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클로피도그렐 저항성 환자에서 동시다발적 세혈관 조기스텐트 혈전증
성충실 ( Choong Sil Seong ),최혜미 ( Hye Mi Choi ),이웅기 ( Woong Ki Lee ),김병선 ( Byung Sun Kim ),이혁수 ( Hyeuk Soo Lee ),이동엽 ( Dong Yob Lee ),박종필 ( Jong Pil Park ) 전북대학교 의과학연구소 2014 全北醫大論文集 Vol.38 No.2
The incidence of early stent thrombosis is decreasing because of the development of new generation drug-eluting stents (DES) and dual antiplatelet therapy. However, early stent thromboses still occur with fatal complications. Nowadays, investigations are focusing on the hyporesponsiveness of clopidogrel and CYP2C19 genetic correlation to reveal the cause of early stent thrombosis. Herein, we report a case of simultaneous early triple stent thrombosis related with clopidogrel resistance and CYP2C19 genetic mutation.
전기동차 및 일반열차 혼용구간 고승강장 설치기준에 관한 고찰
모충선(Choong-Seon Mo),이승열(Syeung-Youl Lee),권세곤(Se-Gon Kwon),손의식(Eui-Sil Son),박성백(Seong Baek Park),허준혁(Jun-Hyuk Heo) 한국철도학회 2014 한국철도학회 학술발표대회논문집 Vol.2014 No.10
“철도건설규칙과 “철도의 건설기준에 관한 규정”에 의하면 승강장은 직선구간에 설치토록 명시되어 있으며, 부득이한 경우에는 곡선구간에도 설치가 가능하도록 제시되어 있다. 일반적으로 곡선구간에 승강장을 설치할 경우는 차량의 편기량에 따라 선로중심으로부터 승강장 연단까지 이격거리를 확대해야 한다. 하지만 확대량에 의해 승강장 연단과 차량의 연단까지의 거리가 넓어짐에 따라 고승강장에서 승객 실족 등의 사고가 종종 발생하게 된다. 이에 대한 대책으로 고무발판 설치나 접이식 발판의 설치가 시행되고 있다. 본 연구에서는 전기동차와 일반열차 혼용구간의 곡선승강장 건축한계 확대량에 대한 검토를 시행하고 과다하게 생기는 이격거리의 확대량의 축소를 위한 안전발판의 크기를 산정할 수 있는 산식을 제시하고자 한다. According to the Railway Construction Regulations, platforms must be installed in a straight section, in exceptional cases platforms could be installed curve section. Generally, the case of platforms installation curve section should be extended distance that from track center to train ends because of slant train. But, extended value often would be occurred stumble accident of passengers. Measures of this phenomenon used to rubber footboard and fold footboard. So, this study will suggest that excessive extension would be reducing measures according to the consideration of footboard size.
( Byung Sun Kim ),( Woong Ki Lee ),( Hye Mi Choi ),( Choong Sil Seong ),( Hyeuk Soo Lee ),( Jeong Gwan Kim ),( Min Woo Kim ),( Kwang Young Lee ),( In O Sun ) 대한신장학회 2013 Kidney Research and Clinical Practice Vol.32 No.4
Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of fibroinflammatory tissue around the abdominal aorta and ureteral entrapment in most cases. Idiopathic RPF is frequently reported in association with autoimmune diseases; however, there have been few reports of idiopathic RPF associated with Hashimoto`s thyroiditis. Here, we report a case of idiopathic RPF with Hashimoto`s thyroiditis in a patient with a single functioning kidney, which was successfully treated by corticosteroid therapy and transient intraureteral stent insertion with a double-J catheter.
( Hyun Ju Yoon ),( Kwang Young Lee ),( In O Sun ),( Jeong Gwan Kim ),( Hye Mi Choi ),( Woong Ki Lee ),( Hyeuk Soo Lee ),( Choong Sil Seong ),( Byung Sun Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The aim of this study is to evaluate the difference of clinical characteristics in patients with hyponatremia, according to the causative drugs such as thiazide diuretics and psychotropic drugs (tricyclics, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, phenothiazines and butyrophenones). Methods: From 2007 to 2013, 266 patients were diagnosed with hyponatremia. We compared clinical characteristics among thiazide (T) group (n=93), psychotropic drug (P) group (n=83), and combination (C) group (n=90). We investigated the severity of hyponatremia based on initial level of serum sodium, initial symptom of the patients and correction time (serum sodium level = 130 mmol/L). Results: The mean age was younger in P group than in other two groups (65±8 vs 71±10 vs 74±13 year, P=0.000). There were no difference in initial urine osmolality (378±131 vs 396±154 vs 341±168 mmol/L, P=0.061) and serum osmolality (249±30 vs 244±17 vs 245±37 mmol/L, P=0.528). Serum uric acid level was higher in group T than in group P by Scheffe`s post-hoc analysis (P=0.046). All patients were divided into three categories based on the serum sodium level (mild: >125 mmol/L, moderate: 120-125 mmol/L, severe: <120 mmol/L), patient`s symptom (mild: general weakness, moderate: nausea or vomiting, severe: syncope or seizure). Incidences of severe hyponatremia and severe symptoms were not different among groups T, P and C (73.1 vs 67.5 vs 71.1 %, P=0.710, 20.4 vs 30.1 vs 17.8 %, P=0.192). Correction time was signifi-cantly different among groups T, P and C (41.98±26.89 vs 34.91±23.96 vs 51.10±43.86 mg/dL, P=0.026). Correction time was longer in group C than group P by Scheffe`s post-hoc analysis (P=0.010). Conclusions: Serum sodium level and severity of symptoms were not different among groups T, P and C. Correction time was longer in group C than in group P.
간성 뇌증과 감별이 어려웠던 C형간염 간경변증 환자의 크립토코쿠스뇌수막염
최혜미 ( Hye Mi Choi ),정금모 ( Gum Mo Jung ),이웅기 ( Woong Ki Lee ),이혁수 ( Hyeuk Soo Lee ),김병선 ( Byung Sun Kim ),성충실 ( Choong Sil Seong ),윤소희 ( So Hee Yoon ),조용근 ( Yong Keun Cho ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5
Cryptococcus neoformans, an encapsulated fungus, is an important opportunistic pathogen that can cause meningitis in immunocompromised patients. Since patients with cryptococcemia have high mortality, it is essential to make an early diagnosis and promptly initiate antifungal therapy. However, it is often very difficult to differentiate between cryptococcal meningitis and hepatic encephalopathy in patients with liver cirrhosis, and there is delay in making the diagnosis. Therefore, these patients have a particularly grave prognosis and consequently many patients die before culture results become available. In one study, starting antifungal therapy within 48 hours of the blood culture was associated with improved survival, but patients with liver cirrhosis were significantly less likely to receive antifungal therapy within 48 hours compared to those without liver cirrhosis. Recently, the authors experience a case of a 68-year-old woman with liver cirrhosis who presented with fever and a drowsy mental status. She had a previous history of having been admitted for infection-associated hepatic encephlopathy. Cryptococcal meningitis and cryptococcemia were diagnosed by spinal puncture and culture of cerebrospinal fluid. In spite of adequate treatment, the patient developed multi-system organ failure and eventually expired. Herein, we report a case of cryptococcal meningitis mimicking hepatic encephalopathy in a patient with liver cirrhosis. (Korean J Gastroenterol 2014,64:294-297)