• Childhood Kidney Diseases
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• 제9권2호
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• pp.222-230
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• 2005

목 적 : ARC 증후군은 관절구축, 신세뇨관 장애 및 담즙 정체의 동반으로 진단되며, 윈인 유전자(VPS33B)가 확인 된 선천성 질환으로, 전세계적으로 41례 정도가 보고되었고, 국내 보고는 거의 없는 매우 드문 질환이다. 저자들은 신세뇨관 기능부전을 중심으로 7례의 ARC 증후군의 임상 경과를 고찰하여 본질환의 진단에 도움이 되고자 하였다. 방 법 : 1995년 3월부터 2005년 8월까지 세브란스병원에 내원한 임상적 진단기준을 만족하는 7례의 ARC 증후군을 대상으로 후향적 조사를 시행하였다. 결 과 : 대상 환아 남, 녀 비는 4:3이었으며, 출생당시 정상체중아가 6례(85$\%$), 미숙아는 1례(14$\%$)였다. 7례 모두 심한 황달을 동반하는 담즙 정체를 보였으며, Brown 등에 의한 관절구축의 분류 기준상 type III 2례, type IV 2례 type VI 1례, type VII 2례, 미분류 1례(14$\%$)였다. 기타 임상양상은 성장장애 6례(85$\%$), 늘어지고 거친 피부 5례(71$\%$), 거대혈소판 4례(57$\%$), 청력장애 2례(29$\%$)였다. 소변 검사상 단백뇨 6례(85$\%$), 혈뇨 3례(43$\%$), 당뇨 5례(71$\%$), 인산뇨 2례(29$\%$), 칼슘뇨 2례(29$\%$)였다. 전해질 검사상 저나트륨혈증 4례(57$\%$), 저칼륨혈증 3례(43$\%$)였고, 혈중 크레아틴치 상승은 1례(14$\%$)에서 관찰되었다. 신세뇨관 기능부전은 신세뇨관 산증 6례(85$\%$), 신성 요붕증 2례(29$\%$), 판코니 증후군 2례(29$\%$)로 나타났다. 치료는 단순관찰 2례(29$\%$), 지속적 전해질 보충 및 산증 교정 5례(85$\%$), 신대체요법 1례(14$\%$)였다. 가계도 분석에서 가계내 발병은 1례에서만 확인되었다. 추적관찰 결과 사망 4례(57$\%$), 생존 2례(29$\%$), 추적관찰 중단 1례(14$\%$)로 사망 환아는 평균 8.1개월에 사망하였으며, 생존 환아의 평균연령은 11.8개월이었다. 결 론 : 전세계적으로 드물게 보고되고 있는 ARC 증후군은 다양한 양상의 신세뇨관 기능 부전을 동반하고 있으나, 본 연구에서는 신세뇨관 기능 손상 정도가 상대적으로 미약하며, 생존 기간도 높은 경향을 나타내었다. 또한 국외 보고와는 달리 대상 환아의 가계 내 동일질환의 발생례가 적어 산발적인 유전자 돌연변이에 의한 발병 가능성도 있으나, 예후가 극히 불량한 본 질환의 철저한 차단을 위하여 무엇보다도 환자 발생 가계 내에서의 정확한 산전 유전자 진단이 요구되는 바이다.

• 한국유가공학회:학술대회논문집
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• 한국유가공기술과학회 2004년도 제58회 춘계유가공심포지움 - 세계 우유의 날 기념 국제 심포지움
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• pp.21-39
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• 2004

Fermented milks have been recognized as healthy foods since ancient times, but those using intestinal bacteria such as Bifidobacterium and lactic acid bacteria (LAB) are even more valuable from the standpoint of view of maintaining health. They have also now come to be recognized as important in the field of preventive medicine. Although advances in the medical sciences in the last 50 years have significantly increased the human lift span, an unfortunate fact is that many of us are now living long enough to experience chronic disorders such as coronary heart disease, hypertension, osteoporosis, diabetes and cancer. In recent years there has been renewed interest in health promotion and disease prevention by incorporating probiotic bacteria into foods to counteract harmful bacteria in the intestinal tract. Therefore, there are now a wide variety of commercial products containing prospective probiotics that claim health-promoting effects, such reductions in large botvel carcinogens and mutagens, antitumor properties, cholesterol-lowering effects, increased lactose digestion, relief from con-stipation, stimulation of immunocomponent cells and enhancement of phagocytosis. Two well-known representative probiotic is LAB and Bifidobaclerium. Traditional probiotic dairy strains of LAB which have been designated as GRAS (Generally Recognized As Safe) bacteria have a long history of safe use and most strains are considered comestible microorganisms with no pathogenic potential. Accordingly, there is considerable interest in extending the range of foods containing probiotic organisms from dairy foods to infant formulas, baby foods, and pharmaceuticals. In addition, the ingestion of probiotics, prebiotics, and symbiotic as wll as combinations of pro- and prebiotics has recently aroused renewed interest as enhancing the beneficial relationship between the host and intestinal microflora in both healthy and diseased indivisuals. Non-communicable chronic diseases such as cancer, cerebral hemorrhage, is chemic heart disease, and diabetes mellitus has recently been recognized as adult diseases in Japan as well as other countries. and are considered to be inevitably associated with aging. These diseases occur as a result of individual life styles. The Japanes Government. Ministry of Health, Labor and Welfare has proposed substituting the term 'adult diseases' with 'lifestyle-related diseases'. It has emphasized the importance of prevention rather than treatment. since the well-known increase in the elderly population in Japan is predicted to result in a variety of socioeconomic problems. n this lecture on the Present status of fermented milk products in Japan, I will report a strategy for the development of fermented milk products in Japan from the standpoint of view of research in Japan on LAB and Bifidobacteria. They could play an important role in preserving human health by controlling intestinal microflora capable of producing toxic effects on the host.

• 한국의료질향상학회지
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• 제9권2호
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• pp.176-197
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• 2002

Backgound : This study is to suggest the standardized format of the clinical sheets and the standardized items of every clinical sheet. The standardization of the medical records will increase the faithfullnes of the contents in them and it will contribute to construct the good health information system. Method : From Jan. 1st. 2001 to March 31st 2001, we gathered as many paper clinical sheets as possible by every class of institutions to review the faithfulness of the clinical contents in them. Clinical sheets of 9 tertiary care hospitals, 6 general hospitals and 56 clinics were gathered. Two experienced medical record administrators reviewed them. The review focus was to check whether the items recommend by the hospital standardization review criteria and hospital service evaluation organization were appeared in the clinical sheets and whether the contents of every item were written. Results : Tertiary care hospitals; In case of administrative data, the contents were filled well if the items were fixed. The clinical data like C.C, history,physical examiniation were filled well, but if the items were not fixed, some items were omitted. The result is that more items are to be filled if they are fixed. General hospitals Administrative data were filled more than 50%. Final diagnosis was filled about 66.7%.But other clinical data were not filled well and not many clinical related items were appeared in the sheets.In the legal point of view, the reason for visiting hosptals or the right diagnosis, patient condition at discharge could not be confirmed well.In surgery cases, surgical procedures could not be confirmed well as many surgical related information(surgery time, fluids and blood, number of sponges, biopsy, etc) were omitted. Clinics More than 70% administrative data were filled and fixed as items. Among the clinical related data, laboratory result was the most credible data. But without the right diagnosis, drug orders were given and doctors' written signatures were not appeared over 96.4%. So the clinical sheets cannot be used as a legal document. Conculusion : There was a tendency that the contents were filled well if the items were fixed in the documents, We also suggest a clinical check list to review the completeness and faithfulness of the clinical sheets. If many hospitals use the suggested clincal check list and if they make the necessary items fixed in the clinical sheets, the quality of the medical record will increase dramatically.

• Investigative Magnetic Resonance Imaging
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• 제19권4호
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• pp.231-236
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• 2015

A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.

• 근관절건강학회지
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• 제14권2호
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• pp.137-148
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• 2007

Purpose: This study was performed to evaluate of practicum by using standardized patient(SP) for nursing assessment. Method: This study had 2 steps. The 1st-step was pre-intervention stage including selection of a learning title, formation of case scenario, training of SP and developing the evaluation tools for students' clinical competence to assessment, 6 categories 29 items. The 2nd-step consisted of intervention and evaluation stages. 34 nursing students divided 2 groups participated in assessing the SP. Evaluation of each group was performed by 2 nursing professors. All students recorded their feelings after assessing the SP. The SP also evaluated about nursing students' attitude toward the SP. Results: ICC(Interclass correlation coefficient) between 2 groups was over 0.7 all categories. Students' assessing score(range 0-1) was muscular-joint function status(0.41), nutritional status(0.39), history taking(0.38), IADL(0.18), ADL(0.15), and emotional status (0.07). The mean scores of the nursing students' attitude by SP was 4.03(range 1-6). Also most students showed positive reactions to the education using SP because they had the chance to experience what they could not practice in clinical setting. Conclusion: The evaluation tool revealed high reliability. Nursing students' clinical competence was below average. But they took a good attitude to SP. We recommended further research using SP with various disease.

• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.154-161
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• 2017

Purpose: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. Materials and Methods: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. Results: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = -0.45 and -0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0-99.0) and 95.3% (95% CI: 90.0-100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0-100.0) and 70.4% (95% CI: 60.0-80.0), respectively. Conclusion: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.

• Journal of Genetic Medicine
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• 제4권1호
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• pp.84-87
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• 2007

척수소뇌성 실조증3는 신경세포의 손상으로 인해 생기는 질병으로 염색체14q32.1지역에 반복적인 CAG 삼염기 서열이 증가하면서 일어나는 것으로 알려져 있다. 본 증례는 척수소뇌성 실조증3으로 진단을 받은 부부에서 자연 임신한 태아를 산전진단한 경우로서 형광으로 포식된 표지자를 이용하여 CAG 지역을 증폭하여 빠르고 정확하게 반복수를 확인하는 방법을 이용하였다. 남편의 경우 CAG반복을 넘는 69개의 반복과 정상인 27개의 반복된 유전자를 갖고 있는 것으로 확인하였으며, 산모의 경우 정상인 26과 32개의 반복된 유전자를 갖고 있는 것으로 확인하였다. 태아는 부계의 27과 모계의 26개를 갖는 정상 유전자를 물려 받은 것으로 확인되어 건강한 아기를 분만하였다. 형광을 이용한 진단방법은 방사능을 사용하는 방법에 비해 안전하고 빠른 진단을 할 수 있으며 시료 채취 후 5-6시간 안에 정확하게 결과를 확인할 수 있는 방법이라 생각된다.

• Journal of Gastric Cancer
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• 제17권1호
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• pp.33-42
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• 2017

Purpose: Endoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors. Materials and Methods: From January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer. They were divided into 2 groups: (1) with preoperative ESD or (2) without preoperative ESD. Clinicopathologic factors and short-term surgical outcomes were retrospectively evaluated along with risk factors such as preoperative ESD. Results: Several characteristics differed between patients who underwent ESD-surgery (n=199) or surgery alone (n=1,505). The mean interval from the ESD procedure to the operation was 43.03 days. Estimated blood loss, open conversion rate, mean operation time, and length of hospital stay were not different between the 2 groups. Postoperative complications occurred in 23 patients (11.56%) in the ESD-surgery group and in 189 patients (12.56%) in the surgery-only group, and 3 deaths occurred among patients with complications (1 patient [ESD-surgery group] vs. 2 patients [surgery-only group]; P=0.688). A history of ESD was not significantly associated with postoperative complications (P=0.688). Multivariate analysis showed that male sex (P=0.008) and laparoscopic total or proximal gastrectomy (P=0.000) were independently associated with postoperative complications. Conclusions: ESD did not affect short-term surgical outcomes during and after an additional laparoscopic gastrectomy.

• 인삼문화
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• 제1권
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• pp.28-42
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• 2019

위대한 철학자이자 미적분을 발견한 수학자로 잘 알려진 라이프니츠(Gottfried Wilhelm Leibniz, 1646~1716)가 인삼에 대해 물었다는 사실은 거의 알려져 있지 않다. 유럽의 계몽주의를 열었던 라이프니츠는 왜 인삼에 관심을 가지게 되었을까? 이 글은 라이프니츠가 남긴 방대한 기록 속에서 인삼을 찾아내고, 개인적 생애와 당대의 지적 흐름을 엮어 그가 인삼에 관심을 갖게 된 경로를 추적한 작업이다. 16세기부터 유럽에서는 약물지와 같은 고대 그리스 텍스트의 재발견과 해외에서 들여온 새로운 식물들로 인해 본초학이 크게 발달하게 되었다. 같은 맥락에서 '구대륙' 중국에서 만병통치약으로 이름을 떨치던 인삼 또한 여행기 등을 통해 유럽에 소개되기 시작했다. 중상주의 기치 하에 유용한 약용식물에 대한 관심이 커 가던 유럽에서는 과학단체들을 중심으로 본격적으로 인삼에 대한 연구가 시작되었다. 라이프니츠는 그런 연구의 중심지였던 왕립학회와 프랑스 왕립과학원을 방문하고 학자들과 교류를 나누었으며 독일에 그와 같은 연구기관을 설립하는 것을 평생의 목표로 삼았다. 라이프니츠는 로마를 방문했을 때 예수회 선교사들과 긴밀하게 교류하는 기회를 갖게 되었다. 그 과정에서 중국에 대한 지적 호기심이 한층 더 깊어갔고, 그 맥락에서 인삼에 대한 관심도 커갔다. 라이프니츠는 그리말디, 부베 등 중국선교에서 핵심적인 활동을 했던 학자들과 인삼의 효능에 대한 정보를 주고받게 된다. 이 논문은 유럽의 계몽주의에서 전혀 주목받지 못했던 인삼이 17세기 말 유럽의 학문적 지형과 지식인들 사이의 교류, 중상주의적 해외팽창을 얽어내는 단초가 될 수 있음을 제시한 것이다.

• 한국임상수의학회지
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• 제30권1호
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• pp.57-60
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• 2013

개에서 포도중독에 의한 신부전 치료결과에 대한 임상적 분석을 위하여 205-2008년 기간 중 강원대학교 수의과대학 동물병원에 내원한 환자의 의료기록부를 분석하였다. 총 11두 (암컷 8두) 중 4두는 완전히 회복하였고, 3두는 폐사, 4두는 안락사로 처리되었다. 1두를 제외한 모든 환자는 포도를 섭취하였으나 정확한 섭취량은 알 수 없었다. 환자의 평균 연령은 5.3세 (범위 0.2-11.3세), 체중은 4.1 kg (범위 1.4-13 kg)였으며, 평균 입원기간은 7.1일 (범위 2-22일)로 나타났다. 모든 환자에서 구토와 식욕부진 증상을 보였으며, 일부 환자는 설사 (4두), 핍뇨 (5두), 무뇨 (4두) 소견을 보였다. 모든 환자에서 혈청 phosphorous, creatinine, BUN 농도가 증가된 소견을 보였으며, 고칼슘혈증 2두, 저칼슘혈증 2두, 나머지 7두는 정상소견이었다. 혈청 농도가 증가한 항목은 amylase 8두, ALP 7두, ALT 5두였으며, 혈액 가스 분석에서 8두는 대사성산증을 보였다. 경미하거나 중등도의 빈혈 소견이 5두에서 관찰되었으며, 회복한 환자와 비교할 때 폐사축의 경우 혈소판과 림프구 수가 상대적으로 낮았다.