Campath-1H로 치료한 T 세포 전림프구성 백혈병 1예

신성훈 ( Seong Hoon Shin ),김양수 ( Yang Soo Kim ),김미향 ( Mi Hyang Kim ),안지현 ( Ji Hyun Ahn ) 대한내과학회 2008 대한내과학회지 Vol.74 No.1S

아동의 자세제어

심성현(Sim, Seong-Hyeon),신성훈(Shin, Sung-Hoon) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.2

The purpose of this study is to primarily investigate the effect of aging and task constraints to the postural control during quiet standing and ankle pivoting. Total 64 children (girls and boys) participated in this study. They conducted 1) a quiet standing and 2)a pivot task in which participants leaned forward, backward, side to side, and diagonally by their whole body at ankle joint without losing balance. Mean distance, sample entropy and fractal dimension were calculated to examine the postural dynamics. Overall results demonstrated that middle childhood(ages 8-11) had greater mean sway distance than early adolescence(ages 11-14) and middles adolescence(ages 15-18) in AP direction. However, middle childhood(ages 8-11) had a larger sample entropy and fractal dimension than early adolescence(ages 11-14) and middles adolescence(ages 15-18) in pivoting. This finding supported the loss of adaptability hypothesis in that the postural dynamics depends not only on aging but also on the task constraints. Further investigation is required to clearly understand the effect of the sex, fat rate, muscle strength etc in postural control in children.

호스피스·완화의료에 대한 인식 및 지식 그리고 죽음에 대한 태도: 일개 지역에서의 의료인을 대상으로

이영은,최은정,박정숙,신성훈,Lee, Young Eun,Choi, Eun Joung,Park, Joung Suk,Shin, Seong Hoon 한국호스피스완화의료학회 2013 한국호스피스.완화의료학회지 Vol.16 No.4

목적: 본 연구는 의료인의 호스피스 완화의료에 대한 인식 및 지식과 죽음에 대한 태도 정도를 파악하고자 하는 것이다. 방법: 대상자는 B광역시 소재하는 의사 84명, 간호사 172명으로 총 256명을 대상으로 실시하였고, 자료수집기간은 2012년 4월 5일부터 동년 4월 30말까지 실시되었다. 결과: 호스피스 완화의료에 대한 목적에 대한 인식에서는 의사와 간호사 모두 '호스피스가 질병으로 더해오는 통증을 완화시켜주고 편안을 도모한다'는 항목에 가장 높게 인식하고 있는 것으로 나타났고, 호스피스 완화의료에 대한 필요성에 대한 인식에서는 의사와 간호사 모두 '말기 환자는 감정의 변화를 많이 겪는다' 라는 항목이 가장 높게 나타났다. 호스피스 완화의료에 대한 지식은 두 군 다 낮게 나타났고, 하위영역에서는 '통증과 증상관리'에서 두 집단 간 차이가 있었으며, 의사가 간호사보다 지식이 더 높은 것으로 나타났다(의사: $6.97{\pm}1.82$, 간호사: $5.68{\pm}1.93$, P<0.001). 죽음에 대한 태도는 두 집단 간에 통계적으로 유의한 차이는 없었다. 결론: 본 연구의 결과를 통해서 의료인의 호스피스 완화의료의 인식 및 지식의 향상과 죽음에 대한 자신의 태도를 정립할 수 있도록 돕는 교육프로그램의 개발이 마련될 것을 제안한다. Purpose: The purpose of this study was to examine medical professionals' perception and knowledge of hospice and palliative care (HPC) and attitude toward death. Methods: The survey was performed on 84 physicians and 172 nurses in Busan, Korea. Data were collected from April 5, 2012 to April 30, 2012. Results: Regarding the purpose of HPC, the most popular perception was "To alleviate pain and accommodate comfort" among both physicians and nurses. For the need for HPC, "Terminal patients need a separate ward for emotional fluctuation" the answer chosen by both groups the most. Both groups scored low on knowledge of HPC. For pain and symptom management, physicians scored higher than nurses (physicians: $6.97{\pm}1.82$, nurses: $5.68{\pm}1.93$, P<0.001). Conclusion: Considering the survey results, we suggest development of a program to improve medical professionals' perception and knowledge of HPC and attitude toward death.

증례 : 혈액종양 ; 조혈모세포이식 후에 만성 이식편대 숙주반응과 동반된 종격동 기종 1예

이호섭 ( Ho Sup Lee ),신성훈 ( Seong Hoon Shin ),김양수 ( Yang Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.6

조혈 모세포이식을 시행한 이후에 호흡기계 부작용은 다수에서 발생한다고 보고되고 있으며, 그 중에서도 만성 GVHD와 병발하는 비감염성 호흡기계 부작용에는 폐색성모세기관지염, 기질화 폐렴을 동반한 폐색성모세기관지염 등이 있다. 그 중에서 폐색성모세기관지염은 만성 GVHD와 관련이 깊고, 이들이 동시에 발생하는 경우 종격동기종과 피하기종 등의 치명적인 부작용들이 나타날 수 있다. 저자들은 조혈모세포이식 이후에 만성 GVHD와 병발하여 발생한 비감염성 호흡기계 부작용 중의 하나인 종격동기종과 피하기종의 드문 1예를 경험하였기에 보고하는 바이다. Pulmonary complications are very common after allogeneic stem cell transplantation and are sometimes serious. Late-onset noninfectious pulmonary complications of chronic graft-versus-host disease (GVHD) after allogeneic stem cell transplantation include bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia. Especially, bronchiolitis obliterans is correlated with GVHD. If they occur simultaneously, serious pulmonary and subcutaneous complications such as pneumomediastinum, subcutaneous emphysema, and pneumothorax can occur. We present the case of a 19-year-old man who had pneumomediastinum, subcutaneous emphysema, and pneumothorax with GVHD after allogeneic stem cell transplantation. (Korean J Med 77:787-792, 2009)

항암화학요법에 의한 말초신경병증의 봉독크림 치료: 연속증례

박병록 ( Byung Rok Park ),김종민 ( Jong Min Kim ),조종관 ( Chong Kwan Cho ),신성훈 ( Seong Hoon Shin ),유화승 ( Hwa Seung Yoo ) 대전대학교 한의학연구소 2014 한의학연구소 논문집 Vol.22 No.2

Objective : This is a case series reporting degree of response to bee venom ointment as a symptom-control therapy for chemotherapy-induced peripheral neuropathy (CIPN). Methods : Four consecutive patients with CIPN were referred to the East-West Cancer Center from October 7th, 2013, to November 9th, 2013. Patients with CIPN were treated with bee venom ointment 1-2 times per day for 7-25 days. Visual Analog Score (VAS) pain scale was compared before and after treatment. All patients were closely examined for any allergenic responses following each treatment session. Results : Using each patient as their own comparator, marked improvements of VAS were observed in 4 patients. Most important, there were no related adverse side effects found. Conclusion : Bee venom Ointment may be considered as an complementary therapy for managing CIPN symptoms.

증례 : 혈액종양 ; 피부와 안구침범을 동반한 NK/T세포림프종 1예

이호섭 ( Ho Sup Lee ),이상민 ( Sang Min Lee ),신성훈 ( Seong Hoon Shin ),김양수 ( Yang Soo Kim ),김미향 ( Mi Hyang Kim ),김태원 ( Tae Won Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1S

철도건널목 정시간 제어방식 개발 및 효과분석에 관한 연구

박동주(Dongjoo Park),오주택(Ju-Taek Oh),이선하(Sun-Ha Lee),정천희(Chun-Hee Jung),신성훈(Seong-Hoon Shin) 한국철도학회 2005 한국철도학회논문집 Vol.8 No.2

R-CHOP으로 치료한 HIV 연관 위 비호즈킨 림프종 1예

신성훈 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

국내에서는 AIDS와 연관된 림프종 발생이 총 8례 보고 되었고 위에서 발생한 증례가 있기는 했지만 수술 치료가 주된 치료로 시행되었다. 저자는 AIDS 환자에서 발견된 위의 CD 20 표면 항원 양성인 미만성 거대 B 세포성 림프종 증례를 경험하였고 복합 항암 화학요법 R-CHOP(rituximab, cyclophosphamide, adriamycin, vincristine, prednisone) 치료에 대해 완전 반응을 보였기에 증례를 보고하고 관련 문헌을 고찰하였다. Human immunodeficiency virus (HIV) infection is a risk factor for developing non-Hodgkin's lymphoma. The AIDS (acquired immune deficiency syndrome) related lymphomas increase as patients live longer with highly active antiretroviral therapy and effective prophylaxis of opportunistic infections. Lymphoma is the secondary most common tumor in HIV-infected individuals and a late manifestation of HIV infection, generally occurring in patients with CD4+T cell counts less than 200/microliter. AIDS-related lymphomas were explained as variably associated with EBV infection, dysfunction of T cells, and HIV itself. Most AIDS related lymphomas are high-grade B cell non-Hodgkin's lymphomas. We report a case of AIDS-related diffuse large B cell non-Hodgkin's lymphoma treated by R-CHOP (Rituximab, Cyclophosphamide, Adriamycin, Vincristine, Prednisone). The patient was presented with epigastric pain and discomfort sensation. He was diagnosed as diffuse large B cell lymphoma by histologic and immunohistochemical study. After 3 cycle of R-CHOP regimen, complete response was attained.

Cerivastatin과 Cyclosporine을 병용 투약한 신이식 환자에서의 횡문근융해증 1예

신성훈,김민대,강승수,김찬욱,이지영,엄재섭,권성일,김길수,정연순,임학 고신대학교 의학부 2002 高神大學校 醫學部 論文集 Vol.17 No.1

Cerivastatin, a kind of statins, is a recently used lipid-lowering drug. which inhibits of hydroxymethylglutarate coenzyme A (HMG-CoA) reductase. The serum concentrations of statins in healthy volunteers are increased by the simultaneous administration of cyclosporine, itraconazole, as well as erythromycin and verapamil and increased risk of myalgia and rhabdomyolysis has been reported after concomitant use of HMG-CoA reductase inhibitors with these drugs. A 57-year-old female kidney transplant recipient admitted because of a dark urine, myalgia and weakness of extremities. Six weeks before admission, the patient has taken cerivastatin 0.3mg daily. Cyclosporine, prednisolone and mycophenolate mofetil were maintained for recent two years. Initial laboratory data showed serum creatinine 1.1mg/dl, AST 235 IU/L, LDH 2,465 IU/L, CPK 1600 IU/L, myoglobin >3,000 ng/ml and cyclosporine 288ng/ml (TDX). Medication of cerivastatin was discontinued, and the patient recovered rapidly with supportive therapy. After eighteen weeks of cerivastatin withdrawal. the drug was represcribed to control the increased lipid levels. The patient showed the same clinical manifestations suggesting rhabdomyolysis following eight weeks of cerivastatin administration. We report a case of rhabdomyolysis associated with cerivastatin and cyclosporine combination therapy in a kidney transplant recipient.

Clopidogrel 복용 중 발생한 혈전성 혈소판 감소성 자반증 1예

신성훈 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Clopidogrel은 드물지만 혈전성 혈소판 감소성 자반증(TTP)를 유발할 수 있는 것으로 알려져 있다.1,2,4,6) 미국내 TTP의 발생 빈도는 매년 백만명 당 3.7명 정도로 보고되고 있고 경피적 관상동맥 중재술 시행 환자 중에는 0.02–0.06%에서 발생하는 것으로 보고되고 있다.1,2,4,6) 저자는 뇌혈관 폐쇄 질환으로 clopidogel을 복용해 오던 환자에서 미세 혈관병 용혈 빈혈 (microangiopathic hemolytic anemia) 급성 신부전, 혈소판 감소에 의한 출혈소견, 의식 장애 발생하여 혈전성 혈소판 감소성 자반증(TTP)으로 진단하고 혈장 교환술, 면역글로불린 치료 시행 후 호전된 증례 1예를 경험하였기에 보고한다. 호전 이후 다른 종류의 항 혈소판제 사용하였으나 특별한 부작용 관찰되지 않았다. thienopyridine에 의해 야기되는 TTP의 경우 약제별(ticlopidine, clopidogrel)로 발생 기전이 다른 것으로 보고되고 있어 반드시 thienopyridine계의 사용이 불가피한 경우는 다른 종류의 약제로의 변경도 고려해 볼 수 있으리라 생각된다.1,2,4,6) Thrombotic thrombocytopenic purpura (TTP) is an extremely rare and life-threatening condition, which is characterized by microangiopathic hemolytic anemia, acute renal failure, fever and changes in mental status. Pregnancy, toxins, malignancy, antineoplastic agents and thienopyridines (clopidogrel and ticlopidine) are known to precipitate it. Clopidogrel, a widely used antiplatelet agent, has been rarely reported to cause TTP. We report a case of clopidogrel-induced TTP. An 81 year old male patient suffered an acute ischemic stroke. Clopidogrel (75mg) was started daily and the platelet count was normal on the 2nd and the 22th day of its administration. On the 45th day, he showed thrombocytopenic purpura and stuporous mentality. Under the diagnosis of TTP, a plasma exchange was performed and his condition eventually returned to normal platelet count and normal mental status.