다기관성 대결절성 결핵

임경리 ( Kyoung Ree Kim ),강명호 ( Myung Ho Kang ),김태석 ( Tae Suk Kim ),문기원 ( Ki Won Moon ),류동열 ( Dong Ryeol Ryu ),이희영 ( Hui Young Lee ),한선숙 ( Seon Sook Han ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.1

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient`s health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

Comparative Evaluation Between the RealStar Pneumocystis jirovecii PCR Kit and the AmpliSens Pneumocystis jirovecii (carinii)-FRT PCR Kit for Detecting P. jirovecii in Non-HIV Immunocompromised Patients

허희재,임경리,기창석,허경민,심향진,송동준,김예진,정두련,이남용 대한진단검사의학회 2019 Annals of Laboratory Medicine Vol.39 No.2

Background: Real-time PCR is more sensitive than microscopic examination for detecting Pneumocystis jirovecii. We compared the performance of two assays for detecting P. jirovecii DNA: the RealStar Pneumocystis jirovecii PCR Kit 1.0 CE (Altona Diagnostics, Hamburg, Germany) and the AmpliSens Pneumocystis jirovecii (carinii)-FRT PCR kit (InterLabService Ltd., Moscow, Russia). Methods: We used 159 samples from the lower respiratory tract (112 bronchoalveolar lavage [BAL] fluid, 37 sputum, and 10 endotracheal aspirate [ETA] samples) of non-HIV immunocompromised patients. Nested PCR and sequencing were used to resolve discordant results. The performance of the two assays was evaluated according to clinical categories (clinical Pneumocystis pneumonia [PCP], possible PCP, or unlikely PCP) based on clinical and radiological observations. Results: The positive and negative percent agreement values were 100% (95% confidence interval [CI], 85.4–100%) and 96.6% (95% CI, 90.9–98.9%), respectively, and kappa was 0.92 (95% CI, 0.84–0.99). P. jirovecii DNA load was significantly higher in the clinical PCP group than in the other groups (P<0.05). When stratified by sample type, the positive rate for BAL fluids from the clinical PCP group was 100% using either assay, whereas the positive rate for sputum/ETA samples was only 20%. Conclusions: The two assays showed similar diagnostic performance and detected low P. jirovecii burden in BAL fluids. Both assays may be useful as routine methods for detecting P. jirovecii DNA in a clinical laboratory setting, though their results should be interpreted considering sample type.

급성 뇌경색이 합병된 Haemophilus parainfluenzae 심내막염의 조기판막치환술 1례

강명호,임경리,김태석,김세현,김경현,오원섭,이길수 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.3

Haemophilus parainfluenzae , one of the member of the HACEK group of gram-negative oropharyngeal species, is a rare cause of subacute native valve endocarditis. Infective endocarditis caused by H. parainfluenzae appears to carry a high incidence rate of cerebral embolism, often making the timing of surgical intervention difficult. A 52-year-old male was diagnosed with acute endocarditis caused by H. parainfluenzae complicated with acute cerebral infarctions. After institution of antibiotic therapy, this patient was mechanically ventilated because of the sudden onset of dyspnea. Repeated two-dimensional echocardiography demonstrated rate-dependent mitral stenosis without interval change of vegetations on the mitral valve. Making a decision regarding the timing of surgical intervention was difficult because of a fear of clinical deterioration after early valve replacement.

Safety of Oriental Medical Therapy: Drug Fever of Herbal Medicine and Procedure-related Fever

문수연,임경리,손준성,Moon, Soo-youn,Lim, Kyoung Ree,Son, Jun Seong The Society of Internal Korean Medicine 2021 大韓韓方內科學會誌 Vol.42 No.6

목적: 약열과 시술관련 발열(시술열)은 원내 발열의 원인이다. 한방은 여러 라에서 시행되나, 이에 의한 약열과 시술열의 빈도에 대한 자료는 없다. 본 연구의 목적은 한방치료에 의한 약열과 시술열의 빈도를 확인하는 것이다. 방법: 2006년부터 8년간 서울의 한 대학 부속 한방병원에서 후향적으로 시행했다. 결과: 한약을 복용한 10800명의 환자 중 95건의 약열이 발생하였다(0.89%). 환자들의 체온은 38.37±0.58 ℃이었고, 발열은 평균 1일간 지속되었다. 호산구증, 독성간염, 피부발진이 각각 15.79%, 8.42%, 5.26%에서 발생하였다. 약열과 관련된 흔한 한약재는 감초, 당귀, 백출이었다. 한방 시술을 받은 8125명의 환자 중 16건의 시술열이 발생하였다(0.20%). 환자들의 체온은 38.26±0.51 ℃이었고, 발열은 평균 1일간 지속되었다. 뜸이 가장 흔한 원인으로, 침이 두 번째였다. 결론: 한방치료에 의한 약열 및 시술열의 빈도는 서양의학보다 높지 않다. Objectives: Drug fever and procedure-related fever are the causes of nosocomial fever. Oriental medicine has been practiced in Asia and is now being practiced as an alternative medicine in western countries. No data are available on the incidence of drug fever and procedure-related fever in oriental medical hospitals (OMHs). The aim of this study was to identify the incidence of drug fever related to oriental herbal medicine and oriental medical procedure-related fever. Methods: This was a retrospective study at one OMH of a university medical institute in Seoul, Korea, conducted from June 2006 to June 2013. Results: Overall, 95 episodes of drug fever occurred among 10880 patients treated with herbal medicine (0.89%). Peak body temperature was 38.37±0.58 ℃, and the fever lasted for 1.0 day (range 1.0-17.0 days). Eosinophilia was found in 15 patients (15.79%) and 8 patients developed toxic hepatitis (8.42%). Five patients had a drug-related skin rash (5.26%). The most common ingredients of the herbal medicines associated with drug fever were licorice, Angelica gigas root, and white Atractylodes rhizome. In total, 16 episodes of procedure-related fever (0.20%) occurred in 8125 patients treated with oriental medical procedures. The peak body temperature was 38.26±0.51 ℃, and the fever lasted for 1.0 day (range 1.0-3.0 days). Among various oriental medical procedures, moxibustion was the most common procedure related to fever, followed by acupuncture. Conclusions: The incidence of drug fever and procedure-related fever in oriental medicine is not high compared with the incidence in western medicine.

대유행 인플루엔자(H1N1 2009) 재감염 3례

김태석,강명호,임경리,오원섭,천성빈,유숙원,이길수,이승준 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.4

Infection with influenza virus results in acquisition of immunity, preventing reinfection with the homologous virus. Although reinfection following primary infection is rare,its incidence depends on immunity of human body, antigenic diversity of influenza virus, and the presence of outbreak in the community. During the pandemic influenza (H1N1 2009), a child and two women were reinfected by H1N1 influenza virus several weeks after the primary infection, and they were successfully treated again by oseltamivir. This case series will provide additional information on diagnosis,treatment, and prevention of the pandemic influenza (H1N1 2009).

직업 및 교육수준에 따른 사망원인별 비례사망비의 연도별 추이: 1993-2004년 우리나라 사망등록자료의 분석

김기혜,이경학,이상민,이승연,이예승,임경리,장지은,조상원,최은혜,정성태,진은정,손미아,Kim, Ki-Hye,Lee, Kyung-Hak,Lee, Sang-Min,Lee, Seung-Yeon,Lee, Ye-Seung,Lim, Kyoung-Ree,Chang, Jee-Eun,Cho, Sang-Won,Choi, Eun-Hye,Chung, Sung-Tae,Jin, E 대한예방의학회 2007 예방의학회지 Vol.40 No.1

Objectives : This study investigated the relationship of occupational class and educational background with proportional mortality ratios in Korea. Methods : Mortality was investigated using the entire registered death data from 1993 to 2004, obtained from the Korean National Statistics Office. Proportional mortality ratios (PMRs) for specific diseases were calculated according to the occupational class and educational background of men aged 20-64. Results : Manual workers were found to have higher PMRs for liver disease and traffic accidents, as did the lower educated group. Especially, this study showed trends of an increasing of the wide gap between lower and higher socioeconomic stati for liver disease, traffic accidents, diabetes mellitus and cerebral vascular disease. The mortality for cerebrovascular disease, diabetes mellitus, heart disease, traffic accident and liver disease showed increasing trends according to the calendar year for the lower than the higher social class. Conclusions : The specific conditions that had higher PMRs in the Korean lower social class were liver disease and traffic accidents. Especially, there was an increasing trend for a widening of the gap between manual and non-manual groups in relation to mortality from liver disease, diabetes mellitus and traffic accidents.

증례 : 신장 ; 급성 신부전이 합병된 전신다한증 1예

김태석 ( Tae Suk Kim ),강명호 ( Myung Ho Kang ),임경리 ( Kyoung Ree Lim ),이상훈 ( Sang Hoon Lee ),이원호 ( Won Ho Lee ),허정원 ( Jeong Won Heo ),오원섭 ( Won Sup Oh ) 대한내과학회 2012 대한내과학회지 Vol.82 No.4

Hyperhidrosis is a disorder characterized by perspiration in excess of the physiologic amount necessary to maintain thermal homeostasis. It is categorized as either a primary condition or a condition occurring secondary to a number of diseases and the use of prescribed drugs and is further classified according to anatomical distribution as being focal, regional, or generalized. Severe generalized hyperhidrosis is extremely rare but significantly inhibits social activities in those affected. A 48-year-old female with oliguria was admitted to our hospital. Both a physical examination and a starch-iodine test showed generalized hyperhidrosis, suggesting that excessive loss of body fluid via sweating had led to prerenal acute renal failure (ARF). To our knowledge, severe cases of generalized hyperhidrosis causing ARF have not previously been reported. The present case is reported with a review of the literature on the etiology and management of generalized hyperhidrosis. (Korean J Med 2012;82:497-502)