장골동맥 폐색 환자에서 금속 스텐트 삽입: 장기 개통율과 재발 관련 인자

김재규,윤웅,박진균,강형근,Kim, Jae-Gyu,Yun, Ung,Park, Jin-Gyun,Gang, Hyeong-Geun 대한영상의학회 2003 대한영상의학회지 Vol.49 No.3

목적: 장골 동맥의 폐색을 보인 환자에서 금속 스텐트 삽입 후 장기 개통율을 알아보고, 재발에 관련된 인자들을 분석해보고자 하였다. 대상과 방법: 장골 동맥 폐색을 보인 환자 중 자가 확장성 금속 스텐트를 삽입한 68명을 대상으로 하였다.간헐성 파행을 보인 환자가 48명,휴식기 동통을 호소한 환자가 11명, 하지 괴저를 일으킨 경우가 9명 이었다.스텐트 내강의 개통성 유무는 추적 혈관 촬영과 색도플러 검사로 판정하였다.Kaplan-Meier method를 이용하여 누적 개통율을 알아보았고, 증상별(Fontainestage),위험 인자별, 병변의 위치 및 길이,측부 순환 발달 유무 등의 해부학적 인자별 재발률을 Cox-proportional hazard model을 이용하여 분석하였다. 추적기간은 1일에서 73개월(평균23.8개월)이었다. 결과: 총 68명의 환자 중 16명(23.5%)이 재발하였다. 누적 개통율은 1개월 95.4%, 6개월93.2%,1년 80.1%,2년 73.2%,3년 68.9%이었고,5년 장기 개통율은 62%이었다.위험인자중 심장 질환의 경우 3배 이상 재발의 위험이 높았으나(p=0.04),흡연, 고혈압, 당뇨, 혈관 질환의 기왕력 등은 유의한 통계학적 차이를 보이지 않았다. 병변의 해부학적 요인별 재발률 비교에서는 총장골동맥에 위치한 병변보다 외장골동맥을 침범한 병변에서 6.5배 이상 재발률이 높은 것으로 나와 통계학적 유의성을 보였다(p=0.02).증상에 따른 재발률에 의의 있는 통계학적 차이는 보이지 않았다. 결론: 장골동맥 폐색 환자에서 자가 확장성 금속 스텐트 삽입 후 재발에 관련된 요인 중 기왕의 심장 질환 유무와 외장골동맥을 침범한 병변에서 더 재발률이 높았다 Purpose: To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Materials and Methods: Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of followup varied from 1 day to 73 months (mean, 23.8 months). Results: Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the Fontaine stage were not statistically significant indicators of recurrence. Conclusion: The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery.

모든 병의 타깃, 만성질환 - 만성위장질환의 대표적인 원인, 위나선균과 관련된 소화기계 질환

김재규,Kim, Jae-Gyu 한국건강관리협회 2010 건강소식 Vol.34 No.6

한 유제품 CF로 인해 누구나 한 번쯤은 들어보았을 헬리코박터 파이로리(Helicobacter Pylori). 헬리코박터 파이로리균은 위 점막에 기생하는 나선균으로 위나선균으로도 불린다. 이 세균은 환자에게서 분리된 균주마다 서로 다른 유전체 구조를 가진 특이한 세균집단으로 만성 전정부 위염, 소화성궤양, 위 MALT(점막연관림프조직형) 림프종, 위암 등의 원인이다.

공교육비와 교육 기회 균등

김재규,Kim, Jae-Gyu 한국대학교육협의회 1999 大學敎育 Vol.97 No.-

소화불량으로 고생하세요?

김재규,Kim, Jae-Gyu 사단법인 한국당뇨협회 2007 당뇨 Vol.208 No.-

위암 표준진료권고안

김재규,Jae Gyu Kim 대한소화기암연구학회 2016 Journal of digestive cancer reports Vol.4 No.1

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

무증상 한국인에서 Helicobacter Pylori 감염의 위험인자

김나영(Na Young Kim),김재규(Jae Gyu Kim),김진호(Jin Ho Kim),김학양(Hak Yang Kim),김상우(Sang Woo Kim),김재준(Jae Jun Kim),노임환(Im Hwan Roe),심재건(Jae Geon Sim),안형식(Hyeong Sik Ahn),윤병철(Byung Chul Yoon),이상우(Sang Woo Lee),이용 대한내과학회 2000 대한내과학회지 Vol.59 No.4

Background : The prevalence of Helicobacter pylori (H. pylori) infection varies between countries and between social classes. The aim of this study was to identify risk factors for with Helicobacter pylori infection in asymptomatic Korean population. Methods : Sera were collected from 2,687 females and 3,049 males (mean age, 29.1 y; range, 1 m-79 y) in Korea from Mar 1998 through Oct 1998. All asymptomatic subjects completed assessment questionnaires. An enzyme-linked immunosorbent assay was performed to detect IgG antibody to H. pylori.Results : The overall seroprevalence observed was 46.6% and showed no statistical diffrerence between female (45.9%) and male (47.2%). The seroprevalences in children (neonate-15 y) and adult (16-79 y) were 17.2% and 66.9%, respectively. According to multivariate analysis, variables such as sex, age, geographic area, crowding (number of person per room) in childhood, economic status in childhood, and types of housing in childhood were significantly and independently associated with H. pylori seroprevalence of adults. In children, age, geographic area, income, mother's education, and drinking water source were significant risk factors of H. pylori infection. Conclusion : Socioeconomic condition and close person to person contact in childhood are the significant determinants for H. pylori infection in adult. Drinking water source is an another important risk factor for H. pylori infection in children, suggesting the fecal to oral transmission in Korea.(Korean J Med 59:376-387, 2000)

상부우장관 증사이 없는 한국인에서 Helicobacter pylori 감염의 혈청학적 유병률에 관한 전국적 역학조사

김나영(Na Young Kim),김재규(Jae Gyu Kim),김진호(Jin Ho Kim),김학양(Hak Yang Kim),김상우(Sang Woo Kim),김재준(Jae Jun Kim),노임환(Im Hwan Roe),심재건(Jae Geon Sim),안형식(Hyeong Sik Ahn),윤병철(Byung Chul Yoon),이상우(Sang Woo Lee),이용 대한내과학회 2000 대한내과학회지 Vol.59 No.4

Background : Helicobacter pylori infection occurs throughout the world and causes various gastroduodenal diseases in all age groups. The prevalence of H. pylori infection varies among countries and races. The aim of this study was to evaluate the seroprevalence of H. pylori infection in healthy people in Korea. Methods : From March 1998 to October 1998, 5,732 asymptomatic subjects responded to the self-assessment questionnaires from 54 hospitals were enrolled. Serum level of anti-H. pylori IgG was measured by ELISA test. Results : The overall prevalence of H. pylori infection was 46.6% and showed no significant difference between male (47.2%) and female (45.9%). According to the geographic areas, the highly prevalent provinces were Kangwon (53.4%), Cheju (52.9%) and Jeonra provinces (50.6%), while Seoul (41.9%) was the lowest prevalent area. The seroprevalence increased with age and was the highest at 40's (78.5%). The characteristic feature of this study was that the infection rate increased steeply in three age groups (10-12, 16-19 years old and 30's). In Seoul, there was no different prevalence rate among the districts studied.Conclusion : The nation-wide seroprevalence of H. pylori infection in Korea is higher than that of the developed countries. We hope that this study provides the landmark for the study of H. pylori infection in Korea.(Korean J Med 59:388-397, 2000)

한국인에서 Helicobacter pylori 감염의 진단에 있어 Genedia™ H . pylori ELISA 검사의 진단 정확도

정인식(In Sik Chung),김상우(Sang Woo Kim),고재성(Jae Sung Go),김나영(Na Young Kim),김재규(Jae Gyu Kim),김진호(Jin Ho Kim),김학양(Hak Yang Kim),김재준(Jae Jun Kim),노임환(Im Hwan Roe),심재건(Jae Geon Sim),안형식(Hyeong Sik Ahn),윤병철(By 대한내과학회 2001 대한내과학회지 Vol.61 No.1

N/A Background: Genedia™ H. pylori ELISA is a newly developed diagnostic method which detects serum anti-H. pylori IgG antibody. The aim of this study was to assess the accuracy of Genedia™ H. pylori ELISA for the diagnosis of H. pylori infection in Korean population. Methods Genedia : H. pylori ELISA and GAP-IgG were performed in 353 adult sera and Pyloriset-IgG EIA in 184 subjects. In children, 43 serum samples were tested with Genedia™ H. pylori ELISA. H, pylori infection was determined by rapid urease test, histology, culture or (13)C-urea breath test in adults. In children, the subject was considered to he H. pylori positive if (13)C-urea breath test was positive. Results: In adults, the sensitivity and specificity of Genedia™ H. pylori ELISA were 93.2% and 83.5% with positive and negative predictive values of 85.1% and 92.5%. Those for GAP-IgG and Pyloriset-IgG EIA were 67.2%, 82.4%, 79.3%, 71.4% and 89.1%, 88.4%, 71.9%, 96.1%, respectively. In children, sensitivity, specificity, positive and negative predictive values of Genedia™ H. pylori ELISA were 80%, 84.8%, 61.5%, and 93.3%. Sensitivity and negative predictive value of Genedia™ H. pylori ELISA were significantly higher than those of GAP-IgG (93.2% vs. 67.2%, p<0.005 and 92.5% vs 71.4%, p<0.005, respectively). Conclusion : Genedia™ H pylori ELISA is a relatively accurate method for the serodiagnosis of H pylori infection in Korean subjects compared to GAP-IgG. These results may suggest the clinical use of Genedia™ H. pylori ELISA for epidemiological studies of H. pylori infection in Korea. (Korean J Med 61:17-23, 2001)

양성 식도 협착의 치료에 있어서 내시경적 식도 확장술의 효과

김재규(Jae Gyu Kim),이국래(Kook Lae Lee),최문석(Moon Suk Choi),최일주(Il Ju Choi),김용태(Yong Tae Kim),최상운(Sang Woon Choi),정현채(Hyun Chae Jung),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: Dilatation therapy of benign esophageal stricture is now standard therapy. Although bougienage is widely used to treat benign esophageal stricture, the long-term effectiveness and clinical course of bougienage are unknown. Thus, we performed this study to evaluate the long-term effectiveness and clinical course of bougienage in benign esophageal stricture. Methods: We reviewed the medical records of patients with benign esophageal stricture who were treated by bougienage from 1988 to 1991. They were diagnosed as benign esophageal stricture by history, radiologic finding, endoscopic finding and pathology. Results: 1) Bougienage of benign esophageal stricture were effective in terms of improvement of dysphagia in 89 % of 35 paients. The etiology of benign esphageal stricture did not influence the effectiveness of bougienage. 2) Kaplan-Meier analysis showed that cummulative recurrence rate was 79% during a projected 60 months follow-up and the interval of 50% recurrence was 12.2 months. 3) Regardless of severity of stricture, the additional dilatations were needed in 55% of 31 patients impoved by first bougienge and 68% of 22 patients followed 6 months or longer. 4) The perforation rate per patient was 23% and the procedure related perforation rate was 7%. They were treated successfully by surgery or conservative treatment. The bleeding which needed transfusion occurred in 1 patient. He was terated successfully by trans-arterial embolization. Conclusion: Bougienage is safe and short-term effective treatment for benign esophageal stricture and could be utilized as primary therapy for most stricture. But in terms of high recurrence and compliication rate, well-designed controlled studies compared with surgical treatment will be necessary to find out long-term effectiveness of bougienage.

프리팹 교량구조물의 품질관리 플랫폼 개발

김재규 ( Kim Jae-gyu ),현병학 ( Hyun B-h ),이순환 ( Lee Soon-hwan ) 한국구조물진단유지관리공학회 2023 한국구조물진단유지관리공학회 학술발표대회 논문집 Vol.27 No.1

건설기술 스마트화를 위해 구조 부재의 자동화/표준화 설계 제작기술이 주목받고 있다. 공장에서 자동화 제작한 모듈을 현장에서 조립하여 구조물을 완성하는 프리팹 공법은 공기 단축, 품질, 경제성을 확보할 수 있는 기술이다. 프리팹 교량의 설계-제작-운반-시공-공용/유지관리 전주기의 구조물 품질관리 수행에 필요한 계측과 의사 결정 데이터를 통합 관리하는 플랫폼 개발을 시도하고 있다.