속립성 (粟粒性) 간결핵 (肝結核)

박재홍,백홍선,고재기,이양근,이중열,안득수 ( jai Hong Park,Hong Sun Baek,Jai Ki Ko,Yang Kun Lee,Jung Yeol Rhee,Deuk Soo Ahn ) 대한소화기학회 1980 대한소화기학회지 Vol.12 No.1

Miliary t:;!'oerculosis of the liver is not often considered as a cause in obscure illness, fever of ur.determir.ed origin or hepatomegaly. A 3p year-old man had suffered from unL.nown fever and chillness, nausea and weight loss for 1p months and had a history of tuberculous pleurisy, confirmed by pleural biopsy in 25 year-old of his age. In local clinic, because of high fever, he had received treatment under the impression of typhoid fever but no improvement vas noted. Physical exaniination on admission revealed that blood pressure was 1ZO/80 mmHg, respira- tion 20/minute, the pulse 100/minute, temperature Rg'C. General appearance was chronic ill and hepato..iegalv and splenomegaly were noted on palpation. On laboratory data showed persistent leukopenia (2,200/mm to 3,400/mm), but bone marrow biopsy was within normal range. Liver scan sliowed hepatospenomegaly and multiple cold area noted. Liver biopsy revealed multiple tubercle with caseous necrotic lesion and large gi,..; cells around the tubercle noted.

미세침 흡인 세포검사 후 발생한 양측 갑상선내 출혈에서 갑상선 절제술을 하지 않고 압박 지혈술로 회복된 증례

백초옥 ( Cho Ok Baek ),장지원 ( Ji Won Jang ),국민하 ( Min Ha Kook ),김인재 ( In Jae Kim ),유경보 ( Kyung Bo Yoo ),조인진 ( In Jin Cho ),임진한 ( Jin Han Lim ),이영선 ( Young Sun Lee ),백홍선 ( Tae Sun Park ),박태선 ( Hong Sun Bae 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.2

Fine needle aspiration (FNA) procedure for thyroid nodule evaluation is considered to be safe and easy to perform, however serious complication such as intrathyroidal hemorrhage causing airway compression can be occurred. Massive hemorrhage compromised airway problem leads to unexpected results including total thyroidectomy. Prior to operation, careful decision for necessity of thyroidectomy and tight compression around bleeding site should be performed. In this case, we present the patient who resolved completely from massive intrathyroidal hemorrhage without thyroidectomy and implicate the importance of manual compression on the bleeding site after FNA before decision of operation.

저산소증에 의한 활막 섬유모세포에서 I CAM-1 발현의 증가

전현순 ( Hyun Soon Jeon ),백홍선 ( Hong Sun Baek ),황병연 ( Byung Yun Hwang ),류완희 ( Wan Hee Yoo ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.1

Objective: Hypoxic conditions are thought to be exist in inflamed arthritic synovium. Several in vitro and in vivo studies indicate that hypoxia can initiate events that lead to pro-adhesive changes. Therefore, this study was designed to examine the effects of hypoxia on the expression of ICAM-1 by cultured human synovial fibroblasts. Methods: Synovial fibroblasts were isolated from patients with RA and cultured at hypoxic condition. To quantify the expression of ICAM-1 mRNA in synovial fibroblasts, RT-PCR was performed. The levels of cytokines in culture supernatants were measured by ELISA. The activation of NF-κB was analyzed by electrophoretic mobility shift assay. The assay of adhesive reaction between synovial fibroblasts and lymphocytes was performed by photographic evaluation with colloidin blue staining and measurement of fluorescent intensity of BCECFAM in lymphocytes. Results: The expression ICAM-1 mRNA was increased at 12 to 48 hours of hypoxic stimuli and peaked at 24 hours (p<0.01). The concentration of IL-1 and TNF-α was increased as the duration of hypoxic stimuli was increased. Hypoxia also induced activatation of NF-κB, which was inhibited by antioxidant (pyrrolidine dithiocarbamate). Fibroblast-lymphocyte adhesive interaction was increased significantly by hypoxic stimuli (p<0.01). Conclusions: Synovial hypoxia may have an important role in inflammatory synovitis, in part, as a cause of adhesion molecule (ICAM-1) expression in synovial fibroblasts and recruitment of inflammatory cells.

Remission of Rheumatoid Arthritis with Taxol in a Patient with Breast Carcinoma

류완희 ( Wan Hee Yoo ),박태선 ( Tae Sun Park ),백홍선 ( Hong Sun Baek ) 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-

Marked Weight Loss in a Type 2 Diabetic Patient Treated with Acarbose

류완희 ( Wan Hee Yoo ),박태선 ( Tae Sun Park ),백홍선 ( Hong Sun Baek ) 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-

당뇨병 환자에 있어서 혈장 Active Renin 및 Inactive Renin 활성도의 변동

장동석(Dong Suk Jang),김진홍(Jin Hong Kim),김원호(Won Ho Kim),백홍선(Hong Sun Baek),김선희(Sun Hee Kim),조경우(Kyung Woo Cho) 대한내과학회 1987 대한내과학회지 Vol.33 No.4

N/A Active, inactive & total renin activity were studied in the groups of l03 controls, 11 diabetids without complications and 39 diabetics with complications. Inactive renin was activated by trypsin, The results were as followins; 1) Active, inactive and total renin activity were decreased with increasing age in normal controls. 2) 1n normal control groups, active renin activity was 1.69±0.06ng/ml/hr, inactive renin activity 1.99±0.13 ng/ml/hr, total renin activity was 3.72±0.13 ng/ml/hr, inactive renin/total renin ratio was 52.19%. 3) In diabetics without complications, active renin activity was 2.68±18 ng/ml/hr. Inactive renin activity was 5.63±1.10 ng/ml/hr, tota1 renin activity was 8.31±1.22 ng/ml/hr, and then inactive renin/total renin ratio was 65.38%. Inactive renin activity in diabetics without complications was increased significantly than normal controls. 5) In diabetics with complications, active renin activity was 1.54±0.28 ng/m1/hr, inactive renin activity was 8.49±1.08 ng/ml/hr, total renin activity was 9.77±1.25 ng/ml/hr and then inactive renin/total renin ratio was 84.94%. Inactive renin activity in diabetics with complications was increased significantly than diabetics without complications.

당뇨병 유발 백서에서 알파-리포산의 피하신경과 미세혈관 보존효과

박명한 ( Ming Han Piao ),진흥용 ( Heung Yong Jin ),송선경 ( Sun Kyung Song ),강선미 ( Seun Mi Kang ),김소영 ( So Young Kim ),박지현 ( Ji Hyun Park ),백홍선 ( Hong Sun Baek ),박태선 ( Tae Sun Park ) 대한당뇨병학회 2007 Diabetes and Metabolism Journal Vol.31 No.6

Rhupus Syndrome 환자에서 발생한 Lupus Enteritis

박지현 ( Ji Hyun Park ),류완희 ( Wan Hee Yoo ),박태선 ( Tae Sun Park ),백홍선 ( Hong Sun Baek ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2

Rheumatoid arthritis(RA) and systemic lupus erythematosus(SLE) are common rheumatologic diseases, and considered to be separate diseases with defined criteria for diagnosis. Occasionally, patients with overlapping features of RA and SLE, termed rhupus syndrome, have been encountered. Appreciation of these patients with rhupus is important since their therapy and outcome differ from those having RA or SLE alone. Rhupus syndrome is a systemic disease which can involve gastrointestinal tract as SLE alone. Lupus enteritis, most feared gastrointestinal complication of SLE, can develop in rhupus syndrome, Recently, we experienced a 54-year-old female patient with lupus enteritis during treatment of rhupus syndrome and present the case here with brief review of literatures.

제2형 당뇨병 환자에서 혈청 라미닌 농도와 경동맥 플라크 진행의 관계

최은경 ( Eun Kyoung Choi ),박명한 ( Ming Han Pao ),박지현 ( Ji Hyun Park ),백홍선 ( Hong Sun Baek ),박태선 ( Tae Sun Park ) 대한내과학회 2006 대한내과학회지 Vol.71 No.4

목적: 제2형 당뇨병 환자의 혈관 기저막에서는 라미닌의 대사와 분포가 변화하고, 혈청 라미닌 농도의 변화는 이 조직학적 변화를 반영하므로 미세혈관병증의 지표로 유용하다고 알려져 있다. 그러나 대혈관병증에서의 라미닌의 변화와 역할에 대해서는 잘 알려져 있지 않다. 이에 본 연구자들은 제2형 당뇨병 환자를 대상으로 혈청 라미닌 농도와 경동맥 죽상동맥경화성 변화 간의 관계를 조사하여 혈청 라미닌 농도가 죽상동맥경화증의 독립적인 예측인자가 될 수 있는지와 여러 임상 변수들이 혈청 라미닌 농도에 어떤 영향을 미치는지 알아보았다. 방법: 103명의 제2형 당뇨병 환자(51;당뇨병성 합병증이 없는 군, 52;당뇨병성 합병증이 있는 군)와 39명의 정상 대조군을 대상으로 혈청 라미닌 농도를 측정하고, 고해상도 B-mode 초음파로 양측의 내경동맥, 경동맥 팽대부, 총경동맥에서 IMT, 플라크의 수 및 점수를 측정하였다. 결과: 혈청 라미닌 농도는 정상 대조군에 비해 합병증이 없는 제2형 당뇨병 환자군에서 합병증이 없는 군에 비해 합병증을 가진 군에서 뚜렷한 증가를 보였다(p<0.01). 합병증이 없는 군과 있는 군 간에 경동맥 IMT 측정값들, 플라크 수 및 플라크 점수는 통계적 차이가 없었다. 경동맥 측정값들과 혈장 라미닌 값 사이의 연관관계 측면에서는 총 IMT, 각 부위별 IMT 및 최대 IMT는 모두 혈청 라미닌 농도와 상관관계가 없었으나(r<0.15, p>0.05), 플라크 수와 점수는 혈청 라미닌 농도와 상관관계(r=0.24, p<0.05)를 보였다(표 3). 또한 당뇨합병증 동반 여부, 허리/엉덩이 둘레 비, 플라크 점수와 apo B가 혈청 라미닌 농도에 독립적인 영향을 미치는 것으로 나타났다. 결론: 제2형 당뇨병 환자에서 혈청 라미닌 농도는 유의한 증가를 보였으며 합병증이 있는 군에서 뚜렷한 증가를 보여 합병증의 유무 판단에 사용가능성을 제시하였다. 또한 제2형 당뇨병 환자에서 혈청 라미닌의 증가는 죽상동맥경화증을 보이는 환자에서 IMT 증가, 플라크의 초기형성 보다는 플라크의 진행에 위험인자로 작용하며, 무증상 동맥경화증의 진행을 예측하는데 도움을 줄 것으로 생각된다. Background: Laminin, the main non-collagenous constituent of vascular basement membranes, can be changed by alteration of metabolism and distribution in diabetic microangiopathy. The serum laminin levels are known to reflect these histological changes. The aim of present study was to investigate whether the serum laminin levels are related to carotid atherosclerosis and diabetic complications, and to assess what clinical variables influence on the serum laminin levels in type 2 diabetes. Methods: The subjects were 103 type 2 diabetic patients (51 in the no complication group and 52 in the complication group) and 39 controls. We evaluated the intima-media thickness (IMT) and plaques in both carotid arteries by duplex scan. and the serum laminin levels were measured. Results: The serum laminin levels were higher in the group with complications complication group compared to the no complication group (p<0.01), and in the no complication group compared to the control group (p<0.01). There were no differences in the carotid parameter values between the complication group and the no complication group. The correlations between the serum laminin levels and the measured IMT values were not significant. However, there were significant correlations between the serum laminin levels and the plaque counts and scores (r=0.24, p<0.05). The presence of diabetic complications, the waist hip ratio, plaque score and apo B affected the elevation of the serum laminin levels (p<0.05). Conclusions: The serum laminin levels were related to the presence of diabetic complications. Such levels may be a risk factor for plaque progression rather than the initiation of plaque formation or IMT thickening in the carotid atherosclerosis of type 2 diabetic patients.(Korean J Med 71:396-404, 2006)

당뇨병성 족부궤양이 당뇨병환자의 재원기간 및 입원비용에 미치는 영향

김재문 ( Jae Moon Kim ),진홍용 ( Heung Yong Jin ),강선미 ( Sun Mi Kang ),김소영 ( So Young Kim ),박지현 ( Ji Hyun Park ),박태선 ( Tae Sun Park ),백홍선 ( Hong Sun Baek ) 전북대학교 의과학연구소 2007 全北醫大論文集 Vol.31 No.2

연구배경: 우리나라에서 아직까지 당뇨성 족부궤양이 재원기간 및 재원 비용에 대해 미치는 영향에 대해 잘 알려져 있지 않다. 비록 당뇨성 족부궤양에 의한 재원기간 및 비용들을 정확히 측정하기는 힘들지만 이러한 시도가 향후 경제학적인 측면 및 사회적 짐이 될 수 있는 측면에서 볼 때 효과적인 의료비 절감을 할 수 있는 방안에 영향을 줄 수 있겠다. 방법: 본 자료는 2005년 1월부터 12월까지 전북대 병원 내분비 내과 및 당뇨성 족부궤양 및 당뇨를 주소로 입원한 환자에 기초하여 조사 및 비교하였다. 이중 49명의 당뇨병성 족부궤양 환자 와 나이 및 성별이 비슷한 족부 궤양이 없는 당뇨병 환자 49명을 재원비용, 협진건수, 수술여부, Lab(TG, HDL, LDL, Cr, HbA1c, Insulin, C-peptide)등을 비교하였다. 결과: 당뇨성 족부궤양이 없는 환자보다 당뇨성 족부궤양이 있는 환자는 있어서 평균 재원기간 및 입원비용이 더 높았다. (46.5 ± 36.2 vs 23.0 ± 21.4 일, P<0.05), (9,114,079 ± 7,341,282 vs 5,770,949 ± 5,387,066 원 P<0.05). 또한 당뇨병성 족부궤양 환자중 수술환자는 23명이었으며 이중 8염이 Major operation을 받았으며 15명이 Minor operation을 받았다. 결론: 위와 같은 결과를 보았을 때 당뇨병성 족부궤양의 예방은 향후 당뇨환자에게 있어서 경제적 짐으로부터 벗어날 수 있게 함을 알 수 있다. 따라서 당뇨병환자를 관리할 때, 당뇨병성 족부궤양에 대한 예방 및 교육, 치료에 좀 더 많은 관심을 가져야 하겠고 이는 요즘 증가하고 있는 사회적 측면에서의 의료비 절감효과에도 영향을 미칠 수 있으리라 사료된다. Background: Few data has been reported about the impact of diabetic foot ulcer on the length of hospitalization and costs in hospital care in Korea. Although it is difficult to estimate precisely, this trial is necessary for efficient medical policy in the respect of social budget and health economy. Methods: From Jan. 2005 to Dec. 2005, diabetic patients who have been admitted in Chonbuk National University Hospital were reviewed according to the presence of foot ulcer. After that, admission days, costs, and treatment modality were compared with diabetic patients without foot ulcer. Results: The mean value of admission days and the direct costs of diabetic patients with foot ulcer were higher than those of diabetic patients without foot ulcer (46.5 ± 36.2 vs 23.0 ± 21.4 days, P<0.05), (9,114,079 ± 7,341,282 vs 5,770,949 ± 5,387,066 won P<0.05). Among diabetic patients with foot ulcer, 23 patients had been operated including of amputation and local debridement in operating room. Conclusion: From this data, we suggest that the prevention of diabetic ulcer has a significant economic benefit in the Korea healthcare budget. Therefore, specific foot care of diabetic patients may be more beneficial in the management of diabetic patients and multidisciplinary team approach with specialized foot clinics, if possible, should be performed in the future.