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간 농양으로 오인 된 담도 확장 유발 담관내 유두 종양 1예
정상윤 ( Sang Yoon Chung ),김효정 ( Hyo Jung Kim ),김재선 ( Jae Seon Kim ),김백희 ( Baek Hui Kim ),이연호 ( Yun Ho Lee ),유양재 ( Yang Jae Yoo ),정용 ( Yong Jeong ),박영태 ( Young Tae Bak ) 대한췌담도학회 2013 대한췌담도학회지 Vol.18 No.4
담관내 유두 종양은 미세한 섬유혈관 중심을 감싸는 수많은 엽상의 유두상 주름이 발생하는 것을 특징으로, 종양자체나 혹은 종양의 잔해로 인한 폐쇄 혹은 과도하게 분비되는 점액으로 인해 담관이 막혀, 간내 담관이 확장되는 다발성의 종양으로, 췌관내 점액 유두 종양과 개념적으로 대척되어 이들 사이의 연관성을 연구 중이다. 최근 발열을 주소로 내원한 환자에서 복부초음파에서 간농양이 의심되어, 간농양의 원인을 찾고자 시행한 추가적 영상 검사에서 담관내 유두 종양이 의심되어 수술을 시행한 결과, 고도의 이형성을 동반한 점액 분비하는 간내 담관내 유두 종양으로 진단되었던 1예를 경험하였기에 문헌고찰과 함께 보고한다. Intraductal papillary neoplasm (IPN) of bile duct presents the tumor of a papillary surface comprising innumerable frondlike infolding of proliferation of columnar epithelial cells surroudings slender fibrovascular stalks. Neoplasm in the bile ducts which are dilated due to obstruction by a tumor itself, sloughed tumor debris, and excessive mucin. There are some researches of IPN of bile duct because they have same embryonic origin between IPN of bile duct and intraductal papillary mucinous neoplasm (IPMN) of pancreas. Patient with fever was suspected liver abscess in abdominal ultrasonography. Intraductal papillary neoplasm (IPN) of bile duct was suspected in additional imaging study. We experienced intraductal papillary neoplasm with high grade intraepithelial neoplasia after surgical resection. Here we report a case with the review of the reported literature.
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크론병 환자에서 인플릭시맵과 메살라진 치료 후 발생한 지연발생 급성 세뇨관간질 신염 증례
유양재 ( Yang Jae Yoo ),정상윤 ( Sang Yoon Chung ),구대회 ( Dae Hoe Gu ),고강지 ( Gang Jee Ko ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ),박영태 ( Young Tae Bak ),원남희 ( Nam Hee Won ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Infliximab is a chimeric anti-tumor necrosis factor-alpha monoclonal antibody. Infusion related reactions and infection are well known side effects of infliximab; however, renal complications have not been well recognized. We report on a patient with late onset-acute tubulointerstitial nephritis (ATIN) after treatment with infliximab and mesalazine for Crohn’s disease. A 25-year-old woman was admitted with a purpuric rash on both lower extremities and arthralgia. She had been diagnosed with Crohn’s disease 5.6 years previously and had been treated with mesalazine and infliximab. Serum creatinine level, last measured one year ago, was elevated from 0.6 mg/dL to 1.9 mg/dL. Results of urinalysis, ultrasound, and serologic examinations were normal. With a tentative diagnosis of Henoch-Schonlein purpura, oral prednisolone was given, and serum creatinine decreased to 1.46 mg/dL, but was elevated to 2.6 mg/dL again at two months after discontinuation of prednisolone. Renal biopsy indicated that ATIN was probably ind ced by drug, considering significant infiltration of eosinophils. Concomitant use of infliximab with mesalazine was supposed to trigger ATIN. Oral prednisolone was administered, and serum creatinine level showed partial recovery. Thus, ATIN should be suspected as a cause of renal impairment in Crohn’s disease even after a long period of maintenance treatment with infliximab and mesalazine.
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JEONG, Sang Yoon,CHUNG, Dong Il,CHOI, Dong Wik 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4
고양이에 實驗的으로 肺吸蟲을 感染시키려고 할 때 가장 效率的인 方法이 무엇인가를 究明하기 위해 고양이 15마리를 5마리씩 3群으로 나누었다. 第1群 고양이에는 肺吸蟲 被囊幼蟲을 10個씩 經口的으로 投與하였고, 第2群 고양이에는 肺吸蟲 被囊幼蟲을 10個씩 腹腔內 注射하였고, 第3群 고양이에는 肺吸蟲 被囊幼蟲을 10個씩 腹腔內 注射하여 感染시켰다. 120日이 지난 後 고양이를 모두 屠殺하여 肺에서 成蟲을 回收하였다. 成蟲의 回收率은 第3群 96.0%로서 가장 높았고, 그 다음은 第2群 92.0%였으며, 第1群은 88.0%로 가장 낮은 回收率을 나타내었다. 右側肺에서 左側肺보다 많은 數의 成蟲이 回收되었고 左右側肺 모두 下葉에서 가장 많은 成蟲이 回收되었다. 以上의 成績으로 미루어보다 고양이에 肺吸蟲을 感染시키는 方法中에서 被囊幼蟲의 腹腔內注射가 가장 效率的임을 알았다. Fifteen outbred cats were divided in 3 groups, and infected with Paragonimus westermani metacercariae. Each cat of group 1 was given orally 10 metacercariae of P. westermani. Each of group 2 was injected intraperitoneally with 10 excysted metacercariae, while each of group 3, injected intraperitoneally with 10 intact metacercariae. All of the cats were killed 120 days after infection and the adult flukes were recovered. The recovery rate of group 3 was the highest, 96.0%, followed by that of group 2, 92.0%. The rate of group 1 was the lowest, 88.0%. More flukes were recovered from the right lungs than the left. The lower lobes of the lung, both right and left, harbored more flukes than the other lobes. In the light of these results, the intraperitoneal injection of encysted metacercariae of P. westermani is regarded as the most available method in infect cats experimentally.
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박윤선,한상훈,진범식,최석훈,정상윤,최준용,박윤수,조정호,장경희,송영구,김준명 대한감염학회 2003 감염과 화학요법 Vol.35 No.5
정맥 내 약물 남용에 의한 HIV 감염은 지금까지 국내 사례가 보고된 문헌이 없었으나, 저자들은 미국에서 다년간 거주하며 정맥내 약물 남용을 하였던 43세 남자가 국내에서 HIV 감염을 진단받아 문헌고찰과 함께 보고하는 바이다. Intravenous (Ⅳ) drug abuse is one of important transmission modes of human immunodeficiency virus (HIV) infection. Ⅳ drug abuse in HIV epidemics is frequent in western countries. In Korea, however, no case has been definitely identified although possibility of such infection route does exist considering rising number of Ⅳ drug use (IDU). Recently, we have experienced a case of HIV infection by IDU. We herein offer the case with review of literature.
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정지영,최석훈,박윤선,진범식,한상훈,허규연,심완섭,이재혁,정상윤,최한석,최준용,박윤수,조정호,장경희,송영구,이광훈,김준명 대한감염학회 2003 감염과 화학요법 Vol.35 No.5
저자들은 면역 억제 치료를 받은 베체트 증후군 환자에서 발생된 주폐포자층 폐렴을 기관지 폐포 세축술 및 경기관지 폐생검을 통해 진단하고 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Pneumocystis carinii pneumonia (PCP) is one of the most common causes of infection in patients with HIV infection. With the development of effective prophylactic agent, the incidence of PCP in patients with HIV infection has been declining. On the other hand, however, the incidence of PCP has been increasing in immunocompromised hosts without HIV infection, such as rheumatoid arthritis, bone marrow transplantaion and Behcet syndrome. The increased occurrence of PCP in non-HIV-infected subjects has been attributed to several factors, such as use of stronger immunosuppressive regimens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. The occurrence of PCP in patients who receive immunosuppressive drugs for autoimmune disease has not been well known in Korea. We report a patient with Behcet syndrome who suffered from PCP after immunosuppressive drugs.
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