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내과계 중환자실에 입원한 객혈 환자들에 있어 APACHE 3 점수 체계의 예후적 가치에 관한 연구
양성연(Sung Yeun Yang),고윤석(Youn Suck Koh),임채만(Chae Man Lim),이무송(Moo Song Lee),유미란(Mi Ran Yoo),최강현(Gang Heun Choi),이상도(Sang Do Lee),김우성(Woo Sung Kim),김동순(Dong Soon Kim),김원동(Won Dong Kim) 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Background: Massive hemoptysis is one of the major medical emergency with high risk of mortality. Though the best predictor of mortality associated with hemoptysis appears to be the amount of bleeding within the first 24 hours, catastrophic hemorrhage could be occurred to the patients who were apparently in a stable condition with scanty hemoptysis at the time of admission. We evaluated APACHE III score system to find if it could be a prognostic index that can predict the mortality of the patients with hemoptysis. Methods : We identified all the patients who had admitted with hemoptysis in the Medical Intensive Care Unit of Asan Medical Center between May 25, 1989, and July 31, 1995. A retrospective analysis was done in 66 patients with hemoptysis on APA- CHE III score. Results: The overall mortality rate was 17.4% (12/69). In univariate analysis of possible prognostic factors, independent predictors of mortality were age(P=0.016), amount of hemoptysis(P=0.012), AaDO2 (P=0.017), requirement of transfusion(P=0.036), mechanical ventilatory care(P<0.05) and APACHE III score(P=0.02), In multivariate analysis with sex, age, amount of hemoptysis, AaDO2, requirement of transfusion and APACHE III score, APACHE III score was the only independent predictor of mortality(P=0.015, odd ratio=19.3, 95% confidence interval, 3.4 to 249.7) Conclusion: APACHE IU score may be a clinically significantly important independent predictor of outcome in the patients with hemoptysis. In addition, invasive procedure, such as bronchial artery embolizaticn or operation, could be considered in advance in the patients with more than 30 points of APACHE III.
염증성 장질환에서 당질 코르티코이드 불응성 판정을 위한 코르티코이드 수용체 β측정의 유용성
양성연 ( Sung Yeun Yang ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),장혜숙 ( Hye Sook Chang ),김태훈 ( Tae Hun Kim ),방성조 ( Sung Jo Bang ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Background/Aims: Glucocorticoid is mainly used for the treatment of inflammatory bowel disease (IBD). However, such a treatment occasionally shows refractory cases and a long-term use causes serious side effects. It would be very useful if we could predic
염증성 장질환에서의 당질 코르티코이드에 대한 불응성 판정을 위한 당질코르티코이드 β 수용체의 유용성
양성연 ( Sung Yeun Yang ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),장혜숙 ( Hye Sook Chang ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 ( Young Il Min ),오현주 ( Hyun Ju Oh ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 염증성 장질환의 치료에 당질 코르티코이드는 효과적인 약물로 사용되고 있다. 그러나, 증례에 따라서 반응의 정도가 다르며 불응성 증례의 경우 심각한 합병증을 초래할 수 있어 당질 코르티코이드의 투여 전 반응 여부를 미리 예측할 수 있다면 임상적으로 매우 유용한 정보가 될 것이다. 당질 코르티코이드 수용체는 α와 β로 이루어져 있으며 최근 말초 혈액 단핵구에서 β 수용체의 발현이 양성인 경우 당질 코르티코이드의 반응이 저하된다는 보고가 있으나 아직
한국인 역류 식도염 환자의 식도 상피 세포 사이 간격 확장과 Esomeprazole 투여 후의 변화
김재환 ( Jae Hwan Kim ),지삼룡 ( Sam Ryong Jee ),박성재 ( Sung Jae Park ),양성연 ( Sung Yeun Yang ),박은택 ( Eun Taik Park ),이연재 ( Youn Jae Lee ),이상혁 ( Sang Hyuk Lee ),설상영 ( Sang Yong Seol ),정정명 ( Jung Myung Chung ) 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.1
목적: 서구에서 역류 식도염 환자의 식도 상피는 세포 사이 간격이 확장되어 있으며, 이는 프로톤 펌프 억제제 치료 후 호전된다고 한다. 이번 연구의 목적은 우리나라 역류 식도염 환자에서 식도 상피 세포 사이 간격이 확장되어 있는지 여부와 프로톤 펌프 억제제 치료 후 세포 사이 간격이 호전되는지 알아보았다. 대상 및 방법: 역류 식도염 증상이 있으며 상부위장관내시경 검사에서 점막 손상이 있는 역류 식도염 환자 10명과 위식도역류의 증상이 없고, 상부위장관내시경 검사에서 점막 손상이 없으며 24시간 보행 식도 산도 검사에서 음성인 정상인 10명을 대상으로 하였다. 모든 대상자에서 상부위장관내시경 검사를 시행하였으며, 위식도 경계부 5㎝ 상방에서 4군데 조직을 생검하여 전자 현미경으로 세포 사이 간격을 측정하였다. 모든 식도 조직의 전자 현미경 소견에서 100 번씩 세포 사이 간격을 측정하였다. 역류 식도염 환자는 8주간 esomeprazole로 치료한 후 내시경 검사를 하고 식도 상피 조직을 생검하여 세포 사이 간격을 다시 측정하였다. 결과: 역류 식도염 환자의 세포 사이 간격(평균 1.49±0.39 ㎛)은 대조군의 식도 상피 세포 사이 간격(평균 0.49±0.10 ㎛)보다 통계적으로 유의하게 확장되었다(p<0.01). 역류 식도염 환자에서 esomeprazole로 치료 후 세포 사이 간격(평균 0.56±0.19 ㎛)은 호전되었다(p<0.01). 결론: 우리나라 역류 식도염 환자의 식도 상피 세포 사이 간격은 정상인에 비해 확장된 소견을 보이며, 프로톤 펌프 억제제 치료 후 호전되었다. Background/Aims: It has been demonstrated that dilated intercellular spaces of esophageal epithelium are a marker of tissue injury in Western gastroesophageal reflux disease (GERD); which heals after proton pump inhibitor (PPI) treatment. The aim of this study was to determine whether dilated intercellular spaces are also a feature of acid damage in Korean GERD patients and are also healed after PPI treatment. Methods: Ten GERD patients with heartburn and esophageal mucosal breaks on endoscopy, and 10 controls with no symptoms, normal mucosa on endoscopy and negative 24-hour pH monitoring were enrolled. During upper gastrointestinal endoscopy, four biopsies from normal mucosa were taken within the lower 5 ㎝ of the esophagus for transmission electron microscopy (TEM) analysis. One hundred computer measurements were taken on TEM photomicrographs of the specimens in each patient. After eight weeks of esomeprazole 40 ㎎/day, patients with erosive esophagitis had another endoscopy with biopsies and the intercellular spaces were measured again. Results: The mean intercellular space diameter, in the erosive esophagitis patients, was greater than in controls (1.49±0.10 ㎛ vs 0.49±0.10 ㎛, p<0.01). The mean intercellular space diameter, in erosive esophagitis patients, improved after PPI treatment. Conclusions: Korean erosive esophagitis patients have dilated intercellular spaces of esophageal epithelium and dilated intercellular spaces can be reversed after esomeprazole treatment. (Kor J Neurogastroenterol Motil 2006;12:19-24)
원인 불명 화농성 간농양 환자의 대장 신생물 유병률: 전향적 등록 횡단 연구
허내윤 ( Nae-yun Heo ),홍영미 ( Young Mi Hong ),김태오 ( Tae Oh Kim ),문영수 ( Young Soo Moon ),양성연 ( Sung Yeun Yang ),박승하 ( Seung Ha Park ),박종하 ( Jongha Park ),최준혁 ( Joon Hyuk Choi ),김성민 ( Sung-min Kim ),윤기태 ( K 대한소화기학회 2016 대한소화기학회지 Vol.68 No.4
Background/Aims: Several studies suggest that pyogenic liver abscess (PLA) is associated with colon neoplasm. A colonoscopic exam for cryptogenic PLA might detect a hidden colon neoplasm, through which intestinal flora can be transmitted into the liver. However, there are no prospectively enrolled cross-sectional data for colonic neoplasm in cryptogenic PLA. Methods: Patients with PLA were prospectively enrolled from two university hospitals. Among them, all the patients with cryptogenic PLA were recommended for colonoscopic exam to check for colonic neoplasm. Results: One hundred eighty-three patients with PLA were enrolled in the study for 22 months. One hundred and one (55.2%) patients did not have a definite cause of liver abscess at initial evaluation. The median diameter of the largest lesion was 5.7 cm (1.0-14.0 cm), and 74.3% of the patients were treated by percutaneous abscess drainage. Ninety-one percent of the patients who had an identified pathogen yielded Klebsiella. Sixty-two patients underwent colonoscopic exams, and no one had a colonic cancer, one had an adenomatous polyp with high grade dysplasia (1.6%), and 27 had adenomatous polyps with low grade dysplasia (43.5%; 41.0% in male and 43.5% in female). Of fifty patients who underwent an esophagogastroduodeno-scopic exam, nine had gastric ulcers, one had an esophageal ulcer, and one had hemorrhagic gastritis. Conclusions: The prevalence of colonic neoplasm among the patients with cryptogenic PLA was not as high as that in previous studies. Further well-designed, large-scale studies are required to assess the association of the colon neoplasm and cryptogenic PLA. (Korean J Gastroenterol 2016;68:195-201)
양성연 인제대학교 백병원 2003 仁濟醫學 Vol.24 No.2
Irritable bowel syndrome (IBS) is a common disorder of the intestines characterized by a combination of chronic or recurrent gastrointestinal symptoms. Symptoms that are commonly associated with IBS include passage of clear or white mucus with a bowel movement, sensation of incomplete evacuation after haying a bowel movement, and relief of abdominal pain or discomfort transiently after defecation and abdominal bloating. In treating IBS, it is important for physicians to remember that IBS represents a spectrum of symptoms, including pain or discomfort, altered bowel habit, as well as additional symptoms, such as bloating rectal urgency. or painful bowel movement. These symptoms tend to fluctuate over time in the patient who is suffering from IBS. This makes symptom-directed treatment, such as treatment for diarrhea or constipation, somewhat less than optimal. Given the high prevalence of IBS both in primary and specialty practice, it is clear that physicians need to be aware of and feel comfortable using these available drugs.