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천은미(Eun Mee Cheon),윤견일(Kyun Il Yoon),강덕희(Duk Hee Kang) 대한내과학회 1995 대한내과학회지 Vol.49 No.3
N/A Objectives: Serotonin (5-hydroxytryptamine) is a vasoactive agent that influence coronary arterial tone during platelet aggregation and deposition, and high levels of serotonin contribute to hypertension in some patients. In addition, serotonin has recently been implicated in the pathogenesis of ischemic heart disease. The serotonin status of patients in chronic renal failure is not clear. Although there were several re- ports about the concentration and role of serotonin in chronic renal failure patients, no concordent data were available only with the results of possible relationship with hypertension and pruritus in these patients. Methods: We studied 55 patients with chronic renal failure (CRF with conservative treatment(n=10), hemodialysis (n=35), continous ambulatory peritoneal dialysis (n=10)), compared to normal healthy groups (n=20) in order to investigate the level of whole blood and serum serotonin according to the different modality of renal replacement therapy and also to know the possible association with the presence of ischemic heart disease and pruritus. Results: 1) The levels of serotonin decreased significantly in hemodialysis patients (serum ; 58±22 ng/ml, whole blood; 5.6±3.6 μg/dl) compared to normal control group (serum ; 151±45ng/ml, whole blood ; 6.8±2.9μpg/dl, p<0.01) and CAPD patients (serum ; 134±26ng/ml, p<0.01). 2) The whole blood serotonin levels in hemodialysis patients showed significant correlation with the peripheral blood platelets count (r=0.3295, p<0.05). 3) In hemodialysis patients, serum serotonin concentration increased significantly with the time of dialysis (p<0.01), although whole blood serotonin concentration showed constant level during dialysis. 4) Whole blood serotonin levels of hemodialysis patients with ischemic heart disease increased significantly compared to the patients without ischemic heart disease (7.1±3.4μg/dl vs. 4.9±2.3μg/dl, p<0.005). 5) There was no statistically significant difference in serotonin concentration in relation to the presence of pruritus. Conclusion. This study suggests that the level of serotonin decreased significantly in hemodialysis patients and serum serotonin concentration increased significantly with the time of hemodialysis.
고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구
천은미 ( Eun Mee Cheon ),김병태 ( Byung Tae Kim ),권오정 ( O. Jung Kwon ),김호중 ( Ho Joong Kim ),정만표 ( Man Pyo Chung ),이종헌 ( Chong H. Rhee ),한용철 ( Yong Chol Han ),이경수 ( Kyung Soo Lee ),심영목 ( Young Mog Shim ),김진국 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.6
기관지경검사에서 Midazolam 의 임상적 유용성에 관한 연구
천은미(Eun Mee Cheon),박상준(Sang Joon Park),권오정(O Jung Kwon),김호중(Ho Joong Kim),정만표(Man Pyo Chung),최동철(Dong Chull Choi),이종헌(Chong H . Rhee),한용철(Yong Chol Han) 대한내과학회 1997 대한내과학회지 Vol.53 No.2
N/A Objectives: Although bronchoscopy is an important diagnostic tool for lung disease, patients compliance is low due to discomfort. Recently, midazolam which has a favorable anterograde amnesia effect and short action duration, has been used to relieve patients discomfort during bronchoscopy. Midazolam was investigated in order to see the beneficial effect and safety during bronchoscopy. Methods: The study design was single blind, randomized, prospective. 102 patients were included, in whom bronchoscopy was performed between June, 19% and October, 1995 at Samsung Medical Center. They were categorized into midazolam group and control group. Patients were asked about the amnesic effect, discomfort of procedure and the willingness to repeat procedure. The consciousness level of patients during procedure, patient cooperation during procedure and ease of procedure were also reported by bronchoscopists. Results: 1) The difference of oxygen saturation between two groups : There was no significant difference in oxygen saturation between midazolam group and control group before and after bronchoscopy. During procedure, however, mean oxygen saturations in midazolam group (90±6.4%) was significantly lower than in control group (93±4.7%)(p<0.05). 2) Evaluations by patients (1) Effect of amnesia : 41 patients (82%) in midazolam group could not recall the procedure but 52 patients (100%) recalled the entire procedure in control group. A favorable amnesic effects could be found in midazolam group(p<0.05). {2) The discomfort during the procedure: 43 patents(86%) did not experience discomfort from procedure in midazolam group but 25 patients(48%) complained of discomfort in control group (p<0.05). (3) Most patients except two(96%) were willing to repeat fiberoptic bronchoscopy in midazolam group but 13 patients (25%) answered that they would never repeat bronchoscapy. There was a statistically significant difference between two groups in the willingness to repeat bronchocopy (p<0.05). 3) The evaluations by bronchoscopists Cooperations of the patients and ease of procedure were not different between two groups. The patients in midazolam group except eight could not respond to verbal stimuli but most patients were awakened during procedure in control group(p<0.05). Conclusion: Midazolam is a good sedative agent for a patient to give a favorable amnesia, reduction of discomfort during bronchoscopy. We concluded that midazolam is a safe and useful sedative agent and midazolam may be used routinely during bronchoscopy. Monitoring of oxygen saturation, however, is essential to prevent severe hypoxia during procedure.
정상 면역가능을 가진 환자에서 발생한 침습성 폐진균증 1예
임영희,천은미,김호철,서지영,박정웅,권오정,이종헌,이재영,이경수,한정호,Lim, Young-Hee,Cheon, Eun-Mee,Kim, Ho-Cheol,Suh, Gee-Young,Park, Jeong-Woong,Kwon, O-Jung,Rhee, Chong-H.,Lee, Jae-Young,Lee, Kyung-Soo,Han, Jeong-Ho 대한결핵및호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.1
Invasive pulmonary aspergillosis is a disease occuring predominantly in patients with defects in immunity such as neutropenia, hematologic malignancies or with defects in cell-mediated immunity. The isolation of Aspergillus from respiratory tract of normal host usually signifies tracheobronchial colonization, making this diagnosis difficult. There are isolated case reports occuring in normal hosts but most of them were diagnosed postmortem at autopsies indicating that early diagnosis of invasive aspergillosis in normal host is difficult. We describe here a case of invasive aspergillosis in a immunocompetent host diagnosed by lung biopsy which was successfully treated with Amphotericin-B. Invasive pulmonary aspergillosis should be included as one of the differential diagnosis if a patient with pneumonic consolidation does not respond to usual therapy, even if the patient does not have any defect in immunity.
폐암절제술후 발생하는 사망 및 합병증의 예측인자 평가에 관한 전향적 연구
박정웅 ( Jeong Woong Park ),서지영 ( Gee Young Suh ),김호철 ( Ho Cheol Kim ),천은미 ( Eun Mee Cheon ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),권오정 ( O Jung Kwon ),김관민 ( Kwan Min Kim ),김진국 ( Jin Kook Kim ),심영목 ( 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.1
악성 종양 환자에 사용된 중심정맥카테터의 안정성에 대한 임상 연구
김형건(Hyung Gun Kim),손태용(Tae Yong Son),유영진(Young Jin Yuh),이상구(Sang Goo Lee),천은미(Eun Mee Cheon),송재관(Jae Kwan Song),임영혁(Young Hyuck Im),강윤구(Yoon Koo Kang),조재일(Jae Ill Zo),심영목(Young Mog Shim) 대한내과학회 1995 대한내과학회지 Vol.49 No.3
N/A Objectives: As the central venous catheters (CVCs) have been inserted frequent,ly in patients with advanced malignant disease, it becomes necessary to investigate the safety and the complications of the CVCs and to search for the ways to improve them. Methods: The complications related with CVCs and the durations of function of them were analyzed via retrospective review of medical records of 87 patients to whom CVCs were inserted for the treatment of cancer at the departrnent. of internal medicine, Korea Cancer Center Hospital. Results: Acute complications of catheter inser1ion were pneumothorax and pain at the insertion site. Infection, thrombosis and mechanical teraring were the major long term complications. 32(36.8%) catheters were removed by development of complications. Among 87 evaluable cases, CVCs could be maintained with function for 4+to 878+days (median 401 days). There were significantly less infection (40 % vs. 72% ) and longer duration of function(median not. reached vs. 151 days) with Chemoport than with Hickman catheter(p=0.002). Conclusion. CVCs could be inserted and maintained safely for considerahle period of time in patients with advanced malignancy. Further effort should be given to prevent catheter-related complications such as infection and thrombosis and to provide the long term patency.
65세 이상 노인 환자에서 흉부외 수술 후 폐 합병증의 발생률 및 예측인자
류연주 ( Yon Ju Ryu ),박지영 ( Ji Young Park ),백수정 ( Su Jung Baik ),이진화 ( Jin Hwa Lee ),천은미 ( Eun Mee Cheon ),장중현 ( Jung Hyun Chang ) 대한내과학회 2004 대한내과학회지 Vol.67 No.1
배경: 최근 노인 환자의 수술 빈도가 증가함에 따라, 수술 후 폐 합병증이 수술 후 이환과 사망의 중요한 원인이 되고 있다. 방법: 전신 마취 하에 흉부외 수술을 받은 65세 이상의 환자 206명을 대상으로 수술 후 폐 합병증의 발생률과 예측인자를 후향적으로 조사하였다. 수술 후 폐 합병증은 수술 후에 새로 발생한 무기폐, 폐렴, 폐색전증, 급성호흡부전으로 정의하였다. 결과:수술 후 폐 합병증의 발생률이 13.6%(28/266)이었다. 수술 후 폐 합병 Background: As number of the older patients for general elective surgery is increasing, postoperative pulmonary complications in the elderly are common and are a significant source of morbidity and mortality. Methods: We retrospectively evaluated the inci