간내담석증 환자에서의 위배출시간

김종혁 ( Kim Jong Hyeog ),한태호 ( Han Tae Ho ),오길찬 ( O Gil Chan ),박상훈 ( Park Sang Hun ),이진 ( Lee Jin ),박충기 ( Park Chung Gi ),박철희 ( Park Cheol Hui ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-

<목적> 간내담석증 환자의 임상증상을 발현빈도순으로 보면 우상복부 동통 및 압통, 발열 및 오한, 소화불량, 구토 및 오심, 황달 순이다. 이 중 네 번째로 흔한 증상인 소화불량의 발생기전에 대해서는 거의 연구되어진바 드물다. 간내담석증에서 위배출반감시간(T1/2)을 측정하여 비정상적인 위배출능이 간내담석증 환자의 소화불량 발생기전에 기여할 수 있는지 알아보고자 본 연구를 시행하였다. <대상 및 방법> 2002년 1월부터 2003년 9월까지 한림대학교성

결핵성 흉막염에서 Soluble Interleukin-2R, Interleukin-6 및 Adenosine Deaminase의 변화에 관한 연구

김종혁 ( Kim Jong Hyeog ),정복현 ( Jeong Bog Hyeon ),문승환 ( Mun Seung Hwan ),조호준 ( Jo Ho Jun ),이명구 ( Lee Myeong Gu ),현인규 ( Hyeon In Gyu ),정기석 ( Jeong Gi Seog ),남송현 ( Nam Song Hyeon ),류지소 ( Lyu Ji So ),조현찬 ( 대한내과학회 1993 대한내과학회지 Vol.44 No.2

흉막 질환을 진단하고 그 기전을 이해하는데 각종 면역학적 지표들이 이용되어 왔으며 특히 결핵성 흉막염은 T 임파구가 활성화도이 조력 T 임파구가 증가하고 sIL-2R, ADA 및 interferon gamma 등이 증가한다고 알려져 있다. 저자들은 이들 T 임파구의 산물인 sIL-2R, IL-6, ADA 등이 흉막질환의 감별 진단에 도움이 되는지를 살펴 보고 서로간의 상관관계를 조사하여 다음과 같은 결론을 얻었다. 1) 흉막액에서 sIL-2R 치는 결핵성에서 877±430pmol/L로 결핵성에서 증가되어 있었다. 2) 흉막액에서 IL-6 치는 결핵성에서 25,593±17,352pg/ml, 악성에서 5,800±3,485pg/ml로 유의한 차이를 보였고 농흉에서 74,080±48,569pg/ml로 가장 높게 나타났다. 3) 결핵성 흉막액내의 sIL-2R 치와 ADA 치는 서로 유의한 상관관계를 보이며 증가되어 있었다(r=0.5623, p=0.001). 4) 결핵성 흉막액의 sIL-2R 치는 IL-6가 증가함에 따라 상승하는 경향을 보였다. 이상의 결과로 흉막염에서 결핵과 악성 종양의 감별은 ADA, sIL-2R 및 IL-6 모두가 의미있는 지표들로 사료되며 결핵성에서 sIL-2R와 ADA 간의 유의한 상관관계가 있고 sIL-2R와 IL-6 간에도 동반상승의 경향을 보여 T 임파구에서 형성되는 이들 지표들이 결핵성 흉막 삼출액내에서 서로 연관성이 있음을 시사하였다. Background: The aim of this study is to evaluate the value of interleukin-6 (IL-6), Soluble interleukin-2 receptor (sIL-2R) and adenosine deaminase in diagnosing tuberculos pleurisy and in differentiating it from malignant pleural effusion, and to find out mutual relationships between the three parameters. Methods: We investigated the level of IL-6, sIL-2R and ADA in various pleural diseases. Included were 77 subjects with pleural effusion (57 bopsy proven tuberculous pleurisy, 9 malignant pleural effusion, 5 empyema, 4 parapneumonic effusion, 1 paragonimiasis and 1 pancreatitis). IL-6 was measured by Quantikine human IL-6 (R&D systems), sIL-2R by h-interleukin-2-receotor ELISA (Boehringer Manheim biochemica) and ADA by Giusti`s colorimetric method. Results: The level of IL-6 was significantly higher in tuberculous effusion (25,593±17,352 pg/ml) than that of malignant effusion (5,800±3,485 pg/ml, p < 0.001). IL-6 was also increased in empyema fluids (74,080±48, 569 pg/ml). The level of sIL-2R was significantly higher in tuberculous effuson (877±430 pmol/l) than that of 20 nontuberculous effusion (259±230 pmol/L, p<0.001). The level of ADA was also higher in tuberculous effusion (82.4±26.9 U/L) than that of nontuberculous effusion (18.8±11.6 U/L, p<0.001). Levels of both ADA and sIL-2R were lower in malignant effusion (16.4±9.66 U/L, 229+171 pmol/L) than those of tuberculous effusion. The sensitivity and specificity of IL-6 in discriminating tuberculosis from malignancy were 84% and 100% respectively (cut-off value: 10000 pg/ml). Those of sIL-2R were 87% and 77% (cut-off value: 350 pmol/L). ADA was most valuable in differentiating tuberculosis from malignancy, sensitivity and specificity of which were 100% (cut-off value: 40 U/L). The correlation coefficient of sIL-2R and IL-6 was 0.3822 (p=0.001). Conclusion: It was suggested that assay of IL-6, sIL-2R and ADA could play an implemental role in differential diagnosis of tuberculous pleural effusion. Increased level of the three parameters and significant correlations between them were suggestive of the involvement of activated T cells in tuberculous pleural effusion.

사립체 근병증에 병발된 횡문근 융해증 및 급성신부전

김종혁 ( Kim Jong Hyeog ),노영준 ( No Yeong Jun ),김지연 ( Kim Ji Yeon ),문성용 ( Mun Seong Yong ),김현우 ( Kim Hyeon U ),김진건 ( Kim Jin Geon ),이정훈 ( Lee Jeong Hun ),노지호 ( No Ji Ho ),천병철 ( Cheon Byeong Cheol ),이관행 ( 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.3

Mitochondrial myopathies are diseases caused by defects in metabolic pathway of mitochondria. Mitochondrial myopathy is known as one of the causes of recurrent myoglobinuria, while clinically, rarely causes acute renal failure requiring medical treatments. We report a case of rhabdomyolysis and acute renal failure associated with mitochondrial myopathy. A 58-year-old male was presented with dyspnea and hypotensive shock. The patient had a history of recurrent dark colored urine and cramping leg pain after prolonged fasting. Laboratory findings showed hyperkalemia, azotemia, metabolic acidosis, and elevated AST, ALT, and creatinine kinase. He had no history of trauma or medication. Muscle biopsy showed ragged red fibers in modified Gomori staining. On electron microscope, increased number of mitochondria and abnormal mitochondria were seen. He received hemodialysis and his renal function recovered after 1 month. (Korean J Nephrol 2004;23(3):509-513)

소화불량증 환자 및 Helicobacter pylori 감염에 관한 일차 진료의 진료 현황

김수진 ( Kim Su Jin ),김학양 ( Kim Hag Yang ),이자영 ( Lee Ja Yeong ),김성은 ( Kim Seong Eun ),이진서 ( Lee Jin Seo ),강기주 ( Kang Gi Ju ),김경호 ( Kim Gyeong Ho ),박준용 ( Park Jun Yong ),김종혁 ( Kim Jong Hyeog ),이진헌 ( Lee J 대한내과학회 2003 대한내과학회지 Vol.65 No.6

배경: Helicobacter pylori (H.pylori )감염은 만성위염, 소화성 궤양, 위선암 및 위 림프종 등 여러 위장질환의 원인으로 알려져 있고, H.pylori 와 관련된 많은 연구 결과들이 있지만 대부분의 환자를 담당하고 있는 일차 진료의에게 어떻게 그리고 어느 정도 정확히 전달되고 있는지에 대한 연구는 미미하다. 이에 본 연구자들은 대한내과개원의협의회 소속 회원들에게 우편 설문을 통하여 소화불량 증상을 주소로 내원한 환자의 진료와 H. Background: Although Helicobacter pylori infection is now known to be the most common cause of various gastrointestinal diseases and progress in our knowledge about H. pylori is remarkable, whether this knowledge is transferred to general community of pra

바터씨 팽대부의 악성 위장관 간질종양

김수호 ( Kim Su Ho ),김종혁 ( Kim Jong Hyeog ),백광호 ( Baeg Gwang Ho ),백일현 ( Baeg Il Hyeon ),한태호 ( Han Tae Ho ),오순옥 ( O Sun Og ),김진봉 ( Kim Jin Bong ),박상훈 ( Park Sang Hun ),장웅기 ( Jang Ung Gi ),김동준 ( Kim Dong J 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1

GIST is a rare neoplasm, the majority of GISTs are located in the stomach and small intestine. Most GISTs are diagnosed histopathologically after resection because of submucosal location. A 37-year-old female patient presented with a 2-weeks history of generalized weakness, nausea accompanied by intermittent passage of black, tarry stools. Esophagogastroduodenoscopy and ERCP showed a large round mass measuring 5 cm in diameter in the ampulla of Vater with ulcer crack. Endoscopic multiple biopsies from the mass including ulcer base were taken. Light microscopic findings showed spindle-shaped and epitheloid tumor cells having high cellularity and frequent mitotic figures. On immunohistochemical stainings, the tumor cells were positive for CD34 and smooth muscle actin. Based on these preoperative findings, a diagnosis of malignant GIST of the ampulla of Vater was made probably. After operation, immunohistochemical studies revealed positive reaction for c-kit and vimentin, as well as focally reactive for CD34 and smooth muscle actin. We report a case of GIST in the ampulla of Vater presenting with melena that was diagnosed preoperatively and postoperatively. (Korean J Gastroenterol 2004;43:66-70)

완전관해 15년 후에 재발한 미세변화 신증후군

신동훈 ( Sin Dong Hun ),김종혁 ( Kim Jong Hyeog ),김지연 ( Kim Ji Yeon ),노영준 ( No Yeong Jun ),문성용 ( Mun Seong Yong ),김진건 ( Kim Jin Geon ),김현우 ( Kim Hyeon U ),이정훈 ( Lee Jeong Hun ),이서진 ( Lee Seo Jin ),김연수 ( Kim 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.5

We report an unusual case of adult minimal change nephrotic syndrome relapsed after 15-year of complete remission. In this case, the disease had occurred to the patient for the first time when he was 52 years old; relatively high age, and had been remitted with steroid therapy. After 15 years of complete remission, he visited our hospital with the symptoms of the generalized edema and the pitting edema of both lower extremities that occurred 15 days ago. Massive proteinuria(15,865 ㎎/day) and hypoalbuminemia(1.7 g/㎗) were detected. The pathologic evaluation of the biopsied specimen of the kidney showed he global sclerosis in 19% of glomeruli in light microscopic finding and the fusion of epithelial foo processes in electron microscopic finding. He was treated with pulse steroid therapy(methylprednisolone 500 ㎎/day iv for 3 days) and then, with oral prednisolone (60 ㎎/day). Generalized edema and proteinuria disappeared after 14 days of treatment, and there has been no relapse ever since. Adult-onset minimal change nephrotic syndrome relapses within 4 years after complete remission in 90% of relapsed patients. The relapse after more than 5 years of complete remission, like this case, is very rare, especially in he case of late-onset disease. However, the possibility of relapse of the minimal change nephrotic syndrome after several years of its remission should be considered constantly and the long-term follow-up more than 10 years may be needed. (Korean J Nephrol 2003;22(5):608-611)

춘천지역에서 위암 발생률 추정에 관한 연구-지난 10년간의 변화

백광호 ( Baeg Gwang Ho ),김동준 ( Kim Dong Jun ),김진봉 ( Kim Jin Bong ),이호권 ( Lee Ho Gwon ),김경호 ( Kim Gyeong Ho ),은창수 ( Eun Chang Su ),백일현 ( Baeg Il Hyeon ),김종혁 ( Kim Jong Hyeog ),김학양 ( Kim Hag Yang ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-

<목적> 위암은 아직까지 국내 발생률 1위의 암으로 조기진단과 확진이 일선 의료기관에서 가능한 질환이다. 최근 H. pylori가 위암의 원인으로 알려지면서 위암의 역학에 대해서 관심이 고조되고 있다. 춘천에서는 1992년부터 2년간 춘전지역에서 위암발생률 추정에 관한 연구 가 수행된 바 있다. 따라서 10년이 지난 시점에서 위암발생률을 추정, 비교함으로써 조기위암을 발견하기위한 노력과 함께 암관리 사업의 기초자료를 만들고자한다. <방법> 2000년

댄스스포츠 종목별 에너지 소비량에 관한 비교 연구

김현태(Kim Hyeon Tae),김종혁(Kim Jong Hyeog),조철훈(Jo Cheol Hun) 한국사회체육학회 2003 한국사회체육학회지 Vol.19 No.2

The purpose of this study is to provide effective information about the guidelines of dance sports and basic data for scientific means, by analyzing energy expenditure and cardiopulmonary function during exercise of dance sports. By repeated measuring those, each five of men and woman who have no cardiopulmonary system problems and are dance sports athlete on school. The results are obtained as following. There are some significant differences(p<0.05) for man at 2,3,10 min, and for woman at 1,2,3,4,7 min on the energy expenditure t-test, in degree of strength of ones both man and woman are showed significant of tango. From the result mentioned above, By using the measurement instruments with the up-to date technique for dance sports as an excellent aerobic exercise on field and measuring for the degree of strength and physiological change of each items, so analyzing characteristics of physiological vired got each items can establish the basis of scientific guidance means for some athletes practices dance sports for competition and provide general subjects with the important informations about selecting appropriate to the fitness level of them the type of dance or setting up the degree of strength of exercise and will be able to contribute widely to the development of dance sports, which has already been selected in Asian games as an regular item and seems to be selected in Olympic games as one.

댄스스포츠 수행시 심폐기능 변화에 관한 연구

남상남(Nam Sangnam),김종혁(Kim Jong Hyeog),최규환(Choe Gyuhwan) 한국여성체육학회 2003 한국여성체육학회지 Vol.17 No.2

The subject of this investigation is to suggest scientifical basis for dance sports. We selected walts, tango which are modern dance and jive, rumba which are latin dance, and we executed an experiment about the changes of the heart condition, and analyzed physiological differences between dance sports. We selected 24 men and 24 women of applicants who have more 2 years experiences in the dance sports. We made four groups, each group includes 3 men and 3 women. All selected applicants executed work which is based on a providison of ISTD(walts: beat 3/4, tempo30 · tango: beat 4/4, tempo 33 · jive: beat 4/4, tempo 38 · rumba: beat 4/4, tempo 28) for minutes and took 10 minutes recovery time, after they had 10-minutes warming up and 5-minute rest. We measured men first day and women second day. We gave 4 days rest time to them for each test and we investigated 5 times for each test. To measure HR, VE, R, VO₂/㎏, we used the MetaMax and Polar. We used the SPSS-PC^(+10), and we met with results after we handled it by One-way ANOVA of p<.05and Scheffe. 1) Heart rate of the man is walts and tango; p<.01, in(the) case of the woman, tango and rumba; p<.05, rumba and jive; p<01, jive and walts; p<.05. 2) A change of air for a minute, the man is walts and tango; p<.01, tango and rumba; p<.001, rumba and jive; p<.01, in case of the woman, tango and jive;p<.05, rumba and jive; p<.001, jive and walts; p<.01. 3) Rate of exchange of breath, the man walts and tango; p<.05, tango and rumba; p<.01, in case of the woman, nothing changed. 4) Oxygen intake per the weight, yhe main is walts and tango; p<.01, tango and rumba; p<.001, rumba and jive; p<.001, in case of the woman, tango and jive; p<.05, rumba and jive; p<.001, jive and walts; p<.05. Therefore, the result of this investigation can serve informations for choices of the form and the intensity of movement when we take dance sports.

중년여성들의 운동참여가 혈액,골밀도,폐활량에 미치는 영향

안정훈(An Jeong Hun),김현태(Kim Hyeon Tae),김종혁(Kim Jong Hyeog) 한국사회체육학회 2003 한국사회체육학회지 Vol.20 No.1

By studying the effect of the exercise practice in the purpose of providing the fundamental data which can be used for improving the effectiveness of participating in the motion program, the benign habits of exercise, and practical health care development, our research focused on measuring the blood, the bond density, and the capacity of the lungs of the group of middle-aged women in order to establish suitable exercise practice and efficient health care. Our consequences are followed. 1. After participating in the motion program, cholesterol, neutral fat, and high density G-protein density were decreased. Although the hemoglobin and glucose were also diminished, the amount of decrement was not considerable 2. The change in bond density was substantial(p<0.05). 3. The significant enhancement of the capacity of the lungs was not observed after it.