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위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예
김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2
28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.
Interleukin-2와 결핵균 30 kDa 항원이 구개편도 및 말초혈액 T 세포 증식에 미치는 상승효과
박정규,박찬권,조은경,김화중,백태현,고필준,김병국,남부현,나기상,박찬일 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1
Widespread use of BCG has not controlled tuberculosis, and more effective vaccines are clearly needed. Although chemotherapy will remain the mainstay of antituberculosis treatment, the use of adjunctive immunotherapeutic modalitites is attractive, particularly in persons with drug-resistant tuberculosis. Administration of IL-2 or IFN-γto tuberculosis patients enhance bacillary elimination. Cell-mediated immunity is the critical protective immune response in tuberculosis. Mycobacterial antigens are recognized by T cells and that elicit production of protective cytokines are potentially important vaccine antigens. The 30 kDa antigen is secreted in large quantities by growing mycobacteria. That antigen elicits greater proliferation in lymphocytes from healthy tuberculin reactors than healthy tuberculin nonreactors. In this study, the T lymphocyte proliferative responses to 30 kDa antigen from Mycobactrium tuberculosis H37Rv were examined by using tonsilar and peripheral blood lymphocytes from PPD(+) and PPD(-) tonsilectomized persons. When cultured with 30 kD antigen, tonsilar mononuclear leukocytes and T cells of PPD(+) demonstrated more ^3H-thymidine incorporation than PPD(-) persons (stimulation index was 2.5 and 1.9, 0.8 and 1.0, repectively). Peripheral blood mononuclear cells (PBMC) and peripheral blood T lymphocytes were shown the similar responses to this antigen. The combination of IL-2 and 30 kDa antigen elicited a significant proliferative responsiveness in tonsilar mononuclear leukocytes and T cells of PPD(+) persons (SI was 20 and 14.1). PBMC and peripheral blood T cells of PPD(+) persons were also shown a significant responsiveness, but PPD(-) persons did not show. These results demonstrate that the 30 kDa antigen and IL-2 have a synergistic stimulatory property in mycobacteria sensitizing lymphocytes.
Trans-sphenoidal approach에 의한 pituitary microadenoma 수술 후의 임신 1례
여준규,이두룡,이미정,최종무,이원주,류효충,임만빈,최은주 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3
We treated a patient with pituitary microadenoma having hyperprolactinemia and irregular menstruation infertility by transsphenoidal microsurgery. Her menstrual cycle become irregular after marriage but previous menstrual cycle was regular. When she visited our hospital due to infertility, initial serum prolactine level was slightly elevated 35.68ng/ml, During bromecriptine therapy, abrupt increase of serum prolactine level up to 126.52 ng/ml and headache and facial flush and galactorrhea developed. Pituitary microadenoma was confirmed by CT and MRI. The patient underwent transsphenoidal microsurgery. Patient was pregnant after surgery, and it was confirmed by USG and she is following up, OPD now.
이규은 關東大學校 醫科大學 醫科學硏究所 1999 關東醫大學術誌 Vol.3 No.1
The purpose of this study was to investigate the relationship between depression, soimatic discomfort and self-esteem in middle-aged women. The subjects for this study were 246 middle-aged women. Data were collected from February 22 to April 24, 1999 by structured questionnaire. The instruments for this study dele CES-D(Radloff, 1977), somatic discomfort scale(Wittenborn, 1979) and self-esteem scale(Rosenburg, 1971). The data were analyzed SAS/PC program using descriptive statistics, ANOYA, Pearson correlation coefficient. The result of this study ere as follows: 1. The mean age of the subjects were 46.79 years. 2. The statistically significant difference in the score of the depression according to the age(F=3.46, p=.0049) and perceived health status(f= 7.11, p=.001) was obtaind. 3. The statistically significant difference in the level of soimatic discomfort according to the age was obtained muscular discomfort(F=4.11, p=.001). autonomic discomfort(F'=3.15, p=.0059), gastric discomfort(F= 3.16, p =.0089), wakefulness(F=2.69, p=.0218), eyes(F=3.30, p=.0066), climacteric discomfort(F=5,48, p=.0001), cold(F=2.33, p=.0433). 4. The somatic discomfort significantly different according to the level of education were muscular discomfort (F=7.46, p=.0001), autonomic discomfort(F=·1.55, p= .0015), intestinal discomfort(F=3.31, p=.0115), gastric discomfort(F=5.09, p=.0006), wakefulness(F=4.31, p=.0022), dry mouth(F=5.21, p=.0005), climacreric discomfort(F=3.65, p=.0063), cold (F=3.61, p=.0071). 5. The somatic discomfort significantly different according to the job were cutaneous discomfort (F=5.36, p =.0214), cold(F=3.90, p=.0493), fatigue(F=6.20, p=.0133), and others(F=4.65, p=.0,120). 6. The somatic discomfort significantly different according to the perceived health status were muscular discomfort (F=15.39, p=.0001), autonomic discomfort(F=4.80, p=.0010), circulation(F=7.74, p=.0001), intestinal discomfort (F=6.48, p=.0001), gastric discomfort(F= 14.00, p=.0001), wakefulness(F=4.57, p=.0014), eyes(F=B.49, p=.0095), rhinitis(F=6.22, p=.0001), menstrual discomfort (F=6.11, p=.0001), dry mouth(F=,3.59, p=.0073), climacteric discomfort(F=8.45, p=.0001), constipation(F=3.38, p=.0103), cold(F=4.47, p=.0017), fatigue(F=15.94, p=.0001), and others(F=3.56, p=.0076). 7. The statistically significant difference in the self-esteem according to the presence of Job(F=5.61, p=.0187) and perceived health status(F= 3.24, p=.0131) was obtined. 8. There were high correlation between depression and somatic discomfort(r=.4856, p=.0001), between depression and self-esteem(r=-.4200, p=.0001), and between somatic discomfort and self-esteem(r=-.2275, p=.0015).
하루 중 운동 수행 시기에 따른 수면의 효율성과 Sleep Onset 시간 변화에 관한 연구
김은정,김정규 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.6
The purpose of this study was to examine the effects of performed exercise timing on Sleep efficiency and sleep onset time. The subjects of present study were 5 university students. All subjects participated in VO₂max test to calculate their 80% VO₂max workload. The performed exercised test were divided of different timing a day morning exercise at 08:00, afternoon exercise at 14:00, and night exercise at 20:00. All exercise test were continued until subjects stopped because of fatigue. To discriminate between wakefulness and sleep onset time, I performed measurement of electroencephalogram(EEG), electromyogram(EMG), and electrooculogram(EOG) using standardized procedures(Rechtschaffen & Kales, 1968). There were no significant differences in the exercise performance time and sleep efficiency Ⅰ & Ⅱ(p>.05). However, there were significant differences in the sleep onset time among the different exercise performed times(p<.05). Therefore, for the optimal physical performance time, it is very important to keep the circadian rhythm for the body's homeostasis, and elso, training program of circadian rhythm adaptation is needed for sleep quality and exercise performance.