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타목시펜과 프레드니솔론으로 호전된 경화성 피막성 복막염 (sclerosing encapsulating peritonitis)
정지윤 ( Ji Yoon Jung ),장원익 ( Won Ik Jang ),윤지현 ( Ji Hyun Yoon ),김의식 ( Eui Sik Kim ),정사라 ( Sa Rah Chung ),최대은 ( Dae Eun Choi ),나기량 ( Ki Ryang Na ),이강욱 ( Kang Wook Lee ),강대영 ( Dae Young Kang ),신영태 ( Young 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.6
Sclerosing encapsulating peritonitis (SEP) is an uncommon but serious complication of long-term peritoneal dialysis (PD). Entrapment of the intestine in fibrous tissue, causing complete intestinal obstruction, is referred to as SEP. The usual clinical presentation is with partial or complete small bowel obstruction, ascites, abdominal mass, or impaired peritoneal ultrafiltration. Conservative treatment carries a poor outcome and surgery has offered variable results. Even though there is no established medical treatment, immunosuppressive drugs, steroid and tamoxifen are often used. Tamoxifen is a nonsteroidal anti-estrogenic drug commonly used in the management of breast cancer. To our knowledge, this is the first case of sclerosing encapsulating peritonitis successfully treated with tamoxifen and prednisolone in Korea. Recently, we have treated three SEP patients with tamoxifen and prednisolone. All three patients showed clinical improvement within a few months.
국소 및 경구 스테로이드 제제의 사용과 연관된 인식도 비교 연구
정지윤 ( Ji Yun Jung ),신요섭 ( Yo Sup Shin ),조은별 ( Eun Byul Cho ),박은주 ( Eun Joo Park ),김광호 ( Kwang Ho Kim ),김광중 ( Kwang Joong Kim ) 대한피부과학회 2017 대한피부과학회지 Vol.55 No.4
Background: Topical and oral steroids are widely prescribed in dermatology. While interest in steroid use has increased rapidly, people have also acquired misinformation that causes rampant fears. Objective: To identify fears and misunderstandings about steroid use by comparing doctors` attitudes and treatment and non-treatment group experiences with steroid use. Methods: A total of 346 participants including outpatients who visited the Department of Dermatology at Hallym University Sacred Heart Hospital, physicians who work at the hospital, and visitors to its Department of Occupational and Environmental Medicine completed questionnaires. Results: The topical treatment group had a high response rate of 46.7% regarding feeling “somewhat anxious” about using topical steroids, while the oral treatment group had a high response rate of 53.8% regarding feeling “somewhat anxious” about using oral steroids. With respect to information about the adverse effects of steroid use, those in the non-experience group obtained their information mostly from the Internet (67.5%) or the media (47.5%), whereas those in the topical treatment group obtained their information from product guides (48%) and doctors (38.7%). Meanwhile, the oral treatment group acquired information from acquaintances (39.7%) or doctors (32.1%). Conclusion: Dermatologists must evaluate the validity of the information that patients have about the adverse effects of topical and oral steroid use as well as the resulting phenomenon of steroid phobia. If the information possessed by patients is inaccurate, clinicians must provide a full understanding and proper education to enhance patient satisfaction and treatment compliance and success rates. (Korean J Dermatol 2017;55(4):227∼236)
지은정 ( Eun Jung Ji ),손혜연 ( Hyae Yeon Son ),김시내 ( Shi Nae Kim ),이용우 ( Yong Woo Lee ),장재혁 ( Jae Hyuk Chang ),정지윤 ( Ji Youn Chung ),문종수 ( Chong Soo Moon ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.11
Actinomyces species are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. Actinomycosis is uncommon and often presents as a complication of an intrauterine device (IUD). IUD and pessaries facilitate the access of the microorganisms to the pelvis. Almost 85% of cases occur in women who have had an IUD in place for 3 or more years. In fact, the detection rate of Actinomyces in patients with pelvic actinomycosis is as low as 2%. The diseases caused by Actinomyces spp. is often of difficult diagonsis. The diagnosis of actinomycosis can be confirmed by culture. However, it is often difficult to culture Actinomyces. Therefore a diagnosis of actinomycosis can be made from the finding of sulfur granules within inflammatory exudate on histologic examination after surgery. However, it may be possible to diagnose actinomycosis before surgery by the finding of Actinomyces-like organisms on Papanicolaou smears. The endometrial involvement is extremely rare. The authors report an unusual case of endometrial infection by Actinomyces in a 21 year-old female without intercourse, admitted into the institute with menorrhagia. She had received oral pills. Abdominal ultrasonography showed a endometrial thickening. The pre-diagnosis was endometrial hyperplasia. The endometrial biopsy was done. The sample from the endometrium developed actinomycosis. After procedure and treatment, the menorrhagia was disappeared.
지은정 ( Eun Jung Ji ),한정미 ( Jung Mi Han ),문철용 ( Cheol Yong Moon ),정지윤 ( Ji Youn Jung ),남은숙 ( Eun Sook Nam ),장봉림 ( Pong Rheem Jang ),이근영 ( Keun Young Lee ),권용일 ( Yong Il Kwon ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.8
Meigs` syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated CA 125 in Meigs` syndrome is unusual clinical condition reported in few cases. We report here, a 49-year-old postmenopausal woman with right ovarian fibrothecoma with ascites, right pleural effusion and high serum levels of CA 125. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA 125 levels probably have malignant ovarian tumors, Meigs` syndrome must be considered in the differential diagnosis.
정지윤 ( Ji Yoon Jung ),구은주 ( Eun Joo Goo ),이재창 ( Jae Chang Lee ),송재이 ( Jay Song ),고성애 ( Sung Ae Koh ),이경희 ( Kyung Hee Lee ),배영경 ( Young Kyung Bae ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2
Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.
Benign Acute Childhood Myositis (BACM)으로 진단된 환아에서 임상양상, 혈액검사에 대한 고찰
정지윤(Ji Yoon Jeong),강은경(Eun Kyeong Kang),김도현(Do Hyun Kim),김지현(Ji Hyun Kim),나소영(So Young Na),이정하(Jung Ha Lee),조성민(Sung Min Cho) 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.2
목적: 양측 하지의 통증과 보행장애로 소아청소년과에 내원하여 BACM으로 의심되거나 진단된 환자들의 임상양상과 혈액검사 간의 연관성을 살펴 보기 위해서 본 연구를 시행하였다. 방법: 2010년 1월 1일부터 2016년 12월 31일까지 동국대학교 일산병원에 내원한 환아 중 갑작스런 발열과 더불어 근육통의 임상적 증거가 있으면서 근효소 검사를 시행한 환자를 대상으로 임상양상, 혈액검사 소견을 후향적으로 조사하였다. 결과: 총 환자는 29명(남 21명, 여 8명)이고 평균 연령은 5.5세였다. 발열기간은 평균 4.2일, 발열이 시작된 후 근염 발현까지의 기간은 평균 3.2일이었다. 근염 증상의 평균 회복기간은 2.4일, 평균 재원기간은 2.2일이었다. 발열, 양측 종아리 근육통이 가장 흔한 증상이었으며, 그 외에 기침, 콧물, 인후통, 두통, 복통이 나타났다. BACM의 원인 병원체로는 influenza B 감염이 23명(79.3%)으로 가장 많았다. 발열 이후 증상이 나타나기까지 시간이 짧을수록 CK, myoglobin, AST, ALT 값이 높게 나타났으며, 통계적으로 유의하였다. [CPK (r =-0.472), myoglobin (r=-0.472), AST (r=-0.443, ALT (r=-0.459)] 통증 기간이 길수록 WBC가 낮게 나타났다. (r=-0.655)결론: Influenza B 감염이 BACM의 가장 흔한 원인이다. 발열부터 증상 발현까지의 시간과 WBC 수치는 BACM에서 근육 관련 효소 수치와 증상 지속 시간과 관계가 있다. Purpose: This study was performed to review the relationship between the clinical features and laboratory findings of patients suspected of benign acute childhood myositis (BACM) in children and adolescents with bilateral calf pain and gait disturbances. Methods: From January 1, 2010 to December 31, 2016, the clinical and laboratory findings of patients who visited Dongguk University Ilsan Hospital with the sudden onset fever and muscle pain were retrospectively examined. Results: The total number of patients was 29 (21 males and 8 females), and their mean age was 5.5 years. The mean duration of fever was 4.2 days. The mean duration from the onset of fever to show the symptom was 3.2 days. The mean recovery period from myositis was 2.4 days. The mean duration of hospitalization was 2.2 days. Fever and bilateral calf pain were the most common symptoms; however, cough, rhinorrhea, sore throat, headache, and abdominal pain were also observed. The causative agent of BACM was influenza B infection in 23 (79.3%) of the cases. Creatinine phosphokinase (CPK), myoglobin, aspartate aminotransferase (AST), and alanine transaminase (ALT) values were higher in the shorter duration of fever and were statistically significant. The following values were noted: CPK (r=-0.472), myoglobin (r=-0.472), AST (r=-0.443), and ALT (r=-0.459). The longer the pain period, the lower the white blood cell (WBC) count (r=-0.655). Conclusion: BACM is mostly associated with the influenza B virus. Time to onset of symptoms after fever and WBC levels are related to muscle enzyme levels and duration of symptoms in BACM.
목정은(Jung Eun Mok),정지윤(Ji Yoon Jung),나준희(Jun Hee Na),김종혁(Jong Hyeok Kim),김봉희(Bong Hee Kim),허주령(Joor Rung Huh),김용만(Yong Man Kim),김영탁(Young Tak Kim),남주현(Joo Hyun Nam) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.12
N/A Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).
조은별 ( Eun Byul Cho ),이민경 ( Min Kyung Lee ),정지윤 ( Ji Yun Jung ),박은주 ( Eun Joo Park ),김광호 ( Kwang Ho Kim ),김광중 ( Kwang Joong Kim ) 대한피부과학회 2016 大韓皮膚科學會誌 Vol.54 No.5
Although the coexistence of vitiligo and psoriasis is well known and considered not unusual, psoriasis localized exactly on vitiliginous lesions has been rarely reported. We report a 13-year-old girl with erythematous scaly plaques localized only on the depigmented vitiliginous patches after narrow-band UVB therapy. Biopsy samples were taken from the areas where the new erythematous plaques occurred. Considering the clinical findings and the biopsy results, our case corresponds to psoriasis co-localized with vitiligo. After the patient discontinued phototherapy and started oral cyclosporine, the psoriatic lesions improved. We report a rare case of psoriasis arising strictly on vitiligo lesions. (Korean J Dermatol 2016;54(5):385∼388)
증례 : 혈액종양 ; 심근 및 전신의 연조직을 침범한 Richter 증후군의 1예
구은주 ( Eun Joo Goo ),김민경 ( Min Kyoung Kim ),공은정 ( Eun Jung Kong ),고성애 ( Sung Ae Koh ),구미진 ( Mi Jin Gu ),정지윤 ( Ji Yoon Jung ),현명수 ( Myung Soo Hyun ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
Richter 증후군은 만성 림프구백혈병이 공격적인 림프종으로 전환되는 것을 의미한다. Richter 증후군의 빈도는 2-10%정도이며, 동아시아에서는 만성 림프구백혈병의 빈도가 드물기 때문에 국내에서 Richter 증후군이 보고된 경우는 매우드물다. Richter 증후군에서는 주로 림프절과 골수의 침범을 보이며 드물게 림프절 외 장기의 침범을 보인다. 만성 림프구백혈병을 진단받은 42세 남자 환자가 2년 6개월 후 양쪽 허벅지와 엉덩이에 종괴가 만져져서 병원을 방문하였다. 양전자방출단층촬영에서 피하, 근육 및 심근에 FDG 섭취증가를 보였으며 조직검사 결과 광범위큰B세포림프종으로 전환된Richter 증후군으로 진단되었다. R-CHOP 항암요법을 6회 시행 후 완전관해되었으나 3개월 뒤 재발하였다. 본 환자는 만성 림프구백혈병에서 광범위큰B세포림프종으로 전환된 Richter증후군으로 진단되었으며 피하 및 근육을 침범하는 드문 경과를 보였기에 문헌고찰과 함께 보고하는 바이다. Richter’s syndrome refers to the development of aggressive lymphoma in a patient with chronic lymphocytic leukemia (CLL). It occurs in about 2% to 10% of patients with CLL. The most frequent manifestation of Richter’s syndrome is diffuse large B cell lymphoma (DLBCL). Extranodal involvement is rare but can occur. The prognosis of Richter’s syndrome is very poor. We herein report a case of a rare presentation of Richter’s syndrome. A 42-year-old man diagnosed with CLL 2 years previously developed nodules on the bilateral thighs and buttocks. A positron emission tomography (PET)-CT scan revealed high fluorodeoxyglucose uptake in multiple lymph nodes, skeletal muscles, and the myocardium. An ultrasonography-guided biopsy confirmed Richter’s syndrome from CLL to DLBCL. The patient was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy. After six cycles of chemotherapy, we performed a PET-CT scan that revealed a complete response. However, 3 months later, the syndrome recurred. The patient was undergoing salvage chemotherapy at the time of this writing. (Korean J Med 2016;90:163-168)