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Impact of Acute Kidney Injury on Survival in Patients With Chronic Hepatitis C
( Hankyu Jeon ),( Jae Heon Kim ),( Sang Soo Lee ),( Hee Jin Kim ),( Ra Ri Cha ),( Hyun Chin Cho ),( Jae Min Lee ),( Chang Yoon Ha ),( Hyun Jin Kim ),( Tae Hyo Kim ),( Woon Tae Jung ),( Ok-jae Lee ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1
임상 연구 : 다중검출 컴퓨터 단층촬영으로 측정한 한국 성인의 정상 신장 용적과 길이
권순효 ( Soon Hyo Kwon ),이호영 ( Ho Young Lee ),김나리 ( Na Ri Kim ),전진석 ( Jin Seok Jeon ),노현진 ( Hyun Jin Noh ),김용배 ( Yong Bae Kim ),김정훈 ( Jung Hun Kim ),한동철 ( Dong Cheol Han ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6
목적: 신장의 크기는 급성 및 만성 콩팥병의 진단에 중요하다. 신장크기 측정의 가장 정확한 방법은 신장의 용적 측정이나, 국내에서 신장 길이와 비교한 신장 용적에 대한 조사는 없었다. 이에 저자들은 다중검출 컴퓨터 단층촬영 (multidetector-row computed tomography, MDCT)을 이용하여 신장용적과 길이를 측정하였다. 방법: 순천향대학교 병원에서 123명을 대상으로 시행한 복부 MDCT의 단면 사진들을 이용하여 3차원 재구성 프로그램 (VoxelPlus 2.0, Mevisys, Daejeon, Korea)으로 신장 용적을 측정하였다. 관상면 사진에서 양쪽 신장의 길이를 측정하였으며, 단층 영상의 신장 크기는 신장의 문부 (hilum)가 보이는 단층영상에서 신장의 외연을 포함하는 직사각형의 넓이와 높이의 합으로 측정하였다. MDRD 공식에 의하여 90 ml/min/1.73m2 이상인 경우를 대상 환자로 하였다. 결과: 신장 용적은 남자 177±34 mL, 여자 146±28 mL이었으며, 나이별 신장 용적은 차이가 없었다. 신장의 길이는 왼쪽 10.5±0.9 cm, 오른쪽은 10.0±0.8 cm이었다. 신장의 단층영상의 크기는 왼쪽은 10.8±1.1 cm, 오른쪽은 10.7±1.0 cm이었다. 신장 용적은 단층영상의 신장의 크기와 매우 높은 상관관계를 보였다 (r=0.80). 결론: MDCT를 이용하여 한국인의 정상 신장 용적과 길이를 제시할 수 있었다. 단순히 신장 길이를 측정하는 것보다 신장 용적을 측정하는 것이 만성 콩팥병의 진단과 치료에 도움이 될 것으로 생각된다. Purpose: Kidney length and volume are important parameters in the diagnosis of kidney disease. There has been no study for kidney volume in Korea. Therefore, we investigated the normal kidney volume and length using multidetector-row computerized tomography (MDCT). Methods: One hundred and twenty-three Koreans were scanned for various medical reasons by MDCT. We measured kidney volume with three dimensional reconstruction programs. In the coronal section, we measured the craniocaudal length of both kidneys. Cross sectional kidney size was defined the sum of both sides of the rectangle enclosing the kidney at the level of the renal (hilum) vessel. Patients were excluded when they have the estimated GFR, calculated by modification of diet in renal disease, less than 90 ml/min/1.73m2, diabetes, any urinary abnormalities, renal anatomical abnormality, renal artery disease, more than three cysts and larger than 3 cm of cyst. Results: Kidney volumes were 177±34 mL for men and 146±28 mL for women. There were no volume differences among age groups. Kidney lengths were 10.5±0.9 cm for left and 10.0±0.8 cm for right. The cross sectional kidney size was 10.8±1.1 cm for left and 10.7±1.0 cm for right. There was a high correlation between the kidney volumes and the cross sectional sizes (r=0.80). Conclusion: We suggest the reference values for kidney volume and length using MDCT. Measurement of kidney volumes may be more helpful to determine diagnosis and treatment of chronic kidney disease as compared with that of simple measuring kidney length.
Metastatic colon cancer mimics HELLP syndrome in pregnancy
( Soohyun Oh ),( Hyo Jeong Ahn ),( Byoung Jae Kim ),( Kyu Ri Hwang ),( Taek Sang Lee ),( Hye Won Jeon ),( Sun Min Kim ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Colorectal cancer(CRC) is rare in pregnant women. Common symptoms include bleeding, abdominal pain, nausea, constipation, and anemia. These symptoms are commonly seen in pregnancy and confused with physiologic changes of pregnancy. This makes early diagnosis of CRC difficult and cancer to spread. We present a 34-year-old pregnant woman who was revealed to have advanced CRC with hepatic metastasis. She was referred to our clinic due to right upper quadrant (RUQ) pain with dichorionic diamniotic twin fetuses at 27+6 weeks of gestation. Her blood pressure 123/91 mmHg. Estimated fetal weight (EFW) of F1 was 1258 g, which was close to average, but EFW of F2 was 773 g (5th percentile=789) and suitable for fetal growth restriction. Umbilical artery Doppler of F2 showed absent of end-diastolic flow. She was hospitalized for maternal and fetal surveillance and workup for preeclampsia. Laboratory testing showed anemia, elevated liver enzyme and LDH, and proteinuria (Hb 9.5g/dL, AST 87 IU/L, LDH 1660 IU/L, random urine protein/creatinine ratio 0.32). She was presumed to have severe preeclampsia, also known as HELLP syndrome. After admission, her diastolic blood pressure was maintained at a level not exceeding 100 mmHg and there were no headache or blurred vision symptoms, but she complained of continuous stabbing RUQ pain, of which NRS scale was 2-5 points. She underwent liver ultrasonography and it showed multiple hyperechoic masses, considered as multinodular hepatocellular carcinoma or multiple metastasis. For further evaluation and management of maternal malignancy, she delivered twin female infants at 28+2 weeks of gestation on March 15th. After delivery, abdominopelvic computed tomography and colonoscopic biopsy revealed colon cancer with multiple metastasis, consistent with stage IV. Now She is under palliative chemotherapy.
증례 : S상 결장암에 동반된 부신생물 말초 호산구증가증 1예
이나리 ( Na Ri Lee ),전승민 ( Soung Min Jeon ),차병효 ( Byung Hyo Cha ),박길효 ( Kil Hyo Park ),이종섭 ( Jong Sup Lee ),문도호 ( Do Ho Moon ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 S상 결장암에 동반된 말초 호산구 증가증이 있는 56세 환자에서 간 및 주위 임파선에 다수 전이가 되어 예후가 불량했던 환자 1예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Eosinophilia is most commonly associated with allergic disorders or parasitic infestation. However, collagen vascular diseases, drug reactions, radiation therapy, and many types of human cancer are also associated with extensive eosinophilia. Peripheral eosinophilia associated with malignancy is a marker of extensive metastasis and is thus associated with a poor prognosis. A 56-year-old male presented with history of right upper quadrent pain and weight loss. Total white blood count was 29,800/㎣ with 69.2% eosinophilia. Abdominal ultrasonogram showed multiple metastasis in liver and abdominal CT scan showed paraaortic lymph node enlargement. Colonoscopy and biopsy revealed moderate to poorly differentiated adenocarcinoma in sigmoid colon. (Korean J Med 69:S753-S757, 2005)
자기공명영상에 의한 자궁내막암의 자궁근층 , 자궁경부 침윤 판별과 수술적 병기와의 비교
전용탁(Yong Tark Jeon),황규리(Kyu Ri Hwang),김재원(Jae Weon Kim),박노현(Noh Hyun Park),송용상(Yong Sang Song),강순범(Soon Beom Kang),이효표(Hyo Pyo Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.9
N/A Objective : The aim of this study was accuracy evaluation of MRI in prediction of myometrial, cervical invasion in endometrial carcinoma by comparing with histopathologic findings and to find causes of inaccurate MRI readings. Method : Fifty patients with endometrial carcinoma who were evaluated with MRI imaging prior to surgery were reviewed. And then, we compared MRI findings and histopathologic findings in view of myometrial, cervical invasion. Results : Overall accuracy of MRI in prediction of myometrial invasion was 48%. Sensitivity/specificity/ PPV/NPV in prediction of no myometrial invasion were 100%/42.9%/42.9%/100% respectively, in prediction of superficial myometrial invasion were 20.0%/86.7%/50.0%/61.9% respectively, in prediction of deep myometrial invasion were 33.3%/94.3%/71.4%/76.7%, respectively. Accuracy in prediction of cervical invasion was 84% and sensitivity/specificity/PPV/NPV were 50.0%/88.6%/37.5%/92.9% respectively. Among the probable causes of inaccurate MRI readings, polypoid tumor occupies large portion. Conclusion : MRI has some value in pre-operative evaluation of patients with endometrial carcinoma. We should cautiously accept the MRI readings when tumor shows polypoid growth.