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복수 재발한 급성림프구성 백혈병 1예에서 중추신경계 질환 치료 방법
지종현,홍유라,박성인,박재선 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1
Methotrexate (MTX) is one of the most widely used drugs for the treatment of childhood acute lymphoblastic leukemia (ALL) and is commonly given in high doses. Systemic chemotherapy, triple intrathecal (TIT) treatment and craniospinal radiation was given to a child with meningeal involvement at presentation. But meningeal leukemia was recurred 3 months later, which was remissioned secondly by TIT chemotherapy. One year later from first diagnosis, second meningeal relapse was presented with immature cell count of 12/㎣ in CSF and a large intracerebral mass on brain CT. A high-does methotrexate (HDMTX) had been challenged in dose of 2.8-5.0 g/㎡ with TIT chemotherapy. In HDMTX schedule, leucovorin (LCV) was administered orally (12 times, 15 ㎎/㎡ every 6 hours), 24 hours later from the start. Intracerebral mass disappeared two weeks later (with 2 weekly administration of HDMTX) and the third remission was lasted for 80 months. Third isolated meningeal relapse, which occurred on July 28, 2000, remissioned again with HDMTX plus TIT chemotherapy, but he died of fungal sepsis and interstitial pneumonia. Although the patient died of treatment related disease, systemic intravenous HDMTX and TIT therapy appears to provide another option in the treatment of relapsed meningeal leukemia after craniospinal irradiation.
설문 및 실측을 통한 대형종합병원 건물의 동계 실내 온열환경 평가
지종현,성민기,조성민,방종일 한국냄새환경학회 2018 실내환경 및 냄새 학회지 Vol.17 No.2
The healing environment in hospitals is very important. Three factors must be satisfied to create a healingenvironment in the hospital. First, chemical elements such as pathogens and pollutants must be controlled. Second,physical factors such as temperature, humidity and airflow must be satisfied. Third, psychological factors mustbe satisfied. The purpose of this study was to evaluate the indoor thermal environment by conducting aquestionnaire (Thermal Sensation Vote, TSV) and a Predicted Mean Vote (PMV) measurement. The questionnaireswere distributed to 20 medical staff (nurse), 84 inpatients and 113 outpatients. Temperature, humidity, air qualityand comfort were evaluated. Measurements were conducted in the waiting room and lobby of the first and secondfloors of the outpatient area as well as wards on 10th floor. Both south and north-facing wards were divided toanalyze the PMV difference by the orientations. The survey results showed high satisfaction values in the outpatientdepartment for temperature satisfaction and comfort. In the inpatient department, air quality satisfaction showedgood values. Moreover, the humidity satisfaction level in the nurse station was high. The PMV measurement resultsshowed that the PMV was lower in the ward than in the outpatient area. Comparison of the questionnaire andmeasurement results showed that the questionnaire results were lower than those of the measurement in theoutpatient area. As a result, it is necessary to reduce the gap between questionnaire and measurement results Itis also important to create an indoor environment that matches the thermal preferences of the occupant by operatingthe air handling unit (AHU).
새로이 고안된 자바라식 천식약 흡입 보조기구(Spacer)를 이용한 기관지 확장제 흡입 효과에 관한 연구
지종현,이창연,홍유라,이보영 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1
목적 : 기관지 확장제의 투여 방법 중 압축 용기를 사용한 MDI 흡입 요법은 경구 투여보다 효과가 빠르고 부작용이 적고 휴대가 간편하여 널리 쓰이고 있다. 그러나 MDI는 사용하는 방법이 까다로워서 잘못 흡입하면 충분한 효과를 볼 수 없는 것으로 알려져 있으며 특히 성인과 달리 소아에서는, 흡입력이 약하고 MDI 흡입을 교육하기가 어렵기에 흡입 보조기구의 사용이 필수적이다. 하지만 소아에서 MDI흡입을 위해 흡입보조기구를 사용하는 경우에 적절하게 흡입을 하고 있는지의 확인이 안되고, 호흡을 적절하게 조절할 수 없는 영유아에서 흡입을 시킬 수 있는 흡입 보조기구가 적어 새로운 흡입기구의 개발이 절실히 요구되었다. 이에 저자들은 소아가 기관지 확장제를 제대로 흡입하고 있는지 확인 할 수가 있고 협조가 안 되는 영유아들도 기관지 확장제를 흡입할 수 있게 고안 제작한 폐쇄형 유동 스페이스를 사용하여 천식 환자들을 대상으로 기관지 확장제에 의한 반응을 조사 연구하였다. 방법 : 고신대학교 복음 병원에서 정상인(14명), 천식환자(13명), 폐기종 환자(3명)들을 대상으로 자바라식 스페이스를 이용하여 기관지 확장제 흡입전, 후 FEV₁을 검사하였다. 결과 : 1) 천식 환자군에서 1례를 제외하고는 모두 FEV_1 이 15%이상 호전 되었다. 2) 정상인 군에서는 FEV_1 의 변화가 없었다. 3) 천식 이외의 기도페쇄 환자 군에서는 FEV_1 의 변화가 없었다. 결론 : 천식 환자에 있어서 자바라식 스페이스를 이용한 기관지 확장제 흡입이 치료에 효과가 있을 것으로 생각된다. Object : Metered dose inhaler (MDI) is designed for administration of drugs by inhalation with a compression instrument. MDI is used widely because it is portable, more effective and has fewer side effects than oral administrations. But the proper inhalation of MDI in young children and the elderly is difficult because of their lower lung volume and ineffective compression of the device. To reduce these drawbacks, several types of spacer were invented. In this study, we evaluated the effectiveness of the newly devised closed Zavala spacer. Method : Thirty participants were consisted of a normal group (n〓14), asthmatic patients (n〓13), and cases of pulmonary emphysema (n〓3). FEV₁ of the participants was examined before and after 2 puffs of salbutamol(200㎍), inhalation with the Zavala spacer. Results : 1. The mean improvement of FEV_1 in the group of asthmatic patients was above 15% except one case 2. FEV_1 was unchanged in the normal group. Conclusion : The MDI inhalatin using the Zavala spacer would be an effctive drug delivery method for the patients who could not inhale properly.
복수 재발한 급성림프구성 백혈병 1예에서중추신경계 질환 치료 방법
지종현,홍유라,박성인,박재선 고신대학교(의대) 고신대학교 의과대학 학술지 2003 고신대학교 의과대학 학술지 Vol.18 No.1
Methotrexate (MTX) is one of the most widely used drugs for the treatment of childhood acute lymphoblastic leukemia (ALL) and is commonly given in high doses. Systemic chemotherapy, triple intrathecal (TIT) treatment and craniospinal radiation was given to a child with meningeal involvement at presentation. But meningeal leukemia was recurred 3 months later, which was remissioned secondly by TIT chemotherapy. One year later from first diagnosis, second meningeal relapse was presented with immature cell count of 12/mm3 in CSF and a large intracerebral mass on brain CT. A high-dose methotrexate (HDMTX) had been challenged in dose of 2.8-5.0 g/m2 with TIT chemotherapy. In HDMTX schedule, leucovorin (LCV) was administered orally (12 times, 15 mg/m2 every 6 hours), 24 hours later from the start. Intracerebral mass disappeared two weeks later (with 2 weekly administration of HDMTX) and the third remission was lasted for 80 months. Third isolated meningeal relapse, which occurred on July 28, 2000, remissioned again with HDMTX plus TIT chemotherapy, but he died of fungal sepsis and interstitial pneumonia. Although the patient died of treatment related disease, systemic intravenous HDMTX and TIT therapy appears to provide another option in the treatment of relapsed meningeal leukemia after craniospinal irradiation.
새로이 고안된 자바라식 천식약 흡입 보조기구(Spacer)를 이용한기관지 확장제 흡입 효과에 관한 연구
지종현,이창연,홍유라,이보영 고신대학교(의대) 고신대학교 의과대학 학술지 2003 고신대학교 의과대학 학술지 Vol.18 No.1
Object : Metered dose inhaler (MDI) is designed for administration of drugs by inhalation with a compression instrument. MDI is used widely because it is portable, more effective and has fewer side effects than oral administrations. But the proper inhalation of MDI in young children and the elderly is difficult because of their lower lung volume and ineffective compression of the device. To reduce these drawbacks, several types of spacer were invented. In this study, we evaluated the effectiveness of the newly devised closed Zavala spacer. Method : Thirty participants were consisted of a normal group (n=14), asthmatic patients (n=13), and cases of pulmonary emphysema (n=3). FEV1 of the participants was examined before and after 2 puffs of salbutamol(200ug) inhalation with the Zavala spacer. Results : 1. The mean improvement of FEV1 in the group of asthmatic patients was above 15% except one case 2. FEV1 was unchanged in the normal group. Conclusion : The MDI inhalatin using the Zavala spacer would be an effctive drug delivery method for the patients who could not inhale properly.
지종현 ( Jong Hyun Jhee ),김현주 ( Hyun Ju Kim ),강원석 ( Won Seok Kang ),김세화 ( Se Wha Kim ),김도영 ( Do Young Kim ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.1
A 25-year-old woman presented with jaundice, palpitation, and weight loss of 5 kg during a period of 2 weeks. Laboratory tests showed elevated levels of liver enzymes (AST 1,282 IU/L, ALT 1,119 IU/L) and total bilirubin (6.4 mg/dL); negative for hepatitis virus infection; elevated serum levels of triiodothyronine (T3, 3.60 ng/dL), free thyroxine (fT4, 3.82 ng/dL), and lowered serum level of thyroid stimulating hormone (TSH, <0.025 꺷IU/mL); and positive for thyroid stimulating antibody and anti-mitochondrial antibody (AMA). The liver biopsy findings were consistent with autoimmune hepatitis (AIH). Accordingly, oral steroid therapy was started with 60 mg of prednisolone under the impression of AIH associated with Graves` disease. After a week of steroid therapy, the clinical manifestation showed significant improvement, with normalization of both liver and thyroid functions. Diagnosis of the liver condition of patients who present with hyperthyroidism and liver dysfunction is important, so that appropriate therapy can be promptly initiated.