Association of Sleep Duration and Obesity According to Gender and Age in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey 2007–2015

조근혁,조은희,허정욱,신다연 대한의학회 2018 Journal of Korean medical science Vol.33 No.53

Background: This study aimed to investigate associations between self-reported sleep duration and general and abdominal obesity in Korean adults stratified according to gender and age. Methods: Data from 41,805 adults, 18–110 years of age, collected by the Korea National Health and Nutrition Examination Survey (KNHANES) in 2007 and 2015, were analyzed. Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for obesity and abdominal obesity by sleep duration after controlling for sociodemographic and lifestyle variables. Results: Among individuals 30–49 years of age, there was an increased AOR for obesity only for sleep duration ≤ 5 hour/day compared with sleep duration 6 to 8 hour/day, both in men (OR, 1.25; 95% CI, 1.02–1.54) and women (OR, 1.56; 95% CI, 1.29–1.90), after controlling for covariates. Regarding women, there was increased AOR for abdominal obesity for sleep duration ≤ 5 hour/day (OR, 1.45; 95% CI, 1.18–1.78) and ≥ 9 hour/day (OR, 1.38; 95% CI, 1.09–1.76) compared with sleep duration 6 to 8 hour/day. However, for elderly individuals (≥ 65 years), there was a negative association between sleep duration ≤ 5 hour/day and obesity, but not with abdominal obesity, in both men and women. Conclusion: This study demonstrated a significant association between sleep duration and obesity, which varied according to gender and age.

Prevalences and Management of Diabetes and Pre-diabetes among Korean Teenagers and Young Adults: Results from the Korea National Health and Nutrition Examination Survey 2005–2014

조은희,신다연,조근혁,허정욱 대한의학회 2017 Journal of Korean medical science Vol.32 No.12

The rapid increases in childhood obesity and physical inactivity are linked to the incidence of diabetes among young individuals. However, few studies have evaluated the prevalence of diabetes among this population. Therefore, we used Korea National Health and Nutrition Examination Survey (KNHANES) data to evaluate the prevalence and management of diabetes and pre-diabetes among young Koreans. We evaluated KNHANES data (2005–2014) from 10–29-year-old individuals. Individuals were considered eligible if they had completed the health examination and the health interview survey, and we excluded individuals with missing data regarding fasting glucose or glycated haemoglobin levels. Among the 100,101 potentially eligible individuals who participated in KNHANES (2005–2014), we included 83,577 (37,677 male and 45,900 female) individuals. The overall prevalences of diabetes and pre-diabetes among 10–19-year-old individuals were 0.2% and 11.9%, respectively. Among 20–29-year-old individuals, the prevalences of diabetes and pre-diabetes were 0.9% and 9.6%, respectively. The overall rates of diabetes awareness during the study period were 36.6% for 10–19-year-old individuals and 50.8% for 20–29-year-old individuals. However, the prevalence of diabetes and pre-diabetes had noticeably increased at the 2013–2014 KNHANES: 0.6% and 25.9% among 10–19-year-old individuals, and 0.8% and 19.2% among 20–29-year-old individuals. The prevalence of diabetes and pre-diabetes is rapidly increasing among Korean teenagers and young adults. Pre-emptive interventions to diagnose and treat diabetes and pre-diabetes are needed to improve glycaemic control among this population.

동정지 및 미주신경성 실신이 동반된 연하실신 1예

김혜진,조은희,조근혁,송영봉,최익성,최재원,박훈기 대한내과학회 2005 대한내과학회지 Vol.68 No.6

국소 진행성 두경부암 환자에서의 Docetaxel과 Cisplatin 유도화학요법

조은희(Eun Hee Cho),조근혁(Keun Hyok Cho),송영봉(Young Bong Song),최익성(Ik Sung Choi),최재원(Jae Won Choi),남승현(Seung Hyun Nam),김봉석(Bong Seog Kim) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

Objectives: To evaluate the efficacy and safety of induction chemotherapy with docetaxel and cisplatin in locally advanced head and neck cancer. Materials and Methods: Between June 1998 and December 2004, 30 patients were enrolled and among them, 20 patients were evaluable. Patients were treated with docetaxel 75mg/m² and cisplatin 60mg/m² on day 1 every 21 days. Results: The median age was 71(range 54-80) years old. All 20 patients were male. Nineteen patients had pathologically squamous cell carcinoma and 1 had undifferentiated carcinoma. Fourteen of 20 patients(70%) demonstrated an objective response with two(10%) achieving a complete clinical response and eleven(60%) a partial response. The median response duration was 5.3(1.6-32.1) months and the median time to progression was 5.6(1.4-33.8) months. The median overall survival of all patients was 14(range 2.2-34) months. The median overall survival of responders was 17.5(range 5-34) months and that of non-responders was 3.2(range 2.2-23) months, but it was not statistically significant(p=0.106). During a total of 92 cycles, granulocytopenia worse than CTC(Common toxicity criteria) grade 2 occurred in 6%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non-hematologic toxicities were minor and easily controlled. Conclusion: The induction chemotherapy of docetaxel and cisplatin has moderate efficacy with acceptable toxicities in patients with locally advanced head and neck cancer.

이중풍선 소장내시경의 소장질환 진단 및 치료적 유용성에 대한 단일 기관 경험

은수훈,이준성,이문성,심찬섭,김부성,김진오,고봉민,조근혁,정규성,조주영 대한소화기내시경학회 2008 Clinical Endoscopy Vol.36 No.2

목적: 이중풍선 소장내시경 검사의 임상 도입은 방사선 검사에 의존해 왔던 소장질환의 진단 및 치료에 커다란 진보를 가져왔다. 이중풍선 소장내시경 검사의 임상적 유용성에 대한 보고들이 일본과 구미에서 나오고 있지만, 국내에서의 경험과 보고는 아직까지 부족한 실정이다. 이에 본 연구에서는 단일기관에서 시행한 이중풍선 소장내시경 경험을 분석하여 진단율 및 내시경적 진단이 치료에 미치는 영향을 알아보았다. 대상 및 방법: 2004년 11월부터 2006년 11월까지 본원에서 소장질환이 의심되어 이중풍선 소장내시경 검사를 시행한 81명의 환자를 후향적으로 분석하였다. 대상 환자를 이중풍선 소장내시경 검사를 시행하게 된 적응증 별로 분류하여 각각의 적응증별 진단율과 치료 방침에 미치는 영향을 분석하였다. 결과: 대상 환자는 평균연령 46세(범위 20∼82세), 남녀 비는 47:34이었다. 이중풍선 소장내시경 검사 시행 적응증은 위장관 출혈(52명, 64.2%), 만성복통 및 설사(24명, 29.6%), 기타 원인(5명, 6.2%)이었다. 전체 114예의 이중풍선 소장내시경 검사가 시행되었고, 이중 경구 진입 25명, 경항문 진입 23명, 양측 진입 33명이었다. 위장관 출혈 환자 52명의 환자 중 44명(84.6%), 만성 복통 또는 설사 환자 24명 중 17명(70.8%)에서 진단이 가능하였고, 전체 진단율은 75.3%였다. 위장관 출혈 환자 52명 중 17명(32.7%), 만성 복통 또는 설사 환자 24명 중 13명(54.2%)에서 내과적, 내시경적, 수술적 치료가 시행되었고, 전체적으로 37.0%에서 치료 방침에 영향을 주었다. 결론: 이중풍선 소장내시경 검사는 소장질환의 진단에 있어 유용하였고, 치료방침의 결정에 있어서 큰 역할을 하여 향후 소장질환의 진단 및 치료에 있어 더욱 비중이 커질 것으로 기대한다.

증례 : 소화기 ; 에피네프린 점막하 주사 후 발생한 허혈성 위괴사 1예

이태희 ( Tae Hee Lee ),이준성 ( Joon Seong Lee ),조근혁 ( Keun Hyok Cho ),김성한 ( Sung Han Kim ),김진오 ( Jin Oh Kim ),조주영 ( Joo Young Cho ),심찬섭 ( Chan Sup Shim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.4

위는 복강동맥으로부터 풍부한 혈액 공급을 받으며 위벽내에 발달된 측부 혈관으로 허혈성 위 괴사는 드물다. 이에 대한 원인으로 주로 알려진 것은 수술 후 합병증 또는 복강동맥의 동맥경화증이다. 에피네프린 점막하 주사는 비교적 안전하게 비정맥류 위장관 출혈의 치료에 이용되지만 조직괴사를 유발할 수 있다. 현재 전세계적으로 보고된 문헌을 살펴보면 에피네프린 주입 후 발병한 위 허혈이 6예로 매우 드물다. 저자들은 평소 고혈압 및 협심증으로 항 고혈압제와 아스피린을 복용 중인 61세 여자 환자에서 에피네프린을 점막하 주사 후 발생한 허혈성 위 괴사를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 고령, 당뇨병, 고혈압, 협심증 등의 동맥경화증 위험인자를 가진 환자에서 궤양 반흔의 에피네프린 점막하 주사는 허혈성 위 괴사를 유발할 수 있으므로 이에 대해 주의가 필요하다. Ischemic gastric necrosis is rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Although the injection of epinephrine is safe and effective for non-variceal bleeding, it may cause tissue necrosis. Six cases of ischemic gastric necrosis after submucosal epinephrine injection have been reported. We describe a case of ischemic gastric necrosis after submucosal epinephrine injection in a 61-year-old woman with hypertension and angina pectoris treated with antihypertensives and aspirin. We should exercise caution when injecting epinephrine submucosally in a patient with atherosclerotic risk factors such as old age, hypertension, diabetes mellitus, or angina pectoris due to a possible risk of ischemic gastric necrosis. (Korean J Med 77:488-492, 2009)

증례 : 다검출 나선형 CT로 확인된 대동맥과 폐동맥으로 연결된 관상 동정맥루 1예

최익성 ( Ik Sung Choi ),조은희 ( Eun Hee Cho ),조근혁 ( Keun Hyuk Cho ),최재원 ( Jae Won Choi ),이세동 ( Sehe Dong Lee ),이근 ( Keun Lee ),곽서현 ( Seo Hyun Kwak ) 대한내과학회 2006 대한내과학회지 Vol.71 No.2

흉통을 주소로 내원한 환자에서 관상동맥 조영술 및 다검출 나선형 CT (MDCT)상 좌전하행지와 대동맥에서 망상형태의 common channel을 통해 폐동맥으로 연결된 관상 동맥루 1예를 진단하고 수술적 치료를 하였기에 이를 문헌고찰과 함께 보고하는 바이다. A congenital coronary artery fistula is a rare condition, which is an abnormal communication of the coronary artery with the ventricles or atriums or the pulmonary artery. A case of 69 year-old man, complaining of recent aggravating chest pain for 5 months is reported. The coronary angiography shows coronary artery-pulmonary artery fistula. Multidetector row CT shows coronary artery-pulmonary artery fistula combined with aortopulmonary fistula via common channel and the fistulas were surgically ligated.(Korean J Med 71:208-213, 2006)