Methimazole-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in the Peripheral Nerves

강미일,김도희 대한갑상선학회 2018 International Journal of Thyroidology Vol.11 No.2

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis has been reported in Graves’ disease patients treated with antithyroid drugs (ATDs), especially propylthiouracil. ATD-induced ANCA-associated vasculitis usually involved the kidneys followed by the respiratory organs and skin. The treatment of ANCA-associated vasculitis induced by ATDs is to stop ATD therapy immediately, which often leads to an overall good prognosis. We report a case of ANCA-associated vasculitis in the peripheral nerves of the lower extremities in a 66-year-old woman who was treated with methimazole (MMI) for Graves’ disease. To our knowledge, this is the third case of peripheral nervous system (PNS) involvement of ATD-induced vasculitis and the first case of PNS vasculitis associated with MMI.

관상 동맥 경화증 환자에서의 혈청 지질 농도와 경동맥 내막두께와의 연관성

강미일,권택근,현대우,배장호,김원식 대한심장학회 2007 Korean Circulation Journal Vol.37 No.8

Background and Objectives:It's not clear whether the serum lipid level is associated with the individual carotid arterial wall thickness for patients suffering with coronary atherosclerosis, although hypercholesterolemia is associated with an increased carotid IMT. We sought to evaluate the association between the serum lipid level and the individual carotid arterial wall thickness (intimal thickness (IT) and medial thickness (MT)) as well as the carotid intima-media thickness (IMT) for patients with coronary atherosclerosis. Subjects and Methods:The carotid arterial wall thickness was measured using high-resolution B-mode ultrasound in 139 consecutive patients (58±11 years old, 75 males) with coronary atherosclerosis by performing coronary angiography. Results:Measurement of the individual arterial wall thickness was possible in 126 patients (90.6%) out of all the study subjects. The carotid IMT was correlated with the total cholesterol (r=0.207, p=0.015) and low-density lipoprotein (LDL) cholesterol (r=0.237, p=0.006). The carotid IT was correlated with the total cholesterol (r=0.210, p=0.020), triglyceride (r=0.212, p=0.018), and LDL-cholesterol (r=0.246, p=0.006), whereas the MT did not show any significant correlation with the serum lipid level. Multivariate analysis disclosed that the serum LDL cholesterol level was associated with the carotid IMT and IT for the patients with coronary atherosclerosis, but it was not correlated with the MT. Conclusion:This study suggests that the serum LDL cholesterol level is more closely associated with the carotid IT than the IMT for patients with coronary atherosclerosis, and each carotid arterial wall has a different response to the serum lipid level. (Korean Circulation J 2007;37:380-384) 배경 및 목적:죽상동맥 경화증의 위험 요인중 하나인 고지혈증과 경동맥 내중막 두께의 상관성은 이미 잘 알려져 있다. 본 연구는 이미 죽상 동맥 경화증의 하나인 관상 동맥 경화증이 있는 환자에서도 혈청 지질과 경동맥 내중막 두께와의 연관성이 있는지 알아보고, 경동맥의 내막, 중막과 내중막 두께에 대한 혈청 지질의 영향을 알아보고자 하였다.방 법:관상 동맥 조영술에서 관상동맥 경화증이 증명된 연속적인 139명의 환자를 대상(평균 58세, 안정형 협심증 78명, 급성관동맥증후군 32명, 기타 심장질환 29명)으로 하였다. 대상 환자에서 고혈압 67명, 당뇨병 27명, 흡연력 41명과 고지혈증 50명이 관찰되었다. 경동맥 내중막과 내막과 중막 두께의 분리 측정을 위해서 본원과 한국표준과학연구원이 공동 개발한 새로운 software를 이용하여 반자동화 측정법을 이용해서 측정하였다. 결 과: 경동맥 내중막 두께는 총콜레스테롤(r=0.207, p=0.015)과 저밀도 지단백 콜레스테롤(r=0.237, p=0.006)과 상관성이 있었고 경동맥 내막두께는 총콜레스테롤(r=0.210, p=0.020), 중성지방(r=0.212, p=0.018), 그리고 저밀도 지단백 콜레스테롤(r=0.246, p=0.006)과 상관성이 있었으나 경동맥 중막두께는 혈중 지질 농도 어느 것과도 상관성이 없었다. 다변수 분석을 통해서 저밀도 지단백 콜레스테롤이 관상동맥질환을 가진 환자에 있어서 내막(β=0.200, p=0.031)과 내중막(β=0.237, p=0.006)의 두께에 영향을 끼치는 인자가 될 수 있으나 경동맥 중막 두께와는 상관 관계가 없었다. 결 론: 관상동맥 질환이 있을 때에도 혈중 저밀도 지단백 콜레스테롤 농도에 따른 경동맥 내중막 두께의 차이가 있으며, 특히 경동맥 내막에 유의한 영향을 미친다.

불명열로 발현하여 진단된 비전형적 거대세포 동맥염 1예

강미일 ( Mi Il Kang ),박희진 ( Hee Jin Park ),전혜민 ( Hyae Min Jeon ),강윤 ( Yoon Kang ),이상원 ( Sang Won Lee ),이수곤 ( Soo Kon Lee ),박용범 ( Yong Beom Park ) 대한류마티스학회 2012 대한류마티스학회지 Vol.19 No.5

Two Cases of Refractory Thrombocytopenia in Systemic Lupus Erythematosus that Responded to Intravenous Low-Dose Cyclophosphamide

박희진,강미일,강윤,정수진,이상원,박용범,이수곤 대한의학회 2013 Journal of Korean medical science Vol.28 No.3

Treatment of thrombocytopenia in systemic lupus erythematosus (SLE) is considered in cases of current bleeding, severe bruising, or a platelet count below 50,000/μL. Corticosteroid is the first choice of medication for inducing remission, and immunosuppressive agents can be added when thrombocytopenia is refractory to corticosteroid or recurs despite it. We presented two SLE patients with thrombocytopenia who successfully induced remission after intravenous administration of low-dose cyclophosphamide (CYC) (500 mg fixed dose, biweekly for 3 months), followed by azathioprine (AZA) or mycophenolate mofetil (MMF). Both patients developed severe thrombocytopenia in SLE that did not respond to pulsed methylprednisolone therapy, and started the intravenous low-dose CYC therapy. In case 1, the platelet count increased to 50,000/μL after the first CYC infusion, and remission was maintained with low dose prednisolone and AZA. The case 2 achieved remission after three cycles of CYC, and the remission continued with low dose prednisolone and MMF.

The Expression of Immunomodulation-Related Cytokines and Genes of Adipose- and Bone Marrow-Derived Human Mesenchymal Stromal Cells from Early to Late Passages

문진희,강미일,신용대,김예슬,박용범 한국조직공학과 재생의학회 2018 조직공학과 재생의학 Vol.15 No.6

BACKGROUND: Mesenchymal stromal cells (MSCs) are multipotent stem cells that can differentiate into several cell types. In addition, many studies have shown that MSCs modulate the immune response. However, little information is currently available regarding the maintenance of immunomodulatory characteristics of MSCs through passages. Therefore, we investigated and compared cytokine and gene expression levels from adipose (AD) and bone marrow (BM)-derived MSCs relevant to immune modulation from early to late passages. METHODS: MSC immunophenotype, growth characteristics, cytokine expressions, and gene expressions were analyzed. RESULTS: AD-MSCs and BM-MSCs had similar cell morphologies and surface marker expressions from passage 4 to passage 10. Cytokines secreted by AD-MSCs and BM-MSCs were similar from early to late passages. AD-MSCs and BMMSCs showed similar immunomodulatory properties in terms of cytokine secretion levels. However, the gene expressions of tumor necrosis factor-stimulated gene (TSG)-6 and human leukocyte antigen (HLA)-G were decreased and gene expressions of galectin-1 and -3 were increased in both AD- and BM-MSCs with repeated passages. CONCLUSION: Our study showed that the immunophenotype and expression of immunomodulation-related cytokines of AD-MSCs and BM-MSCs immunomodulation through the passages were not significantly different, even though the gene expressions of both MSCs were different.

A Case of Neck Abscess Caused by Salmonella Serotype D in a Patient with Liver Cirrhosis

권미혜,강미일,천지영,임현우,염윤식,강영우,김영근,김영진 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.1

Non-typhoidal salmonellosis, which is increasing nowadays in Korea as well as in the developed countries, is manifested as enteritis in most cases, but it also encompasses bacteremia, intraabdominal infections, and bone, joint and soft tissue infections. These rare diseases are known to result from primary gastrointestinal infection and subsequent bacteremia with or without symptoms. We experienced a case of neck abscess caused by Salmonella serotype D, which is a rare but important differential diagnosis of neck abscess. We herein report it.

Sweet’s Syndrome Associated with Graves’ Disease

용호진,강미일,김도희 대한갑상선학회 2017 International Journal of Thyroidology Vol.10 No.1

Sweet’s syndrome, or acute febrile neutrophilic dermatosis, occurs in association with autoimmune diseases such as Hashimoto’s thyroiditis but is rare in Graves’ disease, in which all cases are induced by propylthiouracil (PTU). We report a case of Sweet’s syndrome in a patient with Graves’ disease treated with methimazole (MMI) during three weeks. A 34-year-old man presented with the acute onset of high fever, skin rashes on the whole body, arthralgia, and acroparesthesia. Laboratory results showed leukocytosis and elevated C-reactive protein. MMI first stopped and antibiotics and antihistamine therapy started, but his symptoms dramatically improved after oral prednisolone. Graves’ disease has again been treated by MMI because of his aggravated ophthalmopathy. After one year of retreatment with MMI, there has been no recurrence of Sweet’s syndrome, supporting that Sweet’s syndrome in this case was not related to MMI exposure. To our knowledge, this is the first report of Sweet’s syndrome associated with Graves’ disease per se but not PTU or MMI use.

난치삼차신경통 단독으로 발현한 면역글로불린 G4 연관질환

진상협,이성은,강미일,김지현 대한신경과학회 2018 대한신경과학회지 Vol.36 No.3

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated systemic condition affecting diverse organs which lately has been increasingly recognized. A 40-year-old male presents intractable trigeminal neuralgia lasting more than a year even with numerous pain medication, which lead further evaluation. The infiltrative lesion was found involving left pterygopalatine fossa where maxillary nerve locates. We report a case of IgG4-RD with a sole manifestation of intractable unilateral trigeminal neuralgia which was improved by steroid treatment.

충수돌기의 궤양에서 발생한 급성 하부 소화관 출혈 1예

임대승,김선문,강미일,김용석,정승현,김용문,이태희,임의혁,허규찬,최용우,강영우,고대경 대한소화기내시경학회 2007 Clinical Endoscopy Vol.35 No.1

The common causes of acute lower gastrointestinal bleeding include diverticulosis, colonic vascular ectasia, neoplasm and colitis. Acute lower gastrointestinal bleeding from the appendix is a very rare malady and the causes are reported as angiodysplasia, diverticulum, appendicitis and endometriosis. We report here on the case of a 47-year-old man, who was taking enteric coated aspirin, with severe lower gastrointestinal bleeding that was due to appendiceal ulcer. An active bleeding was identified as coming from the appendiceal orifice during colonoscopy. He was treated by simple appendectomy. Histologic evaluation showed ulceration with both acute and chronic inflammation, along with thickened vessel walls in the submucosa of the appendix. (Korean J Gastrointest Endosc 2007;35:42-45) 하부 위장관 출혈의 가장 흔한 원인은 게실증이고 혈관이형성, 종양, 궤양과 염증 등도 하부 위장관 출혈의 원인이 될 수 있다. 하부 위장관 출혈이 충수돌기에서 발생하는 경우는 매우 드물며, 혈관이형성과 게실, 충수염, 충수의 자궁내막증이 보고되어 있다. 저자들은 아스피린을 복용 중이던 47세 남자 환자가 신선 혈변을 주소로 내원하여 시행한 대장 내시경검사에서 충수돌기에서 발생한 활동성 출혈을 확인한 후 수술을 시행하여 치료한 1예를 경험하여 문헌고찰과 함께 보고한다.

신장 파열과 생식샘 동맥 출혈로 나타난 ANCA 연관 혈관염 1 예

최윤조,김도형,강미일,김소미 대한내과학회 2022 대한내과학회 추계학술대회 Vol.2022 No.2