주물공에서 발생한 Goodpasture증후군 1예

김민기,고동희,이선웅,조민희,유희용,김보연,이준혁 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

Background: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. Case: A 46-year-o1d man, who had worked as a foundry worker for 27 years and had a 12 1/2 pack-year history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomeru-lonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA(0.0106 mg/m³), which was calibrated for overtime. Conclusion: Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure. 배경: 유리규산에 노출되면 말기 신질환의 주요원인인 사구체신염이 증가할뿐만 아니라. 자가면역질환인 Goodpasture 증후군도 발생하는 것으로 보고되어 있다. 저자들은 27년간 주물공으로 근무한 근로자에서 발생한 Goodpasture 증후군이 작업관련성 조사를 통해 유리규산에 의해 발생하였을 가능성이 높다고 판단하였기에 이를 고찰과 함께 보고하는 바이다. 증례: 25년간 반갑씩 흡연을 하였고. 주물공장에서 수동 및 자동조형작업을 27년간 하였다. 내원 2주전부터 발생한 흉통과 기침으로 입원하였으며, 내원 당시 혈뇨, 단백뇨 및 중증의 제한성 폐기능 장애를 보였다. 이후 갑작스럽게 혈액요소질소와 크레아티닌이 증가하였다. 면역검사에서 ANA (+), ANCA (-), Anti-GBM Ab가 36.8 EU/mL(참고치 0∼10 EU/mL)로 양성이었으며, 신조직검사에서 무면역 사구체신염, 기관지내시경에서 출혈이 보여 Goodpasture 증후군으로 진단하고 투석 및 혈장분리 반출술을 시행하였다. 노출평가에서 호흡성분진 중 석영이 0.0793 mg/m³로, 근무시간으로 보정한 노출기준인 0.0106 mg/m³를 초과하였다. 결론: 본 증례는 노출평가와 작업력조사를 통해 유리규산 노출이 확인되었고 다른 전신질환으로 인한 신질환이 아니며 신세뇨관의 기능 이상이 사구체신염보다 먼저 나타난 이유로 유리규산에 노출되어 발생한 Goodpasture 증후군으로 판단된다.

Characterizations of sphingosylphosphorylcholine-induced scratching responses in ICR mice using naltrexon, capsaicin, ketotifen and Y-27632

Kim, Hyoung June,Kim, Hyuk,Han, Eun-Sil,Park, Sun-Mi,Koh, Jae-Young,Kim, Kwang-Mi,Noh, Min-Soo,Kim, Jung-Ju,Lee, Chang-Hoon Elsevier 2008 european journal of pharmacology Vol.583 No.1

<P><B>Abstract</B></P><P>Sphingosylphosphorylcholine (SPC) is upregulated in the stratum corneum of atopic dermatitis patients by sphingomyelin deacylase. We conducted an investigation, both to confirm that intradermal injection of SPC elicits scratching in mice, and to elucidate the detailed mechanism of the SPC-induced itch–scratch response. Intradermal administration of SPC increased the incidence of scratching behavior in a dose-dependent manner. SPC-induced scratching could be suppressed, significantly, by the μ-opoid receptor antagonist, naltrexon, the vaniloid receptor agonist, capsaicin, and the histamine H<SUB>1</SUB> receptor antagonist ketotifen. <SMALL>D</SMALL>-<I>erythro</I> SPC, one of the SPC stereotypes, could elicit the scratch response, but not <SMALL>L</SMALL>-<I>threo</I> SPC. Y-27632 (1?mg/kg, an inhibitor of Rho-associated protein kinase (ROCK)), was found to suppress SPC-induced scratching. Both the stereospecificity of SPC and the involvement of the Rho/ROCK pathway suggested that SPC-induced scratching is related to the receptor.</P>

What Factors Are Associated With Early Mortality in Patients Undergoing Femur Surgery for Metastatic Lung Cancer? :

Kim, June Hyuk,Seo, Sung Wook,Chung, Chae Hoon Ovid Technologies (Wolters Kluwer) - Lippincott Wi 2018 Clinical orthopaedics and related research Vol.476 No.9

MRI-guided Navigation Surgery with Temporary Implantable Bone Markers in Limb Salvage for Sarcoma

Kim, June Hyuk,Kang, Hyun Guy,Kim, Han-Soo Ovid Technologies (Wolters Kluwer) - Lippincott Wi 2010 Clinical orthopaedics and related research Vol.468 No.8

한국인과 한국에 거주하는 외국인간의 타인종 얼굴에 대한 ERP 요소의 흥분성 조절 비교

김혁(Hyuk Kim),이강희(Kang-hee Lee),김현택(Hyun-Taek Kim),최준식(June-Seek Choi) 한국인지과학회 2022 인지과학 Vol.33 No.2

다른 인종의 얼굴 인식에 대한 연구는 지각, 정서, 사회문화적인 과정 등 다양한 수준에서 연구되어 왔다. 특히, “다른 인종 효과(other race effect, ORE)”와 관련된 많은 수의 연구들에서, 신원이나 정서와 같은 얼굴에 대한 미묘한 정보가 처리되는 과정에서 ‘다른 인종’이라는 인종적인 요소가 영향을 주는 것으로 나타났다. 하지만 인종적인 요소가 아닌, 다른 인종의 얼굴에 대한 인지적인 조절로 ORE를 설명하려는 연구는 거의 없다. 본 연구는 다른 인종의 얼굴을 처리함에 있어서 생소하기(낯설기) 때문에 나타날 수 있는 인지적인 작용 여부를 사건관련전위(event-related potential, ERP)를 이용하여 연구하였다. 22명의 한국인과 9명의 백인에게 한국인과 백인의 정서가 표현된 얼굴사진을 보여주면서 성별 분류과제를 수행하였다. 한국인의 경우 백인의 얼굴 사진에 대하여 한국인의 얼굴 사진보다 더 증가된 P3 전위 값을 보였고, 이러한 결과는 한국인들이 자극 인식 초기 과정에서 다른 인종의 얼굴 사진에 대하여 더욱 주의를 기울인 것으로 해석할 수 있다. 흥미롭게도, 백인들은 한국인의 얼굴 사진을 보았을 때 증가된 P3 전위 값을 보이지 않았는데, 아마도 실험에 참여한 백인들의 경우 한국에서 생활을 하면서 많은 사회적인 상호작용을 통하여 한국인 얼굴에 대하여 탈민감화 되어 한국인의 얼굴이 더 이상 생소하지 않기 때문인 것으로 생각된다. 이러한 결과는 다른 인종의 얼굴은 자동적으로 주의를 끌어당기는 높은 각성수준을 갖는 현저한 자극이지만, 반복적인 노출만으로도 탈민감화 되어 타인종의 얼굴에 대한 각성수준이 낮아질 수 있다는 것을 의미한다. Facial processing of different racial origin has been investigated at various levels including perceptual, emotional, and socio-cultural processing. Particularly, a good deal of studies have been conducted to show “other race effect (ORE)” to indicate that subtle facial information such as identity or emotional expressions are often under-processed in racial out-group members. However, few studies have investigated whether attentional modulation toward racial out-group faces could explain ORE. We investigated whether novelty-driven attentional mechanism is involved in face perception using event-related potential (ERP). Twenty-two Korean (KR) and nine Caucasian-American (AM) participants were presented with emotional faces from the two racial origins while they performed a gender categorization task. KRs showed significantly greater P3 amplitudes to AM than to KR faces indicating that the early attentional processing underlies differential perception of racial out-group faces. Interestingly, P3 was not up-regulated in the AM subjects when they were presented with KR faces, perhaps due to massive habituation to KR faces during everyday social interaction. These results indicate that racial out-group faces are highly salient stimuli which automatically occupy attentional resources, but easily habituated with repeated exposure to the racial-out group.

Clinical Score System to Differentiate Severe Fever with Thrombocytopenia Syndrome Patients from Patients with Scrub Typhus or Hemorrhagic Fever with Renal Syndrome in Korea

Dae-Hyuk Heo,Yu Min Kang,송경호,Jun-Won Seo,Jeong-Han Kim,June Young Chun,전강일,강창경,Song Mi Moon,Pyoeng Gyun Choe,Wan Beom Park,Ji Hwan Bang,Eu Suk Kim,Hong Bin Kim,Sang-Won Park,Won Sup Oh,Nam Joong Kim,M 대한의학회 2020 Journal of Korean medical science Vol.35 No.11

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality in East Asia. This study aimed to develop, for primary care providers, a prediction score using initial symptoms and basic laboratory blood tests to differentiate between SFTS and other endemic zoonoses in Korea. Methods: Patients aged ≥ 18 years diagnosed with endemic zoonoses during a 3-year period (between January 2015 and December 2017) were retrospectively enrolled from 4 tertiary university hospitals. A prediction score was built based on multivariate logistic regression analyses. Results: Of 84 patients, 35 with SFTS and 49 with other endemic zoonoses were enrolled. In multivariate logistic regression analysis, independent predictors of SFTS included neurologic symptoms (odds ratio [OR], 12.915; 95% confidence interval [CI], 2.173–76.747), diarrhea (OR, 10.306; 95% CI, 1.588–66.895), leukopenia (< 4,000/mm3 ) (OR, 19.400; 95% CI, 3.290– 114.408), and normal C-reactive protein (< 0.5 mg/dL) (OR, 24.739; 95% CI, 1.812–337.742). We set up a prediction score by assigning one point to each of these four predictors. A score of ≥ 2 had 82.9% sensitivity (95% CI, 71.7%–87.5%) and 95.9% specificity (95% CI, 88.0%–99.2%). The area under the curve of the clinical prediction score was 0.950 (95% CI, 0.903–0.997). Conclusion: This study finding suggests a simple and useful scoring system to predict SFTS in patients with endemic zoonoses. We expect this strategic approach to facilitate early differentiation of SFTS from other endemic zoonoses, especially by primary care providers, and to improve the clinical outcomes.

자궁의 악성 혼합성 중배엽 종양 26예의 임상적 고찰

강혁재 ( Hyuk Jae Kang ),정민형 ( Min Hyung Jung ),김종준 ( Jong June Kim ),김대연 ( Dae Yeon Kim ),김종혁 ( Jong Hyeok Kim ),서대식 ( Dai Shik Seo ),김용만 ( Yong Man Kim ),김영탁 ( Young Tak Kim ),남주현 ( Joo Hyun Nam ),목정은 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12

목적: 자궁의 악성 혼합성 중배엽 종양 환자들의 특징, 생존율, 예후인자를 평가하고자 하였다. 연구 방법: 1994년 1월부터 2004년 12월까지 본원에서 관찰한 26예의 자궁의 악성 혼합성 중배엽 종양 환자의 의무기록을 후향적으로 분석하였다. 환자들의 특징과 병리결과, 병기, 치료, 예후인자와 생존기간을 분석하였다. 결과: 전체 환자의 중앙 연령은 59세였으며, 대부분의 환자 (76.9%)는 폐경 후 상태이었고, 가장 흔한 증상은 질 출혈 (65.4%)이었다. 환자들은 I기가 17명 (65.4%)이고, II기가 3명 (11.6%)이고, III기가 4명 (15.4%)이고, IV기가 2명 (7.6%)이었다. 병리학 적으로 동종형의 종양이 4개 (15.4%)이고 이종형의 종양이 22개 (84.6%)이었다. 모든 환자들의 5년 생존율은 60%이며 병기에 따라 비교하면 진행된 기수 (III, IV)의 환자들이 조기 (I, II)의 환자들에 비해 훨씬 나쁜 예후를 보였으며 전체적인 (Overall) 생존율에 영향을 주는 인자는 수술 후 병기였다 (P=0.001). 그리고 자궁근층을 침범한 깊이도 역시 환자의 생존율에 의미있게 영향을 준다 (P<0.001). 결론: 자궁의 악성 혼합성 중배엽 종양은 매우 악성의 종양이며 중요한 예후인자는 FIGO 병기와 자궁근층을 침범한 깊이이다. Objective: To review the clinicopathological characteristics and prognosis of patients with malignant mixed Mullerian tumor (MMMT) of the uterus. Methods: Retrospective clinical study was done on 26 patients diagnosed with the MMMT of the uterus at our hospital from Janurary, 1994 to December, 2004. Demographic data, pathologic findings, stages, treatment, prognosis and survival time were reviewed. Results: The median age of patients was 59 years. Most of the patients (76.9%) were in the postmenopausal state. The most common symptom was vaginal bleeding (65.4%). There were 17 patients (65.4%) with stage I, 3 patients (11.6%) with stage II, 4 patients (15.4%) with stage III, 2 patients (7.6%) with stage IV disease in this study. Of the hysterectomy specimens, 4 (15.4%) of them were heterologous tumors, 22 (84.6%) of them were homologous tumors. Overall 5 year survival rate of all stages was 60% and the patients with advanced stages (III, IV) showed poorer prognosis than the patients with early stages (I, II) (P=0.001). Myometrial invasion depth was also significant prognostic factor (P<0.001). Conclusion: The MMMT of the uterus is a highly malignant tumor and the significant prognostic factor is the FIGO stage and myometrial invasion depth.

Genetic effect of <i>CCR3</i> and <i>IL5RA</i> gene polymorphisms on eosinophilia in asthmatic patients

Lee, June-Hyuk,Chang, Hun Soo,Kim, Ji Hyun,Park, Se-Min,Lee, Yong Mok,Uh, Soo Taek,Rhim, Taiyoun,Chung, Il Yup,Kim, Yong-Hoon,Park, Byung Lae,Park, Choon-Sik,Shin, Hyoung Doo Elsevier 2007 The journal of allergy and clinical immunology Vol.120 No.5

<P><B>Background</B></P><P>Eosinophilic infiltration and peripheral blood eosinophilia in asthma require the cooperation of eosinophil-specific cytokines and chemokines and their receptors.</P><P><B>Objective</B></P><P>We investigated the association of polymorphisms in <I>CCR3</I> and <I>IL5RA</I> with asthma susceptibility or peripheral blood eosinophilia and the effects of the polymorphisms on receptor expression.</P><P><B>Methods</B></P><P>Polymorphisms in <I>CCR3</I> and <I>IL5RA</I> were identified and genotyped in 576 asthmatic patients and 180 healthy control subjects. CCR3 and IL-5 receptor α (IL-5Rα) protein expression on eosinophils was measured by means of flow cytometry.</P><P><B>Results</B></P><P>Although polymorphisms in <I>CCR3</I> were not associated with asthma susceptibility, the <I>CCR3</I> haplotype <I>ht2</I> showed a negative gene dose effect on the eosinophil count (<I>P</I> = .003–.009). <I>IL5RA c.−5091G>A</I> was weakly associated with eosinophil count. The effects of <I>ht2</I> were greater when paired with <I>IL5RA c.−5091A</I> (<I>P</I> = .001–.002). CCR3 protein expression was higher on eosinophils of asthmatic patients without <I>ht2</I> than in those with <I>ht2</I>. Asthmatic patients with the <I>IL5RA c.−5091A</I> allele showed higher IL-5Rα expression than those who were homozygous for the G allele.</P><P><B>Conclusion</B></P><P>The genetic association between <I>CCR3</I> polymorphisms and the number of circulating eosinophils was revealed as a novel finding. These associations were more pronounced when the <I>CCR3</I> polymorphisms were paired with polymorphisms in <I>IL5RA</I>. The protein expression levels of CCR3 and IL-5Rα on peripheral blood eosinophils are associated with the polymorphisms on their own genes.</P><P><B>Clinical implications</B></P><P>The identification of single nucleotide polymorphisms and haplotypes of <I>CCR3</I> and <I>IL5RA</I> might be useful in developing markers for intermediate phenotypes of eosinophil number and in designing strategies to control diseases related to hypereosinophilia.</P>

외상성 흉쇄관절 관절증으로 오인된 전이성 폐선암

김준혁 ( June Hyuk Kim ),유정현 ( Jeong Hyun Yoo ),곽호일 ( Ho Il Kwak ),송성훈 ( Seong Hun Song ),김준엽 ( Joon Yub Kim ) 대한스포츠의학회 2016 대한스포츠의학회지 Vol.34 No.2

The prevalence of metastatic tumorous lesion at medial clavicle or sternoclavicular joint is low. Herein, we presented a 45-year-old female patient with left sternoclavicular joint pain followed a weight-lifting exercise. The patient was initially diagnosed as traumatic sternoclavicular arthrosis, however, on later computed tomography scan demonstrated the bony destruction of medial clavicle which was diagnosed as metastasized non-small cell lung carcinoma after a fine needle biopsy.

생물학,분자생물학 : 과량 생산되 대장균 Laccase의 정제 및 특성

홍준혁 ( June Hyuk Hong ),김현정 ( Hyun Jung Kim ),김우연 ( Woo Yeon Kim ) 한국응용생명화학회 2007 Applied Biological Chemistry (Appl Biol Chem) Vol.50 No.2