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권장훈(Jang Hoon Kwon),서현성(Hyun Sung Seo),장해인(Hae In Jang),조형민(Hyoung Min Cho),김은영(Eun Young Kim),김경심(Kyoung Sim Kim),김용욱(Yong Wook Kim),김 령(Young Kim) 조선대학교 의학연구원 2023 The Medical Journal of Chosun University Vol.48 No.2
Inflammatory bowel disease (IBD), comprised of two major disorders, Crohn disease (CD) and ulcerative colitis (UC), are chronic inflammatory disorders that can affect the gastrointestinal tract. It is known that IBD commonly presents with extraintestinal manifestations (EIMs). Children and adolescents with IBD are often at risk for suboptimal bone health because of undernutrition, delayed puberty, and prolonged glucocorticoid (GC) use. The authors report a case of a child with IBD and osteolysis in this report.
대장절제술 후 발생한 대장 협착에 전기 소작술을 이용한 치료 2예
권장훈 ( Jang Hoon Kwon ),한군희 ( Koon Hee Han ),김문호 ( Moon Ho Kim ),장우성 ( Woo Sung Jang ),윤정호 ( Jung Ho Yun ),송윤아 ( Yun A Song ),박종규 ( Jong Kyu Park ),천갑진 ( Gab Jin Cheon ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.3
Anastomotic stenosis of the colon is not an uncommon finding; however, its frequency varies from one study to another. Traditionally, postoperative colonic stenosis is managed surgically. However, endoscopic therapy has recently become the preferred treatment modality over traditional surgery. Good short-term success has been achieved with use of endoscopic balloon dilation; however, restenosis may occur over time in 14% to 25% of patients. The current report showed the effectiveness and usefulness of an insulated-tip knife (IT-knife) for electrocautery therapy of a patient with symptomatic anastomotic colonic stenosis. (Korean J Gastroenterol 2014;64:164-167)
소아 결핵성 흉막 유출의 감별진단에서 흉막액 Adenosine Deaminase 의 유용성
권경호(Gyung Ho Kwon),김종석(Jong Suk Kim),정종수(Jong Su Jung),임장훈(Jang Hoon Lim),이균우(Gyun Woo Lee) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2002 소아알레르기 및 호흡기학회지 Vol.12 No.2
N/A Purpose: The aim of this study is to evaluate the value of pleural adenosine deaminase (ADA)in differentiating tuberculous pleural effusion from non tuberculous pleural effusion of children. Methods: We measured pleural ADA activity in patients with pleural effusion whose age were from seven months to seventeen years from January 1995 to October 2001. By some criteria the patients were grouped to tuberculous pleural effusion, bacterial effusion, mycoplasma effusion, malignant effusion, and other effusion. Results: The mean pleural ADA activity in tuberculous pleural effusion was 86.2±27.3 U/L. Pleural ADA activities in bacterial effusion, mycoplasma effusion, malignant effusion, other effusion were 32.6±20.1, 22.1±15.4, 23.1±10.9, 36.7±28.4 U/L, respectively. Pleural ADA activity in tuberculous pleural effusion was significantly higher than in any other group(P <0.001). At a level of 50 U/L, the sensitivity, specificity, positive predictive value (ppv), and and negative predictive value(npv) for the identification of tuberculous pleural effusion from nontuberculous pleural effusion were calculated at 93.8%, 84.8%, 81.1%, 95.1%, respectively. Conclusion: Pleural ADA is a useful test in the diagnosis of tuberculous pleural effusion of children from nontuberculous pleural effusion.
단일 기관에서 경험한 원발성 간세포암의 10년간의 변화 양상
김영돈 ( Young Don Kim ),장우성 ( Woo Sung Jang ),권장훈 ( Jang Hoon Kwon ),홍종삼 ( Jong Sam Hong ),천갑진 ( Gab Jin Cheon ) 대한간암학회 2013 대한간암학회지 Vol.13 No.2
Background/Aims: Hepatocellular carcinoma (HCC) is common cause of liver related death in Korea, and the importance of alcohol as an etiology of chronic liver disease including cirrhosis is emphasized recently. We investigated the epidemiologic changes of HCC during last 10 years in single tertiary center in Gangneung, Korea. Methods: We retrospectively reviewed the medical records of admitted patients diagnosed as HCC in year 2002 and 2012 respectively, and their clinical characteristics were compared. Results: A total of 214 patients were enrolled. Mean age was 60.1 years and 179 (83.6%) was male. Number of patient with cirrhosis was 160 (74.8%) and with viral hepatitis was 164 (74.8%). Chronic hepatitis B (CHB) was the most common cause of HCC patients with liver cirrhosis (61.9%), and alcohol was 14.4%. The possible curative group (by BCLC stage 0 or A) was only 36.4% (n=78), and had not decreased during the study periods (36.3 % vs. 36.6%, P=0.144), and other clinical variables also had no statistical differences. Conclusions: The clinical characteristics of HCC including clinical stage at the time of diagnosis were not changed over the last 10 year period, and CHB was still the most common etiology of HCC in Gangneung, Korea.
강종원 ( Jong Won Kang ),김영돈 ( Young Don Kim ),홍종삼 ( Jong Sam Hong ),권장훈 ( Jang Hoon Kwon ),서현웅 ( Hyun Woong Seo ),김성훈 ( Sung Hoon Kim ),이종혁 ( Jong Hyuk Lee ),천갑진 ( Gab Jin Cheon ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.2
Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.
장우성 ( Woo Sung Chang ),정우진 ( Woo Jin Jeong ),강경훈 ( Kyung Hoon Kang ),권장훈 ( Jang Hoon Kwon ),홍종삼 ( Jong Sam Hong ),엄대운 ( Dae Woon Eom ),천갑진 ( Gab Jin Cheon ) 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Anaplastic large-cell lymphoma (ALCL) is a rare subgroup of non-Hodgkin`s lymphoma. Primary gastric ALCL is extremely rare. Patients with anaplastic lymphoma kinase (ALK)-positive primary systemic ALCL are known to have better overall survival than those with ALK-negative ALCL. We herein report a case of primary gastric ALK-positive anaplastic large-cell lymphoma. A 37-year-old woman presented with postprandial epigastric pain for 2 months. Endoscopic examination of the upper gastrointestinal tract showed multiple variably sized, round, elevated lesions with friable crater-erosion on the body and fundus. Pathologic examination revealed atypical large lymphoid cell infiltration in the lamina propria; the cells were positive for CD3, CD30, and ALK. We diagnosed the patient with ALCL. She underwent a cycle of chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone. However, she developed brain metastases. Despite two cycles of palliative chemotherapy with high-dose methotrexate for brain metastases, she died due to ALCL progression. (Korean J Med 2012;83:752-756)
한국인에서 D-Dimer의 위양성과 관련된 인자와 검사의 정확도 향상을 위한 Cut-Off Value
홍만용 ( Man Yong Hong ),이창근 ( Chang Kun Lee ),유상용 ( Sang Yong Yoo ),신대희 ( Dae Hee Shin ),정상식 ( Sang Sig Cheong ),권장훈 ( Jang Hoon Kwon ),장우성 ( Woo Sung Jang ),유승진 ( Seung Jin Yoo ),오광훈 ( Kwang Hoon Oh ) 대한내과학회 2013 대한내과학회지 Vol.84 No.3
목적: 폐동맥 색전증과 심부 정맥 혈전증 이외에 D-dimer 검사의 양성 결과를 나타내는 여러 질환들이 보고되고 있으나, 현재까지 한국인에서 위양성을 유발하는 인자에 대해서는 명백하게 알려진 바가 없다. 따라서 한국인에서 위양성을 초래하는 인자들을 확인하고, 정확도를 향상시키기 위한 새로운 cut-off value를 제시하고자 한다. 방법: 2009년 1월부터 12월까지 본원에 방문한 환자 중 다양한 이유로 D-dimer 검사를 시행 받은 2,047명의 환자를 대상으로 분석하였고, 위양성을 유발하는 인자들을 확인하기 위해 오즈비와 95% 신뢰구간을 로지스틱 회귀분석을 이용하여 분석하였다. 새로운 cut-off value는 ROC curve를 이용하여 구하였다. 결과: 연령의 증가, 외상, 수술의 기왕력, 급성 감염, 결핵, 뇌혈관 질환, 악성종양, 만성 신부전, 급성 관동맥 증후군, 심부전, 호흡기 질환 등이 D-dimer 검사의 위양성을 유발하는 인자로 확인되었다. 또한 민감도와 특이도를 향상시키기 위해 ROC curve를 이용하여 구한 새로운 cut-off value는 0.68mg/L였다(65세 이하에서는 0.58 mg/L, 65세 이상에서는 0.77mg/L). 결론: 여러 인자들이 D-dimer 위양성과 관련이 있었으며, 임상에서 D-dimer 검사를 시행하고 임상에 적용할 때에는 이러한 인자들이 결과치에 영향을 줄 수 있음을 충분히 고려하여야겠다. Background/Aims: The D-dimer value is a simple blood test used to evaluate venous thromboembolism (VTE). However, due to its low specificity, another test is needed for a definite diagnosis, such as a radiographic test. We evaluate the factors associated with a false positive D-dimer test and propose a new cut-off value for detecting VTE more effectively in Koreans. Methods: This was a retrospective, observational study. From January 2009 to December 2009, 2,047 patients (988 men, 63 ± 15 years) had the D-dimer value checked to evaluate VTE. The main outcome of interest was a positive D-dimer test. Odds ratio and 95% confidence intervals were determined using logistic regression analysis. The new D-dimer cut-off was evaluated using receiver operating characteristics (ROC) curves. Results: The result was positive in 1,093 patients (53%), for a false positive percentage for VTE of 95% and a false negative percentage for VTE of 1%. Significant false positive predictors for a positive D-dimer were increasing age, trauma, postoperative, acute infection, tuberculosis, stroke, malignancy, chronic renal failure, acute coronary syndrome, heart failure, and lung disease. The discriminative value of the D-dimer test was assessed using ROC curve analysis. A D-dimer value of 0.68 mg/L on admission was the best cut-off value for predicting the development of VTE with a sensitivity of 95% and specificity of 57%. Conclusions: Many factors affect the D-dimer value and we must consider these factors before using the D-dimer value to evaluate VTE. A D-dimer value of 0.68 mg/L appears to be a good cut-off value for evaluating VTE more effectively in Koreans. (Korean J Med 2013;84:372-378)