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악성 종양 표지자가 상승된 만성 흉수를 동반한 종격동 기형종
엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee Sook Roh ),김기남 ( Ki Nam Kim ),이기남 ( Ki Nam Lee ),최필조 ( Pil Jo Choi ),방정희 ( Jung Heui Bang ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.2
Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.
혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자
허정훈 ( Jung Hun Huh ),이수미 ( Su Mi Lee ),구태형 ( Tae Hyoung Koo ),신봉철 ( Bong Chul Shin ),엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee Sook Roh ),김기남 ( Ki 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.5
An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients` clinical condition. (Tuberc Respir Dis 2008;64:383-386)
스티븐슨-존슨 증후군 및 독성 표피 괴사용해증 환자에서 고용량 면역글로불린 치료
이수미 ( Soo Mi Lee ),엄수정 ( Soo Jung Um ),이수걸 ( Soo Keol Lee ),김기호 ( Ki Ho Kim ),김영훈 ( Young Hoon Kim ),손춘희 ( Choon Hee Son ) 대한천식알레르기학회 2009 천식 및 알레르기 Vol.29 No.4
Background: There have been some uncontrolled studies on clinical efficacy of high-dose intravenous immunoglobulin (IVIG) in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Objective: This study was conducted to demonstrate the effectiveness of high-dose IVIG therapy in reducing mortality in Korean patients with SJS or TEN. Method: Retrospective data from 2 patients with SJS, 4 patients with SJS/TEN and 3 patients with TEN treated with high-dose IVIG were analyzed. Result: The total dose of IVIG administered was 1.0 gm/kg/day from 2 days to 1.0 gm/kg for 7 days. Of the 8 patients who showed good responses to IVIG, the mean time to objective responses was 2.0±1.4 days (range, 1 to 5 days). The length of stay in hospital was 22.8±9.2 days (range, 11 to 40 days). Two patients had poor outcomes. Based on the SCORTEN system, 3.2 patients (39.9%) were expected to die, but 2.0 patients (25.0%) died. However, there was no statistical significance (P>0.05). Conclusion: Therapy with high-dose IVIG showed a slightly improved mortality in patients with SJS, SJS/TEN overlap and TEN, but there was no statistical significance (P>0.05). Although dramatic clinical improvement was noted in most patients, further nationwide multicenter clinical trials are required to evaluate the effectiveness of high-dose IVIG in the treatment of patients with SJS or TEN. (Korean J Asthma Allergy Clin Immunol 2009;29:256-261)
학교 성폭력의 실태 및 다면적 영향 요인에 관한 질적 연구
오인수(In Soo Oh),이승연(Seung-yeon Lee),궁선혜(Sunhye Kung),엄수정(Su Jung Um),반지윤(Jiyoon Ban) 서울대학교 교육종합연구원 2021 The SNU Journal of Education Research Vol.30 No.1
본 연구는 학교 현장에서 학생들 사이의 성폭력이 크게 증가하고 사회문화적 변화로 인해 그 양상이 더욱 복잡하게 변화하고 있는 현상을 심층적으로 이해하기 위한 목적에서 수행되었다. 초·중·고등학교 교사와 성폭력 관련 전문가 총 10명을 대상으로 포커스그룹 인터뷰를 실시하고, 질적내용분석 방법을 이용하여 학교 성폭력의 실태와 학교 성폭력 경험 관련 다양한 요인들을 개인 및 환경 수준에서 다면적으로 분석하였다. 분석 결과, 성인에 의한 온라인 그루밍과 성적 자기결정권이 없는 성매매가 증가하고 있고, 사이버성폭력이나 데이트 성폭력이 최근 증가하는 성폭력 유형으로 조사되었다. 또한, 성적 모욕이나 언어적 성희롱이 장난이나 놀이로 수용되고 있고, 동성 성폭력이 은닉되어 있음이 확인되었다. 학교 성폭력 경험 관련 개인요인은 사회적, 정서적으로 취약할수록 성폭력 피해경험과 연관이 되고, 성에 대한 왜곡된 인식과 또래관계를 위계적인 권력관계로 인식할수록 성폭력 가해경험과 연관되었다. 환경요인은 가정폭력경험, 보호자의 젠더 감수성, 보호자의 부재의 가정환경요인, 성적 장난이나 놀이가 일상화되어 가는 학교문화와 성폭력을 경험한 학생에 대한 교사의 편견으로 인해 성폭력에 대한 허용도가 높아지는 학교환경요인, 성을 상품화하는 문화와 성범죄에 관대한 사회적 분위기로 인해 성폭력 허용도가 높아지는 사회환경요인이 분석되었다. 이에 기초하여 본 연구는 학교 현장의 성폭력 예방교육에 주는 교육적 시사점과 정책적 제언을 논의하였다. The purpose of this research is to qualitatively understand dynamics of sexual violence in schools and analyze multifaceted influencing factors. Focus-group interviews with ten K-12 school teachers and professionals working at youth sexual violence institutions were conducted in order to analyze multifaceted influencing factors to experiences of sexual violence in schools. Using qualitative content analysis, we investigated that online grooming sex offenses by adults and prostitutions having no sexual self-determination were increased; recent increasing types of sexual violence were cyber sexual violence and dating sexual violence; sexual insult and verbal sexual harassment were accepted as a play; and same-sex sexual violence was hidden. Also, individual factors(socially, psychologically minority group, distorted sexual attitude/perception, hierarchical peer relationship) and family, school, and social environmental factors(exposure to domestic violence, gender sensitivity of parents, physical absence of parents, school culture, teachers’ prejudice, sexual commercialization, and generous punishment against sexual crime) were analyzed. Based on these results, this research proposed educational implications to sexual violence prevention programs and systems.
수원의 한 대학병원에서 10년간 경험한 아나필락시스 환자 분석
김무정 ( Moo Jung Kim ),최길순 ( Gil Soon Choi ),엄수정 ( Soo Jung Um ),성준모 ( Jun Mo Sung ),신유섭 ( Yoo Seob Shin ),박한정 ( Han Jung Park ),예영민 ( Young Min Ye ),남동호 ( Dong Ho Nahm ),이수영 ( Su Young Lee ),박해심 ( Hae 대한천식알레르기학회 2008 천식 및 알레르기 Vol.28 No.4
Background: Anaphylaxis is a systemic hypersensitivity reaction consisting of various etiologies and clinical features. In Korea, reports regarding anaphylaxis are very few. Objective: To evaluate the general characteristics and clinical features of anaphylaxis, especially with regard to the severity of it. Method: A retrospective study was conducted in inpatients, outpatients and patients encountered at the emergency department at the Ajou University Hospital during 1997~2008. The medical records of a total of 158 patients who met diagnostic criteria for anaphylaxis were reviewed. Result: Drugs (51.2%) was the most common cause of anaphylaxis followed by insect stings (25.3%), foods (10.8%) and exercise (6.3%) in our hospital. The common manifestations were dyspnea (70.3%), urticaria (57.6%), dizziness (48.1%) and hypotension (46.2%). There were 65 patients (41.1%) with moderate anaphylaxis and 93 patients (58.9%) with severe anaphylaxis. The patients with older age or underlying cardiovascular disease had more severe anaphylaxis (P<0.05, respectively). Although there were no significant correlation between the severity and etiology of anaphylaxis, some drugs such as antibiotics, NSAIDs, and radiocontrast media tended to develop severe anaphylaxis. Conclusion: We confirmed that drugs, insect stings, foods, and exercise are the major causes of anaphylaxis. In addition, the patients with older age or a cardiovascular disease had a tendency to develop severe anaphylaxis. (Korean J Asthma Allergy Clin Immunol 2008;28:298-304)
수술 절제를 시행받은 제1기 비소세포폐암 환자에서의 Fascin 발현과 예후
노미숙 ( Mee Sook Roh ),엄수정 ( Su Jung Um ),최영민 ( Young Min Choi ),김기남 ( Ki Nam Kim ),최필조 ( Pil Jo Choi ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),양두경 ( Doo Kyung Yang ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2
연구배경: Fascin은 세포 운동에 관여하는 액틴 결합 단백질로서 정상적인 상피세포에는 증가되어 있지 않으며, 일부 악성종양에서 fascin이 증가되어 있다는 보고가 있다. 본 연구는 비소세포폐암 환자의 조직에서 fascin 발현을 조사하고 fascin이 예후 인자로 역할을 하는지를 알아보고자 하였다. 방법: 제 1기 비소세포폐암으로 근치적 절제수술을 받고 추적조사가 가능했던 환자 81명의 조직에서 fascin 발현을 면역조직화학 염색 방법으로 조사하였다. 결과: Fasin 발현은 전체 81예 중 59예(73%)에서 양성이었다. Fascin 발현 정도에 따른 5년 생존율은 fascin 발현 음성군에서 68%, fascin 저발현군에서 76%, fascin고발 현군에서 79%으로 각 군간에 유의한 차이가 없었다(p=0.86). 결론: Fascin 발현이 비소세포폐암으로 근치적 수술을 받은 환자에서 예후 인자로서 역할을 하는지 알아보았으나 통계학적으로 유의한 관련성이 없었다. Background: Fascin is an actin-bundling protein that plays an important role in cellular motility. Fascin is normally expressed in the neuronal and mesenchymal cells and its expression is low or absent in the epithelia. However, an overexpression of fascin has been linked to the invasive behavior of some neoplasms such as breast, stomach and ovarian tumors. In this study, we evaluated the expression of fascin and its prognostic significance in stage I non-small cell lung cancer (NSCLC). Methods: Immunohistochemical staining for fascin was performed on the paraffin-embeded tissue sections of 81 cases of resected NSCLC. Staining of more than 5% of the tumor cells was recorded as positive immunoreactivity. Results: Fascin expression was seen in 73% (59/81) of the cases and this was more frequently seen in squamous cell carcinoma than in adenocarcinoma (93% vs 42%). There were no significant correlations of fascin immunoreactivity with tumor recurrence and overall survival. Conclusion: The expression rate of fascin was relatively high in NSCLC, but this was without prognostic significance. The exact clinical role of fascin should be defined through further investigations. (Tuberc Respir Dis 2008;65: 105-109)
아니사키스 몸체항원의 IgE 매개반응과 교차항원성에 관한 연구
최성진 ( Sung Jin Choi ),허규영 ( Gyu Young Hur ),엄수정 ( Soo Jung Um ),최길순 ( Gil Soon Choi ),박한정 ( Han Jung Park ),예영민 ( Young Min Ye ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2008 천식 및 알레르기 Vol.28 No.4
Background: Anisakis simplex (A. simplex) is a fish parasite which may be responsible for urticaria and anaphylaxis in case of human infections. Objective: We performed this study to identify IgE binding components and evaluate cross-allergenicity with Toxocara, a common cause of parasite allergy and Dermatophagoides pteronyssinus (D.pt). Method: Nine Anisakis allergic patients and 23 non-atopic healthy controls were enrolled. Serum specific IgE and IgG4 antibodies to A. simplex extracts were measured by ELISA. Allergenic relationships with Toxocara were evaluated by immunoCAP, IgE and IgG4 ELISA inhibition tests. IgE binding components were identified by IgE immunoblot analysis and basophil histamine release induced by A. simplex was performed in a representative case. Result: Four of 9 A. simplex allergy patients showed high serum specific IgG4 as well as IgE antibody. No cross-reactivity between A. simplex and D.pt, or Toxocara were observed. Several IgE binding components ranged from 8 to 80 kDa were identified. A significant histamine release by A. simplex extracts was noted from basophils from the representative case. Conclusion: We confirmed that A. simplex could induce IgE mediated response which leads to urticaria and anaphylaxis in patients sensitized to A. simplex. No cross-allergenicity was observed between A. simplex and Toxocara. (Korean J Asthma Allergy Clin Immunol 2008;28:277-283)
혈중 CA 125 수치가 지속적으로 상승되었던 기관지확장증
신봉철 ( Bong Chul Shin ),구태형 ( Tae Hyoung Koo ),김상옥 ( Sang Ock Kim ),형건덕 ( Hsing Chien Ter ),엄수정 ( Soo Jung Um ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),김기남 ( Ki Nam Kim ),이기남 ( Ki Nam Lee ),노미숙 ( Me 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.6
Serum CA 125 is the most useful marker for monitoring patients with epithelial ovarian cancer. However, it can be elevated above normal level in a variety of conditions other than ovarian cancer such as endometriosis, pelvic inflammation disease, and other malignant or nonmalignant disorders, including pulmonary diseases. Recently, we experienced a case of bronchiectasis in which the serum CA 125 level was elevated, changing with the patient`s condition. There was no evidence of underlying malignant disease on positron emission tomography or on gynecologic examination, including transvaginal ultrasonography. During follow-up for 14 months, we could not find any clue of malignant disease that could have been the cause of the elevated levels of serum CA 125. Elevated serum CA 125 level should be interpreted carefully according to the patient`s clinical condition. In addition, our case suggests that CA 125 may be used as a surrogate marker for acute inflammatory status for chronic pulmonary diseases.
p16과 RARB2 유전자의 비정상적인 메틸화 검사를 이용한 악성 흉수의 진단
나서희 ( Seo Hee Rha ),이수미 ( Su Mi Lee ),구태형 ( Tae Hyoung Koo ),신봉철 ( Bong Chul Shin ),허정훈 ( Jung Hun Huh ),엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.4
정일환 ( Il Hwan Jeong ),남영희 ( Young Hee Nam ),김대철 ( Dae Cheol Kim ),이혜원 ( Hye Won Lee ),윤늘봄 ( Neul Bom Yoon ),엄수정 ( Soo Jung Um ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ) 대한천식알레르기학회 2012 천식 및 알레르기 Vol.32 No.3
Background: Churg-Strauss syndrome is a rare systemic disorder characterized by bronchial asthma, hypereosinophilia and systemic vasculitis. The prevalence and severity of renal involvement in patients with Churg-Strauss syndrome is not well known. We report a rare case of a patient with Churg- Strauss syndrome accompanied by acute renal failure. Case History: A 52-year-old woman with skin rash and generalized edema was admitted to our hospital via the emergency room. She had a 7-year history of bronchial asthma and allergic rhinitis. Laboratory evaluation showed marked eosinophilia, elevated creatinine, and heavy proteinuria. She was positive for anti-neutrophil cytoplasmic antibody. Computed tomography of chest and paranasal sinuses revealed pulmonary infiltration and pansinusitis. Peripheral neuropathy was confirmed and small vasculitis was noted in a skin biopsy specimen. Results: She was diagnosed with Churg-Strauss syndrome and showed rapidly progressive renal insufficiency despite systemic corticosteroid administration. Oilguria was aggravated, and hemodialysis was thereafter started. Despite 2 weeks of continuous hemodialysis, her renal function was not improved. Conclusion: We report a rare case of Churg-Strauss syndrome associated with acute renal failure. A long-term follow- up is needed in Churg-Strauss syndrome patients.