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    ๊ตญ์ œ์ˆ˜์ถœํ†ต์ œ๋ ˆ์ง์˜ ๊ตญ๋‚ด ์ •์ฑ…์ง‘ํ–‰์— ๊ด€ํ•œ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ํ–‰์ •ํ•™๊ณผ, 2017. 2. ๊ตฌ๋ฏผ๊ต.ํ•œ๊ตญ์€ 1987๋…„๋ถ€ํ„ฐ ๊ตญ์ œ์ˆ˜์ถœํ†ต์ œ๋ ˆ์ง์„ ์ˆ˜์šฉํ•˜์—ฌ ์ •์ฑ…์„ ์ง‘ํ–‰ํ•ด์™”๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ํ•œ๊ตญ์˜ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ์ •์ฑ…์˜ ํ˜•์„ฑ๊ณผ ์ง‘ํ–‰๊ณผ์ •์„ ์ •์ฑ…ํ™•์‚ฐ๋ก ๊ณผ ์ •์ฑ…์ง‘ํ–‰๋ก ์˜ ์œตํ•ฉ์  ๊ด€์ ์œผ๋กœ ๋ถ„์„ํ•œ๋‹ค. ํŠนํžˆ ์ •์ฑ…์ง‘ํ–‰ ๋ถ„์„์„ ์œ„ํ•˜์—ฌ Matland์˜ ๋ชจํ˜ธ์„ฑ-๊ฐˆ๋“ฑ ๋ชจํ˜•์„ ์žฌ๊ตฌ์„ฑํ•˜์—ฌ ์ฒด๊ณ„์ ์ธ ๋ถ„์„ํ‹€์„ ์ œ์‹œ์ฝ”์ž ํ•œ๋‹ค. ๋ชจํ˜ธ์„ฑ๊ณผ ๊ฐˆ๋“ฑ ์ˆ˜์ค€์— ๋”ฐ๋ผ ๊ตญ๋‚ด ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ ์ •์ฑ…์ง‘ํ–‰์€ ํฌ๊ฒŒ ์ˆ˜์šฉ๊ธฐ, ๋„์•ฝ๊ธฐ, ๋ฐœ์ „๊ธฐ์˜ ์„ธ ๋‹จ๊ณ„๋กœ ๊ตฌ๋ถ„ํ•  ์ˆ˜ ์žˆ๋‹ค. ๊ฐ ์‹œ๊ธฐ๋ณ„๋กœ ๋ชจํ˜ธ์„ฑ-๊ฐˆ๋“ฑ ๋ชจํ˜•์— ๋”ฐ๋ฅด๋ฉด ๊ฐ ์‹œ๊ธฐ๋ณ„๋กœ ์‹คํ—˜์  ์ง‘ํ–‰, ์ƒ์ง•์  ์ง‘ํ–‰, ์ •์น˜์  ์ง‘ํ–‰ ์–‘์ƒ์ด ๋‚˜ํƒ€๋‚  ๊ฒƒ์œผ๋กœ ์˜ˆ์ƒ๋˜๋Š” ๋ฐ”, ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์ด๋ฅผ ๊ฒ€์ฆํ•˜๊ณ  ํšจ๊ณผ์ ์ธ ์ง‘ํ–‰์„ ์œ„ํ•œ ์‹œ์‚ฌ์ ์„ ์ฐพ๊ณ ์ž ํ•œ๋‹ค. ์ˆ˜์šฉ๊ธฐ์—๋Š” ๊ฐ•์•• ๊ธฐ์ œ์— ์˜ํ•ด ๊ตญ์ œ์ˆ˜์ถœํ†ต์ œ๋ ˆ์ง์ด ๊ตญ๋‚ด์— ๋„์ž…๋˜๋ฉด์„œ ๋ชฉํ‘œ ๋ชจํ˜ธ์„ฑ์ด ๋†’์•˜์ง€๋งŒ, ์‹ค์งˆ์  ์ง‘ํ–‰์ด ์ด๋ค„์ง€์ง€ ์•Š์Œ์— ๋”ฐ๋ผ ์ •๋ถ€์กฐ์ง๊ฐ„, ์ •๋ถ€์™€ ๊ธฐ์—…๊ฐ„ ๊ฐˆ๋“ฑ์€ ๋‚ฎ์•˜๋‹ค. ์ˆ˜์šฉ๊ธฐ์˜ ์ •์ฑ…์ง‘ํ–‰์€ ๋ฏธ์•ฝํ•œ ์ˆ˜์ค€์ด์˜€์œผ๋ฉฐ, ์ •์ฑ… ๊ด€๋ จ์ž๋“ค์˜ ์ œ๋„ ํ•™์Šต์ด ๋‘๋“œ๋Ÿฌ์ง€๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๋Ÿฌํ•œ ํŠน์„ฑ์€ ๋ชจํ˜ธ์„ฑ-๊ฐˆ๋“ฑ ๋ชจํ˜•์ด ์˜ˆ์ธกํ•œ ์‹คํ—˜์  ์ง‘ํ–‰์— ํ•ด๋‹นํ•œ๋‹ค. ๋„์•ฝ๊ธฐ๋Š” 9ยท11ํ…Œ๋Ÿฌ๋กœ ์ธํ•ด ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ์— ๋Œ€ํ•œ ๊ตญ๋‚ด์™ธ์˜ ๊ด€์‹ฌ์ด ํฌ๊ฒŒ ๋†’์•„์ง„ ์‹œ๊ธฐ์ด๋‹ค. 2004๋…„์— ์‹œํ–‰๋œ UN๊ฒฐ์˜ 1540ํ˜ธ์™€ ๊ฐœ์„ฑ๊ณต๋‹จ ๋“ฑ ๋‚จ๋ถ๊ต๋ฅ˜ ํ™œ์„ฑํ™”๋ผ๋Š” ์ •์ฑ…ํ™˜๊ฒฝ์˜ ๋ณ€ํ™”๋กœ ์ธํ•ด์„œ ๊ณผ๊ฑฐ๋ณด๋‹ค ๋ชฉํ‘œ ๋ชจํ˜ธ์„ฑ์€ ๋‚ฎ์•„์ง„๋‹ค. ๋‹ค๋งŒ, ์—ฌ์ „ํžˆ ์ˆ˜์ถœ ์ง„ํฅ ์ •์ฑ…์ด ์šฐ์„ ์‹œ๋จ์— ๋”ฐ๋ผ์„œ ์‚ฐ์—…์ž์›๋ถ€ ๋‚ด์—์„œ ์ „๋žต๋ฌผ์ž์˜ ์ˆ˜์ถœ ์ง„ํฅ๊ณผ ํ†ต์ œ ๊ฐ„์— ์šฐ์„ ์ˆœ์œ„ ๋ชจํ˜ธ์„ฑ์ด ๋ฐœ์ƒํ–ˆ๋‹ค. ์ •์ฑ…์ง‘ํ–‰ ์ˆ˜์ค€์ด ๊ธฐ์กด๋ณด๋‹ค ๊ฐ•ํ™”๋˜๋ฉด์„œ, ๋ถ€์ฒ˜ ๊ฐ„ ์—…๋ฌด ์ค‘์ฒฉ์œผ๋กœ ์ธํ•œ ๊ฐˆ๋“ฑ ์ˆ˜์ค€์€ ๋†’์•„์กŒ๋‹ค. ์ง‘ํ–‰ ์ธก๋ฉด์—์„œ ์ •์ฑ…๋ชฉํ‘œ ๊ณต๊ณ ํ™”๋ฅผ ์œ„ํ•œ ์—ฌ๋Ÿฌ ์ œ๋„๊ฐ€ ์‹ ์„ค๋˜์—ˆ์œผ๋‚˜ ์—ฌ์ „ํžˆ ์ง‘ํ–‰ ์ˆ˜์ค€์€ ๋ฏธ์•ฝํ•˜์˜€๋‹ค. ํ•œํŽธ ํšจ๊ณผ์ ์ธ ์ง‘ํ–‰์„ ์œ„ํ•ด ์ „๋ฌธ์„ฑ ๊ฐ•ํ™”๋ฅผ ์œ„ํ•œ ์ •์ฑ…์ˆ˜๋‹จ์ด ์‹œํ–‰๋˜์—ˆ์œผ๋ฉฐ, ์ด๋Š” ์ƒ์ง•์  ์ง‘ํ–‰์˜ ํŠน์„ฑ์— ๋ถ€ํ•ฉํ•œ๋‹ค. ๋ฐœ์ „๊ธฐ ๋™์•ˆ์—๋Š” ๋ถํ•œ ๋ฐ ์ด๋ž€์— ๋Œ€ํ•œ ๊ตญ์ œ์‚ฌํšŒ ์ œ์žฌ ๊ฐ•ํ™”์™€ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœ์ง€์›๊ธฐ๊ด€์˜ ์„ค๋ฆฝ์œผ๋กœ ์ •์ฑ… ๋ชจํ˜ธ์„ฑ์ด ํฌ๊ฒŒ ๋‚ฎ์•„์กŒ๋‹ค. ํ•˜์ง€๋งŒ ์ง‘ํ–‰์ด ๊ฐ•ํ™”๋˜๋ฉด์„œ ์ •๋ถ€์™€ ๊ธฐ์—…๊ฐ„์˜ ๊ฐˆ๋“ฑ์ด ์ ์ฐจ ๋†’์•„์ง€๊ณ  ์žˆ๋‹ค. ์ •์ฑ… ์ดํ•ด๊ด€๊ณ„์ž ๊ฐ„์˜ ๊ฐˆ๋“ฑ์ด ์‹ฌํ™”๋˜๋ฉด์„œ ๋ณด์ƒ์„ ํ†ตํ•ด ๊ฐˆ๋“ฑ์„ ํ•ด๊ฒฐํ•˜๊ณ ์ž ํ•˜๋Š” ์ •์น˜์  ์ง‘ํ–‰์ด ๋‘๋“œ๋Ÿฌ์กŒ๋‹ค. ํ•œ๊ตญ์˜ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ ์ •์ฑ…์ง‘ํ–‰ ๋ณ€๋™์— ๋Œ€ํ•œ ๋ถ„์„์€ ์ ์ฐจ ๋†’์•„์ ธ๊ฐ€๋Š” ์ •๋ถ€์™€ ๊ธฐ์—… ๊ฐ„์˜ ๊ฐˆ๋“ฑ์„ ์ฐธ์—ฌ์  ๊ฑฐ๋ฒ„๋„Œ์Šค๋ฅผ ํ†ตํ•ด ํ•ด๊ฒฐํ•  ํ•„์š”๊ฐ€ ์žˆ๋‹ค๋Š” ์‹œ์‚ฌ์ ์„ ์ œ๊ณตํ•œ๋‹ค. ๋‹ค๋งŒ ๋ณธ ์—ฐ๊ตฌ๋Š” ๋ชจํ˜ธ์„ฑ๊ณผ ๊ฐˆ๋“ฑ์˜ ์ˆ˜์ค€์„ ๊ฐ๊ด€์ ์œผ๋กœ ์ธก์ •ํ•˜๋Š”๋ฐ ํ•œ๊ณ„๋ฅผ ๊ฐ€์ง€๋Š” ๋ฐ”, ํ–ฅํ›„ ์—ฐ๊ตฌ์—์„œ๋Š” ์ธก์ • ์ง€ํ‘œ ๊ฐœ๋ฐœ ๋“ฑ์˜ ๋ณด์™„์ด ํ•„์š”ํ•  ๊ฒƒ์ด๋‹ค.์ œ1์žฅ ์„œ๋ก  1 ์ œ1์ ˆ ์—ฐ๊ตฌ์˜ ๋ชฉ์  1 ์ œ2์ ˆ ์—ฐ๊ตฌ๋ฒ”์œ„์™€ ๋ฐฉ๋ฒ• 2 1. ์—ฐ๊ตฌ์˜ ๋ฒ”์œ„ 2 2. ์—ฐ๊ตฌ์˜ ๋ฐฉ๋ฒ• 4 ์ œ2์žฅ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ์˜ ๊ฐœ์š” 6 ์ œ1์ ˆ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ๋ ˆ์ง์˜ ์˜์˜ 6 1. ์ „๋žต๋ฌผ์ž์˜ ๊ฐœ๋… 6 2. ๊ตญ์ œ์ˆ˜์ถœํ†ต์ œ๋ ˆ์ง์˜ ๋ฐœ์ „ 7 ์ œ2์ ˆ ํ•œ๊ตญ์˜ ์ˆ˜์ถœํ†ต์ œ์ œ๋„ ํ˜„ํ™ฉ 8 1. ์ œ๋„ํ˜„ํ™ฉ 8 2. ๊ด€๋ จ๋ฒ•๋ น ๋ฐ ์†Œ๊ด€๋ถ€์ฒ˜ 9 ์ œ3์žฅ ์ด๋ก ์  ๋ถ„์„ํ‹€ 12 ์ œ1์ ˆ ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  ๋ฐ ํ•œ๊ณ„ 12 1. ์„ ํ–‰์—ฐ๊ตฌ ๋ถ„์„ 12 2. ์‹œ์‚ฌ์  ๋ฐ ํ•œ๊ณ„ 14 ์ œ2์ ˆ Matland์˜ ๋ชจํ˜ธ์„ฑ-๊ฐˆ๋“ฑ ๋ชจํ˜• 15 ์ œ3์ ˆ ์ •์ฑ…ํ™•์‚ฐ ๋ฉ”์ปค๋‹ˆ์ฆ˜๊ณผ ์ •์ฑ…๋ชฉํ‘œ์˜ ๋ชจํ˜ธ์„ฑ 18 ์ œ4์ ˆ ์ •์ฑ…๊ฐˆ๋“ฑ๊ณผ ์กฐ์ •์™ธ๋ถ€ํšจ๊ณผ 20 ์ œ5์ ˆ ์†Œ๊ฒฐ 22 ์ œ4์žฅ ํ•œ๊ตญ์˜ ์ „๋žต๋ฌผ์ž ์ˆ˜์ถœํ†ต์ œ ์ •์ฑ…์ง‘ํ–‰ ๋ณ€๋™๊ณผ์ • 23 ์ œ1์ ˆ ์ˆ˜์šฉ๊ธฐ (1987๋…„-2002๋…„) 23 1. ๊ฐœ์š” 23 2. ๋ชจํ˜ธ์„ฑ ์ˆ˜์ค€ 24 3. ๊ฐˆ๋“ฑ ์ˆ˜์ค€ 31 4. ์ง‘ํ–‰ ํ˜„ํ™ฉ 34 5. ์†Œ๊ฒฐ 37 ์ œ2์ ˆ ๋„์•ฝ๊ธฐ (2003๋…„-2006๋…„) 38 1. ๊ฐœ์š” 38 2. ๋ชจํ˜ธ์„ฑ ์ˆ˜์ค€ 39 3. ๊ฐˆ๋“ฑ ์ˆ˜์ค€ 47 4. ์ง‘ํ–‰ ํ˜„ํ™ฉ 53 5. ์†Œ๊ฒฐ 56 ์ œ3์ ˆ ๋ฐœ์ „๊ธฐ (2007๋…„-2016๋…„) 60 1. ๊ฐœ์š” 60 2. ๋ชจํ˜ธ์„ฑ ์ˆ˜์ค€ 61 3. ๊ฐˆ๋“ฑ ์ˆ˜์ค€ 65 4. ์ง‘ํ–‰ ํ˜„ํ™ฉ 75 5. ์†Œ๊ฒฐ 77 ์ œ5์žฅ ๊ฒฐ๋ก  82 ์ œ1์ ˆ ๋ถ„์„๊ฒฐ๊ณผ ์š”์•ฝ 82 ์ œ2์ ˆ ์—ฐ๊ตฌ์˜ ์‹œ์‚ฌ์ ๊ณผ ํ•œ๊ณ„ 83 1. ์‹œ์‚ฌ์  83 2. ํ•œ๊ณ„ 85 ์ฐธ๊ณ ๋ฌธํ—Œ 87 ๋ถ€๋ก 98 Abstract 99Maste

    Combined Intrathoracic and Intraperitoneal Splenosis after Splenic Injury: Case Report and Review of the Literature

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    Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.ope

    Sarcoidosis Presenting with Massive Pleural Effusion and Elevated Serum and Pleural Fluid Carbohydrate Antigen-125 Levels

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    A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.ope

    Prognostic Implications of Serum Lipid Metabolism over Time during Sepsis

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    BACKGROUND: Despite extensive research and an improved standard of care, sepsis remains a disorder with a high mortality rate. Sepsis is accompanied by severe metabolic alterations. METHODS: We evaluated 117 patients with sepsis (severe sepsis [n = 19] and septic shock [n = 98]) who were admitted to the intensive care unit. Serum cholesterol, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), free fatty acid (FFA), and apolipoprotein (Apo) A-I levels were measured on days 0, 1, 3, and 7. RESULTS: Nonsurvivors had low levels of cholesterol, TG, HDL, LDL, and Apo A-I on days 0, 1, 3, and 7. In a linear mixed model analysis, the variations in TG, LDL, FFA, and Apo A-I levels over time differed significantly between the groups (p = 0.043, p = 0.020, p = 0.005, and p = 0.015, resp.). According to multivariate analysis, TG levels and SOFA scores were associated with mortality on days 0 and 1 (p = 0.018 and p = 0.008, resp.). CONCLUSIONS: Our study illustrated that TG levels are associated with mortality in patients with sepsis. This may be attributable to alterations in serum lipid metabolism during sepsis, thus modulating the host response to inflammation in critically ill patients.ope

    ํ•œ๊ตญ ๊ตญ๋ฏผ๊ฑด๊ฐ•์˜์–‘ ์กฐ์‚ฌ๋ฅผ ํ† ๋Œ€๋กœํ•œ ํ๊ธฐ๋Šฅ๊ณผ ๊ณจ๋ฐ€๋„์˜ ์ƒ๊ด€๊ด€๊ณ„

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    Dept. of Medicine/์„์‚ฌBackground: Osteoporosis is common in chronic obstructive pulmonary disease (COPD) patients. The relationship between osteoporosis and COPD has been primarily reported in patients with moderate to severe COPD, but there is no report in the general population. The aim of this study is to investigate the relationship between bone mineral density (BMD) and lung function in the general Korean population. Methods: This study was based on data acquired from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES IV and V), conducted from 2008 to 2010. The study population included 4,501 subjects (aged โ‰ฅ50 years) who underwent both spirometry and BMD. The study populations were divided into two groups by sex to correct for the effects of gender on BMD. Results: The participants included 2100 (46.7%) males and 2401 (53.3%) females. All female participants were postmenopausal women. For both genders, the BMD of the femur neck, total femur, and L-spine correlated significantly with age, body mass index (BMI), fat free mass index (FFMI), body fat percentage, smoking amount, parathyroid hormone levels(PTH), daily calcium and phosphorus intake, alkaline phosphatase levels (ALP), and FEV1/FVC by simple linear analysis. After adjusting for age, BMI, FFMI, body fat percentage, smoking amount, serum 25(OH) levels, daily calcium and phosphorus intake, ALP, BMD of the femur neck, total femur, and Lumbar spine in both males and females were reduced significantly as age, and ALP levels increased. There were no correlations between BMD and severity of airway obstruction. Conclusion: In the general population, diminution of BMD does not lower pulmonary function. Further work including other factors is needed to determine the possible role of BMD in pulmonary function.ope

    Biochemical characterization of acharan sulfate binding proteins associated with anticoagulation in human plasma

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    Thesis (master`s)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์ œ์•ฝํ•™๊ณผ ์ฒœ์—ฐ๋ฌผ๊ณผํ•™์ „๊ณต,2004.Maste

    Causal commit protocol and replication for distributed main memory database systems

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