Drug Rash With Eosinophilia and Systemic Symptoms Syndrome Induced by Chloral Hydrate in Early Childhood

유석동,김수곤,김성헌,김혜영 대한천식알레르기학회 2014 Allergy, Asthma & Immunology Research Vol.6 No.3

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is a rare, acuteand severe life-threatening systemic disease. DRESS syndrome is characterized by fever, lymphadenopathy, rash, hypereosinophilia and involvementof systemic organs. The most commonly implicated drugs are anticonvulsants, sulfonamides and allopurinol. Chloral hydrate is a sedative and hypnoticdrug frequently used in pediatric patients. We first report a case of DRESS syndrome induced by chloral hydrate in a 14-month-old female.

Clinical Characteristics of Failure to Thrive in Infant and Toddler: Organic vs. Nonorganic

유석동,황은하,이연주,박재홍 대한소아소화기영양학회 2013 Pediatric gastroenterology, hepatology & nutrition Vol.16 No.4

Purpose: To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT).Methods: This retrospective study was done with 123 patients who had visited Pusan National University Children’sHospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT).Results: Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth. Conclusion: Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correct-ing abnormal dietary behavior of caregiver in NOFTT.

복수에서의 Carcinoembryonic Antigen 과 Alpha - Fetoprotein 에 관한 연구

유석동(Seuck Dong Yoo),강영진(Young Jin Kang),홍택종(Taek Jong Hong),박희욱(Hee Ug Park),김성은(Seong Eun Kim),최장락(Jang Rack Choi),조군제(Goon Jae Cho),양웅석(Ung Suk Yang),허윤(Yoon Huh) 대한내과학회 1988 대한내과학회지 Vol.35 No.2

N/A In order to determine whether carcinoembryonic antigen (CEA) & alpha-fetoprotein (AFP) in ascitic fluid assist in the diagnosis of malignant disease in abdominal cavity and their peritoneal metastasis, the authors studied 39 cases of malignant ascites patients (of which 19 cases were proven to be peritoneal metastasis) and 38 cases of nonmalignant ascites patients and analyzed the CEA 8z AFP levels of those cases from February, 1987 to August, 1987 in Pusan National University Hospital. The results obtained were as follows: 1) The CEA level of the malignant ascites group was significantly higher than that of the nonmaligant ascites group in ascitic fluid (p<0.005), but not significant in serum (p>0.05). 2) The AFP level of the malignant ascites group was significantly higher than that of the nonmaligant ascites group in ascitic fluid and serum (p<0.01; ascitic fluid, p<0.005; serum). 3) The CEA level of the hepatoma group was significantly lower than that of the non-hepatic malignant group in ascitic fluid and serum (p<0.005), but the AFP level of the hepatoma group was significantly higher only in ascitic fluid (p<0.005). 4) The AFP level of the hepatoma group was significantly higher than that of the liver cirrhosis group in ascitic fluid and serum (p<0.005) but the CEA level of the hepatoma group was significantly higher only in ascitic fluid (p<0.005). 5) Ascitic fluid and serum CEA levels were higher than the upper limit (4.37 ng/ml; ascitic fluid, 5.35 ng/ml; serum) in 15 of 39 of the cases in the malignant ascites group (38.5%), of which 11 eases proven to be peritoneal metastasis (8 cases of stomach Ca, 2 cases of pancreatic Ca, 1 case of colon Ca). 6) The specificity of ascitic fluid CEA for malignant diseases in the abdominal cavity was 86.8%, the positive predictability was 82.1%, the sensitivity was 59.0%, and the negative predictability was 67.3%. The specificity of serum CEA was 94.7/o, the positive predictability was 88.2%, the sensitivity was 38,5% and the negative predictability was 60.0%. 7) Ascitic fluid and serum AFP levels were higher than the upper limit (35.40 ng/ml; ascitic fluid, 43.02 ng/ ml; serum) in 14 of 39 of the cases in the of the cases in the malignant ascites group (35.9%), all of which were primary hepatoma out only 2 cases proven to be peritoneal metastasis. It was concluded that the measurement of ascitic fluid CEA & AFP levels is useful in determining the existence, peritoneal metastasis and differential diagnosis of malignant diseases in the abdominal cavity.

지상발표 : 복수에서의 α-Fetoprotein 과 CEA 의 진단적 의의

유석동(Seuck dong Yo),김무현(Moo Hyun Kim),한상영(Sang Young Han),조군제(Goon Jae Cho),양웅석(Oong Suk Yang),허윤(Yoon Huh) 대한소화기학회 1987 대한소화기학회 추계학술대회 Vol.1987 No.-

99mTc-MIBI을 이용한 폐결핵의 활동성 평가

김인주 ; 김성장 ; 김용기 ; 유석동 ; 이민기 ; 박순규 부산대학교 병원 암연구소 1998 부산대병원학술지 Vol.- No.3

총수담관 결석을 동반한 전내장 역위증 (situs inversus totalis) 환자에서의 내시경적 괄약근절개술 1례

양창헌,유석동,이구,이영현,강승완,윤환중,서정일,박동건,김용섭,조진용,구정태,최석진,이창우 동국대학교 의학연구소 1999 東國醫學 Vol.6 No.-

국문초록 전내장 역위증은 내부장기가 정상위치에서 반대로 전위한 드문 태생학적 기형이다. 전내장 역위증은 장기의 위치가 특이하므로 다른 침습적 시술 이전에 진단하여 환자에게 불필요한 손상을 주지 않도록 해야한다. 총수담관 결석에 의한 급성 담도염의 치료에 내시경적 괄약근절개술을 시행하여 총수담관 결석을 제거하는 치료는 최소한의 침습적 치료방법이다. 내시경적 역행성 담췌조영술을 통하여 총수담관의 상태를 수술 전 파악함으로써 성공적인 복강경적 담낭절제술을 가능하게 한다. 이에 저자들은 담낭과 총수담관 결석을 동반한 전내장 역위증 환자에서 내시경적 괄약근절개술을 통해 결석을 성공적으로 제거한 환자 1례를 보고하는 바이다. AbstractThis thesis presents a case report of the successful management of a patient with situs inversus totalis, symptomatic choledocholithiasis, acute cholangitis. Situs inversus is a rare congenital anomalies of anatomical alteration resulting in a reversal of visceral organs. It is important that the diagnosis of situs inversus must be made prior to performing any invasive procedures so as to avoid disorientation and iatrogenic injury to the patient. Endoscopic sphincterotomy and common bile duct stone removal by ERCP is a successful minimally invasive treatment for cholangitis secondary to choledocholithiasis. The preoperative evaluation of the choledochus via ERCP and successful common bile duct stone extraction enabled to following successful laparoscopic cholecystectomy.

인슐린비의존형 당뇨병 환자에서의 수용성 E-selectin과 P-selectin 농도

김용기,김인주,유석동 대한당뇨병학회 1998 Diabetes and Metabolism Journal Vol.22 No.1

당뇨병 환자에서 Streptococcus pyogenes에 의한 Fournier's gangrene을 동반한 괴사성 근막염 1예

정소연,이영실,유석동 대한당뇨병학회 2001 임상당뇨병 Vol.2 No.4

괴사성 근막염과 Fournier's gangrene은 기본병리는 동일한 것으로, 독소를 생성하는 병독력이 있는 세균에 의한 광범위한 조직 괴사를 특징으로 하는 연조직 감염으로 드물고 급격히 진행하여 진단하기 어렵고 미만성 연조직 괴사와 독성 쇽 증후군으로 진행하므로 조기 진단과 적극적인 치료를 하지 않으면 치사율이 높은 질환이다. 특히 혈당조절이 불량하고 족부 궤양이 있는 당뇨병 환자에서 조기에 괴사성 근막염과 독성 쇽 증후군을 의심하고, 항균제를 투여하고 신속히 수술하여 괴사 조직을 제거해야 한다. 저자들은 중증 당뇨병 환자에서 Fournier's gangrene을 동반한 S. pyogenes에 의한 괴사성 근막염 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Necrotizing fasciitis is a nuncommon rapidly progressive and destructive infection of soft tissue, caused by toxin-producing virulent bacteria . Recently the re has been a dramatic increase in the recognition and reporting of necrotizing fasciitis due to Streptococcus pyogenes. It is commonly associated with toxic shocksyndrome and is usually rapidly fatal if not promptly recognized and aggressively treated. Fournier's gangrene is a widely destructive, gangrenous process of the genitalia. Necrotizing fasciitis and Fournier's gangrene occurmore common in diabetes. Early recognition, broad-spectrum a ntibiotics coverage and adequate debridement has been associated with improved survival. We report a case of necrotizing fasci it is caused by streptococcus pyogenes with Fournier's gangrene in a severe diabetic patient.

포스터 전시 발표 : 호흡기,내분비-대사 ; 신증 출혈열에 동반한 당뇨병성 비케톤성 고삼투압성 증후군 1예

김준형,이영실,유석동 대한내과학회 2003 대한내과학회 추계학술대회 Vol.65 No.10

Molecular and Phenotypic Characteristics of Patients with Pseudohypoparathyroidism: Single Center's Experience

김민지,윤주영,유석동,이준,전종근,Kim, Min-ji,Yoon, Ju Young,Yoo, Sukdong,Lee, Jun,Cheon, Chong Kun The Korea Society of Inherited Metabolic Disease 2021 대한유전성대사질환학회지 Vol.21 No.1

목적: 가성부갑상선기능항진증은 GNAS 부위의 돌연변이에 의해 발생하며, 여러 호르몬에 대한 저항성과 올브라이트 유전성 골이영양증을 특징으로 한다. 이 연구는 가성부갑상선기능항진증의 표현형 특성과 분자유전학적 특징을 조사하고자 하였다. 방법: 부산대학교 어린이병원에 등록된 가성부갑상선기능항진증으로 진단된 환자 8명의 임상적 특징과, 생화학적, 유전학적 검사 결과들을 포함한 의무기록을 후향적으로 조사하였다. 결과: 총 8명의 환자 중 5명은 PHP1a로 진단되었고 3명은 PHP-1b로 진단되었다. PHP1a 환자는 GNAS 유전자의 3가지 서로 다른 돌연변이를 가졌고, PHPIb 환자는 DMR (differential methylated region) 각인 GNAS의 소실을 보였다. 두 개의 새로운 GNAS 변이(c.313-2A>T, c.1094G>A)가 PHP1a 환자에서 발견이 되었다. 모든 PHP1a 환자는 저신장(80%), 단지증(80%), 둥근 얼굴(80%), 비만(40%), 이소성 골화(60%), 지적 장애(60%) 등의 올브라이트 유전성 골이영양증의 특징을 보였으며, PHP1b 환자의 경우는 한 명(33.3%)만이 둥근 얼굴과 같은 올브라이트 유전성 골이영양증의 특징을 보였다. PHP1a 환자와 PHP1b 환자의 표현형 특징을 비교하였을 때, 현재 키 SDS만이 PHP1b 환자에서 PHP1a 환자보다 각각 더 높은 경향성을 보였다(P=0.06). 결론: 본 연구는 한국인 PHP 환자들의 임상적 표현형 및 유전학적 특징을 요약하였다. PHP1a와 PHP1 환자들 간에 상당한 임상적 중복이 있었지만, 다른 장기 말단 저항의 영향뿐만 아니라 PHP로 진단받은 소아의 성장과 발달을 평가하기 위해서는 더 장기적인 추적 연구가 필요하겠다. Purpose: Pseudohypoparathyroidism (PHP) is caused by genetic and epigenetic alteration in the GNAS locus, and characterized by the resistance to multiple hormones and the Albright's hereditary osteodystrophy (AHO) phenotype. This study investigated the phenotypic characteristics and molecular features of PHP. Methods: Eight patients who diagnosed as PHP were enrolled at Pusan National University Children's hospital and clinical features, biochemical and genetic findings were retrospectively reviewed. Results: Of a total of 8 patients, 5 were diagnosed with PHP1a, and 3 were diagnosed with PHP1b. Patients with PHP1a had three different mutations in the GNAS gene, and patients with PHPIb had imprinting defect in differentially methylated regions (DMRs) of the GNAS locus. Two novel GNAS variants were identified in patients with PHP1a, including c.313-2A>T and c.1094G>A. All patients with PHP1a displayed AHO features; short stature (80%), brachydactyly (80%), a round face (80%), obesity (40%), heterotopic ossification (60%), and intellectual disability (60%), whereas only one patient (33.3%) with PHP1b showed AHO feature such as a round face. When phenotypic features between PHP1a and PHP1b patients were compared, patients with PHP1b showed a tendency of higher current height standard deviation scores (SDS) compared to patients with PHP1a, (-3.2±2.1 vs.-1.1±0.8; P=0.06) Conclusions: This study summarizes the phenotypic and genetic features of the PHP patients. Although we found considerable clinical overlap between PHP1a and PHP1b, further long-term follow-up is needed to evaluate the growth and development of children with PHP, as well as the effects of end-organ resistances to endocrine hormones.