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서울지역 의과대학 학생에서 흔한 흡입성 알레르겐에 대한 감작률과 기도과민성의 유병률
곽현정 ( Hyun Jung Kwak ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),손장원 ( Jang Won Sohn ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),윤호주 ( Ho Joo Yoon ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.3
Background: Sensitization to aeroallergens and airway hyperresponsiveness (AHR) are major risk factors for respiratory allergies such as allergic rhinitis and asthma. The frequency of positive skin tests differs depending on countries and environmental exposure. While skin test positivity has been studied in patients with asthma or respiratory symptoms, there have been few reports on sensitization rates to aeroallergens and AHR in the general population in Korea. Objective: In this study, we aimed to assess skin test positivity to common aeroallergens and AHR in medical students living in Seoul with or without respiratory allergy. Method: In medical students aged 21~36 years respiratory allergy was assessed by the questionnaire regarding the previous diagnosis of allergic rhinitis and asthma. Skin prick testing was performed for 10 common aeroallergens. A positive response was defined as a wheal diameter greater or equal to that of histamine. AHR was determined based on the results of methacholine bronchial provocation tests. Result: The prevalence of allergic rhinitis and asthma in 227 subjects was estimated as 20.7% and 4.4%, respectively. Atopy, which was defined as a positive response to 1 or more allergens on skin test, was present in 48.0% of the population and common aeroallergens were as follows: Dermatophagoides pteronyssinus (37.9%), Dermatophagoides farinae (35.7%), Tyrophagus putrescentiae (8.8%), cat (7.0%), mugwort (6.2%), cockroach (3.5%), ragweed (3.5%), dog (3.5%), Alternaria (3.5%) and Aspergillus (2.2%). Subjects with respiratory allergy showed higher rates of atopy (74.5% vs. 40.3%, P<0.001) and AHR (31.4% vs. 6.8%, P<0.001) than those without. AHR was found in 12.2% of the subjects and was significantly associated with atopy and the sensitization to mite allergens. Conclusion: This study shows a significantly high prevalence of atopy and AHR among young medical students in Seoul with or without respiratory allergy. These findings suggest a recent high prevalence of atopy and AHR in young populations in Korea. (Korean J Asthma Allergy Clin Immunol 2009;29:166-170)
김현수 ( Hyun Soo Kim ),고영선 ( Young Sun Ko ),곽현정 ( Hyun Jung Kwak ),이희경 ( Hee Kyung Lee ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),손장원 ( Jang Won Sohn ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
Paragonimiasis mainly occurs by ingestion of raw or undercooked freshwater crabs or crayfish. In our country, the prevalence of paragonimiasis was high until late 1960s due to eating habits, but after the 1970s the prevalence of the disease has markedly decreased and now the disease is rarely seen. As the clinical and radiological features as well as the laboratory findings are similar to that of pulmonary tuberculosis, the differential diagnosis of pulmonary paragonimiasis is very difficult. We experienced a case of a patient with pulmonary paragonimiasis who was treated as having pulmonary tuberculosis. (Tuberc Respir Dis 2007;63:440-443)
사람 대식세포에 스턴아포에 처리에 의한 P21-activated kinase 2 단백질의 발현양상
서귀문,정경화,곽현정,김성주,김지천,채영규,Seo Gwi-Moon,Jung Kwang-Hwa,Kwak Hyun Jung,Kim Seong-Joo,Kim Ji-Chon,Chai Young-Gyu 한국군사과학기술학회 2004 한국군사과학기술학회지 Vol.7 No.4
In order to elucidate the mechanism of infection on human macrophages, we peformed the 2-dimensional electrophoresis and the western blot analysis using the infected human macrophages with the spores of live and inactivated Sterne. We confirmed P21-activated kinase 2 protein which related to cell death(apoptosis) human macrophages at the early stage events. The inhibition of the P21-activated protein kinase 2 protein will be reduced apoptosis on infected human macrophages with Sterne spores.
임상연구 : 견관절경 수술 환자에서 자세 변화에 따른 혈역학과 가스 교환 지수의 변화
정월선 ( Wol Seon Jung ),김홍순 ( Hong Sun Kim ),김종찬 ( Jong Chan Kim ),박연수 ( Yeon Soo Park ),곽현정 ( Hyun Jeong Kwak ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1
Background: Sevoflurane and propofol have different cardiorespiratory effects on postural changes. The purpose of this study was to compare the effects of sevoflurane and propofol on hemodynamics and gas exchange index when patients are raised from the supine position to the beach chair position. Methods: Forty patients requiring beach chair position for shoulder surgery were randomly assigned to receive sevoflurane (end-tidal concentration 1 vol%, n = 20) or propofol (target concentration 3μg/ml, n = 20). Hemodynamic variables and arterial blood gas analysis data were recorded and gas exchange indices were calculated before induction (baseline), 20 min after endotracheal intubation (supine position), and 20 min after beach chair position. Results: There were significant decreases in mean arterial pressure, central venous pressure, and central venous oxygen saturation after beach chair position. There were no significant changes in gas exchange indices after the position changes. There were no significant differences between groups in hemodynamics and gas exchanges indices. Conclusions: Raising healthy patients from the supine to the beach-chair position produced a significant decrease in hemodynamic indices with little changes in gas exchange indices. However, the effects of sevoflurane and propofol on the both hemodynamic and gas change indices were not significantly different. (Korean J Anesthesiol 2007; 52: 23~8)
폐렴과 급성 호흡부전으로 나타난 흉막의 고립성 섬유성 종양
박혜선 ( Hye Sun Park ),곽현정 ( Hyun Jung Kwak ),박동원 ( Dong Won Park ),구태연 ( Tai Yeon Koo ),김혜영 ( Hye Young Kim ),박소연 ( So Yeon Park ),안성은 ( Seong Eun Ahn ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),손장원 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.4
Solitary fibrous tumors of the pleura (SFTPs) are relatively rare tumors that originate from the mesenchymal cells of the submesothelial tissue of the pleura. Patients with SFTPs are often asymptomatic, while some patients experience pleuritic chest pain, cough and/or dyspnea. We report here on a case of SFTP, and the patient presented with septic shock and respiratory failure that required mechanical ventilation. A 68-year-old woman was admitted for the evaluation of her dyspnea and generalized edema. Chest imaging studies showed an 18 cm-sized voluminous mass occupying the right thoracic cavity with anterior displacement of hilar structures and atelectasis of the right lung. Immediately after admission, she developed pneumonia and septic shock that required antibiotics and mechanical ventilation. She displayed a partial response to medical treatment, and then complete excision of the tumor was performed and the pathologic examination revealed benign SFTP. Afterward, she fully improved without evidence of recurrence until now. (Tuberc Respir Dis 2008;65:334-338)
이상표 ( Sang Pyo Lee ),신현종 ( Hyun Jong Shin ),이희경 ( Hee Kyung Lee ),곽현정 ( Hyun Jung Kwak ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),손장원 ( Jang Wong Sohn ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.4
Tsutsugamushi disease (Scrub typhus) is an acute, febrile illness caused by Orientia tsutsugamushi, which is transmitted to humans through chigger bites. Leptospirosis, a febrile disease caused by various pathogenic Leptospira, and is acquired by exposure to contaminated water and soil. Both diseases have been the most common acute febrile diseases in the autumn in Korea for many years. Concomitant leptospirosis and scrub typhus is quite rare. We report a case of a coinfection with leptospirosis and scrub typhus in a 51-year-old male who presented with fever, abdominal pain and acute dyspnea. The patient was diagnosed with as acalculous cholecystitis, acute respiratory distress syndrome, and septic shock caused by the infection. This is the first case report of a coinfection with leptospirosis and scrub typhus in Korea. (Tuberc Respir Dis 2007; 63: 378-381)
근치적 수술 후 재발한 1, 2 병기 비소세포폐암의 임상양상 및 조직학적 유형의 차이 비교
송성헌 ( Sung Heon Song ),손장원 ( Jang Won Sohn ),곽현정 ( Hyun Jung Kwak ),김사일 ( Sa Il Kim ),이승호 ( Seung Ho Lee ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( Su 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.4
Background: The clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC) have been changing. Recently, Positron emission tomography-computed tomography (PET-CT) has usually been used for diagnosis, follow-up to treatment and surveillance of NSCLC. We studied the pattern of recurrence and prognosis in patients who underwent complete resection for NSCLC according to histologic subtype. Methods: All patients who underwent complete resection for pathological stage I or II NSCLC between January 2005 and June 2009 were identified and clinical records were reviewed retrospectively, especially the histologic subtype. Results: Recurrences were identified in 50 of 112 patients who had complete resection of an NSCLC. Sites of recurrence were locoregional in 15 (30%), locoregional and distant in 20 (40%), and distant in 15 (30%). Also, sites of recurrence were intra-thoracic in 29 (58%), extrathoracic and intra-thoracic recurrence in 15 (30%), and extrathoracic in 6 (12%). In locoregional recurrence, there was 37% recurrence for non-squamous cell carcinoma (non-SQC) and 25% for squamous cell carcinoma (SQC). In distant recurrence, there was 39% recurrence for non-SQC and 18% for SQC. Locoregional recurrence in the bronchial stump was more common in SQC than non-SQC (14% vs. 45%, p=0.025). Prognosis of recurrence was not influenced by histologic subtype and the recurrence-free survival curve showed that the non-SQC group did not differ from the SQC group according to stage. Conclusion: The prognosis for recurrence does not seem to be influenced by histologic types, but locoregional recurrence in the bronchial stump seems to be more common in SQC than non-SQC in completely resected stage I and II NSCLC.
한번의 말초정맥주사로 유발되어 파국적으로 진행된 Trousseau증후군
문지용 ( Ji Yong Moon ),김사일 ( Sa Il Kim ),곽현정 ( Hyun Jung Kwak ),송순영 ( Soon Young Song ),김인순 ( In Soon Kim ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),손장원 ( Jang Won Sohn ),윤호주 ( Ho Joo Yoon ),신동호 ( Do 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.2
Trousseau`s syndrome is an unexplained thrombotic event that precedes the diagnosis of an occult visceral malignancy or appears concomitantly with the tumor. Upper extremity deep vein thrombosis is prevalent in patients with a central venous catheter. Furthermore, a peripheral intravenous injection may cause upper extremity deep vein thrombosis as well. However, a deep vein thrombosis has not been reported in the form of Trousseau`s syndrome with a catastrophic clinical course triggered by a single peripheral intravenous injection. A 48-year-old man presented with a swollen left arm on which he was given intravenous fluid at a local clinic due to flu symptoms. Contrast computed tomgraphy scans showed thromboses from the left distal brachial to the innominate vein. The patient developed multiple cerebral infarctions despite anticoagulation treatment. He was diagnosed with stomach cancer by endoscopic biopsy to evaluate melena and had a persistently positive lupus anticoagulant. After recurrent and multiple thromboembolic events occurred with treatment, he died on day 20.
폐동정맥기형(Pulmonary Arteriovenous Malformation) 환자의 전정맥마취 경험 -증례보고-
김종찬 ( Jong Chan Kim ),이경천 ( Kyung Cheon Lee ),최정주 ( Jung Ju Choi ),이희동 ( Hee Dong Lee ),곽현정 ( Hyun Jeong Kwak ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.6
A 23-year-old woman with pulmonary arteriovenous malformation was scheduled for open reduction and internal fixation due to her mandible fracture. Total intravenous anesthesia using propofol and remifentanil was selected as the anesthetic method in order to avoid the inhibition of hypoxic pulmonary vasoconstriction and the exacerbation of intrapulmonary shunting. After the standard monitoring devices were applied, anesthesia was then induced and maintained with a target controlled infusion of propofol and remifentanil in the range of 2.5-3.0 μg/ml and 2-3 ng/ml, respectively. Anesthesia was performed uneventfully and the patient was discharged without complication. (Korean J Anesthesiol 2009; 56: 713~6)
1, 2병기 비소세포폐암의 예후에 대한 수술 전 양전자방출 컴퓨터 단층촬영기의 임상적 의의
송성헌 ( Sung Heon Song ),손장원 ( Jang Won Sohn ),곽현정 ( Hyun Jung Kwak ),김사일 ( Sa Il Kim ),김상헌 ( Sang Heon Kim ),김태형 ( Tae Hyung Kim ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),최윤영 ( Yoon Young Choi ),박성수 ( 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.6
Background: High 2-[18F] fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) is a prognostic factor for poor survival in non-small cell lung cancer (NSCLC), especially in Stage I. We determined whether the high FDG uptake value of a primary tumor was associated with recurrence and death in patients with resected Stage I and Stage II NSCLC. Methods: We identified consecutive patients who underwent complete surgical resection for Stage I and II NSCLC between 2006 and 2009, who had preoperative PET-CT, and reviewed clinical records retrospectively. FDG uptake was measured as the maximal standardized uptake value (SUVmax) for body weight. Patients were divided into two groups based on SUVmax: (i) above or (ii) below the cut-off value (SUVmax=5.9) determined by a receiver operating characteristic (ROC) curve. Results: Of 57 patients who were enrolled consecutively, 32 (56%) had Stage I NSCLC and 25 (44%) had Stage II. The 5-year recurrence-free survival (RFS) for patients with high (≥5.9) and low (<5.9) SUVmax were 31% and 57%, respectively (p=0.014). The 5-year overall survival (OS) rates were 39% and 60%, respectively (p=0.029). In univariate analyses, SUVmax (p=0.014), T staging (p=0.025), and differentiation of tumor tissue (p=0.034) were significantly associated with RFS. But, multivariate analyses did not show that SUVmax was an independently significant factor for RFS (p=0.180). Conclusion: High FDG uptake on PET-CT is not an independent prognostic factor for poor outcomes (disease recurrence in patients with resected Stage I and II NSCLC).