가정의학과 임상실습학생들의 논문작성법 교육에 적용한 간이 조사 시행 경험

이상엽(Sang-Yeoup Lee),김영주(Young-Joo Kim),최상한(Sang-Han Choi),이해균(Hae-Gyun Lee),안성률(Seong-Yul Ahn),김윤진(Yun-Jin Kim) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.1

Purpose: This study was to report our experience of the brief survey for teaching journal writing by medical students in a clinical curriculum of family medicine. Methods: Brief surveys performed by medical students in clinical clerkship of department of family medicine from 1998 to 2000. Medical students determined theme without rein for brief surveys. Lecture about meaning and process of survey was given for sufficient understanding of students, and then surveys were conducted. The subjects of survey were outpatients, nursing person, medical students, nursing students, and other general persons. The subjects of theme were classified to 17 chapters 7 components by international classification of primary care (ICPC). Results: In analysis of brief surveys according to ICPC, the reasons for surveys by components were diagnostic, screening prevention (89.0%), treatment, procedures, medication (5.7%), symptoms, complaints (5.3%). By chapters, there were social (64.6%), psychological (12.6%), metabolic and endocrine (6.5%). Among social problems, there were other social problem (35.4%), health care system/access (20.9%), problem with education (13.9%), relation problems partner (12.7%). Majority of medical students had affirmative response for survey conduction. In conclusion, our finding suggest that teaching journal writing as brief survey seems to be useful in understanding of journal writing of medical students.

심장외막지방과 대사 증후군 및 심혈관 질환 위험인자와의 연관성

백승희 ( Seung Hee Baik ),안성균 ( Sung Gyun Ahn ),최정현 ( Jung Hyun Choi ),고보람 ( Bo Ram Koh ),유준환 ( Jun Hwan Yoo ),강수진 ( Soo Jin Kang ),최병주 ( Byoung Joo Choi ),최소연 ( So Yeon Choi ),윤명호 ( Myeong Ho Yoon ),탁승제 대한내과학회 2007 대한내과학회지 Vol.72 No.3

목적: 저자 등은 1) 심장외막지방과 대사 증후군과의 연관성과 2) 심혈관 질환의 위험인자와의 상관관계를 알아보고 3) 심장외막지방과 인슐린 저항성 정도를 알아보고자 본 연구를 수행하였다. 방법: 흉통을 주소로 내원하여 처음 관동맥조영술을 시행 받은 289명을 대상으로 경흉부 심초음파을 이용한 심장외막지방의 두께 및 인체 계측, 혈청 총 콜레스테롤, 중성지방, 고밀도지단백 콜레스테롤, 저밀도지단백 콜레스테롤, 공복 시 혈당, 공복 시 인슐린, CRP, 섬유소(fibrinogen), 요산 등을 측정하였다. 결과: 1) 대사 증후군의 환자군(185명, 64%)에서 심장외막지방의 두께가 의미있게 두꺼웠다(평균 4.3±2.5 mm vs. 평균 3.6±2.8 mm, p=0.005). 2) 심장외막지방 두께의 중앙값인 3.4 mm을 기준으로 환자를 두 군으로 분류하여 심혈관 질환의 위험인자들을 비교해 보았을 때 두꺼운 군에서 대사 증후군 동반 빈도가 높고, 대사 증후군의 구성요소의 유병률이 높았으며. 나이, 허리둘레, 총 콜레스테롤, log CRP 등이 통계학적으로 의미 있게 높았고 고밀도지단백 콜레스테롤은 통계학적으로 의미있게 낮았다. 3) 대사 증후군의 여부에 따라 심장외막 지방의 ROC curve를 분석하여 심장외막지방의 두께 3.2 mm가에서 민감도 58%, 특이도 58%를 보여 가장 신뢰성 있는 cut-off 수치였다. 로지스틱 회귀 분석을 이용하여 심장외막지방의 두께가 0.1 mm 증가할 때마다 대사 증후군의 유병률이 1.78배 증가함을 알 수 있었다. 4) 나이, 허리둘레, 고밀도지단백 콜레스테롤, log CRP가 통계학적으로 의미있는 상관관계가 있었고. 이들 중 나이, log CRP는 다중 회귀 분석을 통하여 심장외막지방의 두께와 독립적으로 상관관계가 있었다. 5) 비 당뇨 환자군에서 인슐린 및 HOMA-IR score도 심장외막지방의 두께와 연관이 있었다. 결론: 경흉부 심초음파로 측정한 심장외막지방의 두께는 대사 증후군 및 심혈관 질환의 위험인자와 연관성을 보였고, 인슐린 저항성과도 관련성을 보여 앞으로 내장 지방의 새로운 지표로서 대사 증후군 및 심혈관 질환을 예측하는 새롭고 부가적인 유용한 지표가 될 수 있으리라 생각된다. Background: Increased adiposity is widely accepted as the main expression of obesity and an important risk factor for the development of cardiovascular and metabolic syndrome. The significance of epicardial adipose tissue (EAT), frequently observed during a transthoracic echocardiographic examination, is not well recognized. The purpose of this study was to investigate the relationship of EAT to metabolic syndrome and cardiovascular risk factors. Methods: We collected clinical, biochemical, and anthropometric information from 289 consecutive and prospective patients (147 men; 59±11 years) who visited our hospital for a complaint of chest pain. EAT thickness was measured by transthoracic echocardiography on the free wall of the right ventricle in the parasternal long axis and short axis views at the base level during end-diastole. Results: EAT thickness was significantly increased in 185 (64%) patients with metabolic syndrome as compared with patients without metabolic syndrome (4.3±2.5 mm vs. 3.6±2.8 mm, p=0.005). By a simple linear regression analysis, EAT was correlated to age (r=0.484, p<0.001), waist circumference (r=0.177, p=0.01), the level of HDL cholesterol (r=-0.182, p=0.001) and log CRP (r=0.268, p=0.012). Multivariate analysis showed that age and log CRP were the independent variables that correlated to EAT thickness. Conclusions: These results suggest that echocardiographic EAT should be considered as a new useful imaging indicator of visceral adipose tissue related to metabolic syndrome and cardiovascular disease. (Korean J Med 72:290-297, 2007)

임상화보 : 위창자간막동맥의 단독 벽내 혈종

윤신의 ( Shin Eui Yoon ),안성균 ( Sung Gyun Ahn ),이지영 ( Jee Young Lee ),하경호 ( Kyoung Ho Ha ),윤성우 ( Sung Woo Yoon ) 대한내과학회 2010 대한내과학회지 Vol.79 No.2

범뇌하수체저하증의 호르몬 대체요법 중단 후 발생한 스트레스 심근병증

남승완 ( Seoung Wan Nam ),이준원 ( Jun-won Lee ),심정한 ( Jeong Han Sim ),백현성 ( Hyun Sung Pack ),임창조 ( Changjo Im ),임정수 ( Jung Soo Lim ),안성균 ( Sung Gyun Ahn ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2

Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.

Carbon Dioxide Laser를 이용한 상안검성형술에 대한 임상적 고찰

안성봉,정성균,김창현,임성렬 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.3

The safety and efficacy of the CO₂ laser as a replacement for the steel scalpel is well documented in plastic surgery, but the use of the laser blepharoplasty has been controversy. This study compares and contrasts the use of the CO₂ laser with conventional method in cosmetic upper eyelid blepharoplasty. Thirteen patients underwent blepharoplasty in a paired comparison study. Four patients (Group A) underwent blepharoplasty by laser, another four patients (Group B) underwent blepharoplasty by conventional method, and the other five patients(Group C) underwent upper eyelid blepharoplasty using the laser on one eye and a conventional method on the other side. Preoperative factor (set up time, equipment), intraoperative factor(actual operation time, bleeding, visibility), postoperative factor(swelling, ecchymosis, immediate & short term result) were evaluated. The advantage of using the CO₂ laser rather than the steel scalpel in blepharoplasty are less bleeding and superior intraoperative visibility. The disadvantage of using the laser compared with steel scalpel include the cost of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery. There were no complications with either the scalpel or the laser.

내시경을 이용한 손목 터널 증후군의 치험례

안성봉,정성균,김창현,임성열 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.3

For many years the standard surgical treatment for carpal tunnel syndrome has been division of the transverse carpal ligament under direct vision through a palm incision. Although the effectiveness and patient acceptability of the conventional open carpal tunnel release are good, disability from a painful palm, cutaneous neuroma, and prolonged swelling are reported. Endoscopic carpal tunnel release seems to result in less postoperative morbidity, and minimal serious complications. Because endoscopic carpal tunnel release leaves the overlying skin, the subcutaneous fat, and the palmar fascia and its attachments to the thenar and hypothenar musculature intact, its proponents maintain that their patient have less scar tenderness, quicker recovery of grip strength, and earlier to return activities of daily living and work. The endoscopic approach(Agee single portal technique), which includes specific localization of the hook of hamate, flexor retinaculum, and the superficial palmar arch utilizing topographical landmarks, avoids entry into Guyon's canal and common digital nerves. We experienced four cases of carpal tunnel syndrome. In four cases, patients with carpal tunnel syndrome have been performed endoscopic carpal tunnel release with minor complication.

심근증 환자에서 좌심실 수축기능의 정상화와 관련된 임상 및 심초음파 인자

신준한,최소연,윤명호,안성균,신승수,김한수,탁승제,최병일 대한순환기학회 2001 Korean Circulation Journal Vol.31 No.2

벌독 아나필락시스 환자의 임상적 특성

박해심,김희연,남동호,안성균,김선신 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.3

Background and objective: There has been a few case reports of anaphylaxis due to honeybee in Korea. In order to observe the clinical feature of bee sting anaphylaxis. Moderials and methods: Six patients living in Kyunggi province area were referred under history of anaphylaxis after the bee sting. Atopy was defined by skin prick test result to common inhalant allergen. Serum specific IgE antibody to each bee antigen was detected by radioimmunoassay to identify the causative bee. Results: All six cases were female. Three had atopy and four had combined allergic diseases such as allergic rhinitis, asthma, and urticaria. The etiologic bees consisted of yellow jacket (6 cases), paper wasp (4 cases), yellow hornet (3 cases), white faced hornet (1 case) and honey bee (1 case). Four cases had experienced anaphylaxis after ant bite and they showed positive result on specific IgE to imported fire ant. Specific immunotherapy against causative bee venom was begun using bee venom extracts from Bayer (USA) based upon results of specific IgE anti-body to bee venom. Conclusion: The yellow jacket is the most common cause of bee venom anaphylaxis in this area. Further studies will be needed to evaluate possible cross-reactivity between bee and ant venom.

IgG1 및 IgG3 아형 결핍이 동반된 중증 아스피린 : 과민성 천식 환자에서 intravenous immunoglobulin 치료 1 례

박해심,김희연,한동석,남동호,안성균,유상용 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.4

Common complications in a patient with IgG subclass deficiency include recurrent respiratory infections and concomitant inflammatory lung disease. The most effective therapy in these patients is the administration of intravenous immunoglobulin. The authors report a case of severe aspirin-sensitive asthma and recurrent pneumonia with combined IgG1, and IgG3 subclass deficiency in a 19-year-old man. The patient was treated with 0.4g/kg at monthly intervals for 6 months, and is still receiving 0.2g/kg every 2 weeks at our clinic. After the replacement of in- travenous immunoglobulin, the patient has clinically improved.

관상동맥내 스텐트 시술시 Aspirin과 Cilostazol 2개월 병합요법

윤명호,탁승제,염철훈,장혁재,최소연,유상용,안성균,고종훈,신준한,김한수,최병일 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8