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이홍기(Lee, Hong-ghi),홍연표(Hong, Yeon-pyo),윤은자(Yeun, Eun-Ja) 한국웰니스학회 2017 한국웰니스학회지 Vol.12 No.1
의학과 하이테크놀로지에 의한 의료기술의 발전으로 혈액암 환자의 생존률이 빠르게 증가하고 있으나 치료과정 중에 발생하는 암피로는 대부분의 환자에게 심각한 증상으로 발현되어 암환자의 삶의 질에 지대한 영향을 미치고 있다. 피로는 객관화하여 평가할 수 없는 개인의 주관적 증상이다. 이에 Q 방법론을 이용하여 혈액암 환자 자신의 관점을 통해 암피로 대처에 대한 주관적 판단의 가치와 구조를 발견해내는 접근이 필요한 시점이다. Q방법론을 이용하여 혈액암 환자의 암피로 대처에 대한 태도 유형과 그 특성을 파악하기 위함이다. 연구방법: 암피로와 관련된 문헌고찰과 상급종합병원 환자 8명을 대상으로 비구조화된 심층면담을 실시하여 총 37개의 Q 표본을 선정하였다. 편의표집한 혈액암 환자 29명을 대상으로 Q분류를 하였고 자료분석은 PC-QUANL프로그램을 사용하였다. 혈액암 환자의 암피로 대처에 대한 태도는 2개 유형으로 추출되었으며 각각 ‘활동적 전환 대처형’, ‘예방적 보존대처형’으로 명명하였다. 본 연구의 결과는 암피로 대처 현상을 혈액암 환자의 관점에서 이해하고 접근하도록 하는 근거를 제시해 줄 것이다. 또한 혈액암 환자의 암피로 대처를 위해 유형별 특성에 기초한 맞춤형 증상관리 방안을 모색하여 적용함으로써 혈액암 환자의 삶의 질 향상에도 기여할 것이다. The development of medical technology by medical and high technology is rapidly increasing the survival rate of hematologic cancer patients. Cancer fatigue occurs in over half of patients. Therefore, it is necessary to use the Q methodology to find out the value and structure of subjective judgment about the cancer fatigue coping through the hematologic cancer patient"s own viewpoint. The purpose of this study was to investigate the attitudes toward cancer fatigue and its characteristics in patients with hematologic cancer using Q methodology. Method: A total of 37 Q samples were selected by conducting unstructured in-depth interviews with 8 patients in two university hospitals and literature review. 29 patients with hematologic cancer were divided into Q sorting, and data were analyzed using the PC-QUANL program. Two factors of attitudes toward cancer fatigue were extracted from patients with hematologic cancer, and they were named "active conversion coping" and "preventive conservation coping", respectively. These findings will provide a basis for understanding the treatment of cancer fatigue in patients with hematologic cancer from the perspective of patients with hematologic cancer. Futhmore, these findings are expected to be useful in seeking care strategies to reduce fatigue and increasing quality of life in patients with hematologic cancer.
5-fluorouracil 이 근간이 된 화학요법에 실패한 진행성 위암에서 Docetaxel 과 Cisplatin 복합화학요법
이효락(Hyo Rak Lee),박세훈(Se Hoon Park),송서영(Seo Young Song),박준오(Joon Oh Park),이순일(Soon Il Lee),김기현(Ki Hyun Kim),김원석(Won Seog Kim),정철원(Chul Won Jung),임영혁(Young Hyuck Im),이홍기(Hong Ghi Lee),박근칠(Keun Chil Park 대한내과학회 2002 대한내과학회지 Vol.62 No.1
N/A Background: There is no effective treatment in patients with advanced gastric cancer failed to first-line chemotherapy. Taxane is one of new drugs identified as having substantial activity in gastric cancer. We performed a phase II trial to evaluate the efficacy and toxicity of docetaxel plus cisplatin regimen as a salvage chemotherapy for advanced gastric cancer failed to 5-fluorouracil (5-FU)-based chemotherapy. Methods: Metastatic or recurrent gastric cancer patients failed to 5-FU-based regimen with an Eastern Cooperative Oncology Group (ECOG) performance score≤2 were eligible in this trial. Docetaxel (60mg/㎡) was infused over 1 hour , before cisplatin (60 mg/㎡) infused over 2 hours on day 1, once every 3 weeks until disease progression or unacceptable toxicity was detected. Response to treatment was assessed every two or three cycles. Results: From October 1999 to December 2000, forty-one patients were enrolled in this study. Twenty-eight of forty-one patients were assessable for response. Partial response was observed in seven patients and stable disease in four patients. The response rate was 25.0% (95% confidence interval: 20.4-29.6%) and median duration of response was 22 weeks (range: 11-53 weeks). The median survival of all enrolled patients was 24 weeks (range: 7-65 weeks). For a total of 112 cycles of chemotherapy, grade 3 and 4 toxicity was 8.9% for neutropenia, 4.5% for nausea/vomiting and 1.8% for mucositis. Conclusion: Salvage chemotherapy with docetaxel plus cisplatin regimen in gastric cancer was active with acceptable toxicities. (Korean J Med 62:83-89, 2002)
증례 : 혈액종양 ; 무도병을 주소로 내원한 진성적혈구증가증 1예
김선웅 ( Sun Woong Kim ),유형민 ( Hyung Min Yu ),이윤정 ( Yoon Jeong Lee ),김희진 ( Hee Jin Kim ),허미나 ( Mina Hur ),이홍기 ( Hong Ghi Lee ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by erythrocytosis. Clinical symptoms can range in severity from headache and tinnitus to thrombohemorrhagic complications. Neurologic symptoms are common at the onset of polycythemia; however, chorea due to PV is a rare complication. We present the case of a 77-year-old female who was referred to our hospital because of choreic movement of the limbs, head and face. She was diagnosed with JAK2V617F mutation-positive PV. Her chorea was completely resolved by phlebotomy combined with hydroxyurea and aspirin. (Korean J Med 2014;87:619-624)
손인숙 ( In Sook Sohn ),김수녕 ( Soo Nyung Kim ),이지영 ( Ji Young Lee ),이선주 ( Sun Joo Lee ),권한성 ( Han Sung Kwon ),김영진 ( Young Jin Kim ),우남식 ( Nam Sik Woo ),최영숙 ( Young Sook Choi ),이홍기 ( Hong Ghi Lee ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11
Essential thrombocythemia (ET) is a chronic myeloproliferative disease characterized by a markedly elevated platelet count in the peripheral blood due to excessive proliferation of bone marrow megakaryocytes. When the disease affects women during pregnancy, an adverse obstetric outcome is possible: miscarriages, intrauterine growth restriction, preterm delivery, intrauterine fetal death, preeclampsia. Maternal complications, both thrombotic and hemorrhagic, were reported relatively infrequently. Various treatments as acetylsalicylic acid, hydroxyurea, anagrelide, heparin, interferon-alpha and plateletpheresis have been proposed to improve the pregnancy. Our case was a 38 years old multiparous women at 37 weeks of gestation with preeclampsia, intrauterine growth restriction. Under the impression of oligohydramnios and fetal distress, an emergency cesarean section was performed under epidural anesthesia. During cesarean section, sudden cardiac arrest with unknown cause was developed, and successful resuscitation was done. After cesarean section, patient continued to elevate platelet count. So bone marrow aspiration and biopsy were performed and showed essential thrombocythemia. We report a case of essential thrombocythemia diagnosed during pregnancy with brief review of the literature.
조요한 ( Yo Han Cho ),안수영 ( Soo Young Ahn ),김영백 ( Young Baek Kim ),윤소영 ( So Young Yoon ),이홍기 ( Hong Ghi Lee ) 대한내과학회 2008 대한내과학회지 Vol.74 No.5
목적: 만성질환빈혈은 입원환자에서 가장 흔히 발생하지만 기저 질환의 범위나 병태생리가 명확히 정의되어 있지 않다. 저자는 이러한 빈혈을 포함한 다양한 빈혈에서 적혈구생성인자(EPO)의 분비의 특성을 알아보고 기저 질환별차이점과 분비에 영향을 주는 임상적 인자를 알아보고자 하였다. 방법: 2006년 3월 1일부터 2007년 4월 30일까지 건국대학교병원 종양혈액내과에서 빈혈(남: 혈색소<13 g/dL, 여: 혈색소<12 g/dL)로 진단된 환자를 대상으로 일반적 검사와 함께 혈중 적혈구생성인자(EPO) 값을 구하였다. 그리고 이들 환자에서 혈색소에 따른 EPO 분비의 적절성을 평가하여 질환별로 비교하였다. 결과: 총 161명의 환자가 연구에 포함되었다. 철결핍빈혈군(42명)에 비해 만성질환빈혈군(119명)에서 EPO의 분비가 유의하게 감소되어 있었다(p=0.000). 악성 종양군(20명)을 제외한 감염군(46명), 신부전군(27명) 외에도 심부전군(12명), 기타 질환군(14명) 모두에서 유의하게 EPO 감소가 관찰되었다. 연령별로는 65세 이상의 환자군이 65세 미만 환자군에 비해 유의하게 EPO의 분비가 저하되어 있었고(p=0.01), 신부전이 동반된 경우를 제외한 당뇨 환자군에서도 비당뇨 환자군에 비해 EPO의 분비가 저하되는 경향을 보였다(p=0.055). 결론: 만성질환 동반 빈혈을 포함한 여러 가지 빈혈은 EPO 분비가 감소되어 있었고, 또한 고령이나 당뇨 등이 EPO 분비를 감소시키는 경향을 보였다. 이러한 빈혈 환자에서의 진단적 EPO 측정 및 치료목적 투여에 대한 추가적인 연구가 앞으로 필요한 것으로 생각된다. Background/Aims: The characteristics of erythropoietin response in patients suffering with anemia of chronic disease and in the patients with various other anemias are poorly defined. Thus, we evaluated the clinical factors that influence the erythropoietin response. Methods: We enrolled the anemic patients (hemoglobin <13 g/dL for males and <12 g/dL for females) who visited the Hematology-Oncology department of Konkuk University Hospital from Mar 2006 to April 2007. The laboratory tests, including the complete blood count, serum ferritin, serum vitamin B12/folate, the peripheral blood morphology and serum erythropoietin, were done. The erythropoietin response to anemia was assessed by the ratio of the log of the measured erythropoietin to the log of the expected erythropoietin. Results: A total of 161 patients, including 42 iron-deficiency anemia (IDA) patients, were analyzed. 119 non-IDA patients were diagnosed with infection (n=46), chronic renal failure (n=27), cancer (n=20), heart failure (n=12), or with other diseases (n=14). Except for the cancer patients, all the patients with other diseases showed a blunted erythropoietin response in comparison with the IDA patients (p=0.000). Among the non-IDA patients, those patients older than 65 years showed more blunted erythropoietin response than did the younger patients (p=0.01), and the diabetics without renal dysfunction also tended to respond better to erythropoietin than did the non-diabetics (p=0.055). Conclusion: A blunted erythropoietin response was observed in most of the anemic patients in our study. Old age and diabetes may further blunt the erythropoietin response. The feasibility of erythropoietin testing and supplementation treatment in these patients merits further evaluation.(Korean J Med 74:531-536, 2008)
증례 : 혈액종양 ; 성인 T세포 백혈병/림프종 환자에서 전이성 폐 석회화 1예
김수정 ( Soo Jung Kim ),강원찬 ( Won Chan Kang ),김선웅 ( Sun Woong Kim ),이윤정 ( Yoon Jeong Lee ),김욱연 ( Wookyoun Kim ),김현정 ( Hyun Jeong Kim ),이홍기 ( Hong Ghi Lee ) 대한내과학회 2014 대한내과학회지 Vol.87 No.6
HTLV-1 관련 ATLL은 다양한 임상양상을 나타낼 수 있으며 그 중 고칼슘혈증이 동반된 급성형의 경우 그 예후는 좋지 않을 수 있다. 저자는 HTLV-1 관련 ATLL 환자에서 고칼 슘혈증 및 전이성 석회화 폐결절이 진단된 환자에서 항암치료 변경투약 및 감염치료를 지속하였음에도 호전되지 않는 치명적인 증례를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive disease that is geographically clustered, mirroring areas endemic for human T-cell lymphotropic virus type 1 infection. Most patients with ATLL present with aggressive manifestations such as severe hypercalcemia, lymphadenopathy, hepatosplenomegaly, and bone marrow involvement with progressive thrombocytopenia. We herein report a case of a patient with ATLL exhibiting increased uptake in both lungs as shown on a bone scan using 99mTc methylene diphosphonate. This finding is thought to have been caused by metastatic calcification associated with ectopic parathyroid hormone production. (Korean J Med 2014,87:750-755)
면역저하 환자에서 발생한 폐침윤에서 기관지내시경과 수술적 폐생검의 유용성
박상준 ( Sang Joon Park ),강수정 ( Soo Jung Kang ),고영민 ( Young Min Koh ),서지영 ( Gee Young Suh ),김호중 ( Ho Joong Kim ),권오정 ( O Jung Kwon ),이홍기 ( Hong Ghi Lee ),이종헌 ( Chong H. Rhee ),정만표 ( Man Pyo Chung ) 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.47 No.2