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증례 : 다발성근염과 만성 B형 간염에 병발한 혼합 간세포-담관상피암종 1예
정혜진 ( Hey Jin Jeong ),김성훈 ( Seong Hun Kim ),김세인 ( Se In Kim ),김인희 ( In Hee Kim ),문우성 ( Woo Sung Moon ),이승옥 ( Seung Ok Lee ),김대곤 ( Dae Ghon Kim ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1
다발성근염은 림프구가 골격근에 침윤하여 비화농성 염증반응을 일으켜 골격근의 손상을 초래하는 원인불명의 자가면역 질환으로, 근위부근육의 대칭적인 근무력이 서서히 진행되는 임상적인 특징을 갖는다. 아직까지 뚜렷한 발병 원인이 규명되지 않은 질환으로 최근 자가면역설과 바이러스 감염설이 가장 유력한 가설로 생각되어지고 있다. 그러나 아직까지 만성간질환과 동반된 경우는 발병률이 매우 낮으며 국내에서 원발성 간암이 함께 병발한 사례는 보고된 바가 없었다. 저자는 최근 만성 B형 간염과 다발성근염으로 치료중인 환자에서 혼합 간세포-담도상피암종이 동시에 병발한 환자 1예를 경험하였기에 보고하는 바이다. Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of striated skeletal muscle, an elevation of muscle enzymes, and abnormality of electromyographical changes, but its pathogenesis is not clear. In recent years, there has been an increased awareness of the association of malignant tumors with this disorder. Still, the relationship between polymyositis and a malignant tumor remain obscure. Some researchers have suggested that the cause of polymyositis may be due to an autoimmune response induced by aviral infection. However, a chronic hepatitis B virus infection associated with polymyositis is very rare. We present in this report a rare case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection. (Korean J Med 72:79-84, 2007)
症例(증례) : 관상동맥 스텐트로 치료한 베체트병에 동반된 급성 심근경색증 1예
정혜진 ( Hey Jin Jeong ),김세인 ( Se In Kim ),김소리 ( So Ri Kim ),이규선 ( Kyu Sun Lee ),고은영 ( Eun Young Ko ),김성훈 ( Seong Hun Kim ),김성식 ( Sung Sik Kim ),임호영 ( Ho Young Yhim ),민경훈 ( Kyung Hoon Min ),이상일 ( Sang Il 전북대학교 의과학연구소 2004 全北醫大論文集 Vol.28 No.1
베체트병은 반복되는 아프타성 구강궤양과 성기궤양 및 포도막염과 같은 눈의 반복적인 염증성 병변을 특징으로 하는 전신 질환이다. 베체트병에 동반된 심근경색은 매우 드물어서 소수의 증례만이 보고 되고 있다. 저자들은 베체트병 환자에서 발생한 심근 경색증 1예를 경험하였기에 보고하는 바이다. Behcet`s disease is a systemic disease of unknown cause, belonging to vasculitis pathologically. It rarely involves the coronary arteries. Coronary arteritis may lead to myocardial infarction and death, and the management of coronary lesions due to Behcet`s disease has been described only in a small number of patients. We experienced a -36-year-old man with Behcet`s disease who presented with acute coronary syndrome, and underwent balloon angioplasty and coronary stent implantation. The reduction of the coronary stenosis by balloon angioplasty induced immediate relief of chest pain. He has been still in reltively good health without chest pain during the 24 months of follow-up.
症例(증례) : 특발성 혈소판 감소성 자반증과 동반된 Takayasu 동맥염 1예
민경훈 ( Kyung Hoon Min ),임호영 ( Ho Young Yhim ),정혜진 ( Hey Jin Jeong ),이민희 ( Min Hee Lee ),김성국 ( Sung Kuk Kim ),이기훈 ( Ki Hoon Lee ),정수진 ( Su Jin Jung ),이가영 ( Ka Yeong Yi ),이선화 ( Sun Hwa Lee ),정치량 ( Chi Ry 전북대학교 의과학연구소 2004 全北醫大論文集 Vol.28 No.1
Takayasu 동맥염과 특발성 혈소판 감소성 자반증은 두 질환 모두 발병원인 및 병태생리에 있어 자가면역성이 중요한 역할을 한다고 할 수 있다. 본 저자들은 Takayasu 동맥염과 특발성 혈소판 감소성 자반증이 동반된 57세 남자 증례를 보고하는 바이다. 본 증례 남지는 1년전 특발성 혈소판 감소성 자반증을 전단받았다. 복통 및 혈변배설을 주소로 내원한 환자는 좌측 위팔동맥(Left brachial artery)의 맥박이 감소된 소견을 보였으며, 청진 소견상 복부 잡음(abdominal bruit) 소견 을 보였고, 흉복부 컴퓨터 단층 촬영 및 3차원 대동맥 혈관 재구성 컴퓨터 단층 촬영 소견 상 좌측 쇄골밑 동맥(left subclavian artery), 흉복부 대동맥(thoracoabdominal aorta), 복강 동맥(celiac trunck), 상 창자간막 동맥(superior mesenteric artery)의 다발성 혈관염 소견을 보여 Takayasu 동맥염에 합당한 소견을 보였다. 고용량 스테로이드 치료 후, 환자의 임상적 증상과 혈침속도가 호전되었다. Takayasu`s arteritis (TA), a chronic inflammatory arteriopathy of unknown etiology, lead to both stenotic and ectatic changes, particularly occlusion. The common sites of involvement are the aorta and its main branches, and pulmonary artery. A specific etiology for TA has not been found. Autoimmunity has been found to play an important role in TA, and association with various autoimmune disorders has been reported in selected cases. There is no case report that TA coexists with idiopathic thrombocytopenic purpura (ITP). We report a case of TA associated with ITP in a 57-year-old man. He suffered from ITP 1 years earlier. On admission, the patient presented with periumbilical abdominal pain. TA diagnosed on the basis of decreased pulsation of the left brachial artery, bruit over the abdominal aorta and multifocal vasculitis in the left subclavian artery, thoracoabdomianl aorta, celiac trunk and superior mesenteric artery on thoracoabdominal computerized tomography and 3-D aortic arch reconstruction computerized tomography. Following the high dose steroid therapy, his clinical symptoms improved and erythrocyte sedimentation rate decreased.
김상균 ( Sang Kyoon Kim ),유창우 ( Chang Woo You ),권혁진 ( Hyeok Jin Kwon ),정혜진 ( Hey Jin Jeong ),김성훈 ( Seong Hun Kim ),김인희 ( In Hee Kim ),이승옥 ( Seung Ok Lee ),이민로 ( Min Ro Lee ),장규윤 ( Kyu Yun Jang ),김상욱 ( Sa 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.2
Colonic hypoganglionosis is one variant of the colonic ganglion cell disorders. It is characterized histologically by a small number of ganglion cells in the intestinal myenteric plexuses and it`s characterized functionally by severely impaired gut motility. Most cases reported in the literature have occurred relatively late in childhood, and they usually involve mild constipation. In our case, the patient had a megacolon with severe constipation. He had had repeated admissions due to chronic constipation and abdominal distention. Conservative management failed to relieve those symptoms, and so subtotal colectomy was undergone. The patient recovered normal bowel habits in five months after his operation. (Kor J Neuro-gastroenterol Motil 2006;12:161-165)
증례(症例) : 자발성 점막하 식도 박리 증례의 경과에 따른 영상소견과 문헌고찰
나영균 ( Young Gyun Na ),유창우 ( Chang Woo You ),정혜진 ( Hey Jin Jeong ),김성훈 ( Seong Hun Kim ),김인희 ( In Hee Kim ),이승옥 ( Seung Ok Lee ),김상욱 ( Sang Wook Kim ),김대곤 ( Dae Gohn Kim ),이수택 ( Soo Teik Lee ) 전북대학교 의과학연구소 2007 全北醫大論文集 Vol.31 No.1
Spontaneous intramural esophageal dissection is a rare disorder characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, without perforation. Most spontaneous intramural esophageal dissection responds to conservative management, and usually it dose not lapse into a long protracted course of dealing with sequelae. We experienced a patient who complaints dysphagia and diagnosed as spontaneous intramural esophageal dissection. We managed him with conservative treatment and follow up endoscopy and other diagnostic tests for 3 weeks.