IgA 신병증의 임상 및 병리학적 고찰

이강욱,최영환,신영태,노흥규,서광선 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1

Twenty eight cases of primary IgA nephropathy were diagnosed and studied in the Department of Internal Medicine, Chungnam National University Hospital over a period of 49 months from June 1981 to July 1985. The results were summerized as follows: 1. These cases represented 45.2% of patients with primary glomerular diseases undergoing renal biopsy and immunofluorescent studies during the same period. 2. There were 20 males and 8 females. They were 15 to 54 years old and the average age was 29.1. 3. The main symptoms were loin pain, gross hematuria, myalgia, fatigability and generalized edema in 18, 15, 12, 12, and 4 cases, respectively. Upper respiratory tract infection symptoms were presented in 50% of the cases of all patient just before and during the course of disease. 4. Proteinuria was observed in 27 cases and hematuria was seen in 23 cases, Among hematuria, the gross hematuria was observed in 15 cases. Hypoalbuminemia and hypercholesterolemia was presented in 4 cases with generalized edema. Serum BUN and creatinine were elevated in 3 cases with marked decreased Creatinine Clearence in 3 cases (Ccr<50ml/min). 5. The light microscopic findings showed mainly mesangial proliferative glomerulonephritis and focal and segmental glomerular sclerosis in 11 and 7 cases, respectively. Immunofluorescent microscopic findings disclosed diffuse mesangial deposit of IgA in all cases. IgG, igM, C3 and fibrinogen deposits were observed in mesangium in 5, 4, 20, and 7 cases, respectively.

과립구감소증의 발열환자에 대한 Teicoplanin을 포함하는 제 2선 경험적 항생요법

이강욱,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Background and Purpose : In recent years, the frequency of isolation of Gram-positive organisms, including coagulase negative Staphylococci and Streptococci, is increasing in neutropenic febrile patients. So, it seems reasonable to expect that at least a sub-population of these patients might benefit from the addition of a glycopeptide to the standard empiric regimen. Teicoplanin is a new glycopeptide with comparable activity to vancomycin, which needs be given only once daily. We therefore conducted a study to evaluate the efficacy and safety of teicoplanin as a second-line empiric therapy in neutropenic febrile patients. Patients and Methods : Neutropenic patients were given a empiric antibiotic regimen consisting of cephalosporin, aminoglycoside, and antipseudomonal penicillin when a significant febrile episode occurred. In cases of no clinical improvement after 72 hours of this therapy, cephalosporin was replaced with teicoplanin. Teicoplanin was administered initially 400mg intravenously at 12 hour-interval 2 times and then once daily. Results : 17 neutropenic febrile patients who did not respond to first line empiric antibiotic therapy were enrolled in this study. Infections were documented clinically or microbiologically in 10 of 15 assessable cases(67%). Infection sites were bacteremia in 4 cases, chest 1, Hickman catheter 2, and others 4. Staphylococcus epidermidis was the most frequently isolated organism(5/9, 56%). The others included Staphylococcus hemolyticus(11 %), Streptococcus group A(11%), Pseudomonas species(11%), and Candida tropicalis(11%). In 6 of 9 cases with microbiologically documented infection, causative organisms were eradicated with teicoplanin rescue(response rate 67%). 11 of 15 evaluable patients were cured clinically (response rate 73%). 2 patients were cured after the addition of amphotericin B and 2 patients died of infection (failure rate 13%). Mild elevations of liver enzymes were observed in 3 cases. The relationship of these abnormalities to teicoplanin was uncertain due to concurrent use of anticancer and/or antifungal agents. Any other toxicities requiring cessation of teicoplanin rescue were not observed. Conclusions : These results show that a large proportion of febrile episodes in neutropenic patients is related to infection caused by Gram positive organisms and that teicoplanin has high efficacy in the management of febrile episodes in neutropenic patients without significant toxicity.

각종 갑상선질환에서 혈청 유리 T_3의 진단적 의의

노흥규,이강욱,이종화 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

To estimate the diagnostic significance of serum free T_3 in various thyroid diseases, the serum levels of free T_3, T_3, `ree T_4, T_4 and TSH were measured by radioimmunoassay method in 43 cases of euthyroid thyroid diseases, 19 cases of hyperthyroidism, 2 cases of primary hylothdism and 10 cases of normal subjects as controls at the Dept. of Internal Medicine, CNUH, since January to July, 1984. The diagnostic sensitivity and specificity of each hormone level were calculated according to the clinical diagnosis of the cases. The results were as follow; 1. The serum levels of thyroid hormones in normal controls were; free T_3 : 6.68±2.1 pmol/ml, T_3: 1.24±0.49 ng ml, free T4: 1.27±0.38 ng/dl, T_4, : 7.80±2.04 ug/dl and TSH :1.87±0.9uU/ml(M±2SD). 2. The diagnostic sensitivity of hyperthyroidism was 100% in serum T_3, free T_4 and T_4 , 84% in _fT_3 but the specificity was 93% in _fT_3, 92% in _fT_4. 3. The diagnose c sensitivity was highest as 86% in _fT_3 and _fT_4 while the specificity was 100% in _fT_4, 80% in _fT_3. With the above results, it can be concluded that measurement of serum _fT_4, and _fT_3 levels is the most specific and sensitive measure in diagnosing the hyperthyroidism and euthyroid thyroid diseases.

괴사후성과 비괴사후성 간경변증에서 원인별 주석교질 (^99mTc-tin colloid) 간스캔의 차이

이헌영,허승식,이강욱,정현용,김삼용,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

The differences of the liver scintigraphic features between postnecrotic and nonpostnecrotic liver cirrhosis were studied for 69 patients. Degrees of mottling and splenomegaly were no different between two groups but shrinked form was more frequent finding in postnecrotic type(23:10), and normal shape & enlarged left lobe with shrinked right lobe were relatively dominant in non-postnecrotic group(15:6, 10:2). Grade of extrahepatic uptake of ^99mTc-tin colloid was significantly higher in Child-Pugh B & C group than A group(p<0.05), but there was no difference between postnecrotic and non-postnecrotic groups. These will be important results on the dicision for the presence of cirrhosis according to the variable causes.

전신성 홍반성 낭창의 임상적 고찰

신영태,이정호,신승훈,이강욱 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

To elucidate the clinical feature and clinicopathologic correlation of systemic lupus erythematosus(SLE), the authors analized symptoms and signs, laboratory findings and kidney pathology in 25 patients with SLE who were admitted to the Department of Internal Medicine, Chungnam National University Hospital from My 1985 to October 1989. Kidny biopsy was performed in 15 patients out of 19 patients who showed lupus nephritis. The results were as follows: 1. The ratio of male of females was 1:11.5. They were 14 to 53 years old and mean age was 30.2 years old. The peak age incidence was 3rd and 4th decades. 2. The most frequent chief complaint on admission was fever and chills. Most patients had two or more symptoms such as arthralgia, malar rash, generalized edema or weakness. 3. In 84% of the patients, duration from onset of the disease to diagnosis of SLE was longer than 1 month, which suggested that diagnosis of SLE is not easy in early stage of SLE. 4. The positive anti -DNA was the most frequently observed ARA criteria of SLE. And positive ANA, malar rash, persistent proteinuria, leukopenia, positive LE cell preparation, arthritis and oral ulcer were observed in order of frequency. 5. The frequent and pertinent general symptoms, not included in ARA criteria were fever and chills, arthralgia and abdominal pain which were observed in more than half of the patients. 6. On immunologic test, serum concentrations of C3 and C4 were decreased in 96% of the patients, serum concentration of Ig G, Ig A were increased in 65%, 36.8% and 26.3% of the patients respectively. The RA test was positive in 25% of the patients. 7. Lupus nephritis represented 76% of all SLE patients and pathological classification on 15 patients with lupus nephritis revealed class IV lupus nephritis in 9 patients(60%), class II n 3 patients (21%), class V in 2 patients(13.3%) and class III in 1 patient. 8. 7 out of 9 patients with class IV lupus nephritis and 1 out of 2 patients with class V lupus nephritis showed nephrotic syndrome. Progressive azotemia were observed in 3 out of 9 patient with class IV lupus nephritis and in 1 out of 2 patients with class V lupus nephritis. There were no nephrotic syndroms or azotemia in class II and class III lupus nephritis. 9. Of 17 patients who can be followed up, 9 patients were improved, 5 patients became progressive azotemia and 3 patients resulted in death. The causes of death were myocarditis with pericarditis in 1 patients, pneumonia with acute respiratory failure in 1 patient and CNS involvement of SLE in 1 patient.

급성신우신염의 임상적 고찰

신영태,신승훈,이순구,이정호,이강욱 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

A clinical retrospective study was undertaken in 81 patients with acute pyelonephritis admitted to the Department of Internal Medicine, Chungnam National University Hospital from January 1983 to December 1989. The results were as follows : 1. Total number of patients studied was 81(M/F ratio, 1 : 4.4). The M/F ratio of 22 complicated patients (27.2%) was 1 : 2.7 2. The predisposing factors associated with complicated patients were as follows : 7 cases of urinary tract stone, 7 cases of pregnancy, 4 cases of neurogenic bladder and each one case of prostatic hypertrophy, ureter cancer, bladder diverticulum and polycystic kidney disease. 3. The common subjective symptoms on admission were fever and chills, frank pain, nausea and vomiting. High body temperature and CVA tenderness were noted in 61% and 95% of patients respectively. And 50.6% of patients revealed right CVA tenderness and 28.4% in left, 16% in both respectively. There was no difference in symptoms and signs between complicated and uncomplicated groups 4. In 50 patients(61.7%) microorganisms were isolated on the urine culture specimens. The most common organism was E. coli(80%), and followed by Staphylococcus aureus and Serratia odorifera. E coli was the most frequent pathogen in both female and male patients, and in complicated and uncomplicated groups. (In sensitivity test of complicated and uncomplicated groups). In sensitivity test of causative pathogens to antibiotics, E coli was sensitive to amikacin(93%), tobramycin(83.3%) and gentamycin(79.4%) and 88.9 percent of E coli were ressistant to ampicillin 5. In urinary examination on admission, pyuria was noted in 81% of patients, and proteinuria and microscopic hematuria were noted in 68% and 44% of patients respectively. 6. Within 3 days after antibiotics treatment deference was occured in 73.5% of total patients, and complicated patients revealed delayed defeverence compared to uncomplicated ones.

폐경기 여성에서의 Cyclofenil의 효능에 관한 연구 : 갱년기 장애 및 Ca 장흡수에 관하여

노흥규,윤상임,성기양,이경숙,이강욱 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

In postmenopausal syndrome, most common symptoms are those of vasomotor irritability such as hot flush and palpitation, irritable bladder symptoms and dyspareunia according to atrophy of urogenital epithelium, anxiety, nervousness, depression and insomnia. Approximately 40 percent of women in postmenopausal period develop symptoms serious enough to seek medical assistance. Among non-steroid agents, cyclofenil(4, 4' cyclohexidene methlyene diphenoacetate) is known to be a quite interesting substance according to the action at the level of the hypophyseal and hypothalamic centers by reducing the incretion of FSH and restoring normal endorphin, dopamine and norepinephrine activities, thus favorably affecting the whole postmenpausal neurovegutative symptomatology. In order to evaluate effect of cyclofenil on postmenopausal symptomatology and calcium metabolism, we examined 32 patients with postmenopausal syndrome before and after 200mg/day of oral cyclofenil treatment for 30-60 days. The results were as follows: 1. With 30 days of cyclofenil administration, subjective symptoms such as facial flush, palpitation, anxiety, nervousness and dyspareunia were improved significantly (p<0.001, p<0.001, p<0.01, p<0.005, respectively). But insomnia and depression were improved significantly after 60 days of cyclofenil administration (p<0.05, p<0.001, respectively). 2. Intestinal calcium absorption rate disclosed tendency of improvement without statistical significance 30 days after cyclofenil treatment. 3. Serum calcium and phosphorus level were not changed significantly before and after cyclofenil. 4. There was no definite evidence of side effects such as uterine bleeding due to cyclofenil. In conclusion, we thought that cycofenil is effective in management of postmenopausal syndrome but for the effect on calcium metabolism, further evaluation should be needed.

Indicatory Sign Recognition Using A New Morphological Shape Matching Algorithm

Gang Yi Jiang,Heo Jin Kim,Tae Young Choi 대한전기학회 1996 Journal of Electical Engineering and information S Vol.1 No.3

On Color Morphology

Gang Yi Jiang,Tae Young Choi 한국정보과학회 1998 Journal of Electrical Engineering and Information Vol.3 No.4

In this paper, a new color morphology for color image processing is proposed as an extension of gray-scale morphology, in which a vector norm is used as a measure of magnitude of a color vector. Some properties of color morphological operations are analyzed and discussed in relation with gray-scale morphology. Experimently compared the performances of noise filterings and edge detections for several color and gray-scale morphological operations. As results of noise filterings. the basic dual color morphological operations of erosion and dilation are slightly better than the corresponding separate gray-scale morphological operations, while the other color morphological filters (CMFs) are very similar to the corresponding separate gray-scale morphological filters (SGMFs) with respect to the peak signal to noise ratio (PSNR). And in edge detection, the CMFs show better performances than both SGMFs and the conventional top hat transform of gray image.

On Color Morphology

Gang Yi Jiang,Tae Young Choi 대한전기학회 1998 Journal of Electical Engineering and information S Vol.3 No.4