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증례 : 혈액종양 ; 동측 신장에서 발생한 동시성 집합관세포암종과 이행세포암종 1예
형건덕 ( Chien Ter Hsing ),목지영 ( Ji Young Mok ),한지선 ( Ji Sun Han ),김태효 ( Tae Hyo Kim ),박종혁 ( Jong Hyeok Park ),나서희 ( Seo Hee Rha ),김효진 ( Hyo Jin Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
동측신장에서 발생한 신세포암종과 이행세포암종은 드문 경우이다. 본 증례는 49세 남자가 좌측 옆구리 통증을 주소로 내원하여 복부단층촬영사진상 좌측신장에 조영이 되는 종괴가 보여 좌측신장 적출술을 시행하였으며 병리학 소견에서 집합관세포암종과 이행세포암종이 동시에 발견되었다. 이 증례에서 동시성 동측신장에서 발생한 집합관세포암종과 이행세포암종이 집합관세포암종 단일존재 했을 때보다 더욱 불량한 경과를 관찰하였기에 문헌고찰과 함께 보고하는 바이다. The coexistence of synchronous ipsilateral primary cancer in the genitourinary system has only rarely been described in the literature. We present the case of a 49-year-old man with left flank pain as an initial presentation. An abdominal CT study showed a mildly enhancing lesion at the left renal mid-pole posterior aspect. A left radical nephrectomy was performed. The pathological diagnosis was a collecting duct carcinoma (CDC) and a papillary transitional cell carcinoma (TCC). This is a rare case of combined renal malignancies. (Korean J Med 77:S1293-S1297, 2009)
증례 : 내분비-대사 ; 범뇌하수체저하증, 요붕증을 보인 원발성 육아종성 뇌하수체염 1예
오현진 ( Hyun Jin Oh ),목지영 ( Ji Young Mok ),김지은 ( Ji Eun Kim ),조성배 ( Sung Bae Cho ),장상아 ( Sang Ah Chang ),김지현 ( Ji Hyun Kim ),이정민 ( Jung Min Lee ) 대한내과학회 2015 대한내과학회지 Vol.88 No.5
본 증례에서는 기저 질환이 없던 48세 여자 환자가 두통, 피로함, 오심, 희발 월경, 다뇨 증상을 호소하였고 호르몬 검사와 영상 검사 결과 범뇌하수체 기능 저하증과 중심성 요붕증을 동반하는 뇌하수체 병변으로 진단하였다. 6개월간 스테로이드 및 호르몬 요법을 시행했으나 두통이 지속되고 종괴의 크기도 변하지 않아 접형동을 통한 종괴 절제술을 시행하였다. 수술 후 원발성 육아종성 뇌하수체염으로 확진할 수 있었으며 현재 호르몬 보충 요법을 유지하면서 외래에서 경과관찰 중이다. Primary granulomatous hypophysitis is a rare inflammatory disorder of the pituitary gland and patients commonly present with symptoms of sellar compression and hypopituitarism. A 48-year-old woman was admitted due to headache and fatigue. Magnetic resonance imaging showed a 21 × 18 × 13-mm round sellar mass with a thickened pituitary stalk. The endocrinological examination revealed panhypopituitarism and diabetes insipidus. Suspecting hypophysitis, the patient was given steroid and hormone replacement therapy. Six months later, she continued to complain of severe headaches and nausea. Computed tomography showed no significant change in the sellar mass. Subsequently, transsphenoidal surgery was performed. The pathological examination revealed granulomatous changes with multinucleated giant cells and primary granulomatous hypophysitis was diagnosed. Her headache resolved, but the pituitary functions did not improve. This is the first reported case in Korea of primary granulomatous hypophysitis with dysfunction of anterior and posterior pituitary gland, including the stalk, without optic chiasm compression. (Korean J Med 2015;88:581-586)
오유정 ( You Jeong Oh ),한지선 ( Ji Sun Han ),김도경 ( Do Kyong Kim ),정석희 ( Seuk Hee Chung ),김상옥 ( Sang Ock Kim ),형건덕 ( Chien Ter Hsing ),목지영 ( Ji Young Mok ),안원석 ( Won Suk An ),김성은 ( Seong Eun Kim ),김기현 ( Ki 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Purpose: Recently the incidence of severe hyponatremia is increasing in old patients but there is no report about clinical findings of old patients with hyponatremia. We evaluated the cause and clinical manifestations of severe hyponatremia in old patients who had been admitted via emergency room. Methods: We retrospectively reviewed clinical records of the hyponatremic patients who had been admitted from 2000 to 2007. We enrolled 53 patients (Age>60 years, Na<125mEq/L) without severe liver cirrhosis, heart failure or chronic kidney disease. We analyzed data to evaluate the differences of clinical manifestations according to the presence of symptoms, taking diuretics, urine sodium concentrations and the degree of hyponatremia. Results: Mean serum sodium concentration was 111.4±6.9mEq/L and urine sodium concentration was 68.7±43.8mEq/L. There was no difference in serum sodium concentration according to age. Twenty-nine (54.7%) patients had nausea and vomiting and 19 patients (35.8%) had neurologic symptoms. Patients with neurologic symptoms showed lower serum and urine sodium concentration than patients without neurologic symptoms. The main causes of severe hyponatremia were poor oral intake (79.2%), diuretics use (37.7%) and recent operation (15.1%). The mean sodium concentration of the fluid administered to achieve 125mEq/L of serum sodium level was 336.5±160.6mEq/L. Conclusion: The urinary sodium loss, e.g., diuretics abuse, may be the main cause of severe hyponatremia in elderly patients over 60 years. In elderly patients, diuretics should be carefully administered with frequent electrolyte monitoring.
최윤석 ( Yoon Seok Choi ),반태현 ( Tae Hyun Ban ),조익현 ( Ik Hyun Jo ),목지영 ( Ji Young Mok ),이상빈 ( Sang Bin Lee ),이원직 ( Won Jik Lee ),정성훈 ( Sung Hoon Jung ),오정환 ( Jung Hwan Oh ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.2
Detection of cystic lesions in the pancreas has increased because of the widespread use of high-resolution diagnostic imaging techniques. Therefore, cystic lesions of the pancreas constitute an increasingly important category with a challenging differential diagnosis. Squamoid cyst of pancreatic ducts is a recently recognized type of cystic lesion in the pancreas in which cystically dilated ducts are lined by non-keratinized squamous epithelium. Although it is clinically known as benign cystic lesion, we experienced its malignant behavior and report here with review of the international literatures.