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곽진호 ( Jin Ho Kwak ),진규복 ( Kyu Bok Jin ),김정은 ( Jung Eun Kim ),황은아 ( Eun Ah Hwang ),한승엽 ( Seung Yeup Han ),박성배 ( Sung Bae Park ),김현철 ( Hyun Chul Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2
Posttransplant lymphoproliferative disorder (PTLD) is an uncommon but life-threatening complication of immunosuppressive therapy following solid organ transplantation. It encompasses a heterogeneous group of lymphoproliferative disorders ranging from reactive, polyclonal hyperplasia to aggressive non-Hodgkin`s lymphoma. The majority of PTLD is of B-cell origin and associated with Epstein-Barr virus (EBV) infection. Gastrointestinal involvement, especially small bowel and colon, is common in patients with PTLD, but the duodenum is rarely involved. We have experienced a case of PTLD involving the duodenum eight years after kidney transplantation in 50-year-old man. Two weeks before admission, he had complained of epigastric pain, and was diagnosed as pangastritis and duodenal ulcer by upper gastrointestinal endoscopy. He was admitted due to aggravated epigastric pain despite anti-ulcer medication. On the seventh hospital day, we found a new mass-like lesion in the pyloric area of antrum and diffuse ulceration in the duodenum by follow-up endoscopy. Histologic findings revealed diffuse large B-cell lymphoma. During reduction in immunosuppressive regimens, his conditions deteriorated rapidly. He died of sepsis associated with duodenal ulcer perforation, 18 days after diagnosis.
일부 의과대학 4학년 학생들의 모유수유에 대한 태도 및 지식
강미정,이충원,진규복,서은정,안재석,서석권,이미영,Kang, Mi-Jung,Lee, Choong-Won,Jin, Kyu-Bok,Suh, Eun-Jung,Ahn, Jae-Suk,Suh, Suk-Kwon,Lee, Mi-Young 대한예방의학회 1999 예방의학회지 Vol.32 No.1
Objectives. This study surveyed medical students attending clerkship to assess their attitude toward and knowledge about breastfeeding, and self-confidence to manage common breastfeeding problems. Methods. A self-report questionnaire was administered to the 323 medical students at four medical colleges in Taegu in May 1997. The response rate was 92.9%, but the respondents used in the final data analysis were 245 (75.8%) due to missing variables. Results. Overall, respondents showed equivocal attitudes toward breastfeeding (mean score 2.9 on a 6-point scale). Knowledge about breastfeeding was substantially low with the median % correct 39.2%. Of nine knowledge areas, weak areas were especially 'contraindications and barriers to breastfeeding', 'use of breastfeeding aids', 'expression and storage of breast milk'. Those reported to be confident to manage common breastfeeding problems were only 25.7%. Correlations between knowledge and self-confidence were not statistically significant except in college A (r=0.35, p<0.05). Correlations between knowledge and attitude were not significant. Conclusions. These results suggest that medical students attending clerkship in Taegu show equivocal attitudes toward breastfeeding, low self-confidence to manage common breastfeeding problems and have substantially limited level of knowledge. There should be more concerted efforts to improve this situation on the part of those involved in breastfeeding education.
박봉수 ( Bong Soo Park ),진규복 ( Kyu Bok Jin ),김연미 ( Yeon Mee Kim ),오희택 ( Hee Mee Kim ),송승언 ( Seung Eon Song ),임태원 ( Tae Won Lim ),김양욱 ( Yang Wook Kim ) 대한내과학회 2013 대한내과학회지 Vol.84 No.5
현재까지 우리나라에서는 본 증례를 포함해 아주 적은 수의 원발성 신유암종이 보고되었으며, 치료 및 임상적 특성 예후에 대해 아직 밝혀지지 않은 부분이 많으므로 지속적인 증례 보고 및 연구가 필요할 것으로 생각된다. Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumor is very rare due to the absence of neuroendocrine cells in the kidney and ureter. Therefore, little is known about the management and prognosis of renal carcinoid. Here, we report a case of a primary renal carcinoid tumor arising from a normal kidney in a 21-year-old man. He presented with a left renal mass, which was found accidentally. Abdominal computed tomography (CT) showed a 5.5 × 5.0-cm cystic mass with calcification. We suspected a cystic renal cell carcinoma and performed a laparoscopic radical nephrectomy. However, the histology revealed a well-differentiated neuroendocrine tumor. We concluded that it was a primary renal carcinoid tumor with no distant metastasis and did not administer chemotherapy or radiation therapy. He is recurrence-free after 8 months. (Korean J Med 2013; 84: 747-750)
김정은 ( Jung Eun Kim ),황은아 ( Eun Ah Hwang ),곽진호 ( Jin Ho Kwak ),진규복 ( Kyu Bok Jin ),윤정수 ( Jeong Soo Yoon ),한승엽 ( Seung Yeup Han ),박성배 ( Sung Bae Park ),김현철 ( Hyun Chul Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.5
Purpose: The aims of this retrospective study were to evaluate the sequential changes of parathyroid hormone (iPTH) and calcium metabolism after renal transplantation (RTP) and to identify risk factors for hypertension (HPT). Methods : Biochemical bone parameters were reviewed in 264 patients at pre-transplant, 6, 12, 36 and 60 months after RTP. Results : iPTH levels fell significantly during the first six months after RTP and remained substantially stable thereafter. The mean total serum calcium level showed significant increase during the first six months and progressive and significant decline after the first year. The mean serum phosphorus level returned to the normal range during the first six months and remained normal thereafter. The serum alkaline phosphatase (ALP) level increased during the first year and gradually decreased after then. The prevalence of persistent HPT was 17.8%. Patients with persistent HPT had significantly elevated serum levels of iPTH at the time of RTP and had spent a longer time on dialysis. Significant positive correlations were observed between the serum iPTH levels on the one hand and the pre-transplant iPTH, serum ALP, and creatinine levels on the other hand. Conclusion: The prevalence of persistent HPT after RTP is not uncommon. The patients with long duration of dialysis showing high serum level of iPTH at the time of transplantation are at risk for persistent HPT.
성정훈 ( Jung Hoon Sung ),곽충환 ( Chung Hwan Kuak ),진규복 ( Kyu Bok Jin ),이기태 ( Ki Tae Lee ),황은아 ( Eun Ah Hwang ),한승엽 ( Seung Yeup Han ),박성배 ( Sung Bae Park ),김현철 ( Hyun Chul Kim ) 대한내과학회 2005 대한내과학회지 Vol.68 No.2
배경 : 특발성 막증식성 사구체신염은 주로 소아 및 청년에서 발병하며 약 50%에서 만성 신부전으로 진행하는 예후가 불량한 것으로 알려져 있으나 국내에서는 이들 환자의 임상적 특징 및 장기 예후에 대한 보고는 드물다. 방법 : 1982년 6월부터 2004년 3월까지 만 21년간 계명의대 동산병원에서 신생검을 통해 원발성 사구체신염으로 진단된 1,971예 가운데 특발성 막증식성 사구체신염이 진단된 51명(2.6%)을 대상으로 이들 환자의 진단시 임상양상, Background : Idiopathic membranoproliferative glomerulonephritis (MPGN) is a chronic primary glomerular disease that occurs in both children and adults, with generally progressive course. We have examined the clinical and long-term outcome of patients wit
성인 특발성 신증후군의 임상적 고찰 -단일 기관 성적-
성정훈 ( Jung Hoon Sung ),황은아 ( Eun Ah Hwang ),곽진호 ( Jin Ho Kwak ),진규복 ( Kyu Bok Jin ),한승엽 ( Seung Yeup Han ),박성배 ( Sung Bae Park ),김현철 ( Hyun Chul Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.1
목적: 성인 특발성 신증후군 환자의 남녀별, 연령별 및 병리조직학적 유형에 따른 임상상과 조사 시기에 따른 원인 질환의 발생 비율의 변화에 대해 조사하고자 하였다. 방법: 1978년부터 2005년까지 계명의대 동산병원 내과에 입원하여 신생검을 통해 특발성 신증후군으로 진단받은 15세 이상의 성인 환자 823 예를 대상으로 병리조직학적 유형별 비율, 그 유형에 따른 임상상, 관찰 시기에 따른 원인 신질환 비율의 변화를 후향적으로 분석 비교하였다. 결과: 대상 환자의 수는 823명이었고 평균 연령은 36.7세, 남녀비는 1.7:1로 남자에서 많았다. 병리조직학적 유형은 전체적으로 미세 변화형 신증후군이 51.6%로 가장 많았고, 그 다음이 막성 신염이 21.3%, 초점성 분절성 사구체경화증 12.1%, IgA 신병증 9.1%, 막증식성 사구체신염 3.8% 순이었다. 45세 이하에서는 미세 변화형 신증후군이 가장 흔한 병리조직학적 유형이었으나 45세 이상 군에서는 막성 신염의 비율이 높았다. 1978-1990년과 1991-2005년까지의 두 기간으로 구분했을 때 미세 변화형 신증후군은 다소 감소하는 경향을, 막성 신염은 유의하게 증가한 반면, 막증식성 사구체신염은 유의하게 감소하였다. IgA 신병증은 다소 증가하는 추세를 보였고, 초점성 분절성 사구체경화증은 유의한 변화가 없었다. 결론: 성인 특발성 신증후군의 원인 질환으로 전체적으로 미세 변화형 신증후군이 가장 많았다. 연령별로는 45세 이하에서는 미세 변화형 신증후군이, 45세 이상에서는 막성 신염의 비율이 가장 높았다. 과거에 비해서 최근에 막성 신염의 비율은 유의하게 증가한 반면 막증식성 사구체신염의 비율은 유의하게 감소하였다. Purpose: We examined the clinical characteristics and incidence of adults idiopathic nephrotic syndrome (NS) according to pathologic diagnosis, age, sex. Methods: We retrospectively reviewed the clinical and pathological characteristics of primary glomerular lesions in adults idiopathic NS taken a renal biopsy from 1978 to 2005 at the Dongsan Medical Center. We compared the prevalence of adults idiopathic NS according to the pathologic diagnosis between two time intervals 1978 to 1990 and 1991 to 2005. Results: The patients had mean age of 36.7±16.3 years and male to female ratio was 1.7:1 with male predominance. The frequency of histopathologic diagnoses were minimal change nephrotic syndrome (MCNS) 51.6%, membranous glomerulonephritis (MGN) 21.3%, focal segmental glomerulosclerosis (FSGS) 12.1%, IgA nephropathy 9.1%, membranoproliferative glomerulonephritis (MPGN) 4.2% in decreasing order of frequency. The mean age was youngest in MCNS (32.9±15.1) and oldest in MGN (46.2±16.6). Between 1978 to 1990 period and 1991 to 2005 period, the prevalence of MGN was significantly increased, whereas the prevalence of MPGN was decreased significantly. The prevalence of MCNS had a tendency to decrease and that of IgA nephropathy had a tendency to increase, however, both didn`t reach statistical significance. The incidence of FSGS didn`t show a significant change during the both study periods. Conclusion: MCNS was the most common disease among adults idiopathic NS. MGN was the most frequent etiology in patients older than 45 years. The incidence of MGN was increased over the 28-year period, and that of MPGN decreased significantly. There was no change in the frequency of FSGS.
지속성 외래복막투석 환자에서 발생한 Chryseobacterium indologenes 와 Sphingomonas paucimobilis 복합균주에 의한 복막염 1예
윤정수 ( Jeong Soo Yoon ),황은아 ( Eun Ah Hwang ),장미현 ( Mi Hyun Chang ),박우영 ( Woo Young Park ),진규복 ( Kyu Bok Jin ),한승엽 ( Seung Yeup Han ),박성배 ( Sung Bae Park ),김현철 ( Hyun Chul Kim ),류남희 ( Nam Hee Ryoo ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.6
신봉철 ( Bong Chul Shin ),허내윤 ( Nae Yun Heo ),강미선 ( Mi Seon Kang ),이주원 ( Ju Won Lee ),박승현 ( Seung Hyun Park ),진규복 ( Kyu Bok Jin ),강준 ( Jun Kang ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
Hepatobiliary involvement is a rare manifestation of Henoch-Schonlein purpura (HSP). HSP cases related to hepatitis A, B or C virus have been reported but little is known about HSP cases complicated by cholestatic hepatitis without underlying hepatobiliary disease. Here, we report a case of Henoch-Schonlein purpura presenting with cholestatic hepatitis. The patient presented with upper abdominal pain and cholestasis that developed characteristic purpura. The patient was treated conservatively by therapeutic fasting and nutritional support, and liver function recovered 7 weeks after admission. (Korean J Med 2013;84:831-835)