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인지기능 저하 노인에서 베타아밀로이드 양전자방출단층촬영의 효용성에 대한 증례군 보고 및 고찰
오지훈,나세정,이승엽,이해국,이경욱,권용실,안류연,이성용,이정태 대한노인정신의학회 2016 노인정신의학 Vol.20 No.1
The aim was to evaluate the diagnostic utility of beta-amyloid positron emission tomography (PET) in elderly patients with cognitive impairment in the clinical setting. Five subjects underwent beta-amyloid PET imaging to explore the cerebral beta-amyloid deposition. The two male patients with minor neurocognitive disorder due to Alzheimer’s disease, who displayed similar degree of cognitive impairment and medial temporal atrophy but different in apolipoprotein E4 status, both showed negative for beta-amyloid PET. On the other hand, a female major neurocognitive disorder due to probable Alzheimer’s disease patient was tested positive for beta-amyloid PET, with increased beta-amyloid density in frontal and parietal lobes. Beta-amyloid PET was also used for the differential diagnosis of neurocognitive disorder from other psychiatric disorders in two elderly patients. The results were negative but assisted the diagnositic confirmation. A female patient was determined to be a case of late-onset schizophrenia and a male patient was determined as delirium due to minor traumatic brain injury, persistent. Beta-amyloid PET imaging was able to demonstrate cerebral beta-amyloid deposition in major neurocognitive disorder due to probable Alzheimer’s disease in visual scale. However, further studies are needed for its clinical utility in the minor neurocognitive disorders. Moreover, beta-amyloid PET imaging may provide additional information in diagnosing primary psychiatric disorders with new onset in the old age.
PTEN Mutation Identified in Patient Diagnosed with Simultaneous Multiple Cancers
원혜성,장은덕,나세정,황인용,이동수,유선형,김용석,김정수 대한암학회 2019 Cancer Research and Treatment Vol.51 No.1
PTEN hamartoma tumor syndrome is a spectrum of disorders characterized by unique phenotypic features including multiple hamartomas caused by mutations of the tumor suppressor gene PTEN. Cowden syndrome and Bannayan–Riley–Ruvalcaba syndrome are representative diseases, and both have several common clinical features and differences. Because PTEN mutations are associated with an increased risk of malignancy including breast, thyroid, endometrial, and renal cancers, cancer surveillance is an important element of disease management. We report a germline mutation of the PTEN (c.723dupT, exon 7) identified in a young woman with a simultaneous occurrence of breast cancer, dermatofibrosarcoma protuberans, and follicular neoplasm. This case suggests that it is critical for clinicians to recognize the phenotypic features associated with these syndromes to accurately diagnose them and provide preventive care.
Pseudocirrhosis of Breast Cancer Metastases to the Liver Treated by Chemotherapy
이수림,장은덕,나세정,김정수,안호정,고윤호,원혜성 대한암학회 2014 Cancer Research and Treatment Vol.46 No.1
Pseudocirrhosis refers to a condition that shows changes in hepatic contour thatmimic cirrhosis radiographically in the absence of the typical histopathologicalfindings of cirrhosis. This condition has been observed in patients with cancermetastatic to the liver, both in those who have undergone prior systemic chemotherapyand those who have not. Pseudocirrhosis may cause difficulty in interpretationof the response to chemotherapy and hepatic decompression and complication ofportal hypertension have a negative effect on the prognosis. We report on a case ofbreast cancer with liver metastases that showed cirrhotic changes during diseaseprogression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucosepositron emission tomography/computed tomography (PET-CT). We alsoperformed ultrasound-guided liver biopsy and confirmed tumor infiltration with severedesmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosisthrough histopathological findings and the role of PET-CT in evaluation of the responseto chemotherapy in patients with pseudocirrhosis.
최지연 ( Jiyeon Choi ),김영옥 ( Young Ok Kim ),원유동 ( Yoodong Won ),나세정 ( Sae Jung Na ) 대한내과학회 2020 대한내과학회지 Vol.95 No.3
Flash pulmonary edema is characterized by a sudden episode of dyspnea resulting from acute pulmonary venous congestion, which resolves rapidly. We report a case of renal artery stenosis presenting as flash pulmonary edema in a patient with solitary kidney treated by angioplasty with stent implantation. A 75-year-old man with solitary kidney visited the emergency room with acute shortness of breath. His blood pressure had risen to 206/90 mmHg and a chest radiograph revealed pulmonary edema. Echocardiography and coronary arteriography showed no clear abnormalities, but abdominal computed tomography revealed severe focal stenosis in the left proximal renal artery. A captopril renal scan found that the time to peak and half-time of radioactivity were delayed in the left kidney. Percutaneous transluminal angioplasty was performed, followed by stent implantation. After this procedure, the stenotic segment was completely dilated and blood pressure returned to the normal range. (Korean J Med 2020;95: 205-210)
Hye Sung Won,김용석,Jeong Soo Kim,장은덕,나세정,In Yong Whang,이동수 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.6
Background/Aims: We evaluated the efficacy of docetaxel and epirubicin as neoadjuvant chemotherapy in locally advanced breast cancer and assessed the predictive factors for response to neoadjuvant chemotherapy and prognostic factors related to relapse-free survival. Methods: Forty patients who received docetaxel and epirubicinas neoadjuvant chemotherapy for locally advanced breast cancer were evaluated retrospectively. Neoadjuvant chemotherapy consisted of intravenous injection of 75 mg/m2 docetaxel and 60 mg/m2 epirubucin on day 1, every 21 days, and two to six cycles. Results: Twenty-five (62.5%) patients showed a partial response, and 15 (37.5%) patients showed a stable disease in the first response evaluation after two or three cycles of neoadjuvant chemotherapy. In the second response evaluation of nine patients who received six cycles of neoadjuvant chemotherapy, one patient achieved a complete response, but two patients with hormone receptor-negative, human epidermal growth factor receptor 2-positive breast cancer experienced disease progression. Twenty-five (62.5%) patients experienced downstaging after neoadjuvant chemotherapy. Patients with > 20% pretreatment Ki-67 and decrease of Ki-67 between pre- and post-neoadjuvant chemotherapy showed a trend for better response. In multivariate analysis, advanced pathological stage showed a significant negative effect on relapse-free survival. Conclusions: Docetaxel and epirubicin neoadjuvant chemotherapy showed a good response in locally advanced breast cancer. Pretreatment Ki-67 and change of Ki- 67 may play a role as predictive factor for response to neoadjuvant chemotherapy.