http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Tuberculous Meningitis-Mimicking Varicella-Zoster Meningitis
홍선인,김태은,정지원,박세윤,정용필,이상오,최상호,김양수,우준희,이상암,김성한 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.2
Background: Varicella-zoster virus (VZV) is one of the most common etiologies of aseptic meningitis. The severest manifestation of VZV meningitis is occasionally confused with tuberculous meningitis (TBM). Thus, we investigated the clinical manifestations of VZV meningitis as compared with those of TBM. Materials and Methods: All adult patients who were diagnosed with VZV meningitis or TBM were enrolled at a tertiary hospital in Seoul, South Korea, during an 8-year period. The clinical characteristics and cerebrospinal fluid (CSF) profile of patients were analyzed. Results: Seventy-nine patients with VZV meningitis and 24 patients with TBM were enrolled in this study. Of the 79 patients with VZV meningitis, 63 (80%) did not received empirical anti-tuberculous therapy (Group 1) and the remaining 16 (20%) received empirical anti-tuberculous therapy (Group 2), compared with 24 patients with TBM (Group 3). Altered mental status, intensive care unit (ICU) admission, neurologic sequelae, CSF protein levels, and CSF adenosine deaminase levels revealed a trend of being higher in Group 3 than Group 2, which was higher than Group 1. However, the CSF/serum glucose ratio was significantly lower in Group 3 than in Group 1 or Group 2. Conclusion: About one fifth of VZV meningitis cases presented as severe manifestations, mimicking TBM. The CSF/serum glucose ratio might be useful to differentiate VZV meningitis from TBM until definite diagnostic tests are available. Physicians should keep in mind that a differential diagnosis between severe VZV meningitis and TBM is needed.
홍선인,서영선,김현옥,배인규,신종희,조오현 대한감염학회 2018 Infection and Chemotherapy Vol.50 No.4
Millerozyma farinosa (formerly Pichia farinosa) is halotolerant yeast mainly found in food and ubiquitous in the environment. It was a rare yeast pathogen, but it has recently emerged as a cause of fungemia in immunocompromised patients. Optimal therapy for invasive fungal infection by this pathogen remains unclear. We report a case of catheter related blood stream infection caused by M. farinosa in a 71-year-old patient who recovered successfully after removal of the central venous catheter and treatment with micafungin.
Sensitivity of the Cytomegalovirus Antigenemia Assay to Diagnose Cytomegalovirus Retinitis
홍선인,김태은,박세윤,정지원,이주용,정용필,성흥섭,이상오,최상호,김양수,우준희,김성한 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.4
Background: Cytomegalovirus (CMV) retinitis is one of the most important tissue-invasive CMV diseases in immunocompromised patients. Since 1980, non-invasive diagnostic methods, notably the CMV antigenemia assay, have been widely used as adjunct tests to diagnose tissue-invasive CMV diseases. However, there are limited data on the diagnostic value of the CMV antigenemia assay for diagnosing CMV retinitis. Materials and Methods: We performed a retrospective review of all cases of CMV retinitis at Asan Medical Center, Seoul, South Korea over a 9-year period. The diagnosis of CMV retinitis was made by experienced ophthalmologists according to medical history and an ophthalmoscopic appearance of typical retinopathy, together with absence of an alternative diagnosis. Results: We analyzed 44 patients with CMV retinitis (affecting 57 eyes) for whom the CMV antigenemia assay was performed. Of the 44 patients, 31 (70%) were HIV-uninfected and 13 (30%) were HIV-infected. The overall sensitivity of the CMV antigenemia assay was 66% (95% confidence interval [CI] 50–80%). The test’s sensitivity showed a non-significant trend towards being higher in HIV-infected patients than in HIV-uninfected patients (sensitivity 85% vs 58%, respectively, P = 0.16). In a subgroup analysis of the 35 patients without other concurrent tissue-invasive CMV disease, the sensitivity of the CMV antigenemia assay was 57% (95% CI 40–74%). Conclusions: The CMV antigenemia assay has limited value as a non-invasive diagnostic adjunct test for CMV retinitis. Therefore, the results of the assay need to be interpreted in the context of underlying disease, clinical presentation, and ophthalmoscopic findings.
증례 : 감염 ; 세균혈증을 동반한 비장티푸스 살모넬라에 의한 화농성 천장관절염 1예
홍선인 ( Sun In Hong ),김태은 ( Taeeun Kim ),윤지현 ( Ji Hyun Yun ),조동희 ( Dong Hui Cho ),김양수 ( Yang Soo Kim ),우준희 ( Jun Hee Woo ),김성한 ( Sung Han Kim ) 대한내과학회 2015 대한내과학회지 Vol.88 No.3
화농성 천장관절염은 드문 질환으로 의심하지 않으면 진단이 늦어져 패혈증으로 진행하여 사망할 수 있는 질환이다. 정확한 조기 진단 및 적절한 항생제 치료와 배농술을 통해 치료해야 한다. 저자들은 특별한 위험인자 없이 우측 둔부통증으로 내원한 환자에서 비장티푸스 살모넬라에 의한 화농성 천장관절염을 경험하여 보고하는 바이다. Pyogenic sacroiliitis is a rare joint infection, with a challenging diagnosis due to its nonspecific indicators and symptoms. Staphylococcus aureus is the most common causative bacteria of pyogenic sacroiliitis, with Pseudomonas aeruginosa being the most common causative gram-negative bacteria. Interestingly, whereas Salmonella species. is reportedly the second most common cause of this disorder there have been no reported cases of acute sacroiliitis due to Salmonella spp. in Korea, to the best of our knowledge. In this study, we report on the first case in a young Korean adult caused by Salmonella enterica serotype Livingstone, with no underlying disease or predisposing factors. (Korean J Med 2015;88:346-349)
문선인, 홍장수 충북대학교 의과대학 충북대학교 의학연구소 2012 忠北醫大學術誌 Vol.22 No.1
연구목적: 본 연구는 당귀, 작약, 시호 등 다양한 약초 성분을 혼합하여 제조한 생약추출물이 화상치 료제로서의 가능성이 있는지 확인하기 위한 전임상 예비실험으로 2도 화상을 입힌 랫드의 피부에 수차 례 살포하고 시간경과에 따른 피부조직의 치유 정도를 자연치유군과 비교해 평가하고자 하였다. 대상 및 방법: 4주령의 랫드를 5마리씩 양군에 배정하여 2도 화상을 유도한 후 한군은 자연치과정을, 나머지 한 군은 생약추출물을 살포한 후 3일간 치유과정을 육안으로 관찰하고 면역조직염색을 통한 조 직변화를 비교 평가하였다. 결과: 화상 3일 후의 창상부위는 육안 상으로 관찰했을 때 생약처리군의 경우가 자연치유군에 비해 상 대적으로 매우 빠르게 호전되는 것으로 나타났으며 병리조직학적 비교에서도 생약처리군의 경우가 다 소 경미한 것으로 나타났으나 화상 중앙부위에 대한 조직학적 차이는 관찰되지 않았다. 결론: 본 연구에서 비록 조직학적 측면에서의 효과를 검증하지는 못하였으나 생약추출물의 화상치유 효과에 대한 충분한 가능성을 확인할 수 있었다. 보다 구체적이고 장기적인 연구를 통하여 생약추출물 의 화상치유 효과를 검증할 필요성이 있다.
안지환,강병주,홍선인,이정수,이재승,오연목,이상도 대한의학회 2014 Journal of Korean medical science Vol.12 No.12
We aimed to identify a vasoreactive subset of patients with idiopathic pulmonary arterialhypertension (IPAH) in Korea and to show their clinical characteristics and prognosis. Dataon patients who were diagnosed with IPAH at Asan Medical Center between January 1994and March 2013 were retrospectively collected. Acute vasodilator testing was performedwith inhaled nitric oxide during diagnostic right heart catheterization. A positive acuteresponse was defined as a reduction in mean pulmonary arterial pressure (PAP) ≥ 10 mmHgto an absolute level of mean PAP < 40 mmHg without a decrease in cardiac output. Among a total of 60 IPAH patients included for analysis, 9 (15%) showed a positive acuteresponse to acute vasodilator testing. Acute responders showed significantly lower peakvelocity of a tricuspid regurgitation jet on echocardiography (4.1 ± 0.3 m/s vs. 4.6 ± 0.6m/s; P = 0.01) and significantly lower mean PAP hemodynamically (47 ± 10 mmHg vs. 63 ± 17 mmHg; P = 0.003) than non-responders at baseline. The survival rate of acuteresponders was 88% at 1, 3, 5, and 10 yr, respectively, which was significantly higher thanthat of non-responders (85%, 71%, 55%, and 40%, respectively; P = 0.029). In conclusion,Korean IPAH patients with vasoreactivity showed better baseline hemodynamic featuresand survival than those without vasoreactivity.
A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease
안재환,송진우,홍선인,조동휘,채은진,송준선 대한결핵및호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.77 No.2
Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.
증례 : 감염 ; 균혈증을 동반한 비피막형 Haemophilus influenzae에 의한 요추 척추염 1예
김태은 ( Tae Eun Kim ),홍선인 ( Sun In Hong ),윤지현 ( Ji Hyun Yun ),박소영 ( So Young Park ),우창윤 ( Chang Yun Woo ),성흥섭 ( Heung Sup Sung ),최상호 ( Sang Ho Choi ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
세균성 척추 골수염은 척추체와 추간판을 침범하는 세균감염에 의해 발생하며, 50대 이상의 연령군에서 주로 발생한다. 다양한 균이 척추 골수염을 일으킬 수 있는데, 그 중 H.influenzae에 의한 감염은 드물다. 본 증례에서는 기저 질환이 없었던 사람에서 급성 요통과 함께 영상 검사에서 요추의 골수염 소견이 확인되었고, 혈액 배양 검사에서 비피막형H. influenzae가 분리되어 이에 의한 척추 골수염으로 진단할 수 있었다. 감수성 있는 항생제 치료로 호전되었으며, 비피막형 H. influenzae에 의한 척추 골수염에 대한 국내 보고가 없었기에 본 증례를 통해서 보고한다. Vertebral osteomyelitis is primarily seen in middle-aged individuals, with a mean age of presentation of ~60 years. Recent trends suggest an increase in the incidence of vertebral osteomyelitis due to longer life expectancy of patients with chronic debilitating diseases. Haemophilus influenzae is a small, fastidious, gram-negative bacillus, which is known to cause infections in young children. While invasive H. influenzae infections have become increasingly common in adult populations, bone infections caused by this organism remain extremely rare. The existing medical literature includes only 11 reports of vertebral osteomyelitis caused by H. influenzae since 1978, with no reports of H. influenzae-associated vertebral osteomyelitis observed in Korea. Here, we present the case of a 72-year old patient with hematogenous vertebral osteomyelitis and psoas abscess caused by non-typeable H. influenzae. (Korean J Med 2014;87:636-641)