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불량한 예후와 관련된 피부 발진을 동반한 다발성 연골염 1 예
강신명 ( Shin Myung Kang ),박현성 ( Hyun Sung Park ),정세영 ( Se Young Jung ),이성학 ( Sung Hak Lee ),박평강 ( Pyung Kang Park ),이경용 ( Kyoung Yong Lee ),오지민 ( Ji Min Oh ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
재발성 다발성 연골염 환자에서 피부 병변은 17~37%에서 동반될 수 있다. 최근에는 피부병변이 골수이형성 증후군, 불량한 예후와 연관이 있음이 보고되고 있다. 저자들은 다발성 관절염 및 발열 및 발진으로 발현된 재발성 다발성 연골염 1예를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. Relapsing polychondritis is a rare disease of unknown etiology characterized by recurrent episodes of inflammation with destruction of cartilaginous structures involving ear, nose, joint, and trachea. Recently, the urticarial eruption in relapsing polychondritis was known to be associated with myelodysplasia and a poor prognosis. We report a case of relapsing polychondritis presented with arthritis, fever and rash.
신증후군 범주의 단백뇨를 보인 Churg-Strauss 증후군
강신명 ( Shin Myung Kang ),김창오 ( Chang Oh Kim ),박용범 ( Yong Beom Park ),이원기 ( Won Ki Lee ),정현주 ( Hyeon Joo Jeong ),신동환 ( Dong Hwan Shin ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.2
Churg-Strauss syndrome or allergic granulomatosis and angiitis is a part of spectrum of systemic vasculitis characterized by asthma, ecisinophilia, mono or polyneuropathy, nonfixed pulmonary infiltrates, paranasal sinus abnormality and extravascular eosinophil infiltration. We experienced a case of Churg-Strauss syndrome of 21-year-old male patient with purpura and pitting edema on both hands and feet. He also had heavy proteinuria of nephrotic range and renal failure. Renal biopsy demonstrated crescentic glomerulonephritis with massive infiltration of eosinophils, lymphocytes and plasma cells in the interstitium. Under the treatment with prednisolone and cyclophosphamide, serum creatinine level and amount of proteinuria were reduced.
김동준,김명희,정애순,강신명,Kim, Dong-Jun,Kim, Myung-Hee,Chung, Ae-Soon,Kang, Shin-Myung 대한생리학회 1977 대한생리학회지 Vol.11 No.2
Motor vehicles are the major source of environmental air pollution through the combustion of lead-containing gasolines. People who live in the areas with heavy traffic usually have the higher blood lead levels. This study was to investigate the lead level between the maternal blood and their infants cord blood. Immediatly after Placental delivary, the sampls of cord blood and maternal venous blood were obtained randomly from 14 infants whose mothers had spent their entire pregnancy in Seoul. Lead concentration was determined by the dithizone method. The results obtained were summarized as follows: 1. Hemoglobin, Hct and RBC were significantly higher in cord blood than in the maternal blood, by 36%, 54.9%, 36.9% respectively. 2. MCV in cord blood was higher than that in maternal blood by 13.8%. But MCH and MCHC were lower than those in maternal blood, by 9.7%, 3.3% respectively. The differences were statistically significant. 3. Lead concentration of cord blood $(23.93\;{\mu}g%)$ was higher than that in maternal blood $(21.93\;{\mu}%)$ by 9.1%.
분석 방법 변화에 따른 음성 대조군과 호흡기 검체 간 미생물 구성 차이 비교
김효정 ( Hyojung Kim ),이상표 ( Sang Pyo Lee ),강신명 ( Shin Myung Kang ),강성윤 ( Sung-yoon Kang ),정성원 ( Sungwon Jung ),이상민 ( Sang Min Lee ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.5
Purpose: Identifying microbial communities with 16S ribosomal RNA (rRNA) gene sequencing is a popular approach in microbiome studies, and various software tools and data resources have been developed for microbial analysis. Our aim in this study is investigating various available software tools and reference sequence databases to compare their performance in differentiating subject samples and negative controls. Methods: We collected 4 negative control samples using various acquisition protocols, and 2 respiratory samples were acquired from a healthy subject also with different acquisition protocols. Quantitative methods were used to compare the results of taxonomy compositions of these 6 samples by varying the configuration of analysis software tools and reference databases. Results: The results of taxonomy assignments showed relatively little difference, regardless of pipeline configurations and reference databases. Nevertheless, the effect on the discrepancy was larger using different software configurations than using different reference databases. In recognizing different samples, the 4 negative controls were clearly separable from the 2 subject samples. Additionally, there is a tendency to differentiate samples from different acquisition protocols. Conclusion: Our results suggest little difference in microbial compositions between different software tools and reference databases, but certain configurations can improve the separability of samples. Changing software tools shows a greater impact on results than changing reference databases; thus, it is necessary to utilize appropriate configurations based on the objectives of studies. (Allergy Asthma Respir Dis 2018;6:255-262)
인슐린양 성장 인자 결합 단백-3 유전자-202 좌위의 다형성에 따른 비소세포폐암의 위험도
문진욱 ( Jin Wook Moon ),장윤수 ( Yoon Soo Chang ),한창훈 ( Chang Hoon Han ),강신명 ( Shin Myung Kang ),박무석 ( Moo Suk Park ),변민광 ( Min Kwang Byun ),정우영 ( Wou Young Chung ),박재준 ( Jae Jun Park ),유경남 ( Kyeong Nam Yo 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.4
급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성
정경수 ( Kyung Soo Chung ),박병훈 ( Byung Hoon Park ),신상윤 ( Sang Yun Shin ),전한호 ( Han Ho Jeon ),박선철 ( Seon Cheol Park ),강신명 ( Shin Myung Kang ),박무석 ( Moo Suk Park ),한창훈 ( Chang Hoon Han ),김정주 ( Chong Ju Kim 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
연구배경: 급성폐손상과 급성호흡곤란증후군 대상자에서 폐포모집술의 적절한 방법에 대해서는 정해진 것이 없다. 이 연구를 통해 폐포모집술들 중 압력조절환기법을 이용한 폐포모집술의 효과와 안정성을 확인하고자 하였다. 방 법: 급성폐손상 및 급성호흡곤란증후군에 해당하는 대상자들을 대상으로 압력조절환기 방식에서 30 cmH2O의 흡입압력과 20 cmH2O의 호기말양압으로 2분 동안 폐포모집술을 시행하였다. 동맥혈 산소분압, 정맥혈 산소포화도, 혈압과 맥박, 중심정맥압, 폐탄성, 호기말양압, 흉부 X-ray를 시술 전ㆍ후로 확인하였다. 결 과: 16명의 대상자들 중에서, 3명은 폐외 급성폐손상 및 급성호흡곤란증후군 대상자였고 나머지 13명은 폐내 급성폐손상 및 급성호흡곤란증후군 대상자였다. 평균 나이는 61.0±11.8세였고, 평균 APACHE II score는 21.6±11.9이었으며, SAPS score는 44.6±14이었다. 폐포모집술 시행 전, 평균 호기말양압은 11.3±1.5 mmHg이었으며 평균 동맥혈산소분압/흡입산소분율은 130.3±60.2이었다. 폐포모집술 시행 20분 후, 동맥혈산소분압/흡입산소분율의 비를 측정하여 50% 이상 상승한 경우를 반응군으로 50% 이하로 상승하거나 감소한 경우를 비반응군으로 분류하였다. 8명의 대상자들은 반응군이었고 8명의 대상자들은 비반응군이었다. 두 군간의 인구학적인 특성과 기계호흡의 패턴, APACHE II score, SAPS score, 동맥혈산소분압/흡입산소분율과 혈역동학적 특성 사이에는 차이가 없었다. 폐포모집술 이후, 동맥혈산소분압/흡입산소분율의 비는 상승하였다(p<0.001). 그 최대치는 폐포모집술 이후 60분에서 관찰되었다. 동맥혈 이산화탄소분압은 상승하는 경향을 보였다(p=0.05). 폐포모집술 전ㆍ후의 평균동맥압의 차이는 없었다(p=0.08). 기흉 등의 압력 손상에 의한 합병증은 없었으며, 단 한 예에서만 혈압 저하로 인해 폐포모집술을 중단하였으나 수액 공급 후 바로 회복되었다. 결 론: 본 연구를 통해서, 압력조절환기를 이용한 폐포모집술은 급성폐손상 및 급성호흡곤란증후군 대상자에서 산소화의 개선을 보였다. 또한 혈역학적 부작용은 거의 없었으며 고압력에 의한 합병증은 없었다. 따라서 압력조절환기를 이용한 폐포모집술은 폐보호전략과 더불어 임상적인 유용성과 안전성이 있을 것으로 기대된다. Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients` data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of 30 cmH2O and a PEEP of 20 cmH2O in a 2-minute PCV mode. The venous O2 saturation, central venous pressure, blood pressure, pulse rate, PaO2/FiO2 ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean PaO2/FiO2 ratio was 130.3 before RM. The PaO2/FiO2 ratio increased by 45% after alveolar RM. The PaO2/FiO2 ratio reached a peak 60 minutes after alveolar RM. The PaCO2 increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients. (Tuberc Respir Dis 2007;63:423-429)
증례 : 류마티스 ; 전신 홍반 루푸스 환자에게 발생한 급성 루푸스 폐렴 치료 1예
정세영 ( Se Young Jung ),박현성 ( Hyun Sung Park ),강신명 ( Shin Myung Kang ),이성학 ( Sung Hak Lee ),박평강 ( Pyung Kang Park ),정기환 ( Ki Hwan Jung ),오지민 ( Ji Min Oh ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
전신 홍반 루푸스로 치료를 받고 있는 환자에서 갑작스런 발열과 호흡 곤란이 있었고, 혈액, 객담 배양 검사 등을 통해 감염을 배제하고 루푸스 폐렴으로 진단할 수 있었으며 스테로이드와 보존적 치료로 호전 후 관해를 유지하여 이를 보고한다. Systemic lupus erythematosus is a connective tissue disease with multiple organ involvement due to atypical creation of an antibody to an intracellular component. Although it can directly invade respiratory organs, such as the pleura, pulmonary parenchyma, trachea, pulmonary vessels, and pulmonary muscle, pulmonary involvement is mostly secondary to infection after immunosuppressant use, and pulmonary parenchyma invasion due to an immune response is relatively rare. This is a case report of acute lupus pneumonitis in a patient with systemic lupus erythematosus who was successfully treated with steroid therapy. (Korean J Med 2014;87:642-646)