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Auto-PEEP이 존재하는 환자에서 호흡 일에 대한 External PEEP의 효과
진재용 ( Jae Yong Chin ),임채만 ( Chae Man Lim ),고윤석 ( Youn Suck Koh ),박평환 ( Ryung Whan Park ),최종무 ( Jong Moo Choi ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ) 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.2
관동맥연축에서 서방형 칼슘길항제인 Diltiazem 과 Verapamil 의 치료효과 : Ergonovine Echocardiography 를 이용한 무작위 비교 연구
송재관(Jae Kwan Song),박성욱(Seong Wook Park),제수정(Soo Jung Je),김재중(Jae Joong Kim),두영철(Young Cheoul Doo),김원호(Won Ho Kim),진재용(Jae Yong Chin),김형호(Hyeong Ho Kim),정상식(Sang Sig Cheong),박승정(Seung Jung Park),이종구(Jo 대한내과학회 1994 대한내과학회지 Vol.46 No.3
N/A Background: Detection of left ventricular regional wall motion abnormality with two dimensional echocardiography during ergonovine injection (Ergonovine Echocardiography: Erg Echo) is a useful noninvasive diagnostic method of coronary vasospasm, and as it can be used repeatedly, comparison of the therapeutic efficacy of the prescribed drugs for the patients with variant angina may be possible with this method. The purpose of this study were to compare the antispasmotic action of short-term medication of two currently available sustained-releasing (SR) calcium antagonists (Diltiazem vs Verapamil) with Erg Echo, to investigate the factors determining the drug efficacy and to determine if the results of repeated tests of Erg Echo after shortterm medication correlate with the clinical response. Methods: Forty patients with angiographicallyproven coronary vasospam and positive Erg Echo without medication were randomly assigned into group I and II. Diltiazem SR 90mg b.i,d. was prescribed in the patients of group l and Verapamil SR 120 mg b.i.d. in group II. Isosorbide-5-mononitrate (ISMN, Elantan 20 mg b.i.d.) was commonly given in both groups. After medication of 4 days Erg Echo was repeated, and if follow up results were positive doubling of the dosage of prescribed calcium channel antagonists (i.e. Diltiazem SR 180 mg or Verapamil SR 240 mg b.i.d.) was done and the second follow up test of Erg Echo was performed after another 4 days. Clinical follow-up was done with the dosage of negative Erg Echo, and during 9 (±3) month follow-up period one patient of group I and two of group II were lost and final analysis was done with total 37 patients (19 in group I and 18 in group II). Results: Among 37 patients with variant angina, 32 were male and the mean age was 53 (±8). Sex ratio, mean age, body weight, clinical activity of variant angina assessed by the frquency of chest pain attack, number of spasm-documented coronary vessels, dosage of ergonovine for positive response in baseline Erg Echo and number of the patients with concomitant fixed coronary stenosis were not significantly different between both groups. After 4 day medication coronary vasospasm was not provoked with ergonovine injection in 13 patients of group I, and the positive rate of Erg Echo after medication was 32% (6/19) in group I, which was not significantly different from that (50%, 9/18) of group II (p=0.66). In 15 patients coronary vasospasm was provoked with ergonovine injection despite the medication, and ergonovine dose for positive response rose from 146±84 microgram (mcg) to 218±75 mcg with medication. Patients with 'mixed disease' (coronary vasospasm and concomitant fixed disease) showed higher positive result of Erg Echo after medication than the patients with pure spasm (p=0.001). During open label follow-up of 9±3 months, there was neither case of acute myocardial infarction nor that of sudden cardiac death. Recurrent chest pain with medication was observed in 6 patients of group I and 7 of group II (p=0.90), and recurrent chest pain during follow-up was more frequently observed in patients with positive Erg Echo after 4 day medication than those with negative test (p=0.01). In group II medication was modified to control the high activity of variant angina (chest pain attacks more than 5 per week) in 3 patients and verapamil SR was withdrawned in 4 patients due to side effects (2 cases of impotence, each case of constipation and peripheral edema), while there was no case of drug modification or withdrawl of diltiazem SR (p<0.05) in group I. Conclusion: Although there was no significant difference of short term medication on prevention of coronary vasospasm provoked by ergonovine injection, during long term follow-up of variant angina, diltizem SR with ISMN was superior to verapamil SR with ISMN in control of chest pain and absence of side effects. Erg Echo after short term medication was useful in comparison of drug efficacy, investication of the fact
승모판협착증 환자에서 경피적 풍선확장판막성형술의 폐기능 및 운동부하 검사에 대한 효과
김용태 ( Yong Tae Kim ),김우성 ( Woo Sung Kim ),임채만 ( Chae Man Um ),진재용 ( Jae Yong Chin ),고윤석 ( Youn Suck Koh ),김재중 ( Jae Joong Kim ),박성욱 ( Seong Wook Park ),박승정 ( Seung Jung Park ),이종구 ( Jong Koo Lee ),김원동 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.1
주담관 ( Major Bile Ducts ) 을 침범한 간세포암에 대한 임상적 고찰
박선미(Seon Me Park),최강현(Kang Hyeon Choe),진재용(Jae Yong Chin),김형호(Hyeong Ho Kim),김미경(Mee Kyung Kim),양석균(Suk Kyung Yang),정영화(Young Hwa Chung),이영상(Young Sang Lee),민영일(Young Il Min),이문규(Mun Gyu Lee),성규보(Kyu 대한내과학회 1993 대한내과학회지 Vol.45 No.5
N/A Background: Hepatocellular carinoma (HCC) with major bile duct invasion is a particular type that invades and ruptures into the bile duct in the early stage of HCC. It will be different from the other types of HCC in the clinical characteristics, progonosis and prognostic factors. Method: We investigated 16 patients, who were confirmed to have major bile duct invation by surgical pathology (6 cases), cholangiogram (7 cases), or computed tomography (3 cases), to find clinical features and to evaluate prognosis and prognostic factors affecting the mean survival time. Results: 1) Sixteen (2.8%) of 566 patients with HCC were associated with major bile duct invasion. 2) The macroscopic types of tumor by computed tomography were nodular in 6, infiltrative in 8, and invisible in 2 cases. 3)The mean survival time of 16 patients was 3.3 months. 4) weight loss (>10%) and infiltrative tumor type were correlated to poor prognosis, However, age, total bilirubin, alpha-fetoprotein, and HBsAg positivity did not affect the survival time. Conclusion: In our series, the frequency of HCC with major bile duct invasion was not uncommon and the infiltrative tumor type was more frequent than the nodular tumor type. The assessment of weight loss and gross tumor type can identify some prospect of pro- longed survival in patients with HCC showing major bile duct invasion.
급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과
고윤석 ( Youn Suck Koh ),임채만 ( Chae Man Lim ),이기만 ( Ki Man Lee ),진재용 ( Jae Yong Chin ),심태선 ( Tae Sun Shim ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ) 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.6
pncA 유전자 PCR-SSCP법을 이용한 결핵균 Pyrazinamide 내성의 진단
심태선 ( Tae Sun Shim ),김영환 ( Young Whan Kim ),진재용 ( Jae Yong Chin ),임채만 ( Chae-Man Lim ),이상도 ( Sang Do Lee ),고윤석 ( Youn Suck Koh ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),김원동 ( Won Dong Kim ) 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.6