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- 저자 : 공지현 ( Jee Hyun Kong ) (검색결과 5 건)
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증례 : 그레이브스씨병(Graves` disease) 환자에서 수질암(medullary thyroid carcinoma)이 동반된 1예
공지현 ( Jee Hyun Kong ),김철식 ( Chul Sik Kim ),조민호 ( Min Ho Jo ),안철우 ( Chul Woo Ahn ),김경래 ( Kyung Rae Kim ),장항석 ( Hang Seok Jang ),홍순원 ( Soon Won Hong ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
본 저자들은 54세 여자 환자가 그레이브스씨병으로 치료받던 중 발견된 갑상선 결절을 주소로 내원하여, 수질암으로 전갑상선절제술 및 중앙경부림프절 절제술을 시행받은 증례를 경험하였기에 문헌보고와 함께 보고하는 바이다. It is believed that Graves` disease is associated with an increased prevalence of thyroid carcinoma, but the reported incidence is variable, ranging between 0% and 9.8% generally of differentiated thyroid carcinoma type. The majority of thyroid carcinomas in patients with Graves` disease are papillary, followed in frequency by follicular carcinoma. Medullary thyroid carcinoma in combination with Graves` disease appears to be very rare. To our knowledge, only 11 cases have been described in which medullary thyroid carcinoma associated Graves` disease and all of them, at foreign countries. So we experienced medullary thyroid carcinoma associated Graves` disease, we report this case with review of literature. (Korean J Med 69:S851-S855, 2005)
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성재호 ( Jae Ho Seong ),김현식 ( Hyun Sik Kim ),강용석 ( Yong Seok Kang ),하성삼 ( Seung Sam Ha ),남승완 ( Seoung Wan Nam ),박정은 ( Jeong Eun Park ),한용재 ( Yong Jae Han ),공지현 ( Jee Hyun Kong ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
Unlike most animals, humans are unable to synthesize vitamin C and dependent on vitamin C from vegetables or fruits. Vitamin C deficiency may lead to hyperkeratosis of hair follicles, gingivitis, anemia, arthritis, general fatigue, and depression, and may cause bleeding within the soft tissues. The diagnosis of scurvy can often overlooked because it is rarely encountered in present-day society. A 54-year-old male admitted hospital because of right leg pain due to huge hematoma. He had no trauma and medication history. He`s been unemployed, and rarely eating vegetable and fruit for decades. We could see huge painful hematoma of right thigh. Erythematous and swollen gingiva was also noted. His coagulation profiles were within normal limits. However his blood cell count, the concentration of vitamin C and folate were low. As we diagnosed as scurvy, we supplied vitamin C and folic acid to him. This treatment leads to rapid reversal of scorbutic changes. Scurvy should be considered as a differential diagnosis in the setting of hemorrhagic disease, and detailed history taking is necessary. Along with literature review, we report a case of scurvy accompanied by pancytopenia whose clinical and hematologic symptoms improved with administration of vitamin and folic acid.
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이태희 ( Tae Hee Lee ),정준표 ( Jun Pyo Chung ),윤동섭 ( Dong Sup Yoon ),공지현 ( Jee Hyun Kong ),김수영 ( Soo Young Kim ),추적금 ( Juck Kum Chu ),최성우 ( Sung Woo Choi ),송시영 ( Si Young Song ),정재복 ( Jae Bock Chung ),이상인 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Adenosquamous carcinoma of the pancreas is a rare but particularly virulent variant of invasive ductal carcinoma. In Korea, total 4 cases of adenosquamous carcinoma of the pancreas have been reported. Adenosquamous carcinoma of the pancreas has a slight m
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정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구
조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5
목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.
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