에이즈환자의 인권문제

김준명,Kim, Jun-Myeong 한국건강관리협회 1993 건강소식 Vol.17 No.3

에이즈감염자의 일상생활 방법과 주변에서 도와줄 일

김준명,Kim, Jun-Myeong 한국건강관리협회 1997 건강소식 Vol.21 No.12

레드리본센터 개설에 즈음하여

김준명,Kim, Jun-Myeong 대한에이즈예방협회 2006 레드리본 Vol.70 No.-

에이즈 극복을 위한 서광이 비쳐졌으면

김준명,Kim, Jun-Myeong 한국건강관리협회 1994 건강소식 Vol.18 No.1

도약을 위해 정진하는 한 해를 준비하며

김준명,Kim, Jun-Myeong 대한에이즈예방협회 2009 레드리본 Vol.82 No.-

흰쥐 이자에서 Secretin-CCK 상승작용 기전에 관한 연구

이동기(Dong Ki Lee),김준명(Jun Myeong Kim),권상옥(Sang Ok Kwon),박경선(Kyung Sun Park),정재복(Jae Bock Chung),강진경(Jin Kyung Kang),김경환(Kyung Hwan Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aims: The rnechanism of secretin and CCK potentiation effect was evaluated in the dispersed pancreatic acini of rat. Methods: To observe the presence of potentiating effect of secretin and insulin on CCK, the amount of amylase release according to secretagogues were measured. The mechanism of the potentiating effect of secretagogues were studied by measuring the change of the intracellular amount of cAMP and IP, and concentration of intracellular Ca. Results: In the dispersed pancreatic acini, secretin potentiates the amylase release stimulated by JO and 10'M CCK-8. Insulin slightly increased the secretory response to secretin plus CCK-8, but with no statistical significance. Secretin or forskolin did not increase the intracellular Ipy accumulation stimulated by CCK-8. Alo insulin had no influence on the intraeellular IP accumulation stimulated by CCK-8 plus secretin. CCK-8 and A23187 significantly decreased the intracellular cAMP accumulation stimulated by secretin. But the insulin did not influence the intracellular cAMP accumulation stimulated by secretin plus CCK-8. Secretin alone did not increase the intracellular concentration of Ca . Secretin and dibutyryl cAMP significantly increa- sed the intracellular concentration of Ca stimulated by CCK-8. Conclusions: These results verify the presence of the potentiating effect of secretin but not insulin on CCK. Also the poten- tiating effect of amylase secretion by the simultaneous activation of the secretin and CCK was shown to be associated with increased intracellular Ca concentration, without a further elevation of intracellular IP or cAMP accumulation. (Korean J Gastroenterol 1997;29:380 - 393)

간외담도 결석의 내시경적 치료 성적과 이에 영향을 미치는 요인

백순구(Soon Koo Baik),김준명(Jun Myeong Kim),김광현(Kwang Hyun Kim),정연수(Yon Soo Jeong),이동기(Dong Ki Lee),권상옥(Sang Ok Kwon) 대한내과학회 1998 대한내과학회지 Vol.54 No.4

N/A Objectives : Developments in endoscopic technique and equipments have improved duct clearance rate in patients with extrahepatic bile duct(EHBD) stone. In this study, we reviewed our experience in extracting EHBD stones with standard and more advanced technique and equipments such as mechanical lithotripsy and extracorporeal shock wave lithotripsy. Aims of this study were to determine the overall success rate of endoscopic extracting for EHRD stone, to identify risk factors for failed duct clearance at initial and final therapeutic ERCP. Methods : We retrospectively reviewed 214 consecutive patients who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP) for EHBD stone over 45 months period. Factors evaluated for failed duct clearance included stone size, stone number, stone shape, concomitant stone of gallbladder and intrahepatic duct, presence of distal bile duct stricture, periampullary diverticula(PAD), Billroth-II gastrojejunostomy, and sepsis at admission. Results: The overall success rate of endoscopic treatment for EHBD stone was 93.5% (200/214). The causes of failed duct clearance were failed endoscopic sphincterotomy in 5/214 (2.3%), technical failure of extracting stone in 5/214(2.3%), and aggravation of acute cholecystitis between therapeutic endoscopic sessions in 4/214(1.9%), Risk factors for failed duct clearance with endoscopic extraction of EHBD stone were size and shape of the stone, concomitant stone of gallbladder and intrahepatic duct, and stricture of distal common bile duct. The duct clearance rate with initial therapeutic ERCP was 56.5%(121/200). Risk factors for failed duct clearance with initial therapeutic ERCP were size, shape and number of stone, and sepsis at admission. The complications of endoscopic treatment for EHBD stone were major bleeding in 5/200 (2.5%), pancreatitis in 18/200 (9.0%), but there was no perforation. Conclusion: Eventhough risk for failure of endoscopic treatment for EHBD stone were giant or piston shaped stone, concomitant stone of gallbladder and intrahepatic duct, and stricture of distal common bile duct, we conclude that endoscopic treatment for EHBD stone is safe and effective treatment modality, and choice of treatment.

간경변증에 합병된 균혈증의 임상적 고찰

백승(Seung Paik),김준명(June Myeong Kim),정재복(Jae Bock Chung),박준용(Jun Yong Park),김응(Eung Kim),홍천수(Chein Soo Hong),최흥재(Heung Jai Choi) 대한내과학회 1988 대한내과학회지 Vol.35 No.5

N/A In a nine-year retrospective study, there were S5 episodes (2.24%) of bacteremia among 3789 patients with liver cirrhosis. The total number of causative microorganisms was 87 strains. The mean patient age was 49.6±10.5 years. Of 85 patients, 69 were male and 16 were female giving a ratio of approximately 4.3 to 1. The peak of highest age incidence was the fourth and fifth decades. Community acquired bacteremia numbered 59 episodes and hospital acquired, 26 episodes. In hospital acquired bacteremia, twenty patients (76.9%) underwent one or more major procedures such as gastroscopy, endoscopic sclerotherapy, balloon tamponade, paracentesis, or intraabdominal surgery just before the onset of bacteremia. The causative microorganisms were 72 strains of gram-negative bacteria (82.8%) and 15 strains of gram-positive bacteria (17.2%). Of the more common microorganisms, E. coli accounted for 37.9 percent, Klebsiella 16.1 percent and Staphylococcus 14.9 percent. The incidence of Staphylococcus was relatively high in community acquired bacteremia, and Klebsiella was high in hospital acquired bacteremia. In community acquired bacteremia, E, coli were highly susceptible to aminoglycoside, cefamandole and third generation cephalosporin. Klebsiella were susceptible to aminoglycoside and second and third generation cephalosporin. Staphylococcus were highly susceptible to cephalothin, methicillin and clindamycin. In hospital acquired bacteremia, E. coli were highly susceptible to aminoglycoside and third generation cephalosporin, Klebsiella to aminoglycoside, cephalosporin and chloramphenicol, and Staphylococcus were susceptible to cephalothin, but 50% were susceptible to methicillin, clindamycin, erythromycin and chloramphenicol. Of 85 bacteremic patients with liver cirrhosis, 31 patients (36.5%) died; in community acquired bacteremia, 23 patients (37.7%) died and in hospital acquired bacteremia, 8 patients (30.8%) died. The causes of death were sepsis and/or septic shock, bleeding, hepatic coma, etc. The severity of the cirrhosis was assessed according to Child's grading; 2 patients were found to be in claw A (2.4/c ), 12 in class B (14,1%), and 71 in class C (83.5%), Seventy-three patients suffered from one or more of the following complications: ascites, encephalopathy, hematemesis, and spontaneous bacterial peritonitis. Two or more (mean 2.2) complications were associated with mortality eases, whereas approximately one (mean 1.3) complication was seen in improved patients. In conclusion, patients suffering from liver cirrhosis were highly susceptible to infection because of various defects in the defence system, and when bacteremia developed, the prognosis was very poor. Therefore, bacteremia should be considered a serious complication in liver cirrhosis.

Vi Capsular Polysaccharide Vaccine 접종 후 Vi 간접형광항체법으로 측정한 항체가의 변화

안광진 ( An Gwang Jin ),김준명 ( Kim Jun Myeong ),김응 ( Kim Eung ),정경섭 ( Jeong Gyeong Seob ),홍천수 ( Hong Cheon Su ) 대한내과학회 1990 대한내과학회지 Vol.38 No.6

N/A The efficacy of purified Vi capsular polysaccharide(CPS) vaccine against typhoid fever has recently been reported in Nepal and South Africa. These results showed approximately 75% protective efficacy, which is at least comparable or superior to other parenteral and oral vaccines. In order to evaluate the immunogenecity of the Vi-CPS typhoid vaccine manufactured at the Merieux Institute in France, we vaccinated healthy young college student volunteers with Vi-CPS, and observed the serial changes of antibody titers for 12 months using the Vi indirect fluorescence antibody test. We observed overall seroconversion in 48.1% of the volunteers, which is lower than other reports, but we found that those with relatively low pre-immunization Vi antibody titers (≤1 : 8) showed 91.7% seroconversion, while those with high pre-immunization titers (≥1 : 16) showed only 13.3% seroconvesion. Booster Vi-CPS vaccine was injected in the nonseroconversion group during a period four months after the first vaccination and followed the Vi antibody titers. The changes of Vi antibody titers were not significant. Moreover, we found that the mean Vi antibody titers between the seroconversion group and the nonseroconversion group were essentially identical from the 30th day after vaccination, with no significant decrease for up to 12 months. Also the adverse effects of the Vi CPS vaccine were negligible compared with other vaccines that are currently available. In conclusion, even though the overall seroconversion rate was lower than previous reports, there was a significant difference in the intensity of the immunogenecity according to pre-immunization Vi antibody titers, and ultimately the antibody titers in both groups became identical showing a sustained plateau for up to 12 months. In order to determine whether the protective efficacy at this acquired level of Vi antibody titers through Vi-CPS vaccination is satisfactory or not, further clinical and epidemiological studies need to be performed.

미소위암 8예에 대한 임상적 고찰

김영경(Young Kyung Kim),이동기(Dong Ki Lee),이성우(Seong Woo Lee),김준명(Jun Myeong Kim),이상철(Sang Chul Lee),권상옥(Sang Ok Kwon),장우익(Woo Ick Jang),조미연(Mee Yen Cho) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.6

N/A Background/Aims: The aim of this study is to investigate the clinical characteristics of minute gastric cancer, less than 5mm in the largest diameter of the lesion. Methods: We reviewed 8 patients of minute gastric cancer among 100 patients of early gastric cancer(EGC) and 474 patients of advanced gastric cancer who received operation at our hospital from January 1989 to July 1993. Results: The incidence of minute gastric cancer was 8% among early gastric cancer and 1.4% among stomach cancer who received operation. The patients ages ranged from 32 to 74 years old (mean age 60) and most frequently found in their six and seven decade in 75%(6/8). The ratio of male to female was 1.7:1. The multiplicity of minute gastric cancer was 37.5%(3/8), relatively higher than that of EGC 6%(6/100). Before operation we observed 7 lesions of minute gastric cancer by endoscopy. In Suzukis endoscopic classification for minute gastric cancer, most common type of the lesion was depressed type in 4(57.1%), and flat type in 2(28.6%) and elevated type in one(14.2%) patient. The location of minute gastric cancer was antrum in 4, body in 3 and fundus in one. The histologic type of minute gastric cancer was moderate to well differentiated adenocarcinoma in 7, signet ring cell carcinoma in one. The depth of invasion of minute gastric cancer was mucosal cancer in 7, submucosal cancer in one. There was no lymph node metastasis in all minute gastric cancers. Conclusions Almost minute gastric cancers were confined to the mucosa with rare lymph node metastasis. These characteristics of minute gastric cancer may provide the opinion less invasive operation or endoscopic treatment with curative aim. Further study is warranted to assess its significance of endoscopic treatment for minute gastric cancer. (Korean J Gastroenterol 1995;27: 635 - 644)