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정치량 ( Chi Ryang Chung ),홍윤경 ( Yun Kyung Hong ),김소영 ( So Young Kim ),최영훈 ( Yung Hun Choi ),나영균 ( Young Gyun Na ),박승용 ( Seung Yong Park ),황정환 ( Heong Hwan Hwang ),문희 ( Hee Moon ),오호준 ( Ho Jun Oh ),이석 ( 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.2
Background: An alteration in the balance between a T-helper type 2 cell (Th2) response and a T-helper type 1 cell (Th1) response may predispose to the development of bronchial asthma. IL-18 has an ability to promote both Th1 and Th2 responses depending on the surrounding cytokine environment. Reactive oxygen species (ROS) play a crucial role in the pathogenesis of airway inflammation and hyperresponsiveness. Objective: An aim of the present study was to determine the effect of ROS on the regulation of IL-18 expression. Methods: We used a C57BL/6 mouse model of allergic asthma to examine effects of antioxidants on the regulation of IL-18 expression. Our present study with ovalbumin (OVA)- induced murine model of asthma revealed that ROS production in cells from bronchoalveolar lavage (BAL) fluids was increased, and that administration of L-2-oxothiazolidine-4-carboxylic acid (OTC) or α-lipoic acid reduced the increased levels of ROS, the increased expression of IL-18 protein and mRNA, airway inflammation, and bronchial hyperresponsiveness. Our results also showed that antioxidants down-regulated a transcription factor, nuclear factor-kB (NF-kB) activity. Conclusion: These results indicate that antioxidants may inhibit LL-18 expression in asthma by inhibiting activity of NF-kB, and suggest that ROS regulate the LL-18 expression.
만성폐쇄성폐질환과 천식의 감별진단에서 메타콜린 기관지유발검사의 의의
홍윤경 ( Yun Kyung Hong ),정치량 ( Chi Ryang Chung ),백경현 ( Kyung Hyun Paeck ),김소리 ( So Ri Kim ),민경훈 ( Kyung Hoon Min ),박성주 ( Seoung Ju Park ),이흥범 ( Heung Bum Lee ),이용철 ( Yong Chul Lee ),이양근 ( Yang Keun Rhee 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.5
연구배경: COPD 환자에서 천식을 동반한 환자들이 많이 있다고 보고 되어 있었고 기관지 과민성이 높은 비율로 보고되어 메타콜린 기관지유발검사가 이두 질환을 감별에 어떤 의의가 있는지 알아보았고, 치료에 대한 도움을 얻고자 연구하였다. 방법: 전북대학교병원에서 2004년 1월부터 2004년 12월까지 메타콜린 기관지유발검사를 시행한 환자를 대상으로 전향적으로 연구하였다. 65명의 천식환자 23명의 COPD환자, 대조군에서 메타콜린 기관지유발검사를 분석하였다. 결과: 각 군의 PC(20)의 평균값은 천식군, COPD군 및 대조군에서 각각 8.1±1.16, 16.9±2.21 과 22.0±1.47 ㎎/㎖이고, 천식군, COPD군 및 대조군의 메타콜린 기관지유발검사의 양성율은 각각 65%, 30%와 9%였다. 메타콜린 기관지유발검사 양성 판정 기준을 PC(20) 16 ㎎/㎖ 이하로 가정할 때 천식군과 COPD군의 양성율은 80%와30%이었고 민감도, 특이도, 양성예측률 및 음성예측률은 각각 80%, 75%, 78%와 78%였다. 결론: 메타콜린 기관지유발검사의 양성기준을 PC(20) 16≤㎎/㎖으로 하였을 때 천식 및 COPD가 동반된 천식과 순수한 COPD의 감별에 보다 많은 도움을 줄 것으로 예상되며 궁극적으로 COPD 환자들에게 보다 개별적이고 적절한 치료적 접근에 도달할 수 있도록 해주는 진단 방법 중 하나가 될 수 있다고 생각한다. Background: Although airway hyper-responsiveness is one of the characteristics of asthma. bronchial hyper-responsiveness has also been observed to some degree in patients with chronic obstructive pulmonary disease (COPD). Moreover, several reports have demonstrated that a number of patients have both COPD and asthma. The methacholine bronchial challenge test (MCT) is a widely used method for the detecting and quantifying the airway hyper-responsiveness, and is one of the diagnostic tools in asthma. However, the significance of MCT in differentiating asthma or COPD combined with asthma from pure COPD has not been defined. The aim of this study was to determine the role of MCT in differentiating asthma from pure COPD. Method: This study was performed prospectively and was composed of one hundred eleven patients who had undergone MCT at Chonbuk National University Hospital. Sixty-five asthma patients and 23 COPD patients were enrolled and their MCT data were analyzed and compared with the results of a control group. Result: The positive rates of MCT were 65%, 30%, and 9% in the asthma, COPD, and control groups, respectively. The mean PC(20) values of the asthma, COPD, and control groups were 8.1±1.16 ㎎/㎖, 16.9±2.21 ㎎/㎖, and 22.0±1.47㎎/㎖, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT for diagnosing asthma were 65%, 84%, 81%, and 69%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT (ed note: please check this as I believe that these values correspond to the one PC(20) value. Please check my changes.) at the new cut-off points of PC20 ≤ 16 ㎎/㎖, were 80%, 75%, 78%, and 78%, respectively. Conclusion: MCT using the new cut-off point can be used as a more precise and useful diagnostic tool for distinguishing asthma from pure COPD. (Tuberc Respir Dis 2006; 61: 433-439)
김인재 ( In Jae Kim ),정치량 ( Chi Ryang Chung ),국민하 ( Min Ha Kuk ),박승용 ( Seung Yong Park ),최경화 ( Kyung Hwa Choi ),백초옥 ( Cho Ok Back ),이창훈 ( Chang Hun Lee ),오호준 ( Ho Jun Oh ),박성주 ( Seoung Ju Park ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.2
Allopurinol (4-hydroxypyrazolo-[3,4-d]pyrimidine) is an effective and widely used xanthine oxidase inhibitor administered in the treatment of hyperuricemic states such as gout. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an unexpected complication of drug which can be characterized by eosinophilia, skin rash, fever, lymph node enlargement, and single or multiple organ involvement. The most common culprit drugs for DRESS syndrome are phenobarbital, phenytoin, and carbamazepine. Allopurinol can cause hypersensitivity syndrome, and DRESS syndrome induced by this drug has higher motality despite of proper management. We report here a case of allopurinol-induced DRESS syndrome who develops erythematous skin eruption, fever, hepatitis, and lymphadenopathy after allopurinol therapy for 35 days. This case may alert physicians to be cautious regarding allopurinol-induced DRESS syndrome, as this drug has been frequently prescribed.
증예(症例) : 좌측 아래엽 위구역 기관지에 발생한 샘낭암종 1례
최영훈 ( Young Hun Choi ),김소영 ( So Young Kim ),정치량 ( Chi Ryang Chung ),박승용 ( Seung Yong Park ),황정환 ( Jeong Hwan Hwang ),문희 ( Hee Moon ),고강훈 ( Kang Hun Koh ),이석 ( Seok Lee ),이태환 ( Tae Hwan Lee ),강선미 ( Seo 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.2
샘낭암종은 선암의 조직학적 변형으로서 대부분 침생, 눈물샘 또는 다른 외분비샘에서 발생하며 호흡기계에 드물게 발생하는 경우에도 주로 기관과 주기관지에 발생하며, 주 기관지 이하의 말초에서 발생하는 경우는 매우 드물다. 본 저자들은 좌측 아래엽 위구역 기관지의 페쇄를 초래한 샘낭암종으로 진단된 31세 남자 증례를 보고하는 바이다. 내원 1개월 전부터 시작된 마른 기침과 심호흡시의 흉부 불쾌감으로 내원한 환자는 흉부 전산화 단층촬영에서 좌측 아래엽에 경계가 명확하고 분엽화된 침상 종괴가 관찰 되었고, 종괴는 좌측 아래엽 위구역 기관지를 폐쇄시키고 있었으며, 좌측 페동맥의 좌측 아래엽 위구역 분지를 침범하고 있었다. 기관지내시경에서 좌측 아래엽 위구역 기관지는 혈액 공급이 풍부한 종양으로 폐쇄되어 있었다. 조직검사에서 특징적인 샘낭암종 소견이 관찰되었고, 원격전이 평가를 위한 검사 후 Stage IB로 병기 결정되었다. 환자는 수술적 치료를 적극 권고하였으나, 치료를 거부하고 퇴원하였다. Adenoid cystic carcinoma is rare malignant tumor that usually arise from major salivary gland, and can be found in lower respiratory tract. Adenoid cystic carcinoma of the lower respiratory tract usually arise in the mainstem bronchus and often presents as an endobronchial mass lesion causing bronchial obstruction with atelectasis and pneumonia. But, tumor originated from more distal branch of bronchus is extremely rare, and can be confounded with other primary lung malignancy. Adenoid cystic carcinoma is considered to be a low grade malignant neoplasm and its characteristics are infiltrative nature with tendency of local recurrence and long natural course. Treatment modality and prognosis is different from other lung malignancy. We report a 30 year old male patient with adenoid cystic carcinoma that found in left lower lobe bronchus and will discuss the biologic behavior of this unusual primary lung tumor as it relates to management considerations.
다발성 외상으로 인한 심한 폐 좌상과 스트레스성 심근병 환자에서 체외막형 산화기의 치료 경험
이대상 ( Dae Sang Lee ),길은미 ( Eun Mi Gil ),이아란 ( A Lan Lee ),하태순 ( Tae Sun Ha ),정치량 ( Chi Ryang Chung ),박치민 ( Chi Min Park ),조양현 ( Yang Hyun Cho ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4
A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient’s gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure. [ J Trauma Inj 2014; 27: 229-32 ]
아포지단백 E 유전자 다형성이 폐경 후 여성 류마티스관절염 환자의 골밀도에 미치는 영향
이상일 ( Sang Il Lee ),박진용 ( Jin Yong Park ),오수진 ( Su Jin Oh ),나영균 ( Young Gyun Na ),정치량 ( Chi Ryang Chung ),최영훈 ( Young Hun Choi ),윤희진 ( Hee Jin Yun ),류완희 ( Wan Hee Yoo ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.4
Objective: To evaluate the relationship between the presence of apolipoprotein E (Apo E) 4 allele and bone mineral density (BMD) and severity of joint destruction in postmenopausal women with rheumatoid arthritis (RA). Methods: Apo E genotypes were analyzed in 113 postmenopausal women who were first diagnosed with RA and had not receiving antiresorptive therapy for osteoporosis at the time of enrollment. BMD was measured using dual-energy X-ray absorptiometry (DEXA), and joint destruction was evaluated on plain radiographs according to Larsen score. The differences in BMD and severity of joint destruction in groups with and without an Apo E4 allele were analyzed in 94 patients with clinical information available. Results: BMD (g/cm2) of the lumbar spine in the Apo E4 (-) group was 0.94±0.16 (n=67), whereas that in the Apo E4 (+) group was 0.87±0.14 (n=27; p=0.049). BMD of the femoral neck and great trochanter in the Apo E4 (-) group was 0.74±0.12 and 0.63±0.11, while that in the Apo E4 (+) group was 0.68±0.11 (p=0.039) and 0.57±0.11 (p=0.008). However, there were no significant differences in Larsen scores and erosive disease (%) between the Apo E4 (+) and Apo E4 (-) groups. Conclusion: The Apo E4 allele is associated with a reduced bone mass in postmenopausal RA patients. Therefore, Apo E4 allele is considered to be an independent risk factor for generalized osteoporosis in postmenopausal RA patients.
중환자실에서 체외막산소화장치를 적용한 환자의 조기 운동치료 사례연구
고영준(Young-Jun Ko),조양현(Yang-Hyun Cho),서지영(Gee-Young Suh),이완희(Wan-Hee Lee),정치량(Chi Ryang Chung) 대한심장호흡물리치료학회 2015 대한심장호흡물리치료학회지 Vol.3 No.1
Purpose : The purpose of this case study is to suggest successful methods for mobilization in case of a patient on extracorporeal membrane oxygenation (ECMO) in intensive care unit. Methods : The patient with a pneumonia following acute respiratory failure was received three times of early mobilization during ECMO support by the interprofessional ICU early mobilization team. Result : The patient on ECMO was mobilized successfully including walking training in the ICU. In addition, after the mobilization the standing balance and lower muscle strength were improved. Conclusion : The most important key was the multidisciplinary team approach to mobilize safely and successfully the patient on ECMO. The decision about which therapy and how much intensity of exercise would be implemented was a collaborative process among the all of team members.
증례(症例) : 후천성 면역 결핍증 (AIDS) 연관형 Kaposi 육종 1예
이선화 ( Sun Hwa Lee ),이민희 ( Min Hee Lee ),김상균 ( Sang Kyoon Kim ),유창우 ( Chang Woo Rheu ),백경현 ( Kyung Hyun Paeck ),정치량 ( Chi Ryang Chung ),이석 ( Seok Lee ),이흥범 ( Heung Bum Lee ) 전북대학교 의과학연구소 2004 全北醫大論文集 Vol.28 No.2
Kaposi 육종은 후천성 면역 결핍증 환자에서 가장 흔하게 발생하는 신생물이지만그 치료에 대해서는 최근까지도 명확한 기준이 정립되어 었지 않았다. 근래에는 AIDS 연관형 Kaposi 육종의 병인에 있어서 HHV-8의 감염이나 숙주의 면역 상태가 중요한 역할을 한다는 것이 밝혀지면서 nucleoside analogues reverse transcriptase inhibitor와 protease inhibitor를 병합 사용하는 적극적인 항 retrovirus 치료 (HAART)를 시도하는 경향이며, 그 외에도 다양한 방법들을 사용한 성공적인 치료 예들이 보고 되고 있다. 본 저자들은 국내에 흔하게 보고되지 않은 AIDS 연관형 Kaposi 육종의 증례를 진단하고 HAART와 foscarnet 그리고 고식적 방사선 치료를 병행하여 적극 적인 내과적 치료를 시도한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. AIDS-related Kaposi`s sarcoma is one of the most common neoplasms in patients with acquired immunodeficiency syndrome. Recently, human herpesvirus-8 (HHV-8) and the immune status of the host have known to be closely related to the pathogenesis of AIDS-related Kaposi`s sarcoma. Therefore, highly active antiretroviral therapy (HAART) which includes nucleoside analogues reverse transcriptase inhibitor and protease inhibitor has been widely attempted in AIDS-related Kaposi`s sarcoma. Other successful treatment regimens including cytotoxic agents, interferon-α, thalidomide and so on have been reported. However, standard treatment option. has not been established yet. Hereby, we report a case of patient with AIDS-related Kaposi`s sarcoma who was treated by zidovudine, lamivudine and indinavir for underlying HIV infection, and intravenous foscarnet and palliative radiotherapy for local control of oropharyngeal Kaposi`s sarcoma with literature review.
국민하 ( Min Ha Kook ),김인재 ( In Jae Kim ),백초옥 ( Cho Ok Baek ),이창훈 ( Chang Hun Lee ),장지원 ( Ji Won Jang ),오호준 ( Ho Jun Oh ),최경화 ( Kyoung Hwa Choi ),정치량 ( Chi Ryang Chung ),박승용 ( Seung Yong Park ),박성주 ( Seo 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.2
Tracheobronchopathia osteochondroplastica (TO) is a rare, benign condition and is characterized by the presence of bony and cartilaginous nodules in the tracheal and bronchial submucosa. Bronchoscopy remains the gold standard for the diagnosis of TO and characteristically reveals multiple, submucosal nodules measuring 1 to 10 mm in diameter. The lesions are found most frequently in the distal two thirds of the trachea and the involvement of the lobar and more peripheral bronchial tree is very rare. Here, we report a patient with right middle lobe syndrome caused by tracheopathia osteochondroplastica.