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증 례 : 직장암 치료 중 진단된 만성호중구성백혈병 1예
김석형 ( Seok Hyung Kim ),박해열 ( Hae Yeul Park ),황창혁 ( Chang Hyeok Hwang ),정영학 ( Young Hak Jung ),이민주 ( Minjoo Lee ),최성은 ( Sung Eun Choi ),김유리 ( Yu Ri Kim ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1
증례는 감염 및 악성종양과 동반되어 백혈병양 반응과의 감별이 어려웠고, 또한 악성종양의 전이와 유사하게 종괴를 형성하여 더욱 감별이 어려웠던 CNL 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm characterized by sustained neutrophilia, splenomegaly, and hypercellular bone marrow without Philadelphia chromosome. Diagnosis of CNL requires exclusion of identifiable causes of reactive neutrophilia, such as infection and tumors. Our patient presented with general weakness and weight loss. Computed tomography (CT) showed a mass in the distal rectum, which was confirmed to be an adenocarcinoma by colonoscopic biopsy. Positron emission tomography-CT showed multiple liver, bone, and lymph node metastases. Liver and lymph node biopsies revealed neutrophilic infiltration with no evidence of adenocarcinoma. The pathological findings of the bone marrow were compatible with CNL. Cytogenetic analysis revealed a normal karyotype, and molecular analysis was negative for BCR/ABL. Here, we present a 73 year-old man diagnosed with concurrent CNL and rectal cancer. (Korean J Med 2016;90:59-62)
성인의 눈꺼풀결막에 발생한 랑거한스세포 조직구증식증 1례
김연희,최미영,김석형,Youn Hui Kim,Mi Young Choi,Seok Hyung Kim 대한안과학회 2007 대한안과학회지 Vol.48 No.3
Purpose: To report a case of isolated Langerhans cell histiocytosis (LCH) in the palpebral conjunctiva of an adult patient. Methods: A 39-year-old male presented with a mass of one month`s duration on the palpebral conjunctiva of his left upper lid. The lesion had gradually progressed. The mass was non-tender, relatively well circumscribed, yellowish white, flat, firm, and 5 mm×8 mm in size. Otherwise, the ophthalmic examination was completely normal, including the anterior and posterior segments. Based on the clinical picture, an infiltrative/neoplastic lesion was suspected. Incision biopsy was performed to obtain a diagnosis for proper management. Results: The histopathologic examination of the lesion showed an intensive proliferation of monotonous and histiocytoid cells beneath the epidermis. Immunohistochemical study revealed that the tumor cells were positively stained in the cytoplasm with anti CD1A antibody and anti S-100 antibody. The patient was then referred to the Oncology Department for evaluation. A detailed systemic examination, and the laboratory and radiologic investigations ruled out systemic involvement. The diagnosis of isolated LCH was finally made. Three months later, the lesion underwent remission without any treatment. Conclusions: This rare disorder may also present as a solitary lesion on the palpebral conjunctiva in adults, and so it should be kept in mind during the differential diagnosis of a conjunctival mass in an adult.
증상을 동반한 거대 가성낭종을 형성한 이소성 췌장 1예
박성순 ( Sung Soon Park ),신윤미 ( Yoon Mi Shin ),임성우 ( Seong Woo Lim ),김석형 ( Seok Hyung Kim ),전원중 ( Won Joong Jeon ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ) 대한내과학회 2006 대한내과학회지 Vol.70 No.6
이소성 췌장은 모든 위장관에 발생 가능한 선천성 기형으로 대부분이 무증상으로 지내며, 우연히 발견되는 경우가 대다수이다. 저자들은 식후 상복부 복통을 주소로 내원한 22세 여자 환자에서 위의 이소성 췌장에서 췌장염 합병된 가성낭종을 진단하고 수술 후 증상이 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Heterotopic pancreas is the presence of pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. Most patients with heterotopic pancreas are asymptomatic. Any pathologic change in the normal pancreas also can occur
길호 ( Ho Kil ),최은영 ( Eun Young Choi ),정지인 ( Jee In Jeong ),박찬선 ( Chan Sun Park ),박선미 ( Seon Mee Park ),김석형 ( Seok Hyung Kim ),박길선 ( Kil Sun Park ),장이찬 ( Lee Chan Jang ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.4
Caroli`s disease is a rare congenital hepatobiliary disease characterized by multifocal segmental dilatation of intrahepatic bile ducts affecting all or parts of the liver. Two forms of Caroli`s disease are described, the pure form and that associated with periportal fibrosis. The disease may diffusely affect the liver or be localized to one lobe or segment. Less than 20% of all reported cases of Caroli`s disease are monolobar type. We report a case of simple type Caroli`s disease confined to right lobe of the liver in a 22 year old man. He was admitted due to right upper abdominal pain and diagnosed by magnetic resonance cholangiopancreatography. He was treated with right hepatic lobectomy and recovered completely. (Korean J Gastroenterol 2007;50:271-276)
김석형,이지훈,박해열,송영구,황창혁,이민주 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.2
A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.
전기 기계적 해리로부터 회복된 쯔쯔가무시병에서의 급성 전격성 심근염
정영학,이민주,이경화,이지훈,김석형,이병권 이화여자대학교 의과학연구소 2016 EMJ (Ewha medical journal) Vol.39 No.1
Scrub typhus, caused by Orientia tsutsugamushi , is an acute febrile illness. Characteristics of tsutsugamushi disease are fever, rash and eschar. However, severe complications might rarely occur, such as acute fulminant myocarditis caused by scrub typhus. Thus, there are few reports of recovery from seriously complicated cases. We report on an adult male with scrub typhus complicated with acute fulminant myocarditis with no previous comorbid illness who recovered successfully with proper treatment including antibiotics, ventilator support, percutaneous cardiopulmonary support, and continuous renal replacement therapy.