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사례보고 : 간문맥혈전증을 동반한 특발성 문맥고혈압 환자에서 Protein C, Protein S 결핍 1예
황세나 ( Se Na Hwang ),김도영 ( Do Young Kim ),김민주 ( Min Ju Kim ),전영은 ( Young Eun Chon ),이현정 ( Hyun Jung Lee ),박영년 ( Young Nyun Park ),박준용 ( Jun Yong Park ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),전재윤 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.2
Portal vein thrombosis (PVT) is an uncommon cause of presinusoidal portal hypertension. Among various hepatoportal disorders, noncirrhotic portal hypertension conditions such as idiopathic portal hypertension (IPH) are considered to have a close relation with PVT. PVT is known to have several predisposing conditions, including infection, malignancies, and coagulation disorders. There is growing interest and recognition that deficiencies in proteins C and S are associated with a hypercoagulable state. These deficiencies are regarded as key factors of systemic hypercoagulability and recurrent venous thromboembolism. We report the case of a 19-year-old male diagnosed as IPH with PVT and combined deficiencies in proteins C and S.
급성 췌장염 환자에서 CT Serverity Index의 의의
황호,안인옥,김영미,나재범,전세준,정성훈,유진종,송익훈,Hwang, Ho,Ahn, In-Oak,Kim, Young-Mi,Na, Jae-Boem,Jun, Se-June,Chung, Sung-Hoon,You, Jin-Jong,Song, Ik-Hoon 대한영상의학회 1997 대한영상의학회지 Vol.36 No.2
Purpose : To assess the usefulness of a CT severity index(CTSI) for the evaluation of acute pancreatitis and correlate it with clinical findings. Materials and Methods : We retropectively evaluated contrast enhanced CT in 34 patients with acute pancreatitis. They were categorized into low-score(0-2), middle-score(3-6), and high-score(7-10) groups according to CTSI points, and those groups were correlated with duration of fasting period, days in hospital morbidity and mortality. We attempted to determine the differences in CTSI between pancreatitis caused by alcohol and by biliary tract disease.Results : Of 34 patients, 11 were placed in the low-score group, 19 in the middle-score group, and 4 in the high-score group. The patients in the middle-score group experienced longer fasting period and stayed longer in hospital than those in the low-score group(p<.05 and p=.08, respectively). Morbidity was 0% in the low-score group, 37% in the middle-score group and 50% in the high-score group. Mortality occurred in two patients in high-score group, only. Alcohol-induced pancreatitis generally showed a higher CTSI and more severe clinical course than pancreatitis caused by biliary tract disease. Conclusion : In the evaluation of acute pancreatitis, CTSI can be a useful predictor of its prognosis.
TSH 분비 뇌하수체 선종 환자들의 임상적, 생화학적 특징과 치료
이우경 ( Woo Kyung Lee ),황세나 ( Se Na Hwang ),임정수 ( Jung Soo Lim ),김현민 ( Hyun Min Kim ),이은영 ( Eun Young Lee ),이상국 ( Sang Kook Lee ),김선호 ( Sun Ho Kim ),이은직 ( Eun Jig Lee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1
Background/Aims: Thyrotropin (TSH)-secreting pituitary adenoma (TSHoma) is rare and represents 1~2% of all pituitary adenomas. TSHoma should be distinguished from the thyroid hormone resistance syndrome. Patients with TSHoma may be misdiagnosed with primary hyperthyroidism and often receive inappropriate thyroid gland treatment. Methods: We assessed the clinical characteristics of patients with TSHoma who presented to Severance Hospital at the Yonsei University College of Medicine, Seoul, Korea between 2005 and 2009. Results: Of 484 patients who underwent pituitary tumor resection, eight (1.65%; five women and three men) were found to have TSHoma. The mean age was 40.6±8.9 years at diagnosis (range, 28~55 years). The median duration from onset of symptoms to diagnosis was 17 months (range, 4~60 months). Four patients had overt symptoms of hyperthyroidism and two had visual field defect. Six patients had elevated free thyroxine (FT4) levels with elevated or inappropriately normal TSH levels, and two patients had symptoms associated with Hashimoto`s thyroiditis. The serum levels of free α-subunit measured in two patients were elevated. Six of the tumors were macroadenomas (>10 mm) and two were microadenomas. Complete tumor removal was achieved in all patients. Five patients had preoperative anterior pituitary dysfunction; three patients recovered from this after surgery. Three patients were lost to follow up and five patients showed no evidence of recurrence or hyperthyroidism in the follow-up period (mean, 30.8 months, range, 3~57). Conclusions: Early diagnosis and complete removal of the tumor mass may improve the neurological and endocrine deficits. (Korean J Med 2011;80:47-55)
급성 담낭염으로 발현한 Churg-Strauss 증후군 1예
이우주 ( Woo Joo Lee ),황지원 ( Ji Won Hwang ),김은 ( Eun Kim ),윤세효 ( Se Hyo Yune ),하정민 ( Jung Min Ha ),윤나라 ( Na Ra Yoon ),이병재 ( Byung Jae Lee ),최동철 ( Dong Chull Choi ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4
Churg-Strauss syndrome (CSS) is a rare systemic vasculitis. It is characterized by peripheral eosinophilia, asthma, neuropathy, skin manifestation, and less frequently gastrointestinal tract symptoms. Here we report a case of CSS which is initially manifested as acute acalculous cholecystitis. A 67-year-old asthmatic woman visited Emergency Room because of acute abdominal pain. Computed tomography showed acalculous cholecystitis and laparoscopic cholecystectomy was done. Pathology of gallbladder showed marked eosinophilic infiltration with necrotizing vasculitis and granuloma. On the basis of asthma, sinusitis, lung infiltration, combined peripheral eosinophilia and neuropathy, the patient was diagnosed as CSS. To our knowledge, this is the first case of pathologically proven eosinophilic cholecystitis in Korea. (Allergy Asthma Respir Dis 2013;1:388-390)
급성 담낭염으로 발현한 Churg-Strauss 증후군 1예
이우주 ( Woo Joo Lee ),황지원 ( Ji Won Hwang ),김은 ( Eun Kim ),윤세효 ( Se Hyo Yune ),하정민 ( Jung Min Ha ),윤나라 ( Na Ra Yoon ),이병재 ( Byung Jae Lee ),최동철 ( Dong Chull Choi ) 대한천식알레르기학회(구 대한알레르기학회) 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4
Churg-Strauss syndrome (CSS) is a rare systemic vasculitis. It is characterized by peripheral eosinophilia, asthma, neuropathy, skin manifestation, and less frequently gastrointestinal tract symptoms. Here we report a case of CSS which is initially manifested as acute acalculous cholecystitis. A 67-year-old asthmatic woman visited Emergency Room because of acute abdominal pain. Computed tomography showed acalculous cholecystitis and laparoscopic cholecystectomy was done. Pathology of gallbladder showed marked eosinophilic infiltration with necrotizing vasculitis and granuloma. On the basis of asthma, sinusitis, lung infiltration, combined peripheral eosinophilia and neuropathy, the patient was diagnosed as CSS. To our knowledge, this is the first case of pathologically proven eosinophilic cholecystitis in Korea.
송준창 ( Joon Chang Song ),황현석 ( Hyeon Seok Hwang ),형복진 ( Bok Jin Hyoung ),이소영 ( So Young Lee ),전연주 ( Yeon Joo Jeon ),장세나 ( Se Na Chang ),윤혜은 ( Hye Eun Yoon ),최범순 ( Bum Soon Choi ),김용수 ( Yong Soo Kim ),양 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1
After renal transplantation, we are more likely to encounter hyperkalemia rather than hypokalemia. We report a case of kidney transplantation recipient with hypokalemia and hypertension secondary to primary aldosteronism. A 48 year-old woman was presented with fatigue and weight loss that had lasted for 3 months. She was diagnosed as autosomal dominant polycystic kidney disease that ultimately progressed to end-stage renal disease. She was operated for renal transplantation before 6 months. She had hypokalemia and hypertension at that time. The ratio of plasma aldosterone over plasma renin activity was 851.7. The computed tomography (CT) revealed 2.4×1.7 cm sized adrenal mass on the right side. The pre-transplantation CT also showed that there had been adrenal mass in the same location even before the transplantation. Right adrenalectomy was performed. After she got discharged, she was again presented with nausea and vomiting. She developed hyperkalemia and was diagnosed as hyporeninemic hypoaldosteronism. She was prescribed with fludrocortisones and recovered from the disease, and resumed the state of normokalemia and normotension.
김형욱 ( Hyung Wook Kim ),김영옥 ( Young Ok Kim ),윤선애 ( Sun Ae Yoon ),황현석 ( Hyeon Seok Hwang ),장세나 ( Se Na Jang ),박미연 ( Mi Youn Park ),윤혜은 ( Hye Ene You ),유기동 ( Ki Dong Yoo ),김용수 ( Yong Soo Kim ),김영수 ( Youn 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1
목적: 심혈관계 질환은 말기 신부전 환자에서 가장 흔한 사망 원인으로, 전체의 33.7%를 차지하며, 이 중 27%가 급성 심근 경색증에 의한 것으로 보고되었다. 투석 환자에서 급성 심근 경색증의 중요성에도 불구하고 투석 환자에서 발생한 급성 심근 경색증의 임상적 특징에 대한 연구는 많지 않다. 방법: 본 연구는 2004년 1월부터 2007년 12월까지 급성 심근 경색증으로 입원한 투석 환자 32명을 대상으로 하였으며 대상 환자와 연령 및 성별이 유사한 급성 심근 경색 환자 123명을 비투석군으로 정하였다. 본 연구는 투석 환자와 비투석군에서 급성 심근 경색증의 임상적 특징을 비교하기 위해 임상소견 및 검사실 소견을 후향적으로 조사하였다. 결과: 투석환자는 비투석군에 비해 전형적인 흉통의 빈도가 낮고 (18.8% vs. 62.6%, p<0.001), 심전도에서 전형적인 STEMI의 빈도가 낮았다 (28.1% vs. 82.9%, p<0.001). 또한 심근 손상을 반영하는 CPK, CK-MB, Troponin T의 상승 정도가 비투석군에 비해 유의하게 낮았다 (p<0.001). 그러나 이와는 반대로 심혈관 조영술 검사 결과, 다혈관 관상동맥 질환의 비율이 높았고 (63.0% vs. 43.3%, p=0.045), 좌심실비대가 심하였으며 (78.9±20.9 g/m2.7 vs. 61.0±15.8 g/m2.7, p<0.001), 입원 사망률이 유의하게 높았다 (25.0% vs. 5.7%, p=0.003). 결론: 본 연구결과 투석환자는 일반인에 비해 심근 경색증의 전형적인 임상증세나 심전도 소견을 보이지 않고, 낮은 심근 손상 효소 수준을 보이나 오히려 관상동맥 병변이 더 심하고 사망률도 높았다. 그리므로 호흡곤란 등의 비특이적인 임상증세를 호소하는 투석환자에서 심근경색증을 조기에 진단하려는 적극적인 노력이 필요할 것으로 사료된다. Purpose: Cardiovascular disease is the predominant cause of death in patients with end stage renal disease. Approximately 33.7% of overall mortality is due to cardiovascular disease, and about 27% of these cardiovascular deaths are attributed to acute myocardial infarction (AMI). Despite the significance of AMI, there are little data on the clinical characteristics of AMI in dialysis patients. Methods: Thirty-two dialysis patients admitted for AMI from January 2004 to December 2007 were retrospectively analyzed. One hundred twenty-three AMI patients were included as a control. The clinical and laboratory findings of AMI were compared between dialysis patients and non-dialysis patients. Results: The frequency of typical chest pain was significantly lower in dialysis patients than in non-dialysis patients (18.8% vs. 62.6%, p<0.001), and typical ECG findings of STEMI were significantly less noted (28.1% vs. 82.9%, p<0.001). Increases in CPK, CK-MB, and troponin T levels were significantly lower in dialysis patients than in non-dialysis patients (p<0.001). In contrast, dialysis patients revealed more multi-vessel diseases on coronary angiography and more left ventricular hypertrophy and were associated with higher mortality during admission than non-dialysis patients. Conclusion: Although dialysis patients with AMI had less typical chest pain and typical ECG findings, and had lower increases in cardiac enzyme levels, they revealed more severe coronary vessel diseases than non-dialysis patients. Therefore, efforts for early and accurate diagnosis of AMI are needed in dialysis patients with nonspecific complaints of AMI.
헬리코박터 파이로리의 병원성 단백질, CagA에 대한 분자 독성학적 측면에서의 고찰
김병주(Byung J. Kim),정화진(Hwa Jin Jung),황지나(Jee Na Hwang),강석하(Seok Ha Kang),오세진(Se-Jin Oh),서영록(Young Rok Seo) 한국독성학회 2004 Toxicological Research Vol.20 No.3
Helicobacter pylori (H. pylori) infects more than half of the people in the world as a major<br/> microbe to cause most of gastric diseases. Recently, cytotoxin associated-antigen A (CagA) is believed as<br/> one of the most important virulence factors of H. pylori. Molecular toxicological pathway of CagA is necessary<br/> to investigate for understanding the pathological and toxicological aspects of H. pylori, since this virulence<br/> protein harasses intercellular processes of host cells to get profit for the survival of H. pylori. CagA is<br/> coded from cag pathogenicity island (cag PAI) and translocated into host cells by Type 4 secretion system<br/> (TFSS). Tyrosine phosphorylation of CagA targets Src homology 2-containing phosphotyrosine phosphatase<br/> (SHP-2) to form a CagA-SHP-2 complex. This complex depends on the similarity of sequence<br/> between EPIYA motif and Src homology 2 domain (SH2 domain) of CagA. The generation of growth factors<br/> is an essential role of CagA in protecting and healing gastric mucosa for the survival of H. pylori. On<br/> the other hand, the activation of IL-8 by CagA induces neutrophils generating inflammation and free radicals.<br/> Indeed, free radicals are well known carcinogen to induce DNA damage. In addition, the transduction<br/> of mitogen-activation signal by CagA is one of the interesting features to understand how to cause cancer.<br/> The relationship between cancer and inflammation with CagA was mainly discussed in this review.
차승주 ( Seung-ju Cha ),송영진 ( Young-jin Song ),김보미나라 ( Bo-mi-na-ra Kim ),권세희 ( Se-hee Kwan ),조한울 ( Han-ul Joh ),김민주 ( Min-ju Kim ),조마리아 ( Ma-ri-a Jo ),유영신 ( Young-sin Yu ),황신구 ( Sin-gu Hwang ),윤광일 ( Kwan 한국환경농학회 2022 한국환경농학회 학술대회집 Vol.2022 No.-
농약은 농작물이 잡초나 해충, 세균으로부터 받는 피해를 예방하고 농작물의 생산성 증진 등으로 농업에서 중요한 역할을 하는 농자재이다. 친환경 인증 농산물 외 일반 농산물은 허용기준 이내라도 농약이 잔류할 가능성이 있어 소비자들은 농산물 섭취 시 잔류농약 노출에 불안감을 갖고 있다. 이러한 불안감을 줄이기 위하여 과일에 잔류하는 농약을 효과적으로 제거하는 방법을 규명하기 위한 연구를 진행하였다. 본 실험은 친환경 사과를 처리구당 3개씩 3반복으로 나뉘어 살균제(Carbendazim, Trifloxystrobin), 살충제(Acetamiprid, Diflubenzuron)를 살포한 후, 7일 후에 무처리, 껍질 제거(제거), 물 세척(세척), 물 침지 후 세척(침지), 식초물 침지 후 세척(식초), 소다물 침지 후 세척(소다)의 방법으로 처리한 후 잔류농약을 분석하였다. 침지시간은 5분, 세척시간은 20초로 하였다. 잔류농약 분석을 위한 전처리는 균질화 된 시료 10 g을 50 mL 원심분리관에 칭량하여 Acetonitrile을 10 mL 주가한 후 1분간 진탕하고, 4 g MgSO<sub>4</sub>, 1g NaCl, 1g NaCitrate, 0.5 g Disodium citrate sesquihydrate를 첨가한 후 다시 1분간 균질기로 진탕한 다음 3,000 rpm/min으로 5분간 원심분리를 진행하였다. 상등액 1ml를 Dispersive SPE(25mg PSA, 150 mg MgSO4) tube에 넣고 1분간 진탕하고, 10,000 rpm에서 1분간 원심분리하여 상등액을 0.2 μm 시린지 필터로 여과하여 LC/MS/MS, GC/MS/MS 분석시액으로 사용하였다. 분석방법은 「농산물 잔류농약 다성분 분석방법」에 따라 4가지 농약성분을 분석하였다. 분석 결과 Carbendazim(살균제)은 무처리 대비 제거 88%>소다 72%>침지 64%>식초 61%>세척 55% 순으로 제거되는 결과를 나타냈다. Trifloxystrobin(살균제)은 제거 87%>소다 79%>식초 75%>세척 63%>침지 60% 순으로 제거되었다. Acetamiprid(살충제)는 무처리 대비 제거 91%>식초 63%>소다 59%>침지 50%>세척 47% 순으로 제거되는 결과를 나타냈다. Diflubenzuron(살충제)은 소다 87% >제거 80%>침지 78%>세척 76%>식초 67% 순으로 제거되었다. 4가지 성분 모두 껍질을 제거한 방법에서 잔류농약이 효과적으로 제거되었다. 세척에 따른 결과는 소다침지 후 세척이 Acetamiprid 외 3가지 농약에서 제거효과가 가장 좋았다. 농약성분 별로 처리방법에 따른 제거효과가 다른 결과에 대하여서는 추가적인 연구가 필요할 것으로 사료되었다.
궤양성 대장염에서 나타난 폐쇄성 세기관지염 기질화 폐렴
이현정 ( Hyun Jung Lee ),박병훈 ( Byung Hoon Park ),손지영 ( Ji Young Son ),정지예 ( Ji Ye Jung ),황세나 ( Se Na Hwang ),전영은 ( Young Eun Chon ),김은영 ( Eun Young Kim ),임주은 ( Ju Eun Lim ),이경종 ( Kyung Jong Lee ),윤여운 ( Y 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.3
The ulcerative colitis is a chronic inflammatory bowel disease with an unknown etiology. The major symptoms of ulcerative colitis are diarrhea, abdominal pain and hematochezia. However, arthritis, skin disorders, hepatobiliary inflammation and uveitis are occasionally recognized as systemic complications. Although there are few reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered to be a target organ in ulcerative colitis. We report a patient with ulcerative colitis-related bronchilolitis obliterans organizing pneumonia confirmed by video-assisted thoracoscopic surgery, who responded to corticosteroid therapy.