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전신 스테로이드 치료 중 중증 근무력증 환자에서 발생한 다발성 발진성 피부섬유종 1예
박근휘 ( Geun-hwi Park ),김태욱 ( Taewook Kim ),박성민 ( Sungmin Park ),이현주 ( Hyun Joo Lee ),진현주 ( Hyunju Jin ),심우행 ( Woo-haing Shim ),김건욱 ( Gun-wook Kim ),김훈수 ( Hoon-soo Kim ),고현창 ( Hyun-chang Ko ),김병수 ( Byun 대한피부과학회 2019 대한피부과학회지 Vol.57 No.4
Dermatofibroma is a fibrohistiocytic tumor of the skin that commonly occurs as a solitary lesion on the lower extremities of young women. Multiple eruptive dermatofibromas (MEDFs), defined as the presence of 5 to 8 dermatofibromas appearing within a period of 4 months, are rare, and the etiology of MEDFs remains unknown. However, MEDFs are frequently thought to be associated with altered immunity, such as autoimmune diseases and immunosuppression. It is unclear why MEDFs occur in association with these conditions, but this relationship may suggest that MEDFs are the result of an abortive immunoreactive process. We herein describe a middle-aged woman who developed multiple dermatofibroma. She had myasthenia gravis for 8 years, and developed MEDFs after undergoing oral corticosteroid treatment (245 mg/week) for 3 months. Therefore, our case suggests that the use of immunosuppressants is a more dominant factor for the development of MEDFs than underlying autoimmune diseases. (Korean J Dermatol 2019;57(4):194∼196)
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외래에서 철 결핍 빈혈로 진단된 남자 환자의 악성 종양 유병률과 연관인자
이병현 ( Byung Hyun Lee ),이재중 ( Jae Joong Lee ),심재겸 ( Jae Kyeom Sim ),김정선 ( Jung Sun Kim ),김대식 ( Dae Sik Kim ),박세종 ( Seh Jong Park ),이세련 ( Se Ryeon Lee ),박용 ( Yong Park ),최철원 ( Chul Won Choi ),김병수 ( Byun 대한내과학회 2014 대한내과학회지 Vol.87 No.1
Background/Aims: Despite several reports on clinical aspects of anemia and malignancy, little is known of male patients with iron-deficiency anemia (IDA) and malignancy in Korea. We examined the cause of anemia, prevalence of and factors associated with malignancy, and treatment response to iron therapy in male IDA patients. Methods: The results of 202 males with IDA seen from March 2008 to June 2013 were analyzed retrospectively. The patients were divided into two groups based on the causes of anemia: the cancer group included patients with anemia caused by malignancy and the non-cancer group included patients with anemia due to other causes. We compared the clinical characteristics and response to iron therapy between the two groups. Results: The most common cause of IDA was bleeding (42.6%). The prevalence of malignancy was 11.9%, with colorectal cancer (58.3%) being the most common. Among the cancer patients (n = 24), 22 patients (91.7%) were age 50 or older. Independent factors associated with malignancy were old age (OR, 1.05; p = 0.026) and a positive stool occult blood test (OR, 7.48; p = 0.001). The treatment response to iron therapy based on a normalized hemoglobin level was lower in the cancer group (OR, 0.49; p = 0.31), but the difference did not reach statistical significance. The treatment response based on the mean hemoglobin level was significantly lower in the cancer group (12.6 ± 2.2 vs. 13.8 ± 1.6 g/dL, p = 0.016). Conclusions: Old age and a positive stool occult blood test were independent risk factors for malignancy in male IDA patients. We recommend screening for malignancy in patients older than 50 years or with a positive stool occult blood test. (Korean J Med 2014;87:53-60)
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김병수,장성종,부귀범,조운택,박찬국,김만우,변주남,김정용,전호종 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1
Small bowel leiomyoma is a rare tumor which may occur wherever smooth muscle is present. The small bowel is the most common site and it makes up 20~30% of all benign small intestinal neoplasms. A spectrum of symptoms are common ranging from nausea, vomiting, abdominal pain, to massive intestinal bleeding. Bleeding is the most common symptom and is usually gross and recurrent. Occasionally it may be life threatening. But, the most serious problem is both the absence of specific clinical symptoms, and the difficulties shown in radiological diagnostics of the small bowel. If conventional diagnostic methods fail to reveal any positive findings for gastrointestinal bleeding, the diagnosis of intestinal leiomyoma should be suspected and an SMA angiography shoud be performed. The angiographic criteria of small bowel leiomyoma is very characteristic. We present a case of leiomyoma with considerable and prolonged gastrointestinal bleeding, which was diagnosed by angiography. A 61-year old woman was admitted with a history of melena over the last 10 days. An SMA angiography showed a hypervascular mass with a diameter of 3×3cm. A segmental resection was performed under the impression of the gastrointestinal bleeding due to leiomyoma of the small bowel. Microscopic examination of the lesion shows interlacing or whorl bundles of spindle shaped ces and no mitosis.
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교육포부 형성과 유형에 관한 질적연구 : 의미 있는 타인과의 관계를 중심으로
변민경,김병수 이화여자대학교 사회과학연구소 2014 사회과학연구논총 Vol.30 No.1
이 논문은 교육포부 형성에 의미 있는 타인이 어떠한 영향을 미치는가를 분석하고 그 형성과정의 유형을 살펴보는 것을 목적으로 한다. 이를 위해 서울에 거주하는 중학생 20명을 대상으로 심층면접을 진행한 후, 수집된 자료를 Strauss 와 Corbin(1998)의 근거이론을 기반으로 하여 분석하였다. 개방코딩, 축코딩, 선택코딩의 절차에 따라 분석한 결과 의미 있는 타인과의 상호작용이 학생의 내재적·외재적 동기를 자극하고, 학생이 이를 받아들이는 태도에 따라 교육포부가 형성됨을 알 수 있었다. 이 과정에는 학생의 주변에 유사한 교육포부를 지닌 타인의 존재 정도와 자신의 교육포부 성취가능성을 평가하는 요소들도 영향을 미쳤다. 이 연구의 근거이론적 핵심범주는 ‘의미 있는 타인과의 상호작용을 통한 동기자극과 그 동기자극의 수용전략에 따른 교육포부 형성’이었다. 이러한 핵심범주에 따라 그 유형을 분류한 결과, 교육포부형성의 네 가지 유형(의지형, 순응형, 소극적 수용형, 소극적 반항형)이 도출되었다. 마지막으로 네 가지 유형별로 학생들에 대하여 어떠한 방식으로 진로지도를 하여야 하며 의미 있는 타인들이 어떠한 태도를 취해야 하는지를 논의하였다 This study aims to examine the extent to which significant others affect the formation of educational aspiration among middle school students, and also probe the types of the formation process of the educational aspiration. The data acquired from in-depth interviews for 20 middle school students in Seoul were analyzed based on grounded theory of Strauss and Corbin (1998). Following the coding process of the grounded theory (open coding, axial coding, selective coding) the result shows that educational aspiration is shaped by the intrinsic/extrinsic motivation prompted by the interaction with significant others and students' attitudes adopting impetus of motivation. In this process, educational aspiration is affected by the degree to which there are people having similar/dissimilar educational aspiration with students and by the factors related to the possibilities of achieving their educational aspiration. Therefore, the core category deriving from grounded theory in this study is that educational aspiration is formed from the motivation impetus stimulated by interaction with significant others and students' adopting mechanism for the impetus. As a result of classifying core category, it draws four types of educational aspiration: (proactive type, adaptive type, passive type, defiant type. Finally, we discuss career guidance strategies and proper attitudes for significant others by four different types of educational aspiration and proper attitudes for significant others.
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