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원위부 위암에서 위절제술 후 위재건술식에 따른 잔위기능 및 영양 증상학적 삶의 질 비교
김성근,김영균,허윤정,송교영,김진조,진형민,김욱,박조현,박승만,임근우,김승남,전해명,Kim, Sung Geun,Kim, Young Kyun,Heo, Youn Jung,Song, Kyo Young,Kim, Jin Jo,Jin, Hyung Min,Kim, Wook,Park, Cho Hyun,Park, Seung Man,Lim, Keun Woo,Kim, Seun 대한위암학회 2007 대한위암학회지 Vol.7 No.1
목적: 하부 위암의 절제술 후 각각의 재건술에 따른 환자의 위배출시간과 영양상태, 덤핑 증후군의 발생정도를 비교하여 환자의 증상과 삶의 질을 개선하는 방법을 찾고자 하였다. 대상 및 방법: 1999년 6월부터 2002년 7월까지 원위부 위암으로 절제술을 시행한 환자 중 2003년 1월 한 달간 외래에서 술 후 6개월 이상 경과한 환자 122명을 대상으로 하였다. 위십이지장문합술을 받은 환자(이하 B-I군)는 51명, 위공장문합술을 받은 환자(이하 B-II군)는 71명이었다. 위배출검사는 동위원소 검사법을 이용하여 T1/2값을 얻어 비교하였고, 식사 횟수와 양, 체중감소 정도를 비교하였다. 수술 후 복부증상을 비교하였으며, 덤핑증후군은 Sigstad score를 측정하여 비교하였다. 결과: 수술 후 6개월의 T1/2값은 B-I군에서 지연되어 있었다($159.4{\pm}31.0min$). 12개월 후에는 B-I군의 위배출시간이 빨라져 B-I군과 B-II군 사이의 위배출 시간의 차이가 없어졌다. 식사 횟수는 각 군 간의 차이가 없었고 일회식사량은 수술 전과 비교해 보았을 때 6개월째는 각군간의 차이가 없었으나 12개월에는 B-I군이 B-II군에 비해 식사량이 많은 것으로 나타났다(P=0.038). 수술 후 체중은 B-I군이 B-II군에 비해 체중감소가 의미있게 적은 것으로 나타났다(P=0.023). Sigstad dumping score는 B-I군에서 6개월째에는 7.6점, 12개월째에는 3.4점으로 시간이 경과함에 따라 덤핑 증후군의 빈도가 감소하나 B-II군에서는 시간의 경과해도 덤핑 증후군의 빈도에는 유의한 차이가 없었다. 결론: 원위부 위암환자에서 근치적 수술이 가능한 한도에서는 Billroth I 술식이 체중감소가 적고, 복부 증상도 적게 나타났으며 덤핑증후군의 빈도도 낮아 환자의 삶의 질을 개선하는데 B-II 술식보다 유용한 술식으로 생각된다. Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.
민병근(Byoung Geun Min),김영균(Young Kyoon Kim),최규철(Kyu Cherl Choi) 대한피부과학회 1984 대한피부과학회지 Vol.22 No.1
Basal cell carcinoma is the most common skin cancer, but it rarely metastasizes. Metastatic basal cell carcinoma (MBCC) is rare in terms of incidence as well as absolute numbers. We present a case of 67-year-old woman who had a dirty oozing, ulcerated, tumor mass on the vertex and suffered from dyspnea and mild lumbago. The diagnosis of MBCC was based on clinical, radiological, and histopathological findings. To our knowledge, the occurrence of MBCC has not been reported in the Korean literatures. So we reported herein this case of MBCC of the lung and the bone.
만성 신부전 환자에서 혈액투석 유지요법이 수면구조 및 수면 무호흡에 미치는 영향
박용근 ( Yong Geun Park ),이상학 ( Sang Haak Lee ),최영미 ( Young Mee Choi ),안석주 ( Seok Joo Ahn ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Pa 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.47 No.6
구강악안면 수술 환자의 스트레스와 관련된 요인들의 종류와 영향력의 규모
윤필영(Pil-Young Yun),김영균(Young-Kyun Kim),이창수(Chang-Su Lee),송승일(Sung-Il Song),최용근(Yong-Geun Choi) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.6
Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.
간질(癎疾)의 원인(原因)에 대한 동서의학적(東西醫學的) 고찰(考察)
박지은,권정남,김영균,Park, Ji-Eun,Kwon, Jung-Nam,Kim, Young-Geun 대한한방내과학회 1999 大韓韓方內科學會誌 Vol.20 No.1
Through a literal study upon the cause of epilepsy between east and west medicine, next conclusion have been abtained. 1. The cause epilepsy in the east medicine, congenital embryo disease is due to insufficiency of heart(心虛) or deficiency of heart energy(心氣虛), secondary cause is wind -evil(風), frightness(驚), phlegm(痰), fire(火) 2. The cause epilepsy in the west medicine is divided congenital disease and secondary cause, one is excessive discharge of electricity of the brain have on a central nerve, a digestive organ, a respiratory organ, hamatogenous functions, the other is hereditary it and pathological it. 3. The epilepsy is concerned about the abnormality in five viscera, liver, spleen, heart. 4. In comparison east and west medicine of epilepsy is native factor, or innate primary cause is added to outer cause of wind-evil(風), cold-evil(寒), summer-heat(署), wetness(濕), and inner cause of frightness-terror(驚-恐), seven modes of emotions(七情) and the epilepsy is occurred phlegm(痰), fire(火). It similar that the epilepsy is occurred to structural and functional obstacle in western hereditary and primary cause.