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회복된 B형간염 환자에서 Rituximab 치료 이후 발생한 전격성 간부전을 동반한 B형간염 바이러스의 재활성화 1예
정승민 ( Seong Min Chung ),손주현 ( Joo Hyun Sohn ),김태엽 ( Tae Yeob Kim ),유기덕 ( Ki Deok Yoo ),안용우 ( Yong Woo Ahn ),배중호 ( Joong Ho Bae ),전용철 ( Yong Cheol Jeon ),최정혜 ( Jung Hye Choi ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.4
It is well known that the reactivation of hepatitis B virus (HBV) may occur as an acute hepatitis after chemotherapy or immunosuppressive therapy. Although most of these cases have been reported in HBsAg-positive patients, there have been a few reports of HBV reactivation in HBsAg-negative patients. There have been concerns for the need to screen the reactivation as well as anti-viral prophylaxis in HBsAg-negative patients with possible HBV occult infection who are planning to undergo chemotherapy or immunosuppressive therapy. Rituximab, an anti-CD20 monoclonal antibody, is effective in the treatment of non-Hodgkin`s lymphoma. However, rituximab can affect the immunity against HBV, consequently increasing viral replication. In fact, there have been reports of HBV reactivation after treatment with rituximab. Here, we report a case of HBV reactivation following rituximab plus systemic chemotherapy in diffuse large B cell lymphoma patient who was HBsAg negative, anti-HBs positive, and anti-HBc positive, ultimately leading to treatment-unresponsive fulminant hepatic failure.
유기덕 ( Ki Deok Yoo ),한동수 ( Dong Soo Han ),정승민 ( Seong Min Chung ),김선민 ( Sun Min Kim ),배중호 ( Joong Ho Bae ),은창수 ( Chang Soo Eun ),백승삼 ( Seung Sam Paik ),오영하 ( Young Ha Oh ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.2
Histiocytic sarcoma is a rare malignant neoplasm that originates from a histiocytic hematopoietic lineage characterized by histiocytic differentiation and its corresponding immunophenotypic features. Patients with histiocytic sarcoma usually have a poor prognosis due to its aggressive clinical behavior. Here we report a rare case of extranodal histiocytic sarcoma of the stomach which was confirmed through immunohistochemical staining. A 71-year- old man was presented with epigastric pain. Gastroscopy, abdominal CT, and EUS revealed a mass located on the posterior wall of upper body and fundus of the stomach. Grossly, grayish white solid masses were seen extending down to the submucosal layer. Microscopically, the tumor cells had eosinophilic cytoplasm, abundant vacuole, and mitosis. Immunohistochemical staining revealed that the tumor cells were positive for LCA, CD68, and lysozyme. Early detection and accurate diagnosis of this rare neoplasm is important because it can make a great difference in prognostic outcomes. To make an accurate and definitive diagnosis, immunohistochemical staining is essential in the confimation of histiocytic orign. (Korean J Gastroenterol 2010;55:127-132)
무증상 원발성 막성 신병증에 병발한 반월상 사구체 신염 1례
조아진 ( A Jin Cho ),이진희 ( Jin Hee Lee ),정병호 ( Byeong Ho Jeong ),정승민 ( Seung Min Chung ),이정은 ( Jung Eun Lee ),권기영 ( Gee Young Kwon ),허우성 ( Woo Seong Huh ),김윤구 ( Yoon Goo Kim ),김대중 ( Dae Joong Kim ),오하영 ( 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
Membranous glomerulopathy (MGN) is a common cause of nephrotic syndrome in adults. Renal failure gradually develops in patients with MGN and crescentic glomerulonephritis (CGN) superimposed on MGN is a rare cause of acute renal failure. In most cases patients showed nephrotic syndrome with acute renal failure. We report a 33-year-old woman with azotemia but with no other symptoms such as nephrotic syndrome she had been diagnosed to have MGN 15 months before. There seemed to be no other cause of azotemia. Renal biopsy was performed and revealed CGN on existing MGN. She was treated with immunosuppression treatment and azotemia was improved. When unexplained azotemia develops in patients with MGN, we should promptly investigate superimposed conditions including CGN. In CGN superimposed on MN, a potentially reversible condition with appropriate immunosuppression therapy should be considered.