• 대한치과의사협회지
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• 제50권12호
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• pp.727-731
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• 2012

An ulcer is defined as loss of epithelium. Although many oral ulcers have similar clinical appearances, their etiologies encompass many disorders, including trauma, infection, immunologic disease, and malignant oral cancer. Oral squamous cell carcinoma(SCC) occupying about 90% of oral cancer, usually manifests as unhealed ulcer over 2 weeks. Oral SCC can metastasize to the cervical neck lymph node, and therefore the surgical therapeutic modality for oral SCC could encompass the neck node dissection as well as wide excision for primary lesions, which should leave the post-operative complication of functional damage like dysphagia and facial deformity. Therefore, it is important to discriminate oral SCC from other ulcerative conditions to make a prompt management. The knowledge for the pathogenesis of the ulcerative lesions could help the clinicians to understand the differences of clinical features and to practice an appropriate therapeutics.

• Journal of Oral Medicine and Pain
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• 제26권2호
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• pp.121-126
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• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

• Tuberculosis and Respiratory Diseases
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• 제52권6호
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• pp.651-656
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• 2002

Hyperimmunoglobulin E 증후군, 혹은 Job's 증후군은 비정상적으로 높은 Immunoglobulin E 수치와 더불어 면역기능의 이상으로 인해 반복적인 피부감염과 호흡기계 감염을 특정으로 하는 질환이다. Job's 증후군에서 나타나는 호흡기계 발현 양상은 폐렴, 기류, 기흉, 폐농양, 농흉 등 여러 가지 형태로 나타나며 각각에 대한 치료도 다양하다. 치료원칙은 감염에 관한 예방적 약물치료 및 감염균에 관한 항생제투여와 수술의 적응증이 될 때, 폐실질의 손실을 최소화하는 폐절제술을 시행하는 것이 중요하다.

• Clinical and Experimental Pediatrics
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• 제58권12호
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• pp.478-483
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• 2015

Purpose: Information on the clinical features of lung abscess, which is uncommon in children, at hospitalization is helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. Methods: The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Results: Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. Conclusion: The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.93-96
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• 2005

Background: Myasthenia gravis (MG) and systemic lupus erythematosus (SLE) are well recognized to coexist and have some similarities in immunologic, clinical and serologic findings. Despite several reports of the association with autoantibodies and thymectomy in these disorders, the pathomechanism of coexistence remains to be elucidated. Objective: We aimed to investigate the relationship of MG and SLE through overall features of patients with both disorders;: clinical, laboratory, and electrophysiological findings. Materials and Methods: We reviewed the medical records of 6 consecutive patients with MG and SLE (2 men, 4 women, ages 17-51, mean 30.5 years, Seoul National University Hospital, from 1998 to 2005). Results: Three patients who developed SLE first, had ocular type of MG and 2 were children showing much severe and recurrent SLE features and only 1 patient had thymic hyperplasia. The other 3 developed MG first and they were generalized type and none underwent thymectomy. In addition, the development of MG or SLE was not coincident with remission or improvement of another disorder. Conclusion: The coexistence of SLE and MG may support the hypothesis of two different antibody populations modulated by thymus in the opposite extremesThis report suggests that the systemic and extensive autoimmune response in preceding MG or SLE may effect the development of the other disorder followed, while. the coexistence of two disorders cannot be explained by the hypothesis of two different antibody populations modulated by thymus in the opposite extremes The role of thymectomy and the theorectical subsequent effect on the development of SLE have been debated with controversy. However, SLE occurred without thymectomy in MG and these disorders did not develop in the quiescent period of another disorder. Therefore, the other pathomechanism for the coexistence of MG and SLE should be elucidated.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.122-131
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• 2020

Hypersensitivity Pneumonitis (HP) one of the most common interstitial lung diseases (ILDs) is characterized by exposure to an inhaled inciting antigen that leads to a host immunologic reaction determining interstitial inflammation and architectural distortion. The underlying pathogenetic mechanisms are unclear. The absence of international shared diagnostic guidelines and the lack of a "gold-standard" test for HP combined with the presence of several clinical and radiologic overlapping features makes it particularly challenging to differentiate HP from other ILDs, also in expert contests. Radiology is playing a more crucial role in this process; recently the headcheese sign was recognized as a more specific for chronic-HP than the extensive mosaic attenuation. Several classification proposals and diagnostic models have been advanced by different groups, with no prospective validation. Therapeutic options for HP have been limited to antigen avoidance and immunosuppressant drugs over the last decades. Several questions about this condition remain unanswered and there is a need for more studies.

• 한방안이비인후피부과학회지
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• 제17권3호
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• pp.138-145
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• 2004

The clinical features and therapeutic results of alopecia areata are variable and unpredictable. For example, genetic, psychic, immunologic factors are regarded as the reason of alopecia areata. For the relationship between alopecia and whiplash injury, Dr. Guun explained that whiplash injury by the traffic accident produces cervical muscle spasm, and it makes autonomic nerve change. The tropical changes accompanied with ischemic change of scalp vessels made by this mechanism cause alopecia areata. And Yesudian reported the case of scalp alopecia as the result of ischemic change following traffic accident. We have experienced a 25-year-old woman with Alopecia areata following whiplash injury by traffic accident, and who had no risk factor of it. The patient was treated by acupuncture and physical treatment. Her hair loss, cervical angle and pain were improved through acupuncture treatment. This case of alopecia areata following whiplash injury is uncommon, so we report the mechanism of it, but should collect more cases and observations.

• Journal of Yeungnam Medical Science
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• 제13권1호
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• pp.141-145
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• 1996

Habitual pregnancy loss has been defined as three or more consecutive spontaneous abortions. The rate of recurrent pregnancy loss is 2% to 5% of reproducible women. Half of this failure can be explained by genetic, hormonal, infectious, and anatomic factors. And eighty percent of the unexplained failures are proposed to have an immunologic cause. The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.

• Tuberculosis and Respiratory Diseases
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• 제43권1호
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• pp.22-29
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• 1996

연구배경: 속립성 결핵환자에서 말초혈액의 변화는 골수생검상 결핵성 병변을 보인 군에서 더 많은 것으로 알려져 있고, 폐결핵보다 속립성 결핵에서 세포성 면역의 변화가 심한 것으로 연구되어지고 있다. 방법: 대상은 1990년에서 1994년 사이에 원주의과 대학부속 원주기독병원에 내원하여 속립성 결핵으로 진단받고 골수생검을 시행받은 환자 40예 였다. 이들을 골수생검상 결핵성 병변을 보인 양성군과 보이지 않은 음성군으로 나누어 임상상, 말초 혈액의 혈청 ADA, 수용성 인터루킨 2 수용체, 임파구 아형 분류를 시행하여 비교하였다. 결과: 1) 대상 환자의 평균연령은 39세로, 남녀는 23:17예 이었다. 2) 동반된 폐외 결핵으로는 결핵성 뇌막염이 9예, 결핵성 관절염이 6예, 결핵성 흉막염이 2예 있었다. 3) 골수검사상 60%(24/40)가 결핵성 병변을 보였다. 4) 말초혈액검사상 빈혈은 60%(24/40)가 있었으며 골수생검 양성군에서 11예 음성군에서 13예였고, 백혈구감소증은 12%(5/40)로 양성군에서 4예 음성군에서 1예였고, 혈소판 감소증은 10%(4/40)로 양성군이 3예 였다. 5) 혈청 ADA는 평균 83 U/L로 양성군에서 90 U/L, 음성군에서 70.6 U/L 이었다(p=0.23). 6) 혈청 가용성 interleukin 2 수용체 활성도는 평균 4,643 pmol/L 였으며 양성군에서 $6,840{\pm}7,446\;pmol/L$(n=10), 음성군 $1897{\pm}1663\;pmol/L$(n=8)으로 양성군에서 더 높았다(p=0.06). 7) 혈청내 T 임파구 아형분류에서 총 T 임파구는 평균 64%으로 양성군에서 $62{\pm}19%$(n=18), 음성군에서 $73{\pm}10%$ 였고(n=7)(p=0.2), $T_4/T_8$ ratio는 평균 $1.16{\pm}0.5$으로 양성군에서 $1.14{\pm}0.5$, 음성군에서 $1.18{\pm}0.5$였다(p=0.8). 8) 일부 환자(9예)에서 BAL의 T 임파구 아형분류을 시행하였으며 $T_4/T_8$ ratio는 $1.97{\pm}1.2$으로, 말초혈액소견과 비교하여 더 증가되어 있었다. 결론: 이상의 결과로 속립성 결핵의 골수생검 양성률은 60% 였으며, 골수생검상 결핵성 병변을 보인 군에서 말초혈액내 변화와 세포성 면역의 변화가 더 심한 경향을 보였다.

• 대한두경부종양학회지
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• 제21권2호
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• pp.139-145
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• 2005

Background and Objectives: Because of squamous cell carcinoma of the head and neck undergoes a generally poor hospital course, the prognostic significance of the squamous cell carcinomas in head and neck have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histopathologic characteristics. Materials and Method: To assess the significance of EGFR, c-erbB-2, p21 and p53 protein in head and neck tumors and their correlation with prognostic factors, samples from 74 patients with squamous cell carcinomas of larynx, pharynx, and oral cavity were studied immunohistochemically. Results: EGFR, c-erbB-2, p21, and p53 protein were expressed 94.6%, 24.3%, 85.1%, and 55.4% in 74 cases of head and neck squamous cell carcinoma, respectively. The positive expression of EGFR was associated significantly with clinical stage and the negative expressions of p21 was associated significantly with histopathologic differentiation. There were no significant relationships between the reactivity of EGFR, c-erbB-2, p21, and p53 protein. Conclusion: The expression of EGFR, c-erbB-2, p21 and p53 protein could be related to oncogenesis, and the expression of p21 and EGFR protein can be used as a prognosticator in head and neck squamous cell carcinoma under certain limitations, but c-erbB-2 and p53 protein expression alone is not enough for evaluating prognosis of the carcinoma.