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- 저자 : 백관미 ( Kwan Mi Pack ) (검색결과 4 건)
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백관미 ( Kwan Mi Pack ),김상위 ( Sang We Kim ),이상도 ( Sang Do Lee ),김윤지 ( Yoon Ji Kim ),서철원 ( Cheol Won Suh ),김동관 ( Dong Kwan Kim ),송동은 ( Dong Eun Song ) 대한내과학회 2008 대한내과학회지 Vol.74 No.4
저자 등은 ADA가 증가되어 있는 편측성 흉수를 가진 환자에서 원발성 흉막삼출성 림프종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. A 78-year-old woman was referred to this hospital because of exertional dyspnea for 2 weeks. Although she was treated with anti-tuberculous medication under the assumption that she had tuberculous pleuritis, her dyspnea continued. Physical examination revealed diminished breath sounds over the left lung field. Chest radiography showed a large left pleural effusion. The pleural effusion revealed malignant cell-dominant exudates with a high adenosine deaminase level. Serological tests were negative for HIV. Computed tomography scan of the chest and abdomen showed pleural effusion, but no mass or pathological lymph nodes were detected. The biopsy specimen of the pleura was diagnosed as malignant B-cell lymphoma with plasmacytoid features, suggesting a possibility of primary effusion lymphoma. Polymerase chain reaction assay of tumor was positive for HHV-8 DNA. She underwent pleurodesis during Video-Assisted Thoracic Surgery, and her dyspnea subsequently improved.(Korean J Med 74:441-444, 2008)
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부갑상선호르몬 분비가 저하된 혈액투석 환자에서 저칼슘투석액 사용시 칼슘감지수용체의 유전자 다형성에 따른 호르몬 분비의 변화
박태진 ( Tae Jin Park ),서장원 ( Jang Won Seo ),백관미 ( Kwan Mi Pack ),장재원 ( Jai Won Chang ),양원석 ( Won Seok Yang ),김순배 ( Soon Bae Kim ),이상구 ( Sang Koo Lee ),박수길 ( Su Kil Park ),박정식 ( Jung Sik Park ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.4
Purpose : Low level of parathyroid hormone (PTH) is a risk factor that might cause hip fracture in dialysis patients. Low calcium dialysate (LCD) has been suggested as an approach to increase PTH level. The calcium- sensing receptor (CaSR) polymorphism is known to be associated with the sensitivity to extracellular calcium. Methods : We prospectively investigated the role of genetic polymorphism of CaSR codon 990 as one cause of the different parathyroid responses to LCD in maintenance hemodialysis (HD) patients. 48 patients, using 3.5 mEq/L calcium dialysate, with intact PTH below 100 pg/ml for the last one year underwent HD sessions on 2.5 mEq/L calcium dialysate for 12 weeks. Serum intact PTH, total calcium, phosphorus, alkaline phosphatase (ALP) and bone-specific ALP (BAP) were measured monthly. The CaSR gene from peripheral lymphocytes was amplified to confirm the genotype by polymerase chain reaction. Results : According to the CaSR genetic polymorphism, subjects were divided into 3 groups, A/A (14.6%), A/G (45.8%) and G/G (39.6%). Twelve weeks later, intact PTH (48.5±25.4 to 89.0±49.4 pg/mL, p<0.01), and ALP (78.7±25.7 to 87.4±27.2 IU/L, p<0.01) increased significantly in G/G group, but not in non-G/G groups. However, BAP significantly increased in both G/G group (24.3±11.9 to 29.5±10.6 U/L, p<0.01) and in non-G/G groups (21.4±4.5 to 26.1±9.1 U/L, p<0.01). During the study period, levels of corrected total calcium and phosphorus were not significantly changed. Conclusion : The CaSR polymorphism, G/G genotype, strongly influenced the responsiveness of parathyroid gland to LCD, compared with non-G/G genotypes. However, bone formation may occur actively on LCD, irrespective of CaSR genetic polymorphism.
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김윤지 ( Yoon Ji Kim ),서동완 ( Dong Wan Seo ),백관미 ( Kwan Mi Pack ),정은희 ( Eun Heui Jeong ),김송철 ( Song Cheol Kim ),한덕종 ( Duck Jong Han ),이상수 ( Sang Soo Lee ),이성구 ( Sung Koo Lee ),김명환 ( Myung Hwan Kim ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.3
목적: 췌장암은 예후가 극히 불량하며, 점차 발생빈도가 증가하고 있다. 췌장암의 예후에 영향을 미치는 인자에 대한 많은 연구 결과가 보고되었다. 그러나, 각기 다른 환자, 기와 치료 방법을 포함하고 있어 일정한 결론에 이르지 못하였다. 이에 저자 등은 대규모 연구를 통해 췌장암의 생존기간에 영향을 주는 예후 인자들을 분석하여 향후 치료의 방향을 결정하는 데 도움이 되고자 하였다. 대상 및 방법: 1994년 1월부터 2004년 1월까지 서울아산병원에서 췌장암으로 진단되어 치료를 받았던 971명의 환자를 대상으로 하였다. 환자들은 임상 병기에 따라 절제 가능형(226명), 국소 진행형(409명), 말기 진행형(336명)의 세 군으로 나누었다. 후향 조사를 통하여 각 군 간의 생존기간과 이에 영향을 주는 인자에 대해 분석하였다. 또한 치료 방법에 따른 생존기간을 비교하여 췌장암의 적극적인 치료가 생존율의 향상에 도움을 주는지 알아보았다. 결과: 적극적인 치료를 한 환자와 보존 치료를 받은 환자의 중앙 생존기간은 절제 가능형에서 각각 18개월과 9개월, 국소 진행형에서 각각 10개월과 7개월, 말기 진행형에서 5개월과 3개월로, 모든 병기에서 적극적인 치료를 받은 환자들의 생존기간이 길었다. 다변량 분석 결과, 절제 가능형에서는 CA 19-9 농도, 조직 분화도, 종양의 크기, 국소 림프절 전이 여부가 예후에 영향을 주는 독립적인 인자로 나타났다. 반면에 말기 진행형에서는 연령, 수행 능력, 알부민 농도가 예후와 관련된 인자로 확인되었다. 결론: 췌장암의 적극적인 치료는 진행된 병기를 가진 환자에서도 생존기간을 연장시킬 수 있었다. 또한 췌장암의 예후와 관련된 인자는 임상 병기에 따라 차이를 보여, 절제 가능형 췌장암에서는 주로 종양의 특성과 관련된 인자가, 반면에 말기 진행형 췌장암에서는 주로 환자의 특성과 관련된 인자가 생존율에 영향을 주었다. Background/Aims: The prognosis of patients with pancreatic cancer remains very poor. Although many studies have evaluated the prognostic factors of pancreatic cancer, their results are inconclusive because of different inclusion criteria, tumor stages, and treatment modalities. This large scale retrospective analysis was performed to assess whether active treatment of pancreatic cancer, even in its advanced stage, could improve patients` survival. In addition, we sought to identify factors associated with favorable prognosis of pancreatic cancer. Methods: Between 1994 and 2004, a total of 971 patients with pancreatic cancer were treated at Asan Medical Center. The patients were classified into three groups according to clinical stages: resectable (RE, n=226), locally advanced (LA, n=409), and far advanced (FA, n=336). Treatment response and prognostic factors for survival were analyzed in each group. Results: Compared to supportive care, active treatment significantly increased the median survival time in all groups (RE: 18.0 vs. 9.0 months; LA: 10.0 vs. 7.0 months; FA: 5.0 vs. 3.0 months). Multivariate analysis showed that prognostic factors for survival differed according to clinical stages. In the RE group, unfavorable prognostic factors were high CA 19-9, poor histologic differentiation, large tumor size, and regional lymph node involvement. In the FA group, however, poor outcomes were associated with old age, poor performance status, and hypoalbuminemia. Conclusions: More active treatment of pancreatic cancer, even in advanced stage, can make a significant difference in terms of patient`s survival. The prognosis of resectable pancreatic cancer is dependent on tumor-related factors, while the prognosis of patients with far advanced pancreatic cancer is dependent on patient-related factors. (Korean J Gastroenterol 2008;51:181-189)
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Mycobacterium intracellulare에 의한 요추부 척추염 1예
장은영,김미영,김정욱,송은희,백관미,정용필,성흥섭,김미나,김양수,우준희,이상호 대한감염학회 2007 감염과 화학요법 Vol.39 No.3
비결핵성 미코박테리아에 의한 척추염에 대한 증례 보고가 국내에서는 아직 없었다. 저자들은 기저질환이 없는 환자에서 M. intracellulare에 의한 척추염을 rpoB 유전자에 대한 PCR-RFLP 방법을 통해 진단하였고 수술적 치료와 3제 병합 항균 요법으로 성공적인 임상 경과를 보인 1예를 경험하였기에 보고하는 바이다. We report a case of vertebral osteomyelitis due to Mycobacterium intracellulare in a 60-year-old man without predisposing conditions. He was successfully treated with surgical excision of the inflamed tissue and combined antimycobacterial therapy consisting of clarithromycin, ethambutol, and rifampin. In this case, polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) based on the rpo B gene of cultured isolates allowed rapid identification of M. intracellulare. Although very rare, nontuberculous mycobacteria (NTM) should be suspected as a causative pathogen of vertebral osteomyelitis. To the best of our knowledge, this is the first case of vertebral osteomyelitis caused by NTM reported in the Korean literature.
KCI
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