Castleman 질환 1례

안묘순,송형근,박범수,한헌석,하태선 충북대학교 의과대학 충북대학교 의학연구소 1993 忠北醫大學術誌 Vol.3 No.1

Castleman 질환은 주로 종격동 임파선을 침범하여 임상적, 조직학적으로 흉성종과 유사한 소견을 보이는 질환이다. 보통 침범된 임파선은 3cm에서 7cm의 크기를 보이며 경계가 뚜렷한 종양으로 나타난다. 조직학적 소견상 hyaline-vascular형(H-V형)과 plasma cell형의 두가지로 나눈다. 임상적으로는 hyaline-vascular형은 별증상이 없으며 보통 우연히 발견되고 드물게 기도와 기관지를 압박하는 증세를 보이기도 한다. plasma cell형은 빈혈, 적혈구침강속도의 증가, 고감마글로불린혈증, 저알부민혈증, 그리고 저트란스페린혈증을 보이기도 한다. 저자들은 생후 2개월부터 반복되는 호흡기 감염과 거친 숨소리를 보이면서, 성장 및 발육장애를 보인 14개월된 남아에서, 기도에서 우측 주기관지까지를 압박하고 있는 종양을 흉부 전산화단층촬영에서 발견하고 떼어낸 후 조직소견상 hyaline-vascular형의 giant lymph node hyperplasia의 소견을 보이는 Castleman 질환 1례를 경험하였기에 보고하는 바이다. Castleman's disease(angiofollicular lymph node hyperplasia) can arise from lymph nodes or extranodal tissues and can be classified histologically into the hyaline-vascular form, characterized by hyaline follicle-like structures interspersed with vascular tissue, or the plasma cell variant, in which the follicle-like structures are seperated by sheets of plasma cells amidst vascular interfollicular tissue. The clinical manifestations of the multicentric variant can be protean and inculude fever, night sweats, weight loss, lymphadenopathy, hepatosplenomegaly, pleural effusion, ascites, anemia, thrombocytopenia, polyclonal hypergammaglobulinemia, and neurological and renal abnormalities. We report a case of Castleman's disease in 14-month old male patient with the chief complaints of recurrent respiratory symptoms and delayed growth and development, who was diagnosed as having a hyaline-vascular form of above disease after the excision of pulmonary mass which compressed the right main bronchus.

장벽경색이 선행한 Henoch-Schonlein 자반증 1례

한헌석,하태선,송형근,이상전,안묘순,박범수 충북대학교 의과대학 충북대학교 의학연구소 1993 忠北醫大學術誌 Vol.3 No.1

Henoch-Schonlein 자반증은 피부, 위장관, 관절, 신장 등을 주로 침범하며 소혈관염을 기본 병리 소견으로하는 전신성 혈관 장애 질환이다. 위장관계 증상으로는 복통, 오심 및 구토, 잠혈, 토혈, 흑색변 등이 있을 수 있고, 이러한 증상은 합병증 없이 회복되는 것이 보통이나 드물게는 장중첩증, 장벽경색 및 괴사, 장천공 등의 심한 합병증을 동반할 수도 있다. 이러한 위장관계 증상들은 특징적인 피부 소견에 선행하여 나타날 수도 있으며, 이때는 급성복증에 대한 감별진단이 중요하다. 저자들은 장벽경색이 선행하여 감별진단에 어려움을 겪고 시험적개복술을 시행한 이후에 특징적인 피부 자반이 발현되어 Henoch-Schonlein 자반증으로 진단할 수 있었던 증례를 경험하였기에 이를 보고하고자 한다. 본 증례는 입원 1일전부터 시작된 복통을 주소로 입원한 5세 남아가 배꼽 주위에 심한 경련성 복통을 지속적으로 호소하였고 이학적 소견상 배꼽주위의 압통, 장음의 감소, 흑색변 등이 있었으며 소장조영술상 공장 부위에 미만성의 불규칙한 점막비후 소견을 보여 제 8병일에 시험적개복술을 시행한 결과 근위 공장에 국한된 장괴사의 소견이 발견되어 절제 및 문합술을 실시 하였다. 병리학적 검사에서는 장벽경색의 소견을 보였다. 수술후에 복통은 완화되었으나 경미하게 지속되었고, 제 13병일경에 급성 부고환염이 병발되었다가 회복되었고 제 15병일경에는 하지에서부터 발현된 자반이 3일간 지속되었다. 결구 Henoch-Schonlein 자반증과 이의 합병증으로 발생한 근위 공장의 장벽경색으로 진단하였다. Colicky abdominal pain as symptom of Henoch-Schonlein purpura occurs in up to 70% of patients, and results from submucosal edema and hemorrhage. Abdominal pain and other GI symptoms such as nausea, vomiting, melena and hematemesis resolve mostly without any complications. But rarely life-threatening GI complications such as intussusception, intestinal mural infarction and necrosis, and massive hemorrhage may develope. In 14% of patients, abdominal pain may precede other symptoms, and creats diagnostic difficulties. We reports a case of the Henoch-Schonlein purpura presented with colicky abdominal pain which resulted from intestinal mural infarction and preceded characteristic purpuric skin lesion by several weeks. This 5 year old male patient complained of colicky abdominal pain, nausea and melena. Exploratory laparatomy was done and revealed intestinal mural infarction in proximal jejunum. One week later operation, purpuric skin lesion develiped in both leg and feet, and then, Henoch-Schonlein purpura was diagnosed.

Decreased ex vivo production of interferon-gamma is associated with severity and poor prognosis in patients with lupus

Ahn, Sung Soo,Park, Eun Seong,Shim, Joo Sung,Ha, Sang-Jun,Kim, Beom Seok,Jung, Seung Min,Lee, Sang-Won,Park, Yong-Beom,Song, Jason Jungsik BioMed Central 2017 Arthritis research & therapy Vol.19 No.-

<P><B>Background</B></P><P>Lupus pathogenesis is closely associated with interferon gamma (IFN-γ), which plays a central role in innate and adaptive immunity. The aim of this study was to evaluate the ex vivo production of IFN-γ after stimulation of peripheral blood mononuclear cells with phytohemagglutinin (PHA) in patients with lupus, according to disease activity.</P><P><B>Methods</B></P><P>This study included 118 patients with lupus who had undergone IFN-γ-releasing assays (IGRAs) to screen for tuberculosis. Data on IFN-γ production in negative (nil) and positive (mitogen with PHA) controls were collected and analysed. The difference (mitogen minus nil) was used to calculate ex vivo IFN-γ production. Disease activity was evaluated using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Poor hospitalisation outcome was defined as in-hospital mortality or intensive care unit admission. Associations among disease activity, poor hospitalisation outcome, and ex vivo IFN-γ production were assessed.</P><P><B>Results</B></P><P>The level of ex vivo IFN-γ production was significantly lower in patients with active systemic lupus erythematosus (SLE) (n = 64) than in those with inactive SLE (n = 54) (median 0.92 vs. 11.06 IU/mL, <I>p</I> < 0.001). Ex vivo IFN-γ production was correlated with the SLEDAI-2 K (<I>r</I> = − 0.587, <I>p</I> < 0.001). Results of multivariate logistic regression analysis showed that ex vivo IFN-γ production ≤ 7.19 IU/mL was an independent predictor for discriminating active and inactive lupus. In addition, patients with ex vivo IFN-γ production ≤ 0.40 IU/mL had more frequent poor hospitalisation outcomes than those with ex vivo IFN-γ production > 0.40 (40.0% vs. 9.3%, <I>p</I> = 0.001). The proportion of indeterminate IGRA results was higher in patients with active lupus than in those with inactive lupus (45.3% vs. 0.0%, <I>p</I> < 0.001) because of decreased ex vivo IFN-γ production.</P><P><B>Conclusions</B></P><P>Ex vivo IFN-γ production is a useful biomarker for assessing disease activity and predicting poor clinical outcomes of SLE.</P><P><B>Electronic supplementary material</B></P><P>The online version of this article (doi:10.1186/s13075-017-1404-z) contains supplementary material, which is available to authorized users.</P>

Heat Transfer and Frictions in the Convergent/divergent Channel with Λ/V-shaped Ribs on Two Walls

Beom-soo Kim,Myung-sung Lee,Soo-whan Ahn 한국항공우주학회 2017 International Journal of Aeronautical and Space Sc Vol.18 No.3

The local heat transfer and total pressure drops of developed turbulent flows in the ribbed rectangular convergent/divergent channels with Λ/V-shaped ribs have been investigated experimentally. The channels have the exit hydraulic diameter (Dho) to inlet hydraulic diameter (Dhi) ratios of 0.67 for convergence and 1.49 for divergence, respectively. The Λ/V-shaped ribs with three different flow attack angles of 30°, 45°, and 60° are manufactured with a fixed rib height (e) of 10 mm and the ratio of rib spacing (S) to height (e) of 10 on the walls. Thermal performances of the ribbed rectangular convergent/divergent channels are compared with the smooth straight tube under identical pumping power. The results show that the flow attack angle of 45° with Λ-shaped rib has the greatest thermal performance at all the Reynolds numbers studied in the convergent channel; whereas, the flow attack angle of 60o with V-shaped rib has the greatest thermal performance over Reynolds number of 30,000 in the divergent channel.

On the Design of Statistical Software in the Network Environment

Han, Beom-Soo,Ahn, Jeong-Yong,Han, Kyung-Soo The Korean Statistical Society 2002 Communications for statistical applications and me Vol.9 No.1

Computer network provides a powerful infrastructure for information sharing and the development of the statistical software with new concepts. In this paper, we discuss the design concepts of the statistical software in the network environment.

Original Article : Tenofovir disoproxil fumarate monotherapy for nucleos(t)ide-naive chronic hepatitis B patients in Korea: data from the clinical practice setting in a single-center cohort

( Sung Soo Ahn ),( Young Eun Chon ),( Beom Kyung Kim ),( Seung Up Kim ),( Do Young Kim ),( Sang Hoon Ahn ),( Kwang Hyub Han ),( Jun Yong Park ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.3

Background/Aims: This study assessed the antiviral efficacy and safety of tenofovir disoproxil fumarate (TDF) for up to 12 months in Korean treatment-naive chronic hepatitis B (CHB) patients. Methods: A total of 411 treatment-naive CHB patients who had been treated with TDF for at least 3 months (median 5.6) were consecutively enrolled. Clinical, biochemical, virological parameters and treatment adherence were routinely assessed every 3 months. Results: The median age was 51.3 years, 63.0% of the patients were male, 49.6% were HBeAg (+), and 210 patients had liver cirrhosis. The median baseline HBV DNA was 5.98 (SD 1.68) log10 IU/mL. Among the patients completing week 48, 83.3% had a complete virologic response (CVR, <12 IU/mL by HBV PCR assay), and 88.2% had normalized levels of alanine aminotransferase (ALT). The cumulative probabilities of CVR at 3, 6, 9 and 12 months were 22.8 %, 53.1%, 69.3% and 85.0%. During the follow-up period, 9.8% patients achieved HBeAg loss and 7.8% patients achieved HBeAg seroconversion. There was no virological breakthrough after initiating TDF. The most common TDF-related adverse event was gastrointestinal upset, and three patients discontinued TDF therapy. However, no serious life-threatening side effect was noted. Conclusions: In a clinical practice setting, TDF was safe and highly effective when administered for 12 months to Korean treatment-naive CHB patients. (Clin Mol Hepatol 2014;20:261-266)

Anti-Sm is associated with the outcome of lupus nephritis

( Sung Soo Ahn ),( Byung-woo Yoo ),( Jung Yoon Pyo ),( Se-jin Byun ),( Jason Jungsik Song ),( Yong-beom Park ),( Soo-kon Lee ),( Sang-won Lee ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Introduction: Anti-Sm is one of items of the 1987 American College of Rheumatology classification criteria for systemic lupus erythematosus (SLE). However, its role in the disease course or its significant clinical relevance in lupus nephritis still remains uncertain. We investigated whether anti-Sm is associated with the outcome of lupus nephritis in patients with biopsy-proven lupus nephritis during the follow-up period. Materials and Methods: One hundred-forty nine patients with lupus nephritis who had undergone kidney biopsy were screened, and 90 patients were enrolled and analyzed from January 2005 to December 2014. In addition to anti-Sm, SLE disease activity index (SLEDAI), laboratory results, lupus nephritis classes was assessed. The association between anti-Sm and the patients’renal function, proteinuria and use of immunosuppressive agent was assessed. Immunosuppressive agent was defined as cyclophos-phamide, azathioprine, mycophenolate mofetil, tacrolimus, cyclosporine. Their usages were counted when patients had received them for at least 3 months. Only patients who had been followed up for over 6 months after kidney biopsy was included. Results: The median age at kidney biopsy performance was 32.0 years and median follow up duration after biopsy was 33.0 months (range 6.0 109.8). Anti-Sm was found in 44 of 90 patients (48.8%), and kidney biopsy revealed that class IV (46.6%, 42 of 90) was the most frequently observed. Although anti-Sm was not associated with deterioration of renal function and proteinuria, it (p=0.022) was significantly associated with the use of immunosuppressive agent along with age (p=0.027) and high SLEDAI (p=0.007). Multivariate analysis still revealed the use of immunosuppressive agent was associated with anti-Sm (OR 2.870, 95% confidence interval (CI), 1.033, 7.976, p=0.043), age (OR 0.958, 95% CI, 0.923-0.994, p=0.023) and SLEDAI (OR 1.185, 95% CI, 1.023, 1.373, p=0.024). Conclusions: In biopsy-proven lupus nephritis patients, presence of anti-Sm was independently associated with the use of immunosuppressive agent. Our findings indicated that anti-Sm may be one of the useful markers for the outcome of lupus nephritis.

램버트 W 함수를 이용한 시간지연 순수 특이 섭동 시스템 안정화 제어기 설계

김범수(Beom-Soo Kim),안수환(Soo-Whan Ahn) 한국동력기계공학회 2014 동력시스템공학회지 Vol.18 No.1

Heat Transfer and Frictions in the Convergent/divergent Channel with Λ/V-shaped Ribs on Two Walls

Kim, Beom-soo,Lee, Myung-sung,Ahn, Soo-whan The Korean Society for Aeronautical and Space Scie 2017 International Journal of Aeronautical and Space Sc Vol.18 No.3

The local heat transfer and total pressure drops of developed turbulent flows in the ribbed rectangular convergent/divergent channels with ${\Lambda}/V-shaped$ ribs have been investigated experimentally. The channels have the exit hydraulic diameter ($D_{ho}$) to inlet hydraulic diameter ($D_{hi}$) ratios of 0.67 for convergence and 1.49 for divergence, respectively. The ${\Lambda}/V-shaped$ ribs with three different flow attack angles of $30^{\circ}$, $45^{\circ}$, and $60^{\circ}$ are manufactured with a fixed rib height (e) of 10 mm and the ratio of rib spacing (S) to height (e) of 10 on the walls. Thermal performances of the ribbed rectangular convergent/divergent channels are compared with the smooth straight tube under identical pumping power. The results show that the flow attack angle of $45^{\circ}$ with ${\Lambda}-shaped$ rib has the greatest thermal performance at all the Reynolds numbers studied in the convergent channel; whereas, the flow attack angle of $60^{\circ}$ with V-shaped rib has the greatest thermal performance over Reynolds number of 30,000 in the divergent channel.

窒素施用量 및 施用方法이 稻熱病發現에 미치는 影響

安相培(Sang-Bae Ahn),安允秀(Yoon-Soo Ahn),李春秀(Choon-Soo Lee),許範亮(Beom-Lyang Huh) 한국토양비료학회 1985 한국토양비료학회지 Vol.18 No.4