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류마티스관절염 환자에서 Bucillamine에 의한 신병증
김현아 ( Hyoun Ah Kim ),임현이 ( Hyun Ee Yim ),성준모 ( Jun Mo Sung ),이진우 ( Jin Woo Lee ),서창희 ( Chang Hee Suh ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.3
Objective: Bucillamine is a disease-modifying antirheumatic drug that`s widely used in Korea and Japan, and it is reported to be a cause of proteinuria. However, the clinical course of the nephropathy associated with the use of bucillamine in rheumatoid arthritis patients has not been described in detail in Korea. Methods: We examined clinical records of 835 patients who were treated with bucillamine for rheumatoid arthritis at least 2 months at Ajou University Hospital from 2003 to 2008, and we found 23 patients (2.75%) with proteinuria. Each patient was followed up until the proteinuria had resolved. Results: At the time the proteinuria developed, the mean age of patients was 53.8±11.0 years. Only one patient had marked hypoalbuminemia (<3.0g/dL). The mean value of the random urine protein-creatinine ratio was 3.44±2.99. The proteinuria appeared 4∼18 months after the initiation of the treatment with bucillamine. Among the patients, renal biopsy was carried out in 18 patients, and pathological findings were 17 cases of membranous glomerulopathy and 1 case of focal segmental glomerulosclerosis. On the follow-up of the 18 patients, the proteinuria in all the patients had resolved completely without deterioration of renal function. But the time to resolution of the proteinuria was positively correlated with the length of bucillamine treatment after the onset of proteinuria (p<0.001, r=0.744). Conclusion: Prevalence of proteinuria in patients receiving bucillamine was 2.75%, and bucillamine-induced nephropathy showed a good prognosis in Korea. The most important thing for resolving the bucillamine-induced proteinuria is to discontinue the bucillamine.
알레르기 환자에서 ImmunoCAP 시스템을 이용한 환삼덩굴 및 점박이응애항원에 대한 특이 IgE치 측정: 피부반응도 및 E L ISA 결과와의 비교
김현아 ( Hyoun Ah Kim ),예영민 ( Young Min Ye ),허규영 ( Gyu Young Hur ),김승현 ( Seung Hyun Kim ),서창희 ( Chang Hee Suh ),남동호 ( Dong Ho Nahm ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.2
Background and Objective: Japanese hop pollen (Hop J) and two spotted spider mite (TSM) are common allergens in this country. The aim of this study was to validate a new immunoCAP test for detecting allergen-specific IgE to Hop J and TSM compared to skin reactivity and ELISA results. Method: Ninty-five allergy patients showing more than 2+ response on skin prick test to Hop J, 131 allergy patients showing more than 2+ response on skin prick test to TSM and 60 non-atopic healthy controls were enrolled. Skin prick testing was performed using homemade Hop J pollen and TSM extracts. The specific IgE levels to both homemade allergens were measured by ELISA, which were compared to those of the immunoCAP system. Result: The positive rates of serum specific IgE to Hop J were 57% by ELISA and 51% by Pharmacia immunoCAP system among 95 patients tested. The positive rates of serum specific IgE to TSM were 28% by ELISA and 50% by immunoCAP system among 131 patients tested. A significant correlation was found in specific IgE level between ELISA and the immunoCAP system (r=0.63 for Hop J and r=0.61 for TSM, P<0.05). Conclusion: The new immunoCAP system for detecting serum specific IgE antibodies to Hop J pollen was comparable to the results of other in vivo and in vitro test and can be applied for the diagnosis of Hop J-allergic patients. New immunoCAP system to TSM was superior to the ELISA test, and can be used for screening TSM-sensitive patients. (Korean J Asthma Allergy Clin Immunol 2006;26:129-135)
이지현(Ji Hyoun Lee),김현아(Hyun Ah Kim),문병인(Byung In Moon),이령아(Ryung Ah Lee),성순희(Soon Hee Sung) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.2
Purpose: Granulomatous mastitis (GM), reported for the first time by Kessler and Wolloch in 1972, is a rare and benign inflammatory lesion of the breast. The etiology of GM is currently unknown, but some reports have suggested autoimmunity. The aim of this study was to evaluate the clinical characteristic, clinical presentations and radiological features of GM. Methods: A chart review was performed for 23 patients, with GM confirmed by a pathological examination, between July 1999 and December 2005. A retrospective review of the clinical and radiological finding, as well as the cytological results of the patients was undertaken. Results: The ages of these patients ranged between 29 and 74 years, with a mean of 39.7 years. The median follow-up was 8 months. Twenty patients (87%) presented with a mass as the chief complaint, with a median size of 2.56 cm (range 0.78∼6.5 ㎝). Eight patients (34.8%) had radiological findings suspicious of malignancy. Tuberculosis was diagnosed using Tb-PCR in 1 patient. Twenty-two of the 23 patients underwent a wide excision, and the one remaining patient underwent incision and drainage. One of 23 patients had a recurrent disease. Conclusion: GM is a rare breast disease, which clinically mimics cancer. As radiological imaging, such as mammography or ultrasonography, are unreliable in distinguishing GM from breast cancer, further special examinations, for example FNAB and gun biopsy, are necessary. The single most important differential diagnosis of GM is tuberculosis, especially in developing countries. We suggest that the evaluation for tuberculosis is essential for the differential diagnosis of GM using clinical and pathological methods.
장은정 ( Eun Jung Jang ),김현아 ( Hyoun Ah Kim ),성준모 ( Jun Mo Sung ),이진우 ( Jin Woo Lee ),황의경 ( Eui Kyung Hwang ),김효철 ( Hugh Chul Kim ),한재호 ( Jae Ho Han ),서창희 ( Chang Hee Suh ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.4
Dermatomyositis (DM) is a rare and idiopathic inflammatory myopathy with characteristic cutaneous manifestations. There is a well-recognized association between DM and cancers. In Korea, several DM cases have been reported to be associated with stomach cancer, breast cancer, acute lymphoblastic leukemia, lung cancer, and tonsil cancer. However, an association between DM and lymphoma in Korea has not been reported up to now. We report a case of DM who developed diffuse large B-cell lymphoma 1 year and 8 months later.
김현경 ( Hyun Kyung Kim ),김현아 ( Hyoun Ah Kim ),장은정 ( Eun Jung Jang ),서창희 ( Chang Hee Suh ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.2
Posterior reversible encephalopathy syndrome (PRES) has been described in various clinical settings, including severe hypertension, eclampsia, lupus and immunosuppressive therapy. We report a 27 year-old female systemic lupus erythematosus patient who developed severe headache, seizure and hemiparesis during her lupus nephritis flare. Magnetic resonance image (MRI) showed multi-focal high signal intensity lesions in the parieto-occipital cortex bilaterally and in the subcortical white matter. Her condition improved with immunosuppressive treatments, antihypertensives and hemodialysis. The extent of her lesions decreased on follow-up MRI 2 months later. This case suggests that PRES can be treated with immunosuppressive drugs that do not increase blood pressure.
만성담낭염으로 발현되고 류마티스성 다발성 근육통으로 오진된 아밀로이드증 1예
엄유진 ( Yoo Jin Um ),김현아 ( Hyoun Ah Kim ),정진희 ( Jin Hee Jung ),조헌도 ( Hundo Cho ),강준구 ( Joon Koo Kang ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.1
Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature. (Korean J Gastroenterol 2016;68:49-53)
전신홍반루푸스에 동반된 이차성 혈구포식성 림프조직구증 3예
임은수 ( Eunsoo Lim ),김영건 ( Young Geon Kim ),최원선 ( Won Sun Choi ),정유석 ( Yu Soek Jung ),한재호 ( Jae Ho Han ),배창범 ( Chang Bum Bae ),정주양 ( Ju Yang Jung ),김현아 ( Hyoun Ah Kim ),서창희 ( Chang Hee Suh ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.3
Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by fever, pancytopenia, hyperferritinemia, and phagocytosis of hematopoietic cells in bone marrow, liver, or lymph nodes. HLH can occur during the course of systemic lupus erythematosus (SLE), but can also be a presenting manifestation. Because development of pancytopenia occurs in less than 10 percent of SLE cases, investigation for HLH is necessary when otherwise unexplained pancytopenia persists despite adequate treatment. We experienced three cases of secondary HLH associated with SLE. Among the three patients, two patients developed HLH during the clinical course of SLE. The other patient who presented with pancytopenia was first diagnosed with HLH, and later with SLE. In her case, HLH turned out to be a presenting manifestation of SLE. We report on three successfully treated cases, and discuss the prevalence, characteristics, treatments, and prognosis of secondary HLH associated with SLE. (J Rheum Dis 2015;22:180-185)
아목시실린에 의한 약물 과민반응 16예의 임상적 특성과 혈청학적 검사의 의의
박한정 ( Han Jung Park ),허규영 ( Gyu Young Hur ),김현아 ( Hyoun Ah Kim ),최길순 ( Gil Soon Choi ),최성진 ( Sung Jin Choi ),박해심 ( Hae Sim Park ) 대한천식알레르기학회 2007 천식 및 알레르기 Vol.27 No.3
Background: Amoxicillin is one of the broad spectrum antibiotics and is widely used in the treatment of various infective diseases. There are various forms of amoxicillin-induced hypersensitivity reactions including urticaria/angioedema, erythema multiforme and anaphylaxis. Objective: To observe the clinical features and evaluate the significance of in vitro testing of amoxicilin-induced hypersensitivity reactions. Method: We retrospectively reviewed medical records of patients diagnosed as having amoxicillin-induced hypersensitivity reactions from January 2002 to February 2007. Serum-specifc IgE antiboides to ampicilloyl (AMP) and amoxicilloyl (AXO) were determined using the immunoCAP Result: Sixteen subjects were enrolled in this study. Clinical features of amoxicillin-induced hypersensitivity reactions included erythema multiforme (n=6, 37.5%), urticaria/angioedema (n=4, 25.0%), anaphylaxis (n=3, 18.8%), maculopapular skin eruption (n=2, 12.5%) and fixed-drug eruptions (n=1, 6.3%). Six subjects had a high serum specific IgE to AMP and all anaphylaxis patients had a high serum specific IgE to AXO and/or AMP. Conclusion: These findings suggest that amoxicillin could induce various cutaneous manifestations in which the most common ones are erythema multiforme and urticaria/ angioedema. The serious reactions of anaphylaxis were noted in 18.8% of subjects in which IgE mediated responses to 2 antigenic determinants were involved. (Korean J Asthma Allergy Clin Immunol 2007;27:162-167)