충주 지역에서 10년간 급성심근경색의 임상관찰에 대한 연구

박봉안,류하근,이종혁,김인숙,류주성,유재등,이용구,문언수,김형수 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Background: The current treatments of acute myocardial infarct(AMI) Include noninvasive method using thrombolytics and invasive methods such as primary percutaneous transluminal coronary angioplasty(PTCA) and coronary artery bypass graft(CABG)surgery. Although there are many studies comparing the effectiveness of noninvasive and invasive methods, when large clinical centers, 20% of totar hospitals, were excluded, most middle-sized hospitals lacked personnels and facilities for the invasive methods. Thus they opted for the noninvasive methods. Therefore, in this study, the clinical characteristics of AMI patients and the results of thrombolytic & conservative treatment were observed. Method: 137 patients with acute myocardial infarct, who visited KonKuk University Medical Center, ChoongJu Hospital during Sept. 1990 to Sept. 1999 were analysed retrospectively using medical records. Result: The sexual compositions of patients were 63.5% male, and 36.5% female. The mean age for male patients were 56±12.9, and for female patients 68.7±9.6 (p<0.05). The mean age for female patients was significantly older than male patients. The patients in the thrombolytic treatment group had mortality rate of 6.25% which is lower than that of the conservative treatment group at 12% (p>0.05). Conclusion: Although in our study, small number of acute myocardial infarct patients caused the statistical insignificance, rapid revascularization by thrombolytic therapy within 6 hours of onset of symptoms improved mortality rate and early ambulation. And we had good results on AMI with thrombolytic agent in ChungJu including near rural area as primary emergency hospital. Therefore a prospective research with greater number of subjects is needed to develop better treatments for AMI.

Dimecron 중독증 환자 6예

류하근,박봉안,류주성,유재등,김정수,김치훈,송종오 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

The authors experienced 6 cases of Dimecron intoxication, an organophosphate, that required mechanical ventilator treatment. Among 6 cases, 4 cases were intoxication due to suicidal attempt and 2 cases were due to accidental exposure. Among 4 cases of intoxication due to suicidal attempt, only one patient recovered even after aggressive treatments using gastric lavage, mechanical ventilation, atropine and PAM(pralidoxime). Two cases of intoxications due to accidental exposure, 1 case needed mechanical ventilation. Both cases were recovered without any sequele, however. Organophosphate, especially Dimecron, showed high rates of resfiratory muscle paralysis and mechanical ventilator support. The mortality rate of organophosphate agents can be decreased by education, wearing protectors, and aggressive mechanical ventilator treatment when respiratory failure develops.

소화성 궤양에서 삼제 병합 요법의 저용량에 의한 Helicobacter pylori 제균률과 궤양 치유효과

김예리,박봉안,이재동,이종혁,김인숙,박형석,진춘조,김상윤,박의우 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-

Helicobacter pylori is the major cause of histologic chronic gastritis and is strongly associated with peptic ulcer disease, gastric cancer and lymphoma. Several recommendations for the management of the Helicobacter pylori infection have been developed. However, there has been no clear therapeutic regimen for the optimal treatment of Helicobacter pylori infection. This study was desinged to evaluate the eradication rate and the ulcer healing rate of the triple regimen with low-dose clarithromycin(0.5g/day) in peptic ulcer patients. Forty three patients with gastric ulcer(n=15) and duodenal ulcer(n=28) were enrolled. The patients were treated either with omeprazole 20mg b.i.d. amoxicillin 0.5g b.i.d. and clarithromycin 250mg b.i.d. (low-dose regimen group, n=29) or with omeprazole 20mg b.i.d., amoxicillin 1.0g b.i.d. and clarithromycin 0.5g b.i.d.(high-dose regimen group, n= 14) for 2 weeks. After 4 weeks, the patients were evaluated for the eradication of Helicobacter pylori and the healing of ulcer. And gastritis scores according to the Sydney system were evaluated before and after 4 weeks from the end of the triple regimen. There was no significant difference in the eradication rate and the ulcer healing rate between the low-dose regimen group, group and the high-does regimen group. In the low-does regimen group, the mean initial scores of chronic inflammation and activity were decreased after the eradication of Helicobacter pylori. In conclusion, the low-dose triple regimen is as effective as the high-dose triple regimen on the eradication of Helicobacter pylori and the ulcer healing rate in peptic ulcer disease.

한국인 제2형 당뇨병 환자에 있어 지속적 피하 인슐린 주입법 치료시 Lispro insulin와 Regular insulin의 효과 비교

유재등,박봉안,류하근,류주성,김정수,김치훈,박선민,최수봉 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

Objective: The Lispro insulin has faster onset of effects and shorter duration than the human regular insulin, an analog of human insulin. The differences in the pharmacodynamics between the two types of insulin in the continuous subcutaneous insulin infusion(CSII) with insulin pump for treating the Korean Type 2 DM patients were analyzed. The effects on the regulation of blood sugar, the amount of insulin injected, and the frequency of hypoglycemia were compared between the lispro insulin and the regular human insulin. Method and Material: One hundred and three Korean Type 2 DM patients were randomly divided into two groups, 49 Lispro insulin and 54 Regular insulin.(Table 1) Both groups were treated for 14 days. Also at a set time before meal, insulin was injected as bolus, using a portable insulin pump, in both groups, 15 minutes before for lispro insulin and 30 minutes before for human insulin The HbA1C, C-peptide, AC/PC, height and weight were measured for each patients at the time of admission. The peripheral blood sugar level and insulin injection profile were recorded 7 times per day for each patients. Results: After treating for 7 days and 14 days, the blood sugar level normalized in both groups. There weren't any significant differences in blood sugar levels in both groups at point of the study, and also there weren't any differences in the frequency of hypoglycemia. In order to maintain the normalized blood sugar level, the lispro insulin group had higher total daily insulin requirement than the regular insulin group after 14 days of treatment (0.90±0.35 vs 0.73±0.39u/kg/day, p<0.05) This difference is probably due to the difference in basement insulin requirements rather than prandial insulin requirements (0.32±0.1 vs 0.43± 0.09u/kg/day, p<0.001). Discussion: In the hospitalized Korean Type 2 DM patients with CSII treatment, continuous subcutaneous insulin infusion therapy using lispro insulin has convenience in usage compared to the regular insulin. However, there were not any differences in the blood sugar levels. Also lispro insulin requires more insulin in order to maintain normal blood sugar level, which is probably due to the increase in the basal requirement. Also there were not any difference in the frequency of hypoglycemia.

폐결핵으로 오인된 SIADH를 동반한 편평상피 세포폐암 1예

김순제,류하근,김선두,이길도,박봉안,류주성,유재등,김인숙,신현준,문언수 대한노인병학회 1999 Annals of geriatric medicine and research Vol.3 No.4

백서에서 열량 영양소 배분과 교차가 인슐린 분비능과 인슐린 저항성에 미치는 영향

최수봉(Soo Bong Choi),박봉안(Bong An Park),염세진(Sea Jin Yeom),박선민(Sun Min Park) 대한내과학회 2002 대한내과학회지 Vol.62 No.2

N/A Background: In Korea, the prevalence of type 2 diabetes has been rapidly increased in parallel with the westernization of eating behavior, which can be potential contributors for insulin resistance. We determined whether Western diet (WD), Korean diet (KD), Western-Korean exchange diet (WDK), Korean-Western exchange diet (KDW) and control diet (CD) altered insulin secretion and insulin resistance in weaning male Sprague Dawley rats. Methods : Weaning rats were provided by KD (77 En% of starch, 5 En% of corn oil and 13 En% of gluten plus 5 En% of casein), WD (42 En% of starch, 40 En% of butter and 18% of casein) or CD (62 En% of starch, 20 En% of corn oil and 18% of casein) for 21 weeks. At the 13th week, rats in the WDK and KDW groups exchanged the diets from WD to KD and KD to WD, respectively, and they continued on the exchanged diets for 9 weeks. Results: Fasting serum glucose levels were lower in KD and WDK than any other groups. Insulin secretion was higher by 2.2±0.4 folds in WD and 1.9±0.3 folds in KDW than KD at baseline. In hyperglycemic clamp, insulin secretion to maintain 11.1 mmol/L of serum glucose levels showed the same results as the baseline. Whole body glucose disposal rates were highest in KD among all groups. Glycogen deposits in soleus and quadriceps muscles were highest in KD among all groups, and their triglyceride contents were lowest. GLUT4 contents and fraction velocity of glycogen synthase were highest in KD in soleus muscles. Conclusion: Westernized high fat diets increased insulin resistance, and insulin secretion increased to overcome insulin resistance. Increased insulin resistance was due to increased triglyceride and decreased glycogen, GLUT4 and glycogen synthase contents in muscles.(Korean J Med 62:194-203, 2002)

급성 A형 간염에 동반된 Gianotti-Crosti 증후군 1예

이재동,이길주,송해준,이길도,김선두,김순제,류하근,박봉안,유재등,류주성,박형석,진춘조 대한소화기학회 2000 대한소화기학회지 Vol.36 No.4

Patient with Gianotti-Crosti Syndrome (GCS) presents with a distinctive self-limiting acral papular or papulovesicular eruption. Patient with GCS is associated with an underlying viral and bacterial illness. GCS is a self-limiting cutaneuous response to different infections. Its clinical differences are probably due to individual characteristics of each patient rather than the causative infections agents. GCS in patients infected with hepatitis A virus has not been reported previously in Korea. We report a case of 16-year-old girl who developed an erythematous papular eruption on her extremities a week after an epidemic of hepatitis A. The patient had the characteristics which resembled clinical and histopathologic findings of GCS. Hepatitis A virus RNA was detected by nested reverse transcription-polymerase chain reaction of tissue from lesion site of the patient.

Evaluation of Transnasal Esophagogastroduodenoscopyas a Surveillance Endoscopy in a General Medical Checkup

이윤정,고순영,김선웅,강원찬,이강훈,김정환,이선영,박종훈,박봉안,이정록,기새윤,서희연,김혜영,이정화,성인경 대한상부위장관ㆍ헬리코박터학회 2014 Korean Journal of Helicobacter Upper Gastrointesti Vol.14 No.4

duce patient discomfort that occurs with conventional EGD (C-EGD) performed via an oral route. We aimed to evaluate factors that influence preferences for T-EGD as a surveillance EGD in a general medical checkup. Materials and Methods: A total of 658 subjects (median age, 49 years; 45% men) underwent T-EGD procedures by 8 endoscopists using a 5.2-mm diameter endoscope. All examinees and endoscopists were asked to assess the T-EGD examinations using the post-endoscopy questionnaire. The post-endoscopy questionnaire included a 10-point visual analogue scale, which asked the patient to place a cross on the line according to examinee’s or endoscopist’s experience of the endoscopy procedure. Zero represented the worst experience and 10 the best experience. Results: T-EGD was feasible in 96.6% of the subjects. Younger age (<35 years) and female sex were significant predictive factors for failure of the procedure. Older age (≥35 years) or male examines preferred T-EGD as the modality for the next examination. The endoscopist’s overall discomfort level was higher in the beginner group than in the expert group. Conclusions: The T-EGD may be better tolerated than C-EGD and offers a more comfortable surveillance endoscopic procedure to older (≥35 years), male, or sedated C-EGD-experienced examinees in a general medical checkup. More experience with and education about T-EGD may help to improve the tolerance of the beginner group of endoscopists.