급성 호흡기 감염증 소아에서 Human metapneumovirus 감염의 임상 양상

이재숙,서현주,우정주,장성희,이진아,송미옥,박화영,안영민,Lee, Jae Sook,Seo, Hyun Joo,Woo, Jeong Ju,Jang, Sung Hee,Lee, Jin A,Song, Mi Ok,Park, Hwa Young,Ahn, Young Min 대한소아감염학회 2007 Pediatric Infection and Vaccine Vol.14 No.1

목 적 : hMPV는 paramyxovirus에 속하는 RNA 바이러스로 2001년 van den Hoogen 등에 의해 처음으로 보고되었으며 늦은 겨울이나 이른 봄에 영아와 노인에서 호흡기 감염을 일으키는 바이러스로 알려져 있으나 아직 우리나라에서의 보고는 많지 않다. 최근 호흡기 증상을 보이는 환아들에서 hMPV를 확인한 바 있어 이에 보고하는 바이다. 방 법 : 2004년 10월부터 2005년 5월까지 을지병원, 서울의료원, 보라매병원 소아과에 호흡기 증상을 주소로 방문한 443명의 비인두 흡인물에서 hMPV RT-PCR을 시행하였고, 양성인 15명의 임상 양상과 검사 소견을 의무기록을 통해 후향적으로 조사하였다. 결 과 : 443명 중 15명에서 hMPV PCR 양성을 보여 양성율은 3.4%이었다. 남아가 7명, 여아가 8명이었고 연령은 1개월에서 62개월(정중값 31.5개월)이었다. 이중 24개월 미만의 환아가 53.3%(8/15)이었다. 진단명은 폐렴 9명, 모세기관지염 3명, 상기도염 2명, 후두염 1명이었다. 그 중 1명에서 천식이 있었고 나머지 환아에서는 기왕력이 없었다. 임상 증상으로는 기침이 15명(100%)으로 가장 많았고 그 외 열감 12명(80%), 콧물 10명(67%), 구토 4명(27%), 호흡 곤란 4명(27%), 설사 3명(20%), 발진 1명(7%)이 있었다. 신체 검진 상 인두 발적이 가장 흔하게 보이는 소견이었으며 나음 6례, 흉부 함몰 4례, 빈호흡 2례, 천명 2례, 천음 1례가 관찰되었다. 말초 혈액 검사만으로 hMPV 감염을 시사하는 특징적인 소견은 없었다. 15명 중 2명에서 아데노바이러스와 중복감염이 있었다. 평균 발열 기간은 $4.9{\pm}2.8$일이었으며 입원 치료를 하였던 13명의 평균 재원 기간은 $5.6{\pm}0.9$일이었고 모두 대증적 치료 후 합병증 없이 증상 호전을 보여 퇴원하였다. 결 론 : hMPV는 상기도 및 하기도 호흡기 감염의 중요 원인 바이러스 중 하나로 생각되며 우리나라에서의 임상적, 역학적 특징을 규명하기 위해서는 향후 더 많은 환자를 대상으로 한 연구가 필요할 것으로 사료된다. Purpose : Human metapneumovirus (hMPV) is a newly identified paramyxovirus that causes a variety of clinical syndromes in children, including upper and lower respiratory tract illnesses. hMPV is considered an ubiquitous virus causing respiratory tract diseases among children especially during late winter and spring seasons. We report clinical features of human metapneumovirus infection in Korean children. Methods : hMPV infection was diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) in respiratory specimens obtained from patients with acute respiratory tract infections from October, 2004 to May, 2005. Medical records of all hMPV-positive patients were reviewed, retrospectively. Results : A total of 15 hMPV were identified from 443 nasopharyngeal aspirations by RT-PCR (3.4%). The range of age of the patients with hMPV infection was from 1 month to 62 months (median age, 31.5 months), with similar numbers of females (8/15) and males (7/15). Among hMPV-positive children, 53.3% (8/15) were aged less than 24 months. Fever, cough, rhinorrhea, vomiting, diarrhea, tachypnea, and chest wall retractions were common findings. Most common clinical diagnosis was pneumonia (60%). Two of the 15 hMPV-positive patients were also positive for adenovirus. Fever persisted from 0 to 10 days (mean 4.9 days). The duration of hospitalization ranged from 4 to 7 days (mean 5.6 days). Conclusion : hMPV accounted for a small but significant proportion of respiratory tract infection in infants and children. Future development and application of diagnostic tools will determine the burden of disease caused by this newly discovered pathogen.

기관지 방선균증과 동반된 이차성 기질화 폐렴

이병훈 ( Byoung Hoon Lee ),이기덕 ( Ki Deok Lee ),김상훈 ( Sang Hoon Kim ),우정주 ( Jeong Joo Woo ) 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.3

Several types of infection can cause organizing pneumonia when the inflammatory process remains active with the further organization of the intra-alveolar fibrinous exudates, despite the control of the infectious organism by antibiotics. We report a case of 37-year-old male with secondary organizing pneumonia associated with an endobronchial actinomycosis. The patient presented with a subacute cough, sputum and fever. Bronchial biopsy revealed sulfur granule to be consistent with the actinomycosis, and percutaneous needle biopsy revealed typical pattern of organizing pneumonia. The patient was treated with the appropriate antibiotics and corticosteroid. There was rapid improvement in the symptoms and radiological findings, and after six months of treatment, the corticosteroid dose was tapered off without a recurrence of the organizing pneumonia. (Tuberc Respir Dis 2007; 62: 227-231)

반복적인 결절조직 배출 후 호전된 기관지 결핵

김수웅 ( Soo Woong Kim ),이병훈 ( Byoung Hoon Lee ),안영수 ( Young Soo Ahn ),김남인 ( Nam In Kim ),엄우연 ( Woo Youn Eom ),우정주 ( Jeong Joo Woo ),김상훈 ( Sang Hoon Kim ) 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.2

자가 벌침주사 후 발생한 급성 폐손상 1예

채원영 ( Won Young Chae ),김상훈 ( Sang Hoon Kim ),이용희 ( Yung Hee Lee ),이병훈 ( Byoung Hoon Lee ),이재형 ( Jae Hyung Lee ),우정주 ( Jeong Joo Woo ) 대한천식알레르기학회(구 대한알레르기학회) 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2

Bee stings can cause severe adverse reactions. There have been no cases of acute lung injury induced by bee sting acupuncture. We report a case of a 52-year-old male who required high flow oxygen therapy because of acute lung injury by bee sting acupuncture. The patient had been treated with live bee sting acupuncture by himself for knee pain. After self-injections of live bee sting, he im￢mediately presented with generalized urticaria that remitted within 3 hours after taking an oral antihistamine. Ten days later, he vis￢ited our emergency department due to dyspnea and dizziness. He was diagnosed with acute lung injury by bee sting acupuncture based upon a history of symptom onset after exposure to the allergen and clinical test results. This case emphasizes that practitio￢ners should consider potential risks of delayed-onset adverse reactions induced by bee sting acupuncture.(Allergy Asthma Respir Dis 2015;3:151-154)

우측 빗장밑정맥에 발생한 혈관 내 지방종

류상열 ( Sang Ryol Ryu ),박지영 ( Ji Young Park ),류용석 ( Yong Suc Ryu ),유연화 ( Yeon Hwa Yu ),양동진 ( Dong Jin Yang ),이병훈 ( Byoung Hoon Lee ),김상훈 ( Sang Hoon Kim ),이재형 ( Jae Hyung Lee ),우정주 ( Jeong Joo Woo ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.2

Lipomas are common soft tissue tumors that are located in the body tissues containing adipose tissues. However, lipomas arising from the walls of a vein are very rare. Intravascular lipomas have been described most commonly in association with the inferior vena cava. Intravascualar lipomas involving the subclavian vein are rare. We are reporting a case of an asymptomatic lipoma of the right subclavian vein, growing into the right brachiocephalic vein.

혼합형 자가면역성용혈성빈혈과 동반된 Evans 증후군 1례

선길홍,윤찬영,박상곤,박경희,우정주,한경택,김진화,김영훈,정춘해,박치영 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

Evans syndrome is defined as a simultaneous or sequential occurrence of autoimmune hemolytic anemia and autoimmune thrombocytopenia. Autoimmune hemolytic anemia (AIHA) is usually induced by IgG warm autoantibody or cold-active IgM antibodies reacting specifically with antigens associated with a patient's RBC. AIHA is a fairly uncommon disorder, with estimates of the incidence at 1 to 3 cases per 100,000 per year. Mixed-type AIHA is a relatively uncommon form of AIHA, with studies noting the incidence of 7-8% among cases of AIHA. We experienced a patient, 46-year-old woman who was diagnosed having a very rare clinical presentation of mixed warm and cold antibody mediated Evans syndrome. She was treated with corticosteroid therapy only and has been maintaining a complete response for 15 weeks. 저자들은 혼합형의 자가면역성 용혈성 빈혈과 자가면역성 혈소판 감소증이 동시에 발생한 혼합형 Evans 증후군으로 진단하고 스테로이드 요법 후 혈액학적으로 회복된 상태로 15주가 지난 현재 steroid 5 mg/일 까지 감량한 상태에서 추적 관찰 치료중인 46세 여자 환자를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

급성 폐색전증의 경흉부 심초음파 검사소견

이동민,고영엽,서영욱,우정주,장경식,홍순표 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background : Pulmonary embolism (PE) is a clinically important disease with high mortality if it was untreated, It is often clinically impossible to notice this disease only by symptoms, but it leads to significant dianosis and therapeutic delays. Accuratc diagnosis of PE is difficult due to variable symptoms and nonspecific clectrocardiographic & radiographic finding's, Pulmonary angiography has been considered as gold standard for diagnosis of pulmonary embolism, while pulmonary angiography is an invasive and cost procedure with significant morbidity and mortality, the echocardioraphy is nonUinvasive and available regardless of time and place. We investigated the diagnostic utility of echocardiography in identifying- pulmonary embolism. Methods : We retrospectively analyzed the recorded transthoracic echocadiography videotapes from 18 patients with confirmed pulmonary embolism from January 1996 to October 2001. As echocardiographic criteria of PE , we used the presence of any two of the following: 1) RV dilataton (RVEDA/LVEDA≥0.6), 2) TR (more moderate degree), 3) Pulmonary hypertension 4) RV hypokinesia, 5) Paradoxical septa] movement. Results : The most common symptom of these patients was dyspnea (83.3%), followed by by pleuritic chest pain, cough, leg swelling and hemoptysis. Howevcr, 11.1% patients have not shawn any symptoms. The most frequently observed electrocardiographic finding was a nonspecific ST-T change (89. 3%), which may be appeared on other cardiopulmonary diseases in precordial leads in patients with PE. We assessed retrospectively that the concordance rate of positive results of echocardiography with confirmatory diagnosis tools such as spiral CT and perfusion scan of lung were 77.8%. Conclusion : Echocardiography is non invasive, feasibility at bedside, available and low cost test. It may be sufficient for use as a screening test in patients with complaining unexplained chest pain and dyspnea which are developed abruptly and modality to decide immediate use of anticoagulant or thrombolytics.