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신진경 ( Jin Kyeong Shin ),권순석 ( Soon Seog Kwon ),박기훈 ( Ki Hoon Park ),이희정 ( Hee Joung Lee ),김용현 ( Yong Hyun Kim ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.2
Microscopic polyangiitis is a necrotizing vasculitis, characterized by inflammation of small vessels (capillaries, venules, and arterioles) with few or no immune deposits. The kidneys are the most commonly affected organs and are involved in 90% of patients, whereas pulmonary involvement occurs in a minority of cases (10% to 30%). In cases of lung disease, diffuse alveolar hemorrhage with pulmonary capillaritis is the most common manifestation. Microscopic polyangiitis is strongly associated with antineutrophil cytoplasmic autoantibody, which is a useful diagnostic serological marker. We report a case of microscopic polyangiitis presented as pleural effusion in a 67-year-old female. Pleural effusions have been reported in some cases previously, but the number of cases were small and their characteristics have not been well described. This report describes characteristic findings of pleural fluid and its histological features in a case of microscopic polyangiitis.
증례 : 내분비-대사 ; 말단비대증 환자에서 발생한 급성 림프구백혈병 1예
오영승 ( Young Seung Oh ),최민석 ( Min Seok Choi ),신진경 ( Jin Kyeong Shin ),권희선 ( Hee Sun Kwon ),손장원 ( Jang Won Son ),김성래 ( Sung Rae Kim ),유순집 ( Soon Jib Yoo ) 대한내과학회 2016 대한내과학회지 Vol.90 No.3
말단비대증은 성장호르몬의 과도한 증가로 인해 발생하는 드문 질환이다. 말단비대증 환자는 심혈관질환, 뇌혈관질환, 대사질환이 동반되어 기대수명이 감소한다. 또한 여러 연구를 통해 말단비대증에서 대장, 유방, 기관지와 갑상선에서 악성종양의 유병률이 증가하는 것이 보고되었다. 이러한 악성종양의 증가는 성장호르몬과 인슐린유사성장인자-1과 관련된 것으로 알려져 있다. 그러나 말단비대증에서 혈액암의 발생은 전 세계적으로 보고가 드물고 기전이 명확하지 않다. 저자들은 말단비대증을 진단받고 2년이 경과한 33세 여성에서 발생한 급성 림프구백혈병을 경험하여 국내에서 처음으로 보고한다. Acromegaly is a rare disorder caused by excessive amounts of growth hormone. The incidence of colorectal, breast, and thyroid carcinomas is increased in acromegaly. However, there have been few reports on hematological malignancies in acromegaly. We describe a patient who developed acute lymphoblastic leukemia during the course of acromegaly. A 35-year-old woman presented in February 2012 with unexplained lactation and amenorrhea for 4 months. Her growth hormone level was 12.6 μg/L, insulin-like growth factor 1 592.26 ng/mL, and prolactin 242 μg/L. A pituitary macroadenoma secreting GH and prolactin causing acromegaly was diagnosed. Considering her fertility, the dopamine agonist cabergoline 0.5 mg was administered in March 2012. In February 2014, she presented with cytopenia (hemoglobin 12.2 g/dL, white cell count 2.69 × 109/L, platelets 39 × 109/L) and hepatosplenomegaly. A bone marrow examination showed acute B cell lymphoblastic leukemia. She underwent chemotherapy and bone marrow transplantation. A follow-up bone marrow biopsy showed remission. (Korean J Med 2016;90:243-247)