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Digital ulceration due to the change of hand microvasculature induced by rheumatoid arthritis
( Yu Ra Sim ),( Yea Jin Lee ),( Sung Jae Choi ),( Young Ho Seo ),( Gwan Gyu Song ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Severe Raynaud’s phenomenon enough to make digital necrosis is a rare manifestation of rheumatoid arthritis(RA) without other evidences of overlapped systemic sclerosis. Here we report a case of a severe Raynaud’s phenomenon with finger tip ulceration and gangrene in uncontrolled RA patient. Case Report: A 54-year-old male with 8-year history of taking weekly methotrexate 7.5 mg for RA visitedour cardiovascular surgery department complaining of 2-week history of ulceration of left third fingertip with Raynaud’s phenomenon. Physical examination revealed tenderness, swelling, and limitation of movement in bilateral wrist, 2nd & 3rd MCP and PIP joints. The ulcerative lesion in left 3rd fingertip was combined with bluish color change. He had normal bilateral radial and ulnar pulses. Left forearm arteriography revealed localized hypervascularity of RA affected joints and multiple occlusions at interosseous arteries and digital arteries, especially most severe in third finger. We increased the dosage of methotrexate to 12.5 mg/week, additionaly preiscribed methylprednisolone 4 mg/day and tadalafil. We strongly recommended quitting of smoking. After 2 months, the ulcerated lesion in fingertip was improved and arthritic joint pain was resolved. Conclusions: In uncontrolled RA activity, deprivation of distal blood flow induced by the shunt like filling of the veins through hypervascularized region in severely affected arthiritic joints, can result in Raynaud’s phenomenon and digital gangrene.
Determinants of Nicotine Dependence in Chronic Obstructive Pulmonary Disease
Sim, Yun Su,Lee, Jin Hwa,Kim, Ki Uk,Ra, Seung Won,Park, Hye Yun,Lee, Chang-Hoon,Kim, Deog Kyeom,Shin, Kyeong-Cheol,Lee, Sang Haak,Hwang, Hun Gyu,Ahn, Joong Hyun,Park, Yong Bum,Kim, Yu-Il,Yoo, Kwang Ha The Korean Academy of Tuberculosis and Respiratory 2017 Tuberculosis and Respiratory Diseases Vol.80 No.3
Background: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036-1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376-29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388-34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.
Endophthalmitis due to Streptococcus agalactiae of a serotype V strain in a healthy adult
( Sang Hyun Kim ),( Yu Ra Sim ),( Yea Jin Lee ),( Min Ja Kim ),( Jang Wook Sohn ),( Jae Moon Ahn ),( Young Kyung Yoon ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Streptococcus agalactiae, a group B streptococcus (GBS), is a normal flora. Endogenous endophthalmitis caused by GBS is an extremly rare but visually devastating disease. Here, we describe the first-reported Korean case of GBS infective endocarditis presenting as endogenous endophthalmitis and skin and soft tissue infection. Case Report: A 43-year old female without any underlying medical condition visited our emergency room complaining of a 10-hour history of decreased visual acuity with ocular pain on the right eye. Physical examination revealed a 3 cm-sized skin swelling with purulent discharge on right buttock area which was tender and erythematous. Ophthalmic examination revealed endogenous endophthalmitis on the right eye. Penicillin-susceptible S. agalactiae, sequence type 1 associated with a serotype V, was identified as the causative organism on the specimens from the eyeball, blood, and skin pus of right buttock. For the first 12 days of hospitalization, intravenous ceftriaxone (2 g/day) was prescribed with the regimen of intravitreal vancomycin (1 mg/0.1 mL) and ceftazidime (2.25mg/0.1 mL). However, her visual acuity rapidly deteriorated to light perception within a day. On the third day of hospitalization, she underwent a therapeutic vitrectomy of right eye. Ten days after initially normal transthoracic echocardiography, transesophageal echocardiography revealed a 5 mm-sized vegetation attached to anterior mitral leaflet. The patient was finally diagnosed as invasive GBS infection with infective endocarditis presented as endogenous endophthalmitis and skin and soft tissue infection. At the 6-month follow-up visit after completion of antibiotic therapy for 40 days, the patient remained free of any complications, except phthisis bulbi of the right eye without perception to light and visual acuity. Conclusions: In conclusion, this case suggests that GBSinfections should be added to the list for differential diagnosis of endogenous endophthalmitis even in healthy adults. Our report also highlights the requirement of a high index of suspicion for infective endocarditis among them.
Untargeted metabolomics and steroid signatures in urine after finasteride treatment for a year
( Ji-hoon Lim ),( Yu Ra Lee ),( Eunju Im ),( Haksoon Kim ),( Jeongae Lee ),( Han Bin Oh ),( Ki Jung Paeng ),( Jongki Hong ),( Bong Chul Chung ),( Min-jeong Kang ),( Soon-hyo Kwon ),( Woo Young Sim ),( 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.1
Sex related differences in urinary metabolic profiling of alopecia areata
( Ji-hoon Lim ),( Yu Ra Lee ),( Haksoon Kim ),( Jeongae Lee ),( Han Bin Oh ),( Jongki Hong ),( Bong Chul Chung ),( Min-jeong Kang ),( Soon-hyo Kwon ),( Woo Young Sim ),( Bark Lynn Lew ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.1
공동주택의 열부하 및 탄소배출량 저감을 위한 태양열시스템의 최적 적용 방안 연구
윤종호(Yoon Jong-Ho),심세라(Sim Se-Ra),신우철(Shin U-Cheul),백남춘,곽희열(Kwak Hee-Yu) 한국태양에너지학회 2011 한국태양에너지학회 논문집 Vol.31 No.2
Architectural market in the world is trying to develop Zero Carbon Buildng that doesn't use fossil fuel. Residential building that thermal load such as heating and domestic hot water is over 70% in energy consumption is easy to make Zero Carbon Building compared with office building that is mainly electric load. So, As a preliminary for analyzing the effect of Solar thermal system in the building, an annual energy consumption of residential building and total heat loads are calculated. Based on this result, three alternatives of solar thermal system for hot water and heating are applied in the building while installation area is increasing. Solar thermal system is applied on balcony and roof of apartment building as the way to reduce thermal load. In the first case that solar thermal system for hot water is applied on the balcony, optimum installation area is 56㎡. And you could install 40㎡ of this system in the roof that angle is 30°. In the second case of solar thermal system for heating and hot water, you can install 40㎡ on the roof. As a result of economic evaluation, the most economical application method is to install 40㎡ of solar thermal system for only hot water on the roof of the building. At that time, you can payback the initial investing cost within 10 years. And carbon emission of this method can be reduced until about 4 ton per year.
Different polyamine levels in the vertex and occipital hair of pattern hair loss patients
( Ki-hun Kim ),( Bong Chul Chung ),( Yu Ra Lee ),( Jeongae Lee ),( Jong Ki Hong ),( Bark Lynn Lew ),( Woo Young Sim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2
Background: Pattern hair loss generally begins from the vertex or front of the head. Androgenic steroids, particularly testosterone and dihydrotestosterone are related with pattern hair loss. They existed differently in the vertex and occipital region of scalp and involved in inducing ornithine decarboxylase (ODC) expression. ODC is central enzyme in polyamine biosynthesis. The polyamine produced by ODC plays an important role in pattern hair loss by presenting at different levels along the scalp area. Objectives: This study was conducted to evaluate pathogenesis and diagnosis of patients with pattern hair loss by identifying the differences in polyamine levels according to the area of scalp. Methods: For the profiling of polyamines in patients with pattern hair loss, a liquid chromatography-mass spectrometrybased quantitative profiling method was used. We investigated the differences in polyamine levels in different regions of the hair between patients with male-pattern hair loss and those with female pattern hair loss. Results: We found almost polyamine levels were higher in vertex than occipital hair. Also we confirmed difference levels between N-acetyl polyamines and polyamines in same area of hair. Our results suggest that proliferation occurs at the vertex region rather than at the occipital region. Conclusion: High concentration of polyamine in vertex hair may relate with pattern baldness which begins at vertex.