기억력 저하를 호소하는 노인들을 대상으로 INM176를 3개월간 임상시험한 후의 치료성적 및 부작용 평가 보고

김지혜,고선규,고효정,권영아,김성환,김재경,김태은,박재우,서민영,송영란,이인수,김도관 大韓神經精神醫學會 2003 신경정신의학 Vol.42 No.2

Objectives : We examined the effects of INM 176 (K-l107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. Methods : This was a prospective, 12 week, double-blind, Placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities ofDaily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. Results : The interaction effect of time (pre- and post-trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes ofADAS-cog, IADL, KGDS scores during the 12 week clinical trail ofINM 176 and placebo demonstrated favorable responses in the INM176 administered group. Conclusions : This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory, Further clinical trial should demonstrate its efficacy.

부액와 유방 조직

고명권,김영근 한국의학사 1993 診斷과治療 Vol.13 No.6

거대 난소 종양의 염전 1예

김미영,이해혁,유애리,박정희,이임순,정수호,고은석,레앙소팥,배동한,김태희,이권해 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.1

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전두엽 상내측 신경교종의 수술 수 발생하는 운동보조영역 증후군

김재현,고영초,이채혁,권오기,최우진,박효일 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2

Objective : This retrospective study was aimed to correlate characteristic neurologic deficits of transient contralateral motor weakness with or without speech disturbance(Supplementary Motor Area, SMA syndrome) after the resection of the gliomas in the superior frontal gyrus, especially with the extent of resection of the tumors. Method : Ten patients with medial superior frontal glioma, who underwent gross total or subtotal resection of the tumor, as well as, partial or complete resection of the spolementary motor area were studied. The following parameters were evaluate 1) tumor location 2) extent of resection 3) degree and duration of postoperative deficits. Result : Postoperative neurologic deficits were transient contralateral motor weakness with or without motor dysphasia. As a whole, postsurgical SMA syndrome occurred in 3 patients out of 10 patients with medial superior frontal gliomas(30%), who underwent gross total or subtotal resection of the tumors. Motor deficits were present in 3 out of 10 patients and speech disturbances in 2 out of 3 left frontal gliomas. Recovery of neurological dysfunction was rapid occurring between the 5th 14th POD and their neurological function returned almost normal in two patients. In the remaining one patient, who had preoperative mild motor weakness showed incomplete recovery of the worsened motor weakness and newly developed speech disturbance till 1yr postoperatively. Conclusion : The postsurgical SMA syndrome in patients with glioma in the medial superior frontal gyrus was not so uncommon phenomenon and well correlated with the extent of surgical resection of the supplementary motor area. Thus, preoperative awareness and warning about the possibility of the development of this charicteristic SMA syndrome is necessary.

노령의 대퇴 전자간 골절 치료에서 압박고 나사못의 안정성 및 유용성

김종오,노권재,윤여헌,고영도,유재두,정준모,방한천,정재학 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 노령의 대퇴 전자간 골절에서 압박고 나사못의 안정성에 영향을 주는 인자들간의 상관 관계와 골절 양상에 따른 술후 고관절 기능을 평가 및 분석하였다. 대상 및 방법: 압박고 나사를 이용하여 수술적 치료를 시행한 231명의 환자 중 6개월 이상 추시가 가능하였던 60세 이상 84명의 환자들을 대상으로 했다. 방사선적 계측은 압박고 나사못의 활강 길이 및 내반각, 가압 나사 위치, 정복 상태, 원위 골편의 내측 전위를 측정하였으며 술후 기능은 Clawson의 기능 평가표로 하였고 골절 양상에 따라 방사선 계측과 기능 회복과의 상관 관계를 평가하였다. 결 과: 임상 결과는 불안정 골절에서 양호가 10례, 불량이 23례, 안정 골절에서는 양호 40례, 불량이 11례로 안정 골절에서 임상 결과가 좋았고(p<0.001), 압박고 나사 활강은 10 ㎜ 이상일 때 양호가 4례, 불량이 21례, 10 ㎜ 이하에서 양호가 46례, 불량이 13례로 10 ㎜ 이상 활강시에 술후 결과가 불량했다(p<0.001). 다르 방사선적 계측 요인은 결과에 의미있는 차이를 보이지 않았다. 또한, 불안정 골절 중에서 전위 양상 골절의 경우 10㎜ 이상 활강이 12례, 10㎜ 이하 활강이 8례, 분쇄 양상 골절의 경우는 10㎜ 이상이 11례, 10㎜ 이하가 2례로 분쇄 양상의 불안정 골절에서 10㎜ 이상 활강이 의미있게 많았다 (p<0.001). 결 론: 10㎜ 이상의 지연 나사 활강은 고관절 기능 회복 약화를 유발시킬 수 있으며 불안정 골절 분쇄 양상 골절은 이런 지연 나사의 활강이 과도하게 유발될 수 있으므로 불안정 분쇄 양상 골절에서 압박고 나사의 단독 사용은 재고해 보아야 할 것이다. Purpose: To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fracture of the elderly. Materials and Methods: Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification. Results: There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10㎜, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10㎜, good results were obtained in 46, and poor in 13. (p<0.001).But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10㎜ and 10 cases with less than 10㎜. In comminuted type, there were 11 cases with lag screw sliding more than 10㎜ and 2 cases with less than 10㎜(p<0.001). Conclusion: The sliding of lag screw more than 10㎜ may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not good treatment option.

구조화된 환자교육에 대한 연구논문 분석 : 고혈압 환자를 중심으로 forcused on the patients with hypertension

박청자,이경희,고효정,권영숙,김정남,박영숙 대한보건협회 2003 대한보건연구 Vol.29 No.2

This study was conducted to analyze the nursing research methodology and the key concepts used in articles related hypertension published in the RICH. The purpose of this study was for reflecting the trends of the research on the structured patient education focused the hypertensives. The results were as following. 1. There were 119 research studies related hypertension in RICH from 1994 to 2002. The number increased in 1997. Research studies of 98 have done since 1997 and it is 82% of the total research studies. 2. The most of the research studies are non-degree research studies. Research studies with fund have been rapidly increased in 2000 year. 3. The prevailing research design were the non-experimental design, quasi-experimental and pre-experimental designs in order. 4. The data collection method used most often physiologic measures(32.8%). 5. The domain of the key concepts that prevailed was health domain(51.8%), nursing domain(22.9%), and human being domain(20.5%) in order. And environmental domain (4.8%) were relatively low.

Large Hepatocellular Adenoma Presenting with Iron Deficiency Anemia: A Case Report

Young Kwon Koh,Su Hyun Yoon,Sung Han Kang,Hyery Kim,Ho Joon Im,Suhyeon Ha,Jung-Man Namgoong,Kyung-Nam Koh 대한소아혈액종양학회 2023 Clinical Pediatric Hematology-Oncology Vol.30 No.1

Hepatocellular adenoma is an uncommon, benign liver tumor usually occurring in patients using estrogen or anabolic androgens and in those with a genetic disease, including glycogen storage disease. Hepatocellular adenomas can sometimes induce pain. However, it is usually asymptomatic. Moreover, few studies have reported cases of hepatocellular adenomas presenting with iron deficiency anemia. Herein, we re-port a pediatric case of a large hepatocellular adenoma, presenting with iron ther-apy-refractory iron deficiency anemia. A 14-year-old boy was diagnosed with hep-atocellular adenoma during an anemia work-up. Improvement in iron deficiency anemia was observed after tumor resection.

Improvement of Neurodegenerative Disease after Use of Vemurafenib in Refractory BRAF V600E-Mutated Langerhans Cell Histiocytosis: A Case Report

Young Kwon Koh,Su Hyun Yoon,Sung Han Kang,Hyery Kim,Ho Joon Im,Pyeong Hwa Kim,Ah Young Jung,Kyung-Nam Koh 대한소아혈액종양학회 2022 Clinical Pediatric Hematology-Oncology Vol.29 No.2

Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder characterized by het-erogenous lesions infiltrated with CD1a+/CD207+ cells. Although LCH has a relatively good prognosis, the prognosis for patients with LCH refractory to standard chemo-therapy is poor. Neurodegenerative LCH (ND-LCH) is a central nervous system com-plication of LCH that is characterized by progressive radiological and clinical abnormalities. Symptomatic ND-LCH is difficult to treat and therefore has a poor prognosis. A two-year-old boy presented with a scalp mass. Biopsy confirmed LCH. Whole-body imaging revealed LCH involvement in multiple bones of the skull, facial bones, and lungs. Prednisolone and vinblastine chemotherapy was initiated. One-year post-treatment, most of the lesions in the bones and lung nodules dis-appeared, and chemotherapy was discontinued. New neurodegenerative lesions ap-peared 4 months after chemotherapy was discontinued. Second-line chemotherapy using cytarabine, vincristine, and prednisolone was initiated. However, neurological manifestations of ND-LCH worsened post second-line treatment, and the treatment was switched to cytarabine and cladribine. Despite third-line chemotherapy, the le-sions progressed, and neurological deficits worsened. After identifying BRAF V600E mutation in the tumor tissue using next-generation sequencing, cytotoxic chemo-therapy was discontinued and vemurafenib treatment was initiated. One-year post-vemurafenib therapy, ND-LCH manifestations regressed, and the patient experi-enced neurological improvement.

Acanthosis Nigricans as a Clinical Predictor of Insulin Resistance in Obese Children

Koh, Young Kwon,Lee, Jae Hee,Kim, Eun Young,Moon, Kyung Rye The Korean Society of Pediatric Gastroenterology 2016 Pediatric gastroenterology, hepatology & nutrition Vol.19 No.4

Purpose: This study aimed to evaluate the utility of acanthosis nigricans (AN) severity as an index for predicting insulin resistance in obese children. Methods: The subjects comprised 74 obese pediatric patients who attended the Department of Pediatrics at Chosun University Hospital between January 2013 and March 2016. Waist circumference; body mass index; blood pressure; fasting glucose and fasting insulin levels; lipid profile; aspartate transaminase, alanine transaminase, glycated hemoglobin, C-peptide, and uric acid levels; and homeostatic model assessment insulin resistance (HOMA-IR) and quantitative insulin check sensitivity index (QUICKI) scores were compared between subjects with AN and those without AN. Receiver operating characteristic curves were used to investigate the utility of the AN score in predicting insulin resistance. HOMA-IR and QUICKI were compared according to AN severity. Results: The With AN group had higher fasting insulin levels ($24.1{\pm}21.0\;mU/L$ vs. $9.8{\pm}3.6\;mU/L$, p<0.001) and HOMA-IR score ($5.74{\pm}4.71$ vs. $2.14{\pm}0.86$, p<0.001) than the Without AN group. The AN score used to predict insulin resistance was 3 points or more (sensitivity 56.8%, specificity 83.9%). HOMA-IR scores increased with AN severity, from the Without AN group (mean, 2.15; 95% confidence interval [CI], 1.72-2.57) to the Mild AN (mean, 4.15; 95% CI, 3.04-5.25) and Severe AN groups (mean, 7.22; 95% CI, 5.08-9.35; p<0.001). Conclusion: Insulin resistance worsens with increasing AN severity, and patients with Severe AN (AN score ${\geq}3$) are at increased risk of insulin resistance.

A case of Primary Jejunal Adenocarcinoma

( Young Lyul Koh ),( Young Su Lee ),( Kwon Choi ),( Suk Joong Oh ),( Seoung Wan Chae ),( Jin Hee Sohn ),( Seung Sei Lee ) 대한내과학회 2004 대한내과학회 추계학술발표논문집 Vol.2004 No.1