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말단비대증 환자의 혈중 프롤락틴 수치와 면역조직화학염색과의 상관관계
강보현 ( Bo Hyun Kang ),정인경 ( In Kyung Jeong ),조덕신 ( Duck Shin Cho ),강한욱 ( Han Wook Kang ),김형훈 ( Hyung Hoon Kim ),김범진 ( Beom Jin Kim ),민태훈 ( Tae Hoon Min ),손준성 ( Jun Seong Son ),홍성노 ( Sung No Hong ),이춘영 대한내과학회 2003 대한내과학회지 Vol.64 No.2
목적: 말단비대증은 대부분 성장호르몬 분비 뇌하수체 선종에 의한 것으로 35%에서 고프롤락틴혈증이 동반된다고 알려져 있다. 저자들은 말단비대증 환자의 뇌하수체 조직의 면역조직화학염색 소견과 혈중 호르몬 수치를 비교하여 이들간에 어떠한 관계가 있는지 알아보고자 하였다. 방법: 1998년 8월부터 2001년 5월까지 말단비대증 진단 하에 뇌하수체 종양 제거수술을 받은 환자 28명(남자:여자=18:10, 평균연령: 41세)을 대상으로 하였다. 혈중 기저 성장 Background: Acromegaly occurs by excessive secretion of growth hormone and more than 99% of cases are caused by a growth hormone-secreting pituitary adenoma. Pituitary adenomas expressing multiple immunoreactivities are common. We assumed that the pituita
증례 : 심장을 침범한 Churg-Strauss 증후군 3예
이진영 ( Jin Young Lee ),송필상 ( Pil Sang Song ),오미정 ( Mi Jung Oh ),권남희 ( Nam Hee Kwon ),민태훈 ( Tae Hoon Min ),이병재 ( Byung Jae Lee ),최동철 ( Dong Chull Choi ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 흉통과 호흡곤란으로 내원하여 심장을 침범한 Churg-Strauss 증후군으로 진단하고 치료한 3예를 경험하였기에 보고하는 바이다. Churg-Strauss syndrome (CSS) is a rare syndrome of unknown cause, which is characterized by systemic vasculitis, peripheral eosinophilia, extravascular granulomastosis and chronic atopic disease. Cardiovascular involvement is known to be the major cause of death in patients with CSS accounting for up to 48%. Few clinical records have determined on the cardiac manifestations of CSS, we reported three cases of CSS with cardiac involvement. Since delayed treatment could lead to intractable heart failure, we advocate that Churg-Strauss syndrome should be considered and evaluated for cardiac involvement in asthmatic patients with chronic dyspnea, neuropathy or eosinophilia.(Korean J Med 69:S979-S987, 2005)
만성기침 환자에서 천명의 경험 유무에 따른 기침이형천식 진단율의 차이
이병재,민태훈,최동철 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1
Backgrond : Objective tests including the methacholine bronchial provocation test and the induced sputum examination are now crucial in the detection of causes of chronic cough. On the other hand, carefully taken history of characteristics, complications, or duration of cough are known not useful in diagnosing causes of chronic cough. Objectives : Patients with a history of cough lasting more than 3 weeks were enrolled. Patients who were current smokers, who had been receiving an angiotensin-converting enxyme inhibitor, who had basal EFV3 less than 70% of predicted value, who had adventitial sound on auscultation, or who had experienced resting dyspnea were all excluded. We divided the patients into two groups according to the ever wheeze history. The methacholine test (reference value of PC20 = 25㎎/㎖) and the induced sputum eosinophil percentile (reference value = 3%) were compared between the two groups. All patients were evaluated by an anatomic diagnostic protocol, and the prevalence of cough variant asthma was compared. Results : Three hundred eighty-two patients (138 males and 244 females) with mean age of 48.2 years met the inclusion criteria. The mean duration of cough was 30.4 months (range, 3 weeks to 600 months). Ever wheezers were 154 (40.3%), and non-wheezers were 228 (59.7%). Ever wheeze group showed higher positive methacholine test (37.7% vs. 14.5%, p<0.001) and increased sputum eosinophils (43.5% vs. 11.4%, F<.001) compared to non-wheeze group. The prevalence of cough variant asthma was significantly higher in ever wheeze group (33.8% vs. 6.1%, F<.001), and that of eosinophilic bronchitis showed similar result (13.6% vs. 4.8%. F<.01). The positive predictive value of the methacholine test was lower in non-wheeze group compared to ever wheeze group (42.4% vs. 86.2%, F<.01). Conclusion : Ever wheeze history might be very important in suspecting, cough variant asthma as a cause of chronic cough. In chronic cough patients without ever wheeze, prevalence of cough variant asthma and positive predictive value of methacholine test were low. (J Asthma Allergy Clin Immunol 24 : 94-102, 2004)
조덕신,이병재,민태훈,강보현,김형훈,이병완,최동철 대한내과학회 2002 대한내과학회지 Vol.63 No.4
The hemolytic uremic syndrome (HUS) is a clinical syndrome defined by the presence of thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure with or without a clinically apparent etiology. The conventional treatment of choice is plasmapheresis as a first-line therapy. Most patients respond to plasmapheresis whereas some patients are refractory to the therapy. The second-line therapy is not well established although various therapies such as steroid, vincristine, intravenous immunoglobulin have been suggested. The intravenous immunoglobulin therapy in refractory hemolytic-uremic syndrome have rarely been successful in complete remission. We report a case of refractory HUS in a 48 year-old man who developed hemolytic anemia, thrombocytopenia, acute renal failure and ischemic retinopathy. The patient was refractory to plasmapheresis as a first-line therapy. The patient received intravenous immunoglobulin therapy as a second-line therapy after 8 days of plasmapheresis, which subsequently resulted in a complete remission of refractory HUS. The complete remission using immunoglobulin in HUS has not been previously reported in Korea.