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- 저자 : 최재기 ( Jae Ki Choi ) (검색결과 4 건)
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최현호 ( Hyun Ho Choi ),홍유아 ( Yu Ah Hong ),최재기 ( Jae Ki Choi ),김주상 ( Ju Sang Kim ),김승준 ( Seung Joon Kim ),김석찬 ( Seok Chan Kim ),이숙영 ( Sook Young Lee ),김영균 ( Young Kyoon Kim ),박성학 ( Sung Hak Park ),김태정 ( 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.4
There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.
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증례 : 혈액종양 ; All- trans retinoic acid 관해 유도 치료 후 중추신경계에서 재발한 급성 전골수성 백혈병 5예
김은옥 ( Eun Ok Kim ),길상현 ( Sang Hyun Gil ),최재기 ( Jae Ki Choi ),이현정 ( Hyun Jeong Lee ),김희제 ( Hee Je Kim ),이종욱 ( Jong Wook Lee ),민우성 ( Woo Sung Min ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2
급성 전골수성 백혈병은 특별한 세포의 형태, 전형적인 염색체 이상, 응고 장애 및 ATRA 치료에 반응이 좋은 것을 특징으로 하는 질환으로 일반적으로 중추신경계로의 재발은 흔하지 않다. 진단 당시 백혈구 증다증이 있는 경우에 중추신경계 재발의 위험이 증가하는 것으로 알려져 있으며 현재까지 중추신경계 재발에 대한 적절한 치료원칙은 정립되지 않은 상태이다. 저자들은 급성 전골수성 백혈병 환자 중 ATRA 치료 이후 세포학적 혹은 분자생물학적 재발을 동반하거나 동반하지 않은 중추신경계 재발 환자를 5예 경험하였다. 두부 방사선학적 검사에서 연수막 전이 소견을 보였으며 뇌척수액 검사에서도 전골수성 백혈병 세포의 침윤이 확인되었다. 환자들은 전신적 항암요법과 방사선 치료, 척수 항암치료로 치료를 받았으며 대부분은 삼산화비소로 유지치료를 받았다. 5예 중 1예에서는 2차 관해 이후 동종 조혈모세포이식을 시행 받고 안정된 경과를 유지하였다. Acute promyelocytic leukemia (APL) is distinguished from other subtypes of acute myeloid leukemia (AML) by its distinctive morphology, specific chromosomal abnormality, coagulopathy, and unique response to treatment with all-trans retinoic acid (ATRA). Central nervous system (CNS) involvement is rare in APL. Most CNS relapses occur in patients with hyperleukocytosis at initial presentation, and the optimal management of such patients is still controversial. We report five patients with APL who had CNS relapse with or without evidence of cytological and molecular disease of the bone marrow after ATRA treatment. Brain magnetic resonance imaging revealed leptomeningeal infiltration and cerebrospinal fluid examination showed the presence of promyelocytes. Patients were treated with a combination of systemic chemotherapy and radiotherapy with or without intrathecal chemotherapy, and most were subsequently treated with arsenic trioxide (ATO) as maintenance therapy. Among these patients, one received allogeneic stem cell transplantation in second complete remission. (Korean J Med 2011;80:231-237)
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증례 : 신장 ; Paroxetine 복용 후 발생한 항이뇨호르몬 분비이상 증후군 1예
김영수 ( Young Soo Kim ),김형욱 ( Hyung Wook Kim ),김영옥 ( Young Ok Kim ),안효준 ( Hyo Jun Ahn ),최재기 ( Jae Ki Choi ),윤선애 ( Sun Ae Yoon ) 대한내과학회 2010 대한내과학회지 Vol.79 No.6
저자들은 우울증으로 paroxetine을 투여받은 후 전신 쇠약 감과 저나트륨혈증이 발생한 환자에서 SIADH를 진단한 증례를 경험하여 국내 최초로 보고하는 바이다. Paroxetine is a well-known selective serotonin reuptake inhibitor, and has been reported to be advantageous for chronic pain control. Paroxetine is increasingly used for various types of chronic pain because of its safety; however, hyponatremia, or syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with paroxetine, has been reported. This complication is relatively rare, but some patients have presented with severe neurological symptoms. Here, we report the first case of SIADH associated with paroxetine in Korea. (Korean J Med 79:710-713, 2010)
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국내 혈액질환 환자에서 침습성 아스페르길루스증의 구제치료로서 Voriconazole의 효과와 안전성
권재철,김시현,최수미,최재기,이동건,박선희,최정현,유진홍,신완식 대한감염학회 2010 감염과 화학요법 Vol.42 No.1
Background: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in patients with hematologic malignancies. We investigated the efficacy and safety of voriconazole (VCZ) when used as salvage therapy for IA in Korean adults with hematologic malignancies who had not responded to prior antifungal therapy. Materials and Methods: We retrospectively reviewed data, collected from January 2007 to October 2008, from patients with proven or probable cases of IA. All were probable IA cases, except for one proven case. All cases were refractory or intolerant to antifungal therapy prior to administration of VCZ. Efficacy and safety were assessed in patients treated with VCZ for more than 3 days and for more than one dose, respectively. A favorable response [complete (CR) or partial (PR)] was defined by significant improvement of all clinical symptoms, signs, and radiologic abnormalities. Results: Fifty patients who met the inclusion criteria were enrolled. There were 27 male and 23 female patients with mean age of 44.4 years (range, 15-65 years). Underlying diseases were acute leukemia (35 cases), chronic myelogenous leukemia (4 cases), myelodysplastic syndrome (3 cases), lymphoma (3 cases) and other hematologic diseases (5 cases). Twenty-two patients had received chemotherapy and 13 patients had undergone hematopoietic stem cell transplantation. The lung was the main infection site (94%) followed by the sinus (6%). Amphotericin B deoxycholate alone was the most frequent previous antifungal therapy. The mean duration of antifungal therapy prior to VCZ therapy was 13.9±8.8 days (2-44 days). The median duration of VCZ therapy was 19 days (interquartile range, 49 days). Sixteen patients (32.0%) showed favorable responses (CR:PR=8:8) at the end of VCZ therapy. The numbers of patients with stable disease, progression and death were, 6 (12%), 6 (12%) and 22 (44%) respectively. Most of those with unfavorable responses had relapsed underlying malignancies or refractory graft versus host diseases. Twelve patients developed drug-related adverse events but only one patient stopped VCZ treatment prematurely. Conclusions: VCZ demonstrated an acceptable level of toxicity in patients with hematologic malignancies but further studies are required to prove its efficacy as salvage therapy.
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