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Combined Primary IgA nephropathy and Membranous Glomerulonephritis in a Child
김미경,최정훈,원남희,유기환,Kim Mi-Kyung,Choi Jeong-Hoon,Won Nam-Hee,Yoo Kee-Hwan Korean Society of Pediatric Nephrology 1999 Childhood kidney diseases Vol.3 No.2
IgA 신병증은 사구체 중맥에 IgA가 침착하는 것이 특징적인 질환이며 막성 사구체 신염은 IgG가 사구체 기저막의 상피하에 미만성으로 침착하는 질환이다. 원발성 사구체 질환중 IgA 신병증과 막성 사구체신염은 비교적 흔한 질환이나 전체적인 빈도는 낮은 편으로, 한 환자의 사구체에서 두 질환이 동시에 발생하는 경우는 매우 드물다. IgA 신병증과 막성 사구체신염의 중복 신염은 Doi등이 1983년 원발성 신질환으로서 처음 보고한 이래, 성인에서 20여례가 보고되었다. 저자들은 신증후군이 발생한 환아에서 신생검을 시행한 결과 원발성 신질환으로서 IgA 신병증과 막성 사구체신염의 소견이 동시에 보이는 중복신염의 드문 예를 경험하였기에 보고하는 바이다. 환아는 7세된 남아로 내원 한달 전부터 발생한 전신부종을 주소로 내원하였다. 가족력과 과거력상 특이 소견없었으며, 내원시 이학적 소견상 전신적인 허약감과 안와부종, 복부팽만, 하지의 함요부종이 관찰되었고, 검사소견에서는 WBC $19,800/mm^3$, Hb 14.1g/dL, Platelet $397,000/mm^3$, BUN/Cr 10/0.4mg/dL, protein/albumin 4.43/2.73g/dL, cholesterol 429mg/dL, IgA 85mg/dL, $C_3$ 68.8mg/dL, $C_4$ 13.4mg/dL, ANA(-), ANCA(-), RF(-), HBsAg/Ab(-/-)이었다. 뇨검사에서는 RBC many/HPF, WBC 2-3/HPF, protein ${\le}\;300mg/dL$ 였으며, 24시간 소변 검사상 protein 9.18g/day, Ccr 66.67ml/min의 소견을 보였다. 신생검을 시행한 결과 광학현미경상에서 몇몇 사구체의 분절성 경화와 중맥역의 증식이 관찰되었고, 면역형광현미경검사에서는 IgA(3+)가 과립상으로 미만성 분포를 보이며 중맥역에 침착되어 있고, 미세한 과립상과 위선의 양상으로 IgG(1+)가 모세혈관벽에 침착되어 있었으며, 전자현미경 소견상 중맥역과 모세혈관 기저막 상피하에 소량의 전자 고밀도 침착이 함께 관찰되었다. 환아는 prednisolone을 경구 투여 받았으나 단백뇨와 혈뇨가 지속되어 solumedrol pulse therapy, captopril과 cyclophophamide로 치료 받은 후, 전신 상태 호전되고, 혈뇨가 사라졌으며, 24시간 소변 검사상 단백뇨가 487.5mg/day로 감소하여 외래에서 추적 관찰 중이다.
뇨세포진 검사로 진단된 방광의 원발성 소세포암 - 1예 보고 -
김혜선,김애리,김철환,채양석,원남희,Kim, Hye-Sun,Kim, Aee-Ree,Kim, Chul-Hwan,Chae, Yang-Seok,Won, Nam-Hee 대한세포병리학회 1994 대한세포병리학회지 Vol.5 No.2
Small cell carcinoma of the urinary bladder is a rare tumor which occurs in about 0.48 % of all bladder tumors. We report cytologic features of small cell carcinoma of the urinary bladder in a 66-year-old man who had painless total gross hematuria, which was confirmed by partial cystectomy. In urine cytology, abundant tumor cells appeared in scattered and clustered forms in a bloody background. The tumor cells were small and uniform in size with a high nuclear/cytoplasmic ratio. The nuclei of the tumor cells were hyperchromatic, characteristically molded and showed inconspicuous nucleoli. The cytoplasms were scanty and pale blue.
소아에서 엡스타인-바 바이러스 감염과 관련한 막성 신병증 1례
이은희,임동희,임형은,유기환,원남희,홍영숙,이주원,Lee, Eun-Hee,Lim, Dong-Hee,Yim, Hyung-Eun,Yoo, Kee-Hwan,Won, Nam-Hee,Hong, Young-Sook,Lee, Joo-Won 대한소아신장학회 2008 Childhood kidney diseases Vol.12 No.1
Infection of Epstein-Barr virus(EBV) gives rise to a broad spectrum of clinical manifestations in children. Although renal involvement is rare, diverse renal manifestations are known from hematuria to acute renal failure. Secondary membranous nephropathy(MN) associated with systemic EBV infection is an uncommon renal pathology and only two cases have been reported. We are adding another case of MN associated with EBV infection in a child. An 8-year-old girl was admitted for renal biopsy. She had been followed up for microscopic hematuria and intermittent proteinuria for 5 months. There had been no specific findings in serology and radiology. Tonsil biopsy had been done due to exudative tonsillar hypertrophy and enlarged multiple cervical lymph nodes. And it showed EBV-associated lymphoproliferative findings. Serologic tests for EBV showed positive evidence of recent infection; viral capsid antigen(VCA) IgM was borderline positive, VCA IgG and early antigen IgG were positive, and EB nuclear antigen IgG was negative. In Situ Hybridization of tonsil for EBV mRNA was positive. Because her proteinuria and hematuria were aggravated at that time(protein 3 +, RBC >60/HPF), renal biopsy was done. Renal biopsy showed the findings of MN, characterized by thickened capillary walls with epimembranous spikes on light microscopy and subepithelial, mesangial and subendothelial electron dense deposits on electron microscopy. On immunofluorescence microscopy, IgG, C1q, kappa and lambda chains were positive. After steroid administration, proteinuria and hematuria resolved gradually within 6 months. 막성 신병증은 성인에 비해 소아에서는 드문 신병증으로 감염, 자가면역, 종양에 의한 이차성 신병증이 알려져 있다. 그 중에서도 엡스타인-바 바이러스 감염과의 관련은 잘 알려지지 않아, 최근 1개 보고에서 면역기능이 저하된 2례를 소개한 바 있을 뿐이다. 이에 저자들은 면역기능이 정상으로 보이는 소아에서 엡스타인-바 바이러스 감염과 관련한 막성 신병증 1례를 경험하였기에 보고하는 바이다.
소아에서 우연히 발견된 부신의 낭종성 종괴에서 진단된 정맥성 혈관기형
부윤정,이은희,이광철,원남희,Boo, Yoon-Jung,Lee, Eun-Hee,Lee, Kwang-Chul,Won, Nam-Hee 대한소아외과학회 2013 소아외과 Vol.19 No.2
Adrenal venous malformation is an uncommon disease. We report a case of an incidentally diagnosed adrenal cystic mass during an evaluation for gastritis in a child. A 14-year-old girl admitted to our pediatric department for epigastric pain. After the gastroscopy, she was diagnosed with hemorrhagic gastritis. A 5.5 cm-sized cystic mass was incidentally found adjacent to her left adrenal gland during an ultrasound examination for evaluating her abdominal symptoms. She underwent laparoscopic surgery for the diagnosis and treatment of this cystic mass, which was confirmed to be venous malformation at pathologic diagnosis.
유방 종괴의 세침흡인 세포학적 소견 - Masood 등급에 따른 분류 -
김애리,김혜선,김한겸,원남희,박미자,구범환,Kim, Ae-Lee,Kim, Hye-Sun,Kim, Han-Kyeom,Won, Nam-Hee,Park, Mee-Ja,Koo, Bum-Hwan 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.1
Fine needle aspiration cytology is considered as a useful diagnostic procedure in management of patients with breast lesions. This study was undertaken to evaluate the scoring system of Masood in the interpretation of breast aspirates, to establish the most useful cytologic criteria for the diagnosis of breast lesions, and to subclassify the benign breast diseases. To assess the feasibility of a cytologic grading system, 57 cases of benign breast disease, 61 cases of malignant breast disease were studied, respectively. The aspirates were evaluated for the cellular arrangement, the degree of cellular pleomorphism and anisonucleosis, and the presence of myoepithelial cells and nuceoli. Values ranging from 1 to 4 were assigned to each criterion and the sum of the individual values was made for each case. The presence of stroma, apocrine metaplasia, foamy histiocytes and inflammatory cells, background of the smear, and cellularity were also evaluated. Cut-off value of the scoring system of Masood between benign and malignant lesion was 15. Among the cytologic criteria, cellular arrangement, presence of myoepithelial cells, nucleoli, and stroma, status of chromatin pattern, and background of smear were useful criteria in the differentiation between benign and malignant lesions. Application of the scoring system of Masood does not always make the accurate diagnosis and the subclassification of benign breast disease.
만성 (慢性) 무증상 (無症狀) B형 간염 (肝炎) 표면항원 (表面抗原) 보유자에 (保有者) 있어서 조직학적 (組織學的) 연구
조민구(Min Koo Cho),원남희(Nam Hee Won),서승봉(Seung Bong Suh),최종호(Jung Ho Choe),조경준(Kyeong Joon Cho),박병익(Byung Ick Park) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1
N/A We performed liver needle biopsies on 34 chronic asymptomatic hepatitis B surface antigen (HBsAg) carriers with normal liver function tests. Among them, 12 were found to carry HBeAg and 14 carried anti-HBe. The results were as follows: 1) Of the 34 chronic asymptomatic HBsAg carriers, normal histologies were found in 9, nonspecific reactive changes in 15, chronic persistent hepatitis (CPH) in 9 and chronic active hepatitis (CAH) in l. 2) Of the 12 HBeAg positive carriers, normal histologies were found in 2, nonspecific reactive changes in 6 and CPH in 4 and of the anti-HBe positive carriers, normal histologies were found in 4, nonspecific reactive changes in 6, CPH in 3 and CAH in 1. There was no significant difference between two groups. According to these results, a substantial proportion of chronic asymptomatic HBsAg carriers had histological abnormalities and the status of HBeAg and anti-Hbe did not correlate with liver histology. Qur opinion is liver biopsy is still remains the most useful approach in the evaluation of asymptomatic HBsAg carriers and further long-term clinical studies are needed to understand the prognosis of chronic asymptomatic carrier state.