Human immunodeficiency virus(HIV) 감염자에 있어서 3제 병용요법의 치료효과 및 안전성

홍성관(Sung Kwan Hong),박윤수(Yoon Soo Park),조정호(Jeong Ho Cho),노현정(Hyun Jung Roh),김효열(Hyo Yeol Kim),장경희(Kyung Hee Chang),송영구(Young Goo Song),김준명(June Myung Kim) 대한내과학회 2000 대한내과학회지 Vol.58 No.5

N/A Background : Antiretroviral combination therapy with one protease inhibitor and two reverse transcriptase inhibitors is profoundly suppressive of HIV replication. To determine the efficacy and safety of the triple combination therapy in persons with HIV infection in Korea, we analyzed the response of therapy in terms of immunity and viral load. Methods : Ten persons with HIV infection, who were treated with triple combination therapy at least 12 months at Yonsei University College of Medicine from 1997 to 1999 were studied. The triple combination therapy regimen consisted of two reverse transcriptase inhibitors (zidovudine or didanosine, lamivudine) and one protease inhibitor (indinavir). We analyzed the levels of HIV RNA, CD4+ cell counts, β2MG, and p24Ag before and after treatment. Adverse drug reactions during therapy were described. Results : The mean age of patients at treatment was 38.7 years. Nine patients were male, and 1 patient was female. Six patients received triple combination therapy as initial treatment, while 4 patients received it as re-treatment. The mean level of HIV RNA was 129,222 copies/mm3 before treatment. RNA level decreased to less than 500 copies/mm3 (non-detectable range) at 1 month in 7 of 10 patients, at 12 months in 9 of 10 patients. The mean CD4+ cell counts was 206/mm3 before treatment, and 376/mm3 after 12 months treatment. The β2MG decreased to 2.7 mg/L from 2.8 mg/L after 12 months of treatment. The p24Ag was positive in 3 of 10 patients and negative in all of the patients at 3 months treatment. Mild hyperbilirubinemia (5 cases) was the most frequent adverse reaction followed by flank pain (3 cases), skin rash (2 cases), abdominal discomfort (2 cases), and mild elevation of AST/ALT (1 case). Conclusion : The triple combination therapy in HIV infection appeared to be generally well tolerated, and was able to profoundly sustain suppression of HIV replication.(Korean J Med 58:582-589, 2000)

정보유출방지를 위한 자바 에이전트를 활용한 클라이언트의 정보 추출

홍성관(Sung-Kwan Hong),전희준(Hee-Jun Jeon),권용훈(Yong-Hun Kwon),이상호(Sang-Ho Lee) 한국지능시스템학회 2015 한국지능시스템학회 학술발표 논문집 Vol.25 No.2

후복막강경 부신절제술 41예

홍석경,홍성관<SUP>1<.SUP>,홍석준,Suk Kyung Hong,M.D.,Sung Kwan Hong,M.D.<SUP>1<.SUP> and Suk Joon Hong,M.D. 대한갑상선-내분비외과학회 2003 The Koreran journal of Endocrine Surgery Vol.3 No.2

Purpose: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. Methods: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1∼6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. Results: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21 cases. Conclusion: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience. (Korean J Endocrine Surg 2003;3:178-182)

후복막강경 부신절제술 41예

홍석경(Suk Kyung Hong),홍성관(Sung Kwan Hong),홍석준(Suk Joon Hong) 대한외과학회 2000 Annals of Surgical Treatment and Research Vol.59 No.2

일차성 슬관절 전치환술 환자에서 세균 비강 집락의 유병률

김희천 ( Hee Chun Kim ),홍성관 ( Sung Kwan Hong ),단진명 ( Jin Myoung Dan ),이돈석 ( Don Seok Lee ),조용석 ( Yong Suk Cho ) 대한슬관절학회 2010 대한슬관절학회지 Vol.22 No.4

목적: 일차성 슬관절 전치환술 환자에서 술 전에 세균 비강 집락의 빈도를 조사하고 그 유무가 슬관절부 심부감염 발생빈도에 어떤 영향이 있는 지를 알아보고자 하였다. 대상 및 방법: 일차성 슬관절 전치환술 488명 784예를 대상으로 수술 전일에 비강면봉법으로 균동정을 시도하고, 1년 이상 추시가 가능했던 434명(88.9%) 중 술 전 세균 비강 집락이 있었던 환자들(제1군)과 그렇지 않은 경우 환자들(제2군)에서 추시 기간 중 심부감염 발생 여부를 조사하였다. 결과: 434명 중 69명(15.9%)에서 비강내에서 병원균이 동정되었다. 슬관절 전치환술 후 심부감염은 제1군 69명 113예 중에서는 1예(0.9%)에서, 제2군 365명 591예 중에서는 10예(1.7%)에서 발생하였고 양군 간의 이러한 차이는 통계적으로 유의하지 않았다. 결론: 일차성 슬관절 전치환술 환자에서 술 전 세균 비강 집락의 빈도는 15.9%였고 비강 집락의 유무가 술 후 슬관절부 심부감염률에 미치는 영향은 없었다. Purpose: The objective of the current study was to investigate the prevalence of bacterial nasal colonization in patients who are undergoing primary total knee arthroplasty and to determine whether the prevalence affects the incidence of deep surgical site infections. Materials and Methods: Of the 488 consecutive patients (784 knees) who had been screened for bacterial nasal colonization using nasal swab cultures before elective total knee arthroplasties, 434 patients (88.9%) were available for review at one year postoperatively. We assessed the overall rate of deep surgical site infections in the patients with nasal carriage of bacteria (group I) and in those patients without any bacterial nasal colonization (group II), respectively. Results: Of the 434 patients, 69 (15.9%) had nasal carriage of bacteria. There was 1 infection (0.9%) among 113 knees of 69 patients in group I and 10 infections (1.7%) among 591 knees of 365 patients in group II. Those differences were not statistically significant. Conclusion: The prevalence of bacterial nasal colonization in patients undergoing primary total knee arthroplasty was 15.9% and the preoperative nasal carriage of bacteria did not affect the rate of deep surgical site infections.

쿠싱병에 대한 경접형동접근법의 내분비학적 결과

김준수,김창진,하상수,김정훈,이정교,권병덕,홍성관,이기업,이봉재,김용재,최충곤,이호규,Kim, Joon Soo,Kim, Chang Jin,Ha, Sang Soo,Kim, Jung Hoon,Lee, Jung Gyo,Kwun, Byung Duk,Hong, Sung Kwan,Lee, Ki Up,Lee, Bong Jae,Kim, Yong Jae,Choi, Choo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.5

Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

자가면역성 다선증후군 ( Polyglandular Autoimmune Syndrome ) 1 예

김성연(Seong Yeon Kim),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min),이문규(Moon Kyu Lee),홍성관(Sung Kwan Hong),김원배(Won Bae Kim),이병두(Byoung Doo Rhee),조보연(Bo Youn Cho),이광우(Kwang Woo Lee) 대한내과학회 1989 대한내과학회지 Vol.36 No.6

N/A Polyglandular antoimmune (PGA) syndrome designates endocrine dysfunction involving two or more glands on the basis of autoimmune mechanisms. There are 3 types of PGA syndrome and their etiology or pathogenesis is still not completely understood. We report here a case of polyglandular autoimmune syndrome manifesting insulin-dependent diabetes mellitus, hyperthyroidism and myasthenia gravis, which met the criteria of type III PGA syndrome. HLA-DR4 & -DRw8 were positive and so was the thyroid antimicrosomal antibody. We think that upon further study, additional cases of this syndrome could be found.

공간 인식과 웹 크롤링을 활용한 가구 구매 어플리케이션

김소현(So-Hyun Kim),홍승아(Seung-A Hong),유채연(Chae-yeon Yu),홍성관(Sung-kwan Hong),김황래(Hwang-Rae Kim) 한국정보기술학회 2019 Proceedings of KIIT Conference Vol.2019 No.11

인슐린종 및 nesidioblastosis 16 예의 임상 양상

박형주(Hyung Joo Park),박중열(Jung Yeol Park),송영기(Young Kee Shong),홍성관(Sung Kwan Hong),이기업(Ki Up Lee),한덕종(Duck Jong Han),성규보(Kyu Bo Sung),김기수(Ghi Su Kim) 대한내과학회 1999 대한내과학회지 Vol.56 No.2

N/A Insulinoma is the most important cause of hyperinsulinemic hypoglycemia. Insulinoma can be cured by surgical management but diagnosis and localization are difficult due to their small size and variable clinical manifestation. We studied clinical manifestation of the patients who were diagnosed as insulinoma or nesidioblastosis. Methods : We studied clinical charts of 16 patients who underwent operation under the impression of insulinoma from 1990 to 1997. Results : 1) Of the 16 patients, 13 had insulinoma and 3 had nesidioblastosis. 2) Neuroglycopenic symptoms were present in all cases. Among them, loss of consciousness or confusion were present in 12 cases (75%). Adrenergic symptoms were present in 9 cases (56%). Mean symptom duration until diagnosis was 39 months(range; 15days∼10years). 3) 72 hr fasting test showed hypoglycemia in all cases. 4) Insulin/glucose ratio was above 0.3 except for two cases. 5) CT and MRI had low sensitivity (38%) and specificity (33%) as a preoperative tumor localization tool, and more invasive technique, i.e., selective angiography and transhepatic portal vein sampling, were necessary in most cases. Conclusion : Nsidioblastosis may be more prevalent than previously suspected. Diagnosis of insulinoma is not always easy and invasive diagnostic methods should be considered when the clinical suspicion is high, even if biochemical and noninvasive localization tools give negative results.

만성 간질환에서 당뇨병의 유병률

이현철(Hyun Chul Lee),허갑범(Kap Bum Huh),홍성관(Sung Kwan Hong),노현정(Hyun Jung Roh),최병주(Byung Joo Choi),안상훈(Sang Hoon An),서일(Il Suh),한광협(Kwang Hyup Han) 대한내과학회 1999 대한내과학회지 Vol.57 No.3

N/A The insulin resistance and the altered glucose metabolism in chronic liver disease increase the alteration of glucose intolerance and the prevalence of diabetes mellitus. The prevalence of DM is higher in advanced cirrhosis than in early cirrhosis and higher in C-viral hepatitis or alcoholic liver disease than in B-viral hepatitis. The purpose of this study is to assess the prevalence of DM in chronic liver disease in Korea. Methods : We reviewed the medical records of 417 patients with chronic liver disease who visit the Yonsei University Sevrance Hospital from January 1994 to March 1998. We examined fasting blood sugar, biochemical study and abdominal ultrasonography. DM was defined on the basis of fasting hyperglycemia (fasting blood sugar exceeding 140 mg/dl) at least two consecutive samples or active treatment with insulin or oral hypoglycemic agents. Results :1) The DM prevalence was 16.8%(70 cases) in total patients and 25.0% (56 cases) in cirrhotic patients. 2) According to sex, there was no statistically significant difference in DM prevalence(16.8% in men and 18.1% in women P=0.78). 3) The DM prevalence was increased with increasing of age(0% in below 30 years, 4.9% in 31-40, 19.6% in 41-50, 22.9% in 51-60, 21.3% in 61-70 and 44.4% in over 71 years, P<0.01). 3) According to severity of liver disease, the DM prevalence was higher in uncompensated cirrhosis than in compensated cirrhosis(2.3% in chronic viral carrier, 8.8% in chronic hepatitis, 17.9% in cirrhosis Child class A, 33.9% in class B, 29.5% in class C). 4) According to cause of liver disease, the DM prevalence was higher in C-viral hepatitis and alcoholics than in B-viral hepatitis(12.1% in B-viral hepatitis, 35.1% in C-viral hepatitis, 40.0% in alcoholics). Conclusion : The prevalence of diabetes in the patients with chronic liver disease is much higher than in general population. And the DM prevalence is increased in advanced cirrhosis and C-viral or alcoholic hepatitis. The early diagnosis and treatment of DM in chronic liver disease patients are important. (Korean J Med 57:281-287, 1999)