EGFR 돌연변이와 ROS1 전위를 동시에 가진 폐선암 환자의 Erlotinib 치료 1예

김민환,박예현,박혜정,지아영,송창호,진무년,김영주,김선욱,이중희,김인수,김혜련,김주항,조병철 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.

자료포락분석(DEA)를 이용한 보건의료의 효율성 측정

김남송,박홍섭,김은진,김설화,김정숙,김현아,김경숙,신지혜,최은정,양은진,유선미,유수진 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1

C.G.융의 아니마/아니무스와 여성성

김혜정 ( Kim Hye Jung ) 한국정신분석심리상담학회 2020 정신분석심리상담(구 정신역동치료) Vol.4 No.-

남성과 여성은 서로 다르다. 이것은 우월과 열등의 차이가 아니다. 가부장제적인 시대 속에 사는 우리 인간은 오래전부터 남성의 역할에 가치를 부각 시켜왔다. 여성의 억압이 존재해 왔다. 융은 남성 안에 여성성과 여성 안에 남성성이 서로 보완되어야 인간의 개성화로 나아갈 수 있다고 말한다. 남성 안에 있는 여성성을 회복하고 여성 안에 있는 남성성을 회복한다면 우리의 마음에서는 평화가 찾아오고 우리 인격은 성숙해질 것이다. 여성은 진정한 여성다움을 찾고 남성은 진정한 남성다움 먼저 찾게 되면 우리 마음속에 일어나는 여성성과 남성성의 다툼을 잠재울 수 있을 것이며, 오해와 혼란이 더 이상 우리 의식을 괴롭히지 않게 될 것이다. 특히 여성이 여성의 본성인 여성성을 상실하고 남성적인 가치를 목표로 살다가 자기 자신을 잃어버리며 혼돈과 공허 속에서 고통당하게 될 때, 융의 분석심리학을 통하여 진정한 ‘나’가 되는 길을 고찰해 보고자 한다. Men and women are different. It is not the difference between superiority and inferiority. The humans who live in patriarchal times, have long emphasized the value of men’s roles and there was oppression against women. Jung says that femininity within men and masculinity within women must be complemented so that we can move forward with human individualization. If men restore their femininity and women restore their masculinity inside, peace will come from our hearts and our personalities will mature. Also, if women find true femininity and men find true masculinity first, we will be able to put to rest the disputes between femininity and masculinity that occur in our minds, and misunderstandings and confusion will no longer haunt our consciousness. Especially, when a woman loses her femininity, lives with a goal of masculine values, loses herself, suffers in chaos and emptiness, they can think of the way to become a true ‘me’ through Jung’s analytical psychology.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

경막외 Morphine, Morphine 과 Nalbuphine 병용투여, Morphine 과 Droperidol 병용투여가 제왕절개술 후 통증조절에 미치는 효과에 대한 비교

김혜자,이정은,김동일 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Effect of Epidural Morphine, Morphine with Droperidol and Morphine with Nalbuphine after a Cesarean Section Tong0Il Kim, M.D., Hye-Ja Kim, M.D., and Jung-Un Lee, M.D. Department of Anesthesiology, College of Medicine, Chungnam National University, Daejon, Korea Background: A number of recent reoprts have described the usefullness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, an ??-receptor agonist, produces strong analgesic effects with side effects. Nalbupine, a ??-antagonist and ??-agonis, has an analgesic effect comparable to morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine alone and a combination of nalbuphine and droperidol respectively to morphine were sutudied in cesarean section patients. Methods: We divided 45 patients into 3 groups utilizing a two-day Boxter infusor in normal saline 100 ml at 2.0 ml/hr: Group M (n = 15) initially a 1 mg bolus + 2 mg/day of maintenance morphine. Group M + D (n = 15): initially received a 1 mg bolus + 2 mg/day of maintenance morphine + 1.25 mg/day of maintenance droperidol. Group M + N (n = 15): initially received a 1mg morphine bolus + 2 mg/day of maintenance morphine + 5 mg/day of maintenance nalbupine. The Analgesic effect was evaluated by a visual analogue scale (0-10) at 30 min, 4 hr, 12hr and 24 hr postoperatively and the incidence of side effects was observed too. Results: The average VAS scores are below 3 in all groups. In addition, there are no significant changes between groups. There are no significant differences in side effects between groups except sedation of patients is significantly (P < 0.05) high in group M + D. Conclusion: We concluded that the analgesic effect of epidural morphine, morphine with nalbuphine and morphine with droperidol are good in all patients and there is no significant difference even though there is a belief that a combination of nalbuphine or droperidol increases analgesic effects of morphine. Comparing the incidence of side effects in the three groups, the sedative effect of morphine with droperidol is increased significantly over the other two groups.intubation. (Korean J Anesthesiol 2001; 41: 324~329)

반복적인 급성 신부전을 유발한 호산구성 장염 1 예

정혜진;김현태;김유선;정현걸;강윤경;문정섭 인제대학교 2011 仁濟醫學 Vol.32 No.-

Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by presence of gastrointestinal symptoms, eosinophilic infiltratio n of one or more parts of gastrointestinal tract without involvement of other organs and absence of parasitic infestation. The clinical presentation depends on the extents and depths of eosinophilic infiltration. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. We report a case of eosinophilic enterocolitis in a 55-year-old female presented with abdominal pain and watery diarrhea resulting in recurrent acute renal failure.

재발한 지주막하 포도낭미충증의 Albendazole 치험 1예

김성범,박대원,이재갑,정혜원,송준영,손장욱,김민자,박승철,제보경,김정혁,이진수 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

뇌실이나 뇌기조에 발생하는 포도낭미충증은 매우 드물며 유구조충 유충의 머리부분이 변성되면서 발생하는 낭성 막의 비정상적인 성장을 특징으로 한다. 이러한 유형의 병변은 지름술 후에도 진행적인 경과를 보이며 아직까지 항기생충제를 이용한 치료 사례들이 적고, 따라서 가장 적절한 치료 기간도 알려져 있지 않다. 본 증례 보고는 재발한 실비우스 틈새의 포도낭미충증 환자에서 4주간의 albendazole과 스테로이드로 효과적으로 치료하였던 예이다. 환자는 praziquantel과 뇌복막지름술로 치료를 받고도 포도상의 뇌실질외형의 병변이 악화되어, 뇌척수액 투과가 좋은 것으로 알려진 albendazole로 치료제를 바꾼 뒤 병변의 수와 크기가 감소였으며 이후 2년 간의 추척기간동안 다른 발작 없이 잘 지내고 있다. 지주막하의 포도낭미충증은 albendazole과 corticosteroid 치료에 잘 반응하는 것으로 보인다. The so-called racemose cysticercosis, a rare variety of neurocysticercosis occurring in ventricles or basal cisterns, is characterized by abnormal growth of cystic membranes with degeneration of Taenia solium heads (scolex). Although lesions of this type are known to follow a progressive course even after ventricular shunting, there are limitations of case series treated with antiparasitic drugs, and the optimal duration of the treatment is not yet known. We report a case of relapsed racemose cysticercosis in the Sylvian fissure, who has been successfully treated with albendazole and adjunct corticosteroid for 4 weeks. The patient had been previously treated with praziquantel and ventricul-operitoneal shunt, and maintained on the anticonvulsant drug for one year, but returned to the hospital due to seizure recurrence. The patient has been well in seizure-free state for the follow-up 2 years after albendazole therapy. The subarachnoid racemose cysticercosis seems to respond well to treatment of corticosteroid along with prolonged albendazole.

피질골 절제술을 응용한 견치 및 대구치의 후방 견인

김상철,김선영,김현숙,정혜승,김현태,조진우 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

빠르며 정확하고 안전한 치아이동을 목표로 삼고 있는 교정치료에서 최근 새로이 도입된 피질골 절제술과 견인 골형성술을 응용한 치아이동에 대하여 알아보았다. 특히 견치나 대구치의 후방이동은 기존의 치아 이동 양식으로는 조절이 어렵고, 장기적인 기간에 불가피한 치아이동이다. 피질골 절제술과 견인 골형성술을 동반하여 상당히 효과적인 원심이동을 기할 수 있었던 증례를 통하여 적용 술식, 견인 장치 등을 논하고 그효과를 파악하였다. 이런 술식을 통해 빠른 치아 이동과 이에 따른 전반적인 치료기간의 감소가 가능하였으며, 무리한 치아이동에서 발생할 수 있는 고정원 소실이나 치근흡수, 치주조직의 파괴 같은 부작용도 줄일 수 있었다. Tooth movement facilitated by corticotomy and distraction osteogenesis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed. Active bone deposition was then possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment, which lead to the reduction of the total treatment period. Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or periodontal breakdown.

치내치에 관한 치험례 : A CASE REPORT

김혜영,조호진,김은정,김현정,김영진,남순현 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.4

치내치는 치아 발육 중에 석회화되기 전, 치아의 법랑상피가 일부 함입되어 설측에 깊은 소와를 형성하는 발생학적 변이이다. 주로, 상악 측절치에 호발한다. 치내치는 형태학적으로 다양하며, 종종 초기에 치수괴사에 이르기도 한다. 치내치는 복잡한 해부학적 구조로 인해 치수 치료시 많은 어려움이 따른다. 따라서, 치내치는 초기 진단이 중요하고, 예방적 치료가 추천된다. 이에 본 증례는 치내치를 가진 환아에서의 치료에 관해 보고하고자 한다. Dens invaginatus is a developmental variation resulting from invasination of the tooth crown of root before calcification. Teeth most affected are maxillary lateral incisors. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth. So, the early diagnosis of such malformation is crucial and a preventive approach has been recommended. This report describes three cases of dens invaginatus treatment.

서울 단일 지역의 Helicobacter pylori 1차 제균율과 2차 제균율의 변화

김미연,심기남,김혜인,강현주,류민선,안소영,정혜경,정성애 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

Objectives: To investigate the rate of first-line eradication and the rate of second-line eradication of Helicobacter pylori (H. pylori) from 2001 to 2010 in a single institute in Seoul. Methods: Among the 2,717 patients who received H. pylori eradication treatment from 2001 to 2010 at Ewha Womans University Mokdong Hospital, the medical records of 1,466 patients who satisfied the condition of execution of upper gastrointestinal endoscopy, positive H. pylori eradication results at 6~8 weeks after eradication therapy were reviewed retrospectively. Then the first-line and second-line eradication rates and the eradication rates according to endoscopy findings were also compared. Results: The first-line eradication rate was 77% H. pylori eradication rate for the last 5 years was continuously increasing and no sign of decline was observed even for the whole 10 years. The rates of eradication related to endoscopic findings showed statistical significance (P<0.001) of 79.8% and 70.1% each for peptic ulcer and non-ulcerative gastric diseases, respectively. Conclusion: In this study, no decrease in tendency of first-line eradication rate could be found. In addition, the patients with the non-ulcerative gastric disease seemed to show significantly lower eradication rate. This finding suggests eradication treatment may be affected by the category of gastric diseases, and careful considerations should be taken assessing the effects and needs for the H. pylori eradication treatment.