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부신피질호르몬과 성장호르몬의 증가를 동반한 제2형 다발성 내분비선종(MEN Ⅱa) 1례
구기선,이재홍,유경훈,백승훈,형근영,조정구,이경근 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2
Multiple endocrine neoplasia type 2a(MEN 2a) is autosomal dominant disorders arising from mutations on chromosome 10q11.2 in the region of the RET proto-oncogenes which encodes a receptor tyrosine kinase. The features of MEN 2a include pheochromocytoma (in about 40% of gene carriers), medullary thyroid carcinoma, primary hyperparathyroidism (adenoma or hyperplasia). Carriers of MEN 2a genes can best be identified by serial measurement of stimulated blood calcitonin levels. Recent advances in mapping the MEN 2a gene now allows direct genetic testing, replacing calcitonin testing as a screening tool. We experienced a case of MEN 2a in a 35-year-old female patient. She underwent total thyroidectomy nine years ago due to medullary thyroid carcinoma. The pheochromocytoma, which was detected by biochemical tests, CT scan and ^131I-MIBG scan was successfully removed by bilateral adrenalectomy with preoperative alpha and beta adrenergic blockades. Her blood pressure and blood sugar level became normal after operation.
재발된 급성골수성 백혈병 환자에서 발생된 Pneumocystis carinii 폐렴 1예
이규재,이영진,김광용,정병학,소진탁,박현,구기선 대한감염학회 1998 감염 Vol.30 No.1
면역억제제의 사용증가와 백혈병의 복합 화학요법이 발달함에 따라 pneumocystis carinii 폐렴의 보고가 늘어나고 있으나, 국내에서 전형적인 P. carinii 폐렴이 유발되었음을 처음으로 확인하여 보고한다. 또한 이 환자에서 sulfamethoxazole/ trimethoprim 및 glucocorticoid로 치료를 시작해 좋은 치료효과를 보이는 것으로 보아 P. carinii에 의한 간질성폐염으로 사료되었다. We experienced a 61-year old man with Pneumocystis carinii pneumonia who had been diagnosed as having relapsed acute myelogenous leukemia(AML). He developed severe dyspnea in the nadir state after reinduction chemotherapy. His chest X-ray showed bilateral interstitial pneumonia in both lung fields. We started ventilator therapy and obtained sputum through the endotracheal tude. Typical P. carinii cysts were found in the sputum by Giemsa stain. No other organisms were found in the lavage sediments. From clinical observation and the presence of typical P. carinii cysts, the patient was diagnosed as having P. carinii pneumonia and was treated with sulfamethoxazole/trimethoprim and glucocorticoid. This was the first reported case of P. carinii pneumonia in an AML patient undergoing chemotherapy in Korea.
김용성,백승훈,유경훈,구기선,형근영,김경년,조정구 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2
Kallmann's syndrome is the most common form of isolated gonadotropin deficiency, characterized by hypogonadotropic hypogonadism due to GnRH deficiency, delayed puberty and smelling difficulty. It occurs sporadic or familial pattern, and the mode of inheritence has not been fully documented. The defect in patient of Kallmann's syndrome occurs at suprapituitary level involving mechanism that regulate GnRH synthesis or release, so this syndrome classified as a secondary hypogonadotropic hypogonadism. The gonadotropin or pulsatile GnRH administration enable successful stimulation of spermatogenesis and fertility. We have experienced 1 patient with Kallmann's syndrome and presented with the review of the literature.