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약품(액상소석회) 저장조 준설 작업자의 유해인자 특성 평가 사례
김제훈,김기연 한국산업보건학회 2024 한국산업보건학회지 Vol.34 No.1
Objectives: The study was performed to investigate characteristics of hazardous factors regarding chemical(liquid lime) tank dredging workers by case survey. Methods: Field data such as working condition, MSDS and respirators applied to chemical tank dredging work were analyzed and the work environmental factors of noise and indoor air quality were measured to compare existing data with actual work situations. Results: No health hazards to workers due to working conditions were confirmed during dredging work inside the chemical storage tank. All air quality measurement data during dredging work satisfied the management standards, and there were no by-products. During dredging work, there was a significant change in noise depending on the type of work, but considering the noise reduction rate(NRR) of the earplugs worn by workers, there was no actual health hazard due to noise exposure. Conclusions: A fit test for respirator and the expiration date of the safety helmet should be observed to ensure an appropriate level of safety and health for dredging workers in the chemical storage tank.
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김제훈,최창민,김우성,이재철,김형렬,송시열,김미영 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-
Introduction: Stage IIIA N2 non-small cell lung cancer (NSCLC) is heterogenous. IIIA N2 NSLCLC patients include tumors ranging from single station N2 to multistational bulky N2 disease. The purpose of this study was to evaluate prognostic factors determining recurrence and survival. Methods: A total of 185 patients with resected NSCLC who finally diagnosed pathologic IIIA N2 disease between 2007 and 2011 were analyzed. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded. Results: The median duration of follow-up was 43.6 months. 5-year disease-free survival (DFS) was 24.8% (95% confidence interval [CI], 15.5-22.8; median, 19.2 months), and 5-year overall survival (OS) was 40.6% (95% CI, 35.4-47.2; median, 49.1 months). In a multivariate analysis, the number of metastatic N2 lymph node stations and adjuvant treatment were an independent prognostic factor for DFS and OS. In adenocarcinoma subgroup (n=116, 62.7%) analysis, EGFR mutations were shorter DFS and longer survival from relapse than wild type. EGFR mutations was an independent prognostic factor for only DFS. Conclusions: Multiple station N2 disease was the important prognostic factor for recurrence and survival in resected stage IIIA N2 NSCLC. In adenocarcinoma group, there was no difference in overall survival according to EGFR mutation because the DFS was shorter.
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김제훈 대한약학회 1964 약학회지 Vol.8 No.2
A new alkaloid, named tenuidine was isolated from Polygala tenuifolia Willdenow. Its molecular formula corresponded to $C_{21}$ $H_{31}$ $O_{5}$ $N_{3}$ and its constants were m.p.256, [.alpha.]$_{D}$$^{18.5}$=1200.deg.(ethanol). Its infrared absorption spectra exhibited bands at 3.300, 1600, 1580, 1500 $cm^{-1}$ / confirming indole ring and at 2800-2700 $cm^{-1}$ / indicating quinoline ring. Bands at 1610, 1530 $cm^{-1}$ / indicated the presences of benzene ring and 1642$cm^{-1}$ / carbochelate.e.e.
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Tracheal pleomorphic adenoma with coexisting pulmonary tuberculoma
김제훈,옥철호,장태원,정만홍 영남대학교 의과대학 2018 Yeungnam University Journal of Medicine Vol.35 No.1
Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3- month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.
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기관지폐암으로 오인된 면역 정상 환자의폐 효모균증 1예
김제훈,이진영,옥철호,정만홍,장태원 대한의진균학회 2016 대한의진균학회지 Vol.21 No.3
We experienced a 59-year-old immunocompetent female patient who complained progressive cough. A bronchoscopic examination revealed an endobronchial mass protruding from the left lower lobe and occluding anterior-basal segment bronchus. Bronchial biopsy and endobronchial ultrasound guided transbronchial needle aspiration were consistent with cryptococcal infection. However, the response of medical therapy was an unsuccessful. Finally, the patient underwent left lower lobectomy with lymph node dissection. We report a case of pulmonary cryptococcosis mimicking bronchogenic lung cancer, and surgical therapy with antifungal treatment resulted in successful resolution of the pneumonia.
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S-37 : A rare case of fatal thrombocytopenia after oxaliplatin-based chemotherapy
김제훈,박무인,박선자,문원,김성은 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
서론: Oxaliplatin은 3세대 플라티늄 계열의 항암제로 DNA의 복제와 전사를 저해하여 세포사를 초래한다. 다른 항암제들과 비교했을 때 신독성, 이 독성이 적어 진행성 대장암, 직장암의 치료에 있어 널리 사용되고 있다. Oxaliplatin과 관련된 부작용으로는 말초신경병증과 같은 신경계 증상이 가장 흔한 것으로 알려져 있으며, 이외에 구역, 구토, 설사 등의 소화기계 증상들과 골수 기능 억제에 의한 호중구 감소증, 혈소판 감소증 등이 있다. 드문 것으로 알려진 합병증으로는 가려움증, 발진, 열, 호흡곤란, 아나필락시스 등의 과민 반응들이 있으나 이러한 부작용은 대부분 경증이며 대개 약제를 중단하였을 때 호전된다. 최근, Oxaliplatin으로 치료받고 있는 환자들에게서 발생하는 면역성 혈소판감소증의 기전이 밝혀졌다. 이는 Oxaliplatin-dependent antibodies이 직접적으로 혈소판의 표적 glycoproteins에 결합하여 발생하는 것이며, 골수기능의 억제와는 연관이 없었다. 저자들은 Oxaliplatin으로 치료 중인 진행성 대장암 환자에서 급성으로 발생한 혈소판감소증 한 례를 경험후 이를 보고하고자 한다. 증례: 52세 여자가 건강검진의 목적으로 시행한 대장내시경에서 이상 소견이 발견되어 내원하였다. 2011년 11월 본원에서 다시 대장내시경을 시행하였고 AV 40 cm 위치의 구불결장(Sigmoid colon)에 3 cm 크기의 friable irregular mass가 관찰되어, 시행한 조직검사 결과 Adenocarcinoma, well diffrentiated로 진단받았다. 병기설정을 위한 복부 컴퓨터 단층촬영에서 간우엽의 다발성 간 전이를 발견하여 구불결장암 4기로 진단 받은 후 2011년 11월부터) 2주 간격의 FOLFOX-4 (Oxaliplatin, leukovorin and 5-fluorouracil) 병합화학요법을 시행하였다. 2012년 10월 환자는 20번째 주기의 FOLFOX-4 병합화학요법 항암치료를 위해 내원하였고 항암제 투여 전 시행한 말초 혈액검사, 일반 화학검사에서는 Hb 11.5g/dL, WBC 4400/mm3, PLT 172000/mm3로 경도의 빈혈이외에 특이소견이 보이지 않아 항암제를 투여하였다. 항암제 투여를 시작한 다음날 오전 혈변이 발생하여 시행한 말초 혈액검사에서 Hb 10.1 g/dL, HT 29.8%, WBC 6900/mm3, 혈소판 16,000/mm3로 확인되었다. 혈변의 원인을 찾기 위해 구불결장경을 시행하였고 출혈하고 있는 병변 발견되어 내시경적 지혈술을 시행 후 혈소판 6 pints를 수혈하였다. 수혈 후 다음날, 혈소판은 73,000/mm3이었고 항암치료 종료 5일 후 118,000/mm3인 것을 확인 후 퇴원하였다. 환자는 이후 FOLFIRI (Irinotecan, Leukovorin and 5-fluorouracil)으로 전환하여 항암치료를 시행하였으며 현재 추적관찰 중에 있다.
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