말단비대증 환자의 혈중 프롤락틴 수치와 면역조직화학염색과의 상관관계

강보현 ( Bo Hyun Kang ),정인경 ( In Kyung Jeong ),조덕신 ( Duck Shin Cho ),강한욱 ( Han Wook Kang ),김형훈 ( Hyung Hoon Kim ),김범진 ( Beom Jin Kim ),민태훈 ( Tae Hoon Min ),손준성 ( Jun Seong Son ),홍성노 ( Sung No Hong ),이춘영 대한내과학회 2003 대한내과학회지 Vol.64 No.2

목적: 말단비대증은 대부분 성장호르몬 분비 뇌하수체 선종에 의한 것으로 35%에서 고프롤락틴혈증이 동반된다고 알려져 있다. 저자들은 말단비대증 환자의 뇌하수체 조직의 면역조직화학염색 소견과 혈중 호르몬 수치를 비교하여 이들간에 어떠한 관계가 있는지 알아보고자 하였다. 방법: 1998년 8월부터 2001년 5월까지 말단비대증 진단 하에 뇌하수체 종양 제거수술을 받은 환자 28명(남자:여자=18:10, 평균연령: 41세)을 대상으로 하였다. 혈중 기저 성장 Background: Acromegaly occurs by excessive secretion of growth hormone and more than 99% of cases are caused by a growth hormone-secreting pituitary adenoma. Pituitary adenomas expressing multiple immunoreactivities are common. We assumed that the pituita

개별 작업중심회상치료가 혈관성 치매 노인의 인지기능 및 문제행동에 미치는 영향

강보현(Bo-Hyun Kang),안시내(Si-Nae Ahn) 한국인지운동치료협회 2021 한국신경인지재활치료학회지 Vol.13 No.1

목적: 본 연구는 시설에 거주하는 혈관성 치매 노인을대상으로 개별 작업중심회상치료의 적용가능성을 확인하고, 인지기능 및 문제행동에 미치는 영향을 검증하고자 한다. 방법: 대상자 선정기준 및 제외기준에 따라 혈관성 치매노인 두 명을 대상을 선정하여 회당 30분씩 총 15회기 동안개별 작업중심회상치료를 적용하였다. 중재활동을 선정하기위한 평가도구로는 여가활동평가(Interest Checklist; IC)를사용하였고, 인지기능을 평가하기 위해 한국형 몬트리올인지평가(Montreal Cognitive Assesment Korean Version; MOCA-K)와 CERAD-K 신경심리평가집을 사용하였다. 문제행동에 대한 평가는 문제행동척도(Memory & Behavior Problem Checklist; MBPC)와 신경정신행동검사-간편형(Neuropsychiatric Inventory-Questionnaire, NPI-Q)를 사용하였다. 중재 전과 후에 대한 차이 값에 대한 비교와 그래프를통한 시각적 분석을 실시하였다. 결과: 혈관성 치매 노인에게 개별 작업중심회상치료에대한 중재 후, 인지기능과 문제행동에 대해 평가 결과 인지기능에서는 대상자 A와 B에서 모두 MOCA-K와 CERAD-K에서 향상된 결과가 나타났다. 문제행동에서는 대상자 A는MBPC와 NPI-Q에서 중재에 따른 변화가 없었으며, 대상자B는 중재 전보다 중재 후에 MBPC와 NPI-Q 모두 감소된결과가 나타났다. 결론: 본 연구는 혈관성 치매 노인을 대상으로 개별 작업중심회상치료의 적용가능성을 확인하였고, 인지기능 및 문제행동의 개선이 나타나는 것을 확인하였다. The purpose of this study was to confirm if individual task-oriented recall therapy can be used for older patients with vascular dementia living in facilities and to verify the effects of this therapy on cognitive functions and problem behaviors. Based on the selection and exclusion criteria, 2 older individuals with vascular dementia (participants A and B) were selected, and each task-oriented recall treatment was applied for a total of 15 sessions of 30 minutes each. The Interest Checklist (IC) was used to select intervention activities, and the Montreal Cognitive Assessment Korean Version (MOCA-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer s disease (CERAD-K) neuropsychology tests were used to evaluate cognitive functions. An evaluation booklet was also used. Problem behaviors were evaluated using the Memory & Behavior Problem Checklist (MBPC) and the Neuropsychiatric Inventory Questionnaire (NPI-Q). The differences in values before and after the intervention were analyzed; graphs were plotted and manually analyzed. The MOCA-K and CERAD-K scores of both participants improved after the intervention, which suggests an improvement in cognitive function. Participant A showed no change in the MBPC and NPI-Q scores following the intervention, while participant B showed a decrease in both MBPC and NPI-Q scores after the intervention, which suggests that the problem behavior of participant B had reduced. This study shows that individual task-oriented recall therapy can be used for older patients with vascular dementia, and treatment with this therapy can improve cognitive functions and reduce problem behaviors in these patients

온라인 쇼핑몰의 해외시장 성과향상을 위한 이미지 기반 SNS 마케팅 채널의 활용방안

신설희(Seol Hee Shin),강보현(Bo Hyeon Kang),김상현(Sang Hyun Kim) 한국IT서비스학회 2014 한국IT서비스학회지 Vol.13 No.4

There is a phenomenon that the consumers from all over the countries are using the Korean online shopping malls, which has settled as a distribution industry. To get the attention of the consumers from other countries, the marketing strategy is important in order for the online shopping malls to go advance abroad. The purpose of this study is to overview the Pinterest, which is a shopping-oriented Social Network Service (SNS) based on the image content. The Pinterest is a valuable online shopping mall marketing channel. By looking at the background growth and feature of service, the existence of the mega SNS as a center in the social business is to see how Pinterest is targeting a niche market. As a result of this study, Pinterest has the advantage against other SNS for joining with online shopping malls because a tendency of the traffic referrals from Pinterest is increasing and the average of the cost of the purchase is high. Therefore, this study is reflecting various cases of utilizing the online shopping malls. In conclusion, Pinterest represents an illustrative case of effective marketing channel of the online shopping malls.

세팔로스포린 전구 물질에 의한 직업성 천식 1례

민태훈 ( Tae Hoon Min ),조덕신 ( Duck Shin Cho ),권남희 ( Nam Hee Kwon ),이병완 ( Byung Wan Lee ),강보현 ( Bo Hyun Kang ),손준성 ( Jun Seong Son ),신상엽 ( Sang Yop Shin ),하경원 ( Ha Kyoung Won ),이병재 ( Byung Jae Lee ),최동철 ( 대한천식알레르기학회 2003 천식 및 알레르기 Vol.23 No.1

악성 갑상선 우연종의 임상상 및 초음파 소견의 진단적 가치

강한욱,김광원,이병완,강보현,김형훈,김범진,정재훈,민용기,이명식,이문규 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.5

연구배경: 최근 갑상선 초음파 검사의 빈번한 시행으로 갑상선 우연종의 발견이 증가하고 있다. 이러한 갑상선 우연종은 임상적으로 어떻게 접근하고 치료를 해야 하는지 적지 않은 문제가 되고 있다. 본 연구에서는 직경 1.5㎝ 이하의 갑상선 우연종의 유병률, 입상적 특징 및 초음파 특성, 그리고 가장 효율적인 진단적 접근에 대해 알아 봤다. 방법: 1999년 1월부터 2000년 12월까지 삼성서울병원 내과 및 일반외과로 갑상선 결절을 주소로 내원한 1457명을 대상으로 후향적 연구를 시행하였다. 우연히 발견된 직경 1.5㎝ 이하의 갑상선 결절을 가지는 환자들에서 갑상선 결절의 촉지 유무, 갑상선 기능검사, 항갑상선 항체, 갑상선 초음파 및 미세침 흡인세포검사, 99m^Tc 갑상선 스켄, 수술 조직검사 및 병기를 검토하였다. 결과: 분석한 갑상선 결절 1475예 중 갑상선 우연종의 유병률은 13.4%(198예)였다. 갑상선 우연종에서 악성률은 28.8%(57예)으로 나왔다. 양성 및 악성 갑상선 우연종에서 나이, 성별, 갑상선 기능검사, 결절 크기에는 의미 있는 차이는 없었다. 갑상선 스켄은 갑상선 우연종의 감별에 적합하지 않았다. 갑상선 결절의 초음파 지표 점수만이 양성 및 악석 갑상선 우연종의 감별에서 초음파 지표 점수의 민감도는 88.9%, 특이도는 74.4%, 양성 예측률은 92.4%로 나왔고 진단적 정환도는 85.5%였다. 갑상선암으로 수술을 받은 50명중 stage 1은 34명, stage 2는 6명, stage 3은 10명으로 대부분의 악성 갑상선 우연종은 낮은 TNM 병기로 나타났으나, 상당수에서는 국소 침범의 소견을 보였다. TNM 병기의 3기 환자 전부는 45세 이상이였고, 주로 갑상선암의 피막 침범에 의한 것이었다. 임파절 전이는 6명의 환자에서 나왔다. 결론: 악성 갑상선 우연종은 비교적 흔히 접할 수 있는 질환이며 양성 우연종과는 임상적으로 구별이 안 된다. 악성 갑상선 우연종은 발견 당시 대부분 낮은 병기이나, 갑상선의 피막 침범 및 임파절 전이가 상당수에서 발견되었다. 갑상선 우연종의 초음파 소견은 향후의 진단 방향을 제시하는 중요한 길잡이가 될 수 있다. 초음파 지표 점수 2점 이상의 갑상선 우연종에서만 초음파 유도 미세침 흡입검사를 권장한다. Background: High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5㎝ in size. Methods: A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNA staging of the incidentally detected thyroid nodules of less than 1.5㎝ in size. Results: The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage. Conclusion: Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5㎝; however, ultrasonographic findings can be used to decision of optimal management strategies (J Kor Soc Endocrinol 17:649∼656, 2002).

고주파 전극도자 절제술로 치료한 부자간에 발생한 Wolff-Parkinson-White 증후군

강보현,김현중,남궁준,김준수,홍경표,박정의,서정돈 대한순환기학회 2002 Korean Circulation Journal Vol.32 No.8

관상동맥질환에서의 당뇨병 환자의 임상적 고찰

이병완,강보현,강한욱,김형훈,김현진,노정현,지재환,하창영,정재훈,민용기,이명식,이문규,김광원 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.3

당뇨병은 관상동맥질환의 중요 위험인자이다. 당뇨병의 유병률의 증가와 더불어 관상동맥질환 환자에서의 당뇨병 환자 비율은 점차 증가추세에 있다. 본 연구에서 관상동맥질환의 위험인자는 당뇨병, 나이, 비만, 고혈압, 흡연 그리고 관상동맥질환의 가족력이었다. 관상동맥질환 환자에 서 당뇨병군과 정상 혈당군간에는 나이, 고혈압, 흡연, 관상동맥질환의 가족력, 고밀도지단백 콜레스테롤, 중성지방, fibrinogen, t-PA, PAI-1이 통계적 유의한 차이가 있었다. 심근경색 환자를 대상으로 시행한 연구에서 당뇨병군과 정상 혈당군간에는 흡연, 지질강하제 복용, homocysteine,t-PA, PAI-I 그리고 CRP가 유의한 차이를 보였다. 혈당조절을 잘된 환자군과 잘되지 못한 환자군의 비교에서는 요산과 고밀도지단백 콜레스테롤만이 유의한 차이를 보였다. 당뇨병 환자에서의 지질 수치 중 고밀도지단백 콜레스테롤이 관상동맥질환의 주요 예측인자이며 위험인자라고 생각된다. 당뇨병 환자에서는 특히 금연과 혈압 그리고 혈당수치를 철저히 조절해야 한다. 당뇨병이 발생한 이후 혈당조절을 잘하는 것이 관상동맥질환의 발생과 사망률을 감소시킬 수 있을 지, 그리고 당뇨병 환자에서 혈당조절 이외의 어느 인자를 교정하는 것이 관상동맥질환을 예방하는데 도움이 될지 앞으로 전향적 연구가 필요하리라 사료된다. Background: Diabetes is a very important risk factor of coronary artery disease. The prevalence of diabetes in Korea is increasing steadily. The objective of this study was to establish the prevalence and cardiovascular risk factors of diabetes in coronary artery disease in Korean type 2 diabetes. Methods: Of the patients enrolled in SMC-coronary artery angiography protocol, we investigated 1143 subjects (from Jan. 1st to Dec.31th, 2001) with suspicious coronary artery disease reflected from symptoms of chest pain, EKG and enzyme abnormalities, and thallium scan. Sociodemographic characteristics and laboratory data were investigated using retrospective analysis. Results: The prevalence of diabetes in coronary artery disease patients was 37.49 %. The risk factors of coronary artery disease were diabetes, old age, obesity, hypertension, smoking and family history of coronary artery disease in our study. Among patients with coronary artery disease, there were significant differences in age, hypertension, smoking, family history of coronary artery disease, and levels of HDL-C, triglyceride, fibrinogen, t-PA, PAI-1 between diabetic patients and normo-glycemic patients. In the comparison of patients with myocardial infarction, there were significant difference in smoking, prescription of lipid-lowering drugs, homocysteine, tPA, PAI-I, and CRP between diabetic patients and normo-glycemic patients. Only the levels of uric acid and HDL-C showed meaningful difference between diabetic patients with well-controlled blood sugar and poorly-controlled blood sugar. Conclusion: With the increase in the prevalence of diabetes, the proportion of diabetic patients in coronary artery disease has also increased. Among patients with coronary artery disease, the risk factors of coronary artery disease were age, hypertension, smoking, family history of coronary artery disease, and levels of HDL-C, triglyceride, fibrinogen, t-PA, PAI-1 in diabetic patients compared to normo-glycemic patients. Diabetic patients must stop smoking and maintain strict control of blood pressure and blood glucose level. In addition, HDL-C was very important predictive risk factor for coronary artery disease.

면역 글로블린 투여로 호전된 용형성 요독 증후군 1예

조덕신,이병재,민태훈,강보현,김형훈,이병완,최동철 대한내과학회 2002 대한내과학회지 Vol.63 No.4

The hemolytic uremic syndrome (HUS) is a clinical syndrome defined by the presence of thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure with or without a clinically apparent etiology. The conventional treatment of choice is plasmapheresis as a first-line therapy. Most patients respond to plasmapheresis whereas some patients are refractory to the therapy. The second-line therapy is not well established although various therapies such as steroid, vincristine, intravenous immunoglobulin have been suggested. The intravenous immunoglobulin therapy in refractory hemolytic-uremic syndrome have rarely been successful in complete remission. We report a case of refractory HUS in a 48 year-old man who developed hemolytic anemia, thrombocytopenia, acute renal failure and ischemic retinopathy. The patient was refractory to plasmapheresis as a first-line therapy. The patient received intravenous immunoglobulin therapy as a second-line therapy after 8 days of plasmapheresis, which subsequently resulted in a complete remission of refractory HUS. The complete remission using immunoglobulin in HUS has not been previously reported in Korea.

당뇨병성 케톤산증 및 고중성지방혈증으로 인한 급성 췌장염으로 발현한 말단비대증 환자 1예

민용기,이춘영,이문규,이선영,홍성노,김형훈,강보현,강한욱,이병완,박유정,이명식,김광원,김종현 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.1

Secondary diabetes mellitus caused by increased growth hormone secretion (GH) has well been known. There is a close association between glucose intolerance and GH secretion, and increased GH level itself probably worsens the blood glucose control and lipid profile by increasing glycogenolysis and / or gluconeogenesis and by suppressing lipase activity. We report a case of acromegaly with diabetic ketoacidosis as and hypertriglyceridemia-induced acute pancreatitis. A 38 year old male, previously diagnosed to have acromegaly and diabetes, presented with nausea, vomiting, diffuse abdominal pain and altered mentality. There was no history of drug or alcohol consumption, blood gas analysis showed severe acidosis and urinanalysis for ketone was positive. His serum blood glucose, amylase and lipase levels were 494 ㎎/dL, 331 U/L, and 1288 U/L, respectively (reference values: 70∼110 ㎎/dL, 13∼100 U/L and 13∼190 U/L, respectively). The patient was diagnosed as having diabetic ketoacidosis and acute pancreatitis. With the serum concentration of triglyceride being 1488 ㎎/dL and the absence of any obvious precipitating factors, we considered hypertriglyceridemia to be the cause of acute pancreatitis. He was treated with continuous intravenous insulin infusion, lipid lowering agent, and fluid replacement. After conservative management, general condition gradually improved and his serum amylase, lipase and triglyceride levels were all normalized. GH level was not suppressed under 2 ng/mL during oral glucose loading test, and basal GH and IGF levels were 231 ng/mL and 29.5 ng/mL, respectively. Sella MRI showed a 3.7 ㎝ sized pituitary mass. On the 55th day of admission, transsphenoidal surgery was performed. In immunohistochemical staining, the pathologic tumor specimen was proved to be GH positive pituitary adenoma. This is the first case reported in the English literature of an acromegaly presenting with diabetic ketoacidosis and acute pancreatitis