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증례 : 호홉기 ; 호산구성 염증을 동반한 기관지 협착이 폐암으로 오인된 증례 1예
홍원정 ( Won Jung Hong ),박치영 ( Chi Young Park ),고은정 ( Eun Jung Ko ),조상호 ( Sang Ho Cho ),정소영 ( So Young Chong ),정혜철 ( Hye Cheol Jeong ) 대한내과학회 2014 대한내과학회지 Vol.87 No.6
We report a very unusual case of endobronchial involvement of eosinophilic inflammation. A 58-year-old woman visited our clinic complaining of cough. A chest computed tomography scan showed a poorly enhancing mass compressing both main bronchi in the subcarinal area. Bronchoscopy also showed stenosis of the two main bronchi with irregular mucosal thickening. A bronchoscopic endobronchial mucosal biopsy revealed eosinophilic inflammation without evidence of malignancy. The subcarinal mass disappeared after systemic steroid treatment. This is the first report of mass-forming eosinophilic infiltration involving the central airway mimicking primary lung cancer. (Korean J Med 2014,87:733-737)
정상 심기능을 보이는 노인 환자에서 정형외과 수술 전 NT-proBNP의 역할
고은정 ( Eun Jung Ko ),문재연 ( Jae Youn Moon ),임영민 ( Yeong Min Lim ),홍원정 ( Won Jung Hong ),신석표 ( Suk Pyo Shin ),김상훈 ( Sang Hoon Kim ),양우인 ( Woo In Yang ),성정훈 ( Jung Hoon Sung ),김인재 ( In Jai Kim ),임상욱 ( San 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Background/Aims: Preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) is a useful predictor of postoperative cardiovascular complications. The present study investigated whether blood NT-proBNP values are suitable for predicting postoperative cardiovascular complications after non-cardiac surgery in elderly patients showing normal left ventricular (LV) function on preoperative echocardiograms. Methods: This study was performed by analyzing the medical records of elderly patients referred to the cardiology department for the purpose of assessing their cardiac function before orthopedic surgery. Of the patients who underwent echocardiography and NT- proBNP assessment simultaneously, 275 patients aged ≥ 70 years and with an LV ejection fraction of ≥ 55% were included in the study. Results: Major adverse cardiac and cerebrovascular events (MACCEs) occurred in 33 (12%) of the 275 patients, and the NT-proBNP concentration was higher in patients with complications than in those without complications (1,904.20 ± 2,300.23 vs. 530.58 ± 882.27 pg/mL, p < 0.01). The ROC area under the curve was 0.756 (95% confidence interval 0.701-0.805, p < 0.001) with an optimal cutoff of 416.3 pg/mL (69.7% sensitivity, 67.36% specificity). A multivariate analysis showed that a preoperative age of > 80 years (odds ratio, 2.313; p = 0.047) and an increased blood NT-proBNP concentration (odds ratio, 3.189; p = 0.009) were independent risk factors for the prediction of MACCEs. Conclusions: Although elderly patients scheduled to undergo non-cardiac surgery may show normal LV systolic function on echocardiography, measurement of their preoperative blood NT-proBNP concentration is useful for predicting MACCEs occurring after non-cardiac surgery. (Korean J Med 2014;87:302-310)
임영민 ( Yeong Min Lim ),박치영 ( Chi Young Park ),홍원정 ( Won Jung Hong ),김광일 ( Gwang Il Kim ),정소영 ( So Young Chong ),오도연 ( Do Yeun Oh ) 대한내과학회 2014 대한내과학회지 Vol.86 No.5
혈구 감소 정도에 비해 경도의 골수섬유증을 동반한 원발성 자가면역 골수섬유증 1예로 스테로이드 및 소량의 면역억제제 사용으로 양호한 혈액학적 소견을 유지하고 골수섬유증의 호전을 보였다. 이 원발성 자가면역 골수섬유증은 선행하는 자가면역 질환이 없고 범혈구 감소증 및 자가면역항체 양성, 골수섬유화증의 증거가 있을 때 감별진단의 하나로 고려해야 할 것이다. Primary autoimmune myelofibrosis, the development of which is not preceded by a well-defined autoimmune disease, has recently been defined as a distinct clinicopathologic syndrome. We report herein a case of a 68-year-old woman who was diagnosed with primary autoimmune myelofibrosis and present a review of the literature. The patient manifested peripheral pancytopenia, was positive for autoantibodies, and developed myelofibrosis with no preceding autoimmune or hematologic disorders. Her condition was dramatically improved after administration of prednisolone. (Korean J Med 2014;86:632-636)