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전경만 ( Kyeong Man Jeon ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.3
Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.
전경만 ( Kyeong Man Jeon ) 대한내과학회 2014 대한내과학회지 Vol.86 No.5
Pain, agitation and delirium (PAD) occur frequently in mechanically ventilated patients in the intensive care unit (ICU). Consequently, analgesics and sedatives are frequently administered to critically ill patients with the aim of treating PAD, decreasing the physiological stress response, and improving synchrony with mechanical ventilation. However, many of the analgesics and sedatives in current use can lead to adverse outcomes, including longer durations of mechanical ventilation, prolonged ICU stays, delirium, and an increased risk of death, particularly when these agents are administered at excessive doses for prolonged periods. The purpose of this review is to provide an overview of the initial evaluation and monitoring of, and the medications commonly prescribed for, PAD. Moreover, we highlight the major recommendations of the recent guidelines published by the Korean Society of Critical Care Medicine and American College of Critical Care Medicine. (Korean J Med 2014;86:546-556)
고요산혈증을 보이는 한국인 건강검진 내원자들에서의 통풍의 유병률과 관련 인자들에 관한 연구
김응호 ( Eung Ho Kim ),전경만 ( Kyeong Man Jeon ),박건우 ( Keon Woo Park ),김형진 ( Hyung Jin Kim ),안중경 ( Joong Kyong Ahn ),전찬홍 ( Chan Hong Jeon ),차훈석 ( Hoon Suk Cha ),고은미 ( Eun Mi Koh ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1
Objective: To investigate the prevalence of gout among hyperuricemic Korean people who visited Health Screening Center and to study related factors in the development of gout. Methods: The medical records of 6,461 people who visited Health Screening Center from March to May in 2002 were reviewed. Five hundred twenty one out of 603 hyperuricemic individuals were interviewed by telephone. Gout was diagnosed according to the clinical criteria of Wallace. Basic demographic and lifestyle variables as well as biochemical data were collected. Results: The prevalence of hyperuricemia was 14.3% in men and 2.2% in women. The prevalence of gout among hyperuricemic population was 16.6% for men and 6.7% for women. The mean age was higher in gout patients compared to the hyperuricemic people without gout, and serum uric acid and creatinine levels were increased in gout patients. The mean systolic blood pressure and the alcohol consumption amount were also increased in gout patients. In the multiple logistic regression analysis, statistically significant related factors for the development of gout among hyperuricemic population were age, uric acid level and alcohol consumption amount. Conclusion: The prevalence of gout among hyperuricemic Korean people who visited Health Screening Center was 16.6% for men and 6.7% for women. The possible related factors in the development of gout among hyperuricemic population were age, uric acid level and alcohol consumption amount.
객담 도말 양성 환자에서 폐결핵과 비결핵 항산균 폐질환의 구별을 위한 결핵균 PCR 검사의 유용성
유창민 ( Chang Min Yu ),고원중 ( Won Jung Koh ),류연주 ( Yon Ju Ryu ),전경만 ( Kyeong Man Jeon ),최재철 ( Jae Chol Choi ),강은해 ( Eun Hae Kang ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),권오정 ( O 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.57 No.6
김혜정 ( Hye Jeong Kim ),배소영 ( So Young Bae ),성영경 ( Young Kyung Sung ),송송이 ( Song Yi Song ),전경만 ( Kyeong Man Jeon ),고원중 ( Won Jung Koh ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),권 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.5
Capillary hemangioma of the trachea is an extremely rare benign tumor in adults. We present the case of a 28-year-old woman with hemoptysis owing to a tumor of the proximal trachea. The tumor was removed by rigid bronchoscopy. The resulting specimens showed capillary hemangioma without any signs of malignant transformation. This presentation is the first case in Korea. Although tracheal capillary hemangioma is a rare disease, we should consider it as a possible cause of hemoptysis in the young adult.
박성범 ( Sung Bum Park ),박실비아 ( Silvia Park ),방선하 ( Sun Ha Bang ),김은경 ( Eun Kyung Kim ),전경만 ( Kyeong Man Jeon ),고원중 ( Won Jung Koh ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),권오정 ( 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.2
Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.
원저 : 기계환기중인 환자에서 기관지내시경 검사에 따른 생리적 변화
편유장 ( Yu Jang Pyun ),서지영 ( Gee Young Suh ),고원중 ( Won Jung Koh ),유창민 ( Chang Min Yu ),전경만 ( Kyeong Man Jeon ),전익수 ( Ik Soo Jeon ),함형석 ( Hyoung Suk Ham ),강은해 ( Eun Hae Kang ),정만표 ( Man Pyo Chung ),김호중 ( 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.56 No.5