진성 적혈구 증다증 환자에서 발생한 발목뼈 결핵 1 예

고성애,정선영,손세훈,김동근,박성우,허지안,이경희,김민경,현명수 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.1

Talus tuberculosis is a rare disease, even in an endemic tuberculosis area. In reviews of the worldwide literature, only 18 cases of talus tuberculosis have been reported. Recently, we experienced a case of a 70-year-old polycythemia vera patient with right metatarsopharyngeal joint pain for 2 months duration who was diagnosed with talus tuberculosis with prostate involvement. Tuberculosis should be considered as one of the causes of monoarticulitis, especially in countries, where the disease is endemic. Additionally, we highly recommend taking a biopsy of the site of suspected infection because an early diagnosis is the key to successful treatment.

신이식 환자에서 EBV감염과 관련된 악성 임파종 2예

윤선애,진동찬,김용수,신완식,윤영석,방병기,최영진,심상인,고용복 大韓移植學會 1993 Korean Journal of Transplantation Vol.7 No.1

복막투석복막염 환자에서 발생한 창자벽공기증 1예

정선영,나지훈,최윤정,고성애,조규향,박종원,도준영,윤경우 영남대학교 의과대학 2009 Yeungnam University Journal of Medicine Vol.26 No.1

Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmented resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.

An update on immunotherapy with PD-1 and PD-L1 blockade

( Sung Ae Koh ) 영남대학교 의과대학 2021 Yeungnam University Journal of Medicine Vol.38 No.4

Cancer is the leading cause of death and is on the rise worldwide. Until 2010, the development of targeted treatment was mainly focused on the growth mechanisms of cancer. Since then, drugs with mechanisms related to tumor immunity, especially immune checkpoint inhibitors, have proven effective, and most pharmaceutical companies are striving to develop related drugs. Programmed cell death-1 and programmed cell death ligand-1 inhibitors have shown great success in various cancer types. They showed durable and sustainable responses and were approved by the U.S. Food and Drug Administration. However, the response to inhibitors showed low percentages of cancer patients; 15% to 20%. Therefore, combination strategies with immunotherapy and conventional treatments were used to overcome the low response rate. Studies on combination therapy have typically reported improvements in the response rate and efficacy in several cancers, including non-small cell lung cancer, small cell lung cancer, breast cancer, and urogenital cancers. The combination of chemotherapy or targeted agents with immunotherapy is one of the leading pathways for cancer treatment.

위암과 폐암의 동시성 중복암으로 오인된 폐암의 동시성 단독 위전이

고성애 ( Sung Ae Koh ),이경희 ( Kyung Hee Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.3

Although hematogenous metastasis of cancer to the gastrointestinal track is rare, it sometime has been reported in patients with malignant melanoma and breast cancer. However, it is extremely rare for lung cancer to metastasize to the stomach, not to mention solitary gastric metastasis. Herein, the authors report a case of a 69-year-old man who was initially diagnosed with lung cancer with synchronous primary gastric cancer which proved to be lung cancer with solitary gastric metastasis after the operation. (Korean J Gastroenterol 2014;64:154-157)

혈액종양 ; 국소 연조직 환자의 예후인자 분석

고성애 ( Sung Ae Koh ),이경희 ( Kyung Hee Lee ),김민경 ( Min Kyoung Kim ),현명수 ( Myung Soo Hyun ),신덕섭 ( Duk Seop Shin ),윤상모 ( Sang Mo Yun ),강민규 ( Min Kyu Kang ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4

목적: 연부조직 육종이란 지방, 근육, 신경, 섬유성 관절, 혈관이나 피부의 깊은 조직으로부터 생기는 악성종양이다. 예후를 예측할 수 있는 인자에 대한 분석도 많지 않은데, 현재 국소재발과 관련된 예후인자로 나이, 후복막과 두부에 종양이 위치했을 때, 종양의 등급, 특정한 조직분류가 보고되고 있다. 방법: 이 연구는 2000년 1월부터 2006년 12월까지 영남대학병원에 입원하여 국소적인 연부조직 육종을 진단받고 단독수술 혹은 수술 후 병합치료를 시행한 환자를 선정하여 의무기록을 후향적으로 조사하였다. 나이, 성별, 종양의 위치, 종양의 조직종류, 수술절제 단면의 암세포의 유무, 수술, 항암요법, 방사선 요법 등의 치료 종류 등을 포함한 환자의 특징을 포함시켰다. 전체 생존기간과 무병 생존기간에 연관있는 여러 인자들을 단변량 분석과 다변량 분석을 사용하여 분석하였다. 결과: 환자들의 일반적인 특징을 보면, 평균나이는 50세 (범위 17~70세)였다. 남녀 비율은 남자 31명, 여자 36명으로 비슷한 비율을 보였으며 처음 진단받고 치료한 환자는 58명 (87%)이었고 국소 재발하여 치료한 환자는 9명(13%)이었다. 조직학적으로 많은 부분을 차지한 육종은 지방육종으로 총20명(30%)이었으며 그 다음으로 평활근 육종으로 9명(13%)을 차지하였다. 종양의 크기가 10 cm 보다 큰 환자의 수는 17명(25%)이었으며 19명(28%)의 환자에서 수술절제 단면 양성소견을 보였다. 조직결과에서 고등급이 43명으로 64%를 차지하였다. 육종이 발생하는 가장 흔한 장소는 하지로 35명 (52%)이었으며 다음으로 차지한 곳이 몸통으로 9명(18%)이었다. 생존 기간 중앙값은 62.7개월(95% CI. 25.7-99.4)이었고, 무병생존기간 중앙값은 36.1개월(95% CI. 17.9-54.2)이었다. 수술만 한 집단에서의 생존 기간 중앙값과 무병생존기간 중앙값은 각각 51.2개월이고 21.1개월이었다. 이번 연구에서 전체 생존률과 관련된 예후인자는 종양의 크기, 활동도였다. 무병 생존기간과 관련된 인자는 종양위치와 절제단면이었는데, 수술 절제 단면 양성일 때, 종양의 위치가 두부, 천부몸통, 심부몸통에 위치하였을 때 무병 생존기간이 의미 있게 짧았다. 그러나 수술 후 치료 방법은 전체 생존기간이나 무병생존기간과 통계적으로 유의성이 없었다. 결론: 본 연구에서는 국소 연부조직 육종에서의 예후인자를 분석하였고, 종양이 클수록, 종양의 위치가 두부나 몸통에 위치할 때, 수술 절제 단면이 양성일 때, 그리고 환자의 일상생활 수행능력이 나쁠 때 예후가 나쁜 것으로 분석되었다. Background/Aims: We evaluated the independent prognostic factors for overall and disease-free survival in the treatment of soft tissue sarcoma. Methods: Sixty-seven medical records were retrospectively reviewed. All the patients had presented with localized soft tissue sarcoma and had been treated with conservative surgery, followed by additional therapy or surgery. All were treated at the Yeungnam University Hospital between January 2000 and December 2006. Univariate and multivariate analyses were used to evaluate factors affecting overall and disease-free survival. Results: The median age of the study sample was 50 (range, 15~70) years. Twenty patients (30%) had liposarcoma and nine (13%) had leiomyosarcoma. Seventeen patients (25%) had a tumor measuring greater than 10 cm. Nineteen patients (28%) had positive resection margins. The median overall survival was 62.7 months (95% CI: 25.7~99.4) and the median disease-free survival was 36.1 months (95% CI: 17.9~54.2). Factors that significantly affected the median overall survival were a tumor size greater than 10 cm and performance status. Positive resection margins and tumor site were independent prognostic factors associated with disease- free survival. Other factors, such as histopathology, gender, age, and tumor grade, did not have prognostic value. Additionally, the chosen modality of treatment after surgery was not an independent predictor of the median overall or disease-free survival. Conclusions: Tumor size, positive resection margins, tumor site, and performance status were statistically significant independent predictors of poor prognosis. (Korean J Med 2011;80:419-426)

박종홍 철학의 형성과정 연구

고성애(Koh, Sung-Ae) 서울대학교 철학사상연구소 2013 철학사상 Vol.48 No.-

박종홍 철학에 대한 기존의 연구에서는 그의 철학사상에만 관심을 가졌지 그러한 철학사상의 형성과정과 배경에 대한 연구는 많지 않다. 본고에서는 박종홍 철학을 본격적으로 검토하기 위한 기초 작업으로서 경성제국대학에 입학하기 전에 형성된 어떤 문제의식이 그를 ‘철학함’으로 이끌어주는지 살펴보고자 하였다. 박종홍이 철학함의 출발점에서 고민하였던 문제는 “우리”와 “민족”이었고 고민을 해결하고자 읽었던 것이 최남선이 간행한 책이었다. 그는 민족의 독립을 위하여 “우리 민족”의 특색을 밝혀보고자 시도하였고 다카야마 쵸규의 저작들을 읽으면서 조선 미술사에 대한 연구를 시작하였다. 하지만 결국 한계를 느끼고 중단되었지만 다시 니시다 기타로의 철학사상을 접하면서 박종홍은 생에 대한 고민과 미적 감정에 대하여 철학적인 고찰을 시도하게 되는데 그 결과 심미적 감정이 우위를 차지해야 된다고 한다. 또한 박종홍은 교직에 종사하면서 과도기의 혼돈을 겪고 있는 현실에 직면하여 전통적인 교육사상 중의 근본정신을 살리고자 고민하면서 퇴계의 경(敬) 사상에 주목하게 되었다. 이는 다카하시 도루의 조선 유학에 대한 연구에서 자극을 받은 지식인들이 점차 학문적인 연구를 진행하였던 당시의 시대적ㆍ학문적 상황과 떨어져서는 논의할 수 없다. Previous research on the philosophy of Park Jong-hong has focused mainly on his thoughts as a whole, omitting the background and formation of his thoughts. ‘Before delving into the full-fledged philosophy of Park, this article examines the problematiks he had in mind before he entered Keijo Imperial University. Two starting points of Park’s philosophy are ‘us’ and ‘people of nation’; in searching for the answers he extensively read the books published by Choi Nam-sun. Park attempted to uncover the unique characteristics of ‘our people’ by reading Takayama Chogyu’s books on the history of Joseon art, with which Park faced limitations. As he turned his attention to the philosophy of Nishida Kitaro, which led him to new philosophical inquiries into life and aesthetic feelings, and eventually to conclude aesthetic feelings must take the pride of place in life. As Park was engaged in teaching, the chaotic reality in the turbulent period made him decide to revive the original spirit of traditional thoughts on education, leading him to Toegye’s philosophy of Gyong (敬, pious attention). It must be taken into account, however, that in Park’s time, elites stimulated Takahashi Toru’s work on Joseon Confucianism, and began serious academic research on national spirits.

한국에서의 호산구성 농포성 모낭염의 임상 및 병리조직학적 연구

장경애(Kyoung Ae Jang),고광진(Gwang Jin Koh),김성범(Sung Bum Kim),최지호(Jee Ho Choi),성경제(Kyung Jeh Sung),문기찬(Kee Chan Moon),고재경(Jai Kyoung Koh) 대한피부과학회 2000 대한피부과학회지 Vol.38 No.10

Background:Eosinophilic pustular folliculitis (EPF) is a rare chronic disease of unknown cause with pruritic papulopustular lesions and a prominent eosinophilic infiltrate. Objective:The purpose of this study was aimed at evaluating the clinical and histopathological features of EPF.Methods:The hospital charts and histopathologic slides of 8 patients with EPF diagnosed at Asan Medical Center from 1989 to 1998 were reviewed. We also reviewed the previously published reports of 10 patients with EPF in Korea. Results:Nine male and nine female patients were enrolled in this study. The mean age at diagnosis of EPF was 26 years in men and 27 years in women. All the patients complained of mild to severe pruritus. EPF was presented with follicular papules or pustules, except 2 patients, who presented with erythematous plaques free of papules or pustules. All the patients showed the typical histopathological findings of EPF. Laboratory investigation showed hypereosinophilia in 73% of patients (11/15). The levels of blood eosinophils tended to decrease as cutaneous lesions resolved. EPF was improved with dapsone in 12 patients and the rest were treated with topical or systemic steroid or antihistamines.Conclusion:EPF may be more common in Korea than can be suspected. Because EPF showed characteristic histopathological findings and EPF responds well to dapsone, the knowledge with this disease may be important to diagnose and treat it. (Korean J Dermatol 2000;38(10):1287~1293)

Apolipoprotein A1 Inhibits TGF-β1-Induced Epithelial-to-Mesenchymal Transition of Alveolar Epithelial Cells

( Ae Rin Baek ),( Ji Min Lee ),( Hyun Jung Seo ),( Jong Sook Park ),( June Hyuk Lee ),( Sung Woo Park ),( An Soo Jang ),( Do Jin Kim ),( Eun Suk Koh ),( Soo Taek Uh ),( Yong Hoon Kim ),( Choon Sik Par 대한결핵 및 호흡기학회 2016 Tuberculosis and Respiratory Diseases Vol.79 No.3

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal lung disease characterized by the accumulation of excessive fibroblasts and myofibroblasts in the extracellular matrix. The transforming growth factor β1 (TGF-β1).induced epithelial-to-mesenchymal transition (EMT) is thought to be a possible source of fibroblasts/ myofibroblasts in IPF lungs. We have previously reported that apolipoprotein A1 (ApoA1) has anti-fibrotic activity in experimental lung fibrosis. In this study, we determine whether ApoA1 modulates TGF-β1.induced EMT in experimental lung fibrosis and clarify its mechanism of action. Methods: The A549 alveolar epithelial cell line was treated with TGF-β1 with or without ApoA1. Morphological changes and expression of EMT-related markers, including E-cadherin, N-cadherin, and α-smooth muscle actin were evaluated. Expressions of Smad and non-Smad mediators and TGF-β1 receptor type 1 (TβRI) and type 2 (TβRII) were measured. The silica-induced lung fibrosis model was established using ApoA1 overexpressing transgenic mice. Results: TGF-β1.treated A549 cells were changed to the mesenchymal morphology with less E-cadherin and more N-cadherin expression. The addition of ApoA1 inhibited the TGF-β1.induced change of the EMT phenotype. ApoA1 inhibited the TGF-β1.induced increase in the phosphorylation of Smad2 and 3 as well as that of ERK and p38 mitogenactivated protein kinase mediators. In addition, ApoA1 reduced the TGF-β1.induced increase in TβRI and TβRII expression. In a mouse model of silica-induced lung fibrosis, ApoA1 overexpression reduced the silica-mediated effects, which were increased N-cadherin and decreased E-cadherin expression in the alveolar epithelium. Conclusion: Our data demonstrate that ApoA1 inhibits TGF-β1.induced EMT in experimental lung fibrosis.

거대세포바이러스 감염을 동반한 선천성 흉선이형성증 1 예

이상일(Sang Il Lee),남승연(Seung Yeon Nam),강미애(Mee Ae Kang),안강모(Kang Mo Ahn),고영재(Young Jae Koh),서연림 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2000 소아알레르기 및 호흡기학회지 Vol.10 No.2

N/A Twenty-four months old female child was expired with disseminated Cytomegalovirus infections. The child had a history of intrauterine and postnatal growth retardation and recurrent episodes of upper respiratory tract infection. At the age of 17 months, she had idiopathic thrombocytopenic purpura which was unresponded to intravenous immunoglobulin and steroid. Depending upon the bone marrow biopsy finding at the age of 21 months, myelodysplastic syndrome was suspected and she was treated with chemotherapy(Ara-C). Two months later, pancytopenia was developed with severe pneumonia. Cytomegalovirus was isolated from trachea, blood and urine, and she died. Postmorterm examination revealed congenital thymic dysplasia, which was characterized by a mass of mescenchymal and endothelial cells with occasional lymphocytes and the absence of Hassall`s corpuscles. Lymph nodes were composed of supporting tissue without follicular differentiation. Cytomegaloviral inclusions were found in the endothelial or epithelial cells of visceral organs including lung, heart, liver, pancreas, gastrointestinal tract, thymus, spleen, lymph nodes, retina, brain, kidney and adrenal glands.