http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
부인종양확 : 생식력 보전을 원하는 자궁내막암 환자에서 호르몬 치료에 실패한 경우 광역학치료의 효과
안태규,한세준 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-
서론: 광역학치료(Photodynamic therapy, PDT)는 표재성 암을 치료 할 수 있는 새로운 방법이다. 자궁내막암의 고식적인 치료방법은 수술, 항암화학요법 그리고 방사선 요법이다. 그러나 이러한 방법은 생식력을 보존하고자 하는 여성에서는 적합하지 않다. 그러므로 이러한 여성을 대상으로 자궁내막암 치료와 동시에 생식력 보존을 위해 동시항암화학광역학(Concurrent Chemo-Photodynamic therapy)을 적용하고자 하였다. 방법: 동시항암화학광역학 치료를 위해 두 명의 젊은 자궁내막암 환자(병기 1A, G1 or G2) 가 선택되었다. 이들은 내막암 진단후 Medroxy progesterone Acetate(MPA)를 사용하였으나 치료 실패 후 자궁 전절제술이 권유되었던 환자다. 이들을 대상으로 동시항암화학광역학치료가 시행되었다. 광역학치료를 위한 레이저빛을 조사하기 48시간 전 광과민제(2.0 mg/kg, PhotogemTM[HpD], FINE chemical, Russia) 를 정주하였고 3시간 전에 carboplatin (75 mg/m2 IV) 을 정주하였다. 그 후 자궁내막에 250J/cm2의 레이저(CERALASTM Diode Laser 632 System, biolitec, Germany) 를 조사하였다. 결과: 광역학 치료후 2명의 환자는 3개월 간격의 조직검사를 시행한 결과 모두 음성을 보였고 현재 치료후 약 50개월이 지났다. 현재 1명 은 분만한 상태이며 다른 한명은 임신을 시도하고 있다. 현재까지 2명 모두 재발이나 전이의 흔적은 없다. 결론 : 기존의 치료 방법과는 달리 이러한 동시항암화학광역학 치료는 생식력을 보존하는 동시에 생식기관의 조직학적인 파괴 없이 암조직을 제거 할 수 있다. 그러나 현실적으로 이러한 동시항암화학광역학 치료는 호르몬 치료에 반응하지 않는 자궁내막암 환자에 국한하여 사용해 볼 수 있는 방법이다. 이러한 동시항암화학광역학 치료가 인정을 받게 된다면 호르몬와 관계없이 생식력 보전을 원하는 자궁내막암환자에게 적용이 가능 할 수 있겠다.
안태규,김태연,김연진,황종윤 한국모자보건학회 2018 한국모자보건학회지 Vol.22 No.3
Since the year 2000, low birth rates have resulted in significant decreases to maternity care services throughout many Korean hospitals. However, there has been a concomitant increase in the number of high-risk pregnancies, due to growing trends in delayed marriages and subsequent pregnancies. Increased maternal age is a risk factor associated with complicated pregnancies and high-risk deliveries, both of which are strongly related to maternal death. With this in mind, the Ministry of Health and Welfare has supported the establishment of a regional perinatal center for high-risk pregnancies, estimated to be be fully completed by the year 2020. Despite this, maternity care services for high-risk pregnancies remain insufficient. According to previous reports, the total number of maternity care hospitals and beds available for high-risk pregnant women were 60 and 399, respectively. This is in stark contrast to previous bed estimates of 1,640. The establishment of a maternity care system for high- risk pregnant women is integral to ensuring optimal conditions for both pregnancy and childbirth. This review briefly evaluates the existing maternity care system for high-risk pregnancies, and proposes several new suggestions for improvements.
안태규,황종윤 한국모자보건학회 2017 한국모자보건학회지 Vol.21 No.1
Because childbirth is a complex and difficult process, intensive preparation, and the immediate availability of emergency assistance during every step of delivery support to maternal safety. The World Health Organization recommends that pregnant women must be able to access the right care at the right time. Appropriate obstetricians is important factor for easy access during pregnancy. Especially, an increase in the number of specialists in maternal-fetal medicine would greatly improve the pregnancy outcomes of high-risk women. In 2013, a total of 2,274 obstetricians were employed in maternity hospitals and clinics in Korea. Their average age was 44.8 years and they will get older soon. By 2026, 740 junior obstetricians will join the maternity care system, but 916 senior obstetricians will have retired on night duty at hospital because of above 60 years of age. Thus, obstetrician numbers will fall by 176. Korea requires 2,338~3,507 obstetricians based on an annual number of deliveries per obstetrician in 2016. However, Korea has a shortage of obstetricians because of the low birth rate-induced business losses, inadequate payment system by the national health insurance program, and the quality-of-life preferences of young doctors. Ensuring an appropriate supply of obstetricians is essential for infrastructure of safe childbirth. I believe that adequate payment by the national health insurance program, and new medical insurance fees for management of high-risk pregnancies, will encourage young doctors to become obstetricians. The government should also introduce additional night duty fees and overseas training programs for young obstetricians.
Adverse events and preventive measures related to COVID-19 vaccines
안태규,강수,백진휘,서영호 대한응급의학회 2021 Clinical and Experimental Emergency Medicine Vol.8 No.3
The coronavirus disease 2019 (COVID-19) vaccines are categorized according to the manufacturing technique, including mRNA vaccines and adenovirus vector vaccines. According to previous studies, the reported efficacy of the COVID-19 vaccine is excellent regardless of the type of vaccine, and the majority of studies have shown similar results for safety. Most of the adverse reactions after vaccination were mild or moderate grade, and severe reactions were reported in a very small proportion. However, the adverse reactions that might occur after nationwide vaccinations can contribute to crowding of emergency departments, and this can further lead to significant obstacles to providing necessary treatment for life-threatening conditions. Therefore, as emergency physicians, we would like to present some concerns and suggestions to prevent these predictable problems.