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유광하,진춘조,김홍승,이종인,심영학,정순희,이창훈 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.7 No.-
저자등은 전신적인 소양감을 동반한 홍반성 판상의 피부 병변과 자가 면역성 용혈성 빈혈이 동반된 Sezary 증후군을 진단하고 복합 화학 요법 CHOP으로 치료하여 피부 증상과 빈혈이 호전된 예를 문헌고찰과 함께 보고하였다. Sezary syndrome(SS), a leukemic variant of cutaneous T-cell lymphoma(CTCL), is monoclonal proliferation of CD4 T-cell having cerebriform nuclei in the skin and the peripheral blood. It is associated with erythroderma, pruritis, lymphadenopathy with protracted clinical course and systemic spread. We present a case of SS i a 38-year-old woman with generalized exfoliative erythroderma, plaques, and pruritus. Histopathologic findings of the skin lesions revealed infiltration of atypical lymphocytes in the dermis and epidermis. Electron microscopic findings of peripheral blood and skin showed atypical lymphocytes with cerebriform nuclei. Laboratory findings revealed direct Coombs' positive autoimmune hemolytic anemia, a rare association of SS. Chemotherapy with CHOP produced improvement of the skin manifestation and anemia.
한국 중년 남성에서 인슐린 저항성과 관상동맥질환과의 상관성
김미진,김병국,장원철,박정환,조영일,유광하,박형석,진춘조,정상만 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.13 No.-
Background: Patients with coronary artery disease (CAD) often have multiple risk factors including hypertension, diabetes mellitus, smoking and hypercholesterolemia. However, these do not account for total development of coronary artery disease. It has been known that insulin resistance associated with hyperinsulinemia is closely linked with coronary artery disease. The hyperinsulinemia may accelerate the progression of coronary artery disease and inhibit the regression of atherosclerotic plaque. So we studied whether insulin resistance or hyperinsulinemia may be an independent risk factor of coronary artery disease. Methods: From January 2001 to May 2002, after excluding the patients with hypertension, diabetes mellitus, hypercholesterolemia and medication history that may affect the carbohydrate or lipid metabolism, 8 control subjects without chest pain symptom and normal ECG, 38 patients with typical chest pain and significant coronary artery stenosis and 6 patients with typical chest pain and angiographically insignificant stenosis or normal coronary artery (NCA) wereselected We evaluated the baseline clinical characteristics, oral glucose tolerance test with c-peptide, insulin and lipid profile. And then, we calculated the insulin sensitivity index. Results: 1. There were no significant differences in age, body mass index, systolic and diastolic blood pressure among three groups. 2. In NCA and CAD groups, serum cholesterol levels were higher than that of control group but statistically not significant. 3. In oral glucose tolerance test, the fasting plasma glucose levels were not significantly different among three groups. 4. There were significant differences between control and NCA, NCA and CAD in the area under the c-peptide curve. 5. The area under the insulin curve was significantly larger in NCA than that of control. 6. The insulin sensitivity index was significantly lower in CAD than that of control. Conclusion: There was significant difference in insulin sensitivity index between control and CAD. The increased insulin level and insulin resistance in target tissue may play a role in the genesis of atherosclerosis. However, to determine if insulin resistance could be an independent risk factor in coronary artery disease, prospective study in the larger patient population is warranted.