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CMV감염에 의한 Infection-Associated Hemophagocytic Syndrome 1예
최관수,정 만,류영근,김지운,강상구,천석배 대한감염학회 1993 감염 Vol.25 No.4
저자들은 임상과 혈액검사에서 CMV monoucleosis로 진단된 21세 남자환자에서 골수검사상 적혈구를 탐식하는 조직구의 증식으로 보아 CMV가 그 원인으로 추정되는 IAHS 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The 21-year-old male patient complained of high fever, chills, severe malaise, myalgia, and gingival bleeding for 10 days. The patient presented pancytopenia and hepatosplenomegaly. We examined peripheral blood smear, bone marrow aspiration and biopsy, serologic tests for antibodies on cytomegalovirus(CMV), platelet and heterophil, and upper abdominal ultrasonography. There were pancytiopenia and peripheral lymphocytosis with atypical lymphocytes in the peripheral blood smear and histocytes phagocytosing red blood cells in the bone marrow examination. The CMV-specific IgM antibody was positive. The antibodies for platelet and heterophil were absent. We diagnosed as Infection-Associated Hemophagocytic Syndrome (IAHS) due to CMV for the patient. Therefore, we report a case of IAHS associated with CMV mononucleosis with a brief review of literature.
천석배(Seog Bae Cheon),박창현(Chang Hyun Park),박찬웅(Chan Woong Park),강상구(Sang Gu Kang),최요안(Yo An Choi),김건형(Geon Hyung Kim),심승식(Seung Sik Shim),김지운(Ji Woon Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.4
N/A Objectives: To determine the transmission route of hepatitis C virus in Korea, we studied 75, anti- HCV positive patients by epidemiologic questionnaire, retrospectively. Methods: 75patients were compared with 75healthy controls on the basis of the following factors : blood transfusion, acupuncture, admission, hepatitis patient within household(spouse andother's), extramarital intercourse, ear piercing, frequent alcohol drinking, frequent raw-fish ingestion, frequent shaving at barbershop, low socio-economic status, tattooing. Results: Compared with control group, the relative ratio(anti-HCV positive case/control case) of the history of blood transfusion was 2.4(p=0.275); acupuncture was 1A2 (p=0.383); admission was 1.83(p=0.001); spouse`s hepatitis was 13(p=0.003) (6.4% in male, 28.6% in female); hepatitis patient within household except spouse was 1.75(p=0.46) (17.0% in male, 35.7% in female); extramarital intercourse was 5.44 (p< 0.001); frequent alcohol drinking was 1.42 (p=0.515); frequent shaving at barbershop in male was 2.95(p=0.043); low status of the education or economic was 1.39 or 1.71, and tattooing were 5cases in only anti-HCV positive group, respectively. Conclusion: According to the results, hepatitis C virus infection was related to the histories of admission, spouses hepatitis, extramarital intercourse, frequent shaving at barber-shop, and tattooing, closely. Although the relationship was not siginficant, the histories of blood transfusion, acupunture, hepatitis patient within household except spouse, frequent alcohol drinking and low socioeconomic status in anti-HCV positive group were more than the control group. Therefore, it is necessary to make a close inspection of these suspicious potential risk factors. And also, every risk factor calls for the serologic examination, not by questionnaire, of the intrafamilial or contracked personal transmission, for the prospective study and for the strengthened test by RIHA or PCR.
박찬웅,심승식,정만,박창현,류형선,이영미,천석배,강상구,김지운 대한천식알레르기학회 1993 천식 및 알레르기 Vol.13 No.3
Continuous monitoring of the aualitative and quantitative composition of the airspora is a prerequisite for diagnosis and treatment of respiratory allergic disorders in human beings. As such, survey of airborn pollens has been considered as an essential part of respiratory allergic studies. From July 25th in 1991 to July 24th in 1992, the counts of aeroallergic pollens in Mokpo were monitored to work up a listing of plant species producting airborn pollen. Rotorod sampler was installed on the well-ventilated roof top of an apartment in the center of Mokpo. The results are such as: 1) Twenty six Genera were identified in collected pollen. There were 15 Genera in tree, 2 Genera in grass and 9 Genera in weed. 2) Pollen seasons were divided into tree, grass and weed season but they were overlapped. 3) The tree seaon was from beginning to end of May. The grass season ranged from April to November. The weed season was from middle of August to end of November. 4) The maximum total count was 562 grains/m' 24hr on May 4, 1992. 5) Total number of pollens: Pinus(3502 grains/m, Alnus(1297grains/m), Humulus japonicus(709grains/m), Betula(266grains/m ), Graminaceae(495grains/m). 6) The peak counts of pollens ' Pinus(517 grains/m), Betula(266grains/m), Alnus(237 grains/m), Humulus japonicus(99grains/m 7) Differentiation between the pollen of Cryptomeria and that of Cupressaceae can be established by making investigation into the flowering time. The peak counts of pollens ' Cryptomeria(40grains/m'), Cupressaceae(23 grains/m). 8) The pollen of Artemisia noted three peaks l 73grains/m on September 1, 77 grains/m on September 22, 82grains/m on September 23. It was 15days that were recorded over 20grains/m of the Artemisia pollens during the present investigation. The present paper dealt with the variation patterns in the atmospheric pollen concentration of Mokpo. More information about the distribution of the natural plants as well as the pollen grains is needed. It is also needed to compare the relative incidence of pollen types in different area.
문용,이영미,박창현,김지운,박찬웅,정만,류형선,심승식,천석배,강상구 대한내과학회 1993 대한내과학회지 Vol.45 No.4
Background: Combined ATCH and GH deficiency is a rare disease, Clinical and laboratory features are variable, non-specific and similar to those seen in adrenocortical insufficiency of any cause. Methods: We have exprienced a case of combined ACTH and GH deficiency without combined disease. The patient, 55 years old female, was admitted because of fatigue, nausea and vomiting on admission. Results: Serum sodium was 112 mmol/L, potassium 3. Hmmol/L, serum osmolarity 237m0sm,Kg and urine osmolarity 531 m0sm/Kg. Basal serum cortisol was 0.68 μg/ml, ACTH 12,7pgjml, GH below 0.1 ng/ml, basal urinary 17-hydroxycorticosteroid(17-OHCS) 0.5 μg/dl and blood glucose was 86 mg/dl. Although cortisol did not respond to rapid ACTH stimulation test, it responded to standard ACTH stimulation test. On combinded stimulation test, the cortis1 did not respond and all anterior pituitary hormone showed normal responses except ACTH and GH. In addition, plasma cortisol and ACTH repond to vasopressin test. There was no abnormalities in sellar CT, and hyponatremia was corrected dramatically with prednisolone replacement. Conclusion: Combined ACTII and GI-I deficiency is rare cause of secondary adrenocortical insufficiency, Its clinical manifestation similar to isolated ACTH deficiency in adult. Patients with isolated ACTFI deficiency due to suprapituitary dysfunction may be distinguished from those with intrinsic pituitary disease by stimulation of cortisol and ACTI-I secretion following vasopressin administration. More study needed to identify the definitive cause and hypothalamic-pituitary system.