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.

An Electromyographic Study on Changes of Mandibular Position

이은희,서봉직,오희명,Lee, Eun-Hee,Suh, Bong-Jik,Oh, Hee-Myung The Korean Academy of Orofacial Pain and Oral Medi 1999 Journal of Oral Medicine and Pain Vol.24 No.1

저자는 하악의 위치변화가 저작근에 미치는 영향을 근전도학적으로 평가하고자, 측두하악장애의 징후와 증상이 없는 정상성인 28명을 대상으로 중심위 교합장치(centric relation splint), 중심교합위 교합장치(centric occlusion splint), 전방 재위치 교합장치(anterior repositioning splint)를 장착시킨 상태에서 하악의 중심의, 중심교합위, 전방위률 유도한 후 최대 이악물기 상태의 좌우측 교근 및 전측두근의 근전도를 채득, 분석, 평가한 결과 다음과 같은 결론을 얻었다. 1. 전측두근에서 하악의 위치변화에 따른 최대 근활성도의 차이가 나타났으나(p<0.05), 교근에서는 나타나지 않았다. 2. 전측두근의 경우 중심교합위에서 최대 이악물기 상태의 최대 근활성도는 교합 장치물을 장착하지 않은 경우 및 중심위에서와 비교하여 감소하였다(p<0.05). 3. 전측두근의 경우 전방위에서 최대 이악물기 상태의 최대 근활성도는 교합 장치물을 장착하지 않은 경우 및 중심위에서와 비교하여 감소하였다(p<0.001). 4. 교근과 전측두근의 좌우 비대칭지수(asymmetry index)는 하악의 위치변화에 따른 차이가 나타나지 않았다.

논문편 : 소비자정보요구와 관련요인 연구

이은희,이기춘 ( Eun Hee Lee,Kee Choon Rhee ) 대한가정학회 1991 Family and Environment Research Vol.29 No.1

급성기 Mycoplasma 폐렴의 항체가와 검사소견에 관한 고찰

이은희,이소라,김화인,김종덕,Lee, Eun Hee,Lee, So Ra,Kim, Hwa In,Kim, Jong Duck 대한소아감염학회 1999 Pediatric Infection and Vaccine Vol.6 No.1

목 적 : Mycooplasma 폐렴은 소아과 영역에서 통상 사용하지 않는 macrolide 계열의 항생 제에 감수성이 있어서 초기에 신속한 진단이 중요한데, 이에 저자들은 발병 1주일 이내의 Mycoplasma 폐렴 환아에서 Mycoplasma 항체역가, 냉혈응집소역가, ESR, CRP 등과 임상 소견을 검토하여 진단에 어떤 의의가 있는지 알아보고자 하였다. 방 법 : 1997년 1월부터 12월까지 원광의대병원 소아과에 입원하여 Mycoplasma 폐렴으로 진단되어 치료를 받았던 환아 중에 입원 전에 발열과 기침이 7일 이내였던 환아 56명을 대상으로 M. pneumoniae 균의 항체검사를 시행하였다. 대상 환아를 항체역가가 1:320 미만이었던 어린이 33명(A군)과 1:640 이상이었던 어린이 23명(B군)으로 나누어 입원시에 총 백혈구수와 분획, 혈구 침강속도 및 CRP와, 냉혈응집소치, 흉부 X-선 소견을 비교 검토하였다. Mycoplasma 폐렴의 진단 기준은 기침과 발열 등의 임상증상과 흉부 청진상수포음의 존재, 흉부 X-선 소견상 폐 실질에 침윤을 보이며 indirect particle agglutination test로 측정한 Mycoplasma 항체가가 1:640 이상이거나, 1주일 후에 재검사에서 4배 이상 역가가 증가한 경우로 하였으며 냉혈응집소는 역가가 1:64 이상인 경우를 양성 판정하였다. 결 과 : 1) 남녀 비는 1:1.4이었고 평균연령은 $5.8{\pm}2.96$세 이었다. 2) 내원시 평균 체온은 $38.5{\pm}0.1^{\circ}C$이었으며 52례(93%)에서 객담성 기침이 관찰되었다. 3) 총백혈구수는 Mycoplasma 항체 역가가 640이상으로 높았던 어린이군에서 $10,470{\pm}877.0/mm^3$로 320 이하이었던 어린이군 $7,761{\pm}508.5/mm^3$에 비해 의의 있게 높았다(P<0.014). 4) 혈구침강속도와 CRP는 각각 $27.2{\pm}26.82/mm/hr$, $39.9{\pm}41.50ng/mL$로 의미 있는 상승을 보이지 않았다. 5) 입원시 흉부 X-선 소견상 폐 침윤은 우측폐에 24례(43%)로 가장 흔하게 볼 수 있었고 이중에서도 우측 하엽에서 10례로 가장 흔하였다. 6) 냉혈응집소 역가는 Mycoplasma 항체 역가와 의의 있는 상관 관계를 보이지 않았고 25례(45%)에서 냉혈응집소 역가가 1:64 미만이었다. 결 론 : 발병초기 Mycoplasma 폐렴의 진단은 임상증상, 흉부 X-선 소견 및 항체검사가 유용하며 초기 항체 역가는 임상소견의 정도와는 무관하므로 항체검사가 필수적이며 냉혈응 집소검사는 양성률이 낮아서 발병초기에 Mycoplasma 폐렴의 진단에 도움을 주지 못할 것으로 사료된다. Purpose : For evaluation of acute Mycoplasma pneumoniae(M. pneumoniae) pneumonia in children, we have studied the Mycoplasma indirect particle agglutination test, cold hemagglutinin test, ESR, CRP, and total white blood cell counts and it's differential count retrospectively. Methods : The total numbers of patients whom compatible with diagnostic criteria of acute M. pneumoniae peumonia were 56 cases from Jan. to Dec. 1997. The diagnostic criteria were 1) onset of fever(${\geq}38.0^{\circ}C$) and coughing were within 7 days, 2) rhonchi and/or role was audible on chest, 3) pneumonic infiltration on chest X-ray, and 4) M. pneumoniae indirect particle agglutination test titer was higher than 1:640, or initial titer was less than 1:640 but increased more than 4 folds after week. We classified the enrolled patients according to initial antibody titer, such as soup A(${\leq}1:640$) and group B(${\geq}1:320$). We compared group A and B by demographic findings, clinical symptoms and signs, and laboratory findings. Results : 1) The male and female sex ratio was 1:1.4, and average onset age was $5.8{\pm}2.96$ years. 2) The average body temperature on admission was $38.5{\pm}0.1^{\circ}C$ and productive coughing was noticed in 52 cases(93%). 3) The average total white cell counts were $10,470{\pm}877.0/mm^3$ in group B patients, which was significantly higher compared to $7,761{\pm}508.5/mm^3$ in group A(p<0.014). 4) The average value of ESR and CRP were within normal range in both group. 5) The most common site of pneumonic infiltration was right lower lobe of lung in both groups. 6) There were no correlation between antibody titer and cold hemagglutinine titer in patients and cold hemagglutination titer were less than 1:64 in 25 cases(45%). Conclusion : The clinical manifestations of pneumonia, findings of chest x-ray, and indirect particle agglutination test were useful on diagnosis of M. pneumoniae pnumonia onset within 7 days, but cold hemagglutinin test was a little diagnostic meaning.

경남 창녕군 증산리 일대 방사집수정을 활용한 강변 여과수 개발량 평가

이은희,현윤정,이강근,김형수,정재훈,Lee, Eun-Hee,Hyun, Yun-Jung,Lee, Kang-Kun,Kim, Hyoung-Soo,Jeong, Jae-Hoon 한국지하수토양환경학회 2010 지하수토양환경 Vol.15 No.4

Well production by a riverbank filtration facility with multi-radial collector well systems in Jeungsan-ri, Changnyeong gun, Korea was evaluated. In this study, the drawdown at collector wells due to pumping and groundwater inflow rates along the horizontal arms of the collector wells were computed through numerical simulations. Sensitivities of the well production to hydraulic conductivity and well flow coefficient, which represents the resistance to the flow from the aquifer to the horizontal arms, were analyzed. Simulation results showed that, with given proposed pumping rate conditions, the drawdown in the caisson exceeded maximum drawdown constraints in the study site and the adjustment of the pumping rate at each well is needed. The drawdown is affected by the hydraulic conductivity of the main aquifer and the well flow coefficient, which means the profound field investigation of the study site is needed to accurately estimate the efficiency of riverbank filtration through radial collector wells.

신생아기에 진단된 Netherton 증후군 1례

이은희,김애란,김기수,조범진,고재경,피수영,Lee, Eun-Hee,Kim, Ellen Ai-Rhan,Kim, Ki-Soo,Cho, Beom-Jin,Koh, Jai-Kyoung,Pi, Soo-Young 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.4

Netherton 증후군은 어린선양 피부병증, 머리카락이상, 아토피 소질 등 3가지 임상양상을 특징으로 하는 드문 질병이다. 저자들은 임상소견, 피부조직 검사와 머리카락 현미경 소견을 통하여 신생아기에 Netherton 증후군으로 진단하고 추적 관찰하고 있기에 간단한 문헌 고찰과 함께 보고하는 바이다. Netherton's syndrome is an unusual disorder which consists of triad of ichtyosiform dermatosis, multiple defects of hair shaft and an atopic diathesis. The finding of bamboo hair is pathognomic in Netherton's syndrome and the ichthyosiform dermatosis may consist of either ichtyosis linearis circumflexa or congenital ichthyosiform erythroderma. Often, variability in the clinical features leads to a delay in diagnosis in many cases. We report a case of Netherton's syndrome diagnosed in the neonatal period. The patient presented with severe ichthyosis and confirmed microscopically distinctive bamboo hair.

콩 싹의 Acetohydroxyacid Synthase 의 성질과 피이드백 저해에 관한 연구

이은희,안태우,최정도 ( Eun Hee Lee,Tae Woo Ahn,Jung Do Choi ) 생화학분자생물학회 1991 BMB Reports Vol.24 No.3

Acetohydroxyacid synthase (AHAS) is the first common enzyme in the biosynthetic pathways to valine, leucine, and isoleucine. AHAS has been partially purified from dark grown pea shoots approximately 2000 fold using DEAF-cellulose affinity elution, Sephadex G-150, and leucine-agarose chromatography. The rate of product acetolactate formation from pyruvate shows a sigmoidal relationship with substrate at low pyruvate concentrations. The enzyme preparation has a K_m value for pyruvate of 4 mM, a pH optimum of 7.5 to 8.5, and a temperature optimum of 35℃ to 45℃. The enzyme is inhibited by valine, leucine, and isoleucine singly, and synergistically by the pair of the amino acids, indicating more than one binding site of the enzyme for branched amino acids. The level of the inhibition decreases with increasing substrate concentration, and kinetic analysis shows the inhibition to be mixed type in which the inhibitor affects on both V_(max) and K_m. The degree of inhibition is pH-dependent as it decreases drastically above pH 8.

사람 융모 성선 자극 호르몬에 의한 복강 대식세로로부터 산화질소의 발생

이은희,신태용,김형민,Lee, Eun-Hee,Shin, Tae-Yong,Kim, Hyung-Min 대한약학회 1997 약학회지 Vol.41 No.3

Human chorionic gonadotropin (hCG) is a placental hormone and is involved in maintenance of the corpus luteum during pregnancy. In the present study, effect of hCG on nitiric ox ide (NO) generation from peritoneal macrophage was examined. hCG ahd no effect on NO generation by itself, whereas recombinant interferon- ${\gamma}$ (rIFN-${\gamma}$) alone had modest activity. When hCG was used in combination with rIFN-${\gamma}$, there was a marked cooperative induction of NO generation in a dose-dependent manner. The optimal effect of hCG on NO generation was shown at 6 hr after treatment with rIFN-${\gamma}$. Furthermore, northern blot analysis of showed that hCG increased the expression of inducible NO synthase(iNOS) gene. These results suggest that hCG induces NO generation from macrophages by increasing the expression of iNOS gene.

의료보험본인부담금액에 관한 연구

이은희 대구보건대학 1994 대구보건대학 論文集 Vol.14 No.-

Patients have paid the cost shaving devices of the medical insurance because of protection of insurance public finance as medical cost increase 65.5 percent In the senior nation the cost shaving devices is 0~11 percent but In Korea the cost sharing is 50 percent. These days it is increasing. Insurance public finance has profited since 1986. While people in the lower brackets of income is decreasing medical request because of increasing of the cost shaving devices. The cost shaving devices will be decreased on account of disobedience in medical insurance which pursuits common profited.

Petrology of Granitoids in the Vicinity of Hamyang - Namweon , Korea

이은희,이용종 ( Eun Hee Lee,Yoon Jong Lee ) 한국지구과학회 1992 지구과학교육 학술발표회 Vol.1992 No.-