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      • KCI등재후보
      • 동종 골수이식 후 만성 이식편대숙주질환과 동반되어 신증후군으로 발현된 IgA 신병증 1예

        정철권,김현수,박준성,정성현,조도연,최진혁,남동기,임호영,김명성,신규태,임현이,김효철 대한조혈모세포이식학회 1999 대한조혈모세포이식학회지 Vol.4 No.2

        동종 골수이식 후 발생하는 신기능부전은 원인이 다양하여 감별에 어려움이 있다. 만성 GVHD는 흉선의 기능저하에 따른 면역관용의 실패로 발생되는 자가면역현상에 의해 발생되는 것으로 알려져 있으며 드물게 신장을 침범하여 신증후군을 일으키기도 한다. CaA의 용량을 줄이거나 투약중지 후 발생한 만성 GVHD에 동반된 신증후군의 경우 조기에 신조직검사를 시행하여 감별진단하고 CsA의 용량을 증량하거나 재투약하여 좋은 치료 결과를 보일 것으로 기대된다. 저자들은 문헌고찰을 통해 동종 골수이식 후 발생된 신증후군이 유사한 임상양상을 보이며 발생기전에 만성 GVHD와 자가면역현상이 연관되어 있음을 확인하였으며 동종 골수이식 후 신증후군의 임상양상을 보이는 환자에서 병리조직학적으로 lgA 신병증을 진단하고 이러한 lgA 신병증이 발생기전에 만성 GVHD와 자가 면역현상이 연관되어 있을 가능성을 최초로 확인하였으며 CsA를 이용하여 성공적으로 치료한 경험을 하였기에 보고하는 바이다. Renal insufficiency is occasionally encountered in allogeneic bone marrow transplantation and its cause is difficult to ascertain. Chronic graft-versus-host disease (GVHD) related to thymic dysfunction is immune-mediated and involves autoreactivity of T-lymphocytes derived from donor marrow to recipient's major histocompatibility complex(MHC) minor antigens. The clinical mainifestations of chronic GVHD are similar to those of autoimmune disease but kidney involvement is rare. Few cases of nephrotic syndrome with membranous nephropathy or minimal change nephrotic syndrome have been reported to be associated with chronic GVHD in allogeneic bone marrow transplant recipient especially after cyclosporine A(CsA) withdrawal, and these cases have responded well to CsA. Therefore, it is prudent to differentiate the cause of post-transplant renal insufficiency using renal biopsy and to start CsA in a case of nephrotic syndrome associated with chronic GVHD as early as possible. We report a case who had a massive proteinuria during the post-allogeneic marrow transplantation period. The cause of nephrotic syndrome was diagnosed as IgA nephropathy by renal biopsy. The patient was successfully treated with reintroduction of CsA.

      • KCI등재

        중년기 우울증 여성의 생활사건, 대처방식, 사회적 지지 및 가족관계

        김동인,이진욱,김임,이선미,은헌정 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

        국문초록본 연구는 중년기 우울증 여성의 생활사건 스트레스, 대처 방식, 사회적 지지, 가족 관계 등의 정신사회적 요인들을 알아보기 위한 것으로 각 변인들이 어떻게 우울과 관계가 있는지를 우울증 환자 집단과 정상인 집단으로 나누어서 비교 연구하였다. 이를 위해 35세 이상 64세 이하의 116명의 우울증 환자와 113명의 정상인을 대상으로 Beck 우울 질문지(BDI), 생활사건 질문지, 대처방식 척도, 대인관계 지지 평가척도(ISEL), 가정환경척도 등의 검사를 하였고 다음과 같은 결과를 얻었다. 1) 최고 스트레스는 환자 집단의 경우 결혼생활 스트레스(42명, 36.2%), 정상인 집단의 경우는 가정생활 스트레스(44명, 38.9%)였다. 2) 소극적 대처(t=0.93, p=.35)만을 제외하고 환자 집단과 정상인 집단에서 BDI 우울 점수(t=15.94, p<.0001), 생활사건 스트레스 점수(t=4.73, p<.0001), 적극적 대처점수(t=6.29, p<.0001), 사회적 지지점수(t=7.20, p<.0001), 가족 관계 점수(t=5.75, p<.0001)에서 유의한 차이를 보였다. 3) 우울증 환자 집단에서 BDI 우울 점수는 생활사건 스트레스(r=.24, p<.01) 변인과 유의한 정적 상관을 보였고, 적극적 대처(r= -.22, p<.01) 변인, 사회적 지지(r= -.35, p<.001) 변인, 가족관계(r= -.30, p<.001) 변인과는 유의한 역 상관을 보였다. 4) 우울증 환자 집단에서 BDI 우울에 대한 각 변인들의 중다회귀분석은 사회적 지지(12.3%, β= -.281, T= -3.162, P=.002, 생활사건 스트레스(5.1%, β=.279, T=3.195, P=.002), 적극적 대처(3.5%, β= -.204, T= -2.225, P=.028) 변인이 합하여 20.9%의 설명력을 나타냈다. 5) 중년기 여성에서 생활사건 스트레스는 가족 관계에서 겪는 스트레스가 가장 큰 스트레스였고, 대처방식은 우울과의 관계에서 일관성이 부족하였으며, 사회적 지지는 우울에 영향을 주는 가장 중요한 요인이었고, 가족관계는 양 집단에서 유의한 차이는 있었으나 우울에 대하여 의미있게 설명하지 못하고 있다. ABSTRACTLife Events, Coping Styles, Social Support, and Family Relationships of Middle-Aged Depressed Women Jin-Wook Lee, M.D., Yim Kim, M.D., Sun-Mi Yi, M.S., Dong-In Kim, M.D., Heon-Jeong Eun, M.D. Department of Neuropsychiatry, Presbyterian Medical Center, Chonju The objective of this study was to explore the psychosocial factors such as life events, coping styles and family relationships in middle-aged depressed women. This study was designed to compare how different variables relate to depression in two different test groups : a depressed patient group and a normal group. The Beck Depression Inventory(BDI), The Ways of Coping Checklist, Interpersonal Support Evaluation List(ISEL), Family Environment Scale were administered to 116 depressed patients and 113 normal persons between the ages of 35 and 64. The results were as follows : 1) The highest stress was marital stress(n=42, 36.2%) in patient group and family stress(n=44, 38.9%) in normal group, respectively. 2) There were significant differences between patient group and normal group in BDI scores(t=15.94, p<.0001), life events(t=4.73, p<.0001), active copinig(t=6.29, p<.0001), social support(t=7.20, p<.0001), and family relationships(t=5.75, p<.0001) except for passive coping(t=0.93, p=.35). 3) In depressed patient group, BDI scores had a significantly positive correlation with the scores of the life events(r=.24, p<.01) and negative correlation with active coping(r= -.22, p<.01), social support(r= -.35, p<.001) and family relationships(r= -.30, p<.001). 4) In depressed patient group, multiple regression analysis showed that social support(12.3%, β= -.281, T= -3.162, P=.002), life events(5.1%, β=.279. T=3.195, P=.002), and active coping(3.5%, β= -.204, T= -2.225, P=.028) had predictability on the BDI scores and the total predictability was 20.9%. 5) Stress experienced in family relationships were highest in life events and there was a lack of consistency(in the BDI scores of the coping styles). Social support was the most important factor and there were no significant differences between the two groups in family relationships.

      • 만성 호중구성 백혈병 1예

        박기령,조성민,우가은,이기현,손혜영,임정윤,최진혁,이순남,정화순 梨花女子大學校 醫科大學 醫科學硏究所 1997 EMJ (Ewha medical journal) Vol.20 No.2

        Chronic neutrophilic leukemia(CNL) is a very rare myeloproliferative disease, characterized by sustained mature neutrophilic leukocytosis with granulocytic bone marrow infiltration, high NAP(neutrophilic alkaline phosphatase) score and absence of philadelphia chromosome, It is frequently accompanied by hepatosplenomegaly, elevated serum vitamin B_12 and uric acid level. For the diagnosis of CNL, the leukemoid reaction, especially secondary to neoplasia, infection and autoimmune diseases, should be excluded. Since Tuohy's first description in 1920, more than 50 cases fullfilling the above criteria have been reported worldwide, and 4 cases in Korea. Several authors have demonstrated the defect of intracellualr killing in the mature neutrophil and this finding correlates well with the very high incidence of fatal infection, The hemorrhagic diasthesis in CNL is caused by functional abnormality of the platelet. This disease has tendency to transform to blastic crisis and acute leukemia as in other myeloproliferative disease, but characteristically shows frequent coexistence with multiple myeloma. Until now , the therapeutic trials in CNL have been disappointing. Hydroxyrea and busulfan can control hyperleukocytosis. On the basis of functional defect in neutrophil, alpha-2b-interferon has been tried and several reports have demonstrated the clinical and functional effect of interferon on CNL. CNL is very rate hematologic disease and there are few report about general aspect of disorder. We report here a typical CNL case presenting with splenomegaly and leukocytosis with a review of the literature.

      • 工業敎育大學 敎育改善에 관한 硏究(Ⅲ)

        宋周鎬,李昌岬,洪元杓,孟琦錫,任洪彬,李廷玟,李載元,李來烈,權五憲,金振淳,李文洙 충남대학교 공업교육연구소 1982 論文集 Vol.5 No.1

        This paper aims at providing a concrete plan to improve technical and vocational teacher education in the College of Industrial Education of Chungnam National University. It is intended to propose a practical four-year regular and short-term course. Also, the estimated required facilities is included in this study as well as their management. The main conclusions and recommendations are summarized as follows; 1) The numbers of students enrollment should be reduced to 220 students which is the approximate number of future demand. 2) In order to offer to the students a broader education and to cope with the increase/decrease in demand of technical and vocational teacher within a specific field, the 8 department existing at the present (Department of Architecture Engineering Education, Civil Eng. Educ., Metallurgical Eng. Educ., Mechanical Eng. .Educ., Electrical Eng. Educ., Electronic Eng. Educ., Industrial Chemistry Educ. and Industrial Technology Educ.) would be combined into 5 (Department of Construction Engineering Education, Mechanical Eng. Educ., Electrical Eng. Educ., Industrial Chemistry Educ. and Industrial Technology Educ.). 3) The short-term course program is recommened to provide additional training and education to those candidates who already have experience in technical fields to meet an occasional demand. 4) It is necessary to add the Teaching Profession Section in the administrative organization of the College.

      • SCISCIESCOPUS

        Regulation of ApC/EBP mRNA by the <i>Aplysia</i> AU-rich element-binding protein, ApELAV, and its effects on 5-hydroxytryptamine-induced long-term facilitation

        Yim, Se-Jeong,Lee, Yong-Seok,Lee, Jin-A,Chang, Deok-Jin,Han, Jin-Hee,Kim, Hyoung,Park, Hyungju,Jun, Heejung,Kim, V. Narry,Kaang, Bong-Kiun Raven Press [etc.] 2006 Journal of neurochemistry Vol.98 No.2

        <P>Abstract</P><P><I>Aplysia</I> CCAAT enhancer-binding protein (ApC/EBP), a key molecular switch in 5-hydroxytryptamine (5-HT)-induced long-term facilitation of <I>Aplysia</I>, is quickly and transiently expressed in response to a 5-HT stimulus, but the mechanism underlying this dynamic expression profile remains obscure. Here, we report that the dynamic expression of ApC/EBP during long-term facilitation is regulated at the post-transcriptional level by AU-rich element (ARE)-binding proteins. We found that the 3′UTR of ApC/EBP mRNA contains putative sequences for ARE, which is a representative post-transcriptional <I>cis</I>-acting regulatory element that modulates the stability and/or the translatability of a distinct subset of labile mRNAs. We cloned the <I>Aplysia</I> homologue of embryonic lethal abnormal visual system homologue (ELAV/Hu) protein, one of the best-studied RNA-binding proteins that associate with ARE, and elucidated the involvement of <I>Aplysia</I> ELAV/Hu protein in ApC/EBP gene expressional regulation. Cloned <I>Aplysia</I> ELAV/Hu protein, <I>Aplysia</I> embryonic lethal abnormal visual system (ApELAV), bound to an AU-rich region within the 3′UTR of ApC/EBP mRNA. Additionally, ApELAV controlled the expression of ApC/EBP 3′UTR-containing reporter gene by functioning as a stability-enhancing factor. In particular, 5-HT-induced long-term facilitation was impaired when the AU-rich region within the 3′UTR of ApC/EBP was over-expressed, which suggests the significance of this region in 5-HT-induced ApC/EBP expression, and in the resultant formation of long-term facilitation. Our results imply that the <I>Aplysia</I> ARE-binding protein, ApELAV, can regulate ApC/EBP gene expression at the mRNA level, and accordingly, ARE-mediated post-transcriptional mechanism may serve a crucial function in regulating the expression of ApC/EBP in response to a 5-HT stimulus.</P>

      • SCIESCOPUS

        Osteoblastoma in the Nasal Cavity: F-18 FDG PET/CT and Tc-99m MDP 3-Phase Bone Scan Findings With Pathologic Correlation

        Jeong, Young Jin,Sohn, Myung-Hee,Lim, Seok Tae,Kim, Dong Wook,Jeong, Hwan-Jeong,Jang, Kyu Yun,Yim, Chang-Yeol Lippincott Williams Wilkins, Inc. 2011 Clinical nuclear medicine Vol.36 No.3

        A benign osteoblastoma of the nasal cavity is very rare. A 57-year-old woman, who had a radical hysterectomy for carcinoma of the uterine cervix 5 years ago, underwent F-18 FDG PET/CT. An expansile bone tumor with high glucose metabolism in the middle turbinate of the left nasal cavity was incidentally demonstrated. A subsequent Tc-99m methylene diphosphonate 3-phase bone scan revealed focal increased uptake of radionuclide in all 3 phases at the corresponding tumor. Histology confirmed a benign osteoblastoma that was composed of proliferating osteoblasts with woven bone spicules and rich vascular stroma. Scintigraphic findings, including F-18 FDG PET/CT and 3-phase bone scan, reflected the pathologic features well.

      • F-18 FDG PET/CT Imaging of Metastatic Extrarenal Wilms Tumor Arising in the Inguinal Canal

        Jeong, Young Jin,Sohn, Myung-Hee,Lim, Seok Tae,Kim, Dong Wook,Jeong, Hwan-Jeong,Yim, Chang-Yeol Lippincott Williams Wilkins, Inc. 2011 Clinical nuclear medicine Vol.36 No.6

        Extrarenal Wilms tumor (ERWT) is rare, and has been reported sporadically in the literatures. ERWT can arise anywhere from the renal bed to the testes; reported locations of ERWTs include the retroperitoneum, inguinal canal, endocervix, uterus, epididymis, and sigmoid mesocolon. We report the F-18 FDG PET/CT imaging findings of an ERWT arising from the inguinal canal in a 9-year-old boy. F-18 FDG accumulated in the metastatic lesions of the lung and mediastinal lymph nodes, as well as the primary ERWT. After chemotherapy, a follow-up PET/CT showed complete metabolic remission. F-18 FDG PET/CT is useful in detecting primary and metastatic ERWTs and in evaluating treatment response.

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