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폐색전증 진단의 도구로서의 Spiral Computed Tomography의 유용성 (폐환기관류주사와의 비교)
고재현 ( Jae Hyun Koh ),오은영 ( Eun Young Oh ),박정호 ( Jung Ho Park ),박상준 ( Sang Joon Park ),윤정환 ( Jung Hwan Yun ),박정웅 ( Jung Woong Park ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),이경수 ( Kyung Soo Lee ),권오 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.4
미만성 폐포출혈을 동반한 전신성 홍반성 루푸스 환자에서 Plasmapheresis를 이용한 치험
고재현 ( Jay Hyun Koh ),송서영 ( Seo Young Song ),이창근 ( Chang Keun Lee ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),고은미 ( Eun Mi Koh ),송재훈 ( Jae Hoon Song ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2
Pulmonary alveolar hemorrhage (PAH) is a rare and often fatal presenting feature of systemic lupus erythematosus (SLE) and enters the differential diagnosis of diffuse lung disease in patients with SLE. Reported mortality rates are extremely high, between 70 and 90 percents. Because death frequently occurs within the first several days of the hemorrhage, the diagnosis needs to be established promptly and treatment should be initiated immediately. Treatment of alveolar hemorrhage has included various combinations of corticosteroids, cytotoxic agents, and plasmapheresis, but survival rates have been extremely low despite aggressive therapy. We experienced a case of diffuse alveolar hemorrhage in a 29 year-old SLE male patient. PAH was diagnosed by hemoptysis, anemia, infiltration on chest X-ray and hemosiderin-laden macrophages in bronchoalveolar lavage. After high dose intravenous steroid, cyclophosphamide intravenous therapy and plasmapheresis, the condition of patient was markedly improved. He was discharged and received monthly intravenous pulse cyclophosphamide. He has done well since, showing no further pulmonary hemorrhage with steroid tapering.
고재현 ( Jae Hyun Koh ),홍석주 ( Suk Joo Hong ),안홍준 ( Hong Joon Ahn ),안중경 ( Joong Kyung Ahn ),전찬홍 ( Chan Hong Jeon ),차훈석 ( Hoon Suk Cha ),안중모 ( Joong Mo Ahn ),김현숙 ( Hyun Sook Kim ),서연림 ( Yeon Lim Seo ),고은미 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.3
Objective: The purpose of the study is to describe the magnetic resonance imaging (MRI) findings and to investigate useful sequences of MRI in inflammatory myopathies. A third goal is to correlate MRI findings with the grade of histopathologic severity. Methods: Sixteen patients (13 women, 3 men), aged 21~74 years (median age of 49) with inflammatory myositis (examined with both MRI and muscle biopsy) were studied. Ten patients were diagnosed with polymyositis and 6 with dermatomyositis. Conventional T1-weighted (SE 366/12) and T2-weighted (SE 4766/90) fast spin-echo and fat-suppressed T1-weighted MR images with contrast enhancement (FSAT T1 CE) were obtained. Ratios between the signal intensities of a muscle and the signal intensities of subcutaneous fat in the same tomographic sections were calculated to objectively represent the degree of signal intensities. Semi-quantitative grading of severities in muscle biopsy specimen was examined based on invasion of inflammatory cells and necrosis, degeneration and regeneration of muscle fiber by a neuromuscular pathologist. Results: FSAT T1 CE could objectively describe the severity of involvement in inflammatory myopathies. The quadriceps muscle group, especially the vastus muscle tended to be most severely and frequently involved in inflammatory myositis with FSAT T1 CE (statistically insignificant). The vastus intermedius muscle was more severely involved in dermatomyositis than polymyositis. The signal intensity of abnormal muscle sampled by biopsy correlated positively with the grade of muscle biopsy. Conclusion: MRI shows promise in identifying pathologic muscle in patients suspected of having one of the inflammatory myopathies. The degree of signal intensity on MRI may reflect the severity of grade in muscle biopsy.
고재현 ( Jae-hyun Koh ),정기현 ( Gi-hyun Jung ),최경희 ( Kyung-hee Choi ) 한국정보처리학회 2005 한국정보처리학회 학술대회논문집 Vol.12 No.2
본 논문은 최근의 네트웍 장비의 기본적인 기능인 stateful inspection 을 지원하기 위해 생성되는 세션 테이블들의 구조와 그 효율성을 확인한다. 그를 위해 LINUX, FreeBSD, OpenBSD 등의 운영체제에서 사용되고 있는 방화벽 소프트웨어들의 세션 테이블 구조 및 특징을 확인하고 실제 실험을 통해 구조적 특징 및 트래픽의 지역성이 테이블의 탐색에 걸리는 오버헤드를 줄이는 데에 어떠한 영향을 미치는지 실제 실험하였으며, 트리 구조를 가지는 세션 테이블이 worst case 시의 테이블 탐색시간을 줄여줌으로써 전체적인 패킷 처리시간을 줄여줄 수 있는 구조임을 확인한다.
초기 류마티스 관절염에서 적혈구 침강속도, 혈청 C-반응성 단백과 방사선학적 진행의 상관관계
고재현 ( Jay Hyun Koh ),김재형 ( Jae Hyung Kim ),이창근 ( Chang Keun Lee ),전찬홍 ( Chan Hong Jeon ),서기현 ( Gi Hyeon Seo ),안홍준 ( Hong Joon Ahn ),차훈석 ( Hoon Suk Cha ),김진석 ( Jin Seok Kim ),안중모 ( Joong Mo Ahn ),고은미 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.4
Objective: To investigate the clinical usefulness of serial measurement of erythrocyte sediment rate(ESR) and C-reactive protein(CRP) for monitoring the radiological progression in early rheumatoid arthritis(RA). Methods: Thirty one patients with RA according to the 1987 ACR criteria, with joint symptoms for less than one year, and who had not previously received disease modifying antirheumatic drugs(DMARDs) were assessed from Oct. 1994 to Aug. 1998 in retrospective study. Area under curve(AUC) of ESR and CRP were calculated in these patients. Joint damage in the hands was assessed by modified Sharp`s method. Results: Male to female ratio was 1: 3.4. Median age of this group was 45.8±13.2 years. Patients who had positive rheumatoid factor were 82%. Mean duration until first visit was 271.9±145.8 days. At the first clinic visit, mean ESR and CRP were 50mm/hr and 2.0mg/dL. Mean erosions and joint space narrowing score by modified Sharp`s method were 55.2 and 12.4, respectively. Correlation analysis showed that ESR AUC and CRP AUC were significantly associated with radiologic progression. Conclusions: Elevated over-time ESR and CRP provide a convenient short term correlation with radiologic outcome(i. e. erosions). Elevated over-time ESR and CRP can be used as a guide for therapy.
안중경 ( Joong Kyung Ahn ),고재현 ( Jae Hyun Koh ),전찬홍 ( Chan Hong Jeon ),차훈석 ( Hoon Suk Cha ),김영호 ( Young Ho Kim ),고은미 ( Eun Mi Koh ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.4
Intestinal pseudo-obstruction is an uncommon and poorly understood complication of systemic lupus erythematosus. It is characterized by acute or chronic symptoms suggestive of the obstruction of small or large intestine without any radiologic, surgical or endoscopic evidence of mechanical obstruction. Although the exact pathogenesis of intestinal pseudo-obstruction in SLE remains unknown, it can be caused by derangement of the visceral smooth muscle, enteric nerves or visceral autonomic nervous system. Concomitant involvement with dilatation of gastrointestinal and genitourinary tract highly suggests of intestinal pseudo-obstruction in systemic lupus erythematosus. There is an apparent association between lupus-related intestinal pseudo-obstruction and ureterohydronephrosis. The management of intestinal pseudo-obstruction consists of high dose corticosteroid, adequate nutrition, hydration and prokinetics. Early recognition of intestinal pseudo-obstruction in systemic lupus erythematosus and the use of adequate dose of corticosteroid are important. We report a case of systemic lupus erythematosus presenting as intestinal pseudo-obstruction.
전신성 괴사성 혈관염에서 다발성 단신경염의 임상적 고찰
김진석 ( Jin Seok Kim ),차훈석 ( Hoon Suk Cha ),서기현 ( Gi Hyun Seo ),안홍준 ( Hong Joon Ahn ),이창근 ( Chang Keun Lee ),고재현 ( Jae Hyun Koh ),김현숙 ( Hyeon Sook Kim ),최동철 ( Dong Chull Choi ),고은미 ( Eun Mi Koh ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Background: The vasculitides are heterogeneous clinical syndromes characterized by inflammation of blood vessels. There are no pathognomonic symptoms. Mononeuritis multiplex is an acute or subacute asymmetric sensory motor syndrome involving discrete peripheral nerves and is known to occur in many illnesses including certain types of systemic vasculitis. Our purpose was to evaluate the clinical manifestations and significance of mononeuritis multiplex in systemic necrotizing vasculitis. Patients & Methods: Eight patients who were diagnosed as systemic necrotizing vasculitis at Samsung Medical Center between 1995 and 1997 were reviewed. Vasculitis was diagnosed by ACR criteria for each vasculitis and microscopic polyangiitis was diagnosed by the Chapel Hill Consensus Conference on the nomenclature of systemic vasculitis. Three were diagnosed as Churg-Strauss syndrome, 3 as polyarteritis nodosa, and 2 as microscopic polyangiitis. In most cases, vasculitis was confirmed by a biopsy specimen showing infiltration of granulocytes, lymphocytes, and/or plasma cell into vessel walls. Occasionally, polyarteritis nodosa was confirmed by mesenteric or renal arteriography which showed microaneurysms. EMG/NCV was performed in seven patients who had neuropathy. Results: Seven of the eight patients presented with mononeuritis multiplex and one had no neuropathy. Four patients presented with neuropathy as the first symptom, and three developed neuropathy within 3 weeks after the onset of vasculitis symptoms. The peroneal nerve and sural nerve were involved in all seven patients. The median nerve, ulnar nerve and posterior tibial nerve were involved in four, two and six patients, respectively. All seven patients had lower extremity involvement. Two showed only lower extremity involvement and five had both lower and upper extremity involvement. Isolated upper extremity involvement was not seen. All patients with mononeuritis multiplex were improved by treatment with cyclophosphamide and steroid therapy. Conclusion: Mononeurtis multiplex is a common manifestation of vasculitis and occurs early in the course of systemic vasculitis. Prognosis of mononeuritis multiplex is excellent, although it may take up to one year to recover.