베체트병 포도막염 환자에서 Infliximab 사용 중 발생한 속립성 결핵

유정완 ( Jung Wan Yoo ),노재형 ( Jae Hyung Roh ),박진욱 ( Jin Wook Park ),김용균 ( Yong Giun Kim ),장지웅 ( Ji Woong Jang ),나수영 ( Soo Young Na ),심태선 ( Tae Sun Shim ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.5

Infliximab, a TNF-α antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn`s disease and Behcet`s disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet`s disease and uveitis. We report this case with a review of the relevant literature.

Bacillus Calmette-Guérin 부족 시 고위험 비근침윤성방광암의 치료 대안

유정완(Jeongwan Yoo),김연주(Yeon Joo Kim),태범식(Bum Sik Tae),박재영(Jae Young Park) 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.2

Bladder cancer is the second most common malignant tumor of the urinary tract and is the seventh most common cancer among men worldwide and 17th among women. Seventy to eighty percent of bladder cancers are nonmuscle invasive bladder cancer (NMIBC) at the first diagnosis, and about 20%-25% of patients progress to invasive bladder cancer. According to the EORTC (European Organisation for Research and Treatment of Cancer) risk classification study, patients with high-risk NMIBC (T1, high grade/G3, carcinoma in situ) have a 5-year recur risk of up to 80% and a 50% chance of advance. Treatment options for high-risk NMIBC recommend Bacillus Calmette-Guérin (BCG) intrabladder infusion therapy after transurethral resection of bladder tumor, and intrathecal bladder chemotherapy such as mitomycin C or epirubicin, or early radical bladder resection may also be considered in recurrent high-risk patients. Among them, BCG intrathecal bladder infusion therapy has been demonstrated to reduce progression to mycoinvasive disease and has been used as a primary treatment for high risk NMIBC patients. BCG intrathecal infusion therapy reported that less than 10%-20% of patients in the responding group developed myoinvasive disease, while 66% of the patients in the poor response group developed myoinvasive disease. However, because BCG is made from Mycobacterium bovis, mass production is difficult due to a number of factors, such as the strength, quality, purity, and potency of BCG vaccines that pharmaceutical companies need to control. Most of all, BCG vaccines are prone to bacterial contamination due to long incubation periods and expensive specialized equipment. These factors eventually led to the closure of the Sanofi Institute for BCG vaccines in 2012, which continues the difficulties Merck has faced due to the lack of BCG supplies. Because BCG is a generic drug, the 2003 Medicare Modernization Act limited costs by up to 6% above the Medicare average selling price. Therefore, in 2016, Sanofi did not find any party to continue BCG’s manufacturing technology and acquire the company, as a result, it announced that it will stop production in the United States, Canada, the United Kingdom, and France. In this article, we will discuss how to treat high-risk NMIBC patients under these BCG deficiencies, along with some of the treatment options that can be implemented in cases of drug shortage.

중증 폐혈전색전증 환자에서 Urokinase와 Alteplase의 효과 및 출혈 합병증 비교

유정완 ( Jung Wan Yoo ),김원영 ( Wong Young Kim ),최창민 ( Chang Min Choi ),홍상범 ( Sang Bum Hong ),오연목 ( Yeon Mok Oh ),심태선 ( Tae Sun Shim ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Do 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.1

연구배경: 폐혈전색전증 환자에서 혈전용해제의 효과는 차이가 없는 것으로 보고되어 있으나 출혈 등의 부작용에 대해서는 잘 알려져 있지 않다. 본 연구는 한 병원에서 중증 폐혈전색전증환자들에 사용한 alteplase와 urokinase의 치료효과 및 출혈 유발 정도를 비교하였다. 방법: 2000년 1월부터 2008년 7월까지 대상 환자 40명을 urokinase군(16명)과 alteplase군(24명)으로 나누어 의무기록을 후향적으로 분석하였다. 결과: 혈전용해제 사용한 이유는 혈역학적 불안정 23명, 중증 우심실부전 7명 그리고 헤파린 사용에도 불구하고 진행하는 저산소증 10명이었다. 두 군간 나이, APACHE II, SOFA score, 혈전용해제에서 유의한 차이는 없었다. 혈전용해제를 사용 후 승압제의 사용기간에서 aletplase군이 urokinase군보다 더 짧았으나, 인공호흡기 사용 기간과 중환자실 입원기간에서는 양 군간 유의한 차이가 없었다. 입원기간 동안 사망한 환자수는 13명(30%)으로 urokinase와 alteplase군 5명, 8명으로 유의한 차이는 없었고, 폐혈전색전증과 연관된 사망한 환자수에서도 urokinase와 alteplase군에서 1명, 4명으로 유의한 차이는 없었다. 혈전용해제 사용 후 수술적 치료가 필요한 환자수도 urokinase군 2명, alteplase군 1명으로 차이가 없었다. 혈전용해제 사용 후 발생한 출혈은 14명(35%)에서 관찰되었고 urokinase군 3명(7.5%), alteplase군 11명(27.5%)으로 urokinase군에서 적은 경향을 보였다. 중증 출혈은 2명으로 모두 alteplase군에서 발생하였으며 1명은 뇌출혈로 사망하였다. 결론: 중증 폐색전혈전증환자에서 urokinase 사용은 alteplase에 비하여 치료효과는 차이가 없으면서 출혈의 위험은 낮을 것으로 사료된다. Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.

면역글로불린 G4 연관 자가 면역 질환의 폐 침범 2예

유정완 ( Jung Wan Yoo ),노재형 ( Jae Hyung Roh ),임채만 ( Chae Man Lim ),이상도 ( Sang Do Lee ),김우성 ( Woo Sung Kim ),김동순 ( Dong Soon Kim ),송진우 ( Jin Woo Song ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4

Immunoglobulin G4 (IgG4) related autoimmune diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation of numerous IgG4-positive lymphoplasma cells of varying origin, and a positive response to steroid treatment. Autoimmune pancreatitis, sclerosing cholangitis, and retroperitoneal fibrosis are representative presentations of IgG4 related autoimmune disease. Herein, we describe 2 patients (40-years-old woman and 47-years-old man) diagnosed with pulmonary involvement of IgG4-related autoimmune disease. The patients were admitted for an evaluation of the lung mass or multiple lung nodules found on chest radiography. Surgical lung biopsies were performed and pathologic finding revealed lymphoplasmacytic sclerosing inflammation with numerous IgG4 positive cells. The patients had elevated serum total IgG and IgG4 levels. Treatment consisted of high dose methylpredinisolone (1 mg/kg/day) and demonstrated good responsiveness. However, one patient experienced 2 relapses while being tapered off of steroid treatment.

중학생의 운동습관이 자아존중감 및 스트레스에 미치는 영향

유정완(You, Jung-Wan),심유진(Shim, Yoo-Jin),김규태(Kim, Kyu-Tae) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.5

The purpose of this study is to investigate the effects of long-term and regular exercise habits of middle school students on self-esteem and stress, which are mental aspects. The subjects were 106 middle and high school students (61 males, 45 females) attending S middle school in Seoul, and their exercise habits, self-esteem and stress scale were analyzed using questionnaires. In the exercise period of exercise habit, there were significant differences in self-steem and stress-related study, school, grades and test areas according to period of exercise(p <.05). The difference in exercise time of the exercise habits affected the self-esteem and stress only in self-esteem(p <.05). However, the difference between exercise frequency and exercise intensity did not show any significant difference in all areas of self-esteem and stress scale. The results of this study showed that middle school students with exercise habits have higher self -esteem and lower stress than students without exercise habits. Also, it was found that regular exercise habit of about 1 year plays an important role in enhancing self-esteem and lowering stress of middle school students. In addition, exercise habit which did not exceed 2 hours positively influenced the self-esteem of middle school students to increase.

듀에슬론 경기의 레이스 성적에 영향을 미치는 신체적 및 생리학적 요인에 관한 연구

유정완(You, Jung-Wan),김아람(Kim, A-Ram),심유진(Shim, Yoo-Jin),김규태(Kim, Kyu-Tae) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.3

The purpose of this study is to identify the physical and physiological factors that affect the performance of the du-athlon competition for college triathlon athletes. Subjects were 12 healthy male college students from the triathlon club. Each race performance is composed of first run 4.3km, bike 36.9km, and the second run 4.5km, total distance of 45.7km which is the official race record of the du-athlon. The experiment consisted of ① an incremental load running test using a treadmill (Run Test), ② a gradual submaximal bike test of running and cycling using a treadmill and a bicycle ergometer a (Run-Cycle Test), and ③ cycling and running gradual submaximal test (Cycle-Run Test) was conducted three times. Examining the Stepwise Multiple Regression Analysis of the physical and physiological factors affecting race results, of the maximum speed of the treadmill measured in the Run Test and the two measurements in CE from the Cycle-Run Test were detected as factors affecting the race performance. The correlation coefficient was 0.82 and detected two measurements can be used to predict race outcomes by 84%. In conclusion, from the results of this experiment, maximum power at maximum speed of treadmill in running race and effective endurance was needed in the bike race for du-athlon competition. Especially, for cycle race, which takes up most part of the du-athlon race, it appears that the power which can sustain a constant load for a long time and long distance is thought to be important.

성인뇌성마비의 운동능력이 유산소능력에 미치는 영향

유정완(You, Jung-Wan),심유진(Shim, Yoo-Jin),양윤권(Yang, Yoon-Kwon) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.6

The aim of the study was to examine the relationship between Motor Ability and aerobic capacity based on the fact that GMFCS(Gross Motor Function Classification System) is closely related to Shuttle Run Test in adults with cerebral palsy(CP). The subjects were ambulant adults with CP(N=46; GMFCS Level Ⅰ=14, Ⅱ=29,Ⅲ=3). Motor Ability and aerobic capacity were measured in this study. The Shuttle Run Test I was developed for adults at GMFCS level Ⅰ, and the Shuttle Run Test Ⅱ was developed for adults at GMFCS level Ⅱ, Ⅲ. As a result, GMFCS in CP showed significant difference in distance(m) test of Shuttle Run Test(p<.05), GMFCS Level was significantly larger than either Level Ⅱ or Level Ⅲ(p<.05). Also, time(min) of Shuttle Run Test showed significant difference in level of motor functions(p<.05), and Level Ⅱ was significantly larger than Level Ⅲ(p<.05). In conclusion, exercise function of CP has influence of aerobic capacity. Especially, GMFCS had close relations with exercise distance(m) of Shuttle Run Test which is an indirect measurement of aerobic capacity.

SWG 적용을 위한 인구증감에 따른 상수도 사용량과의 상관관계 분석

박현기(Park, Hyun Ki),이호선(Lee, Ho Seon),유정완(Yoo, Jeong Wahn),박형순(Park, Hyoung Soon),한국헌(Han, Kuk Heon) 대한토목학회 2013 대한토목학회 학술대회 Vol.2013 No.10

증례 : 호흡기 ; 굴곡형 기관지경을 이용하여 치료한 기관지 내 과오종 2예

노재형 ( Jae Hyung Roh ),박태선 ( Tai Sun Park ),김선영 ( Sun Young Kim ),유정완 ( Jung Wan Yoo ),박경민 ( Gyung Min Park ),박성연 ( Seong Yeon Park ),최창민 ( Chang Min Choi ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5

기관지 내 과오종은 드물게 발견되기는 하지만 조기에 진단과 치료가 이루어 지지 않으면, 기관지 폐쇄로 비가역적인 폐 실질의 손상을 일으킬 수 있다. 보통 이러한 기관지 내과오종의 치료로는 전신마취가 필요한 수술적 절제나 경직성 기관지경을 이용한 절제가 이루어져 왔지만, 저자들은 국소 마취 하에서 굴곡형 기관지경을 이용해 기관지 내 과오종을 성공적으로 제거 하였다. 앞으로는 기관지 내 과오종뿐만 아니라, 다른 기도 내 양성 종양이나 폐암환자의 고식적 치료에서도 굴곡형 기관지경을 이용한 중재술에 대한 활발한 연구와 다양한 시도가 필요할 것이다. Hamartoma is the most common benign neoplasm occurring in the lung. By contrast, endobronchial hamartomas are rare and cause irreversible lung damage due to bronchial obstruction if not diagnosed early and treated properly. Of the various treatments for this rare disease, surgical resection and removal using rigid bronchoscopy remains the most popular; this requires general anesthesia and relatively more time to recover from the procedure. Here, we report the cases of a 50-year-old woman and 65-year-old man who presented with endobronchial hamartomas that were removed successfully using cryotherapy and electrocoagulation via a flexible bronchoscope. (Korean J Med 77:625-629, 2009)

파킨슨병과 운동에 관한 문헌고찰

최재희(Choi, Jae-Hee),이지연(Lee, Ji-Yeon),김아람(Kim, A-Ram),유정완(You, Jung-Wan),심유진(Shim, Yoo-Jin),김희재(Kim, Hee-Jae),최승욱(Choi, Seung-Wook) 한국체육과학회 2017 한국체육과학회지 Vol.26 No.4

The purpose of this study is to investigate the effects of exercise on physical function and quality of life of patients with Parkinson’s disease through precedent studies to identify improvements and to provide information about the importance and effects of exercise to patients with Parkinson’s disease. This study obtained the following results by reviewing Korean and foreign literatures. First, it has been observed that exercise makes positive effect on strength of lower extremity and physical function of patients with Parkinson’s disease. Secondly, it has been observed in PDQ-39 Test on mental function that exercise makes positive effect on quality of life as well. To conclude, it was identified that exercise improves both physical function and mental function of patients with Parkinson’s disease, and based on these results, this study suggests to use exercise program on patients with Parkinson’s disease and to conduct more various studies in the future by developing more systematic and scientific programs.