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이선녕 ( Shun Nyung Lee ),이석정 ( Seok Jeong Lee ),노진규 ( Jin Kyu Noh ),이민수 ( Min Su Lee ),이남석 ( Nam Seok Lee ),이부길 ( Bu Ghil Lee ),리원연 ( Won Yeon Lee ),용석중 ( Suk Joong Yong ),신계철 ( Kye Chul Shin ),김상하 ( Sa 대한천식알레르기학회 2008 천식 및 알레르기 Vol.28 No.4
Occupational allergic rhinitis caused by rabbit fur has been reported in Korea. However, occupational asthma due to rabbit fur has not yet reported in Korea. We report a suspected case of allergic asthma caused by rabbit fur on occupational exposure. A 35-year-old male developed dyspnea, chest discomfort related to rabbit fur. He has been worked for a spinning factory. He presented with a history of allergic rhinitis and asthma. Peripheral blood eosinophil count was 690/mm3. Bronchodilator response was positive, the results of skin prick test were positive for house dust mite, cockroach and rabbit fur. The level of specific IgE for rabbit fur was 8.39 KU/L. The methacholine challenge test was positive (PC20 1.96 mg/mL). These findings suggest that the rabbit fur could induce occupational asthma. We could not perform bronchoprovacation test with rabbit fur due to patient`s refusal. He is in a well controlled state with the use of a combination of inhaled corticosteroid and long acting β2 agonist after the avoidance of rabbit fur. (Korean J Asthma Allergy Clin Immunol 2008;28:309-312)
Lee, Seok Jeong,Lee, Jong-Young,Jung, Soon Hee,Lee, Shun Nyung,Lee, Ji-Ho,Kim, Chong Whan,Jung, Saehyun,Jung, Ye-Ryung,Lee, Won-Yeon The Korean Academy of Tuberculosis and Respiratory 2012 Tuberculosis and Respiratory Diseases Vol.73 No.6
High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.
( Seok Jeong Lee ),( Jong-young Lee ),( Soon Hee Jung ),( Shun Nyung Lee ),( Ji Ho Lee,),( Chong Whan Kim ),( Sae Hyun Jung ),( Ye Ryung Jung ),( Won-yeon Lee ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.73 No.6
High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7∼32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.
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)
이석정 ( Seok Jeong Lee ),리원연 ( Won Yeon Lee ),정순희 ( Soon Hee Jung ),권우철 ( Woo Cheol Kwon ),이선녕 ( Shun Nyung Lee ),이남석 ( Nam Seok Lee ),김상하 ( Sang Ha Kim ),신계철 ( Kye Chul Shin ),용석중 ( Seok Joong Yong ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.6
We report on a case of a patient with laryngo-tracheobronchial amyloidosis who complained of cough, sputum, and hoarseness. A chest X-ray showed consolidation in the right middle lobe. A chest CT scan showed diffuse, irregular narrowing of the tracheobronchial tree and atelectasis of the right middle lobe, with calcification of bronchial wall. Bronchoscopic findings were multinodular submucosal thickening of the right vocal cord, and yellowish multinodular submucosal thickening from the lower trachea through both main bronchi, as well as the lingular division of the left upper lobe, the right middle lobe, and the right lower lobe. The right middle lobe bronchus was nearly obstructed. The diagnosis of amyloidosis was made by multiple bronchoscopic biopsies on the right vocal cord and both bronchi. Pathologic findings were characteristic apple-green birefringence under polarized microscopy with Congo-red stain. The patient had no evidence of systemic amyloidosis. The patient is under conservative symptomatic treatment. (Tuberc Respir Dis 2008;65:532-536)
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)
Risk Factors Related with Mortality in Patient with Pulmonary Tuberculosis
Kim, Chong Whan,Kim, Sang-Ha,Lee, Shun Nyung,Lee, Seok Jeong,Lee, Myoung Kyu,Lee, Ji-Ho,Shin, Kye Chul,Yong, Suk Joong,Lee, Won Yeon The Korean Academy of Tuberculosis and Respiratory 2012 Tuberculosis and Respiratory Diseases Vol.73 No.1
Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.
Risk Factors Related with Mortality in Patient with Pulmonary Tuberculosis
( Chong Whan Kim ),( Sang Ha Kim ),( Shun Nyung Lee ),( Seok Jeong Lee ),( Myoung Kyu Lee ),( Ji Ho Lee ),( Kye Chul Shin ),( Suk Joong Yong ),( Won Yeon Lee ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.73 No.1
Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.
A Case of Autoimmune Progesterone Dermatitis Misdiagnosed as Allergic Contact Dermatitis
이명규,리원연,용석중,신계철,Shun Nyung Lee,이석정,이지호,김상하 대한천식알레르기학회 2011 Allergy, Asthma & Immunology Research Vol.3 No.2
Autoimmune progesterone dermatitis is a rare autoimmune response to endogenous progesterone that usually occurs in fertile females. Cutaneous or mucosal lesions develop cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. Symptoms usually start 3–10 days before menstruation and resolve 1–2 days after menstruation ceases. We report the case of a 48-year-old woman with intermittent eczematous skin lesions of the legs, forearms, and buttocks. She was diagnosed with allergic contact dermatitis, and topical steroids were prescribed. Her skin eruptions waxed and waned for 6 years and were associated with her menstrual cycle. We performed an intradermal test using progesterone,which was positive, and prescribed gonadotropin-releasing hormone analogues monthly for 3 months. The patient’s skin lesions improved, confirming the diagnosis. Autoimmune progesterone dermatitis should be included in the differential diagnosis of recurrent eczema that is refractory to treatment in women of child-bearing age.
김신태 ( Shin Tae Kim ),이선녕 ( Shun Nyung Lee ),이석정 ( Seok Jeong Lee ),정필문 ( Pil Moon Jung ),박홍준 ( Hong Jun Park ),신명상 ( Myung Sang Shin ),김종환 ( Chong Whan Kim ),이부길 ( Bu Ghil Lee ),김상하 ( Sang Ha Kim ),리원 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.6
Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation. (Tuberc Respir Dis 2007;63:515-520)