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황선혁 ( Sun Hyuk Hwang ),박선영 ( Sun Young Park ),김기찬 ( Ki Chan Kim ),박주한 ( Joo Han Park ),김시연 ( Si Yeon Kim ),송가원 ( Ga Won Song ),정숙희 ( Jun Goo Kang ),임선교 ( Sook Hee Chung ),이기명 ( Sun Gyo Lim ),이광재 ( Kwa 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
Cavernous hemangioma of the colon is a rare disease. It mostly affects young patients with recurrent painless rectal bleeding. Complete surgical excision with a sphincter saving procedure is the best therapeutic option. A 25-year-old man referred to our hospital because of a chronic anemia and recurrent painless rectal bleeding. In esophagogastroduodenoscopy, there was gastric erosion. In colonoscopy, there were multiple submucosal vessel dilatations on whole colon. Prominent submucosal vessel was noted on cecum and rectum suspicious for cavernous hemangioma. Biopsy was not performed because of the risk of bleeding. Abdomen computer tomography (CT) showed bowel wall thickening in rectum and colon. Multiple small aggregated cystic lesions in omentum and mesentery were seen. Multiple calcifications in the rectum were noted, a finding compatible with phleboliths. We recommended surgery but patient refused and now he is followed up in our outpainet clinic without complication. Cavernous hemangioma is a rare disease but clinicians should be cautious about the occurrence of this malformation in young patients with recurrent rectal bleeding. Suspicion and knowledge of this disease would reduce the misdiagnosis and mismanagement.
Anaphylaxis to Polyethylene Glycol (Colyte®) in a Patient with Diverticulitis
이소희,황선혁,박진수,박해심,신유섭 대한의학회 2016 Journal of Korean medical science Vol.31 No.10
Polyethylene glycols (PEGs) are believed to be chemically inert agents, but larger PEG polymers could have immunogenicity. A 39-year-old man was referred to emergency room for loss of consciousness and dyspnea after taking of PEG-3350 (Colyte®). In laboratory findings, the initial serum tryptase level was increased to 91.9 mg/L (normal range: 0.00-11.40 mg/L) without any other laboratory abnormalities. The intradermal test with 10 mg/mL Colyte® showed a 5×5 mm wheal, but basophil activation and histamine releasability tests were negative. PEG-3350 is widely used as an osmotic laxative due to its lack of absorption from the gastrointestinal tract. However, the loss of mucosal integrity at gastrointestinal membrane such as diverticulitis may be a predisposing factor for anaphylaxis to Colyte®. We report a case of anaphylaxis induced by the ingestion of PEG-3350 in a patient with diverticulitis which might be a risk factor of anaphylaxis.
T-cell lymphoma presenting as drug rash with eosinophilia and systemic symptoms syndrome
김미애,유혜수,황선혁,신유섭,남동호,박해심 대한 소아알레르기 호흡기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.3
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is diagnosed by three criteria including cutaneous drug eruption, hematologic abnormalities, and systemic involvements. The hematologic abnormalities include presence of atypical lymphocytes or eosinophilia. The systemic involvements include lymphadenopathy, hepatitis, interstitial nephritis, interstitial pneumonia, or carditis. We experienced a 41-year-old female patient who presented DRESS syndrome at initial visit, but finally manifested with T-cell lymphoma. The patient complained of erythematous pruritic plaques with itching on her abdomen and thigh. There was no initiating factor and she was diagnosed with urticarial dermatitis. After treatment with antihistamine and systemic steroid, she recovered from skin lesion. However, 1 month later, she came to emergency department with aggravated skin lesion after taking nonsteroidal anti-inflammatory drug for 3 days. On admission, she showed a fever, skin rash, atypical lymphocytes in peripheral blood smear, and hepatitis. She was treated with systemic steroid under the impression of DRESS syndrome. Her symptoms began to improve, however, laboratory parameters were aggravated again. We performed bone-marrow biopsy because of her unusual progress. Finally she diagnosed with peripheral T-cell lymphoma and treated with allo-peripheral blood stem cell transplantation. In conclusion, we report a case of T-cell lymphoma which presented as DRESS syndrome. If patients with DRESS syndrome present lymphadenopathy and atypical lymphocytes, and do not respond to anti-inflammatory treatment, we should consider underlying lymphoproliferative disease.
증례 : 혈액종양; Sclerosing Angiomatoid Nodular Transformation of Spleen 1예: 스포크 휠(Spoke Wheel) 모양의 조영증강
박주한 ( Joo Han Park ),황선혁 ( Sun Hyuk Hwang ),김기찬 ( Ki Chan Kim ),김시연 ( Si Yeon Kim ),송가원 ( Ga Won Song ),한재호 ( Jae Ho Han ),박준성 ( Joon Seong Park ) 대한내과학회 2014 대한내과학회지 Vol.86 No.3
Sclerosing angiomatoid nodular transformation (SANT) is a rare, benign vascular neoplasm. Most patients have no clinical symptoms, and the tumors are usually discovered incidentally on abdominal computed tomography or ultrasonography. Some studies have reported the clinical features and imaging findings of SANT, but the diagnosis is based on histopathologic examination of a tissue specimen obtained at splenectomy. We report herein an incidentally discovered case of SANT and review the related literature.
혈청양성 류마티스관절염 환자에서 급성 신부전을 동반한 다발성 골수종
이승경 ( Seung Kyung Lee ),황선혁 ( Sun Hyuk Hwang ),박주한 ( Joo Han Park ),송가원 ( Ga Won Song ),박선영 ( Sun Young Park ),김세란 ( Sei Rhan Kim ),정주양 ( Ju Yang Jung ),배창범 ( Chang Bum Bae ),김현아 ( Hyoun Ah Kim ),정성현 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.5
It is known that rheumatoid arthritis (RA) patients show increased incidence of multiple myeloma (MM), despite its rarity. Only one case of MM with seronegative RA was reported in Korea, thus far. We report a case of MM with seropositive RA. The patient was a 66 year old female who had been diagnosed with seropositive RA 4 years ago. Over the last 1 month, the patient experienced general weakness and weight loss of 10 kg. It was found that her serum creatinine had increased and her urine analysis showed proteinuria. To evaluate renal failure and proteinuria, renal biopsy, bone marrow biopsy and electrophoresis were carried out. A diagnosis of myeloma cast nephropathy was made. We report this rare case of MM represented as acute renal failure during the treatment for RA, and include a review of the literature.