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크론병에서 항문 주위 병변의 임상상과 치료에 대한 반응
김현대 ( Kim Hyeon Dae ),김찬규 ( Kim Chan Gyu ),김지원 ( Kim Ji Won ),김상균 ( Kim Sang Gyun ),김병관 ( Kim Byeong Gwan ),김주성 ( Kim Ju Seong ),정현채 ( Jeong Hyeon Chae ),송인성 ( Song In Seong ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.2
Background/Aims: The aim of this study was to assess the clinical features and therapeutic responses of perianal lesions in Crohn`s disease. Methods: We retrospectively reviewed medical records of 94 cases with perianal lesions among 231 cases registered as Crohn`s disease in Seoul National University Hospital between January 1975 and June 2001. The cases were investigated after dividing into two different groups. One group included the cases registered between January 1975 and December 1996 and the other group between January 1997 and June 2001. Results: The perianal lesions were observed in 41% of the cases. Perianal lesions were more frequent in colonic Crohn`s disease after 1997, but not before 1996. Fistula was significantly prevalent, followed by abscess, fissure, and stricture. Perianal lesions preceded intestinal symptoms such as abdominal pain and diarrhea in 25% of the cases. The remission rate with non-specific conservative treatment (10%) was lower than that before 1996. The remission rate after specific treatment (77%) was higher than that after surgery (53%). In cases of specific treatment, cumulative relapse rates were 7% in 1 year and 39% in 5 years. Conclusions: Crohn`s disease should be considered in young male patients who have the refractory perianal lesions. Perianal lesions should be managed initially with medical treatment. (Korean J Gastroenterol 2003;42:128-133)
염증성 장질환에서 IL-10과 TNF-α 유전자의 단염기 다형성
김지원 ( Ji Won Kim ),김찬규 ( Chan Gyoo Kim ),김현대 ( Hyeon Dae Kim ),김병관 ( Byeong Gwan Kim ),김태호 ( Tae Ho Kim ),이국래 ( Kook Lae Lee ),이동호 ( Dong Ho Lee ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 염증성 장질환의 병태생리에 중요한 역할을 하는 IL-10과 TNF-α유전자의 단염기 다형성과 염증성 장질환과의 연관성을 살펴봄으로써 염증성 장질환의 발생에 관여하는 유전적 원인을 규명하고자 하였다. <방법> 궤양성 대장염 환자 76명(남 37, 여 39), 크론병 환자 60명(남 41, 여 19)과 정상 대조군 203명(남 1129, 여 84)을 대상으로 혈액을 채취하였다. IL-10 유전자 촉진자의 일부인 ?082, -819,-592 및 +1
김찬규 ( Chan Gyoo Kim ),김현대 ( Hyeon Dae Kim ),김지원 ( Ji Won Kim ),김병관 ( Byeong Gwan Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 크론병은 한국에서 아직 드문 질환이지만 점차 발병빈도가 증가하고 있는 질환이다. 본 연구는 이전의 국내보고에 비해 다수의 환자를 관찰하여 한국에서의 크론병의 임상적 특징을 알아보고자 하였다. <방법> 1975년 1월부터 2000년 12월까지 서울대학교병원에서 관찰한 크론병 213례를 대상으로 의무기록지 열람과 전화대담을 통해 후향적 분석을 시행하였다. <결과> 1)1990년 이전 16년간 26례에 불과하던 크론병은 이후 점차 증가하여 1991년
궤양성 대장염의 발생률, 단기적 치료 반응 및 재발률의 변화 양상
김지원 ( Ji Won Kim ),김찬규 ( Chan Gyoo Kim ),김현대 ( Hyeon Dae Kim ),김병관 ( Byeong Gwan Kim ),장동경 ( Dong Kyung Chang ),김주성 ( Joo Sung Kim ),이동호 ( Dong Ho Lee ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.1
Background/Aims: In Korea, there are few studies about the incidence rates and clinical features of ulcerative colitis (UC) in the late 1990s. The aim of this study was to compare the incidence rates, short-term outcome of medical treatment and relapse rates of UC between before and after 1993. Methods: We retrospectively reviewed the medical records of 265 UC patients registered in the Seoul National University Hospital between January 1993 and July 2001. Results: The incidence rates of UC from 1993 to 2001 were relatively steady status, and the average annual incidence rate was 1.6%. There was proctitis in 28.2% and extensive colitis in 31.5%, mild disease in 50.4% and severe disease in 21.8%. Those results were similar to the distribution of UC patients until 1992. The symptomatic remission rates were 75.4%, 75.0%, and 55.1% in order of proctitis, left colitis and extensive colitis, and 80.6%, 53.8%, and 57.1% in mild, moderate and severe disease. The cumulative relapse and operation rates were 24.7% and 3.8% in 1 year, respectively, while 57.3% and 16.1% in 5 years. Conclusions: There seems to be a steady state in the incidence rates of UC since 1993, and the clinical features, short-term outcome of medical treatment of UC since 1993 were similar to those of UC until 1992. (Korean J Gastroenterol 2003;41:15-25)
정태기(Tae Gi Chung),김형곤(Hyung Gon Kim),송영수(Young Soo Song),한성훈(Seong Hoon Han),김정수(Jeong Soo Kim),김현대(Hyeon Dae Kim),남경재(Kyung Jae Nam),정성광(Sung Kwang Chung),이윤우(Yun Woo Lee) 대한내과학회 1997 대한내과학회지 Vol.53 No.1
N/A Objectives: The clinical manifestations of gout in Korea would be changed lately according to the rapid economical development and the development of diagnostic methods. This study was done to reveal the late clinical features of gout in Korea. Methods: A retrospective study was done for the 90 gout patients who had been treated in Seoul Paik Hospital from March 1974 to August 1994. Age of onset, sex, duration of disease, serum uric acid level, uric acid concentration of 24 hour urine, joint of first attack, recurrently involved joints, X-ray of involved joint, frequency of tophi, renal ultrasonography, and associated diseases were analyzed. The uric acid levels of the 808 civilians who visited our hospital for the periodic health examination were used as a control value. Results: 1) The serum uric acid level in Korean adults was 5.2±1.1mg/dL in male, 3.8±0.7mg/dL in female, and 4.7mg/dL in general. The serum uric acid concentration of the gout patients was 8.6±2.2mg/dL in male, 6.1±2.1mg/dL in female, and 8.5±2.3mg/dL in general. The age of onset was 46.4±12.9 years old and male to female ratio was 44: 1 2) The renal excretion of uric acid was 470±173 mg/day in gout patients. 3) The sites of first attack were first MTP joint(76%), tarsal joint(13%), knee(5%), and other MTP joints(5%) 4) The involved joints during the repeated attacks were first MTP joint(84%), tarsal joint(23%), and fingers(23%), The duration of disease was significantly longer and the serum uric acid concentration was higher in the patients with tophi than they are in the patients without. 5) The 4l% of patients showed hone change in X-ray. 6) The renal ultrasound examinations were abnormal in 42% of the patients and the serum uric acid concentrations were significantly higher. 7) Obesity was found in 68% of patients, hypertension in 39%, hyperlipidemia in 16%, and chronic renal disease in 12%. Conclusion: The clinical features of gout in our study were similar to those of others done in and out of Korea, except that the frequency of hypertringlyceridemia was much lower than that of the foreign countries.
고콜레스테롤 식이가 Spontaneously Hypertensive Rat의 체내지질과 항산화성 영양소 상태에 미치는 영향
유언호 ( Yu Eon Ho ),류왕성 ( Lyu Wang Seong ),김현대 ( Kim Hyeon Dae ),유재격 ( Yu Jae Gyeog ),최영선 ( Choe Yeong Seon ),이희숙 ( Lee Hui Sug ),조성희 ( Jo Seong Hui ) 대한내과학회 1993 대한내과학회지 Vol.44 No.5
연구배경 : 고혈압과 고콜레스테롤혈증은 동맥경화와 심혈관계 질환의 대표적인 위험인자로 알려져있다. 순환기 질환과 관련된 영양은 주로 지질영양에 편중되어 왔으며 항산화기능을 영양소에 관하여 조사된 바가 적다. 동맥경화 과정에서 저밀도지단백의 산화는 지질과 산화물의 형성에 의하여 개시되고 촉진되므로 이 과정에서 과산화물 생성을 억제하는 항산화영양소들의 역할이 주목된다. 방법 : 성장기 Wistar쥐 및 자연발생고혈압쥐(SHR)를 대상으로 하여 고콜레스테롤식이를 6개월간 섭취케 함으로써 고콜레스테롤증을 유발시켰으며 고혈압과 고콜레스테롤혈증이 중복된 상황에서 체내 지질상태의 변화와 고혈압 대상의 지질대사 특이성을 조사하고 과산화지질의 형성과 항산화성 영양소들의 유지수준을 평가하였다. 결과 : Wistar쥐의 수축기혈압이 전체 실험기간 동안 102∼120㎜Hg에 머무르는데 비하여 SHR의 수축기혈압은 생후 5주째 평균 118㎜Hg에서 점차 혈압이 상승하여 식이 2개월에는 175±13㎜Hg로 고혈압이 뚜렷하여 졌으며 Wistar쥐와 SHR 모두에서 고콜레스테롤식이에 따른 혈압의 변화는 없었다. 혈청과 간의 콜레스테롤은 식이콜레스텔롤에 의하여 각각 약 2배, 10배 증가하였다. 혈청중성지방과 인지질은 SHR에서 다소 낮았고 간의 중성지방은 고콜레스테롤식이로 유의하게 증가하였다. 혈청지질 과산화물은 SHR에서 높았으나 식이콜레스테롤에 의한 영향은 적었고 간에서는 고혈아과 식이콜레스테롤 모두에 의하여 증가되었다. 혈청, 간의 비타민 E수준은 SHR에서 낮았고 고콜레스테롤식이에 의하여 혈청수준은 더 감소하였다. 비타민 A 수준도 식이콜레스테롤에 의하여 현저히 낮아졌다. 결론 : 고혈압과 고콜레스테롤혈증은 체내 지질과산화물을 증가시키고 비타민 E와 A의 소모를 가져올수 있다. Backgrounds: Hypertension and hypercholesterolemia are two of the most important risk factors for atherosclerosis and cardiovascular morbidity. The mechanism by which hypertension and hypercholesterolemia accelerates atherosclerosis is still uncertain. Methods: To investigate the effect of high cholesterol diet on lipid and antioxidant nutritent status in spontaneously hypertensive rat (SHR), SHRs and Wistar rats were fed diets with or without 2% cholesterol and 0.3% Na-taurocholate for 6 months. Results: SHRs became apparently hypertensive after 2 months of feedings, when their systolic pressure was over 180 mmHg. Heart weight-to-body weight ratios of SHRs were significantly higher than those of Wistar rats. Levels of serum total cholesterol were increased about two-folds and those of liver, ten-folds in both SHRs and Wistar rats by dietary cholesterol. Serum HDL-cholesterol of SHRs were significantly lower than those of Wistar rats and HDL·/total cholesterol. Serum TG levels were not changed, but liver levels increased by dietary cholesterol and lower in SHRs. Serum TBARS levels were higher in SHRs, but little changed by dietary cholesterol. Liver levels appeared to be higher in SHRs and cholesterol groups. Serum and liver vitamin E levels were lower in SHR. Serum vitamin A levels were little changed, but liver contents were somewhat decreased in SHRs and remarkably reduced by dietary cholesterol. Conclusions: It is concluded that hypertension and hypercholesterolemia, individually, result in accumulation of lipid peroxide as well as consumption of body tocopherol and retinol, which can be further augmented by coexistence of two abnormal conditions.
김현대,최진우,강기혁,송영수,최석구,유원상 인제대학교 1995 仁濟醫學 Vol.16 No.3
심장 점액종은 희귀한 질환으로 다양한 임상증상을 나타낸다. 저자 등은 좌심방 점액종에 의한 재발성 뇌경색을 일으킨 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다 We report 62 year old female with the left atrial myxoma, diagnosed by M-mode and 2-D Echocardiography, complicated with the recurrent cerebral infaction with review of literature.
Monoclonal Gammopathy of Undetermined Significance 를 동반한 베체트 병(Behcet`s Disease) 1 예
정성광,남경재,전영빈,이윤우,한성훈,김정수,김현대 대한내과학회 1996 대한내과학회지 Vol.51 No.4
The term $quot;monoclonal gammopathy of undetermined significance (MGUS)$quot; denotes the presence of a M-protein in patients without multiple myeloma, macroglobulinemia, amyloidosis, or other related disease. MGUS is characterized by a serum M-protein concentration $lt;3.0g/dL, $lt;5% plasma cells in the bone marrow, either a small amount of M-protein or none at all in the urine, absence of lytic bone lesion, anemia, hypercalcemia, and renal insufficiency, and, most importantly, stability of the M-protein and failure of development of additional abnormalities. Recently we experienced one ease of MGUS associated with Behcet's disease confirmed by electrophoresis, immunoelectrophoresis and bone marrow biopsy. A 37-year-old woman was admitted to our hospital in 1991 because of migratory joint pain for 2 years. On physical examination oral and genital ulcers were found, and erythematous palpable tender subcutaneous nodules were found also in the forearms and legs. The level of IgG K fraction in the serum was 0.52g/dl and the bone marrow biopsy was normal. Initially she had been treated with ibuprofen, prednisolone, colchicine and azathioprine under the diagnosis of Behcet's disease with MSUS. The concentration of serum M-protein after treatment of four years was 2.69g/dL and she complained only migratory pain in back and extremity, and easy fatigability. Lately she has been managed with the combination of colchicine and azathioprine.