간절제술 후 담관-대장 누공은 매우 드물게 나타나는 합병증으로 알려져 있다. 저자들은 73세 여성에서 간절제술을 시행한 후 발생한 담즙종에 대하여 반복적인 담도 배액술 치료 중 내시경적 역행성 췌담도 조영술을 통하여 우연히 담관-대 장 누공을 발견하였고, 이를 내시경적으로 대장 클립 거치를 통하여 치료에 성공하였던 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

IgG4 연관 질환은 다양한 조직의 섬유 경화성 반응과 연관되어 IgG4 양성의 형질세포와 임파구가 침착되는 염증 반응을 특징으로 하는 전신 침범 자가면역 질환이다. 이 중 IgG4 연관 경화성 담관염은 IgG4 연관 질환의 담관 침범을 말한다. IgG4 연관 경화성 담관염에 대한 대부분의 증례 보고는 단기간의 임상 경과만을 보고하였고 이 단기간의 경과의 대부분은 스테로이드 치료 후 담도 협착과 황달의 호전을 보였다. IgG4 연관 경화성 담관염의 장기적 예후와 자연 경과는 아직 잘 보고되지 않았으며 국내에서는 아직까지 IgG4-SC 환자가 간경변으로 진행되었다는 보고는 없다. 저자들은 IgG4-SC 환자가 제대로 치료를 받지 않고 오랜 시간 지났을 때 자연 경과로서 비대상성 간경변으로 진행하고 더 이상 스테로이드에 반응하지 않은 1예를 경험하여 문헌고찰과 함께 보고하는 바이다.

Today, environmental pollution has been found to be one of the causes of various diseases, including brain and nervous system diseases. In particular, neurodegenerative diseases have been found to be caused by hyperactivation of immune system cells such as microglia. Preventive and therapeutic measures are needed to suppress them. Hirudo is known as a traditional herbal medicine, based on its multiple biological activities such as anti-eczema and anti-coagulation. In the present study, the anti-neuroinflammatory potential of hirudo extract was investigated in lipopolysccharide (LPS)-stimulated BV2 microglial cells and in mice. Hirudo extract significantly inhibited LPS-stimulated nitric oxide (NO) production and cytokine (IL-1Ra, KC, MCP-5, and RANTES) expression in a dose-dependent manner without causing cytotoxicity. Pretreatment with hirudo extract suppressed LPS-induced NF-κB p65 nuclear translocation. Moreover, hirudo extract reduced LPS-stimulated microglial acitivation and improved memory impairments. The results demonstrated that hirudo extract exerts anti-neuroinflammation activities, partly through inhibition of the NF-κB signaling pathway. These findings suggest that hirudo extract might have therapeutic potential with respect to neuroinflammation and neurodegenerative diseases.

Purpose: The contextual interference effect is a theory crucial for explaining the importance of efficient practice and its application in the field, and representative hypotheses on the theory are elaboration hypothesis and reconstruction hypothesis. as the recent studies on contextual interference by Lin et al. (2008, 2009, 2010) and Cross et al. (2007) support different hypotheses, this study purposed to examine the time point and tasks of interest in order to compare the result of the two hypotheses Methods: The subjects were 36 right‐handed male and female adults aged between 19 and 32, and they were divided into two groups (n=18 each) at random according to practice condition (blocked practice/random practice). In each group, 9 subjects were given transcranial magnetic stimulation(TMS) before task performance and the other 9 were given TMS after task performance. In the test, key pressing response time was used, and each group had the acquisition phase (1st day), and retention test and transfer test (2nd day), and then response time measurements were analyzed statistically Results: When TMS was given after task performance in the acquisition phase, the performance level was lower in the blocked practice group, but in the retention test when TMS was given before task performance the stimulation hindered the random practice group’s learning and lowered its performance level and consequently the contextual interference effect did not occur. Conclusion: After task performance in the acquisition phase, the information process occurs between tasks in the resting phase, and at the same time, the information process occurs in the preparation phase before task performance and affects learning. Accordingly, both the retention phase before task performance suggested by the reconstructive hypothesis and the resting phase after task performance suggested by the elaboration hypothesis can be the time points when contextual interference occurs between tasks, and therefore it is concluded that the reconstructive hypothesis and elaboration hypothesis may coexist with each other.