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- 저자 : 하동천 ( Dong Cheon Ha ) (검색결과 6 건)
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증례 : 소화기 ; 위장관 기질종양으로 오인된 거대 유경성 간세포암종 1예
하동천 ( Dong Cheon Ha ),김보경 ( Bo Kyoung Kim ),김문성 ( Moon Sung Kim ),김가영 ( Ka Young Kim ),권기현 ( Ki Hyun Kwon ),안영용 ( Young Yong Ahn ),이동수 ( Dong Soo Lee ) 대한내과학회 2011 대한내과학회지 Vol.81 No.6
유경성 간세포암종은 간세포암중에서 매우 드문 형태이다. 국내에서의 유경성 간세포암종의 증례 보고는 매우 드물었고, 대만과 일본 등의 증례가 소수 보고되어 있다. 저자들은 위저부 옆의 거대종괴에 대해 위장관 기질종양으로 의심하고 진단 겸 치료를 위해 수술을 시행하였던 경우로, 수술후 목이 없는 거대한 외성장 형태의 유경성 간세포암종으로 진단되었다. 유경성 간세포암종은 일반적 간세포암종에 비해 절제 가능한 경우가 많지만, 빠른 성장을 보이기 때문에 빨리 진단을 하는 것이 예후에 매우 중요하다. 이러한 이유로 종괴가 간 이외의 위치에 있다고 하더라도, 초기 추정진단시 간세포암종의 가능성을 배제하여서는 안될 것이다. Pedunculated hepatocellular carcinoma (P-HCC) can be defined as a carcinoma protruding from the liver with or without a pedicle. Cases of P-HCC showing extrahepatic growth are very rare. P-HCC constitutes 0.2-4.2% of all HCC cases in Japan and Taiwan, but few cases in Korea have been reported. A 67-year-old female patient was admitted to our hospital with a 6-month history of epigastric discomfort. Examination identified an abdominal mass in the left upper quadrant, and abdominal computed tomography revealed a huge mass adjacent to the fundus of the stomach. We diagnosed this mass as a gastrointestinal stromal tumor because of its size and site. However, postoperative histopathological findings showed that the mass was HCC. Here, we report this case and review the relevant medical literature. (Korean J Med 2011;81:764-768)
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하동천 ( Dong Cheon Ha ),윤준영 ( June Young Yoon ),조성원 ( Sung Won Cho ),정정임 ( Jeong Ihm Jeong ),김진엽 ( Jin Yub Kim ),김한권 ( Han Gwun Kim ),엄대운 ( Dae Woon Eom ),김성수 ( Sung Soo Kim ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.2
Wegener`s granulomatosis is a rare disease that pathologically causes necrotizing granulomatous vasculitis in the arterioles and venules and it can invade the whole body. In addition, it is difficult to distinguish between a nontuberculous mycobacteria infection that shows manifestations of granuloma and Wegener`s granulomatosis. There has been no reported on a patient who had the 2 abovementioned two diseases at the same time. A 69 year old male patient had Wegener`s granulomatosis that had invaded the prostate. He also had a scrotal swelling and back pain. He had manifestations of granulomatous infection on the scrotum and spine biopsies. However, there was no clinical evidence of Wegener`s granulomatosis. As a result, we examined him for other diseases that can cause a granuloma. Consequently, he was also diagnosed as suffering with a nontuberculous mycobacteria infection. We report here on this case and we review the relevant medical literature.
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증례 : 소화기 ; 페그인터페론과 리바비린 병합요법 중 발생한 피부 유육종증 1예
권기현 ( Ki Hyun Kwon ),하동천 ( Dong Cheon Ha ),이정화 ( Jeong Hwa Lee ),허태윤 ( Tae Youn Heo ),안영용 ( Young Yong Ahn ),김연수 ( Yeon Soo Kim ),이동수 ( Dong Soo Lee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
만성 C형 간염 환자 치료에 있어서 페그인터페론과 리바 비린을 병합하여 치료하는 것이 표준치료이다. 페그인터페론과 리바비린 병합치료 후에 발생하는 부작용으로는 인플루엔자 유사 증상, 불면증, 탈모, 우울증, 빈혈 등이 있으며, 피부에 발생하는 부작용으로는 소양감과 피부염이 알려져 있다. 그러나 피부에 발생한 유육종증은 국내의 경우 아직 보고된 바가 없다. 저자들은 만성 C형 간염 환자에서 페그인 터페론과 리바비린의 병합요법 중에 피부에 발생하였고, 자연 치유된 유육종증 1예를 경험하였기에 이를 보고하는 바이다. Pegylated interferon plus ribavirin is the standard treatment regimen in chronic hepatitis C. The main adverse events of pegylated interferon plus ribavirin combination therapy are bone marrow depression, alopecia, insomnia, and influenza-like symptoms. However, there are few reports of cutaneous sarcoidosis occurring during pegylated interferon alpha-2a and ribavirin therapy. Here, we report a case of cutaneous sarcoidosis induced by pegylated interferon alpha-2a and ribavirin during the treatment for chronic hepatitis C. The patient`s sarcoidosis improved spontaneously after the treatment. (Korean J Med 2011;80:S117-S120)
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이정화 ( Jeong Hwa Lee ),권기현 ( Ki Hyun Kwon ),하동천 ( Dong Cheon Ha ),김보경 ( Bo Kyoung Kim ),정승혜 ( Seung Hye Jung ),김연수 ( Yeon Soo Kim ),이동수 ( Dong Soo Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.6
췌장의 가성낭종은 췌장염에 의하여 흔히 발생하는 합병 증으로 대개 췌장 내부나 췌장의 주위조직에 발생한다. 합병 증으로는 감염, 주위내장이나 복강 내로의 파열, 누공, 장관폐쇄, 출혈 등이 발생하며, 가성낭종에 의한 출혈은 상부위 장관 출혈의 드문 원인중의 하나이지만, 위험한 합병증이다. 저자들은 혈변을 주소로 내원한 만성 췌장염 환자에서 십이지장 점막하종양 출혈로 오인하였다가 췌장 가성낭종이 십이지장의 유두부를 침범하여 이로 인해 유발된 상부위장관 출혈로 진단하였으며, 보존적 치료로 호전된 1예를 경험하였기에 보고하고자 한다. Pancreatic pseudocysts occur following acute pancreatitis, chronic pancreatitis or secondary to pancreatic trauma. Most pancreatic pseudocysts are located in or around the pancreas, but they can be found in all the potential spaces around viscera in and outside of the abdominal cavity. The complications of pancreatic pseudocyst are infection, rupture, obstruction, fistula, or hemorrhage. Hemorrhage is a rare but frequently fatal complication of pancreatic pseudocysts. We report a case of pancreatic pseudocyst presented as bleeding of duodenum, which was misidentified for duodenal submucosal tumor bleeding.
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소화기 ; 집단으로 발생한 박새( Veratrum patulum) 중독 23예
이세형 ( Se Hyung Lee ),김영돈 ( Young Don Kim ),하동천 ( Dong Cheon Ha ),한군희 ( Koon Hee Han ),정우진 ( Woo Jin Jeong ),강희동 ( Hui Dong Kang ),천갑진 ( Gab Jin Cheon ) 대한내과학회 2010 대한내과학회지 Vol.79 No.4
고산 지대에서 임의로 산나물을 채취하여 먹은 후 구역, 구토 등을 호소하며 저혈압 및 서맥을 보이는 경우 임상적으로 박새 중독을 의심하여야 하며, 진단 후에는 입원 상태에서 면밀한 생체 징후 감시와 적절한 보존적 치료를 시행한다면 빠른 시일 내에 회복될 수 있다. 저자들은 박새 잎을 섭취 후 집단으로 구토와 서맥, 저혈압 등의 중독 증상을 보인 23명의 환자들을 아트로핀 정맥 주사와 대증요법을 통해 치료한 예를 경험하였기에 보고하는 바이다. Veratrum patulum is a perennial plant with toxicity, which grows wild in the high mountain areas of Korea. Various types of steroidal alkaloids contained in Veratrum patulum are known to cause symptoms such as nausea, vomiting, bradycardia and hypotension. Twenty-three patients were admitted to our center with chief complaints of nausea and vomiting after ingesting leaves of Veratrum patulum. The mean age of the group was 44 years old and was comprised of 19 males and 4 females. Some patients showed hypotension and bradycardia with symptoms such as dizziness. Ten patients with severe bradycardia coupled with other symptoms received atropine administration. Nausea and vomiting were improved after the administration of anti-emetics. Blood pressure and the pulse rate were all normalized on the day after admission, and all of the patients were discharged without any symptoms. (Korean J Med 79:417-421, 2010)
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고령에서 일차 항결핵 화학요법에 의한 약물 이상반응이 치료에 미치는 영향
정정임 ( Jeong Ihm Jeong ),정복현 ( Bock Hyun Jung ),김미혜 ( Mi Hye Kim ),임재민 ( Jae Min Lim ),하동천 ( Dong Cheon Ha ),조성원 ( Sung Won Cho ),류대식 ( Dae Sik Rhui ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4
Background: Pulmonary tuberculosis (TB) is still common disease among the elderly patients in Korea where the overall incidence of TB is decreasing. Adverse drug reactions (ADR) associated with anti-TB drugs occurs frequently. Especially the aged tends to have more frequent ADRs than younger ones. These ADRs can cause significant morbidity, compromise therapeutic effects of drugs and even induce drug resistance. Therefore we evaluated the effect of ADRs on the first-line anti-TB drugs in elderly patients with active pulmonary TB. Methods: We retrospectively reviewed the charts and radiological findings of the patients with 65 and older who were bacteriologically confirmed as active TB and treated with standard anti-TB drugs for at least 6 months. Major ADR was defined with temporary or continuous stop of any first-line drugs intake. Results: An ADR was noted in 54% of all patients. The incidence of major ADR was 32% in all elderly patients. Dermatologic ADR (9%) was the most common among the major ADRs. GI trouble (8%), arthralgia (6%), visual change (6%), hepatotoxicity (4%), and fever (1%) were also noted. The drugs responsible for major ADR were ethambutol (62%), pyrazinamide (35%), rifampin (18%) and isoniazid (9%). Major ADRs were associated with higher ESR level at the initiation of anti-TB drugs. Conclusion: First-line anti-TB drugs in elderly patients frequently caused the major ADRs. Therefore the elderly patients receiving anti-TB drugs should be closely monitored and better tolerable therapy should be considered as part of a TB research agenda.
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