http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Unilateral Diaphragmatic Paralysis after Thyroid Surgery
변종규,이상열,김유진,엄유진,김슬기,손정일,진상욱,전숙,김우식,김주영,이병욱,우정택,김영설,Byun, Jong Kyu,Rhee, Sang Youl,Kim, Yu Jin,Um, Yu Jin,Kim, Seul Ki,Son, Jung Il,Chin, Sang Ouk,Chon, Suk,Kim, Woo-Shik,Kim, Joo Young,Lee, Byoung Woo The Korean Society for Head and Neck Oncology 2014 대한두경부 종양학회지 Vol.30 No.2
갑상선 암 진단과 치료기술이 발전하면서 최근 그 수술 건 수가 급격하게 증가하고 있다. 하지만이와 관련된 합병증과 부작용을 면밀하게 평가해야 할 필요 역시 점차 늘어나고 있다. 갑상선 암 수술 후 발생할 수 있는 드문 합병증의 하나로 횡격막 신경마비(phrenic nerve paralysis)가 있다. 이러한 횡격막신경마비는 대부분 증상이 경미하고 쉽게 호전되어 임상적으로 크게 중요하게 다루어지지 않았다. 하지만, 갑상선 수술 후 갑작스런 호흡곤란이 발생한다면 횡격막 신경마비에 의한 횡격막 마비(diaphragmatic paralysis)와 관련되었을 가능성을 놓치지 말아야 한다. 저자들은 최근 갑상선암 수술 후 발생한 호흡곤란으로 2년 동안 심각한 호흡곤란을 호소하던 73세 여자환자에서 투시촬영(fluoroscopy) 상 편측으로 상승되고 운동성이 저하된 횡격막을 확인하여 일측성 횡격막신경마비(Unilateral phrenic nerve paralysis)를 확진 하였다. 갑상선수술 후 발생하는 일측 횡경막 신경마비는 임상에서 드물게 관찰되는 수술 합병증이기에 환자는 상당기간 이에 대한 감별이 제대로 이루어지지 않았다. 우리는 횡격막 마비의 조기 진단과 적극적인 치료를 통하여 심한 호흡곤란을 호소하는 환자의 증상 및 병의 경과를 호전 시킬 수 있었다.
슈퍼와파린(Superwarfarin) 중독으로 진단된 원인미상의 응고장애 2례
변종규 ( Jong Kyu Byun ),맹치훈 ( Chi Hoon Maeng ),변자민 ( Ja Min Byun ),엄유진 ( Yu Jin Um ),김진숙 ( Jin Sug Kim ),이철현 ( Cheol Hyun Lee ),이태인 ( Tae In Lee ),윤휘중 ( Hwi Joong Yoon ),조경삼 ( Kyung Sam Cho ),김시영 ( Si Y 전북대학교 의과학연구소 2014 全北醫大論文集 Vol.38 No.1
브로디파쿰은 강력한 항응고억제작용을하여 장기간 지속되는 응고장애를 유발하는 살서제로 이로 인한 중독은 비교적 흔히 보고되나 원인이 밝혀지지 않은 중독은 드물게 보고 되고 있다. 본 증례에서는 와파린이나 살서제의 복용력이 없었으나 무통성 혈뇨를 주소로 내원한 환자에서 후천성 비타민 K 의존성 혈액응고인자의 결핍을 보여 브로디파쿰 중독을 의심하였고 혈청 브로디파쿰 농도 측정 결과 이로 인한 중독에 의한 응고장애로 진단되어 비타민 k로 혈액응고 장애를 교정하고 치료하였다. 본 사례에서와 같이 임상적으로 유의한 응고장애를 보이는 환자에서 노출 병력이 명확하지 않은 경우에도 살서제 중독을 원인으로 고려하여 혈청 농도 측정을 하고 진단시 장기간의 비타민 K 투여를 통한 치료를 통하여 치료 중단으로 인한 재출혈이 없도록 주의해야 한다. superwarfarins are popular and are readily accessible, they are associated with intoxication, leading to prolonged and sometimes life-threatening coagulopathies. We report our experience managing 2 patients who had clinical evidence of superwarfarin intoxication at Kyung Hee Medical Center in Seoul, Korea. Superwarfarin exposure or poisoning is an important public health concern in South Korea, affecting those of all ages. The diagnosis of superwarfarin poisoning is usually straightforward in cases of acute poisoning, but because many cases present with obscure history of exposure, clinical suspicion is the key to early diagnosis and timely intervention. Prolonged treatment with large doses of vitamin K is needed for superwarfarin intoxication.
Disseminated Gonococcal Infection Presenting as Bacteremia and Liver Abscesses in a Healthy Adult
이민혜,변종규,정명화,양정석,박기호,문수연,이희주,이미숙 대한감염학회 2015 Infection and Chemotherapy Vol.47 No.1
Herein, we describe a bacteremia caused by Neisseria gonorrhoeae that presented as liver abscesses. The patient had no riskfactors for disseminated gonococcal infection. Periodic fever, skin rashes, and papules were present and the results of an abdominalcomputed tomography scan indicated the presence of small liver abscesses. The results of blood culture and 16S rRNAsequencing of the bacterial isolates confirmed the presence of N. gonorrhoeae. The patient improved with antibiotic therapy.
정인경,변종규,노정현,김상완,정윤석,박태선,김성운 대한내분비학회 2020 Endocrinology and metabolism Vol.35 No.4
Insulin-like growth factor-I (IGF-I) plays a pivotal role in the diagnosis and treatment of growth hormone (GH) excess or deficiency. The GH study group of the Korean Endocrine Society aims to establish the Korean reference ranges of serum IGF-I and insulin-like growth factor binding protein-3 (IGFBP-3) and assess the relationship between IGF-I and IGFBP-3 and clinical parameters. Fasting serum was collected from healthy Korean adults at health promotion centers of five hospitals nationwide. Serum IGF-I and IGFBP-3 were measured via an immunoradiometric assay using a DSL kit (Diagnostic Systems Laboratories). Serum samples from 354 subjects (180 male, 174 female) were analyzed based on sex at 10-year intervals from 21 to 70 years. IGF-I levels were inversely correlated with age. After adjustment of age, the IGF-I/IGFBP-3 ratio was significantly negatively associated with blood pressure and free thyroxine and positively associated with weight, hemoglobin, creatinine, alanine transferase, fasting glucose, and thyroid stimulating hormone. Therefore, age- and sex-specific reference ranges of serum IGF-I and IGFBP-3 can be efficient in evaluating GH excess or deficiency in Korean population.
김유진,이상열,변종규,박소영,홍수민,진상욱,전숙,오승준,우정택,김성운,김영설 대한당뇨병학회 2015 Diabetes and Metabolism Journal Vol.39 No.3
Background: We developed for the first time a smartphone application designed for diabetes self-management in Korea and registered a patent for the relevant algorithm. We also investigated the user satisfaction with the application and the change in diabetes related self-care activities after using the application. Methods: We conducted a questionnaire survey on volunteers with diabetes who were using the application. Ninety subjects responded to the questionnaire between June 2012 and March 2013. A modified version of the Summary of Diabetes Self-Care Activities (SDSCA) was used in this study. Results: The survey results exhibited a mean subject age of 44.0 years old, and males accounted for 78.9% of the subjects. Fifty percent of the subjects had diabetes for less than 3 years. The majority of respondents experienced positive changes in their clinical course after using the application (83.1%) and were satisfied with the structure and completeness of the application (86.7%). Additionally, the respondents’ answers indicated that the application was easy to use (96.7%) and recommendable to others (97.7%) and that they would continue using the application to manage their diabetes (96.7%). After using the Diabetes Notepad application, diabetes related self-care activities assessed by SDSCA displayed statistically significant improvements (P<0.05), except for the number of days of drinking. Conclusion: This smartphone-based application can be a useful tool leading to positive changes in diabetes related self-care activities and increase user satisfaction.
Insufficient Experience in Thyroid Fine-Needle Aspiration Leads to Misdiagnosis of Thyroid Cancer
손정일,이상열,우정택,박원서,변종규,김유진,변자민,진상욱,존석,오승준,김성운,김영설 대한내분비학회 2014 Endocrinology and metabolism Vol.29 No.3
Background: Fine-needle aspiration (FNA) of the thyroid is a widely accepted confirmatory test for thyroid cancer with high sensitivity and specificity. FNA is a simple procedure that is learned by many clinicians to enable accurate diagnosis of thyroid cancer. However, it is assumed that because the FNA test is a relatively simple procedure, its cytologic results are reliable regardless of the operator’s experience. The aim of this study was to evaluate the differences in the diagnostic indices of FNA between operators with different levels of experience. Methods: A total of 694 thyroid FNA specimens from 469 patients were reviewed, and were separated based on the experience of the clinicians who performed the procedure. One hundred and ninety were categorized in the experienced group, and 504 in the inexperienced group. All FNA results were then compared with histological data from surgically resected specimens, and the sample adequacy and diagnostic accuracy of the groups were compared. Results: The age, gender, and nodule size and characteristics were similar in both groups. The sample adequacy rate was not significantly different between the experienced and nonexperienced groups (96.3% vs. 95.4%, P=0.682). However, the non-experienced group had a higher false-negative rate than the experienced group (6.4% vs. 17.2%, P=0.038), and the sensitivity of the FNA test also tended to be lower in the nonexperienced group (95.6% vs. 88.9%, P=0.065). Conclusion: These results suggest that FNA operators who have less experience may miss cases of thyroid cancer by performing the procedure incorrectly. As such, the experience of the FNA operator should be considered when diagnosing thyroid cancer. When clinicians are being trained in FNA, more effort should be made to increase the accuracy of the procedure; therefore, enhanced teaching programs and/or a more detailed feedback system are recommended.
홍성훈 ( Seonghun Hong ),장영운 ( Young Woon Chang ),변종규 ( Jong Kyu Byun ),김민제 ( Min Je Kim ),채정민 ( Jung Min Chae ),박선희 ( Sun Hee Park ),오치혁 ( Chi Hyuk Oh ),박용구 ( Yong Koo Park ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.4
Gastric cancer frequently disseminates to the liver, lung, and bone via hematogeneous, lymphatic, or peritoneal routes. However, gastric adenocarcinoma that metastasize to the colon and that shows typical linea platisca pattern on colonofiberscopy has rarely been reported. Recently, the authors experience a case of advanced gastric cancer with colonic metastases in a 55-year-old female patient. Multiple colonic lymphoid hyperplasias were detected on colonofiberscopy and biopsy revealed metastatic gastric cancer to the colonic wall. She was treated with mFOLFOX (5-FU, oxaliplatin, leucovorin) and has achieved stable disease status without disease progression. Herein, we report a rare case of signet ring-cell gastric cancer which metastasized to the colon in the form of multiple colonic lymphoid hyperplasias. (Korean J Gastroenterol 2015,66:221-226)
증례 : 순화기 ; 건강한 성인에서 인플루엔자 A (H1N1)에 감염에 의해 발생한 급성 심장막염 1예
오치혁 ( Chi Hyuk Oh ),김진배 ( Jin Bae Kim ),김유진 ( Yu Jin Kim ),이태인 ( Taein Lee ),변종규 ( Jong Kyu Byun ),김권삼 ( Kwon Sam Kim ),김우식 ( Woo Shik Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
A 21.year.old male with no any other diseases presented with fever, chills, and chest discomfort. A chest radiography scan and transthoracic echocardiogram revealed a large amount of pericardial effusion. An H1N1 viral real.time PCR test confirmed the presence of H1N1 viral infection. Pericardiocentesis was performed to reduce symptoms, and oseltamivir (Tamiflu TM ) was administered. His symptoms improved during the first 4 days, and there was no relapse of the pericardial effusion. The most common manifestation of influenza A infection is respiratory tract infection. Although a cardiovascular manifestation is possible, it is extremely rare. We have reported here a case of acute pericarditis with a large amount of pericardial effusion in a healthy adult infected with influenza A virus (H1N1, swine.origin). (Korean J Med 2014;87:461-465)