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Henoch-Scho¨nlein 신염에 관한 임상 및 조직학적 고찰
신채옥,이시동,고철우,구자훈,곽정식 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.1
Retrospective study was conducted to evaluate clinical and pathological characteristics in children with HSP nephritis. Study population consisted of 16 children with biopsy-proven HSP nephritis who had been admitted to Kyungpook University Hospital for the duration of Jan. 1989 to Dec 1991. The following results were obtained. Out of 16 patients, all had abdominal pain and 12(75%) had joint symptoms. Renal involvement after purpura was observed in 12(75%), and mean duration of interval was 1.8 months. Initial serum IgA values were significantly elevated, compared to control(p<0.01). In light microscopic classification according to ISKDC, theree were grade Ⅰ, 6 were grade Ⅱ and 7 were grade Ⅲ. And immunofluorescent microscopic findings showed prominent mesangial IgA deposition in all patients. Finally, further studies are needed for the evaluation of the effect of prenisolone and/or dipyridamole to HSP nephritis.
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김행미,신채옥,현명철,이건수,이상범,구자훈 慶北大學校 醫科大學 1995 慶北醫大誌 Vol.36 No.3
목적 : 신생아 적혈구는 그 모양이 불규칙하여 여러 측정치가 성인 및 소아와 다르다, 저자들은 국내에서 보고된 바 없는 신생아의 Red cell distribution width(RDW)를 조사하여 신생아 정상 측정치를 제시하는 동시에 신생아 시기의 적혈구에 손상을 미치는 질환의 RDW를 분석하여 진단상 의의를 조사하였다. 대상 및 방법 : 신생아 집중치료실에 입원한 만삭아중 감염소견이 없었던 78명과 ABO부적합증 및 패혈증 환아에서 hemoglobin, hematocrit, MV, RDW 및 망상적혈구를 측정하였다. 결과 : 생후 1일부터 7일까지의 만삭신생아의 RDW 17.4±1.5로 소아 정상치 13.4±1.2%에 비해 증가되어 있었으나 출생후 7일까지 hemoglobin, hematocrit는 의의있게 감소한 반면 RDW는 변동이 없었다. 같은 연령의 ABO 부적합증 및 패혈증 환아군은 대조군에 비해 의의있게 hemoglobin과 hematocrit가 낮았으나 RDW는 대조군과 질병군 및 각 질병군 사이에 차이를 보이지 않았다. RDW와 망상적혈구는 ABP 부적합증에서만 상관계수 0.91 (p<0.001)의 상관관계를 보였다. 결론 : 출생후 7일까지 계측한 정상 신생아의 RDW는 소아에 비해 증가되어 있으나 출생후 변화는 없었다. ABO 부적합증 및 패혈증 환아군의 RDW는 대조군과 질병군 및 각 질병군 사이에 차이를 보이지 않아 이들 질환의 진단적 의의가 없었다. ABO 부적합증에서 RDW가 망상적혈구 수와 높은 상관관계를 나타내므로서 자동 분석기로 측정된 RDW로서 망상적혈구 수를 추정할 수 있었다. The RBC distribution width(RDW) has been reported to be of value in the early and differential diagnosis of several RBC disorders, with no sufficient studies on the newborn population. Seventy-eight normal fullterm newborns were studied to establish normal values for RDW of 1st week of life. The RDW of 43 patients with ABO incompatibility or sepsis was then evaluated for the usefulness of the RDW in diagnosis of Jaundice. The RDW was 17.7 ± 1.2 and 17.5 ± 0.8 at 1st and 4-7th days of life, revealing no differences de pending on the postnatal age. The RDW of newborns with ABO incompatibility, sepsis with and without jaundice were 18.4 ± 2.2, 18.2 ± 1.1 and 17.3 ± 0.9 respectively. The RDW was found to be consistently elevated in all these newborn infants-the normal newborns and the newborns with ABO incompatibility or sepsis-when compared with normal older children at our hospital. That reveals a physiologic state of anisocytosis in the newborn, showing no significant differences between these infants. Our results suggest that RDW alone cannot be used as an indicator to distingish between jaundice induced by hemolysis and by other causes. In this study all parameters examined except the reticulocyte counts of ABO incompatibility, which showed, by regression analysis, no correlation with the RDW. High RDW in ABO incompatibility is consistent with high reticulocyte count. One clinical value of the RDW therefore may lie in its capacity for reflecting active erythropioesis in ABO incompatibility. Thus the study has confirmed that red blood cell anisocytosis, as determined by RDW, has no value to differentiate the etiology of jaundice in the newborn period but it seems that RDW plays a role in determining the reticulocyte count in newborns with ABO incompatibility.
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