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전신성 홍반성 루푸스 및 이차성 항인지질항체 증후군 환자의 재발성 무도병 2예
심기식 ( Ki Shik Shim ),백주은 ( Joo Eun Back ),김석현 ( Seok Hyun Kim ),박기종 ( Ki Jong Park ),이윤종 ( Yun Jong Lee ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.2
Chorea is an uncommon movement disorder of systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APLS). It frequently develops early in the course of SLE and is not recurrent in most patients. In this report, we presented the clinical features of two cases of recurrent chorea secondary to APLS associated with SLE. A 24 year-old woman with SLE for 10 years was admitted because of choreic movement involved both extremities, facial and neck muscles. She had the same episode 1.5 years ago. Laboratory investigation showed increment in SLE activity, prolongation of aPTT without correction by mixing with normal plasma, and positive lupus anticoagulant. Brain MRI and SPECT revealed no evidence of ischemic change. The second case, a 36-year-old lady with SLE for 8 years, was admitted due to recurrent dysarthria. On physical examination, she had choreic movement involved neck and tongue. The activity of her disease increased and lupus anticoagulant was positive. Brain MRI showed infarct in insular cortex and multiple high signals in the frontal and occipital lobes. In both cases, haloperidol rapidly brought their symptom under control. We describe the first cases of secondary APLS-related recurrent movement disorder in Korea and review the literatures.
증례 : 소화기 ; 낭액 CA 19-9 및 CEA 증가를 동반한 진성 비장낭종 1예
심기식 ( Ki Shik Shim ),김현진 ( Hyun Jin Kim ),문인규 ( In Kyu Moon ),정경아 ( Kyoung Ah Jung ),김태효 ( Tae Hyo Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한내과학회 2009 대한내과학회지 Vol.76 No.3
True non-parasitic splenic cysts are rare. Series have reported over 30 cases of true splenic cysts producing elevated serum CA 19-9 levels. A 27-year-old woman presented with a painless mass in her left upper abdomen. Computed tomography (CT) of the abdomen showed a 16-cm cyst in the spleen. The serum CA 19-9 and CEA levels were 432 U/mL and 1.67 ng/mL, respectively. The cystic fluid CA 19-9 and CEA levels were markedly elevated. A splenectomy was performed. The pathology showed a benign true epidermoid cyst, which was negative for CEA. The serum CA 19-9 level returned to normal after removing the splenic cyst. This is the first reported case of a true benign splenic cyst producing high levels of CA 19-9 and CEA in Korea. (Korean J Med 76:348-351, 2009)
위장관염과 장간막 림프절병증으로 발현한 제한성 베게너 육아종증 1예
정용근 ( Yong Geun Jeong ),김태효 ( Tae Hyo Kim ),이창민 ( Chang Min Lee ),심기식 ( Ki Shik Shim ),문인규 ( In Kyu Moon ),이상일 ( Sang Il Lee ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5
Wegener`s granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis. (Korean J Gastroenterol 2010;55:331-335)