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전신경화증 관련 간질성 폐질환에서의 임상적 특징과 예후 인자 분석
여유미,채은진,김동순,송진우 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.0
Interstitial lung disease (ILD) is a frequent complication in patients with systemic sclerosis and is associated with significant morbidity and mortality. However, limited data exist regarding clinical characteristics and prognostic factors in Asian patients with systemic sclerosis related ILD (SSc-ILD). The aim of this study is to evaluate the clinical features, outcome and prognostic factors for SSc-ILD patients in South Korea. Clinical data were retrospectively analyzed in 85 patients with SSc-ILD (biopsy proven case, n=17). The Cox proportional hazards regression model was used for analyzing predictors for clinical outcomes. Median follow-up period was 4.6 years (interquartile range: 2.7-7.4 years). Mean age of the subjects was 53 years, 15% were male, and 21% were smokers. The overall mortality rate was 12.9% during follow-up (1-year=0%, 3-year=4.7%, 5-year=5.9%). Non-survivors showed shorter duration of dyspnea (0.9years vs. 2.1 years, p=0.006) and lower diffusing capacity of carbon monoxide (49.3±23.1 % predicted. vs. 60.5±18.7 % predicted. p=0.089) compared with survivors; however, there were no significant differences in other variables including age, sex, smoking history and exercise capacity. In univariate Cox analysis, age (hazard ratio [HR], 1.140), male gender (HR, 3.527), estimated pulmonary artery systolic pressure (HR, 1.102) and Gender-Age-Physiology (GAP) stage (HR, 6.899) were predictors for mortality.
신경학적 증상 없이 통풍성 관절염만으로 발현된 Lesch-Nyhan Syndrome 1례
여유미 ( Yoo Mi Yeo ),최은영 ( Eun Young Choi ),윤혜진 ( Hyae Jin Yoon ),정소담 ( So Dam Jung ),김담 ( Dam Kim ),이승훈 ( Seung Hun Lee ),주경빈 ( Kyung Bin Joo ),전재범 ( Jae Bum Jun ) 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.4
Deficiency of hypoxanthine-guanine phosphoribosyltrans-ferase is a purine nucleotide disorder and is the most common genetic cause of uric acid overproduction. This disease has a wide range of spectrum with regard to neurological features depending on the extent of the enzymatic deficiency. Complete deficiency of hypoxanthine-guanine phosphoribosyltransferase, called Lesch-Nyhan syndrome, is presented with hyperuricemia and characteristic neurological manifestation and self-mutilation. Partial hypoxanthine-guanine phosphoribosyltransferase--deficient patients are presented with a various intensities of the aforementioned symptoms, from almost normal neurologic manifestation to a severe form along with hyperuricemia. We report a twenty-year-old man with complete hypoxanthine- guanine phosphoribosyltrans-ferase mutation and Lesch-Nyhan sydrome, who manifested gouty arthritis without neurologic symptom.
이상훈,여유미,김태형,이홍렬,이진화,박용범,박종선,김이형,송진우,전병우,김현정,박진경,어수택,김영환,김동순,박무석,on behalf of Korean Interstitial Lung Diseases Study Group 대한결핵및호흡기학회 2019 Tuberculosis and Respiratory Diseases Vol.82 No.2
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts’ help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.
Adherence to latent tuberculosis infection treatment in healthcare workers
정승준,여유미,박태선,박동원,문지용,김태형,김상헌,손장원,윤호주 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.0
Introduction: Poor adherence to medication frequently leads to treatment failure. We investigated the completion rate to treatment of latent tuberculosis infection (LTBI) among healthcare workers. Methods: In a prospective design in a single tertiary university hospital, we enrolled health care workers who were newly diagnosed as LTBI based on positive reaction to QuantiFERON-TB Gold In-Tube test. The subjects were prescribed isoniazid only and followed up regularly for up to 9 months. At each visit, adherence to medications and development of adverse reaction to isoniazid were evaluated by use of a standard questionnaire. The primary outcome was the completion rate of 9-month isoniazid treatment and factors affecting adherence. Results: Of the total of 114 patients with LTBI, 63 subjects (55.3%) completed 9-month isoniazid treatment. Drop out occurred steadily over time up to 9 months. In analysis of factors affecting adherence, there was no significant difference in age, gender, body mass index, type of occupation between completion group and non-completion group. In addition, adherence were not influenced by the baseline comorbidities. However, development of isoniazid induced liver injury were significantly more common in subjects who did not complete the scheduled medication (P<0.05). Conclusion: The completion rate of 9-month isoniazid treatment was low in healthcare workers. While age, gender, occupation and pretreatment comorbidities were not associated with treatment adherence, the development of drug-induced liver injury affected the scheduled treatment.
Clinical value of pleural biopsy obtained from percutaneous catheter drainage of pleural effusion
박태선,여유미,정승준,이현,박동원,문지용,김상헌,손장원,윤호주,김태형 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-
배경: 흉수의 진단은 임상양상, 영상의학적 검사, 그리고 흉수분석을 통해 이루어진다. 초음파를 이용한 경피적 흉막카테터삽입술은 비교적 안전한 시술로 흉강천자와 함께 흉수검체를 얻을 수 있을 뿐만 아니라 흉막조직검사까지 동시에 시행할 수 있다. 본 연구에서는 흉막카테터삽입 술에서 동시에 얻어진 흉막조직검사의 임상적 가치에 대해 분석하였다. 방법: 2011년 1월부터 2017년 7월까지 흉막카테터삽입술과 함께 흉막조직검사를 시행한 환자들의 의무기록을 후향적으로 분석하였다. 일측성 삼출성 흉수를 가진 환자의 흉수검사를 포함한 임상적 정보와 함께, 영상의학적 검사로 얻은 진단과 흉막조직검사결과를 비교하였다. 결과: 133명의 환자 중 호중구 우세는 38명 (28.6%), 림프구 우세는 95명 (71.4%)였다. 호중구 우세 환자의 흉막조직검사결과는 염증 (20명, 52.6%), 정상흉막 혹은 진단되지 않음 (12명, 31.5%), 악성질환 (3명, 7.9%), 결핵 (2명, 5.3%), 비정형세포 (1명, 2.6%) 순이었다. 악성질환 3명의 환자는 흉수세포검사에서도 모두 악성세포가 관찰되었다. 림프구 우세 환자의 흉막조직검사결과는 염증 (41명, 43.2%), 결핵 (30명, 31.6%), 정상흉막 혹은 진단되지 않음 (18명, 18.9%), 악성질환 (4명, 4.2%), 비정형세포 (2명, 2.1%) 순이었다. 염증을 진단된 41명 중 adenosine deaminase <40 U/L는 21명이었고 결핵으로 진단된 30명 중에서는 6명이었다. 4명의 악성질환을 가진 환자는 흉수세포검사에서 악성세포가 관찰되었고, 2명의 비정형세포로 진단된 환자에서도 흉수세포검사에서 1명은 악성세포가, 다른 1명은 비정형세포가 관찰되었다. 결론: 흉막카테터삽입술에서 동시에 얻어진 흉막조직은 다양한 결과를 보이며, 일부 임상적인 상황에서 진단적 가치가 있을 수 있다.
주명호,여유미,최필선,이재혁,양광열,이영진 한국자원식물학회 2018 한국자원식물학회지 Vol.31 No.6
Previously, we have reported a plant extract isolated from Lysimachia foenum gracum Herba as a newenvironment friendly biopesticide that has the mycelial growth inhibition effect on Magnaporthe oryzae, the pathogenicfungus of the rice blast disease. For the finding of additional biopesticide candidate, we tested the mycelial growth inhibitoryeffects about 700 species of plant extracts on PDA media. Among them, the extract of Anemarrhena asphodeloides showedprominent inhibitory effect of which IC50 was 139.7 ㎍/㎖. Mycelial radii of M. oryzae were measured on PDA mediumcontaining the four organic solvent fractions isolated from total extract from A. asphodeloides. Ethyl acetate fractionshowed the impressive inhibitory effect of IC50, 54.12 ㎍/㎖. In the subsequent rice field test for the total extract of A. asphodeloides, we obtained encouraging 62.0% control rate of rice blast disease without any phytotoxicity. It is almostequivalent to that of chemical pesticides implying the applicability of the extract as a new biopesticide. In further study, theanalysis of active ingredients of the extract would be necessary for the development of a new biopesticide and for theverification of cellular mechanism by which the mycelial growth of M. oryzae inhibited.
이지영,여유미,김지연,오일환,황순우,이상기,곽동신,최지윤,김정은,박준성 대한중환자의학회 2013 Acute and Critical Care Vol.28 No.4
In Asia, snakebites are estimated to affect 4 million people every year, and of these, 100,000 people are estimated to die. In Korea,snakebites occur frequently from the spring to the fall, but their importance is often overlooked. Fatal complications, including acute respiratory distress and acute kidney injury, can occur, and in some cases, severe hemorrhage results from coagulopathy. There have been only a few cases of snakebite-induced liver or intestinal bleeding, but to our knowledge, spontaneous bleeding from the spleen has not been previously reported. Here, we report the case of a 61-year-old male who visited the emergency room with abrupt abdominal pain due to hemoperitoneum associated with splenic hemorrhage after a snakebite.