발열과 두드러기를 동반한 반복적 복통 1예

이창근 ( Chang Geun Lee ),임윤정 ( Yun Jeong Lim ),강현우 ( Hyoun Woo Kang ),김재학 ( Jae Hak Kim ),이준규 ( Jun Kyu Lee ),고문수 ( Moon Soo Koh ),이진호 ( Jin Ho Lee ),허희진 ( Hee Jin Huh ),이승호 ( Seung Ho Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.1

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent episodes of fever and serosal, synovial, or cutaneous inflammation, caused by a dysfunction of pyrin as a result of mutation within the MEFV gene. It occurs mainly among Mediterranean and Middle Eastern populations, including Jews, Arabs, and Turks. However, FMF cases have been reported outside the Mediterranean and Middle Eastern countries in recent years. Although FMF has been relatively rare in Korea until now, proper recognition of FMF might lead to more frequent diagnoses of FMF. We experienced an interesting case, a 31-year-old Korean man who presented with recurrent abdominal pain with fever and urticarial eruption for 10 years. DNA analysis showed complex mutations (p.Leu110Pro, p.Glu148Gln) in the MEFV gene. To date, three cases have been reported, and this case of FMF with skin conditions is the first case in Korea. (Korean J Gastroenterol 2014;64:4 -44)

CD7+, CD4+, CD8-, CD3- 급성T 세포 림프구성 백혈병 1예

허희진,허정원,이미애,한운섭,정화순 대한임상병리학회 2001 대한임상병리학회지 Vol.21 No.4

자동화 매독 검사법인 Architect Syphilis TP assay와 Mediace TPLA의 일치율 및 위양성 평가

허희진,채석래 동국대학교 의학연구소 2009 東國醫學 Vol.16 No.1

자동화장비로 검사 가능한 Mediace Treponema pallidum latex agglutination (Sekisui, Japan; 이하 Mediace TPLA)와 Architect Syphilis TP assay (Abbott, Germany; 이하 Syphilis TP)의 결과치를 비교하여 일치율을 조사하였다. 트레포네마검사에서 위양성의 가능성이 높은 환자 검체를 대상으로 두 검사법의 위양성률을 구하여 두 자동화검사법의 유용성을 평가하고자 하였다. Mediace TPLA 양성이었던 161 예를 대상으로 Syphilis TP 검사를 시행하였다. 위양성률을 평가하기 위해 항핵항체 양성이거나 B형간염표면항원 양성, 항-C형간염바이러스항체 양성, rheumatoid factor 양성, CRP 양성 또는 70세 이상의 고령 환자 검체 234예를 연구 대상으로 Mediace TPLA와 Syphilis TP 검사를 시행하였다. 두 검사 결과의 차이를 보이는 예는 line-blot immunoassay (Innolia Syphilis score, Innogenetics, Belgium)로 확인하였다. Mediace TPLA 양성이었던 161예중 4예 (2.5%)는 Syphilis TP 음성이었고, 이 중 2예는 line-blot immunoassay 양성, 2에는 음성이었다. 중화후 Mediace TPLA, 중화전 Mediace TPLA와 Syphilis TP의 위양성률은 각각 0%(0/234), 1.7%(4/234), 1.7%(4/234)였다. 두 검사의 일치율은 98%(387/395) 였다. 자통화 매독검사인 Mediace TPLA와 Syphilis TP는 양성으로 나온 검체에서의 일치율이 높고 기존의 트레포네마검사 보다 낮은 위양성률을 보이므로, 수기법을 대체할 수 있는 유용한 검사로 생각된다. We compared the results of Mediace Treponema pallidum latex agglutination (TPLA) (Sekisui Chemical Co., Ltd, Japan) with Architect Syphilis TP assay (Syphilis TP) (Abbott, Germany), automated treponemal tests for the diagnosis of syphilis. To establish false positive rates, two methods were tested with patients' sera with laboratory results reported to be related with false positivity of treponemal test. One hundred sixty one patients' sera with Mediace TPLA positivity underwent Syphilis TP. Two hundred thirty four patients' sera with positivity for anti-nuclear antibody, HBs Ag, Anti-HCV, rheumatoid factor or CRP, or old age (≥70) were included in the evaluation of false positive rates. Discrepancies between Mediace TPLA and Syphilis TP results were confirmed by line-blot immunoassay (Innolia Syphilis score, Innogenetics, Belgium). Among 161 patients' sera with Mediace TPLA positivity, 4 cases (2.5%) showed discrepancy between Mediace TPLA and Syphilis TP results: Among 4 cases, 2 cases showed positive line-blot immunoassay results and 2 showed negative results. False positive rate of Mediace TPLA after neutralization, Mediace TPLA before neutralization and Syphilis TP was 0.0% (0/234), 1.7% (4/234) and 1.7% (4/234), respectively. The concordance rate of Mediace TPLA and Syphilis TP was 98% (387/395). The results of comparison data demonstrated that Mediace TPLA and Syphilis TP had high concordance. False positivity of Mediace TPLA and Syphilis TP were low compared with previously reported that of treponemal test. Therefore, automated treponemal tests would be considered to be a valid alternative to traditional treponemal test for confirmation of syphilis.

골수이형성증후군에서 소량의 thalidomide 치료경험 1예

임지현,허희진,채석래,김도연 동국대학교 의학연구소 2006 東國醫學 Vol.13 No.1

골수이형성증후군은 말초혈액의 범혈구감소증과 골수의 혈구 이형성증으로 정의되는 조혈모세포의 후천성 클론질환이다. 골수이형성증후군의 주된 치료는 수혈 및 지지요법이고 최근 thalidomide가 유망한 약제로 보고되고 있다. 저자들은 급성 발열성 호중구성피부염(Sweet's syndrome)을 동반한 69세 남자 골수이형성증후군 환자에서 thalidomide 50 mg을 지속적으로 투여하여 혈액수치들의 호전과 수혈 비의존적이 된 1예를 경험하였기에 보고하는 바이다. Myelodysplastic syndrome (MDS) refers to a heterogeneous group of closely related clonal hematopoietic disorders. The recent therapeutic advances are intensive low dose chemotherapy, erythropoietin, colony-stimulating factors and new drugs. Thalidomide has demonstrated a considerable efficacy in MDS. We report a case of MDS in a 69-year-old man who presented with acute febrile neutrophilic dermatosis (Sweet's syndrome). Initially, the prednisolone was administered as treatment of Sweet's syndrome. Thalidomide was added to the patient with a 100 mg initial dose but the patient did not tolerate the side effects of fatigue and constipation. Maintenance with the tolerable dose of 50 mg resulted in transfusion independence and no recurrence of cutaneous lesions.

Candida tropicalis에 의한 요로감염에서 Randomly Amplified Polymorphic DNA (RAPD)법을 이용한 분자역학조사 및 위험인자 분석

한성희,허희진,이미애,정화순 대한임상병리학회 2002 대한임상병리학회지 Vol.22 No.1

Vertebral Osteomyelitis due to Salmonella enterica serovar Othmarschen in an Immunocompetent Patient

Choi, Byong Kwan,Kim, Shukho,Huh, Hee Jin,Kim, Eu Suk,Lee, Sang Min,Chae, Seok Lae 대한감염학회 2008 감염과 화학요법 Vol.40 No.4

Salmonellae have been recognized as uncommon etiological organisms causing osteomyelitis in patients with sickle cell anemia and other immunocompromised conditions. A 34-year old man who had no underlying illness except for congenital block vertebrae at T10-11 vertebrae was admitted to the hospital due to lower back pain and fever for a week. Vertebral osteomyelitis was diagnosed and surgical drainage was performed. Salmonella enterica serovar Othmarschen was isolated from the drained pus. Therapy with ciprofloxacin for 8 weeks was successful without relapse. We describe here a case of vertebral osteomyelitis which was caused by S. Othmarschen in an immunocompetent patient.

한 병원 의료종사자의 A형 간염 혈청역학과 예방접종

김민수,김의석,장윤정,허희진,채석래,이진호 대한감염학회 2009 감염과 화학요법 Vol.41 No.5

Background : Recently, the incidence of hepatitis A has increased in Korea and an outbreak among healthcare workers (HCWs) has also been reported. This study was performed to evaluate the seroepidemiology of hepatitis A among HCWs and their response to vaccination recommendation at a Korean hospital. Materials and Methods :HCWs aged 20-39 years were tested for IgG antibodies against hepatitis A virus (HAV) using ARCHITECT HAVAb-IgG (Abbott Diagnostics Division, Wiesbaden, Germany) during July, 2008. Vaccination was recommended for the seronegative HCWs. Data on age, sex, place of birth, number of siblings, number of children, travel history to endemic areas, occupations, and vaccination history were collected. Statistical analyses were conducted to identify variables related to HAV seropositivity. Results : Among a total of 391 HCWs enrolled, 75 (19%) were males and 316 (81%) were females. The percentages of HCWs aged 20 to 24 years, 25 to 29 years, 30 to 34 years, and 35 to 39 years were 23%, 48%, 17%, and 12%, respectively. The study population comprised of physicians (11%), nurses (62%), nurse aides (5%), paramedical technicians (13%), and administrative staff (9%). Seropositivity for HAV significantly increased with age (P<0.05):1.1% for 20.24, 8.6% for 25-29, 35.8% for 30-34, and 60.9% for 35-39 years-of-age. Multivariate analysis revealed that HAV seroprevalence correlated significantly with age, HCWs born in the non-metropolitan areas, and having ≥ 3 children (P<0.05). The types of work the HCWs do at the hospital were not significantly associated with HAV seropositivity in multivariate analyses. Of a total of 322 seronegative HCWs, 121 (38%) were not vaccinated in spite of recommendation. The reasons for non-compliance were lack of understanding on the necessity of vaccination (39%), lack of time (26%), expensive costs (16%), fear of injection (15%), and some other reasons including pregnancy (4%). Conclusions : Since the seropositivity for HAV is low, vaccination against Hepatitis A should be considered for all HCWs aged 20-39 years in Korea. Education on the necessity of vaccination is warranted to increase compliance.