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장현,김동영,이철희,민양기,이재서,한두희,김정훈,모지훈 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.3
Objectives. Sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment for allergic rhinitis. This study aimed to investigate the efficacy and adverse effects of SLIT in Korean patients with allergic rhinitis caused by house dust mites. The treatment compliance and the patient satisfaction with SLIT were also assessed. Methods. The patients who were sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farinae and who started SLIT between November 2007 and July 2008 were included in this study. The symptom questionnaires, which included items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance, were obtained before and 6 months after SLIT. The patient satisfaction and the adverse effects were also investigated. Results. One hundred forty-two patients started SLIT and 98 of them continued SLIT for 6 months or more. Ninety-two of the 98 patients completed the questionnaires. The duration of receiving SLIT was 9.8 months on average (range, 6 to 13 months). All the symptoms of allergic rhinitis were improved with SLIT. Forty-five percent of the patients were satisfied for SLIT, while 12% were unsatisfied. The incidence of adverse effects was 12% during maintenance therapy, although it was 48% during the up-dosing phase. The drop-out rate of SLIT was 31.0%. Conclusion. The subjective symptoms were improved with SLIT in Korean patients with allergic rhinitis for house dust mites. Yet the drop out rate was high despite of the symptomatic improvement.
Picibanil 경화요법을 이용한 경부절제술 후 발생한 난치성 유미유출의 치료 1예
장현,안영진,성명훈,김광현 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.9
Injury of the thoracic duct after radical neck dissection is a well known complication that occurs in about 2% of patients who undergo radical neck dissection. Subsequent chyle leakage can cause complications such as skin flap necrosis, orocutaneous fistula, electrolyte imbalance and protein loss. Chyle leakage is managed conservatively with total parenteral nutrition and mediumchain triglyceride diet or is treated surgically with leakage site ligation or thoracic duct ligation. Sclerotherapy can be one of the treatment options and tetracycline and povidone-iodine have been reported to be used as sclerosing agents. However, Picibanil sclerotheray for post-neck dissection chyle leakage has not been reported. This paper presents our experience in the management of a intractable chyle leakage which was irresponsive to conservative management and thoracic duct ligation, by successfully employing Picibanil. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:846-9)
흡인을 동반한 일측성 성대마비 환자에서 일시적 성대주입술의 역할
장현,안영진,임윤성,하정훈,성명훈,김광현,권택균 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.3
Background and Objectives:We evaluated the role of temporary injection laryngoplasty in patients with unilateral vocal fold paralysis (UVFP) after cardiothoracic surgeries. Subjects and Method:Taking the introduction of injection laryngoplasty as a milestone, we divided patients into those who underwent cardiothoracic surgery with UVFP during the years 2001-2004, before the introduction of injection laryngoplasty as pre-injection group (n=83) and those who underwent after the introduction during the years 2000-2007 as post-injection group (n=103). Of the post injection group, patients who received injection laryngoplasty postoperatively before being discharged were defined as injection group (n=37). Patients were also divided into non-esophageal surgery group and esophageal surgery group. Clinical outcomes including the length of hospital stay and oral feeding initiation time were compared between the pre-injection group and the injection group within the same operation group. The degrees of aspiration were classified into 4 grades. Results:In the non-esophageal surgery group, the injection group with aspiration grade III had shorter hospital stay and oral feeding initiation time after extubation compared to the pre-injection group with grade III aspiration (p=0.042). However, in the esophageal surgery group, there was no statistical difference between the pre-injection and injection groups. Conclusion:Temporary injection laryngoplasty can reduce the hospital stay and enhance oral feeding initiation in patients with aspiration due to UVFP after non-esophageal cardiothoracic surgeries.
장현,정준원,한지숙 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.5
Autologous stem cell transplantation (ASCT) is commonly used in relapsed or refractory non-Hodgkin's lymphoma (NHL). Several trials report the role of ASCT for high risk patients. We evaluated the results and the prognostic factors influencing the therapeutic effects on the patients who were treated with high dose chemotherapy (HDC) and autologous peripheral stem cell transplantation. We analyzed the data of 40 cases with NHL who underwent ASCT after HDC. Twenty- four patients had high-risk disease, 12 cases sensitive relapse, and two cases resistant relapse or primary refractory each. The median age of patients was 34 years (range, 14-58 years). The median follow-up duration from transplantation was 16 months (range, 0.6-94 months). Estimated overall survival and progression-free survival at 5 years were 40% and 30%, respectively. Poor prognostic factors for survival included older age (≥45 years), poor performance status in all patient analysis, and a longer interval between first complete remission and transplantation in high risk patients. In high risk NHL patients, transplantation should be done early after first complete remission to overcome chemo-resistance.
Study on Hyunpil Lee's Spirituality and Figures That Influenced His Spirituality
장현 한국실천신학회 2011 신학과 실천 Vol.0 No.29
The purpose of this research is to provide implications for Christians who pursue spirituality that concurs with faith and lifestyle by probing into the life and spirituality of Hyunpil Lee, who is representative of Christian spirituality in the Honam area, and studying the people who influenced him Lee’s spirituality can be represented by nobleness, purity, martyrdom; he wished to follow the life of Jesus and he was most influenced by Sejong Lee. Heungjong Choi, Hyunbong Kim, Youngmo Yoo were also his mentors; Dongwan Hyun, Codington were Lee’s sharers in practicing love. In Lee’s teens, Naechongamsam led him to church, and nobleness, purity, martyrdom was enrooted by Sejong Lee. During his 20s, Heungjon Choi and Hyunbong Kim greatly influenced on Lee’s life direction and patterns of behavior. In his 30s and 40s, Lee became companions with Youngmo Yoo, who influenced more of Lee’s disciples while Dongwan Hyun and Codington were companions with Lee in sharing love. Other figures such as Soonmyung Kang, Sepyung Seo, Inse Jung, Bukwhan Oh, Choonsung Baek, Gyungsun Won also had an impact on Lee’s life. Hyunpil Lee’s life and community management principles were influenced by the above figures, especially Sejong Lee and Youngmo Yoo’s introvert self‐examination principle composes the primary principle. On the other hand, Heungjong and Codington’s outer self‐examination composes the secondary principle. Also, in the base, there is the grand proposition in concurrence of religion in the pattern of Naechongamsam and lifestyle.