일렬 자가조혈모세포이식을 받은 다발성 골수종 환자에서 발생한 뇌 톡소포자충증 1례

김계형,송경호,전재현,박완범,박상원,김홍빈,김남중,김인호,오명돈 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Toxoplasmosis is a rare but fatal complication in hematopoietic stem cell transplant recipients, usually associated with allogeneic hematopoietic stem cell transplantation (HSCT). We report a case of cerebral toxoplasmosis in a patient with multiple myeloma, following tandem autologous stem cell transplantation. A 55-year-old Korean male presented with weakness in both legs that had progressed to both arms. A magnetic resonance imaging scan of the brain revealed multiple, variablesized ring-enhancing lesions with surrounding edema in the cerebral hemispheres and brain stem. Stereotactic biopsy revealed bradyzoites of Toxoplasma gondii in the brain tissue. The patient received trimethoprim-sulfamethoxazole, followed by pyrimethamine and sulfadiazine, accompanying treatment for progressive multiple myeloma. Cerebral toxoplasmosis should be considered as one of the differential diagnoses in patients with neurologic signs following autologous HSCT.

원발성 난소 소세포암 2례

조인숙,남계현,김태희,김정식,이해혁,이권해,권계원 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Two cases of primary small cell carcinoma of the ovary occurred. One was a case of 43-year-old woman associated with hypercalcemia and the other was a case of 40-year-old woman with pulmonary type. Ovarian small cell carcinoma of the hypercalcemic type have clinicopathological, immunohistochemical, ultrastructural, and flow cytometric features that from differ from those of small cell carcinomas of the pulmonary type. It is important for therapeutic reasons to distinguish these two types of ovarian tumors from each other and from a variety of malignant small cell tumors that ovary primarily or secondarily. So, we reported these cases with a brief review of the concerned literatures.

Paclitaxel 및 Apo-2L/TRAIL이 자궁경부암 세포주 아포토시스에 미치는 영향

김주영,남계현,김태희,이권해,이해혁,배동한 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.2

Objective: TRAIL(also called Apo-2L) is a member of the tumor necrosis factor(TNF) family of cytokines which induces apoptosis cell death in a variety of tumor cell lines. It mediates its apoptotic effects through one of two receptors, DR4 and DR5, which are members of the TNF receptor family, and whose cytoplasmic regions contain death domains. TNF and Fas ligand induces apoptosis in tumor cells; however, their severe toxicity toward normal tissues hampers their application to cancer therapy. We examed if paclitaxed and/or Apo-2LTRAIL induces apoptosis of cervical cancer HeLa, SiHa, ME-180, and CaSki cells. Mehods : We have demonstrated that paclitaxel and Apo-2L/TRAIL induces apoptosis of cervical cancer HeLa, SiHa, CaSki and ME-180 cell lines in a dose-dependent manner. HeLa, SiHa, ME-180 and CaSki were obtained from American Type Culture Colection. Recombinant Human TRAIL(Chmicon). DR4 and DR5 were purchased from Santa Cruz. Paclitaxel, MTT assay Kit, Acridine orange and Ethium bormide were purchased from Sigma. HeLa and SiHa were grown in DMEM. ME-180 and CaSki were grown in RPMI. Tripan blue stain and MTT assay were done for cytotoxicity. Annexin V-FITC and PI(propidium iodide) flowcytometry for apoptosis assay. DR4 and DR% were expressed by Western Blot. Fluorescent Microscopy used Acridine orange(AO) and Ethium bromide(EB). Results : Importantly, concurrent treatment of cervical cancer cells with paclitaxed and Apo-2L/TRAIL induces significantly more apoptosis than Apo-2L/TRAIL alone. Conclusion : We need further studies which reveals possible therapeutic potential in the women with cervical cancer by suing Apo-2L/TRAIL.

Mycobacterium mageritense에 의한 당뇨병성 족부 감염증 1예

김충종,김낙현,김문석,김계형,전재현,박문석,박경운,박완범,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Diabetic foot infection is one of the important complications in patients with advanced diabetes mellitus. Limb threatening infections such as osteomyelitis, abscess, and necrotizing fasciitis are frequently accompanied by the disease. Non-tuberculous mycobacterium (NTM) is a rare causative organism of diabetic foot infection. Thus, if one is not suspicious or meticulous, infection due to NTM will be easily overlooked and this will result in delayed diagnose and treat. Therefore, it is necessary to consider NTM as the causative organism if the wound does not respond to the conventional antibiotic treatment and the culture from the adequately obtained specimen reveals atypical acid-fast bacilli. We present a case of diabetic foot infection with osteomyelitis and abscess due to Mycobacterium mageritense, one of the rapid growing mycobacteria, that was successfully treated with surgical debridement and appropriate antibiotic treatment.

자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

복식 전자궁적출술후 절단부에 발생한 난관탈출증 1예

송은석,이해혁,김태희,김정식,남계현,이권해,고은석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Prolapse of the fallopian tube into the vaginal vault after hysterectomy is a rare complication. Since most of cases may resolve before detection or remain undiagnosed, the exact incidence is still unknown. Though most common sign of tubal prolapse is tender friable tissue in vaginal cuff, with the simptoms of lower abdominal pain, dysparenunia, vaginal discharge, or postcoital spotting. The definitive diagnosis should be confirmed histologically Recently, we experienced a case of fallopian tube prolapse after abdominal hysterectomy in a 41-year-old woman and report with a brief review of the literature.

외음부와 자궁에 생긴 평활근종 1예

박혜인,이해혁,김태희,김정식,남계현,이권해,고은석 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The leiomyomas of the vulva are rare benign tumors the incidence is 0.024%~0.55% in women. There are no relationship between leiomyomas of the vulva and uterus. But there are some reports that leiomyomas of the vulva and uterus simultaneously. The leiomyomas of the vulva present without symptoms and excision with biopsy is treatment of choice. Tumors of the gynecological apparatus may present without symptoms, or they may mimic other common gynecological conditions. Because of this, any vulva mass must be considered cautiously. We reported this case with a brief review of the concerned literatures.

골반 내 농양 1예

조인숙,이해혁,김태희,이권해,남계현,이임순,김정식,박성진 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Pelvic inflammatory disease (PID) is a disease that affects young, sexually active, reproductive age women. Most pathogens are Chlamydia trachomatis and Neisseria Gonorrheae transmitted sexually. One of serious acute complication of PID is tubo-ovarian abscess (TOA) that involves the fallopian tube, ovary and adjacent structures (eg, bowel, pelvic peritoneum). The microbiology of TOAs is polymicrobial with anaerobic organisms and causal organisms of PID. Common anaerobic organisms are Peptostretococcus spp, Bacteriodes spp, Prevotella spp, Escherichia coli and aerobic streptococci. Treatment is necessary to admission for intravenous broad-spectrum antibiotics and surgery is often reserved for patients with suspected rupture or patients who fail to respond to antibiotics. So, we reported this case found pelvic abscess due to ruptured tube-ovarian abscess.

자궁선근증의 고찰

조환성,이해혁,정성윤,김성욱,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: This study was designed to estimate the frequency and risk factor for edenomyosis Methods: The clinical records of 623 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, during 5 years, from Jan. 1995 to Dec. 1999. Results: The following result were obtained. 1. Adenomyosis was found in 247 of 623 patients(39.6%) 2. The highest incidence was 40-49 years of age group, an incidence of 46.6% and mean age was 44.7 years. 3. Adenomyosis was more frequently observed in parous women than non-parous women, such as 93.1% and 6.9%, respectively. 4. Dysmenorrhea, metrorrhagia, pelvic pain and vaginal bleeding were common symptom of adenomyosis, an incidence of 28.7%, 19.0%, 18.2% and 16.2%, respectively. 5. Myoma was the most combined disease in adenomyosis, showing the incidence of 54.7%. 6. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 61.9%. 7. Preoperative diagnostic accuracy of adenomyosis was 6.9%. Conclusion: The results show that deeply understanding of the common symptoms and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.

경정맥 신우조영술중 파열된 자궁의 악성혼합뮬러리안 종양 1예

조희정,김태희,김정식,이해혁,남계현,김희경 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The Malignant Mixed Mullerian Tumor(MMMT) of uterus, a biphasic malignant tumor composed of both epithelial and stromal component, is rare but very aggressive and generally lethal. Most of these tumors arise spontaneously in the sixth to eighth decade of life, but certain proportions are known to be occurred in women, who had received pelvic irradiation. But, the precise role of irradiation in the genesis of uterine neoplasia remains uncertain. We experienced a case of MMMT of uterus which ruptured during intravenous pyelogram and she had received pelvic irradiation 40years ago.