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( Myeong Jun Song ),( Jung Hyun Kwon ),( Soon Woo Nam ),( Tae Hee Lee ),( Young Woo Kang ),( Ji Woong Jang ),( Seok Hyun Kim ),( Byung Seok Lee5 ),( Sea Hwan Lee ),( Hong Soo Kim ),( Ji Hoon Kim ),( S 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: We aimed to evaluate the efficacy and safety of Daclatasvir (DAV) and Asunaprevir (ASV) in patients with chronic hepatitis C virus (HCV) and chronic renal failure (CRF). Methods: 22 chronic hemodialysis patients with HCV infection at 12 medical centers have prospectively enrolled from Feb, 2016 to Feb, 2017 (NCT02580474). Of those, 9 patients who were followed 12 weeks after treatment ended were included. We evaluated the virological responses at each week 4, 12, 24 and the 12-week sustained virologic response (SVR12). The tolerability and safety of patients were also evaluated. Results: Of these 20 patients, there had no resistance-associated variant of NS5A (NS5A RAVs) and 2 patients showed indeterminate NS5A RAVs. 12 patients (54.5%) completed the 24 weeks treatment of DAV and ASV. 6 patients (27.2%) have continued, but 4 patients discontinued study prior to 12 weeks. Overall, all patients (n=9) achieved SVR12. Virologic response at week 4, 12 and 24 showed 94.4% (17/18), 93.3% (14/15), and 100% (12/12) respectively. DCV and ASV were well tolerated among the majority of patients and discontinuation of the treatment due to adverse events (hypertension, bradycardia, leukemia) was occurred in 3 patients. In two patients with indeterminate NS5A RAVs, one achieved SVR12 but the other showed viral breakthrough and discontinued treatment. Conclusions: In this study, DAV and ASV combination therapy for chronic hemodialysis patients with HCV infection achieved high sustained virological response with few adverse events. Close monitoring of safety and tolerability may be necessary when treating chronic hepatitis C patients with CRF receiving DCV and ASV.
이명수,장혜숙,류훈,문성록 한국정신과학학회 2002 韓國精神科學學會誌 Vol.6 No.2
The oriental idea that health begins in mind is currently being applied in the clinical field by mind-body medicine. In the past decade. we have seen an increase 10 the popularity of mind-body medicine as an alternative or complement to traditional health care interventions. This paper explores the scientific idea of mind-body medicine and how particular mind-body intervention focusing on stress reduction and relaxation can be useful methods to Improving health state. On the basis of the psycho- neuroendocrine-immune triangular circuit, the mind-body pathway has been Investigated. Among many mind-body intervention, Qi-training and Qi-therapy are described, research on their effectiveness is reviewed, conclusions are drawn, and the applicability to clinical practice is discussed. Given existing empirical support for the effectiveness of these interventions, the authors provide Korean scientists With an overview of the psychoneuroimmunological effects of Qi-training and Qi-training, and possibility of their medical benefits.
관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results
이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6
목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.
이명수,허화정,김병기,류훈,정현택 한국정신과학학회 1998 韓國精神科學學會誌 Vol.2 No.2
심장박동간격은 최근 교감신경과 부교감신경의 안정을 알아보는 척도로 쓰이고 있다. 본 연구는 4~12개월 천도선법 기수련을 행한 20대의 20명의 기수련자와 동일 연령층의 20명의 일반인을 대상으로 하여 1시간 동안 천도선법을 수행하게 하여 전, 참선, 후의 심장박동을 생리 기록계로 측정을 하여 빠른 퓨리에 변환 (FFT)을 통하여 심장박동간격을 조사하였다. 그 결과 자율신경제의 안정척도인 저주파수 적분 값과 고주파수 적분 값의 비(LF/HF)가 수련전과 수련 중에서 천도선법 기수련생들의 값이 일반인과 비교하여 통계적으로 유의한 차이가 났으며 (p<0. 01) 특히 두 그룹 모두 HF 의 값이 유의하게 변화하는 것을 보았을 때 천도선법 기수련이 부교감신경의 활동을 조절하여 자율신경계를 안정화 시킨다는 것을 보여주었다. The effects of ChunDoSunBup (CDSB) Qi-training on the power spectrum of heart rate variability were studied in 20 healthy subjects and 20 CDSB Qi-trainee (subjects with CDSB Qi-training for 4-12 months) Continuous ECG signals were recorded during 1) 10 min of rest in sitting position, 2) 1 hour of CDSB Qi-training , 3) 10 min of post-training. Fast Fourier transformation was used to determine the power spectrum of heart rate variability While CDSB Qi-training, there were significant decrease in the ratio of low to high frequency power spectrum. And value of pre and mild-training in CDSB Qi-trainees were lower than that of control subjects There was a significant changes in high frequency power of both group, but net in low frequency These results suggest that CDSB Qi-training may stabilize autonomic nervous system by modulate parasympathetic nervous system.
정명아,서유승,양진수,박준섭,윤진훈,이중건,이준승,이영규,김동희,조성범,주종은 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2
Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic grampositive organism Actinomyces israelii. It is com-monly associated with an intrauterine device(IUD) and can mimick pelvic or intra-abdominal malignant neoplasm. Ureteral obstruction leading to hydronephrosis is a rare complication of tubo-ovarian abscess. We experienced a case of hydronephrosis as a complication of pelvic actinomycotic abscess. The patient was a 46-year-old women presenting with fever and right flank pain. Leukocytosis and pyuria were present and a hydronephrosis was diagnosed by intravenous pyelography. Ultrasonography and a computerised tomography revealed a mass in right adnexum compressing the right ureter. Removal of retroperitoneal abscess and salphingo-oophorectomy were done and the diagnosis of actinomycosis was made by pathologic finding of resected mass. Postoperatively, the patient was treated with second-generation cephalosporin successfully. (Korean J Nephrol 2002;21(2):337-340)