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알레르기성 천식환자에 있어서 투베르쿨린 피부반응 검사와 Cytokine의 변화
윤형규 ( Hyoung Kyu Yoon ),신윤 ( Yoon Shin ),이상학 ( Sang Haak Lee ),이숙영 ( Sook Young Lee ),김석찬 ( Seok Chan Kim ),안중현 ( Joong Hyun Ahn ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),박성학 ( Sung Hak Park ),송정 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.2
윤형규 ( Hyoung Kyu Yoon ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.5
The number of immunocompromised patients has increased over the past decades due to HIV infection, solid and stem cell transplantation, intensified chemotherapy and treatment of autoimmune disease. Pneumonia is a major cause of both morbidity and mortality in immunocompromised patients. Clinical management of pneumonia is difficult, since differential diagnosis in this setting is broad and includes both infectious and noninfectious processes. Because the development of pneumonia in immunocompromised patients is frequently life threatening, early therapeutic and diagnostic intervention is essential to obtain better outcomes.
담배 연기에 의한 Muc5ac 유전자 발현에 관여하는 세포 내 신호 전달 경로로서의 ERK1/2와 p38 MAPK
김용현 ( Yong Hyun Kim ),윤형규 ( Hyoung Kyu Yoon ),김치홍 ( Chi Hong Kim ),안중현 ( Joong Hyun Ahn ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),박성학 ( Sung Hak Par 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.58 No.6
Lewis 폐암 마우스 모델에서 Interleukin-12가 E-selectin 발현에 미치는 영향
이상학 ( Sang Haak Lee ),신윤 ( Yoon Shin ),윤형규 ( Hyoung Kyu Yoon ),이숙영 ( Sook Young Lee ),김석찬 ( Seok Chan Kim ),권순석 ( Soon Seog Kwon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ) 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.47 No.2
IP-10에 의한 기도상피세포에서의 TNF-α 유도 MUC5AC발현 억제: 특발성폐섬유증 환자의 적은 객담과의 연관성
김승준 ( Seung Joon Kim ),강춘미 ( Chun Mi Kang ),유문빈 ( Moon Bin You ),윤형규 ( Hyung Kyu Yoon ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),박성학 ( Sung Hak Park ),송정섭 ( Jeong Sup Song 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.5
연구배경: 특발성폐섬유증 환자의 전형적인 증상은 운동호흡곤란과 마른기침으로, 객담이 적은 원인에 대해서 아직까지 잘 알려져 있지 않다. Interferon-γ inducible protein-10 (IP-10)은 여러 호흡기질환과 관련되는데 폐 내로 염증을 유입시키는데 중요한 역할을 한다. 본 연구는 특발성폐섬유증 환자에서 객담이 적은 기전으로 IP-10이 연관성이 있는지에 대해 연구하였다. 방법: 특발성폐섬유증 환자를 대상으로 기관지폐포세척액에서 IP-10의 농도를 ELISA로 측정하였다. IP-10이 기도 점액소 발현에 미치는 영향을 간접적으로 알아보기 위해 NCI-H292 세포(점막표피모양 암종 세포주)에서 IP-10을 전처치한 이후 tumor necrosis factor-α (TNF-α)로 자극하여 발현정도를 측정하였다. 이때 점액소 발현과 관련되는 기전으로 epidermal growth factor receptor-mitogen activated protein kinase (EGFR-MAPK)의 신호전달 경로를 알아 보았다. 결과: IP-10의 기관지폐포세척액내 농도는 특발성폐섬유증 환자가 건강 대조군에 비해 유의하게 높았다. IP-10의 전처치는 NCI-H292 세포에서 TNF-α 유도 MUC5AC 점액소 발현을 감소시켰는데 이 때 EGFR-MAPK 신호전달 경로의 차단과 관련되었다. 결론: 특발성폐섬유증 환자의 적은 객담은 IP-10의 발현증가와 일부 관련 가능성이 있으며, 이때 IP-10의 작용은 MUC5AC 점액소 유전자 발현에 필요한 EGFR-MAPK 신호전달 경로의 차단과 관련될 것으로 생각한다. (Tuberc Respir Dis 2008;64:347-355) Background: IPF is characterized by chronic, fibrosing inflammatory lung disease of unknown etiology. Typical symptoms of IPF are exertional dyspnea with nonproductive cough. Why patients with typical IPF have dry cough rather than productive cough, is unknown. IP-10 plays an important regulatory role in leukocyte trafficking into the lung. The present study investigated the effect of IP-10 in the pathogenesis of dry cough rather than productive cough in IPF patients. Methods: IP-10 concentration was measured by ELISA from BALF of IPF patients. To evaluate the role of IP-10 in mucin expression, the expression of the MUC5AC mucin gene was measured in NCI-H292 cells, a human pulmonary mucoepidermoid carcinoma cell line, after stimulation by TNF-α with or without IP-10 pretreatment. EGFR-MAPK expression was also examined as a possible mechanism. Results: IP-10 levels were significantly higher in the BALF of IPF patients compared to healthy controls. IP-10 pretreatment reduced TNF-α induced MUC5AC mucin expression by inhibiting the EGFR-MAPK signal transduction pathway in NCI-H292 cells. Conclusion: These findings suggest that little mucus production in IPF patients might be attributable to IP-10 overproduction, which inhibits the EGFR-MAPK signal transduction pathway required for MUC5AC mucin gene expression.
가정산소치료의 보험급여 실시 이후 처방 실태 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구-
박명재 ( Myung Jae Park ),유지홍 ( Jee Hong Yoo ),최천웅 ( Cheon Woong Choi ),김영균 ( Young Kyoon Kim ),윤형규 ( Hyoung Kyu Yoon ),강경호 ( Kyung Ho Kang ),이승룡 ( Sung Yong Lee ),최혜숙 ( Hye Sook Choi ),이관호 ( Kwan Ho Lee 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.2
Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3±13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56±0.68 L/min at rest, 2.08±0.91 L/min during exercise or 1.51±0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18±10.48% and 91.64±7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85±6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414±15,618 won/month and 40,352±36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.
결핵성 심막염으로 항결핵약을 복용하던 중 발생한 혈구 탐식증후군
노진희 ( Jin Hee No ),강지영 ( Ji Young Kang ),이보희 ( Bo Hee Lee ),김윤지 ( Yun Ji Kim ),이정은 ( Jung Eun Lee ),민진수 ( Jin Soo Min ),강민규 ( Min Kyu Kang ),김경희 ( Kyung Hee Kim ),윤형규 ( Hyoung Kyu Yoon ),송정섭 ( Jeong S 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.6
A 63-year old woman was admitted to our hospital for an evaluation of thrombocytopenia. She had been diagnosed with tuberculous pericarditis three months earlier in a local clinic and treated with anti-tuberculosis medication. Two months later, thrombocytopenia developed. The medication was subsequently stopped because it was suspected that the anti-tuberculosis medication, particularly rifampin, might have caused the severe platelet reduction. However, the thrombocytopenia was more aggravated. A bone marrow biopsy was performed, which showed moderate amounts of histiocytes with active hemophagocytosis. This finding strongly suggested that the critical thrombocytopenia had been caused by hemophagocytic syndrome, not by the side effects of the anti-tuberculosis medication. Furthermore, the development of hemophagocytosis might have been due to an uncontrolled tuberculosis infection and its associated aberrant immunity. Therefore, she was started with both standard anti-tuberculosis medication and chemotherapy using etoposide plus steroid. One month after the initiation of treatment, the thrombocytopenia had gradually improved and she was discharged in a tolerable condition. At the third month of the follow-up, her platelet level and ferritin, the activity marker of hemophagocytic syndrome, was within the normal range. (Tuberc Respir Dis 2008;65:522-526)
정의성 ( Eui Sung Chung ),김정호 ( Jeong Ho Kim ),정진환 ( Jin Hwan Jung ),신주영 ( Ju Young Shin ),염주옥 ( Ju Ok Yeom ),강지영 ( Ji Young Kang ),윤형규 ( Hyoung Kyu Yoon ),송정섭 ( Jeong Sup Song ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.5
Crohn`s disease, a major form of inflammatory bowel disease (IBD), is a chronic inflammatory condition that is characterized by microvascular and macrovascular involvement. Some extraintestinal complications can occur due to chronic systemic inflammation in IBD. Among them, a pulmonary thromboembolism is a rare manifestation of IBD but is associated with a high morbidity and mortality. To our best of knowledge, there is only one case report of a pulmonary thromboembolism as a complication of Crohn`s disease in Korea. We present another rare case of pulmonary thromboembolism as complication in a 25-year-old man with underlying Crohn`s disease.
증례 : 호흡기 ; 유방암 환자에서 방사선 조사 후 발생한 폐쇄성 세기관지 기질화 폐렴 1예
홍지형 ( Ji Hyung Hong ),강지영 ( Ji Young Kang ),김태정 ( Tae Jung Kim ),이재호 ( Jae Ho Lee ),김대원 ( Dae Won Kim ),윤형규 ( Hyoung Kyu Yoon ),송정섭 ( Jeong Sup Song ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4
폐쇄성 세기관지 기질화 폐렴은 방사선 치료 후에 드물지만 발생할 수 있는 합병증이다. 종양으로 흉부 방사선 조사의 기왕력이 있는 환자에서 다발성 경결성 폐병변이 있는 경우, 특히 방사선에 노출되지 않은 부위라 하더라도 감염성폐렴이나 방사선 폐렴, 종양의 재발 뿐만 아니라 본 증례와 같이 방사선 유도 BOOP의 가능성이 발생할 수 있음을 염두에 두고 접근하는 것이 필요하겠다. Pulmonary toxicity can develop following radiation therapy during breast cancer treatment. Of the pulmonary toxicities that can develop, radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) is relatively rare. A 43-year-old woman who had previously undergone radiation therapy for right breast cancer presented with fever and cough for 4 days. Chest radiology findings demonstrated consolidations in the right middle and lower lobe. Initially, we assumed that her findings were consistent with pneumonia and started empirical antibiotics. However, even after 10 days of antibiotic treatment, the fever persisted, and the consolidations showed progression. A transbronchial lung biopsy of the right middle lobe via bronchoscopy revealed organizing pneumonia. We strongly suspected radiation-induced BOOP and began steroid treatment. The symptoms and consolidations rapidly disappeared. We tapered the steroids, and no relapse has occurred since then. Considering the clinical, radiological, and pathological findings, we diagnosed the patient with radiation-induced BOOP. To our knowledge, this is the first case of radiation-induced BOOP in Korea. (Korean J Med 2011;80:458-463)