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고호모시스테인혈증에 의한 근위심부정맥혈전증 및 폐색전증 1예
정예령 ( Ye Ryung Jung ),용석중 ( Suk Joong Yong ),신계철 ( Kye Chul Shin ),성재호 ( Jae Ho Seong ),김종환 ( Chong Whan Kim ),이명규 ( Myoung Kyu Lee ),이지호 ( Ji Ho Lee ),정세현 ( Sae Hyun Jung ),김상하 ( Sang Ha Kim ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.2
위험인자가 없이 발생한 근위심부정맥혈전증 및 폐색전증 환자에서는 고호모시스테인혈증을 포함한 혈전성향을 확인하는 것이 필요하다. 저자들은 엽산 결핍에 의한 고호모시스테인혈증으로 인해 근위심부정맥혈전증및 폐색전증이 발생한 것을 진단하고 엽산과 항혈소판제의 투여를 유지하여 혈중 호모시스테인의 수치를 정상화하고 혈전증을 치료한 환자를 경험하여 보고하는 바이다. Most cases of venous thrombosis occur at underlying condition. If a patient is diagnosed with venous thrombosis without any apparent risk factor, evaluation of thrombophilia maybe needed. Hyperhomocysteinemia is associated with hypercoagulability and cardiovascular disease including venous thrombosis, the leading cause of it is vitamin deficiency. We report a case of pulmonary embolism and both internal iliac vein thrombosis with hyperhomocysteinemia due to folate deficiency. A 29-year-old male patient presented with chest pain. Chest and lower extremity CT scans revealed pulmonary embolism and thrombosis of both internal iliac veins. His plasma homocysteine level was elevated to 14.8μmol/L, folic acid level was decreased to 2.30 ng/mL. He was treated with folic acid and warfarin for six months. After treatment, plasma homocysteine level was normalized and the evidence of thrombosis has disappeared.
들깨 볶는 작업에 의한 연기 흡입으로 발생한 직업성 천식
정세현 ( Sae Hyun Jung ),리원연 ( Won Yeon Lee ),용석중 ( Suk Joong Yong ),신계철 ( Kye Chul Shin ),김종환 ( Chong Whan Kim ),이지호 ( Ji Ho Lee ),정예령 ( Ye Ryung Jung ),김현식 ( Hyun Sik Kim ),유태선 ( Tae Sun Yu ),김상하 ( San 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.1
Perilla is an Asian grain that consumed for food ingredient, oil crops, medicinal materials through the process of roasting. A 49-year-old male has been roasting grains for 10 years, who met with shortness of breath during the roasting perilla seeds, but not in other situations. Serum total immunoglobulin E (IgE) level, serum eosinophil count and skin prick test didn`t showed significant results. Methacholine bronchial provocation test was positive (PC20 0.31 mg/mL). Specific bronchial provocation test with inhaling smoke from roasting perilla seeds showed a dual asthmatic response. Measured peak expiratory flow rate on his work place showed the result of 37% decrease at the end of work and full recovery at 6 hours after the end of work. Skin prick test to row perilla showed positive response with late symptoms. We diagnosed that the patient had an occupational asthma caused by inhaling smoke from roasting perilla seeds with IgE mediated mechanism. (Allergy Asthma Respir Dis 1(1):90-93, 2013)
성인 비아토피 호흡기알레르기 환자에서 혈청 총 IgE와 신체질량지수의 관계
이지호 ( Ji Ho Lee ),리원연 ( Won Yeon Lee ),용석중 ( Suk Joong Yong ),신계철 ( Kye Chul Shin ),이선녕 ( Shun Nyung Lee ),이석정 ( Seok Jeong Lee ),김종환 ( Chong Whan Kim ),정세현 ( Sae Hyun Jung ),정예령 ( Ye Ryung Jung ),김상하 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.4
Background: Serum total IgE levels are increased in some obese patients with nonatopic respiratory allergy. It has not yet been fully determined a significant relationship between total IgE and body mass index (BMI) in nonatopic patients. We sought to examine the relationship between total IgE and BMI in patients with nonatopic respiratory allergy. Methods: We retrospectively reviewed 468 patietns with nonatopic asthma or allergic rhinitis without sensitization to 33 aeroallerens out of the 1,596 patients wirh respiratory allergic diseases who visitied Wonju Christian Hospital between June 2005 and July 2007. Nonatopy was determined by negative skin prick test results for all of the aeroallergens. Patients with were excluded from the study total IgE levels of >500 IU/mL because such levels were more frequently associated with other causes. Results: There were 468 patients with nonatopy and total IgE levels of <500 IU/mL (169 males and 299 females). The mean total IgE levels were 41.0 IU/mL in female patients with underweight (BMI<18.5 kg/m2), 64.6 IU/mL in those with normal weight (18.5≤BMI<23 kg/m2), 78.9 IU/mL in those with overweight (23≤BMI<25 kg/m2), and 85.5 IU/mL in those with obesity (BMI≥25 kg/m2). The mean total IgE levels were significantly higher in female patients with obesity or overweight than in those without (83.4 versus 61.8 IU/mL, P=0.036). There were no significant difference in serum total IgE levels according to BMI in male patients. Conclusion: Obesity may be a contributor to increased total IgE levels in female patients with nonatopic respiratory allergy. (Korean J Asthma Allergy Clin Immunol 2011; 31:288-294)
김현식 ( Hyun Sik Kim ),박정은 ( Jeong Eun Park ),성재호 ( Jae Ho Seong ),신계철 ( Kyechul Shin ),용석중 ( Suk Joong Yong ),김상하 ( Sang Ha Kim ),정예령 ( Ye Ryung Jung ),이명규 ( Myoung Kyu Lee ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
베게너육아종증은 상부 및 하부 호흡기의 괴사성 육아종성 염증과 다양한 기관을 침범할 수 있는 전신성 혈관염을 특징으로 하는 질환으로 침샘의 침범은 드물다. 저자 등은 침샘을 침범한 베게너육아종증 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다. Wegener`s granulomatosis is an autoimmune disease characterized necrotizing granulomatous inflammation with systemic vasculitis of unknown etiology that can invade various organs including upper and lower respiratory tract, but salivary gland involvement is rare. A 66 year-old male was presented with symptoms of general weakness and palpable neck mass during two weeks. On physical examination, about 3 cm-sized mass was palpable on left submandibular area. On radiographic examination, chest x-ray revealed inverted S shaped atelectasis on right upper lung field, and chest CT showed about 11.0 cm-sized heterogenous enhanced mass with necrosis and obstructive pneumonitis on right upper lobe. PET-CT revealed 12.8 cm-sized FDG-uptaked mass on right upper lobe with invasion of anterior mediastinum and visceral pleura, and also revealed FDG-uptaked both submandibular gland and right nasal cavitary wall. We supposed the mass was lung cancer. But the pathology of lung mass obtained by percutaneous needle aspiration biopsy revealed multiple necrotizing granulomatous inflammations and vasculitis with neutrophilic infiltration, but acid-fast stain was negative. In additional serologic examination, C-Anti neutrophil cytoplasmic antibody (ANCA) was 100.0 AU/mL. We diagnosed Wegener`s granulomatosis based on pathology and serologic test, and prescribed cyclophosphamide and prednisolone for two weeks and change the regimen to methotrexate and prednisolone due to side effect of cyclophosphamide. After treatment, lung and left neck mass size was definitely decreased and another symptom was improving. We report a case of Wegener`s granulomatosis with salivary gland involvement as a rare manifestation.
호흡기 알레르기증상으로 강원도의 한 대학병원을 방문한 환자에서 흡입 알레르겐에 대한 감작률
이명규 ( Myoung Kyu Lee ),리원연 ( Won Yeon Lee ),용석중 ( Suk Joong Yong ),신계철 ( Kye Chul Shin ),이선녕 ( Shun Nyung Lee ),이석정 ( Seok Jeong Lee ),이지호 ( Ji Ho Lee ),정세현 ( Sae Hyun Jung ),정예령 ( Ye Ryung Jung ),김상하 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.1
Background: There are some differences in common inhalant allergens among regions in Korea. Gangwon region, including Wonju City, which has a lot of mountains is relatively less urbanized and industrialized. It is necessary to determine which inhalant allergens are common in this region. Objective: This study was conducted to observe the prevalence of sensitization to inhalant allergens in patients visiting a university hospital in Gangwon region and to evaluate the difference in sensitization rates to allergens from other regions in Korea. Method: Skin prick tests were performed with 33 common inhalant allergens on 1,596 patients with respiratory allergic symptoms from June 2005 through July 2007 at a university hospital. Result: The number of positive responders to more than 1 allergen was 609 (38.2%) of the 1,596 patients. The most common offending allergen was Dermatophagoides pteronyssinus (19.5%), followed by Dermatophagoides farinae (17.2%), Tyrophagus putrescentiae (10.1%), Trichophyton (9.5%), rabbit fur (7.8%), mugwort (7.4%), cockroach (6.5%) and orchard grass (4.9%). Conclusion: The most common offending allergen was found to be the house dust mite in Gangwon region. The sensitization rate to mugwort pollen is the highest among pollen allergens, followed by orchard grass pollen. (Korean J Asthma Allergy Clin Immunol 2011;31:27-32)