봄 꿩

전병조 문예운동사 2017 수필시대 Vol.12 No.7·8

아세트아미노펜 중독의 해독제: 아세틸시스테인

전병조,문정미,김승호 대한의사협회 2013 대한의사협회지 Vol.56 No.12

N-acetylcysteine (NAC) is widely recognized as the antidote of choice for acetaminophen overdose. Acetaminophen is a commonly used analgesic and antipyretic agent, and its use is one of the most common causes of poisoning worldwide. Acetaminophen toxicity may occur acutely when supratherapeutic amounts are ingested purposefully or unintentionally. Liver failure may occur in severe toxicity. However, if treated early, patients with acetaminophen poisoning generally recover uneventfully. Acetaminophen is metabolized to N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified by conjugation with glutathione. In overdose, hepatic stores of glutathione are depleted and NAPQI binding to hepatocytes induces cell death and hepatic necrosis. NAC replenishes hepatic glutathione and may also act as a glutathione substitute,combining directly with the toxic metabolite. Intravenous NAC is indicated in patients who present with a history of acetaminophen overdose within the previous 8 to 10 hours, patients unable to tolerate oral NAC, and patients who present with evidence of fulminant hepatic failure. However,caution should be used in patients who have experienced previous hypersensitivity or anaphylactoid reactions to intravenous NAC, as well as in patients with asthma. The most common anaphylactoid reactions include rash, flushing, and bronchospasm. Adults should receive 150mg/kg administered for 45 minutes, followed by 50 mg/kg administered for 4 hours, followed by 100 mg/kg administered for 16 hours. The total dose is 300 mg/kg delivered over 21 hours. Additionally,caution should always be used when intravenous NAC is prescribed and the amount of diluent is calculated. Monitoring of patients with a should include repeated neurologic and hemodynamic assessment.

발작성 상실성 빈맥 환자의 응급실 내 치료 결과 및 재발 인자에 관한 분석

전병조,문정미,위준선,정경운,김현창,정승태,허탁,민용일 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: The purpose of this research was to evaluate the factors predicting recurrence and the characteristics of patients who recurred after the treatment of spontaneous paroxysmal supraventricular tachycardia (PSVT) with adenosine. Methods: From January 1999 to December 2001, 62 patients with PSVT were enrolled in this study. The conversion group included patients who had had a therapeutic response, which was defined as the occurrence of a change in the sinus rhythm after adenosine administration. The recurred group consisted of all patients who had not had a therapeutic response. Clinical features, the results of treatment, ECG findings, and the hemodynamic statuses were analyzed. Results: The treatments were vagal maneuver (5 pts, 7.5%), adenosine 6 ㎎ (37 pts, 55.2%), adenosine 12 ㎎ (14 pts, 20.9%), verapamil 5 ㎎ (9 pts, 13.4%), and cardioversion (2 pts, 3.0%). Twenty-five of the 62 patients failed to have a therapeutic response, yielding a recurrence rate of 40.3%. Atrioventricular reentrant tachycardia (AVRT) was more prevalent in the recurred group. The most common symptom at presentation was chest pain. The recurred group had increased heart rate, and increased blood pressure. When patients were monitered after adenosine, unifocal premature ventricular complex was the most common rhythm encountered in the conversion group, but atrial fibrillation, and multifocal premature ventricular complex was the most common rhythm encountered. Conclusion: Age, heart rate, difference in systolic blood pressure from presentation to discharge, previous history of heart disease, and rhythms encountered after adenosine administration ere factors predicting recurrence.

정책토론회 ( 1997 . 9 . 5 ) / 국제 경쟁력 강화를 위한 금융발전 방안 : 금융개혁 법률안 주요내용

전병조 부산대학교 노동문제연구소 1997 정책토론회 97-1 Vol.- No.-

응급병동을 효율적으로 운영하여 응급실 재실시간을 줄이자

전병조 한국의료QA학회 2005 가을학술대회 Vol.2005 No.2

유기인계농약 음독환자에서 내원시 혈장 Cholinesterase 활성도의 의의

전병조,문정미,윤한덕,허탁,민용일 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1

Purpose: Plasma cholinesterase is a sensitive measure determining the severity of organophosphate intoxication. The author evaluated the usefulness of the plasma cholinesterase level as a prognostic indicator of the severity of organophosphate intoxication. Methods: From June 1999 to May 2001, 55 patients presented with organophoshate insecticide intoxication to the Emergency Medical Center of the Chonnam National University Hospital, and these were enrolled in this study. The plasma cholinesterase activities of these 55 patients were determined at the time of presentation. The relationships between the plasma cholinesterase level and the clinical variables of organophosphate toxicity, quantity of ingested poison, elapsed time to gastric lavage, and the APACHE score at the time of hospitalization were analyzed. Results: The plasma cholinesterase activity significantly decreased in association with the degree of toxicity of the poison (p<0.001), elapsed time to gastric lavage (p<0.001), and the quantity of organophoshate ingested (p=0.013). In the 55 patients, lower plasma values of cholinesterase were observed in patients with longer durations of mechanical ventilation (r= 0.717, p<0.001) and in patients who developed pneumonia during treatment (r=-0.538, p<0.001). Also, decreased cholinesterase activity correlated with a higher APACHE score(r=-0.672, (p<0.001). Conclusion: These results suggest that immediate determination of the plasma cholinesterase level at the time of hospitalization may be useful as a prognostic indicator in patients with organophosphate intoxication.

Preoperative sterile pyuria as a prognostic biomarker for intravesical recurrence in upper urinary tract urothelial carcinoma

전병조,태범식,최훈,배재현,김종욱,박홍석,박재영 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.1

Purpose: To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS)in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery. Materials and Methods: We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS. Results: We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS. Conclusions: Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.

용안(Diamocarpus longan)씨앗을 활용한 묵 제조 및 겔 강도에 미치는 식염농도의 영향

전병조,장미진,정인학 한국식품영양과학회 2016 한국식품영양과학회 학술대회발표집 Vol.2016 No.10

상부 요로상피암에서 신보조 항암요법 및보조 항암요법의 최신 지견

전병조,태범식,박재영 대한비뇨기종양학회 2018 대한비뇨기종양학회지 Vol.16 No.3

Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.

Analysis of Present Status for Surgery of Benign Prostatic Hyperplasia in Korea Using Nationwide Healthcare System Data

전병조,정홍,배재현,정한,이정구,최훈 대한배뇨장애요실금학회 2019 International Neurourology Journal Vol.23 No.1

Purpose: There are no established statistical data available for the comparison of different surgical methods adopted for the resection of benign prostatic hyperplasia (BPH). This study investigates the present status related to BPH surgery in Korea for the past 8 years. Methods: National-level data from the National Health Insurance Service and National Statistical Office were analyzed in this study. From 2010 to 2017, the trends of surgeries for BPH were reviewed according to the procedure code including transurethral resection of the prostate (TURP), holmium laser enucleation of the prostate (HoLEP), or high-power potassium titanyl phosphate (KTP), and this trend also analyzed by age, geographic distribution, and hospital type. Results: Over the past 8 years, there was not much change in the total number of BPH-related surgeries (range, 10,393– 11,072). Although there was not much alteration in the number of conventional TURP (from 6,801 in 2010 to 6,645 in 2017), the number of HoLEP has dramatically increased (from 278 in 2010 to 3,805 in 2017). The number of HoLEP surgeries after 2011 exceeded the number of surgeries using KTP, and the gap is anticipated to rise. The number of surgeries by age group was most common in the 70s and the total number of surgeries is decreasing in all age groups; for HoLEP, the trend is steadily increasing over the age of 60 years. Most of the BPH surgeries were performed in metropolitan areas, such as Seoul, Gyeonggido, and Busan, and in larger hospitals compared to smaller hospital settings. Conclusions: Through the data of the National Health Insurance Service, we could apprehend the present status of BPH-related surgery in Korea. Then, we could know about the trend according to several factors and we think these results will be valuable as academic references as well.