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증례 : 호흡기 ; 폐암 진단 과정 중 발견된 기도 내 연골종 1예
임선미 ( Sun Mie Yim ),강지영 ( Ji Young Kang ),강현희 ( Hyeon Hui Kang ),이수연 ( Soo Yeon Lee ),김경희 ( Kyung Hee Kim ),최수진 ( Su Jin Choi ),이상학 ( Sang Haak Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Tracheal chondromas are very rare benign cartilaginous tumors. We present the first case report, to our knowledge, of a tracheal chondroma in Korea. A 73-year-old male was referred to our hospital for a mass in the left lung. Flexible bronchoscopy was performed to evaluate the lung mass and incidentally found a tracheal mass as well. A biopsy and histological examination of the tracheal mass revealed a chondroma. (Korean J Med 2012;82:352-356)
증례 : 호흡기 ; 임산부에서 발생한 원발성 폐암 1예
고선혜 ( Sun Hye Ko ),강현희 ( Hyeon Hui Kang ),임선미 ( Sun Mie Yim ),황유미 ( You Mi Hwang ),지은혜 ( Eun Hye Ji ),오유석 ( You Suk Oh ),이상학 ( Sang Haak Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.1
A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial Lung biopsy confirmed primary Lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal Lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother`s brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with Lung cancer. (Korean J Med 2012;82:85-89)
다발내분비샘종양1형 환자에서 다른시기에 발생한 유방의 관상피내암과 가슴샘종 -1예 보고
김은혜 ( Eun Hye Kim ),이양원 ( Yang Won Lee ),장수선 ( Su Sun Jang ),송미애 ( Mi Ae Song ),김상배 ( Sang Bae Kim ),임선미 ( Sun Mie Yim ),박기훈 ( Ki Hoon Park ),송정섭 ( Jeong Sup Song ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1
Though a wide series of sporadic tumors has already been explored for multiple endocrine neoplasia type 1 (MEN1), the occurrence of ductal carcinoma in situ (DCIS) of the breast and thymoma in MEN1 has never been reported so far. Here, we present a43-year-old woman who was referred to evaluate incidentally detected breast mass. Four years prior, she was diagnosed with primary hyperparathyroidism due to parathyroid hyperplasia, type AB thymoma and diabetes mellitus. Recently, right breast mass and adrenal mass was detected. Wide local excision of the breast mass and laparoscopic left adrenalectomy was performed. Histologically, the breast mass was DCIS and the adrenal mass was adrenal cortical carcinoma. This is the first case presenting metachronuosly occurred DCIS of the breast and thymoma in MEN1.
외상 후 발생한 Mycobacterium intracellulare에 의한 만성 관절염 1예
김재경 ( Jae Gyung Kim ),김대원 ( Dae Won Kim ),조율희 ( Yul Hee Cho ),임선미 ( Sun Mie Yim ),강주현 ( Ju Hyun Kang ),주영빈 ( Young Bin Joo ),강현희 ( Hyeon Hui Kang ),송정섭 ( Jeong Sup Song ),윤형규 ( Hyoung Kyu Yoon ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.2
While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.
결핵성 공동으로 오인된 외상 후 발생한 가성 폐낭종 1예
이현정 ( Hyun Jeong Lee ),강지영 ( Ji Young Kang ),임선미 ( Sun Mie Yim ),지은혜 ( Eun Hye Ji ),김지현 ( Ji Hyun Kim ),김세원 ( Sei Won Kim ),이상학 ( Sang Haak Lee ),문화식 ( Hwa Sik Moon ),이배영 ( Bae Young Lee ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.5
A traumatic pulmonary pseudocyst is a rare complication of blunt thoracic trauma. The clinical symptoms and signs are similar to other respiratory diseases, such as pulmonary tuberculosis. Therefore, a trauma history with the resulting radiologic and clinical findings is important for making a diagnosis. A 26-year-old male was admitted to our hospital due to cough for 3 days. The chest x-ray revealed diffuse infiltrations and a cavitary lesion at the left lung. His left chest had hit a tree as a result of motorcycle accident one day before admission. Initially, it was assumed that his symptoms and chest X-ray might be due to a tuberculosis infection. However, bronchoscopy revealed old blood clots at both lungs, particularly in the left lower lobe bronchus. A transbronchial lung biopsy showed alveolar hemorrhage. A traumatic pulmonary pseudocyst was diagnosed from his trauma history and these findings. Computed tomography of the chest performed 4 months later showed regression of the cavitary lesion.
증례 : 순환기 ; 좌심실 부전과 심낭 압전을 유발한 급성 화농성 심낭염 1예
최수진 ( Su Jin Choi ),정우백 ( Woo Baek Chung ),김현진 ( Hyun Jin Kim ),임선미 ( Sun Mie Yim ),최윤석 ( Yun Seok Choi ),박철수 ( Chul Soo Park ),이만영 ( Man Young Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.2
호흡곤란을 주소로 내원한 85세 남자 환자에서 폐렴과 동반한 심비대 소견이 관찰되었고, 심초음파 소견에서 중등도의 심낭 삼출액으로 인한 삼출성 협착 심낭염과 중증의 좌심실 부전이 관찰되었다. 입원 경과 중 심인성 쇼크로 진행하였고, 수축촉진제(inotropic agent) 투여 및 IABP 삽입하여도 쇼크 상태가 회복되지 않았으나, 심낭 천자 및 배액술을 시행한 후 즉시 활력 징후가 안정화되었다. 심낭 삼출액 배양 검사에서 폐렴구균(Streptococcus pneumoniae)이 동정되었다. 항생제 개발 이후 폐렴구균에 의한 심낭염은 매우 드문것으로 알려져 있고, 좌심실 부전까지 유발하는 경우는 보고된 바가 없었다. 저자들은 급성 화농성 심낭염으로 인하여 중등도 심낭 삼출 및 심낭 압전과 좌심실 부전을 경험하였기에 문헌고찰과 함께 보고하는 바이다. An 85-year-old male visited our hospital because of dyspnea. Chest radiography showed marked cardiomegaly and pneumonic infiltration. Transthoracic echocardiography showed moderate pericardial effusion, which resulted in effusive constrictive pericarditis and severe left ventricular systolic dysfunction. During the hospital course, the patient developed cardiogenic shock and was treated with an inotropic agent and intra-aortic balloon pump. The patient`s vital signs were stabilized after pericardiocentesis and drainage. A yellowish purulent pericardial effusion was drained and Streptococcus pneumoniae was isolated. Bacterial purulent pericarditis was not uncommon before the antibiotics era, but it is extremely rare nowadays. Here, we report a case of purulent bacterial pericarditis presenting with severe left ventricular systolic dysfunction and cardiac tamponade. (Korean J Med 2012;82:221-226)
심한 오목가슴 환자에서 우심실 눌림에 의한 심장 카켁시아
김재형 ( Jae Hyung Kim ),김수정 ( Su Jung Kim ),조은주 ( Eun Joo Cho ),최규영 ( Kyu Young Choi ),임선미 ( Sun Mie Yim ),장경윤 ( Kyung Yoon Chang ),전현지 ( Hyun Ji Chun ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
External compression of the right ventricle (RV) due to a depressed sternum in patients with pectus excavatum is uncommon. Moreover, mid-RV obstruction-induced cachexia rarely occurs in patients with pectus excavatum. We report a case of cardiac cachexia caused by significant RV compression in a patient with pectus excavatum. (Korean J Med 2012;83:637-640)