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증례 : 혈액종양 ; 폐정맥 폐색을 동반한 원발성 심장 골육종 1예
유은상 ( Eun Sang Yu ),강은주 ( Eun Joo Kang ),김홍준 ( Hong Jun Kim ),강가원 ( Ka Won Kang ),송지영 ( Ji Young Song ),전지호 ( Ji Ho Jeon ),김준석 ( Jun Suk Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.2
Primary cardiac osteosarcoma is extremely rare. We herein report a case involving a 31-year-old woman with a 2-week history of left upper trunk pain and hemoptysis. She was diagnosed with primary cardiac osteosarcoma with pulmonary vein obstruction and successfully treated via surgical resection and chemotherapy. (Korean J Med 2015,89:233-237)
경피적 관상동맥 중재술 이후 발생한 후천성 제5인자 결핍증 1예
유은상 ( Eun Sang Yu ),김대식 ( Dae Sik Kim ),최철원 ( Chul Won Choi ) 대한내과학회 2017 대한내과학회지 Vol.92 No.5
본 증례의 경우 1개월 전 심근경색으로 치료를 받았던 환자로, 혈변으로 내원하여 후천성 제5인자 결핍증을 진단받았으며, 제5인자 억제 인자 형성의 원인으로는 이전 입원시 시행한 경피적 관상동맥 중재술이 의심된다. 환자는 신선냉동혈장 수혈에 반응하지 않았지만, 스테로이드 치료에 좋은 반응을 보였으며 현재 스테로이드 투약을 중단한 채 경과 관찰 중 재발 소견은 확인되지 않고 있다. 이에 경피적 관상동맥 중재술 이후 발생한 후천성 제5인자 결핍증의 첫 번째 증례로 보고하는 바이다. Acquired factor V deficiency is extremely rare. Here we report the case of an 88-year-old female patient who presented with hematochezia 1 month after undergoing percutaneous coronary intervention. Her laboratory results showed an extremely prolonged prothrombin time and an activated partial thromboplastin time, but neither improved after fresh frozen plasma transfusion. She was finally diagnosed with acquired factor V deficiency and successfully treated with an immunosuppressant. (Korean J Med 2017;92:480-483)
신장 ; 경화성 피막성 복막염 환자에서 치료 중 병발된 세균성 복막염 2예
김홍준 ( Hong Jun Kim ),김지은 ( Ji Eun Kim ),강가원 ( Ka Won Kang ),유은상 ( Eun Sang Yu ),홍유아 ( Yu Ah Hong ),박진완 ( Jin Wan Park ),권영주 ( Young Joo Kwon ) 대한내과학회 2015 대한내과학회지 Vol.89 No.3
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis associated with a high mortality rate. Bacterial peritonitis (BP), a complication of EPS treatment, is uncommon, and treatments for BP are not well known. We report two patients who had undergone steroid treatment who developed BP after hemodialysis transfer. In the first case, we treated the BP with antibiotics and performed several surgical drainage procedures; however, the fluid became too thick to drain. This patient died of malnutrition and sepsis. In the second case, antibiotics and surgical enterolysis with peritonectomy were used to treat the BP. Solid food was accepted on day 7 postoperatively, and the patient was stable after 20 months. Thus, surgical enterolysis with peritonectomy may be a good treatment modality for patients with EPS and BP. (Korean J Med 2015;89:346-352)
혈액종양 : 원발 부위 불명암으로 발현된 호르몬 수용체 음성의 전이성 유방암 1예
김환일 ( Hwan Il Kim ),이강원 ( Kang Won Lee ),유은상 ( Eun Sang Yu ),김홍준 ( Hong Jun Kim ),송지영 ( Ji Young Song ),전지호 ( Ji Ho Jeon ),서재홍 ( Jae Hong Seo ) 대한내과학회 2015 대한내과학회지 Vol.89 No.6
A 37-year-old woman was admitted to our hospital because of cervical and axillary lymphadenopathy that developed after delivery. An axillary lymph node biopsy revealed metastatic adenocarcinoma. Immunohistochemical staining indicated that the tumor cells expressed c-ErbB-2, but were negative for the estrogen and progesterone receptors. No definite evidence of breast cancer was detected. The patient underwent chemotherapy for suspected metastatic breast cancer. She complained of swelling in the left breast 22 months later, and a biopsy showed invasive ductal carcinoma. Here, we report a case of hormone receptor-negative occult breast cancer in a patient with cervical and axillary lymphadenopathy presenting as a cancer with an unknown primary site. (Korean J Med 2015;89:728-732)