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김세원(Sei Won Kim) 대한수면의학회 2023 수면·정신생리 Vol.30 No.2
Obstructive sleep apnea (OSA) is prevalent among the elderly, with incidence rising due to aging trends. Clinical manifestations in the elderly differ significantly, deviating from conventional risk factors such as male gender and obesity. Postmenopausal women experience a notable surge in OSA prevalence, while traditional features like snoring and high body mass index (BMI) di-minish. Limited evidence exists on elderly OSA progression, but untreated cases elevate stroke, cognitive decline, and heart fail-ure risks. Continuous positive airway pressure (CPAP) emerges as the most effective treatment. CPAP therapy proves effective for elderly OSA patients, enhancing sleep quality, addressing nocturia, and improving neurobehavioral outcomes. Elderly individ-uals often require lower CPAP pressures, with positive effects observed on cardiovascular risk factors and neurobehavioral dis-orders. Overcoming challenges like nocturnal awakenings and comorbidities, age does not significantly impact PAP adherence. Education, troubleshooting, and emphasizing therapy benefits are vital. Addressing adherence factors in the elderly, including depression, is pivotal. Individualized strategies, considering aging-related challenges and comorbidities, are imperative for suc-cessful PAP treatment in this population. Despite potential hurdles, PAP therapy remains a valuable intervention, even for those with dementia.
증례 : 호흡기 ; 특발성혈소판감소성자반증 환자에게 발생한 폐혈전색전증 1예
김승경 ( Seung Kyoung Kim ),강지영 ( Ji Young Kang ),최승화 ( Seung Hwa Choi ),홍유아 ( Yu Ah Hong ),김진석 ( Jin Seok Kim ),김세원 ( Sei Won Kim ),송정섭 ( Jeong Sup Song ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2
일반적으로 특발성혈소판감소성자반증과 같이 혈소판감소증이 있는 경우 출혈합병증이 아닌 심부정맥혈전증이나 폐혈전색전증과 같은 혈전성 질환이 발생하는 것은 드문 현상이다. 하지만 본 증례와 같이 특발성혈소판감소성자반증환자에서 혈전증이 합병되면서 항인지질증후군이 병발하는 경우가 있으므로 의심증상이 있을 때에는 적극적인 진단 및 치료가 필요하다. 저자들은 특발성혈소판감소성자반증 환자가 하지혈전증 및 폐혈전색전증이 발생하면서 항인지질증후 군이 진단되고, 항응고제 및 면억억제제를 동시에 투여하면서 효과적으로 치료된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Idiopathic thrombocytopenic purpura (ITP) is an autoimmune blood disorder haracterized by thrombocytopenia. Common clinical manifestations include bleeding events. Rarely, thrombotic complications may develop in ITP. A 43-year-old man was admitted with dyspnea. His platelet count at admission was 48,000/mm3. The patient had a history of ITP diagnosed 12 years earlier and had been treated with low-dose steroids. Two months before admission, he had been diagnosed with deep vein thrombosis and treated only with clopidogrel due to severe thrombocytopenia. Chest computed tomography showed filling defects in both pulmonary arteries. In the workup for precipitating factors, only lupus anticoagulant was positive. The concomitant administration of warfarin and methylprednisolone was used to treat the pulmonary thromboembolism and ITP, respectively. Six months later, the lupus anticoagulant test remained positive. The patient was confirmed to have a pulmonary thromboembolism due to antiphospholipid syndrome, which might be related to the underlying ITP. After 10 months, his symptoms and radiological findings had improved. (Korean J Med 2011;81:251-256)
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.
이재호 ( Jae ho Lee ),박성환 ( Sung Hwan Park ),박경수 ( Kyung Su Park ),김호연 ( Ho Youn Kim ),최우형 ( Woo Hyung Choi ),전병연 ( Byoung Yeon Jun ),민진수 ( Jin Soo Min ),김세원 ( Sei Won Kim ),정연오 ( Yeon Oh Jeong ),지은혜 ( E 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.4
Ankylosing spondylitis (AS) is occasionally accompanied by hematological malignancies such as myelodysplastic syndrome, acute myelogenous leukemia, or multiple myeloma. Chronic myelogenous leukemia (CML) is a myeloproliferative disorder associated with Philadelphia chromosome and is usually treated with imatinib, which inhibits tyrosine kinases. Although there have been reports of CML cases accompanied by several rheumatic diseases such as rheumatoid arthritis, Behcet`s disease, systemic sclerosis, or undifferentiated spondylopathy, no studies have reported a case of CML with AS. We experienced a 50-year-old male patient who presented with buttock and low back pain and was diagnosed with both AS and CML. Magnetic resonance imaging showed sacroiliitis along with abnormal marrow infiltration, and a bone marrow biopsy confirmed the CML diagnosis. He was treated with imatinib, which was effective for the CML but not for the AS. This is the first case report of AS accompanied by CML.