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비타민 B12 결핍성 거대적아구성 빈혈의 원인 분석 및 임상소견
송헌호,권정혜,김정한,정주영,김효정,이근석,장대영,안진석,신동훈,강성하,박영이 대한혈액학회 2004 Blood Research Vol.39 No.4
Background:Vitamim B12 deficinecy is not a common disease and the causes and clinical findings were not clearly documented in Korea so far. Concerning that vitamin B12 deficiency caused by gastrectomy is not uncommon, we analysized the causes of vitamin B12 deficiency and clinical findings. Methods:We reviewed the clinical records of cases diagnosed as vitamine B12 deficiency megaloblastic anemia in Hallym Medical Center from July, 1992 to Octorber, 2004. Results:Forty five cases were included. Twenty five cases were performed gastrectomy and 8 cases had pernicious anemia, however the causes of 10 cases with vitamin B12 deficiency were not clear. The rate of the cases induced by gastrectomy were increased after 2001 compared with the rate before this point. Six cases were combined with iron deficient anemia. In five of the 6 cases who were combined with iron deficient anemia, the MCV and MCH were not increased. Forty three cases had anemia and anemia-associated symptoms such as dyspnea and weakness. Some of the cases complained diarrhea, numbness, or ataxia. Conclusion:We found that the gastrectomy was the dominant cause of vitamin B12 deficient megaloblastic anemia in this study. We suggest that vitamin B12 deficient megaloblastic anemia should be considered in follow-up of the cases of gastrectomy.
한국인 다발성골수종 환자에서 치료에 대한 반응 및 생존기간에 영향을 미치는 예후인자 분석
송헌호(Hun Ho Song),이제환(Je Hwan Lee),박종범(Jong Beom Park),최성준(Seong Jun Choi),김정균(Jeong Kyoon Kim),김성배(Sung Bae Kim),김상위(Sang We Kim),서철원(Cheol Won Suh),이규형(Kyoo Hyung Lee),이정신(Jung Shin Lee),김우건(Woo Kun 대한내과학회 2000 대한내과학회지 Vol.58 No.1
N/A Background : New therapeutic modalities such as high dose chemotherapy and stem cell support have been tried to prolong the survival period of the patients with multiple myeloma. However, little is known about the criteria for the application of those new therapies. There are only a few reports for the prognostic factors of multiple myeloma in Korea. The purpose of this study is to analyze the prognostic factors affecting chemotherapy response and survival in patients with multiple myeloma. Methods : We retrospectively analysed the clinical records of 122 patients who were newly diagnosed as multiple myeloma by SWOG criteria, between November, 1989 and April, 1997 at Asan Medical Center. Results : 1) The peak incidence was the 7th decade and male to female ratio was 1.3:1. The most common presenting symptom at first diagnosis was bone pain. 2) Initial clinical stage was as followed: stage I in 17.2% , stage II in 16.4% and 66.4% in III. The immunoglobulin classes were IgG in 51.6%, light chain only in 25.4%, IgA in 16.4%, IgD in 4.1%, and non-secretory type in 2.5%. Plasma cell types in bone marrow were classified as plasmablastic type in 45.9%, plasmacytic type in 54.1%. 3) Eighty two patients who recieved chemotherapy more than 3 cycles were evaluable for chemotherapy response. Overall response rate was 69.5%. Factors affecting response to chemotherapy were serum creatinine level, plasma cell type, total plasma cell percentage and plasmablast percentasge of total nucleated cells in bone marrow. 4) For total 122 patients, overall median survival period was 21 months, and estimated 5 year survival rate was 23.5%. Factors affecting survival were serum creatinine, corrected calcium, albumin, β2-microglobulin level, response to chemotherapy, total plasma cell percentage and plasmablast percentage in bone marrow. Conclusion : Bone marrow findings at initial diagnosis are significantly associated with response to chemotherapy and survival duration.(Korean J Med 58:83-90, 2000)
송헌호 ( Hun Ho Song ),오순옥 ( Soon Ok O ),김수호 ( Su Ho Kim ),문상호 ( Sang Ho Moon ),김진봉 ( Jin Bong Kim ),윤종우 ( Jong Woo Yoon ),구자룡 ( Ja Ryong Koo ),홍경순 ( Kyung Sun Hong ),이명구 ( Myung Goo Lee ),김동준 ( Dong Joo 대한내과학회 2002 대한내과학회지 Vol.63 No.5
N/A Background : Since Plasmodium vivax malaria reemerged in Korea in 1993, a number of patients with malaria have been reported. We analyzed the cases with malaria who lived in Chuncheon and neighboring communities to find out clinical manifestations, laboratory findings and the differences in clinical findings compared to previous studies. Methods : We reviewed the clinical records of the cases who were confirmed as malaria by peripheral blood smear in Chuncheon Sacred Heart Hospital from July, 1998 to Octorber, 2001. Results : Forty-four cases were included. All cases were Plasmodium vivax with high fever, but tertian fever developed only in 15 patients (35.7%). A number of cases showed various symptoms including headache, abdominal pain, nausea, vomiting. Of the all cases, 41 cases (93.2%) developed malaria between June and September. Thrombocytopenia was prominent finding which was noted in 75% of the cases at diagnosis, and recovered during or after treatment. Other laboratory abnormalities such as anemia, elevated transaminases, coagulopathies, and elevated LDH level were also noted. Five patients were performed CSF studies, one patient showed pleocytosis in CSF. Conclusion : We observed that only 15 patients (35.7%) had tertian fever, the others had variable fever patterns. Thrombocytopenia was the prominent findings. Therefore we suggest that malaria should be included in the differential diagnosis of febrile diseases which developed from June to September regardless of the fever patterns. (Korean J Med 63:546-551, 2002) Key Words : Malaria, Fever, Thrombocytopenia