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대한내과학회> Korean Journal of Medicine(구 대한내과학회지)

Korean Journal of Medicine(구 대한내과학회지) update

  • : 대한내과학회
  • : 의약학분야  >  내과학
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  • : 1738-9364
  • : 2289-0769
  • : 대한내과학회잡지(~1992) → 대한내과학회지(1993~) → korean journal of medicine(1996~)

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수록범위 : 1권1호(1949)~97권3호(2022) |수록논문 수 : 12,170
Korean Journal of Medicine(구 대한내과학회지)
97권3호(2022년 06월) 수록논문
최근 권호 논문
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KCI후보

1노인장기요양제도와 의료서비스: 의료계 역할을 중심으로

저자 : 장현재 ( Hyun Jae Jang )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 147-149 (3 pages)

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노인장기요양보험 제도는 2005년부터 3년 동안 시범사업을 거쳐, 지난 2008년 7월부터 본격적으로 시행되었다. 이 제도의 목적은 증가되는 노인 인구에 있어, 노인의 삶의 질 개선과 가족의 돌봄 부담 경감이다. 2021년, 노인장기요양보험 수급자는 86만 명, 급여비는 9조 8,248억 원으로 도입된 이후 그 규모가 2-4배로 증가하였다. 이러한 증가에 맞추어 효율적으로 제도가 안착되고, 수급자의 의료적 요구를 바로 연계할 수 있는 제도의 보완이 필요하다. 이를 통하여 급증하는 노인 진료비의 지출의 감소, 즉 사회적 비용의 감소의 효과도 볼 수 있다. 결론적으로, 노인 돌봄은 의료·보건·복지가 각 영역 내 혹은 영역 간에 유기적으로 연계할 수 있도록 제대로 체계를 마련되고 시행되어야 하겠다.


The long-term care insurance for the elderly system was officially implemented in July 2008, following a 3-year pilot program starting in 2005. The purpose of this system was to improve the quality of life of seniors and reduce the burden of care among family members, given the growing elderly population. By 2021, the scale of the system had increased by two to four times, with 860,000 beneficiaries and 9,824,800,000,000 KRW worth of insurance benefits. In line with this increase, it is necessary to efficiently establish and improve the system so that it can directly meet the medical needs of the beneficiaries. This may serve to reduce the rapidly increasing expenditure related to the elderly medical expenses, which in turn leads to a decrease in societal costs. In conclusion, senior care needs to be properly established and implemented in order to create organic intra- and inter-field connections between medicine, healthcare, and welfare. (Korean J Med 2022;97:147-149)

KCI후보

2수술 및 시술 시 항혈전제 사용에 대한 전문가 합의문: 1부. 종설편

저자 : 박용휘 ( Yongwhi Park ) , 허애영 ( Ae-young Her ) , 김현국 ( Hyun Kuk Kim ) , 문재연 ( Jae Youn Moon ) , 박재형 ( Jae Hyoung Park ) , 박근호 ( Keun-ho Park ) , 이경훈 ( Kyung Hoon Lee ) , 주형준 ( Hyung Joon Joo ) , 원호연 ( Ho Yeon Won ) , 안성균 ( Sung Gyun Ahn ) , 박홍준 ( Hong Jun Par

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 150-168 (19 pages)

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The prevalence of ischemic heart disease is steadily growing as populations age. Antithrombotic treatment is a key therapeutic modality for the prevention of secondary cerebro-cardiovascular disease. Patients with acute coronary syndrome or who are undergoing percutaneous coronary intervention must be treated with dual antiplatelet therapy for a mandatory period. The optimal perioperative antithrombotic regimen remains debatable; antithrombotics can cause bleeding. Inadequate antithrombotic regimens are associated with perioperative ischemic events, but continuation of therapy may increase the risks of perioperative hemorrhagic complications (including mortality). Many guidelines on the perioperative management of antithrombotic agents have been established by academic societies. However, the existing guidelines do not cover all specialties, nor do they describe the thrombotic and hemorrhagic risks associated with various surgical interventions. Moreover, few practical recommendations on the modification of antithrombotic regimens in patients who require non-deferrable interventions/surgeries or procedures associated with a high risk of hemorrhage have appeared. Therefore, cardiologists, specialists performing invasive procedures, surgeons, dentists, and anesthesiologists have not come to a consensus on optimal perioperative antithrombotic regimens. The Korean Platelet-Thrombosis Research Group presented a positioning paper on perioperative antithrombotic management. We here discuss commonly encountered clinical scenarios and engage in evidence-based discussion to assist individualized, perioperative antithrombotic management in clinical practice. (Korean J Med 2022;97:150-163)

KCI후보

3진행성 악성 간문부 담관 폐쇄의 고식적 치료를 위한 담관내 고주파 소작술

저자 : 강화평 ( Huapyong Kang ) , 김의주 ( Eui Joo Kim ) , 김연석 ( Yeon Suk Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 164-170 (7 pages)

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Malignant hilar biliary obstruction (MHBO) frequently accompanies cholestasis and cholangitis, and requires biliary stent placement. To prevent stent occlusion and prolong survival, local ablation therapy can be considered adjunctive to stent placement. Intraductal radiofrequency ablation (ID-RFA) is a recently developed local therapy for malignant biliary obstruction that can be easily performed employing endoscopic retrograde cholangiography. The use of ID-RFA to treat MHBO (as distinct from distal biliary obstruction) was suggested to be associated with severe adverse events. However, recent comparative studies have shown that ID-RFA is feasible and safe, and acceptably efficacious, in patients with advanced MHBO; newer temperature-controlled ID-RFA devices may enhance safety further. Regularly repeated ID-RFA with stent exchange affords better survival than stenting alone. However, the optimal ID-RFA strategy for MHBO remains inconclusive given the lack of data. Further large-scale clinical trials are needed. (Korean J Med 2022;97:164-170)

KCI후보

4이차고혈압의 진단과 치료

저자 : 송수현 ( Su Hyun Song ) , 최홍상 ( Hong Sang Choi ) , 배은희 ( Eun Hui Bae )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 171-178 (8 pages)

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Secondary hypertension, which refers to arterial hypertension caused by an identifiable medical condition, accounts for 5-10% of all hypertensive diagnoses; however, this is thought to be an underestimate. If diagnosed promptly, secondary hypertension can be treated, and proper blood pressure restored. This review focuses on the screening, diagnosis, and management of the most common forms of secondary hypertension, including primary aldosteronism, renovascular hypertension, pheochromocytoma, Cushing's syndrome, and renal parenchymal disease. (Korean J Med 2022;97:171-178)

KCI후보

5호기산화질소 검사의 시행과 해석

저자 : 권재우 ( Jae-woo Kwon )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 179-185 (7 pages)

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Nitric oxide is produced by the human lungs and increases in response to type 2 inflammation. The level of fractional exhaled nitric oxide (FeNO) may reflect type 2 inflammation in the airways, which is related to eosinophilic inflammation and treatment responsiveness to corticosteroids. The FeNO test is a non-invasive, simple, and safe point-of-care test to evaluate airway inflammation. It has been standardized for clinical use and has been widely utilized in daily medical practice. However, various intrinsic and extrinsic factors can affect FeNO levels, and understanding and controlling such factors will improve the utility of this measure. The FeNO test can be used to confirm an asthma diagnosis, predict treatment responses to corticosteroids, and guide inhaled corticosteroid therapy for asthma treatment. (Korean J Med 2022;97:179-185)

KCI후보

6육아종성 세관사이질신염으로 확인된 크론병

저자 : 한정석 ( Jung Suk Han ) , 최범순 ( Bum Soon Choi ) , 박철휘 ( Cheol Whee Park ) , 최영진 ( Yeong Jin Choi ) , 양철우 ( Chul Woo Yang ) , 이한희 ( Han Hee Lee ) , 반태현 ( Tae Hyun Ban )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 186-190 (5 pages)

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크론병의 장관 외 발현 중 육아종성 세관사이질신염은 매우 드문 사례이다. 아직 정립된 치료는 없으나, 크론병 환자에서 신기능의 악화를 보인다면 크론병에 의한 세관사이질신염을 의심하여야 하며, 빠른 진단과 치료를 하여 환자의 신기능의 악화를 억제하여야 한다.


Crohn's disease is usually diagnosed according to intestinal symptoms, but extra-intestinal manifestations are important in approximately one-third of cases. Although several extra-intestinal symptoms associated with various organs have been reported, renal involvement is uncommon in patients with Crohn's disease. Tubulointerstitial nephritis in a patient with Crohn's disease is usually caused by infection, sarcoidosis, or medications. However, primary tubulointerstitial nephritis caused by Crohn's disease alone is extremely rare. A 19-year-old male patient was referred to our hospital because of an increase in serum creatinine level. He underwent a kidney biopsy with renal insufficiency. Renal histological findings revealed granulomatous tubulointerstitial nephritis. Thereafter, a colonoscopy was performed with suspicion of Crohn's disease. Ultimately, he was diagnosed with granulomatous tubulointerstitial nephritis based on Crohn's disease. The patient had improved gastrointestinal symptoms after the last treatment. This case report presents a rare case of primary tubulointerstitial nephritis caused by Crohn's disease. (Korean J Med 2022;97:186-190)

KCI후보

7소장 폐색이 합병된 말기 암환자에서 고식적 내시경 초음파하 소장 연결술

저자 : 오지홍 ( Ji Hong Oh ) , 홍승권 ( Seung Goun Hong )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 97권 3호 발행 연도 : 2022 페이지 : pp. 191-197 (7 pages)

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Recurrent or refractory small bowel obstruction in postsurgical patients with advanced malignancies poses therapeutic dilemmas. Although some promising results have been achieved as small bowel endoscopic techniques advanced, palliative stent placement is both challenging and complex. Endoscopic ultrasound (EUS)-guided anastomosis using a lumen-apposing metal stent has been recently used during gastroenterostomy to treat benign or malignant gastric outlet obstruction. Data on the outcomes of EUS-guided enterostomy in patients with recurrent small bowel obstruction are lacking, although the technique is applicable throughout the entire gastrointestinal tract. We recently encountered recurrent or refractory small bowel obstruction in two poor surgical candidates. For the first case, we performed EUS-guided enterostomy to treat a recurrent obstruction after conventional stent insertion. The second case underwent EUS-guided transenteric stent placement to treat refractory small bowel obstruction associated with diffuse peritoneal carcinomatosis after failure of a conventional “push” endoscopic procedure. (Korean J Med 2022;97:191-197)

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