Clinical characteristics of patients with nontuberculous mycobacteria lung disease who were culture-positive only on liquid media

한진형,정병호,박혜윤,전경만,허희재,기창석,이남용,고원중 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Background: For culturing nontuberculous mycobacteria (NTM), liquid media are more sensitive than solid media. The culture-positive only on liquid media may result in diagnosis of NTM lung disease. This study evaluated the clinical characteristics of patients with NTM lung disease who were culture-positive only on liquid media. Methods: Of 978 patients with NTM lung disease diagnosed from January 2009 to December 2013, 111 (11.3%) patients were culture-positive only with liquid media and 867 (88.7%) were culture-positive using both liquid and solid media. Results: Compared with patients who were culture-positive using both on liquid and solid media, patients who were culture-positive only with liquid media were less likely to have hemoptysis (11.7% vs. 20.0%, p =0.037), smear positive sputum (14.4% vs. 50.2%, p <0.001), cavitary lesions on chest computed tomography (8.1% vs. 26.2% , p <0.001), and the fibrocavitary form (3.6% vs. 14.6%, p =0.001). The proportion of patients who required antibiotic therapy during follow-up was lower in patients who were culture-positive only with liquid media (44.1% vs. 61.6%, p <0.001). Conclusions: About one-tenth of the patients with NTM lung disease were diagnosed based on liquid media, and these patients may have mild form of NTM lung disease.

스마트폰을 이용한 합성 의약품 관리 어플리케이션 개발

한진형 ( Jin-hyung Han ),서홍주 ( Hongju Seo ),이화민 ( Hwamin Lee ) 한국정보처리학회 2013 한국정보처리학회 학술대회논문집 Vol.20 No.2

본 논문에서는 어플리케이션을 통하여 우리가 자주 사용하는 의학품을 좀 더 안전하고 편리하게 다루어 사용자가 무분별하게 사용하는 약물 오남용을 줄이고 안전사고를 예방하는데 초점을 두었다. 또한 어플리케이션 특유의 편리함과 간편함을 통하여 사용자에게 좀 더 다가가는데 목적을 두었다.

알레르기 ; 천식증상으로 내원한 성인에서 운동유발성 천식과 아토피의 상관관계

한진형 ( Jin Hyung Han ),권병운 ( Byung Woon Kwon ),현경희 ( Kyung Hee Hyun ),김용현 ( Young Hyun Kim ),이현숙 ( Hyun Suk Lee ),김도형 ( Do Hyung Kim ),김윤섭 ( Yon Seop Kim ),박재석 ( Jae Suk Park ),김경묵 ( Kyung Mook Kim ),지 대한내과학회 2011 대한내과학회지 Vol.81 No.6

목적: 아토피는 천식과 밀접한 관련이 있으며, 천식의 발생과 악화의 위험인자로 알려져 있다. 이 연구에서는 천식으로 내원한 환자들을 대상으로 아토피와 운동유발성 천식사이의 연관성을 알아보고자 하였다. 방법: 2002년 1월부터 2010년 1월까지 천식증상으로 단국 대학교병원 호흡기-알레르기내과를 방문하여 운동유발 검사를 시행한 환자들을 대상으로 하였다. 진단적 검사로 피부단자시험, 메타콜린 기관지유발 검사를 함께 시행하였다. 과거에 흡연을 하였거나 현재 흡연 중인 환자들은 모두 제외하였다. 결과: 총 40명의 성인 환자들을 분석하였다. 기도과민성을 보인 환자는 운동유발성 천식 양성군에서 음성군에 비해 더많았다(85.7 vs. 42.1%, p=0.007). 아토피는 운동유발성 천식군에서 대조군에 비해 더 흔히 관찰되었고(85.7 vs. 47.4%, p=0.017), 아토피 점수(16.5±3.0 vs. 6.5±2.0, p=0.011) 및 아토피 지수(2.1±0.3 vs. 1.0±0.3, p=0.004)는 운동유발성 천식군에서 대조군에 비해 높았다. 총 40명의 환자들 중기도과민성이 있는 26명의 천식 환자들과 기도과민성이 없는 14명의 환자들 각각을 대상으로 운동유발성 천식 유무에 따른 특성을 비교하였다. 26명의 천식 환자들 중 운동유발성천식은 18명(69.2%)에서 관찰되었으며, 이들에서 아토피 빈도, 아토피 점수 및 아토피 지수가 높은 경향이 관찰되었지만 유의한 차이는 없었다. 기도과민성이 없는 14명의 환자들중 운동유발성 천식은 3명(21.4%)에서 관찰되었으며 아토피빈도는 운동유발성 천식 양성군과 음성군 사이에 유의한 차이가 없었으나 아토피 점수(22.3±3.3 vs. 5.9±2.3, p=0.007) 및 아토피 지수(2.3±0.3 vs. 1.0±0.4, p=0.028)는 운동유발성천식 양성군에서 유의하게 높았다. D. pteronyssinus (76.2% vs. 42.1%, p=0.028)와 D. farinae (76.2% vs. 36.8%, p=0.012) 양성률은 운동유발성 천식군에서 대조군에 비해 높았다. 이분형로지스틱회귀분석을 시행한 결과 메타콜린에 대한기도과민성(위험비[OR]: 14.3, 95% 신뢰구간[CI]: 1.86-109.4)과 아토피(OR; 16.9, 95% CI; 2.04- 140.74)는 운동유발성 천식의 유의한 위험인자였다. 결론: 아토피는 운동유발성 천식과 연관된 위험인자로 생각된다. 운동유발성 천식 환자에서 대조군에 비해 D. pteronyssinus와 D. farinae의 양성률이 높아 집먼지진드기 항원이운동유발성 천식의 발생과 악화와 관계가 있을 가능성을 확인하였다. Background/Aims: Atopy is closely related to asthma and is a risk factor for the development and exacerbation of asthma. The aim of this study was to evaluate the association between exercise-induced asthma (EIA) and atopy in adult patients with asthma-like symptoms. Methods: Forty young male patients with asthma-like symptoms were enrolled. Skin prick, methacholine bronchial provocation, and exercise provocation tests were performed. Current and ex-smokers were excluded. Results: Exercise provocation tests were positive in 21 patients (52.5%). Airway hyperresponsiveness (AHR) to methacholine (85.7% vs. 42.1%, p=0.007) and atopy (85.7% vs. 47.4, p=0.017) was found more frequently in patients with EIA than in those without EIA. EIA was significantly associated with atopy score (16.5±3.0 vs. 6.5±2.0, p=0.011), atopy index (2.1±0.3 vs. 1.0±0.3, p=0.004), and positive responses to Dermatophagoides pteronyssinus (76.2% vs. 42.1%, p=0.028) and Dermatophagoides farinae (76.2% vs. 36.8%, p=0.012), but not with positive responses to pollen allergens. AHR to methacholine (odds ratio [OR]: 14.3, 95% confidence interval [CI]: 1.86-109.4) and atopy (OR: 16.9, 95% CI: 2.04-140.74) were significant risk factors for EIA. Conclusions: Atopy was a risk factor for EIA in young adult men, and sensitization to house dust mites was associated with EIA. (Korean J Med 2011;81:723-728)

A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death

조종태,한진형 대한의학회 2016 Journal of Korean medical science Vol.31 No.7

Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis.

Functional Gastrointestinal Disorders in Young Military Men

방창석,김연수,한진형,이용섭,백광호,김진봉,석기태,윤재훈,김동준 거트앤리버 소화기연관학회협의회 2015 Gut and Liver Vol.9 No.4

Background/Aims: To estimate the prevalence and evaluate the associated psychological factors of functional gastrointestinal disorders (FGIDs) in males in their twenties who are currently enrolled in military service. Methods: A total of 1,073 men in the Korean army were asked to complete questionnaires based on the Rome III criteria and Symptom Checklist-90-revised (SCL-90R). The prevalence of FGIDs was estimated, and the associated psychological factors were evaluated. Results: A total of 967 men participated. The total prevalence of FGIDs was 18.5% (age-adjusted prevalence, 18.1%; 95% confidence interval [CI], 15.3% to 20.8%). The total SCL-90R scores were higher in men with FGIDs than men without FGIDs (24 [interquartile range, 13 to 44] vs 13 [5 to 28], p<0.001) and higher in men with overlapping syndromes than in those with single FGIDs (31 [18 to 57] vs 14 [5.75 to 29], p<0.001). Somatization (odds ratio [OR], 1.141; 95% CI, 1.09 to 1.20; p<0.001), obsessive-compulsive behaviors (OR, 1.084; 95% CI, 1.03 to 1.14; p=0.002) and depression (OR, 0.943; 95% CI, 0.90 to 0.99; p=0.020) were identified as independent predictive factors for FGIDs. Conclusions: FGIDs are common among men in their twenties who are fulfilling their military duty. Somatization and obsessive-compulsive features from the tense atmosphere are associated with the development or progression of FGIDs. Patients who exhibit overlapping syndromes require greater attention given their more severe psychopathology.

범혈구감소증을 동반한 쉬한 증후군 1예

이현숙,권병운,한진형,김희진 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.1

Sheehan’s syndrome is characterized by varying degrees of anterior pituitary dysfunction due to postpartum ischemic necrosis of the pituitary gland after massive bleeding. The spectrum of clinical presentation of Sheehan’s syndrome is broad, with changes from nonspecific complaints, such as weakness, fatigue, and anemia, to severe pituitary insufficiency resulting in coma and death. Normochromic anemia is commonly associated with Sheehan’s syndrome, but pancytopenia is rarely observed in patients with Sheehan’s syndrome. We describe a 57-year-old woman with Sheehan’s syndrome who presented with pancytopenia that was treated by hormone replacement with levothyroxine and glucocorticoid.

증례 : 알레르기 ; 서혜부에 재발한 기무라씨 병 1예

한성환 ( Sung Hwahn Hahn ),한진형 ( Jin Hyung Han ),김경묵 ( Kyung Mook Kim ),김도형 ( Do Hyung Kim ),김윤섭 ( Youn Seup Kim ),박재석 ( Jae Seuk Park ),지영구 ( Young Koo Jee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.6

기무라씨 병은 주로 젊은 동양인 남자에게서 다양한 부위에 무통성 종괴로 나타나지만 두경부 영역에 호발하며 양성경과를 띠는 것으로 알려져 있어 국내에서 장기적인 경과관찰이 이루어진 예가 드물다. 이에 병변의 발생이 드문 서혜부에 재발하여 수술적 절제 후 전신적으로 스테로이드를 투여하며 5년간 경과관찰 중인 여성 환자의 1예를 보고하는 바이다. Kimura disease is a rare chronic inflammatory disorder of unknown etiology, suggestive of an allergic or autoimmune mechanism, which presents mainly as soft tissue masses in the head and neck area in young Asian males. Blood tests show eosinophilia and an elevated immunoglobulin E; the typical pathologic findings are lymphoid follicular hyperplasia, interfollicular eosinophilic infiltration, and vascular hyperplasia. There is no standard treatment; surgical resection is preferred and systemic steroid or radiotherapy is used to treat disease relapses. Kimura disease in unusual sites has been reported, but there are few cases with long-term observations because of its benign nature. Here, we present the case of a female with recurrent Kimura disease; we follow her progress for about 5 years after surgical resection of masses in the right groin area, an unusual site, with a brief review of the literature. (Korean J Med 2011;80:745-750)

뚜렷한 신경학적 증상 없이 통풍성 관절염만으로 발현된 hypoxanthine-guanine phosphoribosyltransferase (HPRT) 완전 결핍증 (Lesch-Nyhan 병) 1례

권병운 ( Byung Won Kwon ),현경희 ( Kyung Hee Hyun ),한진형 ( Jin Hyung Han ),김소미 ( So Mi Kim ),이상석 ( Sang Seok Lee ),추영광 ( Young Kwang Choo ),이은경 ( Eun Kyoung Lee ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1

Lesch-Nyhan disease is a very rare X-linked recessive disorder characterized by mental retardation, spasticity resembling cerebral palsy, choreoathetosis, self-mutilation and hyperuricemia. Self-mutilative behavior is a hallmark of the disease. The underlying defect is a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT). We report on a fourteen-year-old boy, who manifested gouty arthritis and mild renal insufficiency with Lesch-Nyhan disease, lacking self-mutilative behavior in spite of undetectable HPRT activity. Though there were several reports about some cases of Lesch-Nyhan disease in the past Korean literature, the cases were classic forms with definite neurological manifestation. As far as we know, this is the first case of Lesch-Nyhan disease without self-mutilation in Korea.

페그-인터페론과 리바비린 병합치료 중 발생한 간질성 페렴 및 범혈구 감소증

서지현 ( Ji Hyun Suh ),한성환 ( Sung Hwahn Hahn ),이지은 ( Ji Eun Lee ),한진형 ( Jin Hyung Han ),김경묵 ( Kyung Mook Kim ),김도형 ( Doh Hyung Kim ),김윤섭 ( Yon Seop Kim ),박재석 ( Jae Suk Park ),지영구 ( Young Koo Jee ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.1

The combination therapy of pegylated interferon and ribavirin is the mainstay of treatment for chronic hepatitis C patients. Anti-viral therapy is commonly associated with side effects such as headache, fever, myalgia, and arthralgia. However, anti-viral therapy can continue because these side effects are mostly mild and can be improved with supportive management. Anti-viral therapy should be stopped promptly if serious side effects, such as interstitial pneumonitis or hemolytic anemia occur, although those serious side effects are rare. There were a few case reports of interferon-related interstitial pneumonitis worldwide. In Korea, one atypical case report of interstitial pneumonitis has been reported, which followed the combination therapy of interferon-alpha and ribavirin in a patient with chronic hepatitis C. We present a case of interstitial pneumonitis and pancytopenia following the combination therapy of pegylated interferon and ribavirin in a patient with chronic hepatitis C.

Analysis of prognostic factors and 5-year survival rate in patients with hepatocellular carcinoma: a single-center experience

이상석,신현성,김형준,이수진,이현석,현경희,김용현,권병운,한진형,최훈,김배환,이준혁,강하얀,신현덕,송일한 대한간학회 2012 Clinical and Molecular Hepatology(대한간학회지) Vol.18 No.1

Background/Aims: Hepatocellular carcinoma (HCC), which is the third most common cancer in Korea, has a very poor prognosis. However, only a few studies have performed a comprehensive survival-related analysis in all patients who were consecutively diagnosed and treated over a given period of time. The aim of this study was to determine the 5-year survival rate and its prognostic factors among HCC patients. Methods: In total, 257 patients who were consecutively diagnosed with HCC between January 2000 and December 2003 were followed until death or until December 2008. We analyzed their survival outcomes according to their clinical characteristics, tumor staging, and treatment modalities, and determined the independent prognostic factors affecting survival. Results: The patients were aged 59±10 years (mean±SD). During the follow-up period, 223 patients (86.8%) died and the overall median survival was 10.8 months; the 1-, 3-, and 5-year survival rates were 44.4%, 21.0%, and 12.1%, respectively. The outcomes in patients with tumor node metastasis (TNM) stage I or II and Child-Pugh class A or B were significantly better with surgical resection than with other treatment modalities (P<0.01). Patients who underwent supplementary transcatheter arterial chemoembolization as a second-line treatment after surgical resection had better outcomes than those who underwent surgical resection alone (P=0.02). Initial symptoms, Child-Pugh class, serum alpha-fetoprotein, tumor size, portal vein thrombosis, and TNM stage were found to be independent prognostic factors for survival among HCC patients. Conclusions: This retrospective cohort study elucidated survival outcomes and prognostic factors affecting survival in HCC patients at a single center. (Korean J Hepatol 2012;18:48-55)