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호흡기내과 외래로 내원한 환자들에 대한 금연프로그램의 단기간 효과
여창동 ( Chang Dong Yeo ),강현희 ( Hyeon Hui Kang ),강지영 ( Ji Young Kang ),김성경 ( Sung Kyoung Kim ),김명숙 ( Myung Sook Kim ),김승수 ( Seung Soo Kim ),이상학 ( Sang Haak Lee ),문화식 ( Hwa Sik Moon ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.2
Background: There is very limited data present on smoking cessation rates in outpatient departments of pulmonology. In this study, we aimed to investigate the effectiveness of a brief smoking cessation intervention program in an outpatient department of pulmonology and identify predictors of smoking cessation failure. Methods: After a brief recommendation of smoking cessation from pulmonologists, smokers willing to quit smoking were given individual counseling and supplement drugs. Fifty smokers were included in this study and baseline characteristics, smoking history and success rate were reviewed at 3 months. Results: The mean age of the patients was 58.3±14.6 years and the total group of patients included 3 women. The rate of smoking cessation success was 74% at 3 months, and there were no differences in age, spirometric indexes and associated diseases between the smoking cessation success and failure group. The rate of supplement drug usage was not different in both groups either. However, body weight, mean number of cigarette usage per day and nicotine dependence scores in the failure group were significantly higher than in the success group. In multivariate analysis, body weight and mean number of cigarette usage per day were significant. Two smokers with a depressive disorder failed the smoking cessation. Conclusion: A smoking cessation intervention program in the outpatient department of pulmonology showed a favorable success rate. More intensive interventions are needed to unfavorable groups which include the obese and heavy smokers.
김순섭 ( Soon Sub Kim ),여창동 ( Chang Dong Yeo ),김진동 ( Jin Dong Kim ),김현성 ( Hyeon Seong Kim ),장정원 ( Jeong Won Jang ),김창욱 ( Chang Wook Kim ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon 대한소화기학회 2004 대한소화기학회지 Vol.44 No.6
Hepatitis E is a self-limited and enterically transmitted acute viral hepatitis that occurs from epidemic outbreaks of developing countries and sporadic hepatitis in non-endemic areas. In endemic areas, hepatitis E virus (HEV) is one of the most common ca
송도선 ( Do Seon Song ),여창동 ( Chang Dong Yeo ),박진민 ( Jin Min Park ),손덕승 ( Der Sheng Sun ),황현석 ( Hyun Suk Hwang ),박신애 ( Shin Ae Park ),임윤선 ( Yun Sun Im ),심병용 ( Byoung Yong Shim ),김훈교 ( Hoon Kyo Kim ) 대한내과학회 2007 대한내과학회지 Vol.73 No.5
목적: 암 환자에서 피로는 흔한 증상임에도 연구가 많이 이루어져 있지 않고, 의료진도 관심이 적다. 또한 국내에서 이루어진 연구는 피로의 유병율에 대해서는 이루어진 것이 없다. 성빈센트 병원에 입원한 암 환자를 대상으로 암 환자의 피로의 유병율과 동반 증상들에 대해 알아보고자 하였다. 방법: 2006년 4월 4일, 11일, 18일, 성빈센트 병원의 암 병동과 호스피스 병동에 입원하고 있는 의식이 있는 환자 93명을 대상으로 성별, 나이, 기저질환, 피로를 느끼는지 여부에 대해 조사하였다. 피로를 느낀다고 대답한 환자를 대상으로 다른 동반 증상의 유무를 조사하였다. 결과: 대상 환자 93명 중 남자가 71명(76.3%), 여자는 22명(23.7%)이였으며 중앙 연령은 66세(범위 35~84세)였다. 기저 질환은 폐암(70%)이 가장 많았으며, 위암, 대장암, 담낭암, 췌장암 순이었다. 피로를 느낀다고 답한 환자는 30명(32.3%)이었으며 그 중 남자는 71명 중 20명(28.2%)이었고, 여자는 22명 중 10명(45.5%)으로 여자암 환자에서 피로의 빈도가 높았다. 피로도는 경증, 중등도, 중증이 각각 17명(56.7%), 6명(20.0%)과 7명(23.3%)이었다. 이들의 기저 질환은 폐암 환자가 21명(70%)으로 가장 많았으며, 대장암, 위암, 담낭암, 췌장암 순이었다. 피로를 느끼는 환자들의 치료내용은 항암요법 치료를 받는 환자가 14명(46.7%), 방사선 치료를 받는 환자가 6명(20%), 항암요법과 방사선치료를 동시에 받는 환자가 3명(10%), 완화요법을 받는 환자가 7명(23.3%)으로 항암요법을 받는 환자가 제일 많았다. 피로를 느끼는 환자들의 활동도는 ECOG 1, 2, 3에 해당되는 환자가 각각 10, 12, 8명이었으며 ECOG 4인 환자는 없었고, 활동도가 저하될수록 더 큰 피로를 느꼈다. 피로를 느끼는 환자에게 동반되는 증상으로는 통증이 17명(56.6%)으로 가장 많았고, 식욕부진, 수면장애, 불안, 우울증상, 탈수, 스트레스 등의 순으로 호소하였다. 이 중 통증을 Visual Analogue scale (VAS) 로 평가하였을 때 통증이 심할수록 피로도가 높았다. 피로를 느끼는 30명 중 28명에서 빈혈이 있었다. 피로도와 헤모글로빈 농도는 관계가 없었으며, 남자와 여자로 구분하여도 차이가 없었다. 결론: 의료진은 암 환자의 피로에 대해 관심을 가지고 피로와 연관된 동반 증상들에 대한 치료를 통해 피로도를 개선시키는 것이 필요하겠다. Background: Fatigue is one of the most common problems in terminally ill cancer patients in North America and Europe. However, fatigue has been almost neglected by health care professionals and even by patients and their families in Korea. We studied the prevalence and characteristics of fatigue in cancer patients who were admitted to St. Vincent`s Hospital. Methods: Ninety-three competent patients who were admitted to the cancer or hospice ward were asked to answer whether they had fatigue or other cancer related problems on three occasions on April 4, 11 and 18, 2006. Additional demographic data were also analyzed. Results: Thirty (32.3%) of the 93 patients responded that they had fatigue. The response was from 20/71 male and 10/22 female patients. The median age was 66 years (range 35-84 years). The ECOG performance status was 1, 2 and 3 in 10, 12 and 8 patients respectively. Lung cancer (21 patients) was the most common malignancy followed by gastric cancer, colon cancer and other cancers. Fourteen patients received chemotherapy, 13 patients received supportive care and 3 patients received chemoradiotherapy. Other cancer related symptoms were pain (17 patients), anorexia (16 patients), sleep disturbance (14 patients), and anxiety and depression. The severity of fatigue was grade 1, 2, 3 in 17, 6 and 7 patients respectively. Twenty-eight patients had anemia based on the WHO scale, and there was no relationship between the grade of fatigue and hemoglobin level. Conclusions: Fatigue was a frequent symptom in cancer patients (32%) and more frequent in female patients (45%). More attention needs to be paid to the significance of fatigue in cancer patients.(Korean J Med 73:512-518, 2007)
이달의 X-선 : 양측 폐문 림프절 종대를 동반한 간질성 결절성 폐침윤
윤재호 ( Jae Ho Yoon ),여창동 ( Chang Dong Yeo ),신은중 ( Eun Joong Shin ),송소향 ( So Hyang Song ),김치홍 ( Chi Hong Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 ( Sung Hak Park ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
단순 흉부 X-선에서 양측성 폐문 림프절 비후를 보이는 대표적인 질환으로 유육종증, 림프종, 결핵, 폐암, 아밀로이드증, 브루셀라증, 콕시디오이데스진균증(Coccidioidomycosis) 등이 있다. LIP의 방사선학적 소견은 보통 비특징적이고, 초기 병변에서 양측 폐하에 망상, 망상결절성 침윤을 보이며 병이 진행됨에 따라 낭성 변화를 동반하고, 봉소상을 보이는 경우가 있으나, 본 증례의 환자와 같이 종격동과 양측 폐문에 림프절 종대를 동반하는 경우에 대한 보고는 흔치 않다. 저자들은 흉부 X-선 및 CT상 종격동과 양측 폐문 부의 림프절 종대를 동반한 간질성 결절성 폐침윤 소견을 나타낸 환자에서 흉강경하 폐 생검을 통해 진단된 LIP를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Lymphocytic interstitial pneumonia(LIP) is an uncommon condition in which the alveolar septa and extra-alveolar interstitial space are markedly expanded by small lymphocytes, plasma cells and histiocytes. Chest radiographs generally show nonspecific patterns with the most common pattern showing bibasilar reticular or reticulonodular infiltrates. Hilar or mediastinal lymphadenopathy and pleural effusions are usually absent. We encountered a 42-year-old female patient who was admitted to hospital because of exertional dyspnea and palpitation. The chest X-ray showed an enlarged bilateral hilar shadow and diffusely increased bronchovascular markings in both lung fields. The chest CT showed diffuse nodular infiltrations with mild septal thickening and combined patchy ground glass opacity in both lungs, and conglomerated mediastinal and bilateral hilar lymphadenopathy. A diagnosis of LIP was made from the tissue pathology taken by a thoracoscopic lung biopsy. The patient showed clinical and radiographic improvement after 3 months of treatment with prednisolone. We report a case of LIP presenting as diffuse nodular interstitial infiltrations with multiple mediastinal and bilateral hilar lymphadenopathy. (Tuberc Respir Dis 2006; 61: 294-298)
박보형 ( Bo Hyoung Park ),민정요 ( Jeong Yo Min ),여창동 ( Chang Dong Yeo ),오수성 ( Soo Seong Oh ),허기훈 ( Ki Hoon Hur ),허성은 ( Sung Eun Hur ),김진수 ( Jin Soo Kim ),김원철 ( Won Chul Kim ),김완욱 ( Wan Uk Kim ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.3
Adult onset Still`s disease (AOSD) is a multi-systemic inflammatory disorder characterized by several distinguished manifestations including high spiking fever, evanescent salmon-colored skin rash, arthralgia/arthritis, hepato-splenomegaly, lymphadenopathy, sore throat, serositis, and leukocytosis. The frequently noticed cardiopulmonary manifestation is pleuritis, pneumonitis, and pericarditis. Diffuse myocardial dysfunction is uncommon in AOSD, but it may be the cause of life-threatening heart failure. We have experienced a case of AOSD with acute heart failure in 20-year-old female complained of high fever and skin rash. On echocardiogram, the wall motion of left ventricle was globally decreased with a marked diminished ejection fraction (<25%). Two weeks after treatment with high dose steroid and intravenous immunoglobulin, her symptoms and cardiac function on echocardiogram was completely resolved. To our knowledge, this is the first case of AOSD with acute heart failure reported in Korea.