2~5세 영·유아의 발달 상태를 객관적으로 평가함과 동시에 발달이 지연된 영·유아를 선별할 수 있는 발달평가도구 문항을 개발하기 위한 예비연구이다. 이를 위해 문헌고찰 및 발달관련 평가도구들을 비교 분석하여 발달지표를 선정하고, 만 2세~5세까지의 영·유아의 언어, 인지, 사회·정서발달영역을 교사관찰에 기초하여 평가할 수 있는 문항을 개발하였다. 연구대상은 대도시, 중소도시, 읍면 소재지 별로 표집 된 만 2세부터 5세까지 총 13개 유아교육기관에 다니는 435명의 영·유아들이며, 본 연구에서 최종 개발된 평가도구의 문항은 총 141문항이다. 평가도구 문항은 언어, 인지, 사회·정서발달영역별로 영·유아의 행동과 언어를 중심으로 교사가 관찰하고, 관찰하기 어려운 문항에 대해서는 단서와 kit를 제시하여 평가할 수 있도록 구성하였다. 개발된 평가도구 문항의 적절성을 알아보기 위하여 내용 타당도와 내적 신뢰도를 살펴본 결과 비교적 양호한 것으로 나타났다. This was a preliminary study to construct a developmental rating scale for understanding children's objective developmental levels and screening developmental disabilities. For this purpose, a developmental indicator was selected by a literature review and comparative analysis of related developmental assessment tests. An assessment scale based on teacher's observations to measure language, recognition, and social-emotional developmental areas was developed. The subjects were 435 young children aged 2 to 5 who lived in both urban and rural areas. A trial test consisted of 141 assessment items in the language, recognition, and social-emotional developmental domains. The developmental scale was evaluated by teachers who observed children's behavior and language, and used clues and kits. Tests on validity and reliability for confirming the appropriateness of the developed assessment scale showed that content was relatively valid and internally consistent.

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

전신마취 후 발생한 악성고열증 환자의 치료 경험

이근무,정승환,이정한,정순호,최영균,김영재,신치만,박주열,이영민 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Malignant hyperthermia is the disorder of calcium regulation within skeletal muscle associated predominantly with anesthesia. It is triggered by volatile anesthetics and depolarizing neuromuscular blocking agents. We experienced a case of malignant hyperthermia. 50 years old female patient was transferred to our emergency room that she was developed tachyarrhythmia and high fever. She was taken arthroscopic examination under the general anesthesia with enflurane and succinylcholine. We suspected malignant hyperthermia and promptly treated her with dantrolene sodium. She was developed disseminated intravascular coagulopathy and acute renal failure then we were intensive care to her. She was discharged without sequela. We experienced successful management of malignant hyperthermia.

국가예방접종전산등록체계 개발을 위한 민간의료 기관 하부구조 및 환경 조사연구

이무식,김은영,이건세,이석구,홍지영,김건엽,김대경,신의철,이연경,기몽서,나백주,김영택 한국모자보건학회 2003 한국모자보건학회지 Vol.7 No.2

상염색체우성 다낭신의 임상경과 및 합병증

이상주,이영모,이한규,최대은,박기현,이강욱,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Autosomal dominant polycystic kidney disease(ADPKD) is one of most common hereditary disorder. It is potentially fatal and the major mobilities are hypertension and renal failure. To elucidate clinical characteristics and outcomes of ADPKD, 67 ADPKD patients were analyzed retrospectively. The male to female ratio was 48 years for males and 42 years for females. The factors leading to the dignosis of ADPKD were flank or abdominal pain (46%), palpable abdominal mass (24%), incidental findings (18%), gross hematuria and headache. Urinalysis result showed hematuria (31%), proteinuria (19%), pyuria (18%). Among renal complications hypertension (67%) was the most common. Other complications were urolithiasis (16%) upper urinary tract infection (9%), cyst infection (7%). Azotemia was observed in 24% of cases. Echocardiography showed left ventricular hypertrophy in 24% and valvular regurgitation in 18% of cases, but there was no mital valve prolapse. Cerebrovascular events occurred in 6 cases (2 cases of intervertebral hemorrhage and 4 cases of cerebral infarction). Hipatic cyst were observed in 64% of cases. Eighteen cases culminated in end stage renal failure (ESRF) at an of 47. According to this study, the most common complications of ADPKD was hypertension (67%), ESRF (27%), and cerebrovascular event (9%). Hypertension was more frequently observed in increased creatinine group than normal.

기관지 방선균증의 임상 1례

이은영,장태원,정만홍,옥철호,이규원,손창배,이지숙,신은경,서정아,백종현,김영옥 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2

Actinomycosis is a chronic suppurative infection, whitch infiltrates mucosa-associated tissues. Thoracic, pelvic and cervicofacial infections of actinomyces are not uncommon, but endobronchial actinomycosis is rarely reported. We report a case of a 29 year old man who presented with a recurrent pneumonia and chronic cough. Fiberoptic bronchoscopy revealed occlusion of the right. lower medio-basal segment bronchus with exophytic endobronchial mass. The diagnosis was confirmed histologically by demonstration of sulfur granules in the bronchoscopic biopsy of the mass. Intravenous administration of amoxacillin and clindamycin followed by oral amoxacillin and clindamycin therapy resulted in complete recovery.

영아급사증후군과 소아급사증후군

이한영,양경무,이주한,강신몽 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-