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이강욱(Gang Wook Yi),이정호(Chung Ho Lee),김민범(Min Bum Kim),박헌진(Hyun Jin Park),김삼용(Sam Yong Kim),신영태(Young Tai Shin),노흥규(Heung Kyu Ro),이복희(Bok Hee Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.6
N/A To investigate cell mediated immunity in chronic renal failure, delayed cutaneous hypersensitivity responses to 7 microbial antigens and peripheral blood T cell subsets using monoclonal antibodies against T helper-inducer, T cytotoxic-suppressor and total T cell subsets were measured in 23 uremic patients and 17 healthy controls. IgG production by peripheral blood lymphocytes in response to PWM triggering was evaluated. The results were summarized as follows: 1) Total peripheral blood lymphocyte counts were significantly decreased in patients with chronic renal failure. 2) T cell subsets in uremic patients were not different from those in healthy controls. 3) Delayed cutaneous hypersensitivity was significantly depressed in uremic patients, 4) IgG production by peripheral blood lymphocyte culture in response to PWM triggering was significantly decreased in patients with chronic renal failure. In conclusion, decreased peripheral blood lymphocyte counts and impairment of T cell function other than T cell subsets are thought to be involved in depressed cell mediated immunity in chronic renal failure.
99mTc - Methylene Diphosphonate 골신티그램으로 관찰된 유선엽상 낭포육종
이강욱(Gang Wook Yi),최지영(Ji Young Choi),김기우(Ki Woo Kim),신동진(Dong Jin Shin),목차수(Cha Soo Mok),최대섭(Dae Seop Choi),김재평(Jae Pyeong Kim),차경수(Kyung Soo Cha) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.1
The Tc-99m-phosphate compounds, of which methylene diphosphonate is most widely used, originally introduced as bone scanning agents intended primarily to detect metastatic bone deposit. They may also accumulate in extraskeletal sites including breast. Recently we had the opportunity to observe one case of cystosarcoma phyllodes that was confirmed by tissue biopsy and demonstrated diffuse extraskeletal uptake of Tc-99m-MDP in the breast on Tc-99m-MDP bone scan in the breast on Tc-99m-MDP bone scan. So we present this case with the brief review of literatures.
Single Pass Radionuclide 심혈관 촬영술로 진단된 대동맥류에 의한 상대정맥 증후군
이강욱(Gang Wook Yi),최지영(Ji Young Choi),김기우(Ki Woo Kim),신동진(Dong Jin Shin),목차수(Cha Soo Mok),박소배(So Bae Park),최대섭(Dae Seop Choi) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.1
Single pass radionuclide cardiac angiography was performed in 67-year old woman due to dyspnea and chest discomfort. The study showed markedly dilated ascending aorta and collateral ciculations from left sudclavian vein, and confirmed aortic aneurysm with partial obstruction of superior vena cava.
급성신우신염에서 99mTc - DMSA 신장스캔의 임상적 의의
이강욱(Gang Wook Yi),신동진(Dong Jin Shin),목차수(Cha Soo Mok),최대섭(Dae Seop Choi),최호천(Ho Cheon Choi),김경욱(Gyeong Wook Kim) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.2
N/A Patients with acute pyleonephritis may present with a spectrum of clinical symptoms and signs. There are few noninvasive diagnostic studies, however to confirm or exclude this diagnosis. To evaluate the clinical utility of 99mTc-DMSA renal scan in diagnosis of acute pyelonephritis, we performed 99mTc-DMSA renal scan in 37 patients suspected with urinary truct infection. Simultaneously kidney ultrasonography was done in 21 patients diagnosed with acute pyelonephritis, clinically. And we performed the followup scan after treatment in two to six weeks. The results were as follows. 1) 99mTc-DMSA renal scan disclosed single of multiple cortical defects and decreased radiouptake ratio of affected kidney in 23 patients among 25 patients diagnosed with acute pyleonephritis. 2) In the 21 patients with acute pyelonephritis, kidney ultrasonography showed abnormal findings in the 7 patients. And 99mTc-DMSA renal scan disclosed abnormal cortical defects in this 7 patients also. 3) Between the patients with acute pyelonephritis and those with lower urinary tract infection, asymptomatic bacteriuria or pyuria, right-to-left radiouptake ratios (R/L ratio ) were significantly different(p<0.001). 4) In two to six weeks after antibiotic therapy, we performed followup 99mTc-DMSA renal scan for 5 patients among 25 acute pyelonephritis patients. And we have found the improvement of cortical defects and the right-to-left radiouptake ratio. In conclusion, we thought that 99mTc-DMSA renal scan should be useful in diagnosis of acute pyelonephritis and follow up examination.
최영환(Young Hwan Choi),이정호(Jeong Ho Lee),신승훈(Seung Hun Shin),이순구(Sunn Kgoo Rhee),구대회(Dae Hoe Ku),이강욱(Gang Wook Yi),김상용(Sam Yong Kim),신영태(Young Tai Shin) 대한내과학회 1991 대한내과학회지 Vol.40 No.5
N/A To investigate the humoral immune function in patients with systemic lupus erythematosus (SLE), peripheral blood T cell subsets, and serum levels of IgG, IgA and IgM were measured in 11 patients with SLE and 17 healthy controls. IgG and IgA production by peripheral blood lymphocytes to pokeweed mitogen triggering were also evaluated. The results were as follows: 1) Serum IgG, IgA and IgM levels in patients with SLE were more significantly elevated than those of the healthy controls. 2) T cell subsets in patients with SLE were not different from those of the healthy controls. 3) Spontaneous in vitro IgG production from peripheral blood lymphocytes was significantly higher in patients with SLE than that of healthy controls (p<0. 01), but pokeweed mitogen-stimulated in vitro IgG production was significantly lower in patients with SLE(p < 0. 005). Spontaneous in vitro IgA production in patients with SLE increased without statistical significance compared with the healthy controls, but pokeweed mitogen-stimulated in vitro IgA production slight1y decreased in patients with SLE without statistical significance. 4) Stimulation indices of in vitro IgG and IgA production were significantly lower in patients with SLE than those the of healthy controls(p<0.005). It is suggested that there is a preactivation of B cells in vivo of patients with active SLE. Furher studies on the mechanism of cellular interactions in B-cell immunoglobulin production in vitro of patients with SLE should be pursued.
간경변증 환자에서 간신티그램을 이용한 Propranolol 투여 전후의 간혈류 변화
김병호(Byeong Ho Kim),서광석(Kwang Suk Seo),김진희(Jin Hee Kim),김성걸(Seong Gul Kim),육은주(Eun Ju Yook),임의혁(Euyi Hyeog Im),성자원(Ja Won Sung),이강욱(Gang Wook Yi),정현용(Hyun Yong Jeong),이헌영(Heon Young Lee),김영건(Young Kun 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1
N/A Esophageal varix bleeding due to portal hypertension in liver cirrhotics is very emergency state and difficult for management. In spite of many kinds of treatment in esophageal varix bleeding such as medical and surgical methods, but cant be expected of good results. Lebrec report that propranolol is significantly decreased portal venous pressure in 1980. This study analyzed the portal hemodynamics by liver scintigraphy of 38 patients with liver cirrhosis who were proven to have esophageal varices and 10 norrnal subjects. The 19 cirrhotics had taken liver scintigraphy before and after propranolol medication. There were significant difference in HAI(Hepatic Arterial Index) between cirrhotics and normal subjects(64.7k16.5/ vs 31.9+8.3%, p<0.001). There were no significant difference in HAI according to the Childs classification, the type of variceal morphology and the presence of ascites, but the HAI in Child B(68.1%) and C(63.4%) groups were higher than that in Child A group(55.5%). The heart rate decreased significantly after propranolol ( 7.6No./min, p<0.001) and the HAI increased significantly after propranolol (+8.0%, p<0.05). It should be suggested that propranolol is effective in decreasing the portal hypertension by decreasing the portal blood flow. There were no serious complication of propranolol. In conclusion, these results suggest that propranolol could be a potentially useful and safe agent in management and prevention of variceal bleeding by decreasing the portal hypertension and the liver scintigraphy with Tc tin colloid is reasonably a accurate, simple, safe, and rapid method, therefore can be considered suitable for use in the assecement of liver hemodynamics.(Korean J Gastroentero11994; 26: 119-126)
통상적 99mTc - DTPA 신장스캔을 이용한 GFR측정
한진석(Jin Suk Han),이정상(Jung Sang Lee),고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이강욱(Gang Wook Yi) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.1
N/A Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintigraphy. We measured Tc- 99m-DTPA renal clearance with Jackson's method during the routine Tc-99m-DTPA renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of ClDPDA was from 19.9 ml/min to 170 mi/min and the correlation of ClDPDA and creatinine clearance was discribed by Y=16.2570+0.7852X(X=C1DPDA, Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that Tc-99m-DTPA renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine Tc-99m-DTPA renal scintigraphy simultaneously.
과립구감소증의 발열환자에 대한 Teicoplanin을 포함하는 제 2선 경험적 항생요법
이강욱,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1
Background and Purpose : In recent years, the frequency of isolation of Gram-positive organisms, including coagulase negative Staphylococci and Streptococci, is increasing in neutropenic febrile patients. So, it seems reasonable to expect that at least a sub-population of these patients might benefit from the addition of a glycopeptide to the standard empiric regimen. Teicoplanin is a new glycopeptide with comparable activity to vancomycin, which needs be given only once daily. We therefore conducted a study to evaluate the efficacy and safety of teicoplanin as a second-line empiric therapy in neutropenic febrile patients. Patients and Methods : Neutropenic patients were given a empiric antibiotic regimen consisting of cephalosporin, aminoglycoside, and antipseudomonal penicillin when a significant febrile episode occurred. In cases of no clinical improvement after 72 hours of this therapy, cephalosporin was replaced with teicoplanin. Teicoplanin was administered initially 400mg intravenously at 12 hour-interval 2 times and then once daily. Results : 17 neutropenic febrile patients who did not respond to first line empiric antibiotic therapy were enrolled in this study. Infections were documented clinically or microbiologically in 10 of 15 assessable cases(67%). Infection sites were bacteremia in 4 cases, chest 1, Hickman catheter 2, and others 4. Staphylococcus epidermidis was the most frequently isolated organism(5/9, 56%). The others included Staphylococcus hemolyticus(11 %), Streptococcus group A(11%), Pseudomonas species(11%), and Candida tropicalis(11%). In 6 of 9 cases with microbiologically documented infection, causative organisms were eradicated with teicoplanin rescue(response rate 67%). 11 of 15 evaluable patients were cured clinically (response rate 73%). 2 patients were cured after the addition of amphotericin B and 2 patients died of infection (failure rate 13%). Mild elevations of liver enzymes were observed in 3 cases. The relationship of these abnormalities to teicoplanin was uncertain due to concurrent use of anticancer and/or antifungal agents. Any other toxicities requiring cessation of teicoplanin rescue were not observed. Conclusions : These results show that a large proportion of febrile episodes in neutropenic patients is related to infection caused by Gram positive organisms and that teicoplanin has high efficacy in the management of febrile episodes in neutropenic patients without significant toxicity.
이강욱,최영환,신영태,노흥규,서광선 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1
Twenty eight cases of primary IgA nephropathy were diagnosed and studied in the Department of Internal Medicine, Chungnam National University Hospital over a period of 49 months from June 1981 to July 1985. The results were summerized as follows: 1. These cases represented 45.2% of patients with primary glomerular diseases undergoing renal biopsy and immunofluorescent studies during the same period. 2. There were 20 males and 8 females. They were 15 to 54 years old and the average age was 29.1. 3. The main symptoms were loin pain, gross hematuria, myalgia, fatigability and generalized edema in 18, 15, 12, 12, and 4 cases, respectively. Upper respiratory tract infection symptoms were presented in 50% of the cases of all patient just before and during the course of disease. 4. Proteinuria was observed in 27 cases and hematuria was seen in 23 cases, Among hematuria, the gross hematuria was observed in 15 cases. Hypoalbuminemia and hypercholesterolemia was presented in 4 cases with generalized edema. Serum BUN and creatinine were elevated in 3 cases with marked decreased Creatinine Clearence in 3 cases (Ccr<50ml/min). 5. The light microscopic findings showed mainly mesangial proliferative glomerulonephritis and focal and segmental glomerular sclerosis in 11 and 7 cases, respectively. Immunofluorescent microscopic findings disclosed diffuse mesangial deposit of IgA in all cases. IgG, igM, C3 and fibrinogen deposits were observed in mesangium in 5, 4, 20, and 7 cases, respectively.