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김자선,박영민,김나영,윤한결,이기종,김보현,박상종,연재우,정구흥 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.2
Background/Aims: Combination treatment consisting of hepatic arterial infusion chemotherapy with epirubicin and cisplatin (HAIC-EC) and systemic infusion of low-dose 5-fluorouracil (5-FU) are sometimes effective against advanced hepatocellular carcinoma (HCC). However, there is no effective treatment for advanced HCCs with arterioportal shunts (APS) or arteriovenous shunts (AVS). Methods:We investigated a response and adverse events of a new combination protocol of repeated HAIC-EC and percutaneous intratumoral injection chemotherapy with a mixture of recombinant interferon-gamma (IFN-γ) and 5-FU (PIC-IF) in patients with far-advanced HCCs with large APSs or AVSs. Results: There was a complete response (CR) for the large vascular shunts in all three patients and for all tumor burdens in two patients. Significant side effects were flu-like symptoms (grade 2) and bone marrow suppression (grade 2 or 3) after each cycle, but these were well-tolerated. Conclusions: These results suggest that the combination of HAIC-EC and PIC-IF is a new and promising approach for advanced HCC accompanied by a large APS or AVS.
채덕희,김자선,아사미 게이꼬,김종대 한국보건교육건강증진학회 2019 보건교육건강증진학회지 Vol.36 No.3
Objectives: The purpose of this study was to identify factors associated with the self-rated health of migrant workers and to compare the difference between factors according to the length of stay. Methods: Study subjects were 8,696 migrant workers in Korea who worked at least 40 hours a week. Data were analyzed using logistic regression. Results: Of the subjects, 24.1% rated their health as poor. In the group with more than 10 years of residence in Korea, two times more people rated their health poor than the group of less than 3 years. Factors associated with health were relationship satisfaction, life satisfaction, leisure satisfaction, roommates, discrimination, residential environment satisfaction, unmet health needs, job satisfaction, and income satisfaction. Regardless of the length of stay, relationship satisfaction, unmet health needs, and job satisfaction were common influences. As the length of stay increased, while the significance of employment insurance and life satisfaction decreased, leisure satisfaction, income satisfaction, and Korean language ability increased. Conclusions: The findings suggest that measures to protect the health of migrant workers should begin early in migration. Furthermore, for influencing factors differ depending on the length of residence, health policies for migrant workers should be developed according to the different lengths.
A Case of Gardner’s Syndrome Presenting as an Abdominal Wall Mass
김지은,김자선,서병선,권계원,박주상 대한장연구학회 2013 Intestinal Research Vol.11 No.3
Familial adenomatous polyposis (FAP) is characterized by large numbers of adenomatous polyps in the colon and inherited as an autosomal dominant disease. Gardner’s syndrome is a form of FAP accompanied by extra-colonic tumors and desmoid tumors. Desmoid tumors are rare, and benign tumors characterized by fibroblastic proliferation of fascial and musculoaponeurotic components. There is an approximate 1,000 times higher incidence of desmoid tumors in patients with FAP compared with the general population. Desmoid tumors in Gardner’s syndrome occur in the small bowel mesentery in 80% of all cases, and the other 20% in the abdominal wall or the extremities. Almost all cases of desmoid tumors in Gardner’s syndrome were incidentally found after prophylactic total proctocolectomy for colon cancer prevention in the patients with FAP. We report a case of Gardner’s syndrome associated with codon 1099 mutation of the adenomatous polyposis coli gene, in which the patient was initially found to have desmoid tumors and subsequently diagnosed as FAP by screening colonoscopy. (Intest Res 2013;11:217-222)
혈액투석환자를 위한 동영상 식사교육 프로그램의 적용 효과
김소연,김진동,박애경,구자선 병원간호사회 2014 임상간호연구 Vol.20 No.1
Purpose: The purpose of this study was to develop and apply a video dietary instruction program for hemodialysis patients to understand dietary compliance as well as the effect on the physiological indicator. Methods: This is a quasi-experimental study of a nonequivalent control group pre-post test design. Data were collected from August 6, 2012 to January 10, 2013. Twenty patients were assigned to an experimental group and twenty-one patients were assigned to a control group. A video dietary instruction program was developed and applied only to the experimental group once a week for a total of 8 weeks. Dietary compliance and physiological indicators were subsequently measured. Results: Dietary compliance was improved in both groups over time. There was no significant change in the physiological indicator value in both groups, indicating that there was no correlation between the treatment type and time. Conclusion: The video dietary instruction program could not make a statistically significant change on the physiological indicator value of the experimental group; however, this change was maintained within the allowable limits. Therefore, the video dietary instruction program can be utilized continuously as a standardized nursing intervention program in order to maintain the dietary compliance of hemodialysis patients.
첫 1년간 혈액투석 환자의 식사 관련 생리적 지표 변화 분석
정희진,구자선,김진동,박진선 병원간호사회 2017 임상간호연구 Vol.23 No.1
Purpose: The purpose of this study was to determine the time and content of dietary education by analyzing the physiological indicators of hemodialysis patients during their first year and to present baseline data related to dietary education for patients on hemodialysis. Methods: For this retrospective study physiological indicators for 73 patients on hemodialysis were analyzed. Data included levels of potassium, phosphorus, albumin and the IDWG rate, and Kt/V during the first year after starting hemodialysis. Repeated-measure ANOVA was used for statistical analysis. Results: Serum levels of phosphorus (p<.006), albumin (p<.001) and the IDWG rate (p<.001) increased significantly in the 7 months fromthe start of hemodialysis. Conclusion: The results indicate that the period in which diet related educational intervention is necessary is before physiological changes, that is, after 6 months of dialysis. The contents for effective education should include phosphorus-limited and weight control dietary restrictions at 6 months. 목적: 본 연구는 혈액투석 시작 후 첫 1년간 식사와 관련된 생리적 지표를 분석하여 교육이 필요한 시기와 교육의 내용을 파악하고, 식사 관련 교육중재를 개발하는데 기초자료를 제시하고자 시도되었다. 방법: 인공신장실에서 처음 혈액투석을 받은 외래환자 73명의 첫 1년간 생리적 지표 중 혈중 칼륨, 인, 알부민, 투석간 체중증가율, 혈액투석 적절도를 Repeated- measure ANOVA로 분석한 후향적 조사연구이다. 결과: 혈중 인(p<.006), 알부민(p<.001), 투석간 체중증가율(p<.001)은 투석 시작 후 7개월 경과 시점부터 유의하게 증가하였다. 결론: 위 결과로 식사 관련 교육중재가 필요한 시기는 생리적 지표에 변화가 오기 전인 투석 시작 후 6개월 시점인 것으로 확인되었다. 식사교육 내용으로는 6개월에 인 제한 식사요법과 체중조절 방법이 포함되어야 교육의 효과를 높일 수 있을 것으로 사료된다.
만성B형 간염 환자에서 발생한 A형 간염에 의한 다발성 장기부전 1예
윤한결,김나영,김자선,이기종,연재우,백소야,박영민 대한내과학회 2011 대한내과학회지 Vol.80 No.-
Hepatitis A virus is a major cause of viral hepatitis worldwide. The prevalence of hepatitis A in young adults has recently been increasing in Korea. Hepatitis A infection rarely complicates fulminant hepatitis, acute pancreatitis, and acute renal failure. We experienced a case of multiple organ failure involving fulminant hepatitis, acute pancreatitis, and acute renal failure complicating a hepatitis A superinfection in a chronic hepatitis B patient. The patient was a 38yearold man who presented with febrile sense and myalgia. He was initially alert, but became confused and developed acute renal failure and acute pancreatitis. He received continuous renal replacement therapy and conservative treatment and completely recovered from the multiple organ failure. It is important to consider a variety of potential complications in hepatitis A patients, especially in those with underlying chronic liver disease. (Korean J Med 2011;80:S111-S116) A형 간염 바이러스는 세계적으로 바이러스성 간염의 주요한 원인이다. 최근 우리나라에서는 젊은 성인에서의 A형 간염이 증가하고 있다. A형 간염은 드물게 전격성 간염, 급성 췌장염, 급성 신부전을 일으킨다. 저자들은 만성 B형 간염 환자가 A형 간염 바이러스 중복감염에 의해 전격성 간염, 급성 췌장염, 급성 신부전의 다발성 장기 부전을 보인 증례를 경험하였다. 38세 남자 환자가 열감, 근육통이 있어 내원하였다. 초기에 의식이 명료하였으나 의식이 혼탁해지고 급성 신부전, 급성 췌장염이 발생하였다. 환자는 지속적 신대체 요법과 보존적 치료를 받았으며, 다발성 장기 부전에서 완전히 호전되었다. 특히 기저 간 질환이 있는 환자에서 A형 간염의 여러 합병증에 대한 주의를 기울여야 할 것으로 생각된다.