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- 저자 : ( Ga Young Ban ) (검색결과 37 건)
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반가영 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4
Diabetic muscle infarction (DMI) is a rare complication that usually occurs in patients with longstanding microvascular complications of diabetes. The typical clinical presentation of DMI includes a sudden onset of pain, tenderness, and swelling of the lower limbs. DMI can be diagnosed by typical clinical manifestations and magnetic resonance imaging (MRI). Treatment usually includes immobilization of the affected extremity and taking analgesics. A 44 year-old woman with type 2 diabetes mellitus and Hashimoto's thyroiditis for 10 years, presented with an abrupt and spontaneous onset of severe pain in the left thigh. In order to evaluate the etiology, angio-computed tomography, bone scan, and MRI of the lower extremities were performed. DMI was diagnosed based on the hyper-intense T2 weighted signals on the MRI. The patient was fully recovered with the conservative treatment.
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S-522 : Clinical features of elderly chronic urticaria
( Ga Young Ban ),( Mi Yea Kim ),( Hye Soo Yoo ),( Dong Ho Nahm ),( Young Min Ye ),( Yoo Seob Shin ),( Hae Sim Park ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Background: Chronic urticaria (CU) is defined as itchy wheals lasting for at least 6 weeks, with or without angioedema. It is a common disabling disorder occurring in about 0.5-1% of the population. Recently, the aged population is increasing worldwide, and this group responds differently to environmental stimuli. Therefore, it is essential to identify the specific features of disease in aged group. Nevertheless, there have been few studies reporting the features about CU in the elderly population. We investigated the prevalence and clinical features of elderly CU in comparison with non-elderly CU in this country. Method: We retrospectively analyzed the medical records of 827 CU patients who were followed in the outpatient Allergy Clinic of Ajou University Hospital, South Korea. According to the EAACI/GA2LEN/EDF/WAO guideline, physical or other secondary types of urticarial patients were excluded, and chronic spontaneous urticarial patients were included. Elderly CU was defined as the CU patients older than 60 years old. Severe CU was defined when urticaria activity score was ≥13 at initial visit. Results: Of the total 827 patients, 37 (4.5%) were elderly. Among co-morbid conditions, atopic dermatitis (AD) was significantly higher (37.8% vs. 21.7%, p=0.022), while prevalence of aspirin intolerance was lower (18.9% vs. 43.6%, p=0.003) in elderly CU. However, prevalence of severe CU was not significantly different between the two groups. Other clinical parameters such as sex, atopy and laboratory findings including anti-thyroid antibodies and serum specific IgE to staphylococcal superantigens were found to have no significant differences between the two groups. However the prevalences of serum specific IgE to staphylococcal enterotoxin A (SEA) and staphylococcal enterotoxin B (SEB) were significantly higher in elderly CU with AD than in those without AD (37.5% vs. 0%, respectively). Conclusion: Considering the higher prevalence of AD in elderly CU, it is needed to observe the coexistence of AD in elderly CU. Specific IgE to SEA/SEB may play a role in the pathogenesis of elderly CU, especially who are accompanied by AD.
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Ban Ga-Young,김수진,이현영,예영민,신유섭,박해심 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.3
Purpose Minimizing the future risk of asthma exacerbation (AE) is one of the main goals of asthma management. We investigated prognostic factors for risk of severe AE (SAE) in a real-world clinical setting. Methods This is an observational study evaluating subjects who were diagnosed with asthma and treated with anti-asthmatic medications from January 1995 to June 2018. Risk factors for SAE were analyzed in 2 treatment periods (during the initial 2 years and the following 3–10 years of treatment) using the big data of electronic medical records. Results In this study, 5,058 adult asthmatics were enrolled; 1,335 (28.64%) experienced ≥ 1 SAE during the initial 2 years of treatment. Female sex, higher peripheral eosinophil/basophil counts, and lower levels of forced expiratory volume in 1 second (FEV1; %) were factors predicting the risk of SAEs (P < 0.001 for all). Higher serum total immunoglobulin E levels increased the risk of SAEs among the patients having ≤ 2 SAEs (P = 0.025). Patients with more frequent SAEs during the initial 2 years of treatment had significantly higher risks of SAEs during the following years of treatment (P < 0.001, for all) (patients with ≥ 4 SAEs, odds ratio [OR], 29.147; those with 3 SAEs, OR, 14.819; those with 2 SAEs, OR, 9.867; those with 1 SAE, OR, 5.116), had higher maintenance doses of systemic steroids, and showed more gradual decline in FEV1 (%) and FEV1/forced vital capacity levels maintained during the following years of treatment (P < 0.001 for all). Conclusions Asthmatics having risk factors for SAEs (female sex, higher peripheral eosinophil/basophil counts, and lower FEV1) should be strictly monitored to prevent future risk and improve clinical outcomes. Purpose Minimizing the future risk of asthma exacerbation (AE) is one of the main goals of asthma management. We investigated prognostic factors for risk of severe AE (SAE) in a real-world clinical setting. Methods This is an observational study evaluating subjects who were diagnosed with asthma and treated with anti-asthmatic medications from January 1995 to June 2018. Risk factors for SAE were analyzed in 2 treatment periods (during the initial 2 years and the following 3–10 years of treatment) using the big data of electronic medical records. Results In this study, 5,058 adult asthmatics were enrolled; 1,335 (28.64%) experienced ≥ 1 SAE during the initial 2 years of treatment. Female sex, higher peripheral eosinophil/basophil counts, and lower levels of forced expiratory volume in 1 second (FEV1; %) were factors predicting the risk of SAEs (P < 0.001 for all). Higher serum total immunoglobulin E levels increased the risk of SAEs among the patients having ≤ 2 SAEs (P = 0.025). Patients with more frequent SAEs during the initial 2 years of treatment had significantly higher risks of SAEs during the following years of treatment (P < 0.001, for all) (patients with ≥ 4 SAEs, odds ratio [OR], 29.147; those with 3 SAEs, OR, 14.819; those with 2 SAEs, OR, 9.867; those with 1 SAE, OR, 5.116), had higher maintenance doses of systemic steroids, and showed more gradual decline in FEV1 (%) and FEV1/forced vital capacity levels maintained during the following years of treatment (P < 0.001 for all). Conclusions Asthmatics having risk factors for SAEs (female sex, higher peripheral eosinophil/basophil counts, and lower FEV1) should be strictly monitored to prevent future risk and improve clinical outcomes.
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Clinical features of elderly chronic urticaria
( Ga Young Ban ),( Mi Yea Kim ),( Hye Soo Yoo ),( Dong Ho Nahm ),( Young Min Ye ),( Yoo Seob Shin ),( Hae Sim Park ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.6
Background/Aims: Chronic urticaria (CU) is defined as itchy wheals lasting 6 weeks or more. As the aged population increases worldwide, it is essential to identify the specific features of this disease in the elderly population. Methods: We investigated the prevalence and clinical features of CU in elderly patients. Medical records of 837 CU patients from the outpatient Allergy Clinic of Ajou University Hospital, Korea were analyzed retrospectively. Patients with chronic spontaneous urticaria according to the EAACI/GA2LEN/EDF/WAO guidelines were included. Patients older than 60 years were defined as elderly. Results: Of the 837 patients, 37 (4.5%) were elderly. In elderly versus nonelderly CU patients, the prevalence of atopic dermatitis (AD) was significantly higher (37.8% vs. 21.7%, respectively; p = 0.022), while that of aspirin intolerance was lower (18.9% vs. 43.6%, respectively; p = 0.003) in terms of comorbid conditions. The prevalences of serum specific immunoglobulin E antibodies to staphylococcal enterotoxin A and staphylococcal enterotoxin B were considerably higher in elderly CU patients with AD than in those without AD (37.5% vs. 0%, respectively). Conclusions: Elderly patients with CU had a higher prevalence of AD. Therefore, there is a need to recognize the existence of AD in elderly CU patients.
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Genetic Effects on Leukotriene Production in Aspirin Exacerbated Respiratory Disease
( Ga-young Ban ),( Kumsun Cho ),( Seung-hyun Kim ),( Moon Kyung Yoon ),( Ji-hye Kim ),( Yoo-seob Shin ),( Young-min Ye ),( Dong-ho Nahm ),( Hae-sim Park ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: It is widely known that there have been strong genetic associations with aspirin exacerbated respiratory diseas (AERD) development. Leukotriene overproduction is the major feature of AERD. Genetic polymorphisms of CysLTR1 and HLA-DPB1*0301 were associated with the phenotypes of AERD. Objective: To investigate the genetic effects on leukotriene production in AERD. Subjects and Methods: A total of 95 AERD and 94 aspirin tolerant asthma (ATA) patients were enrolled. Serum samples were collected from all of the study subjects whereas urine samples were collected from 45 AERD and 44 ATA patients when the asthma was stable. The metabolites of LTE4 were analyzed using liquid chromatography with mass spectrometry. HLA-DPB1 high-resolution genotyping wasobtained from direct sequencing method and polymorphism of CysLTR1 was genotyped using SNaP shot ddNTP primer extension kit. Results: The frequency of HLA-DPB1*0301 allele was significantly higher in AERD compared with ATA (p=0.004, OR=4.178). The TT genotype frequency at CysLTR1 -634C>T is significantly higher in AERD compared to ATA (p 0.006, OR= 2.891). Serum and urine LTE4 levels were significantly higher in AERD than in ATA (19.10 ± 14.14 pg/mL vs. 13.59 ± 10.10 pg/mL, p=0.002; 7.36 ±13.19 pmol/mg creatinine vs. 2.69 ±3.62 pmol/mg creatinine, p=0.047, respectively). The levels of urine LTE4 were significantly higher in patients carrying HLA-DPB1*0301 (p=0.041), while no differences were found in serum LTE4. The asthmatic patients with the TTgenotype at -634C>T had a significantly higher levels of urine LTE4 (p=0.015), but no differences were found in serum LTE4 levels. The levels of urine LTE4 correlated significantly with fall of FEV1% after lysine aspirin bronchoprovocation test (r=0.463, p=0.008). Conclusions: HLA-DPB1*0301 and genetic polymorphisms of CysLTR1 -634C>T affect cysteinyl leukotriene overproduction which can contribute to develop the phenotypes of AERD.
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( Young Soo Lee ),( Ga Young Ban ),( Ji Hye Kim ),( Dae Hong Seo ),( Young Min Ye ),( Yoo Seob Shin ),( Dong Ho Nahm ),( Hae Sim Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Eosinophilic gastroenteritis (EG) is a rare disease characterized by massive eosinophilic infiltration of gastrointestinal tissue, increased peripheral eosinophilia and nonspecific gastrointestinal symptoms. EG have no known causes for eosinophilia such as drug, parasite, or malignancy. About 50% of EG patients have allergic diseases suggesting EG may be associated with allergic status since some EG patients exhibit elevated serum immunoglobulin E (IgE) levels. We report a case of EG which led to severe malabsorption and iron deficiency anemia associated with multiple food allergies. A 28-yearold Caucasian male patient visited emergency room complaining general weakness and leg swelling for 2 months. He had allergic rhinitis and vomiting whenever eating eggs, steaks, and salmons. He looked chronically-ill and conjunctivae were pale. In laboratory findings, hemoglobin level and WBC count were 6.4g/dL and 7,400/uL with 24.4% of eosinophil fraction as well as serum total protein and albumin levels were 3.9g/dL and 2.8g/dL, respectively. Serum iron level (12μg/dL), total iron binding capacity (247μg/ dL), and ferritin level (2.2μg/L) were all decreased. Serum eosinophil cationic protein level was increased (30.0μg/L) whereas serum total IgE level was within normal reference value (77KU/L). Serologic tests for parasite were all negative. Endoscopic studies were performed to exclude gastrointestinal bleeding and multiple nodular lesions were seen on gastric antrum with increased eosinophil in. ltration in lamina propria. High serum specific IgE levels to offending foods (beef: 0.82kU/L, pork: 0.83kU/L, egg white: 0.40kU/L, egg yolk: 0.54kU/L, and milk: 0.81kU/L) were noted. He was recommended avoiding offending foods with oral prednisolone therapy. Six months after food restriction, eosinophil count was 400/uL and hemoglobin level was restored to 11.5g/dL with 4.1g/dL of serum albumin level. We report a rare case of eosinophilic gastroenteritis associated with multiple food allergies.
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반가영 ( Ga Young Ban ),양은미 ( Eun Mi Yang ),김지혜 ( Ji Hye Kim ),신유섭 ( Yoo Seob Shin ),예영민 ( Young Min Ye ),남동호 ( Dong Ho Nahm ),박해심 ( Hae Sim Park ) 대한천식알레르기학회(구 대한알레르기학회) 2015 Allergy Asthma & Respiratory Disease Vol.3 No.5
Anaphylaxis is a severe and life-threatening systemic reaction. Despite the extensive evaluation to determine the cause, 30%-60% of cases of anaphylaxis in adults remain idiopathic. Recently, omalizumab treatment has been postulated to treat refractory idiopathic anaphylaxis. We report a case of idiopathic anaphylaxis treated with omalizumab and investigated its pharmacological mechanism. A 66-year-old female presented to our clinic with recurrent anaphylaxis. She suffered from anaphylaxis 2-3 times a month for 6 months. She had past medical history of nonallergic bronchial asthma. History was carefully undertaken and anaphylaxis was not related to any specific foods, drugs, exercise, and insect bites. Serum specific IgE antibodies to common food allergens showed negative results. Oral provocation tests to food additives revealed to be negative. To screen systemic mastocytosis and mast cell activating syndrome, baseline tryptase level was checked, and it was within normal range. From comprehensive evaluation, she was diagnosed as having idiopathic anaphylaxis. She could not tolerate oral medications due to gastrointestinal discomfort, therefore, omalizumab treatment (150 mg, monthly) was started. After 6 months of treatment, anaphylaxis did not occur with complete remission status. To evaluate the pharmacological mechanism of omalizumab treatment, basophil histamine releasability test was performed. Histamine releasability induced by anti-IgE did not change after 6 months of treatment, while that induced by calcium inophore decreased. Omalizumab treatment can induce remission or favorable effects on idiopathic anaphylaxis, which may be derived from increased threshold of mast cell degranulation. Long-term studies in a larger cohort will be needed to confirm its efficacy. (Allergy Asthma Respir Dis 2015;3:380-383)
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