http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례 : 혈액종양 ; 슬관절 전이로 인한 통증이 초기 증상으로 발현된 대장암 1예
조율희 ( Yul Hee Cho ),장민옥 ( Min Ok Jang ),권희선 ( Hee Seon Kwon ),고윤호 ( Yoon Ho Ko ),강진형 ( Jin Hyoung Kang ),홍영선 ( Young Seon Hong ),이명아 ( Myung Ah Lee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.3
저자들은 슬관절의 전이로 인한 증상이 내원 당시의 첫 증상이 되어 진단된 직장암 1예를 경험하였기에 이를 문헌고찰과 더불어 보고하는 바이다. Knee pain is rarely an initial symptom of colon cancer, because most bone metastases develop in the late stage of cancer. Therefore, patients with colorectal cancer usually present with gastrointestinal symptoms. Recently, we experienced a 46-year-old female with rectal cancer that presented as knee pain due to tibial metastasis without other organ metastasis. She was evaluated for knee pain and diagnosed with a rectal cancer after biopsies of the tibial and rectal masses. We report the first such case in Korea with a review of the literature. (Korean J Med 2011;80:352-355)
증례 : 십이지장 우회술을 받은 신장이식환자에서 반복적 급성 거부반응으로 인한 이식 신소실 1예
김하늘 ( Ha Neul Kim ),조율희 ( Yul Hee Cho ),김영신 ( Young Shin Kim ),전현지 ( Hyun Ji Chun ),최수진 ( Su Jin Choi ),김은오 ( Eun Oh Kim ),양철우 ( Chul Woo Yang ) 대한내과학회 2012 대한내과학회지 Vol.83 No.3
Tacrlolumus는 calcineurin inhibitor의 한 종류로서 신이식 후 연역 억제위해 널리 사용되고 있다. Tacrolimu의 흡수는 전 장에서 일어나지만, 십이지장이 흡수와 대사에서 가장 많은 부분을 차지하는 것으로 알려져 있다. 따라서 신이식 환자에서 십이지장 우회술을 받은 경우 tacrolimus의 흡수과 대사저하가 발생할 수 있다. 저자들은 신이식을 받은 41세 여자환자가 십이지장 우회술을 받은 뒤 이식실패를 경험한 사례를 보고하고자 한다. 환자는 췌장염으로 입원, 십이지장천공으로 십이지장 우회 술 및 위공장연결술을 시행 받았고, 수술 이후 tacrolimus 용량 증가에도 불구하고 혈중 tacrolimus 농도가 치료 목표 수준을 유지하지 못하였으며, 반복적인 거부반응으로 우회술 3개월 만에 이식실패를 경험하였다. 이 증례는 신이식 환자가 십이지장 우회술을 받은 경우 약물 흡수의 중요성을 보여주는 사례로 생각된다. The calcineurin inhibitor-immunosuppressant tacrolimus is widely used in patients undergoing kidney transplantation. Although tacrolimus is absorbed from the entire gastrointestinal tract, the duodenum is the primary site of its absorption and metabolism. Therefore, duodenal bypass surgery in a renal transplant recipient can significantly disrupt tacrolimus absorption and metabolism, Here, we report a case of allograft failure that developed after duodenal bypass surgery, The patient was a 41-year-old woman who received a deceased donor kidney transplantation, She underwent a gastrojejunostomy due to a duodenal perforation and pancreatitis after endoscopic retrograde cholangiopancreatography, After the surgery, her blood tacrolimus level decreased gradually, and remained lower than therapeutic target levels, even after the tacrolimus dose was increased from 5 to 12 mg/day. Repetitive rejection developed and the patient suffered allograft failure 3 months after bypass surgery. This case raises the importance of drug absorption in renal transplant recipients undergoing duodenal bypass surgery.
외상 후 발생한 Mycobacterium intracellulare에 의한 만성 관절염 1예
김재경 ( Jae Gyung Kim ),김대원 ( Dae Won Kim ),조율희 ( Yul Hee Cho ),임선미 ( Sun Mie Yim ),강주현 ( Ju Hyun Kang ),주영빈 ( Young Bin Joo ),강현희 ( Hyeon Hui Kang ),송정섭 ( Jeong Sup Song ),윤형규 ( Hyoung Kyu Yoon ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.2
While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.