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혈액투석요법을 받는 만성 신부전증 환자의 수면의 질과 삶의 질
박영현(Young-Hyon Park),문치영(Chi-Young Moon),이경규(Kyung-Kyu Lee) 대한생물치료정신의학회 2008 생물치료정신의학 Vol.14 No.2
Objectives : Sleep problems are plentiful in patients with chronic renal failure on hemodialysis. It is known that low quality of sleep impacts negatively on health-related quality of life in the general population. The objective of this study is to examine the prevalence of low sleep quality and the association between quality of sleep and quality of life in hemodialysis patients. Method: Ninety two pallents with chronic renal failure on hemodialysis were studied. Pittsburgh Sleep Quality Index(PSQI), 36-item Short-form Healthy Survey(SF-36), Epworth Sleepiness Scale(ESS), Beck Depression Inventory(BDI), and Beck Anxiety Inventory(BAI) were used for assessment. Statistically Spearman's correlation test, ANCOVA, Mann-Whitney U test, and χ² test were used by SPSS 13.0. Results: In the SF-36 subscales, physical functioning subscale was correlated inversely with age, BDI, BAI, ESS, and scores of total subscale, sleep onset latency subscale, sleep efficiency subscale, sleep disturbance subscale, and daytime dysfunction subscale of PSQI. Bodily pain subscale score of SF-36 was correlated with BDI, BAI, ESS, and total subscale, subjective sleep quality subscale, sleep onset latency subscale, sleep disturbance subscale, use of sleep medication subscale, daytime dysfunction subscale of PSQI, and correlated inversely with duration of dialysis. But the other subscales of SF-36 were not correlated significantly with PSQI total score. Sixty-two(69,66%) subjects were 'poor sleepers'(global PSQI>5), and showed higher in BAI and BDI, lower in physical functioning subscale, role physical subscale and pain subscale of SF-36 than good sleepers(global PSQI<5). Conclusion : This study showed that lower quality of sleep is common in hemodialysis patients and is associated with lower subjective quality of life. We suggest that management of the sleep problems is helpful for patients with chronic renal failure on hemodialysis to increase the quality of life.
이경훈(Kyoung Hoon Lee),문치영(Chi Young Moon),김원(Won Kim),이대열(Dae Yeol Lee),박성광(Sung Kwang Park),강성귀(Sung Kyew Kang) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.2
N/A The insulin-like growth factor-I(IGF-I) is a hormone that has growth stimulation and metabolic effects. Insulin-like growth factor binding proteins (IGFBPs) were known to be the most important factors that affect bioavailability of IGF. Thereby, the changes of IGFBPs may affect the bioavailability of IGF-I. Because growth hormone/IGF system may be affected by dialysis therapy, the changes of GH, IGF-1, IGFBPs levels after dialysis therapy can affect the bioavailability of IGF. To evaluate the changes of serum levels of IGF-I and IGFBP-3 after long-term dialysis therapy, we measured the serum IGF-I and IGFBP-3 levels in the patients on hemodialysis and on peritoneal dialysis. Eight: patients undergoing peritoneal dialysis, 10 patients undergoing hemodialysis, and age-matched 10 normal control patients were studied. In patients on hemodialysis, the mean serum level of IGF-I before hemodialysis was 90.6±9.0ng/mL, and after long-term hemodialysis was 130.9±31.0ng/ mL. The mean serum level of IGFBP-3 before hemodialysis was 14,549±7,815 μg/L, and after longterm hemodialysis was 5,726±883 μg/L. There were no significant changes of serum IGF-I and IGFBP-3 levels after long-term hemodialysis therapy. In patients on peritoneal dialysis, the mean serum level of IGF-I before peritoneal dialysis was 169.8±20.5ng/ mL, and after long-term peritoneal dialysis was 242.6±37.6ng/mL. The mean serum level of IGFBP- 3 before peritoneal dialysis was 10,272±885 μg/L, and after ling-term peritoneal dialysis was 8,604±1,721 μg/L. There were no significant changes of serum IGF-I and IGFBP-3 levels after long-term peritoneal dialysis. We found that the level of IGF-1 before hemodialysis was lower then that of normal control group and the level of IGFBP-3 before hemodialysis or peritoneal dialysis was higher then that of normal control group. Our results suggested that the blood levels of growth hormone, IGF-I and IGFBP-3 may not be significantly affected by long-term dialysis therapy.
증예(症例) : 장기간 Furosemide 사용후 발생한 신석회화증 1예
강경표 ( Kyung Pyo Kang ),이강휴 ( Kang Hyu Lee ),라방주 ( Bang Joo La ),문치영 ( Chi Young Moon ),고정곤 ( Jung Ghon Ko ),김원 ( Won Kim ),박성광 ( Sung Kwang Park ),강성귀 ( Sung Kyew Kang ) 전북대학교 의과학연구소 2001 全北醫大論文集 Vol.25 No.2
본 저지들은 성인에서 체중 조절을 목적으로 이뇨제를 장기간 오용하여 발생한 신석회화증을 경험하고 이에 대한 문헌고찰과 함께 보고하는 바이다. Nephrocalcinosis in the adult has many causes, some of which reflect serious renal disease. The major abnormal imaging pattern is the large, diffusely hyperechoic kidney with abnormal architecture. Its differential diagnosis includes hypercalcemia, hypercalciuria, hyperparathyroidism, sarcoidosis, uremia, increased Ca×P, metastatic calcification. The ultrasonic screening of the patients is essential in the evaluation. Other causes of the enlarged hyperechoic kidneys with abnormal architecture include chronic diuretics abuse, medullary sponge kidney and gouty nephropathy. Furosemide and acetazolamide are often used concurrently to control weight in young woman. We experience a case of nephrocalcinosis associated with chronic furosemide abuse. We report that long-term furosemide abuse can cause medullary nephrocalcinosis in adults.
최광호,문치영,박지현,김현중,최수미,이흥범,이용철,이양근 의과학연구소 1997 全北醫大論文集 Vol.21 No.2
Unilateral pulmonary emphysema or unilateral hyperlucent lung was rare case, first described by Swyer and James in 1953. There was characterized by obliteration of small bronchiole, hypoperfusion of the pulmonary artery and abscence of the peripheral vascular bed. We have experienced three case of idiopathic hyperlucent lung syndrome and reported with relevalent literature review.
혈액투석 환자에서 ApoE 유전자 다형성과 혈청 지질에 대한 연구
김원,문치영,김달식,강성귀,박성광 의과학연구소 2000 全北醫大論文集 Vol.24 No.1
Apolipoprotein(apo) E polymorphism consists of there major groups (E2, E3, and E4). Because of their difference in a lipid-modulating effect, the polymorphism has been reported to affect the morbidity of atherosclerosis in general population. Therefore, in hemodialysis patients, the apo E polymorphism may also modulate serum levels of cholesterol. We determined apo E phenotypes in 45 HD patients and 51 controls. We measured postprandial serum levels of lipids in the dialysis patients. We found a similar phenotype distribution and allele frequency between hemodialysis patients and healthy controls. Serum levels of total cholesterol, and triglyceride did not differ significantly among patients with apo E groups. Patients with apo E4 had significantly lower levels of high-density lipoprotein cholesterol, significantly higher levels of low-density lipoprotein cholesterol(LDL-C) than those with apo E2 (P<0.05). Apo E polymorphism modulates cholesterol metabolism in dialysis patients but appears to have little association with the prevalence of cerebrovascular complications in the patients.
안혁수,최상인,문치영,임석태,채제건,김원호,고재기 의과학연구소 1997 全北醫大論文集 Vol.21 No.2
Myocarditis is an inflammatory process of the heart caused by infection, radiation, chemicals, physical agents, hypersensitivity reaction such as acute rheumatic fever, and drugs. Overall, the enteroviruses, and particularly the Coxsackie-B viruses, predominate among viruses as the cause of myocarditis. In most cases, the clinical manifestations are nonspecific, and the presence of myocarditis is inferred only by the finding of trasient electrocardiographic ST-T wave abnormalities, arrhymias, heart failure. Death may occur in culminant cases, particularly in infants and pregnant women. Virus-related myocarditis and cardiac autoimmunity may play a role in the pathogenesis of progressive cardiac injury. We experienced a case of aborted sudden cardiac death complicating acute myocarditis. In general, the long-term prognosis in myocarditis is favorable but some cases may occur long-term sequelae or sudden death. Myocarditis should be monitored for in the acute inflammatary phase because of its life-threatening fulminan course and physicians should understand the differences between sudden cardiac death that occur in acute myocarditis patients and that of patients with other cardiac deseases in particular with ischemic heart disease. 저자들은 심장 병력이 없는 건강한 젊은 여성에서 상기도 감염증상을 앓은 후 급성 심근경색증과 유사한 임상증상을 보인 후 심실반맥과 심실 세동으로 인한 급성 심정지까지 이르렀다가 소생된 급성 심근염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
결핵성 기관지 협착 환자에서 팽창성 금속 스텐트 시술후 발생한 기관지 폐색 2례
이홍,김현철,문치영,김인희,이흥범,이용철,이양근 의과학연구소 1997 全北醫大論文集 Vol.21 No.2
Expandible metallic stents(Gianturco type) were used in airway narrowing due to tumoral compression, post-surgical stenosis, posttransplantation lesion, posttraumatic lesion, and tracheobronchial malacia. Some papers reported that the complication of self-extending metalic stents were granuloma formation, stent migration, localized inflammation, fatal massive hemoptysis, wall perforation, obstruction, and respiratory distress etc. Expandible metallic stents were used successfully in tuberculous bronchial stenosis that do not respond to medical therapy. But there was little long-term follow-up report after stent insertion. We report two cases of bronchial obstruction after successful Gianturco metallic stent insertion due to tuberculous bronchial stenosis.
갑상선 중독성 위기와 간 기능 이상을 동반한 임신오조증 환자에서 발생한 Wernicke 뇌병증 1예
최상인,백홍선,문치영,임철수,박태선 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.2
A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function (J Kor Soc Endocrinol 13:247-251, 1998).