전신성 홍반성 루푸스 환자에서 Terbinafine에 의한 심한 백혈구 감소증으로 발생된 심경부 감염

양종태 ( Jong Tae Yang ),조영신 ( Young Shin Cho ),주유철 ( Yoo Chul Joo ),장대용 ( Dai Yong Jang ),김종오 ( Jong O Kim ),고희관 ( Hee Kwan Koh ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.2

Terbinafine, a fungicidal agent used for the treatment of onychomycosis, has been found to be safe and adverse effects are usually mild and transient. Neutropenia is a rare side effect of terbinafine. Terbinafine-induced neutropenia have been reported 7 cases worldwide and these patients had no predisposing factors that give rise to developing neutropenia. To date there has not been reported in Korea. We report a case of systemic lupus erythematosus of 47-year-old female patient who developed deep neck infection requiring intravenous antibiotics, tracheostomy, granulocyte colony-stimulating factor(G-CSF) to recover from terbinafine-induced neutropenia.

전신성 홍반성 루푸스에서 발생한 만성 결절성 통풍 2예

조영신 ( Young Shin Cho ),양종태 ( Jong Tae Yang ),고희관 ( Hee Kwan Koh ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.4

Gout and systemic lupus erythematosus(SLE) are relatively common diseases in rheumatism. But the case of coexistent gout and SLE is extremely rare. The rarity is that may be due to misdiagnosis and disparity of the epidemiology. It is suggested that immulonogic milieu in SLE and therapy for SLE may have a negative effect on the manifestations of gout. Especially, hyperuricemia that not caused by nephritis, renal failure, use of diuretics, alcohol drinking and other risk factors in premenopausal women is extremely rare. We experienced two cases of chronic tophaceous gout in female patients with SLE who did not have other hyperuricemic risk factors.

간질성 및 다낭성 폐질환이 동반된 쇼그렌 증후군 1례

장대용,신병철,정기영,김종오,양종태,주유철,이승일,Jang, Dai-Yong,Shin, Byung-Chul,Jung, Ki-Young,Kim, Jong-O,Yang, Jong-Tae,Joo, Yoo-Chul,Lee, Seung-Il 대한결핵및호흡기학회 2001 Tuberculosis and Respiratory Diseases Vol.51 No.6

A 47-years-old woman presented with a 2-month history of a dry mouth and dry cough. The patient had been taking medication for Sj$\ddot{o}$gren's syndrome for approximately 7 years. The chest radiography showed multiple cystic lesions and a hazy density in both lower lung fields. The HRCT showed a diffuse ground glass like appearance and multiple variable sized cystic lesions in both lung fields. After medication, the symptoms were aggravated. Bronchoscopy was preformed with a transbronchial lung biopsy. The biopsies showed an infiltration of lymphocytes, neutrophils, monocytes and histiocytes through the interstitial space of the alveola and a widening of the alveolar septa. However, the histological findings of the cysts were not obtained. Sj$\ddot{o}$gren's syndrome is a slowly progressive inflammatory autoimmune disease, which is characterized by lymphocyte mediated destruction of the exocrine glands, with pulmonary involvement in approximately 19-65%, High-resolution CT is a sensitive technique for assessing the pulmonary involvement in patients with Sj$\ddot{o}$gren's syndrome. Although a lung biopsy is not always necessary for establishing a diagnosis of an interstitial lung disease in Sj$\ddot{o}$gren's syndrome. A lung biopsy may reveal a wide spectrum of changes ranging from a mild inflammatory response to end stage fibrosis with honeycombing. Because of the predominantly peribronchiolar inflammatory infiltration and inspissated secretions the cysts were suspected to have been formed by the ball-valve phenomen. However, no definite evidence was obtained.

간질성 및 다낭성 폐닐환이 동반된 쇼그렌 증후군 1례

장대용 ( Jang Dae Yong ),신병철 ( Sin Byeong Cheol ),정기영 ( Jeong Gi Yeong ),김종오 ( Kim Jong O ),양종태 ( Yang Jong Tae ),주유철 ( Ju Yu Cheol ),이승일 ( Lee Seung Il ) 대한결핵 및 호흡기학회 2001 Tuberculosis and Respiratory Diseases Vol.51 No.6

S-상 심실중격의 임상적 고찰

이동민,장경식,양종태,장대용,김종오,서영욱,고영엽,홍순표 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

Background: The sigmoid septum described an anatomical variation in the contour of the left ventricular outlet. It is related to degenerative change with aging. We observed clinical significance of sigmoid septum in Korean. Methods: Echocardiographic examination was performed in 434 patients. Sigmoid septum is defined as discrete bulging of the proximal interventricular septum with that thickness is greater than 1.3cm or the thickness is grater 1.5 times than adjacent mid interventricular septum in apical 3 chamber view. Result: The incidence of patient with sigmoid septum(septum patient) is 24.8% (male 8.4%, female 16.3%) . The incidence increases with age and is more common in women. The patients with sigmoid septum were compared with targeted groups, there was no significant difference in blood pressure between them, but in height and weight, the former were lower. (p<001, p<03). In the patients with sigmoid septum, weight and the surface area of a body have an opposite correlation with increase of age (p<03, r=-0.34) (p<04, r=-0.31) , but no decrease of height was found according to age increase (p=0.47, r=-0.11) The main reason patients with sigmoid septum ask echocardiolography and its clinical symptoms were abnormal results of previous electrocardiography and/or usual chest pain. Compared with control group, interventricular septal thickness is larger in septum patients (p<001). The thickness of interventricular septum located in subaortic left ventricular outflow tract is 1.6±0.3cm. There is another web like structure that continued from interventricualr septum to anterior free wall of left ventricle and the width is 1.6±0.4cm. A sign of insignificant obstruction due to left ventricular outflow was observed from three sigmoid septum patients. Conculusion: Septum patient is largely found in older age group and the body weight and body surface area are lower than control group. The body weight and body surface area are opposite correlation with age. So sigmoid septum is considered as structural change by weight reduction with aging. It is assumed that septum patients are related with asymptomatic ischemia because they have more abnormal ECG finding such as T wave inversion on precordial leads or standard leads, nonspecific ST-T change, LBBB etc. Sigmoid septum is not only proximal interventricular septal bludging but also another web like structure continuing to anterior wall of left ventricle.

급성 지주막하 출혈에 동반된 관상동맥 연축에 의한 심근경색증 1예

부귀범,박근호,양종태,이동민,장성종,김건영,장경식 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

In many cases, acute cerebrovascular disease is accompanied by abnormal electocardiograms. Also, though rather uncommon, acute myocardial infraction is also seen. The mechanism of its occurance is uncertain but it is thought to be related to coronary artery spasms, an abnormal autonomic nervous system, and a catecholamine increase. A female patient of 34 years of age came to the hospital because of sudden headache accompanied by substernal chest pain. A subarachnoid hemorrhage due to a cerebral aneurysm rupture had occured, and there was ST segment elevation in lead II, III, and aVF of the electrocardiogram. A cardiac enzyme test, an echocardiography, and a coronary angiography were performed, and she was diagnosed to have acute myocardial infarction due to coronary artery spasm. Clipping of the aneurysm was performed. With the use of nitrate and an angiotension converting enzyme inhibitor, the condition of the patient improved.

재발성 류마티즘 환자에서 발작의 유발인자

주유철,이동민,양종태,신병철,임태영,서정균,정기영,최동헌,김원,조영신,고희관 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Background and Objectives : Palindromic rheumatism (PR) is known to be triggered without any obviously inciting events in most patients, although, in a few cases, attacks have been noted to relate to another events such as weather change, childbirth, ingestion of certain foods, or over-exercise. The aim of this study was to characterize the triggering factors on palindromic attacks. Materials and Methods : We evaluated sixty-four patients with PR for the presence of triggering factors and the relationship between attacks and triggering factors by interview of patients. We considered that there was an probable association between episodes and PR, if episodes within 24 hours prior to PR had triggered at least 50% of all attacks and a definite association between episodes and PR, if episodes within 24 hours prior to PR had triggered 100% of all attacks. Results : In 15 patients (35.9%), there was a possible association between episodes of PR and initiating events. In 8 patients (12.5%), there was a definite association between episodes of PR and initiating events. The triggering factors were physical over-activity including exercise (19/64: 29.7%), foods, such as rawfish, crab, and chicken, including alcohol (19/96: 19.8%). However, there were no difference between the groups with and without the triggering factor in sex ratio, duration and onset of PR, the positive rate of rheumatoid factor and involved sites. Conclusion : Our observations showed that PR was triggered by physical over-activity more than in previous reports and hypersensitivity to foods was a causative factor in some patients with PR. However, patients with triggering factors had a similiar clinical profile to patients without triggering factors.