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증 례 : 담낭담관염 및 방광염으로 발현한 과호산구증가증후군
이계연 ( Gye Yeon Lee ),김선형 ( Sun Hyung Kim ),이승연 ( Seung Youn Lee ),박형도 ( Hyung Do Park ),장홍석 ( Hong Suk Chang ),고동희 ( Dong Hee Koh ),이진 ( Jin Lee ),최영희 ( Young Hee Choi ) 대한췌담도학회 2015 대한췌담도학회지 Vol.20 No.4
호산구성 담낭염은 비교적 드문 질환으로 다른 일반적인 원인의 담낭염과 비교하여 증상, 검사실 소견 및 이학적 검사에 있어 차이가 없어, 주로는 수술 후 진단하게 된다. 한편, 호산구성 방광염은 호산구성 담낭염과 마찬가지로 드물게 발생하며 이 역시 조직학적 진단을 통해서만 확진된다. 본 저자들은 우상복부통증으로 내원하여 급성 담낭담관염으로 담낭절제술 시행 후 호산구성 담낭염이 진단된 환자에서, 수술 후에도 경도의 말초혈액 호산구증가증의 지속과 만성 하부 요로 증상으로 인해 경요로방광조직검사 후 호산구성 방광염의 병발을 국내 최초로 확인하였고, 과호산구증가증후군으로 발현한 호산구성 담낭담관염 및 방광염 진단하에, 이에 대해 스테로이드 투약을 통해 증상 및 말초혈액 호산구증가증의 소실을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Eosinophilic cholangiopathy is a rare disease characterized by dense transmural eosinophilic infiltration of the gallbladder and bile duct. It’s clinical and laboratory manifestations are not different from those of other causes of cholangiopathy, and the diagnosis is usually made based on pathologic findings after cholecystectomy. Moreover, the occurrence of eosinophilic cystitis accompanied by cholangiopathy is extremely rare. We report a rare case of hypereosinophilic syndrome manifested as eosinophilic cholangiopathy accompanied with eosinophilic cystitis, for the first time in Korea, in a 49-year-old woman who presented with persistent right upper quadrant pain. After performing imaging study to validate the diagnosis of acute acalculous cholecystitis and cholangitis, an urgent cholecystectomy was performed. Pathologic examination of the excised gallbladder was consistent with eosinophilic cholecystitis. The patient underwent bladder biopsy because there was persistant irritative voiding symptoms combined with constant mild peripheral eosinophilia even after cholecystectomy, and the pathologic findings revealed eosinophilic cystitis. Symptoms and peripheral eosinophilia were improved after steroid therapy for an indicated period.
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수업의 질 개선을 위한 교사 수업능력 자기평가 방략에 관한 논리적 고찰
김정환(Jeong Hwan Kim),이계연(Gye Yeon Lee) 한국교육평가학회 2005 교육평가연구 Vol.18 No.3
교육의 질 향상을 위해 학생을 위한 평가뿐만 아니라 교사를 위한 체계적인 평가, 그 중에서도 수업 능력 평가가 요구되어진다. 교사의 수업 능력을 촉진하기 위한 방안의 하나로 교사의 수업 능력 자기평가 방안을 탐색하고자 한다. 이를 위해 교사의 수업 능력을 정의하고 교사의 자기평가가 어떤 특징을 지니고 있는지를 밝히고자 한다. 교사의 자기평가는 자신의 교수능력 개선을 목적으로 지식, 수행 신념, 혹은 결과에 대한 적절성과 효과성을 자기 스스로 판단하는 과정으로 자신의 수업 현장에 초점을 맞추어 교수에 관련된 행위를 개선하기 때문에 전문성 신장의 중심 역할을 한다. 또한 전문직으로서 교사는 자신의 수업기법과 전략에 대한 개선방법을 스스로 찾을 수 있으며 전문가로서의 자기 수월성을 유지·개선할 수 있다고 판단되기 때문에 교사 수업능력 자기평가를 통해서 자율적으로 교사의 수업 능력 신장을 위해 노력하게 될 것이다. It is necessary to evaluate teachers' instructional competence for improving educational quality which is very closely related with students' learning improvement. Here, teachers' self-evaluation strategy was investigated for improving teachers' instructional ability. The concept of teachers' self-evaluation of their own instructional competence refers to evaluate the level of appropriateness and effectiveness of teachers' subjective-related knowledge, belief of their own performance and result of their teaching. The main goal of teachers' self-evaluation of instructional competence is to improve their own competence of instruction. Accordingly, teachers' self-evaluation of their own instructional competence is becoming one of the important role for the improvement of teachers' professional competence. Especially, teachers' self-regulated evaluation of their own instructional ability could perform professional role for the progressive improvement of educational quality.
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Valproic acid 사용과 관련된 급성췌장염에 합병된 출혈성 가성낭종
김미강 ( Mi Kang Kim ),김광택 ( Kwang Taek Kim ),이재은 ( Jae Eun Lee ),유준재 ( Jun Jae Yoo ),이계연 ( Gye Yeon Lee ),박세우 ( Se Woo Park ),고동희 ( Dong Hee Koh ),이진 ( Jin Lee ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.4
The occurrence of valporic acid (VPA)-induced pancreatitis is a rare condition, predominantly observed in adolescent. Also, the occurrence of VPA-associated with hemorrhagic pseudocyst is extremely rare. We report the case of a 54-year-old man who had been taking VPA for uncontrolled seizures. He was admitted to our hospital with complaints of abdominal pain and diagnosed with acute on chronic pancreatitis. There were no other causes explaining pancreatitis, and it was thought to be due to VPA therapy. Despite of cessation of VPA, there was ongoing severe abdominal pain with fever. The patient underwent follow-up CT, which revealed a large loculated fluid collection that was observed with intra-cystic hemorrhage. After treatment with percutaneous catheter drainage, he was discharged with regression of the pancreatic pseudocyst. VPA-associated pancreatitis with hemorrhagic pseudocyst is rare but possible. Therefore, this possibility should be considered in the cause of hemorrhagic pseudocyst in a patient taking VPA. Korean J Pancreatobiliary 2014;19(4):194-198
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다른 양성자 펌프 억제제에 교차반응이 없는 lansoprazole 아나필락시스
박인영 ( In Young Park ),도병주 ( Byung Joo Do ),안재성 ( Jae Sung Ahn ),이재혁 ( Jae Hyuk Lee ),이계연 ( Gye Yeon Lee ),김선형 ( Sunh Yung Kim ),최정희 ( Jeong Hee Choi ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.5
Anaphylaxis to proton pump inhibitors (PPIs) has rarely been reported. Different patterns of cross-reactivity between PPIs have also been demonstrated using skin tests. Here, we report a case of anaphylaxis to lansoprazole with tolerance to other commercially available PPIs, which was proved by skin tests and oral provocation tests (OPTs). A 47-year-old female patient visited our Emergency Department with a sudden onset of whole body urticaria, facial swelling, dyspnea, and loss of consciousness that developed 1 hour after ingestion of 30 mg of lansoprazole for her episodic epigastric soreness. The skin prick test (SPT) and the intradermal test (IDT) with lansoprazole, esomeprazole, rabeprazole, and pantoprazole were performed. Lansoprazole showed positive reactions in both the SPT (3 mg/mL) and the IDT (0.003 mg/mL). Rabeprazole (3 mg/mL) showed a positive reaction only in IDT. The SPT and the IDT with esomeprazole and pantoprazole were all negative. The OPT with 30 mg of lansoprazole was positive (showing generalized rash and facial swelling 30 minuites after ingestion), while OPTs with esomeprazole, pantoprazole, and rabeprazole were all negative. Other PPIs could be safe alternatives in cases of anaphylaxis to 1 PPI. Skin tests seem to be helpful to define cross-reactivity between PPIs.(Allergy Asthma Respir Dis 2014;2:383-386)
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