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증례 : 혈액종양 ; Steroid와 Cyclophosphamide로 치료한 후천성 제5인자 결핍증
하승혜 ( Sung Hae Ha ),김정희 ( Jung Hee Kim ),장성열 ( Sung Yeol Jang ),황정아 ( Jeong Ah Hwang ),손희정 ( Hee-jung Sohn ),연재우 ( Jae-woo Yeon ) 대한내과학회 2012 대한내과학회지 Vol.82 No.1
후천성 제5인자 결핍증은 드문 출혈성 질환으로, 무증상 에서부터 생명을 위협하는 중증 출혈을 유발하기도 한다. 치료로는 신선냉동혈장 및 혈소판 수혈, 혈장분리교환술, 면역 억제요법 등이 이용되고 있다. 저자들은 특발성 후천성 제5인자 결핍증으로 후복막강 출혈이 발생한 환자에게 steroid와 cyclophosphamide를 투여하여 성공적으로 치료하였으며, 이는 국내에서 보고된 예가 없기에 문헌고찰과 함께 보고하는 바이다. Acquired factor V deficiency is a rare bleeding disorder, the severity of which ranges from mild to fatal. There are various suggested treatments, including transfusion of fresh frozen plasma (FFP) or platelets, plasmapheresis and immunosuppressive therapy. We encountered a case of idiopathic acquired factor V deficiency with fatal retroperitoneal bleeding treated with steroid and cyclophosphamide. (Korean J Med 2012;82:105-109)
장성열 ( Sung Yeol Jang ),김정희 ( Jung Hee Kim ),하승혜 ( Sung Hae Ha ),황정아 ( Jeong Ah Hwang ),박상종 ( Sang Jong Park ),백소야 ( So Ya Paik ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.3
There are various etiologies of duodenojejunitis such as Henoch-Schonlein purpura (H-S purpura), vasculitis, Crohn`s disease, celiac sprue, ischemia, lymphoma, Zollinger-Ellison syndrome, bacteria or parasite infection, radiation, drug induced jejunitis, eosinophilic jejunitis, and toxins. A 31-year-old man presented with left upper quadrant pain. He did not have febrile sense, hematochezia, melena, diarrhea, arthralgia and hematuria. He had neither drug history nor traveling history. Esophagogastroduo-denoscopy showed diffuse mucosal erythema and segmental hemorrhagic erosions on the distal area to the descending portion of the duodenum and proximal jejunum, which were commonly observed in the gastrointestinal involvement of H-S purpura. However, he showed no skin lesions, joint and urologic problems until the discharge. Autoimmune markers such as antinuclear antibody and antineutrophil cytoplasmic antibody were negative. Celiac and mesenteric angiogram showed no vascular abnormality. After the administration of oral prednisolone 40 mg daily for therapeutic trial, abdominal pain and endoscopic lesions were improved. He experienced relapses of same episode without skin lesions 16 times during follow-up of 8 years, which were also treated with prednisolone. The abdominal computed tomography during the follow-up also showed no significant finding. We report a case of primary recurrent duodenojejunitis similar to the gastrointestinal involvement of H-S purpura without purpura.
간암으로 오인된 Castleman 병: 증례 보고 및 문헌 고찰
장성열 ( Sung Yeol Jang ),김보현 ( Bo Hyun Kim ),김정희 ( Jung Hee Kim ),하승혜 ( Sung Hae Ha ),황정아 ( Jeong Ah Hwang ),연재우 ( Jae Woo Yeon ),김기호 ( Ki Ho Kim ),백소야 ( So Ya Paik ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.1
Castleman`s disease is a rare disease characterized by lymph node hyperplasia. Although Castleman`s disease can occur wherever lymphoid tissue is found, it rarely appears in the abdominal cavity, and is especially rare adjacent to the liver. Here, we report a rare case of Castleman`s disease in the portal area that mimicked a hepatocellular carcinoma (HCC) in a chronic hepatitis B patient. A 40 year-old woman with chronic hepatitis B presented with right upper quadrant discomfort. Computed tomography and magnetic resonance imaging results showed a 2.2 cm-sized, exophytic hypervascular mass in the portal area. HCC was suspected. However, histologic examination revealed Castleman`s disease. We suggest that Castleman`s disease should be included as a rare differential diagnosis of a hypervascular mass in the portal area, even in patients with chronic hepatitis B. (Korean J Gastroenterol 2012;59:53-57)
10년 동안 추적 관찰한 심재성 낭종성 위염에 동반된 위선종의 내시경 점막하박리술
김정희 ( Jung Hee Kim ),장성열 ( Sung Yeol Jang ),황정아 ( Jeong Ah Hwang ),하승혜 ( Sung Hae Ha ),최원규 ( Won Gyu Choi ),박주상 ( Ju Sang Park ),한은미 ( Eun Mee Han ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.5
Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection. (Korean J Gastroenterol 2012;59:366-371)
이기종 ( Ki Jong Lee ),서지현 ( Ji Hyun Suh ),안영 ( Young Ahn ),하승혜 ( Sung Hae Ha ),박주상 ( Ju Sang Park ),장은정 ( Eun Jeong Jang ),박상종 ( Sang Jong Park ),김상중 ( Sang Jung Kim ),박상운 ( Sang Woon Park ),백현욱 ( Hyun 한국정맥경장영양학회 2011 한국정맥경장영양학회지 Vol.4 No.1
Purpose: In Korea, the prevalence of metabolic syndrome has increased. The relationship between metabolic syndrome, adiponectin, and dietary components is widely known. However, the relation between cytokine and dietary components is not yet well studied in Korea. Methods: Five hundred and ninety-six Korean adults between 30 and 59 years of age were recruited by advertisement to the Bundang Jesaeng General Hospital (BJGH), and those not taking regular medications and without diagnoses of fulminant disease were included. Data was collected on anthropometric measurements, diagnostic parameters for metabolic syndrome (MetS), and 3-day dietary intakes from individuals in the study. Results: Serum adiponectin level was positively correlated with serum HDL-cholesterol level and was negatively correlated with BMI, waist circumference, and systolic and diastolic blood pressure. Intake of dietary fiber was high in the high-adiponectin group. Conclusion: High-fiber diet and adiponectin can be helpful for improving metabolic syndrome. (JKSPEN 2011; 4(1):16-20)