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RISS 인기검색어
- 검색키워드
- 저자 : 洪久賢 (검색결과 32 건)
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홍구현,이경종,전경만,고원중,서지영,정만표,김호중,권오정,한정호,엄상원 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.6
Purpose: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate and minimally invasive technique used routinely for investigation of mediastinal and hilar lymphadenopathy. However, few studies have addressed its role in comparison to the traditional diagnostic approaches of transbronchial lung biopsy (TBLB), endobronchial biopsy (EBB), and bronchoalveolar lavage (BAL) in the diagnosis of sarcoidosis. We evaluated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis compared to TBLB, EBB, and BAL. Materials and Methods: Consecutive patients with suspected sarcoidosis (stage I and II) on chest radiography and chest computed tomography were included. All 33 patients underwent EBUS-TBNA, TBLB, EBB, and BAL during the same session between July 2009 and June 2011. EBUS-TBNA was performed at 71 lymph node stations. Results: Twenty-nine of 33 patients, were diagnosed with histologically proven sarcoidosis; two patients were compatible with a clinical diagnosis of sarcoidosis during follow-up; and two patients were diagnosed with metastatic carcinoma and reactive lymphadenopathy, respectively. Among 29 patients with histologically proven sarcoidosis in combination with EBUS-TBNA, TBLB, and EBB, only EBUS-TBNA and TBLB revealed noncaseating granuloma in 18 patients and one patient, respectively. The overall diagnostic sensitivities of EBUS-TBNA, TBLB, EBB, and BAL (CD4/CD8 ≥3.5) were 90%, 35%, 6%, and 71%, respectively (p<0.001). The combined diagnostic sensitivity of EBUS-TBNA,TBLB, and EBB was 94%. Conclusion: EBUS-TBNA was the most sensitive method for diagnosing stage I and II sarcoidosis compared with conventional bronchoscopic procedures. EBUS-TBNA should be considered first for the histopathologic diagnosis of stage I and II sarcoidosis.
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홍구현,송준휘,이경종,전경만,고원중,서지영,정만표,김호중,권오정,엄상원 대한결핵및호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.74 No.4
We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.
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洪久賢 한국가정과교육학회 2002 한국가정과교육학회 학술대회 Vol.2002 No.-
臺灣の敎育界は1995年以後,敎育課程の改革を通じて敎員養成の制度と敎育課程,敎授-學習などいろぃろな分野で改革してきた.特に敎員養成の制度は開放化,自由化,多次元化の特徵を見せてきた.このような動きは敎員養成の競爭力を高め,家庭科で敎える專門の領域を擔當する家庭科敎員の受給を簡單にする長所があるが,このような制度を先に運營している韓國の場合を見ると問題點もある. 一つ,敎員の過剩養成の問題と敎員敎育の不實である.二つ,豫備敎員の資質の低下である.三つ,敎員敎育の課程が敎員免許の準備の課程になりやすい問題である.このような問題をなくすためには,一般大學で敎員養成ができるように開放するより. 師範大學で高級中學校敎員を,一般大學で高級職業中學校敎員を養成するようになるためには,敎科敎育を强化する方案が必要である. 家庭科敎員の採用課程は1段階の筆答試驗,2段階の面接試驗,模擬受業,實習試驗などの評價の段階で構成されてぉり,韓國と似ているが, 韓國では實習試驗はない.このよう家政科敎員の採用課程は豫備敎員の深い部分ぉ評價する事がでぎる. 家庭科敎員の硏修は生涯硏修を志向して中央及ひ地方の敎育行政機關,敎員硏修機關,大學,中學校,敎員自身の次元などで樣樣な形で行われている.洪先生が紹介した「敎員は反省の實踐者」,知.行.思の融合は敎員の專門性の發展と言と觀點で個人的に興味深く,このようなことが 實際に敎員硏修の過程にどう適用去れているかを詳しく紹介してくれると理解し易い. 臺灣の師範大學の家庭敎育科の敎育課程を見ると,敎職基礎科目,敎育方法論,敎育實習科目などを履修すると言っても,文科敎材敎授法と家庭敎育槪論を除けば,家庭敎科敎育學の關蓮敎科目が韓國と比べて微弱な所がある. 現在,臺灣の家庭科敎員の養成と關連して,問題點と解決方案を韓國的な視野から見ると,一っ,家庭科敎員の養成制度の開放に從う敎育の不實を防ぐ方案が必要である. 二つ,效果的な敎育課程の確立は他の國の敎員敎育課程を探索し,相互交流を通じて共同的に改善する必要がある.敎員の硏究活動に對しての 現實的な硏究費の支援と硏修を通じて發展できると思うのである.三つ,臺灣で敎育實習を一年間實施するのは素晴 らしいことだが,體系的 な實習敎育課程と評價體系がなければ,その期間が無?になりやすいので,敎員敎育機關と實習學校との緊密なつながりが必要である.四つ, 硏修と敎員專門性と關蓮して,敎員と學校次元の硏修活動に人氣がないというのは大變じれつたいことである. 終わりに,家政科目の位相正立は家政科敎育課程の刷新と敎授-學習の方法の開發など,敎科の內質化を通じて行われる.そして,家庭敎科が現代と未來の社會を生きるのに必ずし必要な敎科だという認識を高めると,敎科の位相が正立できると思う.
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결핵성 흉막염에서 초감염 결핵과 재발성 결핵의 임상 양상
홍구현 ( Koo Hyun Hong ),임상수 ( Sang Soo Lim ),신재민 ( Jae Min Shin ),박재석 ( Jae Seuk Park ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.6
연구배경: 결핵성 흉막염은 대부분 초감염 결핵의 형태로 발생하는 것으로 알려져 왔다. 그러나 최근 결핵환자가 감소함에 따라 초감염 결핵보다 재발성 결핵으로 결핵성 흉막염이 발생하는 경향이 늘고 있다. 대상 및 방법: 2003년 1월부터 2006년 2월까지 단국대학교병원에서 결핵성 흉막염으로 진단받은 환자들의 과거력과 방사선 소견에 따라 초감염 결핵과 재발성 결핵으로 분류하고 두 군 사이에 임상 소견, 방사선 소견, 그리고 6 개월 동안 항결핵 약물치료 후 잔여 흉막비후에 있어서 차이가 있는지 알아보았다. 결과: 1. 결핵성 흉막염 환자 141명 중에서 135명에서 초감염 결핵과 재발성 결핵의 구분이 가능하였는데 초감염 결핵의 소견을 보인 환자는 38명(28%), 재발성 결핵의 소견을 보인 환자는 97명(72%)으로 재발성 결핵의 소견을 보이는 환자가 더 많았다. 2. 초감염과 재발성 결핵 환자 사이에서 성별, 나이, 증상의 발현 시작부터 흉수검사까지의 기간, 진단 시의 흉수의 양, 흉수 총백혈구수, 림프구수, LDH, ADA 수치에 있어서 유의한 차이가 없었다. 3. 6개월 이상 추적관찰이 가능하였던 124명의 환자들의 잔여 흉막비후의 정도에 있어서 초감염 결핵과 재발성 결핵 사이에 차이가 없었다. 결론: 결핵성 흉막염 환자 중에서 초감염 결핵보다 재발성 결핵의 소견을 보이는 환자가 더 많았으며 두 군 사이에 임상 소견, 방사선 소견, 흉수 소견에서 유의한 차이가 없었으며, 6개월 치료 후의 잔여 흉막비후의 정도에 있어서도 유의한 차이가 없었다. Backgroud: Traditionally, tuberculous pleurisy has been known to largely develop as primary tuberculosis. However, as the incidence of tuberculosis decrease, recent studies have shown reactivation tuberculosis has become the main cause of tuberculous pleurisy. Methods: 141 cases of tuberculous pleurisy, between January 2003 and February 2006, at the Dankook university hospital, were retrospectively studied. The patients were divided into primary and reactivation tuberculosis, based on the history and radiological characteristics, and the clinical, radiological characteristics at the time of diagnosis and residual pleural thickening after 6 month of chemotherapy were compared between the two groups. Results: 1. Of the 141 tuberculous pleurisy cases, in 135 it was possible to differentiate between primary and reactivation tuberculosis. 2. Of the 135 tuberculous pleurisy cases, 38 (28%) showed a primary tuberculosis pattern, and 98 (72%) showed a reactivation tuberculosis pattern. 3. There were no significant differences between primary and reactivation tuberculosis in relation to age, sex, duration of symptom, amount of pleural effusion, pleural fluid WBC, lymphocyte count, and level of protein, LDH and ADA at the time of diagnosis 4. 124 patients were followed for 6 months after diagnosis of tuberculous pleurisy, and there was no significant difference in the residual pleural thickening between primary and reactivation tuberculosis. Conclusion: In South Korea, a reactivation disease is currently a more common cause of tuberculous pleurisy than a primary disease. There was no difference in the clinical characteristics between primary and reactivation tuberculosis. (Tuberc Respir Dis 2006; 61: 526-532)
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Natural Stent로 치료한 Metallic Stent 삽입 후 재발한 악성 종양에 의한 기관기관지폐쇄 1예
홍구현,전경만,엄상원,고원중,서지영,정만표,권오정,김호중,김태성 대한중환자의학회 2012 Acute and Critical Care Vol.27 No.2
Tracheal tumors are very rare disease, which may cause dyspnea, obstructive pneumonia and life-threatening hypoxemia, depending on the site of the lesion and the severity of the narrowing. Such patients frequently die within hours or days due to suffocation. Patients who expressed upper airway stenosis, should be secured the airways prior to the diagnosis and treatment commonly. Then, treatment plan should be determined. For the relief of such stenosis, various modalities of therapy including surgery, laser photoresection, balloon dilatation and sometimes stent insertion have been used. Tracheobronchial stent insertion has been a good therapeutic option in these patients in point of avoiding morbidities associated with surgery. We report a case of repeated tracheobronchial stenosis by infiltrating tumor mass after metallic stent insertion in a 48-year-old man. The patient was treated successfully by Natural stent insertion with rigid bronchoscopy after removal of previous inserted metallic stent.
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