포스터 전시 발표 순서 : 소화기 ; Clostridium difficile PCR ribotype 027 균에 의한 패혈증 쇼크를 동반한 재발성 위막성 대장염 1 예 (초)

태정현,정성애,송현주,박재정,강민정,정지민,김성은,정혜경,심기남,유권,문일환,이미애,황유선,김희정 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

The First Case of Antibiotic-associated Colitis by Clostridium difficile PCR Ribotype 027 in Korea

태정현,정성애,송현주,김성은,최희정,이미애,황유선,김희정,이경원 대한의학회 2009 Journal of Korean medical science Vol.24 No.3

Clostridium difficile (C. difficile) is a common causative agent of pseudomembranous colitis (PMC). C. difficile-associated diarrhea (CDAD) ranges from mild diarrhea to life threatening PMC. Recently, a highly virulent strain of C. difficile polymerase chain reaction ribotype 027 was found in North America, Europe, and Japan. A 52-yr-old woman with anti-tuberculosis medication and neurogenic bladder due to traffic accident experienced five episodes of C. difficile PMC after taking antibiotics for pneumonia along with septic shock and acute renal failure. She was readmitted to the intensive care unit and treated with oral vancomycin with refractory of oral metronidazole, inotropics and probiotics for over 60 days. C. difficile isolated both at the first and the last admission was identified as C. difficile ribotype 027 by ribotyping, toxinotyping, and tcdC gene sequencing, which turned out the same pathogen as the epidemic hypervirulent B1/NAP1 strain. This is the first case of C. difficile PCR ribotype 027 in Korea. After discharge, she was maintained on probiotics and rifaximin for 3 weeks. She had no relapse for 6 months.

우리나라 Helicobacter pylori 제균치료의 현재 전략

태정현,심기남 대한상부위장관ㆍ헬리코박터학회 2015 Korean Journal of Helicobacter Upper Gastrointesti Vol.15 No.4

ince the development of guidelines for the diagnosis and treatment of Helicobacter pylori infection in 1998, the Korean College of Helicobacter and Upper Gastrointestinal Research proposed revised guidelines in 2009 and 2013. The revised guideline in 2013 recommends triple therapy including conventional proton pump inhibitor (PPI), clarithromycin, and amoxicillin for 7 days as the primary eradication regimen. When clarithromycin resistance is suspected, quadruple therapy including PPI, metronidazole, bismuth, and tetracycline for 7∼14 days is recommended as an alternative primary regimen for H. pylori eradication. Bismuth-containing quadruple therapy is recommended in cases of H. pylori eradication failure when the initial treatment was triple therapy. When initial bismuth-containing quadruple therapy fails to eradicate H. pylori, it is very difficult to create a secondary regimen. There is paucity of evidence regarding these secondary regimens. In addition, due to the declining eradication rates of primary regimens in recent years, other potential combinations including sequential and concomitant therapies have been considered.

대장내시경 전임의 수련에서 실시간 회수시간 기록의 유용성

태정현,정성애,전승정,노선희,최주영,강민정,정지민,김성은,심기남,정혜경,김태헌,유권,문일환 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.6

Background/Aims: Attempts to increase colonoscopy withdrawal time have been the topic of several recent publications. We assessed whether the real-time measurement of withdrawal time affected the withdrawal time and polyp detection rate. Methods: Real-time colonoscopy withdrawal time was measured in 197 subjects in a study group and 184 subjects comprised a control group without real-time measurements. Colonoscopies were performed by four endoscopy specialists and three fellows during their first year of training. Withdrawal time, clinical features, bowel preparation, and polyp detection rates were comparatively analyzed. Results: No significant differences in age, gender, bowel preparation, or polyp history were found in the two groups. Withdrawal time was significantly higher in the study group than that in the control group when a fellow performed the withdrawal. However, polyp detection rate did not significantly increase in the study group, regardless of physician. Conclusions: Real-time measurement of colonoscopy withdrawal time did not increase polyp detection rate, but the withdrawal time was significantly higher when a fellow performed the withdrawal phase than when a specialist performed withdrawal. Therefore, the real-time measurement of colonoscopy withdrawal time seems to be a useful tool for fellow training. 목적: 대장내시경의 질 관리 지표로 회수시간이 중요하게 고려된다. 이번 연구에서는 대장내시경 검사 중 회수시간을 실시간으로 측정하여 검사자가 회수시간을 측정한다는 사실을 알고 있을 때, 회수시간에 유의한 변화가 있는지 알아보고 이에 따른 용종 발견율에 차이가 있는지 알아보고자 하였다. 대상 및 방법: 대장내시경 중 실시간으로 회수시간을 측정한 197건과 회수시간을 측정하지 않은 184건을 대상으로 하였다. 대장내시경은 4명의 내시경 전문의와 3명의 1년차 전임의가 참여하였다. 회수시간의 측정과 함께 연구 대상군의 나이, 성별과 장 정결도, 용종 발견율을 비교 분석하였다. 결과: 회수시간을 측정한 군과 측정하지 않은 군 사이에 나이, 성별, 장 정결도와 대장 용종의 과거력은 차이는 없었다. 전임의가 회수한 경우, 실시간으로 회수시간을 측정한 군에서 회수시간을 측정하지 않은 군보다 유의하게 높은 회수시간을 보였다. 그러나 전임의와 내시경 전문의 모두에서 회수시간의 측정에 따른 용종 발견율의 증가는 없었다. 결론: 회수시간을 실시간으로 측정하는 방법은 용종 발견율에 영향을 주지는 않았다. 그러나 전임의에서는 회수시간을 실시간으로 측정하는 방법이 실제로 더 많은 회수시간을 할애하여 검사하도록 하였다. 따라서 회수시간을 실시간으로 측정하는 방법은 전임의가 충분한 시간을 할애하여 검사하도록 수련하는데 좋은 방법이 될 수 있다.

Clostridium difficile PCR ribotype 027 균에 의한 패혈증 쇼크를 동반한 재발성 위막성 대장염 1 예

태정현,정성애,송현주,박재정,강민정,정지민,김성은,정혜경,심기남,유권,문일환,이미애,황유선,김희정 대한내과학회 2008 대한내과학회 추계학술대회 Vol.2008 No.-

Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?

태정현,Ki-Nam Shim 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.5

Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective.

위식도역류질환의 진단과 치료에 대한 진료지침

태정현 대한내과학회 2023 대한내과학회 춘계학술대회 Vol.2023 No.0

경피내시경위루술 임상진료지침

태정현,이주엽,주문경,박찬혁,공은정,신철민,임현,최혁순,최미영,김상훈,임철현,변정식,심기남,송근암,이문성,박종재,이오영 대한소화기학회 2023 대한소화기학회지 Vol.82 No.3

With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tubes removal for PEG based on the currently available clinical evidence.

소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군

태정현 ( Jung Hyun Tae ),이진화 ( Jin Hwa Lee ),김윤경 ( Yoon Kyung Kim ),심윤수 ( Yun Su Sim ),이경종 ( Kyung Jong Lee ),노영욱 ( Young Wook Noh ),박재정 ( Jae Jung Park ),류연주 ( Yon Ju Ryu ),천은미 ( Eun Mi Chun ),장중현 ( Jun 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2

Small cell lung cancer is characterized by an aggressive clinical course and a high tendency for early dissemination in spite of a good chemotherapy response. Topotecan is a topoisomerase I inhibitor, and it is used as second-line treatment for small cell lung cancer. The reported dose-limiting adverse reactions to topotecan are mainly hematologic. Yet pulmonary toxicity associated with topotecan is known to be rare. We report here on a case that showed the development of acute respiratory distress syndrome during the 3rd cycle of topotecan chemotherapy in a patient with small cell lung cancer. He developed dyspnea and respiratory failure, and the chest CT scan revealed diffuse ground-glass opacity that was probably due to chemotherapy-related pulmonary toxicity. He finally died of acute respiratory distress syndrome. (Tuberc Respir Dis 2008;65:142-146)

현금보유가 기업의 투자-현금흐름민감도에 미치는 영향에 대한 연구

태정현(Tae, Jeong-Hyeon) 한국산학기술학회 2011 한국산학기술학회논문지 Vol.12 No.4

본 연구의 목적은 Ӧ.Arslan et al.(2006)의 연구방법론을 적용하여 국내 기업의 현금보유(cash holdings)가 투 자-현금흐름 민감도(investment-cash flow sensitivity)에 어떤 영향을 주는지를 분석하는 데 있다. 1981년부터 2009년 까지 외환위기 이전과 이후 그리고 외환위기 기간으로 분류하여 각 기간별로 현금보유가 투자-현금흐름 민감도에 어 떤 영향을 주는 지를 비교 분석하였다. 연구 결과는 다음과 같다. 첫째, 전체 기업을 재무적 제약(financial constraint) 에 대한 고려 없이 3개의 기간으로 분류해서 살펴본 결과 외환위기 기간을 제외한 외환위기 이전과 이후 기간에서는 현금보유가 많은 기업일수록 투자-현금흐름 민감도는 감소하였다. 둘째, 기업규모나 배당지급 기준에 의해 재무적 제 약하에 있지 않은 기업으로 분류된 경우에는 현금보유가 많을수록 투자-현금흐름 민감도는 오히려 증가하는 것으로 나타났다. 이는 Ӧ.Arslan et al.(2006)의 연구와 일치하지 않는 결과인데 첫째, 기업규모나 배당지급 여부는 국내에서는 기업의 재무적 제약을 나타내는 기준으로 불완전하며 둘째, 본 연구에서 고려하지 못한 투자-현금흐름 민감도에 영향 을 주는 다른 요인들이 존재할 수 있기 때문이다. 하지만 현금보유기준에 의해 재무적 제약하의 기업으로 분류된 경 우에는 투자-현금흐름 민감도는 낮게 나타났다. 이는 Ӧ.Arslan et al.(2006)의 연구결과와 일치한다. 끝으로 전체 기간 동안 현금보유 결정요인은 다음과 같다. 현금흐름(cash flow)과 시장가/장부가비율(market to book ratio)은 증가할수록, 단기부채와 투자지출 그리고 기업규모는 감소할수록, 기업의 현금보유증가에 양(+)의 영향을 주는 것으로 나타났다. This paper investigates how does cash holdings have effect on investment-cash flow sensitivity in korea firms over the period 1981-2009. According to Ӧ.Arslan et al.(2006), I expect that financially constrained firms have more cash holdings. and financially constrained cash-rich firms are likely to have less investment-cash flow sensitivity especially in the financial crisis period. Using financial constraint classification variables(firm size, dividend, cash holdings), we divide whole sample firms into financially constrained firms and financially unconstrained firms, and then I compare investment-cash flow sensitivity in pre-financial crisis(1981-1996), financial crisis(1997-1998) and after-financial crisis(1999-2009) period. This paper's findings are as follows: First, under no financial constraint classification conditions, cash-poor firms exhibit greater investment-cash flow sensitivity than cash-rich firms do during 1981-2009 period except financial crisis period. These findings support the hypothesis that firms have more cash holdings less investment-cash flow sensitivity except in financial crisis period. In financial crisis period, cash holdings have no effect on investment-cash flow sensitivity. Second, this paper findings are somewhat different as Ӧ.Arslan et al.(2006)'s. Under the financial constraint classification conditions, financially unconstrained firms have more investment-cash flow sensitivity rather than constrained firms have. The reason is that both dividend and firm size are not a complete classification criteria variables. And there exists other possible determinants of investment-cash flow sensitivity. Finally, this paper find that there are common determinants of corporate cash holdings in all periods. This paper suggests that cash flow and market to book ratio are positive determinants of corporate cash holdings but short-term debt, investment and firm size are negative determinants of corporate cash holdings.