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만성 C형 간염의 약물 치료와 연관된 구강 내 색소 침착의 치험례
김영건,안형준,최종훈,권정승,Kim, Young Gun,Ahn, Hyung-Joon,Choi, Jong-Hoon,Kwon, Jeong-Seung 대한안면통증구강내과학회 2012 Journal of Oral Medicine and Pain Vol.37 No.4
구강내의 다발성 색소침착은 애디슨증후군, 포이츠-예거 증후군과 같은 선천성질환에 의하여 유발되거나, 악성 흑색종, 흑색극세포종, 신경섬유종증과 같은 국소적인 질환, 흡연, 만성 외상, 약물 복용 등에 의해서 유발될 수 있다. 이러한 질환 중 악성흑색종과 같은 질환은 생명을 위협할 수 있는 질환이므로 구강 내 색소 침착이 발견될 경우 정확한 진단이 필수적이다. 이러한 병소의 정확한 감별 진단을 위해서는 구강 내 색소 침착을 유발할 수 있는 원인에 대해서 숙지하고 있어야 하며, 상세한 병력 청취가 중요하다. 또한, 필요 시 혈액검사를 비롯한 이화학검사를 시행하거나 생검을 통하여 조직병리학적인 소견을 확인하고, 주기적으로 환자의 임상 소견에 대한 평가를 시행하여 변화를 확인하여야 한다. 그 동안 일반적으로 색소 침착을 유발하는 것으로 알려졌던 약물 외에, 만성 C형 간염 환자에서 페그인터페론 알파와 리바비린의 병용 요법 중 발생한 구강 내 다발성 색소 침착 증례가 있어 문헌 상에 보고되었던 만성 C형 간염 환자의 약물치료와 연관된 구강 내 색소 침착의 증례들과 함께 고찰해 보고자 한다. Oral pigmentation has numerous etiologies. It can be associated with congenital diseases and syndromes, certain acquired diseases, and systemic medications. Pigmented lesions caused by serious disease such as melanoma should be diagnosed correctly, because it would be fatal. For appropriate differential diagnosis, clinicians should know about the etiologies causing oral pigmentation and take patients history carefully. Biopsies would be necessary for histopathological findings. Close follow up for clinical symptoms are also necessary. In this case report, we presented a case of oral hyperpigmentation in Asian patient who was receiving pegylated interferon and ribavirin combination therapy for hepatitis C virus infection.
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김영건,Kim, Yeong-Geon 사단법인 한국당뇨협회 2007 당뇨 Vol.212 No.-
당뇨병은 발병 후 거의 완치가 불가능한 질환으로 당뇨병의 치료는 고혈당에 의한 증상을 개선, 여러 가지 급성 및 만성합병증을 예방하는 데 그 목적이 있다. 당뇨병 조절 및 합병증 연구 등에서 엄격한 혈당조절을 통해 당뇨병의 만성합병증이 예방되거나 이미 발생된 합병증도 진행이 지연됨이 알려졌으며, 이에 따라 지속적인 혈당조절의 필요성이 더욱 중요해지고 있다. 지속적인 혈당조절을 위한 당뇨병관리의 기준이 되는 지표에는 여러 가지가 있지만 그 대표적인 것으로 공복혈당, 식전혈당. 식후 2시간 혈당, 당화혈색소 등이 있다. 환자들은 어떤 검사가 나의 혈당변화를 가장 정확히 나타내 주는지 궁금할 때가 있다. 또한 혈당검사를 하루 중 언제 측정해야 가장 정확하고, 얼마나 측정해야 하는지도 궁금하다. 여기서는 혈당조절의 지표가 되고 합병증 예방의 가장 기초가 되는 검사의 종류와 검사 시기, 빈도를 알아보고자 한다.
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김영건,조규송 ( Young Geon Kim,Kyu Song Cho ) 한국하천호수학회 1995 생태와 환경 Vol.28 No.2
This study was performed to investigate the environmental factors and the zooplankton communuty in Lake Soyang from Jan. to Dec. 1990. The ranges of concentration variation of water environmental conditions in Lake Soyang were as follow; 5.0∼29.1˚C for water temperature, 0.1∼98. Omg/m^3 for chlorophyll a, 6∼llmg/l for dissolved oxygen, 6.6∼9.6 for pH and 0.6∼4.5m for transparency. The zooplankton community was composed of 63 species, 39 genera, 21 families, 6 orders, 4 classes, 4 phylums. The characteristic species of this area were filinia longiseta, Tintinnopsis cratera, Leptodora kindtii, Bosminopsis deitersi, and Conochiloides coenobasis that these species were appeared specific times. Dominent species were Peridinium sp., Ceratium hirundinella, Pompholyx complanata, Conochilus unicornis, Keratella cochlearis. Variation of vertical and seasonal distribution of individual number and species were affected by dissolved oxygen and water temperature.
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김선영(Sun Young Kim),김진희(Jin Hee Kim),이경태(Kyung Tae Lee),이승민(Seung Min Lee),김석현(Seok Hyun Kim),이병석(Byung Seok Lee),김남재(Nam Jae Kim),정현용(Heon Young Jeong),이헌영(Heon Young Lee),김영건(Young Kun Kim) 대한내과학회 1999 대한내과학회지 Vol.56 No.5
N/A Objective : Eradication of H. pylori not only results in ulcer healing, but reduces recurrences essentially curing peptic ulcer disease. The purpose of this study was to evaluate the eradication rate of H. pylori and side effects with regard to three drug regimens. Methods : 96 patients were included and divided into three groups: 14 patients(group 1: OA) received omeprazole(20 mg b.i.d.) and amoxicillin(1.0 gm b.i.d.) for 14 days ; 12 patients (group 2: BAM) received colloidal bismuth subcitrate(CBS)(120 mg b.i.d.), amoxicillin(500 mg q.i.d.) and metronidazole(250 mg q.i.d.) for 14 days. ; 70 patients(group 3: OAC) received omeprazole(20 mg b.i.d.), amoxicillin(500 mg q.i.d.) and clarithromycin(250 mg q.i.d.) for 10 days. The diagnosis of the status of H. pylori was made by histology or culture or rapid urease test(CLO test). Results : 1) The eradication rate of H. pylori was higher group 2(91.7%) and group 3(91.4%) than group 1(57.1%). 2) The total failure rate regardless of the regimens (n=96) was 13.5%(13 patients). 10 patients whose treatment failed were randomly assigned to receive retreatment with the alternative regimen of BAM or OAC. In retreatment group(n=10), the eradication rate of H. pylori infection was achieved in 100 %. 3) The side effects were oral burning sensation, odynophagia, nausea, epigastric pain, diarrhea, constipation, gas bloating. The side effects were negligible. Conclusions : 10-day therapy with omeprazole, amoxicillin and clarithromycin(OAC) achieved eradication rate of 91.4 %. The side effects were few and negligible. 10-day therapy with OAC was a safe and very effective regimen for the eradication of H. pylori infection.
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김진희(Jin Hee Kim),서광식(Kwang Sik Seo),김성걸(Seong Gul Kim),김남재(Nam Jae Kim),정현용(Hyun Young Jeong),이헌영(Heon Young Lee),김영건(Young Kun Kim) 대한내과학회 1997 대한내과학회지 Vol.52 No.5
N/A Objective: Despite increased awareness of the fatality of mesenteric ischemia, the diagnosis seldom is made prior to the onset of gangrene. The multiplicity of etiologic factors, the many varied presentations, and splanchnic vasoconstriction all affect the extent of ischemic injury, adding to the complexity of the clinical problem. Extensive acute processes are still catastrophic illnesses with a high mrotality, but there is a potential for both better diagnisis and therapy with an improved outcome. Discussion of the pathophysiology, diagnosis, and treatment of this entity will be presented. Methods: A Retrospective review of our experience with ischemic bowel disease was made. Ten consecutive clinical cases admitted in ChungNam National University Hospital from October 1990 to April 1994 were observed. Results: 1) We experienced 5 patients with arterial embolic occlusion, 1 patient with venous thrombosis and 4 patients with colonic ischemia. 2) The peak ages were 6th decade and 8th decade. 3) The major clincal symptoms and signs were abdominal pain (100%), abdominal tenderness (70%), melena (70%), nausea (60%), fever (50%), vomiting (40%) and abdominal distension (30%). 4) On laboratory findings, there were leukocytosis (80%) and thrombocytopenia (20%) 5) In plain film, there were ileus (70%), edematous intestinal wall (50%), mucosal edema (30%), thumb printing (10%) and gasless abdomen (10%). Among the 5 cases performed abdominal CT, there were thickening of intestinal wall in 4 cases, narrowing of intestinal lumen in 2 case and ascites in 3 cases. 6) Bowel resections were perfomed in 7 cases and supportive care was performed in 3 cases. 7) The overall mortality rate was 30%, Conclusion: An oggressive approach in patients suspected of having ischemic bowel is indicated if the diagnosis is to be made before necrosis has occurred. A high index of suspicion, early angiography, correction of the underlying cardiac disease, treatment of splanchnic vasoconstriction, surgical revascularization, and resection of gangrenous bowel are necessery if there is to be a significant reduction in the high mortality rates associated with mesenteric ischemia.
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김성걸(Seong Gul Kim),최지영(Jee Young Choi),임의혁(Euyi Hyeog Im),김진희(Jin Hee Kim),육은주(Eun Ju Yook),김병호(Byeong Ho Kim),성자원(Ja Won Sung),김남재(Nam Jae Kim),정현용(Hyun Yong Jeong),이헌영(Heon Young Lee),김영건(Young Kun 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2
Primary small intestinal lymphomas are a hetorogenous group of tumors ortginating from the lymphoid cells of the mucosa and submucosa of the small bowel. The ileum and jejunum are most frequently affected, whereas duodenal involvement is less common. There is a himodal age distribution with peak incidences below the age of 10 and in the fifth and sixth decados, with a slight male prodominance. And it is very difficult to diagnose until the dovelopment of any complications such as obstruction, perforation ancl hemorrahage because of the insidious onset of disense and relative inaccuracy of the diagnostic tools as in all the small bowel tumor. Optimal treatment choices for lymphoma remain controversial. Surgical resection, in many cases, is considered the first line of defense. Primary malignant lymphoma of the small intestine has poorer prognosis due to the delay of the diagnosis than any other extra-intestinal malignancy, but has the better prognosis than any other small intestinal malignancy. The histologic type, the extent of the intestinal disease, and the prosence or absence of extraintestinal involvement are the important factors in prognosis. Patients with resectable disease typically have a 40/r, to 507r, S-year survival. Recently the authers diagnosed the primary small intestinal lymphoma associated with a large amount of bleeding confirmed by intraoperative biopsy. So we report this case with the review ot literatures. (Korean J Gastroenterol 1995;27:251-255)
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김태균 ( Tae Kyun Kim ),강예은 ( Yea Eun Kang ),김지민 ( Ji Min Kim ),홍우정 ( Woo Jeong Hong ),김군순 ( Koon Soon Kim ),김현진 ( Hyun Jin Kim ),김영건 ( Young Kun Kim ),구본정 ( Bon Jeong Ku ) 대한내과학회 2012 대한내과학회지 Vol.83 No.2
목적: 당뇨병은 완치되지 못하는 만성 질환이므로 환자 자신에 의한 자가관리가 특히 중요하다. 자가 관리를 위한 교육으로 당뇨병 캠프가 전국적으로 실시되고 있다. 이에 본연구에서는 당뇨캠프에 참여한 제2형 당뇨병 환자들을 대상으로 캠프의 효과를 평가하고자 하였다. 방법: 2005년 8월부터 2011년 8월까지 대전충청지회 당뇨캠프에 참여한 30명의 제2형 당뇨병 환자를 대상으로 하였다. 캠프 전과 캠프 후의 두 군으로 나누어 신체계측치, 당화혈색소, 혈청지질값, 자아존중감, 순응도를 조사하였다. 자아존중감은 Rosenberg 자아존중감 척도를 사용하였고, 순응도는 약물 처방 비율(medication possession ratio)을 이용해 측정하였다. 결과: 당화혈색소는 당뇨캠프 전 8.2 ± 1.6%, 캠프 후 7.5 ± 1.5%로 유의하게 감소하였다(p = 0.004). 두 군 사이의 자아존중감 측정에서는 캠프 전 26.2 ± 4.6, 캠프 후 29.3 ± 4.0으로 캠프 후에 자아 존중감의 상승을 보였고(p = 0.000), 순응도로측정된 약물 처방 비율은 캠프전 0.92 ± 0.07에서 캠프 후 0.96 ± 0.05로 호전되었다(p = 0.001). 이외에 임상자료에서는 캠프전후 차이가 없었다. 결론: 제2형 당뇨병 환자에서 당뇨캠프를 통한 교육은 혈당감소와 자아 존중감 향상, 순응도에 효과를 나타낸다. Background/Aims: When a patient is diagnosed with diabetes mellitus, it is important to help both the patient and their family members gain knowledge and confidence with regard to self-management. A diabetes camp is an excellent way to recognize the benefits of education. This study was conducted to evaluate the effects of diabetes camp on patients with type 2 diabetes. Methods: This study comprised 30 patients with diabetes who had participated in a diabetes camp from August 2005 through August 2011. The effectiveness of the diabetes camp was examined retrospectively via clinical parameters, compliance behavior, and a self-esteem questionnaire. Results: Glycated hemoglobin (HbA1c; p = 0.004) was significantly decreased, while measures of self-esteem (p = 0.000) and compliance (p = 0.001) were significantly increased after attending the camp. No significant differences were observed in other clinical parameters, such as weight, body mass index (BMI), and lipid profiles, before and after camp attendance. Conclusions: Diabetes camp may be an effective way to control diabetes mellitus.
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