장골동맥 폐색 환자에서 금속 스텐트 삽입: 장기 개통율과 재발 관련 인자

김재규,윤웅,박진균,강형근,Kim, Jae-Gyu,Yun, Ung,Park, Jin-Gyun,Gang, Hyeong-Geun 대한영상의학회 2003 대한영상의학회지 Vol.49 No.3

목적: 장골 동맥의 폐색을 보인 환자에서 금속 스텐트 삽입 후 장기 개통율을 알아보고, 재발에 관련된 인자들을 분석해보고자 하였다. 대상과 방법: 장골 동맥 폐색을 보인 환자 중 자가 확장성 금속 스텐트를 삽입한 68명을 대상으로 하였다.간헐성 파행을 보인 환자가 48명,휴식기 동통을 호소한 환자가 11명, 하지 괴저를 일으킨 경우가 9명 이었다.스텐트 내강의 개통성 유무는 추적 혈관 촬영과 색도플러 검사로 판정하였다.Kaplan-Meier method를 이용하여 누적 개통율을 알아보았고, 증상별(Fontainestage),위험 인자별, 병변의 위치 및 길이,측부 순환 발달 유무 등의 해부학적 인자별 재발률을 Cox-proportional hazard model을 이용하여 분석하였다. 추적기간은 1일에서 73개월(평균23.8개월)이었다. 결과: 총 68명의 환자 중 16명(23.5%)이 재발하였다. 누적 개통율은 1개월 95.4%, 6개월93.2%,1년 80.1%,2년 73.2%,3년 68.9%이었고,5년 장기 개통율은 62%이었다.위험인자중 심장 질환의 경우 3배 이상 재발의 위험이 높았으나(p=0.04),흡연, 고혈압, 당뇨, 혈관 질환의 기왕력 등은 유의한 통계학적 차이를 보이지 않았다. 병변의 해부학적 요인별 재발률 비교에서는 총장골동맥에 위치한 병변보다 외장골동맥을 침범한 병변에서 6.5배 이상 재발률이 높은 것으로 나와 통계학적 유의성을 보였다(p=0.02).증상에 따른 재발률에 의의 있는 통계학적 차이는 보이지 않았다. 결론: 장골동맥 폐색 환자에서 자가 확장성 금속 스텐트 삽입 후 재발에 관련된 요인 중 기왕의 심장 질환 유무와 외장골동맥을 침범한 병변에서 더 재발률이 높았다 Purpose: To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Materials and Methods: Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of followup varied from 1 day to 73 months (mean, 23.8 months). Results: Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the Fontaine stage were not statistically significant indicators of recurrence. Conclusion: The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery.

공교육비와 교육 기회 균등

김재규,Kim, Jae-Gyu 한국대학교육협의회 1999 大學敎育 Vol.97 No.-

모든 병의 타깃, 만성질환 - 만성위장질환의 대표적인 원인, 위나선균과 관련된 소화기계 질환

김재규,Kim, Jae-Gyu 한국건강관리협회 2010 건강소식 Vol.34 No.6

한 유제품 CF로 인해 누구나 한 번쯤은 들어보았을 헬리코박터 파이로리(Helicobacter Pylori). 헬리코박터 파이로리균은 위 점막에 기생하는 나선균으로 위나선균으로도 불린다. 이 세균은 환자에게서 분리된 균주마다 서로 다른 유전체 구조를 가진 특이한 세균집단으로 만성 전정부 위염, 소화성궤양, 위 MALT(점막연관림프조직형) 림프종, 위암 등의 원인이다.

위암 표준진료권고안

김재규,Jae Gyu Kim 대한소화기암연구학회 2016 Journal of digestive cancer reports Vol.4 No.1

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

소화불량으로 고생하세요?

김재규,Kim, Jae-Gyu 사단법인 한국당뇨협회 2007 당뇨 Vol.208 No.-

Boerhaave Syndrome

김재규(Jae Gyu Kim),이우진(Woo Jin Lee),장동경(Dong Kyung Chang),이풍렬(Poong Lyul Rhee),이정상(Jeong Sang Lee),최상운(Sang Woon Choi),윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(chung Yong Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2

Spontaneous rupture of the esophagus is a rare emergency that requires immediate diagno- sis and surgical treatment. Delay in diagnosis is common and is caused mostly by lack of knowledge of the disease and consequent tendency to diagnose cases as perforated peptic ulcer, pancreatitis and acute coronary disease, etc.. Mortality and morbidity increase propor- tionally to the time between esophageal perforation and adequate treatment. We experienced a case of spontaneous esophageal perforation after alcohol ingestion, The patient was 49 year old male, who complained of sudden epigastric pain, hematemesis follow- ing forceful vomiting 4 hours before visit to emergency room. Emergency gastrofibroscopy showed oval mucosal defect with dark brownish blood clot. Under the suspision of esophageal rupture, we performed ermegency esophagography, which revealed leakage of gastrograffin and also showed pneumomediastinum. Emergency thoracotomy was performed, and esophage- al tear was primarily repaired and the insertion of chest tubes was done. He was discharged with recovery 1 month later. (Korean J Gastroenterol 1994; 26: 332 336)

프리팹 교량구조물의 품질관리 플랫폼 개발

김재규 ( Kim Jae-gyu ),현병학 ( Hyun B-h ),이순환 ( Lee Soon-hwan ) 한국구조물진단유지관리공학회 2023 한국구조물진단유지관리공학회 학술발표대회 논문집 Vol.27 No.1

건설기술 스마트화를 위해 구조 부재의 자동화/표준화 설계 제작기술이 주목받고 있다. 공장에서 자동화 제작한 모듈을 현장에서 조립하여 구조물을 완성하는 프리팹 공법은 공기 단축, 품질, 경제성을 확보할 수 있는 기술이다. 프리팹 교량의 설계-제작-운반-시공-공용/유지관리 전주기의 구조물 품질관리 수행에 필요한 계측과 의사 결정 데이터를 통합 관리하는 플랫폼 개발을 시도하고 있다.

Helicobacter pylori 감염 치료

김재규 ( Jae Gyu Kim ) 대한소화기학회 2005 대한소화기학회지 Vol.46 No.3

Significant progress and new insights have been gained since Helicobacter pylori was found in 1982. Even with currently most effective treatment regimen, about 10-20% of patients will fail to obtain the eradication of H. pylori infection. This review will focus on the empirical treatment for H. pylori infection in Korea. Seven days triple therapy (proton pump inhibitor, amoxicillin and clarithromycin) has been the main first line therapy for H. pylori infection in Korea after the recommendation by Korean H. pylori study group in 1998. Such triple therapy has been the effective regimen for eradication of H. pylori infection. However, the efficacy of 7 days proton pump inhibitor-amoxicillin-clarithromycin therapy becomes lower and various eradication rates probably reflects the increase in antimicrobial resistance, recently. The recent multi-center prospective randomized study and meta- analysis showed 14 days proton pump inhibitor-amoxicillin-clari-thromycin therapy is more effective than 7 days or 10 days therapy. In the case of failure, quadruple therapy (proton pump inhibitor, a bismuth salt, metronidazole and tetracycline) is a very effective second-line regimen. After the failure of two or more eradication treatments, bacterial resistance to antibiotics should be evaluated and the regimen of third-line therapy should be selected according to each antimicrobial susceptibility. The empirical third-line therapies, recommended in the cases that antimicrobial susceptibility test is unavailable, are unclear of its validity at present in Korea. The triple therapies including rifabutin, moxifloxacin, or levofloxacin or dual therapy including high dose proton pump inhibitor and amoxicillin are needed to be proven as possible candidates for the empirical third-line therapy. Multiple eradication failures should be handled on a case-by-case basis by specialists. (Korean J Gastroenterol 2005;46: 172-180)

드론(UAV)을 활용한 프리팹 구조물 형상계측 기술개발

김재규(Kim, Jae Gyu) 한국콘크리트학회 2022 한국콘크리트학회 학술대회 논문집 Vol.34 No.2

장상피세포에서 enteroinvasive E. coli에 의한 NF-k B와 NF-k B 목표유전자 활성화에 있어서 Nod1의 역할

김재규 ( Kim Jae Gyu ),( Martin F. Kagnoff ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-

선천면역 (innate immunity)은 숙주세포에는 없는 감염미생물이 공통으로 가지고 있는 구조물 (pathogen associated molecular pattern, PAMP)에 대한 반응으로 이루어지며 pattern-recognition receptor (PRR)에 의해 인식된다. Nod1 (CARD4)은 intracellular PRR의 하나이며 세포자멸사의 조절인자인 Apaf-1과 유사하고 caspase-9을 통해 세포자멸사를 촉진시키는 작