세침흡인 세포검사로 진단된 폐에 전이한 정상피종 - 1예 보고 -

정화숙,이건국,김원재,엄재호,송형근,Jeong, Hwa-Sook,Lee, Geon-Kook,Kim, Wun-Jae,Earm, Jae-Ho,Song, Hyung-Geun 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.1

Fine needle aspiration cytology of a pulmonary mass was performed on a 51-year-old man who had a left testicular mass. Cytologic features were composed of a homogeneous population of malignant cells associated with a background of foamy and lacelike material. The cellular features were characterized by monomorphous cell proliferation of relatively regular large cells, generally isolated or grouped. Occasionally, fine blanching stroma with large tumor cells and scanty lymphocytes were noted. The tumor cells had a round, regular nucleus, prominent round nucleoli, and a thin rim of cytoplasm containing large vacuoles or lacunae filled with glycogen. The fine needle aspiration cytologic diagnosis was highly consistent with metastatic seminoma from testis and less likely primary or other metastatic carcinoma. The diagnosis of resected testicular mass was classic seminoma. Despite the fact that cytopathologists were not familial with diagnosis of seminoma due to clinician's lack of interest in fine needle aspiration cytology of germ cell tumors including seminoma, it appears that a diagnosis of this tumor should not be problematic in cytologic material if specific histologic criteria are applied.

신증후군 환자에서 알부민 병용 투여가 Furosemide 이뇨 효과에 미치는 약력학 및 약동학적 유용성 평가

김도형 ( Doe Hyeong Kim ),엄재호 ( Jae Ho Earm ),한진석 ( Jin Suk Han ),김혜영 ( Hye Young Kim ),오태근 ( Tae Geun Oh ),허우성 ( Wooseong Huh ),이정상 ( Jung Sang Lee ),장인진 ( In Jin Jang ),신상구 ( Sang Gu Shin ) 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4

There have been controversies on the effect of albumin in treating edema in nephrotic syndrome patients. We evaluated the additive diuretic effect of coadministration of furosernide with albumin in the six patients with nephrotic syndrome. We administered 160mg of furosemide intravenously for 1 hour with 100rnl of 20% albumin or 5% dextrose by random cross-over design. The urine and plasma furosemide concentrations were measured by HPLC. After the administration of furosemide alone, urine volume, urinary excretions of sodium and chloride were increased significantly compared to those of basal state(P<0.05). But, coadministration of furose- mide with albumin did not increase significantly the urine voume(2285+-445ml vs. 3023+-715ml), urinary excretions of sodium(194+-58rnmol/day vs. 282+-85 mmol/day) and chloride(213+- 54mmoVday vs. 286+- 74mmoVday) comparing to those of furosemide only cases. Addition of albumin to furosemide did not sig- nificantly changed pharmacokinetic parameters such as AUC(28.3+-5.5ug/ml hr vs 36.0+-6.7ug/ml hr), total plasma clearance(115+-30mVmin vs 108+-41ml/min), volume of distribution(0.13+-0.02L/kg vs 0.10+- 0.01L/kg), elirnination half life(1.4+-0.3hr vs 1.5+-0.3hr), and urine furosemide excretion(44+-8% vs 43+ 10%). We concluded that albumin infusion did not enhance the diuretic action of furosemide pharmaco-dynamically and pharmacokinetically in patients with nephrotic syndrome.

원위부 신세뇨관성 산중의 임상적 특징

조종태(Jong Tae Cho),김근호(Geun Ho Kim),엄재호(Jae Ho Earm),안규리(Gu Rie Ahn),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee) 대한내과학회 1990 대한내과학회지 Vol.39 No.6

N/A We observed the clinical features, underlying disorders, complications, treatment and outcome of 12 cases of distal renal tubular acidosis and the following results were obtained. 1) The patient`s age ranged from 23 to 53 years old (39±9) and female to male ratio was 10:2. 2) The chief complaints on admission were generalized weakness (5), periodic paralysis (4), recurrent renal stone (2) and paresthesia (1). 3) The identified underlying disorders were systemic lupus erythematosus (3), medullary spongy kidney (2), Sjogren`s syndrome (2), and hyperparathyroidism (1). 4) The major complications were nephrolithiasis (3), nephrocalcinosis (3), osteomalacia (2) and rhabdomyolysis (1). 5) Replacement of alkali and potassium, and specific therapy for underlying disorders showed good outcome.

흉막 삼출증을 동반한 원발성 담즙성 간경변증

김혜영(Hye Young Kim),이동호(Dong Ho Lee),윤세진(Sei Jin Youn),엄재호(Jae Ho Earm),조명찬(Myeong Chan Cho),이상도(Sang Do Lee),궁성수(Sung Soo Koong),이복희(Bok Hee Lee),정화숙(Hwa Sook Jeong),성노현(Ro Hyun Sung) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2

Primary biliary cirrhosis is a chronic, progressive liver disease of unknown etiology that is characterized by inflammatory destruction of intrahepatic bile ducts and by association of multiple autoimmune disease. Ten cases of primary biliary cirrhosis were reported so far in Korea. None of these was associated with pleural effusion. bV experienced a case of a 68-year old female with primary biliary cirrhosis with unexplained pleural effusion who has suffered from pruritus, generalized weakness and dyspnea. She was treated with pleurodesis, cholestyramine and ursodeoxycholic acid. We report a case of primary biliary cirrhosis with pleural effusion. (Korean J Gastroenterol 1994; 26; 378-383)

Inverse Effort Dependence 가 노력성호기류량의 측정에 미치는 영향

김대수(Dae Soo Kim),이현숙(Hyeon Suk Lee),진영주(Young Joo Chin),엄재호(Jae Ho Earm),조명찬(Myeong Chan Cho),윤세진(Sei Jin Yoon),이상도(Sang Do Lee) 대한내과학회 1995 대한내과학회지 Vol.48 No.6

N/A Objectives: During forced expiratory vital capacity maneuvers, if volume is measured at mouth instead of body surface, the flow during the effort independent portion becomes inversely effort dependent. This negative effect largely depends on compression of thoracic gas and has been termed inverse effort dependence. We performed this study to determine how the test results of FEV1, FEF25-75, FEF25, FEF50, and FEF75 are affected by effort. Methods: We compared the test results selected by effort based criteria(highest PEFR) with that selected by volume based criteria(ATS criteria). And we also studied the correlations between effort dependent changes of each paramaters. Randomly sampled routine pulmonary function test results obtained from 50 normal subjects and 45 subjects with obstructive pulmonary disease were analyzed. Results: 1) In both normal and abnormal group, selection based on the highest PEFR resulted in a decline of mean FEV1 compared to volume based criteria(p< 0.01), and was accompanied by an even more significant, decrease of FVC(p<0.01). 2) In both normal and abnormal group, there was no significant difference in FEF25-75 FEF25, FEF50, and FEF75 between volume based criteria and effort based criteria. 3) In both normal and abnormal group, there was no significant correlation between relative change of PEFR and effort dependent change of FEV1. 4) In normal group there was significant between effort dependent change of FEV1 and accompanying change of FVC(r=0.55, p<0.01). 5) In abnormal group there was significant, correlation between effort dependent change of FEV1 and accompanying change of FVC (r=0.69, p<0.01). Conclusion: It can be concluded that FEV is little affected by effort once the lungs are fully inflated and FEF25-75, FEF25, FEF50, and FEF75 are not affected significantly by inverse effort dependence in clinical practice.

급성 아황산가스 폭로후 흰쥐의 폐에 유발된 염증반응에 관한 연구

진영주 ( Young Joo Chin ),박남규 ( Nam Gyu Prak ),이현숙 ( Hyean Suk Lee ),김대수 ( Dae Soo Kim ),엄재호 ( Jae Ho Earm ),조명찬 ( Myeong Chan Cho ),윤세진 ( Sei Jin Yoon ),정화숙 ( Hwa Sook Jeong ),송형근 ( Hyung Geun Song ),성노 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.4

증례 : 에리트로포에틴에 저항성 빈혈을 보이는 혈액 투석환자에서 발생한 순수 적혈구 무형성증 1예

한지숙 ( Ji Sook Hahn ),김혜영 ( Hye Young Kim ),문기원 ( Ki Won Moon ),이기형 ( Ki Hyeong Lee ),권순길 ( Soon Kil Kwon ),신경섭 ( Kyeong Seob Shin ),엄재호 ( Jae Ho Earm ) 대한내과학회 2004 대한내과학회지 Vol.67 No.-

위암 환자에서 혈청 CA72-4 측정의 임상적 의의

김혜영(Hye Young Kim),조명찬(Myeong Chan Cho),최기원(Ki Won Choi),박남규(Nam Kyu Park),곽남주(Nam Ju Kwak),박국태(Kuck Tae Park),엄재호(Jae Ho Earm),윤세진(Sei Jin Youn),이복희(Bok Hee Lee) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2

N/A Background: A new tumor marker, TAG-72 has been identified using monoclonal antibody B72.3. It is found in a wide variety of carcinomas but rarely expressed in normal adult tissue.', and benign lesions. Methods: The presence of TAG-72 in serum samples from patients with gastric carcinoma and benign gastrointestina1 disease was evaluated using the CA72-4 assay. Results: Elevated levels of serum TAG-7'2 antigen were found in 2S(39. I io) of 64 gastric carcinona patients and none of 32 benign gastrointestinal disease patients. The serum concentrations of TAG-72 were compared to those of CEA. The positive rate of CEA in gastric carcinoma and benign gastrointestinal disease patients was 37.5% and 9.4%, respectively. These resu]ts indicate a preferential expression of TAG-72 compared to CEA in gastric carcinoma patients versus in patients with a benign disorder. Combination assay using CA72-4 and CEA RIAs unchanged positive rate(50%, p>0.05). Patients with the tnore advanced stage of gastric carcinoma revealed the higher positive rate of serum CA72-4 and the ]evels were increased in all patients with recurrent gastric carcinoma. ( onclusions: These results suggest that the measurement of serum CA72-4 in patients with gastric carcinoma serve a complementary role to differentiate the disease from benign gastric lesions and may be useful to predict the disease recurrence in postoperative patients. (Korean J Gastroenterol 1996; 28:164 171)

혈액투석 환자에서 Erythropoietin 의 피하주사와 저용량 Androgen 의 병용투여가 빈혈과 영양지표에 미치는 효과

서정철(Jeong Chul Seo),김혜영(Hye Young Kim),양용모(Yong Mo Yang),전원중(Won Joong Jeon),이현희(Hyun Hee Lee),이경수(Kyoung Soo Lee),정지봉(Ji Bong Jeong),엄재호(Jae Ho Earm),이기형(Ki Hyeong Lee) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.1

Recombinant human erythropoietin(r-HuEPO)은 말기 신부전 환자의 빈혈 치료에 있어서 가장 효과적이고 중요한 치료제로 이용되고 있다. 하지만, 상당한 비용이 필요하기 때문에 r-HuEPO의 조혈효과를 향상시키는 방법들이 제시되고 있는데, 이 중 안드로겐(androgen)과 r-HuEPO의 병용투여는 효과 면에서 아직까지 논란이 있다. r-HuEPO 투여 후 단백질 대사와 운동 능력 및 영양지표의 향상이 보고되고 있으며, 강한 단백 동화작용이 있는 안드로겐의 병용 투여시 영양지표가 더 호전될 것으로 기대되지만, 이에 대한 연구는 아직 없었다. 이에 저자들은 혈액투석 환자에서 r-HuEPO 피하 단독투여와 저용량 안드로겐의 병용투여시 빈혈의 치료 및 영양지표의 변화를 비교하고자 전향적 연구를 시행하였다. 충복대학교병원에서 혈액투석을 받는 환자 중 혈색소치가 8.0g/dL 이하 또는 헤마토그리트치 24% 이하인 환자를 대상으로 A군 ( r-HuEPO 단독투여군, n=12)은 주 2회 r-HuEPO 2000단위를 피하주사하였고, B군(r-HuEPO/안드로겐 병용투여군, n=12)은 동일한 양의 r-HuEPO와 nandrolone decanoate 100mg을 2주 마다 근주하였다. 6개월 투여 전후의 혈액검사와 인체계측을 시행하여 다음과 같은 결과를 얻었다. 1) 성별, 연령, 체중, Kt/V, 체중 당 r-HuEPO 용량(A군:71.8U/자,B군: 74.9U/wk)은 양군 간에 차이가 없었으며, nandrolone decanoate 용량은 주당 0.9±0.1mg/kg이었다. 투여 전혈색소, 헤마토크리트, 혈청 저장철, 혈청 부갑상선호르몬, 비타민 B12 folate, transferrin saturation과 영양지표인 알부민, 콜레스테를, prealbumin, transferrin, 인체계측지표는 양군 간에 차이가 없었다. 2)투여 6개월 후 A군의 혈색소는 7.1±0.7g/dL 에서 8.5±1.3g/dL로, 헤마토크리트는 20.7±2.2%에서 26.0±3.8%(P<0.05)로 상승하였고, B군의 혈색소는 6.8±0.4g/dL 에서 9.4±1.4g/dL로 헤마토크리트는 21.5±3.5%에서 30.1±2.8%(p<0.05)로 상승하였다. 치료시작 후 4개월 이후부터 평균 헤마토크리트는 A군에 비하여 B군에서 유의하게 높았다(p<0.05). 치료 후 혈색소 10.0g/dL 이상 또는 헤마토크리트 30% 이상에 도달한 환자수는 A군에서 12명 중 4명(33.3%)이었고,B군에서는 12명 중 10명(83.3%)으로 차이가 있었다(p<0.05). 3) 투여 6개월 후 영양지표는 양군 간에 차이가 없었다. 4) 연구기간 동안 안드로겐 투여에 따른 부작용은 근주부위의 동통 1예, 부종 1예 이외에는 없었다. 이상의 결과로 혈액투석환자에서 r-HuEPO 피하주사 단독투여에 비하여 저용량 안드로겐의 병용투여가 빈혈의 개선에 효과적이었다. 따라서, 경제적인 이유로 실제적으로 필요한 용량보구 Recombinant human erythropoietin(r-HuEPO) is the mainstay of anemia therapy in patient with end stage renal disease(ESRD), but the use of r-HuEPO is primarily limited by its high cost. So, it encourages any strategies that potentially enhance the erythropoietic response. However, studies designed to assess whether androgens would enhance the response to r-HuEPO were inconclusive. While androgens may be less expensive and may improve several nutritional parameters, their potential adverse effects discourage usage. We carried out a prospective study to examine the effect of low-dose androgen in combination with subcutaneous r-HuEPO on anemia and nutritional paramenters in hemodialysis patients. Twenty-four hemodialysis patients with hematocrit <24% or hemoglobin <8.0g/dL were randomly assigned into two groups. Group A(n=12) received 2000U r-HuEPO subcutaneously twice a week for six months. Group B(n=12) received the same dose of r-HuEPO plus nandrolone decanoate 100mg intramuscularly biweekly. Anthropometry, albumin, cholesterol, prealbumin, and transferrin were measured as nutritional parameters. The groups showed no differences in baseline levels of the followings : Hemoglobin, hematocrit; transferrin saturation, serum ferritin; intact serum parathyroid hormon, Kt/V; vitamin Biz, folate; nutritional parameters. At the cornpletion of the study, both groups showed significant increase in hematocrit compared with baseline levels(group A 20.7±2.2M to 26.0±3.8%; group B: 21.5±3.5% to 30.1±2.8%). The mean hematocrit in group B was significantly higher than in group A after 4 month study period(p<0.05). Ten of 12 patients in group B achieved a target hematocrit of 30%, as compared with four of 12 patients in group A. Both groups didn't show significant changes in any nutritional parameters. No significant side effects of androgen were noted during this short-term study. We conclude that low-dose androgen in combination with subcutaneous r-HuEPO is effetive treatment on anemia in hemodialysis patients, but does not improve nutritional status.

말기 신부전 환자에서 첫 12 개월간의 투석 후에 자율신경과 말초신경 기능의 변화

임정묵(Joung Muk Leem),김혜영(Hye Young Kim),권순길(Sun Gil Kwon),박영선(Young Sun Park),유일영(Il Young You),홍의실(Eui Sil Hong),엄재호(Jae Ho Earm),이현희(Hyun Hee Lee),이경무(Kyung Mu Lee) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.5

목 적 : 말기 신부전 환자에서 투석요법이 자율신경 및 말초신경 기능에 미치는 효과에 대해서는 상반된 견해를 보고하고 있고, 아직까지 전향적 연구는 부족한 상태이다. 이에 저자들은 투석을 시작하는 말기 신부전 환자에서 첫 12개월간의 투석요법이 자율신경 및 말초신경 기능에 미치는 효과를 알아보고자 하였다. 방 법 :투석을 시작하는 말기 신부전 환자 25명을 대상으로 하였으며, 대상환자를 혈액투석군 (14명)과 복막투석군 (11명) 또는 당뇨군 (11명)과 비당뇨군 (14명)으로 나누어 비교하였다. 자율신경 기능은 Ewing 등이 제안한 종합테스트법으로 평가하고, 말초신경 기능은 Medelec Pre-mierer^plus 근전도 기기를 이용하여 정중신경 운동전도속도를 측정하였으며, 투석 시작 전과 투석 12개월 후에 반복 검사하였다. 결 과 : 투석 시작 전의 자율신경 기능은 대상 환자 모두에서 교감신경 장애와 부교감신경 장애를 보였다. 투석 12개월 후 시행한 자율신경 기능검사는 투석 시작 전과 유의한 차이가 없었으며, 혈액투석군과 복막투석군, 당뇨군과 비당뇨군 간에 유의한 차이는 없었다. 투석 시작 전의 정중신경 운동전도속도는 혈액투석군과 복막투석군간에 유의한 차이는 없었으며, 투석 12개월 후 에도 유의한 차이는 없었다. 당뇨군에서는 투석 시작 전에 6명이 비정상 전도속도를 보였으나, 투석 12개월 후에는 2명이 악화되어 총 9명에서 비정상 전도속도를 보였고, 투석 시작 전 49.4±5.0 m/sec에서 투석 12개월 후 46.2±4.6 m/sec로 유의하게 감소하였다. 비당뇨군에서는 투석 12개월 후에 비정상 전도속도를 보였던 4명 중에서 3명이 정상화되었으며, 투석 12개월 후 당뇨군과 비당뇨군간에 유의한 차이를 보였다. 결 론 : 투석을 시작한 말기 신부전 환자에서 첫 12개월간의 투석요법은 투석방법에 관계없이 자율신경 기능장애에 유의한 영향을 미치지 않았다. 그러나 말초선경 기능장애는 비당뇨병성 투석환자에서 투석요법으로 일부 호전될 수 있을 것으로 생각된다. Background : The efficacy of dialysis on the autonomic and peripheral nerve function has been a subject of considerable debate. In addition, no longitudinal study on the course of uremic neuropathy in end-stage renal disease (ESRD) during dialysis has been reported. We carried out a prospective study to investigate the effect of dialysis on the autonomic and peripheral nerve function during the first 12 months of dialysis. Methods : Twenty-five patients with ESRD (14 on HD and 11 on CAPD; 11 diabetic and 14 nondiabetic) were enrolled. Autonomic nerve function test and median nerve conduction velocity study were done at the initiation of dialysis and then repeated after 12 months of dialysis. Results : At the initiation of dialysis, sympathetic nerve function and parasympathetic nerve function were abnormal in all HD and CAPD patients. After 12 months of dialysis, no significant changes occurred in autonomic function test. There was no significant difference in autonomic function test between HD and CAPD patients. There was no significant difference in median nerve conduction velocity between HD and CAPD patients after 12 months of dialysis. At the initiation of dialysis, 6 of 11 diabetic and 4 of 14 non-diabetic patients had abnormal median nerve conduction velocity. After 12 months of dialysis, normalization of median nerve conduction velocity occurred only in 3 non-diabetic patients. There was a singinficant difference in median nerve conduction velocity between diabetic and non-diabetic patients after 12 months of dialysis. Conclusion : We conclude that dialysis does not significantly alter the autonomic nerve function during the first 12 months of dialysis, but may improve the peripheral nerve function in non-diabetic uremic patients.