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만성 폐쇄성 폐질환 환자에서 ST 분절 상승 심전도를 보인 자발성 기흉 1예
김지숭 ( Ji Soong Kim ),이은영 ( Eun Young Lee ),홍승표 ( Seung Pyo Hong ),오창교 ( Chang Kyo Oh ),이정훈 ( Jung Hoon Lee ),문인태 ( In Tae Moon ),손영석 ( Young Seok Sohn ),신정훈 ( Jeong Hun Shin ) 전북대학교 의과학연구소 2014 全北醫大論文集 Vol.38 No.2
Chest pain and dyspnea are the dominant manifestations in various acute chest conditions. Electrocardiography is one of the most important diagnostic tools used in the differential diagnosis of these conditions. In the majority of cases, electrocardiographic abnormalities suggest cardiac problems. However, there are many non-cardiovascular diseases that may affect electrocardiography. We experienced a case of a 60-year-old man who developed spontaneous pneumothorax associated ST-segment elevation on electrocardiography during the treatment of acute exacerbation of chronic obstructive pulmonary disease. Our case reminds us of the importance of meticulous physical examination as well as accurate analysis of uncommon electrocardiographic alterations.
증례 : 순환기 ; 아급성 관상동맥 스텐트 혈전증에서 Ticagrelor를 사용한 1예
고준권 ( Jun Kwon Ko ),김지숭 ( Ji Soong Kim ),정승준 ( Sung Jun Chung ),김성종 ( Seong Jong Kim ),김병식 ( Byung Sihk Kim ),김유신 ( You Shin Kim ),신정훈 ( Jeong Hun Shin ) 대한내과학회 2014 대한내과학회지 Vol.87 No.5
뇌졸중으로 아스피린과 클로피도그렐을 복용하던 71세 남자 환자에서 급성 하벽 심근경색증으로 관상동맥 중재술을 시행하였다. 시술 7일째 급성 호흡곤란 및 ST분절 상승 소견으로 시행한 관상동맥 조영술에서 스텐트 혈전증을 진단후 중재술을 시행하였다. 혈소판 기능 검사에서 Clopidogrel 저항성이 확인하였고 뇌졸중 과거력을 고려해 Ticagrelor로 구조요법(rescue therapy)을 시행한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Stent thrombosis (ST) is a rare but catastrophic complication of a drug-eluting stent. Although dual antiplatelet therapy with aspirin and clopidogrel significantly reduces the occurrence of ST, it continues to occur and is occasionally associated with clopidogrel resistance. Here, we describe a 71-yr-old man with subacute stent thrombosis and clopidogrel resistance following drug-eluting stent implantation who underwent successful ticagrelor rescue therapy. (Korean J Med 2014;87:598-602)
Gastric Syphilis and Membranous Glomerulonephritis
노민,손주현,김태엽,김성정,김지숭,정성준,표주연,오영하 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.3
Syphilis is a chronic systemic infectious disease caused by the bacterium Treponema pallidum. Gastric involvement and nephrotic syndrome are uncommon but well documented complications of syphilis, but the co-occurrence of these two complications in the same patient is extremely rare. Thus, because of their nonspecific presentation, suspicion of gastric syphilis (GS) and nephrotic syndrome is essential for diagnosis. Patients should be investigated thoroughly and a diagnosis made based on clinical, endoscopic, and histological findings, in order to initiate appropriate therapy. We report of a 34-year-old male patient with a history of epigastric pain and a diagnosis of GS and syphilis-associated membranous glomerulonephritis confirmed by gastroscopy and kidney biopsy, who was treated successfully with penicillin G benzathine. This case report provides information on the typical features of GS that should help raise awareness of this rare disease entity among clinicians, resulting in earlier diagnosis and administration of appropriate therapy.
이강록,노민,유미연,곽주희,홍승표,김지숭,김연재,배현주 대한감염학회 2015 Infection and Chemotherapy Vol.47 No.3
Human infection by Rhodococcus species is rare and mostly limited to immunocompromised hosts such as patients infected with the human immunodeficiency virus (HIV) or organ transplant recipients. The most common strain is R. equi, and the most common clinical presentation is pulmonary infection, reported in 80% of Rhodococcus spp. infections. The central nervous system is an uncommon infection site. We report a case of a patient with pneumonia, brain abscess, and recurrent meningitis caused by Rhodococcus spp. He initially presented with pneumonia with necrosis, which progressed to brain abscess and recurrent meningitis. Rhodococcus spp. was identified from the cerobrospinal fluid (CSF) collected during his fourth hospital admission. Despite prolonged treatment with appropriate antibiotics, meningitis recurred three times. Finally, in order to administer antibiotics directly into the CSF and bypass the blood-brain barrier, an Ommaya reservoir was inserted for administration of 90 days of intrathecal vancomycin and amikacin in conjunction with intravenous and oral antibiotics; the patient was finally cured with this treatment regimen.