Case Reports : Non-Hodgkin`s Lymphoma Manifest as Gingival Hyperplasia in a Renal Transplant Recipient

권정현 Jung Hyun Kwon,Joon Chang Song,Sang Hun Lee,So Young Lee,Chul Woo Yang,Yong Soo Kim,Byung Kee Bang 대한내과학회 2005 The Korean Journal of Internal Medicine Vol.20 No.4

Gingival hyperplasia is a frequent complication in transplant patients who receive cyclosporine or calcium channel blockers. We studied an unusual case involving a renal transplant recipient with post-transplant non-Hodgkin`s lymphoma that manifested as gi

AT운동강도에 따른 에르고메타 운동이 중년비만여성의 VO₂, kcal, R, HR, Glucose에 미치는 영향

권정현(Kwon Jeung-Hyun),김규태(Kim Kyu-Tae) 한국체육과학회 2007 한국체육과학회지 Vol.16 No.1

The purpose of this study was to survey the effect of AT level Ergometer Exercise on VO₂, kcal, R, HR and Glucose in Middle Aged Obese Women. The conclusion of this study is as follows. 1. No significant differences were observed in glucose with aboveAT, atAT, and belowAT during 60minute of exercise, respectively. 2. VO₂ and kcal were significantly changed at 15min, 30min, 45min, 60min in the intensity of below AT, atAT, and aboveAT(p<.05). 3. RER was significantly changed at 45 min and 60 min in the intensity of atAT and belowAT. At aboveAT RER was significantly changed after 30 min and 60 min(p<.05). 4. HR was significantly different in every time interval during 60 minute of exercise between belowAT and aboveAT(p<.05). The glucose level was not changed, and this might explain that more lipid was utilized than glucose. Significant increase of energy expenditure showed that the prolonged exercise with high intensity might depend on additional energy source such as lipid. In conclusion, long durations of exercise with AT level was very effective in lipid utilization and energy expenditure in middle aged obese women.

12주간의 복합운동프로그램이 고령여성의 심혈관질환 위험 요소 및 골밀도 (T-score)에 미치는 영향

권정현(Kwon Jeung-Hyun),최철순(Choi Chul-Soon) 한국체육과학회 2006 한국체육과학회지 Vol.15 No.4

The purpose of this study was to survey the effect of 12 Weeks Combined Exercise Program on blood lipid profiles and bone mineral density(T-score) in the Olde Women. The conclusion of this study is as follows. 1. As HDL-C was decreased by 5.2㎎/㎗(9.35%)1.2㎎/㎗(2.8%) in comparison preㆍpost exercise training, it wasn't statistically significant. 2. As LDL-C was increased by 0.62㎎/㎗(0.57%)11.1㎎/㎗(8.4%) in comparison preㆍpost exercise training, it wasn't statistically significant. 3. As TG was decreased by 5.0㎎/㎗(2.25%)5.1㎎/㎗(4.3%) in comparison preㆍpost exercise training, it wasn't statistically significant. 4. As TC was decreased by 5.86㎎/㎗(2.72%)10.6㎎/㎗(5.1%) in comparison preㆍ post exercise training, it wasn't statistically significant. 5. As weight was decreased by 0.05㎏(0.08%)1.75㎏(2.58%) in comparison preㆍpost exercise training, it wasn't statistically significant. 6. As body fat(%) was increased by 0.09%(0.26%)0.68%(2.53%) in comparison preㆍpost exercise training, it wasn't statistically significant. 7. As bone mineral density(T-score) was increased by 0.07(3.62%) in comparison preㆍpost exercise training, it wasn't statistically significant. 8. As SBP was decreased by 4.06㎜Hg(3.13%) in comparison preㆍpost exercise training, it wasn't statistically significant. 9. As DBP was decreased by 5.00㎜Hg(6.13%) in comparison preㆍpost exercise training, it was statistically significant(p<.0.05).

12주간의 복합댄스운동이 과체중고령여성의 체중ㆍ체지방률 및 심혈관 질환 위험요소에 미치는 영향

권정현(Kwon Jeung Hyun),김현경(Kim Hyun-Kyung),최철순(Choi Chul-Soon) 한국체육과학회 2006 한국체육과학회지 Vol.15 No.3

The purpose of this study was to survey the effect of 12 Weeks Combined Dance Exercise Program on body weight, %fat and blood lipid profiles in the Olde Over-weigh Women. The conclusion of this study is as follows. 1. As HDL-C was increased by 1.2㎎/㎗(2.8%) in comparison preㆍpost exercise training. it wasn’t statistically significant. 2. As LDL-C was decreased by 11.1㎎/㎗(8.4%) in comparison preㆍpost exercise training, it was statistically significant. 3. As TG was decreased by 5.1㎎/㎗(4.3%) in comparison preㆍpost exercise training, it wasn't statistically significant. 4. As Te was decreased by 10.6㎎/㎗(5.1%) in comparison preㆍpost exercise training, it wasn't statistically significant. 5. As weight was decreased by 1.75㎏(2.58%) in comparison preㆍpost exercise training, it was statistically significant. 6. As %fat was decreased by 0.68㎏/㎡(2.53%) in comparison preㆍpost exercise training, it was statistically significant.

중년비만여성의 AT운동강도에 따른 Hormone의 변화

권정현(Kwon Jeoung-Hyun),최승욱(Choi Seung-Wook) 한국체육과학회 2006 한국체육과학회지 Vol.15 No.1

The purpose of this study was to investigate the metabolic responses to 60 minutes of steady state bicycle ergometer exercise with three different exercise intensities and determine the most optimal exercise intensity for improving cardiorespiratory function and maximal substrate utilization rate; belowAT (the intensity 30 Watts belowAT), atAT and aboveAT(the intensity 30 watts aboveAT). Insulin, cortisol were measured throughout 60 min exercise of each of three exercise intensities. The result were as follows : 1. No significant differences were observed in cortisol with aboveAT, atAT, and belowAT during 60minute of exercise, respectively. 2. Growth hormone was significantly changed after 30minute of bicycle ergometer exercise with the intensity of belowAT(p<.05). 3. No significant differences were observed in epinephrine and norepinephrine with aboveAT, atAT, and belowAT during 60minute of exercise.

중년비만여성의 AT운동강도에 따른 Glucose, Insulin, FFA의 변화

권정현(Kwon Jung-Hyun) 한국체육과학회 2005 한국체육과학회지 Vol.14 No.2

The purpose of this study was ted investigate the metabolic responses to 60 minutes of steady state bicycle ergometer exercise with three different exercise intensities and determine the most optmal exercise intensity for imporving cardiorespiratory function and maximal substrate utilization rate; belowAT(the intensity 30 Watts belowAT), atAT and aboveAT(the intensity 30 Watts aboveAT). Ten baese female(n=10, 45.7±9.8 yrs)subjects performed 60-min continuous exercise on the cycle ergometer with three different exercise intensities. Oxygen uptake(VO₂), kcal, heart rate (HR), respiratory exchange ratio (RER), insulin, glucose, FFA(free fat mass) were measured throughout 60-min exercise of each of three exercise intensities. The repeated measure ANOVA was used to determine if significant differences exist among mean values within eachk variable. The two way repeated measure ANOVA was also used ted determine the group by time interaction effect of each variable. Within the limitations and design of this study, the following conclusions can be drawn: 1. Insulin response was significantly changed at 15min, 30min, 45min, 60min only in intensity of at AT(p<.05). 2. FFA was significantly changed at 45min and 60min in the intensity of atAT and belowAT, FFA was also significantly changed 60min in the intensity of aboveAT(p<.05). 3. No significant differences wer observed in glucose with aboveAT, atAT, and belowAT during 60minute of exercise, respectively. As exercise began, the heart rate and catecholamine secretion were increased, and this is very typical of physiological response to physical stimulus. In this study FFA was significantly increased in high intensity exercise unlikely observed in previous studies. This would speculate that lipid utilization could also occur at high in tensity exercise such as in AT level if the exercise prolonged more than 60minute. The glucose level was not changed, and this might explain that more lipid was utilized than glucose. Significant increase of energy expenditure showed that the prolonged exercise with thigh intensity might depend on additional energy source such as lipid. In conclusion, long durations of exercise with AT level was very effective in lipid utilization and energy expenditure in middle aged obese women.

12주간의 복합운동 프로그램이 고령여성 혈압 및 RBC, WBC, Hb, Hct에 미치는 영향

권정현(Kwon Jeong-Hyun),김규태(Kim Kyu-Tae) 한국체육과학회 2007 한국체육과학회지 Vol.16 No.2

The purpose of the study was to find out the effect on the change in blood pressure and RBC, WBC, Hb, Hct of combined exercise prigram of the older women during 12 weeks. The conclusion of this study is as follows; 1. As RBCwas decreased by 0.02(106/㎣)(0.37%) in comparison preㆍpost exercise training, it wasn't statistically significant. 2. As WBC was decreased by 0.93(103/㎣)(14.48%) in comparison preㆍpost exercise training, it was statistically significant(p<0.05). 3. As Hb was increased by 0.007g/㎗(0.05%) in comparison preㆍpost exercise training, it wasn't statistically significant. 4. As Hct was decreased by 0.03g/㎗(0.07%) in comparison preㆍpost exercise training, it wasn't statistically significant. 5. As SBP was decreased by 13.4㎜Hg(9.45%) in comparison preㆍpost exercise training, it was statistically significant(p<0.05). 6. As DBP was decreased by 3.67㎜Hg(4.20%) in comparison preㆍpost exercise training, it wasn't statistically significant.

12주간의 복합운동이 고령여성 경계성고혈압 환자의 혈압, 혈청지질 및 혈당에 미치는 영향

권정현(Kwon Jeong-Hyun),김현걸(Kim Hyun-Guell) 한국체육과학회 2007 한국체육과학회지 Vol.16 No.3

The purpose of the study was to find out the effect on the change in blood pressure, serum lipids and glucose of combined exercise(aerobic dance, resistance exercise and stretching) of the older women(borderline hypertensive patients) during 12 weeks. The combined exercise was consist of aerobic dance, weight, dumbbell and elastic band with the intensity of RPE 11-13, 50%-60% of HRR% and 40%-50% of IRM for 75 minute in a time by three day a week. The conclusions obtained were as follows; 1. HDL-C was increased by 3.76% in comparison preㆍpost combined exercise, it wasn't statistically significant. 2. LDL-C was increased by 0.84% in comparison preㆍpost combined exercise, it wasn't statistically significant. 3. TG was increased by 14.16% in comparison preㆍpost combined exercise, it wasn't statistically significant. 4. TC was decreased by -1.63% in comparison preㆍpost combined exercise, it wasn't statistically significant. 5. SYS was decreased by -11.36% in comparison preㆍpost combined exercise, it was statistically significant(p<.05). 6. DIA was decreased by -4.80% in comparison preㆍpost combined exercise, it wasn't statistically significant. 7. Glucose was increased by 3.63% in comparison preㆍpost combined exercise, it wasn't statistically significant.

12주간의 복합운동프로그램이 고령여성 고혈압환자의 혈압 및 심혈관질환 위험 요소에 미치는 영향

권정현(Kwon Jeong-Hyun),최철순(Choi Chul-Soon) 한국체육과학회 2008 한국체육과학회지 Vol.17 No.1

The purpose of the study was to find out the effect on the change in blood pressure and risk factors for cardiovascular disease(serum lipids) of combined exercise in the older women hypertensives during 12 weeks. The combined exercise was consist of walking, dumbbell and elastic band with the intensity of 40-60%HRRmax and 40-50%1RM for 70 minute in a time by three days a week. The conclusions obtained were as follows; 1. HDL-C was increased by 4.29% in comparison preㆍpost combined exercise, it wasn't statistically significant. 2. LDL-C was decreased by 8.51% in comparison preㆍpost combined exercise, it was statistically significant(p<.05). 3. TG was increased by 0.43% in comparison preㆍpost combined exercise, it wasn't statistically significant. 4. TC was decreased by 1.48% in comparison preㆍpost combined exercise, it was statistically significant(p<.05). 5. SYS was decreased by 13.03% in comparison preㆍpost combined exercise, it was statistically significant(p<.05). 6. DIA was decreased by 0.89% in comparison preㆍpost combined exercise, it wasn't statistically significant.

B형간염바이러스 고혈중 산모에서 수직감염 예방을 위한 테노포비어의 역할

권정현 ( Jung Hyun Kwon ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.3

B형간염은 전 세계적으로 2억 4천만 명의 감염자가 있고, 매년 60만 명 이상이 관련 질환으로 사망하는 질환으로 우리나라에서도 필수예방접종의 대상이다. 현재는 예방접종이 보편적으로 시행되고 있으나 임산부에서 신생아로의 수직감염은 여전히 B형간염바이러스(hepatitis B virus [HBV]) 전파의 중요한 경로라고 할 수 있다. 최근에는 HBsAg 양성 임산부에서 태어난 신생아의 경우 출생 직후 B형간염 면역글로불린과 B형간염 예방접종, 즉 수동과 능동 면역예방(immune prophylaxis)을 모두 시행하여 수직감염률을 90%에서 10%까지 감소시켰으나,^1-4 여전히 혈청 HBV DNA 치가 6 log₁₀copies per milliliter 이상인 경우는 감염될 확률이 10-30%정도된다.^5-9 임신 중 항바이러스제 투약을 통해 수직감염률을 낮출 수 있을지에 대한 연구가 진행되어 왔지만 소규모 연구이거나 대조군이 없는 연구, human immunodeficiency vi-rus(HIV) 중복감염환자에서 라미부딘을 이용한 연구가 대부분이었다. 현재까지 임신투여안전성 등급 B약제는 텔비부딘과 테노포비어이며, 이 중 유전적 장벽이 높은 테노포비어에 대한 연구는 많지 않다. 2015년 Chen 등의 발표에 의하면 테노포비어로 치료받은 62명의 산모와 치료 받지 않은 56명의 산모에서 수직감염률이 각각 3%와 2%로 차이를 보이지 않았다(p=0.14).¹⁰ 이번 연구는 대상군을 좀 더 세분화하여 혈청 HBV DNA 치가 높은 산모를 대상으로 하였을 때 테노포비어가 수직감염 예방에 유용한지를 알아보았다. 이번 연구의 대상은 HBeAg 양성이면서 혈청 HBV DNA치 200,000 IU/mL 이상인 20-35세 사이의 산모이며, 다기관, 전향적, 공개, 무작위 배정으로 진행되었다. 산모들은 1:1의 비율로 무작위 배정되어 임신 30-32주부터 출산 후 4주까지 테노포비어 복용군과 복용하지 않는 대조군으로 선정되었고, 출산 후 28주까지 관찰하였다. 테노포비어 복용군 산모들은 복용 기간 동안은 수유를 하지 않도록 권고하였다. 출산 전에는 4주 간격으로 간기능 검사와 혈청 HBV DNA 치를 검사하였고, 출산 후에는 4, 12, 24, 28주 검사를 시행하였다. 모든 신생아들은 200 IU의 면역글로불린과 B형간염백신 10 μg을 출생 12시간 이내와 4주 이내에 접종받았고 추가적인 예방접종을 24주에 시행받았다. 테노포비어를 중단한 후 12주 동안 산모들은 4주 간격으로 alanine aminotransferase (ALT)를 검사하여 정상 범위(40 U/L) 이상으로 상승하는지를 또는 ALT 치가 상승한 경우는 정상이 될 때까지 관찰하였다. 지속적으로 ALT 치가 높을 시에는 항바이러스 치료를 다시 시작하였다. 처음 등록 당시 ALT 치가 정상의 5배 이상 높거나 total bilirubin이 2 mg/dL 이상이거나 albumin 2.5 g/dL 이하인 경우는 제외하였다. 또한 등록 당시 birth defect가 산과적 초음파 등을 통해 의심되는 경우도 제외하였다. 첫 번째 관찰항목은 테노포비어 치료에 따른 두 군 간의 수직감염률과 birth defect의 차이였다. 수직감염의 정의는 생후 28주에 신생아 혈청 HBV DNA 치 20 IU/mL 이상이거나 HBsAg 양성인 경우로 하였고 생후 28주까지의 주산기동안의 birth defect를 조사하였다. 두 번째 관찰 항목은 출산당시 혈청 HBV DNA 치 200,000 IU/mL 이하인 산모의 비율과 출산 28주에 HBeAg 또는 HBsAg가 소실 또는 혈청 전환된 산모의 비율이었다. 결과적으로 216명의 산모가 스크리닝 후 200명의 산모가 등록되었다. 등록 당시 산모의 평균 혈청 HBV DNA 치는 8.0-8.2 log10 IU/mL, ALT 치는 20.5-23.0 U/L였으며, 테노포비어 평균 복용 기간은 8.57±0.53주였다. 첫 번째 관찰항목인 출산28주 시점의 수직감염률은 테노포비어 복용군 97명 중 5명(5%), 대조군 100명 중 18명(18%)으로 intention to treatment 분석을 하였을 때 복용군에서 수직감염률이 통계적으로 유의하게 낮았다(p=0.007). 동의 철회나 경과 관찰이 안 된 신생아를 제외한 per-protocol 분석에서도 마찬가지로 테노포비어 복용군에서는 수직감염된 신생아 0명, 대조군에서는 88명 중 6명(7%)으로 복용군에서 의미 있게 낮은 수직감염률을 보였다(p=0.01). 수직감염 예방에 실패한 신생아 6명은 출생 28주시점에 모두 viremia와 HBsAg 양성 소견을 보였다. 주산기동안 birth defect 율은 투여군 95명 중 2명(2%), 대조군 88명 중 1명(1%)으로 두 군에서 차이를 보이지 않았다(p=1.00). 두 번째 관찰항목인 출산 당시의 산모 혈청 HBV DNA 치200,000 IU/mL 이하는 테노포비어 복용군 97명 중 66명(68%), 대조군 100명 중 2명(2%)으로 유의하게 테노포비어복용군에서 높게 나타났다. 한편 테노포비어를 복용했지만 출산 당시에 혈청 HBV DNA 치 200,000 IU/mL 이상이었던 산모 31명은 출산 시점까지 평균 1.7 log10 IU/mL 감소하였으며 이 중 12명은 혈청 HBV DNA 치 1,000,000 IU/mL 이하로 나타났다. 산모와 신생아의 안전성 측면에서 분석하였을 때 혈청creatinine kinase 치는 테노포비어 복용군 산모에서 7%로 대조군보다 높았으며(대조군 0%, p=0.006), 특히 ALT 치의 상승은 테노포비어 중단 후인 출산 5주에서 28주 사이에 복용군 45%, 대조군 30%로 복용군에서 더 높게 나타났다(p=0.03). 테노포비어 복용군을 더 자세히 보면 중단 시점인 출산 4주 시점 이후 viral rebound 현상은 89%의 산모에서 보였지만 임상적으로 의미 있는 ALT의 상승(baseline시점의 5배 이상 또는 정상 상한치의 10배 이상 증가)은 보고되지 않았다. 대조군에서도 출산 후 4주 이내에 3명의 환자에서 정상 상한치의 10배 이상 ALT 상승을 보였으나 이후 HBeAg 소실이나 혈청전환이 되어 항바이러스 치료를 시작하지는 않았다. 산모에서 HBeAg 또는 HBsAg의 소실이나 혈청전환율은 두 군 간에 큰 차이를 보이지 않았다.