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고환 부신잔류종양과 부신 우연종을 동반한 선천부신과다형성 1예
조규랑,최희원,김중표,정진아,유재호,윤성국,황규근 대한내분비학회 2007 Endocrinology and metabolism Vol.22 No.5
The fundamental defect among patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylse deficiency is the inability to synthesize cortisol and aldosterone adequately. Ineffective cortisol synthesis signals the hypothalamus and pituitary to increase the production of corticotropin releasing hormone and adrenocorticotropic hormone, respectively. Consequently, the adrenal glands become hyperplastic. It is well known that an adrenal adenoma can develop from hyperplastic tissue under increased corticotropin stimulation of the adrenal cortex in patients that are suffering with CAH. The etiologic mechanism of adrenal incidentaloma remains uncertain, but several hypotheses have been suggested. A testicular adrenal rest tumor has been reported to form in association with the excessive secretion of adrenal androgen by inadequate control after adolescence in CAH. We present a case of poorly controlled salt-losing CAH due to 21-hydroxylase deficiency combined with a testicular adrenal rest tumor and adrenal incidentaloma. (J Kor Endocrine Soc 22:365~370, 2007) 선천부신과다형성은 코르티솔과 알도스테론 합성 장애로 부신의 과형성과 과도한 부신 남성호르몬이 분비된다. 선천부신과다형성 환자에서 부신 선종이 발견되는 경우는 적지 않으나, 그 발생 기전에 대해서는 잘 알려져 있지 않다. 선천부신과다형성 환자 중 사춘기 남아에서 부절절한 호르몬 조절로 부신 남성호르몬이 과도하게 분비될 경우 고환 부신잔류종양이 발견되는 경우가 있다. 그러나 고환 부신잔류종양과 부신 우연종이 동반된 선천부신과다형성은 아직 국내에서 보고된 예가 없다. 저자들은 신생아기에 21-수산화효소 결핍으로 인한 염분 소실형 선천부신과다형성으로 진단되었으나 약물 순응도가 매우 낮아 환아의 나이 14세 1개월에 고환 부신잔류종양과 부신 우연종이 동반된 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
2002년과 2007년 부산 지역 1개 대학병원에 내원한 소아 아토피피부염 환자의 우유, 난백, 대두에 대한 감작률의 비교
조규랑,김미진,김지은,정진아 대한 소아알레르기 호흡기학회 2008 Allergy Asthma & Respiratory Disease Vol.18 No.4
Purpose : The incidence of food allergy associated with atopic dermatitis is approximately 40-60%. We evaluated serum specific IgE to cow's milk (CM), egg white (EW) and soybean in atopic dermatitis and then compared the sensitization rates of patients in 2002 to those in 2007. Methods : Two hundred fifty-eight patients with atopic dermatitis who visited Dong-A University Medical Center in 2002 (n=121) and 2007 (n=137) were enrolled in this study. Medical records were retrospectively reviewed to determine serum total eosinophil count (TEC), and total IgE and specific IgE to CM, EW, and soybean. Results : The TEC was significantly higher in 2002 than in 2007. The sensitization rates to CM, EW and soy bean were significantly different in 2002 and 2007.(P=0.001 and P=0.03 for each) The sensitization rates to CM were significantly different according to age in 2007.(P= 0.04) The sensitization rates to EW were significantly different according to age in 2002 and 2007.(P=0.02 and P=0.00 for each) The sensitization rates to CM were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.04, P=0.01 for each) The sensitization rates to EW were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.00, P=0.002 for each) Conclusion : Among atopic dermatitis patients who visited a single university hospital in Busan, there were no significant differences in the overall sensitization rates in 2002 and 2007. Purpose : The incidence of food allergy associated with atopic dermatitis is approximately 40-60%. We evaluated serum specific IgE to cow's milk (CM), egg white (EW) and soybean in atopic dermatitis and then compared the sensitization rates of patients in 2002 to those in 2007. Methods : Two hundred fifty-eight patients with atopic dermatitis who visited Dong-A University Medical Center in 2002 (n=121) and 2007 (n=137) were enrolled in this study. Medical records were retrospectively reviewed to determine serum total eosinophil count (TEC), and total IgE and specific IgE to CM, EW, and soybean. Results : The TEC was significantly higher in 2002 than in 2007. The sensitization rates to CM, EW and soy bean were significantly different in 2002 and 2007.(P=0.001 and P=0.03 for each) The sensitization rates to CM were significantly different according to age in 2007.(P= 0.04) The sensitization rates to EW were significantly different according to age in 2002 and 2007.(P=0.02 and P=0.00 for each) The sensitization rates to CM were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.04, P=0.01 for each) The sensitization rates to EW were significantly different according to combined allergic diseases in 2002 and 2007.(P=0.00, P=0.002 for each) Conclusion : Among atopic dermatitis patients who visited a single university hospital in Busan, there were no significant differences in the overall sensitization rates in 2002 and 2007.