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혈전성 혈소판 감소성 자반증의 임상상을 보인 항사구체 기저막 항체질환 1 예
천정현(Jeong Hyun Chun),서상렬(Sang Yeol Suh),조상경(Sang Kyung Jo),김형규(Hyoung Kyu Kim),조원용(Won Yonpg Cho) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.2
Thrombotic thrombocytopenic purpura(TTP) was first described in 1925, however, the definite cause of TTP remained unknown. Further study revealed that the pathogenesis of thrombotic thrombocytopenia was related to autoimmune disease. Autoantibodies generated by vessel injury and other causes result in excessive platelet aggregation and consumption. Recently, many autoimmune diseases and conditions associated with vascular injury have been reported to be accompanied by TTP-like feature, such as microangiopathic hemolytic anemia and thrombocytopenia. Anti-glomerular basement membrane(GBM) mediated glomerulonephritis is also related to autoantibody against collagen IV fiber in GBM, and cha- racterizded by diffuse glomerular capillary injury. Although the relationship of these two diseases is not clearly defined, here we report a case of anti- GBM antibody disease accompanied by TTP-like feature in a 40-year old man admitted for dyspnea. The patient had hemolytic anemia, thrombocytopenia, and acute renal failure. Anti-GBM antibody was positive and crescent formation and linear deposition of IgG along glomerular basement membrane was seen in renal biopsy. Disease progressed with no clinical response despite of prompt treatment by steroid and cyclophosphamide pulse therapy and plasmapheresis.
반대측 비기능성 흑색선종과 동반되 일측성 알도스테론분비선종 1예
이명식,양정현,오은영,김광원,민용기,정재훈,김병준,이문규,임영희,강수정,천정학 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.1
Primary aldosteronism due to unilateral adenoma is a rare cause of surgically curable hypertension. Bilateral adrenal mass has occasionally been reported in this syndrome, and bilateral aldosterone-producing adenoma (APA), or bilateral adrenal nodular hyperplasia have been demonstrated in some cases. However, another possibility is the coexistence of a unilateral APA with a contralateral benign or metastatic nonfunctioning mass, because adrenal tumors are frequently found at autopsy or incidentally detected during abdominal morphological evaluation in patients without adrenal dysfunction. A 39 year-old woman presented with hyperaldosteronism, suppressed renin levels, and bilateral adrenal mass on adrenal CT scanning. Selective adrenal venous sampling was unsuccessful in demonstrating concentration gradient of aldosterone. Postoperative measurement of hormone content in the tumor extract revealed unilateral aldosteron-producing adenoma with contralateral nonfunctioning black adenoma, Determination of hormone content in the tumor extract could be useful for the discrimination of functioning and nonfunctioning endocrine tumors, particularly in case of multiple tumors (J Kor Soc Endocrinol 14:177~182, 1999).
본드 및 휘발성 용제의 습관적 흡입 후에 발생한 재생불량성 빈혈 1예
신재욱,신동우,정상용,정종익,권덕호,송태의,김진휘,천정현,권정아 대한내과학회 1999 대한내과학회지 Vol.57 No.1
The inhalation of volatile substances has becoming a popular fad among adolescents in the world. Glue sniffing is associated with injury of nervous system, liver and kidney. And rarely abnormality of blood and bone marrow suppression can develop. The main components of volatile substances that cause hematologic abnormality is thought to be benzene, toluene, and xylene. A 24 year-old male was admitted to our hospital due to gum bleeding. He was a chronic glue and organic solvents sniffer for 6 years, and quit sniffing 1 year before admission. He had no specific drug history. On admission, CBC was as follows: WBC 2,500/mm3; hemoglobin 8.9g/dl; hematocrit 25.1%; platelet 2,000/mm3. Bone marrow biopsy showed severe hypocellular marrow compatible with aplastic anemia. We report a case of aplastic anemia after habitual sniffing of glue and volatile substances with brief review of the literature.
한국판 노인 행동평가척도의 평정자 집단의 따른 자기-타인 평가 비교 연구
김민영(Kim, Min-Young),이진(Lee, Jin),천정현(Chun, Jung-Hyun),김영아(Kim, Young-Ah),오경자(Oh, Kyung-Ja) 한국노년학회 2015 한국노년학 Vol.35 No.2
The purpose of this study was to verify the validity and clinical utility of the Korean version of the OASR and the OABCL by comparing self-other scores across 4 informant groups: Spouse, Child, Friend, and Care Worker. The samples were originally recruited for standardization of the Korean version of ASEBA Older Adult Forms. Qualitative data of 464 participants ranged from 59 to 88 years old were used in the study. There was no notable difference in rating tendencies between self(OASR) and other(OABCL) report across 4 informant groups. A correlation analysis showed that self-other congruence is higher in Child and/or Care Worker group than in Spouse and/or Friend group. Discriminant analysis indicated that with the exception in Friend group, OASR and OABCL Total Problem scores effectively discriminated between clinical and non-clinical groups based on its counterpart’s score. In addition, most successful discriminative sub-scale varied depending on informant groups. Implications of using OASR and OABCL as a clinical and research instrument by informant groups are further discussed. 본 연구에서는 Achenbach, Newhouse와 Rescorla(2004)가 개발한 ASEBA 노인 행동평가척도의 평정자 집단(배우자, 자녀, 친구, 요양보호사)에 따른 자기보고(OASR)와 타인보고(OABCL) 점수 차이 및 일치도 등을 통해 노년기 문제행동의 자기-타인 보고 결과를 통합, 해석할 때의 시사점을 검토해보았다. 한국판 노인 행동평가척도 표준화 자료에서 OASR과 OABCL 자료가 모두 유효한 464명의 59~88세 자료를 분석에 활용하였다. OASR과 OABCL 척도 점수 차이를 살펴본 결과, 전반적으로 대상자와의 관계에 따른 평가 경향성의 차이는 크지 않았다. 상관 분석 결과, 자녀, 요양보호사 집단이 배우자, 친구 집단에 비해 대상자 본인과 유사한 점수를 보고하는 경향이 있었다. 배우자, 자녀, 요양보호사 집단의 경우, 자기-타인 보고 문제행동총점을 통해 서로의 문제행동총점 임상범위 여부를 예측할 때 대체로 높은 일치도를 보인 것에 비해 친구 집단은 상대적으로 낮은 일치도를 보였다. 또한, 평정자 집단에 따라, 자기보고/타인보고 여부에 따라, 판별 일치도가 높은 소척도가 다른 것으로 나타났다. 한국판 OASR, OABCL의 평정자 집단에 따른 임상 및 연구 장면에서의 활용에 대한 논의가 이루어졌다.
신미경,정상용,신재욱,신동우,구양서,김진휘,천정현,정종익,권덕호 대한소화기학회 1999 대한소화기학회지 Vol.34 No.6
Multiple lymphomatous polyposis (MLP) is a rare type of malignant gastrointestinal lymphoma characterized by multiple polyps involving long segments of the gastrointestinal tract. The malignant cells of MLP share morphological, immunohistologic and cytogenetic similarity with cells of nodal- based mantle cell lymphoma. A few cases of synchronous with metachronous primary gastric lymphoma and adenocarcinoma were reported. However, we could not find any case of synchronous with metachronous MLP and gastric adenocarcinoma. We report a case of MLP involving various segments of gastrointestinal tract and synchronous gastric adenocarcinoma observed in a 78-year-old woman who complained of epigastric pain and indigestion.
심영보,임재현,신재욱,신동우,한병철,천정현,서상렬,한연석,조이대 대한내과학회 2001 대한내과학회지 Vol.61 No.2
Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory demyelinating disease of central nervous system, and is related to allergic or immune-mediated reaction to systemic viral infection or vaccination, which is usually self limited monophasic illness. As the clinical manifestations or laboratory findings is nonspecific, it is diagnosed by brain magnetic resonance imaging (MRI) showing multiple foci of increased T2 signal within white matter. We report the clinical and radiologic imaging findings in a 36-year-old man in whom acute disseminated encephalomyelitis developed after serologically proven herpes infection combined with liver abscess. His clinical course, despite without corticosteroid or plasmapheresis because of liver abscess, was shown spontaneous remission.(Korean J Med 61:215-220, 2001)
심영보,신미경,임재현,신동우,신재욱,한병철,천정현,한연석,서상렬 대한내과학회 2000 대한내과학회지 Vol.59 No.1
Crohn's disease is one of the chronic inflammatory disorders of unknown cause involving the gastrointestinal tract. The inflammation may occur in the colon, either alone or with small intestine. Crohn's disease has been associated with increased risk for coloretal carcinoma in patients with long-standing colitis, strictures and fistulae. Recently, we experienced a case of Crohn's disease complicating carcinoma in a 85 year old male. Ten years ago, he compained severe abdominal pain and diarrhea. and was detected colon obstruction and enteric fistula. But, he spontaneously improved. Recently, the patient was admitted complaining abdominal pain. He complaind abdominal pain and indigestion chronically and aggravated recently. He was examined with colonofibroscopy, and computered tomography, and carcinoma was detected at the site of Crohn's disease. (Korean J Med 59:80-84, 2000)