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Grave`s 병 환자에서 발생한 심한 임상 경과를 보인 E형 간염 1예
이제수,김호정,이승훈,김동휘,최원석 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
ABASTRACT Hepatitis E (HEV) is an enterically-transmitted acute viral hepatitis which is caused by infection with hepatitis E virus. The illness often resembles that associated with other hepatotropic viruses and is usually self-limiting; in some cases, the disease progresses to acute liver failure. The infection is particularly severe in pregnant women. Patients with chronic liver disease and superimposed HEV infection can present with severe liver injury, the so-called acute-on-chronic liver failure. Chronic hepatitis E has been reported among immunosuppressed persons, in particular solid organ transplant recipients. We report here atypical clinical presentation of HEV case with extremely high liver enzyme in Grave``s disease.
이제수 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4
저자들은 단순 복부 불쾌감 및 우하복부에서 종괴가 만져지는 듯한 양상을 보인 남자 환자에서 검사를 진행하는 과정에서 상피세포 표지자인 pancytokeratin과 신경원성 표지자인 neuron specific enolase, 간엽조직 표지자 desmin과 vimentin에서 모두 양성을 보이는 비전형적 양상과 함께, 내시경상 검사상 외벽으로부터 눌리는 듯한 모습을 보이지만, 정상 점막을 보이는 결합조직형성 소원형 세포종양을 확진한 증례를 경험하였기에 문헌 고찰과 함께 보고 하는 바이다. Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive neoplasm that involves the abdominal and pelvic cavities in relatively young man. We experienced a 31-year-old man with right lower quadrant discomfort for 1 month. Normal mucosa with external compressing mass was found in colonoscopy and liver metastasis occurred with peritoneal carcinomatosis in CT evaluation. Histological finding showed nests of undifferentiated tumor cells were surrounded by fibrous stroma. The tumor cells had small hyperchromatic nuclei with inconspicuous nucleoli. Immunohistochemical staining for vimentin, pancytokeratin, NSE, desmin were all positive. We report here on a case of atypical DSRCT with immunohistochemistic and endoscopic finding arising from intra-abdominal cavity.
만성 알코올성 췌장염 환자에서 총정맥 영양공급 치료 중에 발생한 베르니케 뇌병증 1예
최원석;김호정;강성환:최정우;김동휘;이기성;김재승;이승훈;이제수:송영주 중앙대학교 의과대학 의과학연구소 2012 中央醫大誌 Vol.37 No.1/2
Wernicke's encephalopathy is an acute neurological disorder which arises as a result of thiamine deficiency. It is most commonly associated with alcohol misuse and is also seen in a number of medical conditions. Acute pancreatitis can rarely be a predisposing condition to develop Wernicke's encephalopathy. Long fasting, severe vomiting and total parenteral nutrition without thiamine supplementation can result in thiamine deficiency during this illness. We report a case of Wernicke's encephalopathy developed during management of chronic pancreatitis in a 61-year-old man. It needs special attention to nutritional aspects such as thiamine deficiency for a patient with pancreatitis