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조계중 ( Gye Jung Cho ),임정환 ( Jung Hwan Lim ),채동렬 ( Dong Ryeol Chae ),지수영 ( Su Young Chi ),반희정 ( Hee Jung Ban ),윤병갑 ( Byeong Kab Yoon ),권용수 ( Yong Soo Kwon ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Y 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.6
Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.
김희경 ( Hee Kyung Kim ),반희정 ( Hee Jung Ban ),지수영 ( Su Young Chi ),채동렬 ( Dong Ryeol Chae ),조계중 ( Gye Jung Cho ),임정환 ( Jung Hwan Lim ),주진영 ( Jin Yung Ju ),권용수 ( Yong Soo Kwon ),오인재 ( In Jae Oh ),김규식 ( Kyu 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.2
A sarcoidosis is a multisystemic granulomatous disorder that has a predilection for pulmonary involvement, and the common radiological findings for the disease are bilateral nodular or reticulonodular patterns. Pseudoalveolar sarcoidosis is a rare presentation of sarcoidosis. The radiological finding is an alveolar pattern that involves or compresses the alveoli by clustered interstitial granuloma. A 58-year-old man was admitted due to incidental findings of a unilateral consolidative lesion as seen on chest radiography. A chest computed tomography (CT) examination showed multiple bronchoalveolar consolidations that were suspicious of a malignancy. However, a percutaneous needle biopsy revealed non-caseating granuloma with an asteroid body that was compatible with sarcoidosis. After one month, the consolidative lesions improved without any treatment. (Tuberc Respir Dis 2008;64:149-152)
폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예
주진영 ( Jin Yung Ju ),조재영 ( Jae Yeong Cho ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),채동렬 ( Dong Ryeol Chae ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young C 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as ``pinch-off syndrome``. ``Pinch-off syndrome`` refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter. (Tuberc Respir Dis 2007;63:449-453)
채동렬 ( Dong Ryeol Chae ),임성욱 ( Seong Uk Lim ),조계중 ( Gye Jung Cho ),임정환 ( Jung Hwan Lim ),주진영 ( Jin Yung Ju ),권용수 ( Yong Soo Kwon ),오인재 ( In Jae Oh ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il Kim ),임성철 ( Sung Chu 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2
유육종증의 비강 침범은 드물게 발견되며 폐 침범 없이 비강만 단독으로 침범하는 경우는 더욱 드물게 보고되고 있다. 37세의 여자 환자가 콧물과 비강 폐색을 주소로 내원하였다. 비강 종괴의 조직 검사상 일부분에서 괴사를 동반한 비건락성 육아종으로 나와 폐외 결핵으로 생각하고 9개월간 항결핵제의 투약을 하였다. 그러나 항결핵제 투약 완료 후에 결막 종괴 및 많은 수의 흉곽 내 림프절 비대가 새로이 발견되었고, 결막 종괴에서 시행한 조직 검사상 비강 종괴와 동일한 양상의 비건락성 육아종이 발견되었다. 항결핵제 투약에도 불구하고 임상 증상의 호전이 없었고 비강과 결막 조직 검사에서 비건락성 육아종 소견이 동일하게 보여 최종적으로 유육종증으로 진단 할 수 있었다. 혈청 안지오텐신 전환효소 수치는 상승되어 있었다. 부신피질 호르몬 투여 이후 환자의 증상은 점차 개선되었다. (Tuberc Respir Dis 2008;65:121-124)
오인재 ( In Jae Oh ),정종필 ( Jong Pil Jeong ),김수옥 ( Soo Ok Kim ),손준광 ( Jun Gwang Son ),반희정 ( Hee Jung Ban ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),주진영 ( Jin Young Ju ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il K 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.1
Wegener`s granulomatosis is a disease with an unknown etiology that is characterized by necrotizing granulomatous vasculitis involving the upper and lower respiratory tract and the kidneys. The typical pulmonary findings are bilaterally involved multiple variable sized nodules. We report a case of Wegener`s granulomatosis that presented as a single lung mass. A male patient presented with a nasal obstruction, arthralgia, cough, and intermittent dyspnea. The chest radiograph showed a mass, approximately 4.5 cm in diameter, in the right lower lobe. Lung cancer or tuberculosis was initially considered. However, the clinical, laboratory and pathological findings of the mass indicated Wegener`s granulomatosis. The patient was administered prednisolone and cyclophosphamide, and improved temporarily. Unfortunately, the immunocompromised patient expired as a result of respiratory failure with pneumonia. (Tuberc Respir Dis 2007; 63: 88-93)
한국인 폐암 환자에서 RRM1 유전자 Promoter의 다형성
고경행 ( Kyung Haeng Ko ),김은정 ( Eun Joung Kim ),오인재 ( In Jae Oh ),김수옥 ( Soo Ock Kim ),손준광 ( Jun Gwang Son ),정종필 ( Jong Pil Jung ),조계중 ( Gye Jung Cho ),주진영 ( Jin Young Ju ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
연구배경: 약 75%의 비소세포 폐암에서 loss of heterozygosity (LOH)를 보이는 11p15.5에 위치한 ribonucleotide reductase M1 subunit gene(RRM1) 유전자는 ras transformed fibroblast를 이용한 실험에서 암세포의 전이능력을 감소시키는 것으로 보고되어 있어서 암억제 유전자로서의 가능성이 높다. RRM1의 promoter 부위인 exon 1 시작에서 (-)37과 (-)524번째 염기에 A/C 그리고 C/T 다형성이 발견되었는데 이 다형성의 양상에 따라 RRM1 유전자의 발현 정도가 조절될 수 있어서 폐암 발생의 위험도가 다를 수 있다. 대상 및 방법: 전남대학교 병원에 내원한 폐암환자들과 비폐암 대조군 환자 127예와 미국인 폐암 환자 140예의 말초혈액 백혈구로부터 얻은 DNA를 이용하여 미국인과 한국인에서의 유전자 다형성의 분포 및 임상적 의의를 조사하였다. 결과: RRM1 유전자의 Exon 1으로 부터 (-)37 염기에서 A/C 유전자 다형성은 127예 중 CC가 64예(50.4%), AC는 55예(43.3%), 그리고 AA는 8예(6.3%)에서 발견되었다. Allele A의 빈도는 미국인들의 27.9%에 비하여 한국인에서 28.0%로 차이가 없었고, 폐암군과 비폐암군 간에도 유의한 차이는 관찰되지 않았다. RRM1 유전자의 (-)524 염기에서 C 또는 T 유전자 다형성의 양상은 CC가 24예(18.9%), CT는 44예(34.6%), 그리고 TT는 59예(46.5%)에서 발견되었다. Allele C의 빈도는 36.2%로써 미국인의 34.6%와 차이가 없었고, 폐암군과 비폐암군 간에도 차이는 관찰되지 않았다. RRM1 유전자의 (-)37 염기는 인종에 관계없이 70% 이상에서 C 이었고, (-)524 염기는 65% 정도에서 T를 보이고 있었다. 또한 (-)37과 (-)524 염기는 서로 밀접한 상관관계를 보이고 있었다. 즉 (-)37염기가 모두 C인 경우 (-)524 염기도 모두 T인 빈도가 높았고, (-)37 염기가 한 개라도 A를 가지고 있는 경우 (-)524 염기도 C를 가지고 있는 빈도가 높았다 (p<0.001). 결론: RRM1 유전자의 발현을 조절하는 promoter 부위의 두 개의 유전자 다형성의 빈도는 인종 간에 그리고 폐암군과 비폐암군 간에 차이가 없어서 폐암 발생의 위험인자는 아니었다. 그러나 두 유전자 다형성이 서로 특정 조합을 보임으로 그 조합 양상에 따른 promoter 활성도에 대한 연구가 뒤따라야 할 것이다. Background: LOH11A is a region with frequent allele loss (>75%) in lung cancer that is located on the centromeric part of chromosome 11p15.5. Clinical and cell biological studies suggest that this region contains a gene associated with metastatic tumor spread. RRM1 encoding the M1 subunit of ribonucleotide reductase, which is an enzyme that catalyses the rate-limiting step in deoxyribonucleotide synthesis, is located in the LOH11A region. Methods: Polymorphisms were found at nucleotide position (-)37 (C/A) and (-)524 (C/T) from the beginning of exon 1 of the RRM1 gene that might regulate the expression of RRM1. We studied the polymorphisms in 127 Korean individuals (66 lung cancer and 61 normal controls) and compared with those of 140 American patients with lung cancer. Results: CC, AC and AA were found at the (-)37 position in 64(50.4%), 55(43.3%), and 8(6.3%) out of 127 Korean individuals (66 cancer, 61 non-cancer patients), respectively. There was a similar frequency of allele A at (-)37 in the American(27.9%) and Korean population(28.0%). CC, CT and TT was found at the (-)524 position in 24(18.9%), 44(34.6%), and 59(46.5%) out of the 127 Korean individuals, respectively. There was a similar frequency of allele C at (-)524 in the American(34.6%) and Korean population(36.2%). There was no difference in the frequency of the (-)37 and (-)524 genotypes between the cancer and non-cancer group. However there was a significant correlation of the genotypes between (-)37 and (-)524 (p<0.001), which suggests the possible coordination of these polymorphisms in the regulation of the promoter activity of the RRM1 gene. Conclusion: RRM1 promoter polymorphisms were not found to be significant risk factors for lung cancer. However, a further study of the promoter activity and expression of the RRM1 gene according to the pattern of the polymorphism will be needed. (Tuberc Respir Dis 2006; 61: 248-255)
손준광 ( Jun Gwang Son ),오인재 ( In Jae Oh ),정종필 ( Jong Pil Jeong ),김수옥 ( Soo Ok Kim ),주진영 ( Jin Yung Ju ),임정환 ( Jung Hwan Lim ),조계중 ( Gye Jung Cho ),채동렬 ( Dong Ryeol Chae ),김규식 ( Kyu Sik Kim ),김유일 ( Yu Il 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5
Recently, intra-Muscular Stimulation (IMS) therapy is being increasingly used for musculoskeletal pain. This procedure is generally regarded as a safe procedure for the general public. Some cases of iatrogenic pneumothorax caused by acupuncture have been reported in the medical literature. However, a case of an IMS therapy associated pneumothorax has not reported. We experienced two cases of iatrogenic pneumothorax after IMS therapy. A 62 year-old man received IMS therapy on the right shoulder due to posterior neck pain. After IMS therapy, acute dyspnea and chest discomfort developed. The other patient was a 74 year-old woman who also received IMS therapy. This patient experienced a nonproductive cough and acute dyspnea after the treatment. As the popularity of this form of alternative medicine increases, we might expect to see more cases of iatrogenic pneumothorax. Physicians should be aware of the adverse events associated with IMS therapy. (Tuberc Respir Dis 2007;63:444-448)