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S-477 Primary sjogren``s syndrome diagnosed from extraglandular manifestation
안유란,김예니,유지현,정병하,최범순,박철휘,양철우,김용수 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Primary Sjogren's syndrome (pSS) is a autoimmune disorder that primarily affects epithelial tissue characterized by lymphoplasmacytic infiltration of the exocrine glands. The patients may develop a extraglandular manifestation such as tubulointerstitial nephritis, hepatitis, or myositis due to systemic involvement of pSS which mark disease prognosis and can cause mortality. Recently, we experienced a patient who had acute kidney injury due to tubulointerstitial nephritis, autoimmune hepatitis and myositis, finally diagnosed as pSS. The 73 year-old female presented with oliguria, abdominal distension and edema. She had a diabetic nephropathy and hypertension. Abdomen CT scan showed advanced liver cirrhosis with ascites. Hepatocellular pattern of hepatitis and acute kidney injury had not improved with conservative care, therefore we biopsied the liver and kidney. Kidney showed tubulointerstitial nephritis, infiltrated with CD3, CD8, CD68, CD138 positive cells in immunohistochemistry. Liver showed chronic hepatitis with cirrhosis, marked plasma cell infiltration in portal area and serologic markers of hepatitis B and C were all negative, hence, we presumably diagnosed her as autoimmune hepatitis and started oral prednisolone. She also complained progressive weakness of lower extremities and bone scan showed increased uptake in both thighs and the symptom accompanied with elevated muscle enzyme. We also biopsied thigh muscle and it showed mild inflammatory cell infiltration in the endomysium, suggestive of inflammatory myopathy. Anti SS-A (Ro) and SS-B (La) which were checked during the work up of autoimmune hepatitis, were strong positive, therefore we started to have a suspicion for pSS. Salivary gland scan showed markedly impaired function of both submandibular glands, Shirmer test was positive, and lip biopsy showed focal lymphocytic sialadenitis. Finally, we diagnosed her as pSS with kidney, liver, and muscle involvement.She was discharged with fully recovered renal function, normalized hepatic enzyme and partially recovered muscle power continued on steroid treatment.
안유란,윤종찬 대한의사협회 2022 대한의사협회지 Vol.65 No.1
Background: Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent, is associated with high morbidity, and has very few effective treatments. Current Concepts: HFpEF is a heterogeneous syndrome arising from the interplay of cardiac (diastolic, systolic dysfunction, pulmonary hypertension, right ventricular dysfunction, left atrial dysfunction, and chronotropic incompetence) and extracardiac (endothelial dysfunction, skeletal muscle abnormality, pulmonary disease, and renal dysfunction) abnormalities. Although various pharmacological therapies of HFpEF have been introduced and studied, most of them showed a limited clinical benefit. With some advancement in the specific phenotype of HFpEF, diuretics, mineralocorticoid antagonists, sacubitril/valsartan, and lifestyle modifications are recommended as important treatments. Recently, EMPEROR-Preserved trials showed that empagliflozin reduced the combined risk of cardiovascular death or hospitalization for patients with HFpEF, regardless of the presence or absence of diabetes. Several non-pharmacological therapies, including interatrial septal shunt and pacing therapies, have been introduced and are under investigation. Discussion and Conclusion: HFpEF has been recognized as the single greatest unmet need in cardiovascular medicine. Further research is required to understand the concrete pathophysiology for each phenotype of HFpEF. Prevention and management of comorbidities and risk factors for HFpEF are of great importance. Sodiumglucose cotransporter 2 inhibitors may contribute to a change in clinical practice, given the lack of therapeutic options available for patients with HFpEF.
Construction of a predictive model for evaluating multiple organ toxicity
안유리,김재영,김양석,김양석 대한독성 유전단백체 학회 2016 Molecular & cellular toxicology Vol.12 No.1
The liver and kidneys are major target organs that suffer in adverse drug reactions, and liver and kidney toxicity are often present together. A multiple organ toxicological study is more helpful in understanding the effects of drugs in living systems than targeting a specific organ for a toxicity study. There are many prediction models for evaluating toxicity, but they are limited by single organ predictions and insufficient to understand the toxic mechanisms of drugs in the human body. Thus, we developed multiple organ toxicity prediction models and sought to lay a foundation for understanding the toxic effect of drugs on other organs, apart from the target organ. Here, we developed and evaluated the four computational prediction models (ANN, kNN, LDA, and SVM) that can predict whether a drug is liver toxic or liver-kidney toxic. To construct the predictive model, we extracted 210 molecular signatures of two classes of 108 drugs from TG-gate transcriptome data. Among the four algorithms, SVM was the ‘best’ method for multi-organ toxicity classification, with over 90% accuracy and the maximum power of classification with a small number of features. These bioinformatics tools will help researchers to recognize the side toxicity of drugs, not just in the target organ, before advancing them to clinical trials and exposing humans.
고온 양생 환경에서 비파괴 평가를 이용한 지연제 첨가 시멘트 페이스트의 응결 모니터링
안유리 ( Ahn Yu-rhee ),임홍재 ( Yim Hong-jae ) 한국구조물진단유지관리공학회 2021 한국구조물진단유지관리공학회 학술발표대회 논문집 Vol.25 No.2
지연제는 특정 수화물 억제를 통한 응결 속도 지연을 통한 내구성 향상을 위해 첨가되며 주로 고온 양생 환경에서 사용되는 혼화제이다, 일반적으로 시멘트 페이스트의 응결 시간은 비카트 시험을 통해 확인할 수 있다. 본 연구에서는 지연제 첨가에 따른 초기 재령 시멘트 페이스트의 전기비저항과 초음파 속도를 측정하여 지연제 첨가에 따른 응결 지연 현상을 확인하고 비카트 시험 결과와 비교·분석하였다.