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간암 절제술 후 단발 림프절 전이로 재발한 소간세포암종 1예
임주한 ( Joo Han Lim ),이진우 ( Jin Woo Lee ),김은주 ( Eun Joo Kim ),이정일 ( Jung Il Lee ),정석 ( Seok Jeong ),이돈행 ( Don Haeng Lee ),신용운 ( Yong Woon Shin ),김준미 ( Joon Mee Kim ) 대한소화기학회 2006 대한소화기학회지 Vol.50 No.1
Extrahepatic recurrence of hepatocellular carcinoma (HCC) has been considered unsuitable for surgical resection since the disease is considered to be extensive. However, solitary local lymph node recurrence in small HCC is rarely reported with suitable treatment modality being uncertain. We herein, present a case of 60-year-old female patient with small HCC showing late lymph node metastasis after complete resection of primary HCC. A 2 cm-sized hepatic mass was completely resected by segmentectomy (VIII). Eight months later, CT and PET scan revealed a 4.5 cm-sized portocaval lymph node (LN). In addition, whole body PET/CT scan strongly suggested a solitary tumor recurrence. Radical lymphadenectomy was performed. Tumor was confirmed as LN metastasis from HCC by excisional histopathological examination. Adjuvant chemotherapy and radiotherapy were followed. (Korean J Gastroenterol 2007;50:66-69)
췌장암 환자의 보조요법의 항암 치료제 결정을 위한 접근
임주한 ( Joo Han Lim ) 대한내과학회 2020 대한내과학회지 Vol.95 No.5
Pancreatic cancer generally has a dismal prognosis, with a 5-year overall survival rate of approximately 10%. At present, surgical resection is the only treatment with a curative aim; however, it is applicable to only 15-20% patients with pancreatic cancer at the time of diagnosis and the median survival following treatment with surgery alone is only 11-20 months. Many trials have shown that adjuvant chemotherapy offers improved outcomes over observation following surgical resection. Recently, modified folinic acid-fluorouracil-irinotecan-oxaliplatin (FOLFIRINOX) treatment following surgical resection in patients with good performance status has shown an impressive 9-month increase in disease-free survival. However, patients included in the study were selected based on a narrow set of criteria, and adverse events during adjuvant chemotherapy remain a limitation. In this article, we review some key trials of adjuvant chemotherapy treatment for pancreatic cancer and discuss future perspectives including neoadjuvant treatment approaches. (Korean J Med 2020;95:315-319)
A Case of Metastatic Eccrine Porocarcinoma with a Review of the Literatures
이정환,임주한,김루시아,김철수,이현규,나소연,김성현,정지중,이명동,예재호,이문희,Lee, Jung-Hwan,Lim, Joo-Han,Kim, Lucia,Kim, Chu-Soo,Yi, Hyeon-Gyu,Nah, So-Yun,Kim, Seong-Hyun,Jeong, Ji-Joong,Lee, Myung-Dong,Ye, Jea-Ho,Lee, Moon-Hee The Korean Society for Head and Neck Oncology 2011 대한두경부 종양학회지 Vol.27 No.2
에크린 한공암종은 흔하지 않으며, 전이성 에크린 한공암종은 매우 드문 암이다. 에크린 한공암종은 표피내 한관에서 기원하는 피부 부속기 악성 종양으로, 대부분 에크린 한공암종은 항암치료와 방사선치료에 효과가 없으며, 따라서 유일한 치료방법은 전이되기 전에 국소 및 광범위 절제술을 시행하여야 한다. 본 환자는 두피에 발생한 에크린 한공암종이 점점 진행하여 피부, 림프절, 폐 등으로 전이하였고, 다수의 광범위 절제술에 이어 항암치료와 방사선치료를 받았지만, 결국 폐전이가 악화되어 사망하였다. 본 저자들은 항암치료와 방사선치료에 불응한 에크린 한공암종 1예를 치료에 대한 문헌고찰과 더불어 보고하는 바이다.
증례 : 혈액종양 ; 비장절제술로 진단된 아시아변종 혈관내대B세포림프종 1예
한지영 ( Jee Young Han ),이현규 ( Hyeon Gyu Yi ),이진수 ( Jin Soo Lee ),최석진 ( Suk Jin Choi ),임주한 ( Joo Han Lim ),김철수 ( Chul Soo Kim ),이문희 ( Moon Hee Lee ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 불명열, 비장경색을 동반한 비장종대를 주요 임상양상으로 발현하여, 최종적으로 비장절제술에 의해 확진 된 아시아변종 혈관내대B세포림프종을 경험하였고, 불명열 및 비장경색의 감별진단으로 아시아변종 혈관내대B세포림프종을 고려해야 하는 것을 알리고자 한다. Intravascular large B cell lymphoma (IVLBCL) is a rare form of non-Hodgkin`s lymphoma, characterized by systemic proliferation of neoplastic B cells within blood vessels. The diagnosis is frequently delayed, because of the lack of clues in imaging studies. The course is usually aggressive and fatal. Asian-variant intravascular large B cell lymphoma (AIVL) shows characteristic clinical manifestation as hemophagocytic syndrome, associated with bone marrow and hepatosplenic involvement and, rarely, neurological abnormalities and skin manifestations. We report the case of a 51-year-old female who was considered initially to have fever of unknown origin with splenic infarction and was confirmed as AIVL by splenectomy involving liver, spleen, and bone marrow, with hemophagocytic features. (Korean J Med 77:S1309-S1313, 2009)
A Case of Metastatic Eccrine Porocarcinoma with a Review of the Literatures
Jung Hwan Lee(이정환),Joo Han Lim(임주한),Lucia Kim(김루시아),Chul Soo Kim(김철수),Hyeon Gyu Yi(이현규),So Yun Nah(나소연),Seong Hyun Kim(김성현),Ji Joong Jeong(정지중),Myung Dong Lee(이명동),Jea Ho Ye(예재호),Moon Hee Lee(이문희) 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.2
에크린 한공암종은 흔하지 않으며, 전이성 에크린 한공암종은 매우 드문 암이다. 에크린 한공암종은 표피내 한관에서 기원하는 피부 부속기 악성 종양으로, 대부분 에크린 한공암종은 항암치료와 방사선치료에 효과가 없으며, 따라서 유일한 치료방법은 전이되기 전에 국소 및 광범위 절제술을 시행하여야 한다. 본 환자는 두피에 발생한 에크린 한공암종이 점점 진행하여 피부, 림프절, 폐 등으로 전이하였고, 다수의 광범위 절제술에 이어 항암치료와 방사선치료를 받았지만, 결국 폐전이가 악화되어 사망하였다. 본 저자들은 항암치료와 방사선치료에 불응한 에크린 한공암종 1예를 치료에 대한 문헌고찰과 더불어 보고하는 바이다.
증례 : 대장 샘암종 환자에서 이시성으로 발생한 간의 샘편평세포암종 1예
방병욱 ( Byoung Wook Bang ),임미진 ( Mie Jin Lim ),임주한 ( Joo Han Lim ),김은주 ( Eun Joo Kim ),정석 ( Seok Jeong ),최석진 ( Suk Jin Choi ),박인서 ( In Suh Park ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1
간의 원발성 샘편평세포암종은 드물게 발생하며, 간의 다른 원발성 종양보다 불량한 예후를 가지고 있다. 저자들은 상행결장암으로 수술 후 항암화학요법 중 우연히 발견된 간의 원발성 샘편평세포암종을 경험하였기에 보고한다. A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine. (Korean J Med 72:74-78, 2007)
Lim, Joo-Han,Kim, Eun Sil,Chung, Moon-Hyun,Kang, Jae-Seung 대한감염학회 2008 감염과 화학요법 Vol.40 No.1
Azifomycins은 경도의 쯔쯔가무시병 치료에서 doxycycline에 비길만하며, 부작용도 적고 임신부나 소아에게도 투여할 수 있다. 드물게 심장 부정맥이 부작용으로 발생할 수 있다. 저자들은 중증 쯔쯔가무시병에서 정주용 azitomycin을 2번 정맥으로 투여한 직후, torsades de pointes가 발생한 예를 경험하였다. Cardioversion으로 정상 리듬으로 회복시켰고 항생제를 doxycycline으로 바꾼 후, 환자는 다른 합병증 없이 퇴원하였다. Azithromycin shows a comparable therapeutic efficacy to doxycycline against mild to moderate scrub typhus. It is safe enough to use in pregnant women or children less than 8 years of age, but may be associated with fatal cardiac dysrhythmia. Herein we report a case of scrub typhus in which torsades de pointes developed during treatment with intravenous azithromycin. A 63-year-o1d man with a history of hypertension and prolonged QT interval was admitted because of fever with duration of 13 days, rash, an eschar, and delirium. An initial electrocardiography showed atrial fibrillation with rapid ventricular response. Scrub typhus complicated by meningoencephalitis, pneumonitis, and possible myocarditis was diagnosed. Two 500 mg doses of azithromycin were infused over 30 minutes, 12 hours apart. The patient developed a cardiac arrest due to torsades de pointes 30 minutes after the second dose of azithromycin. After the patient was resuscitated successfully and the antibiotic was change to doxycycline. The patient eventually improved and was discharged without any sequelae.