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특발성 문맥압 항진증 환자에서 반복적인 간문맥과 상장간막정맥 혈전증
임금남 ( Keum Nam Rim ),손주현 ( Joo Hyun Sohn ),김현수 ( Hyun Soo Kim ),김태엽 ( Tae Yeob Kim ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),한동수 ( Dong Soo Han ) 대한내과학회 2008 대한내과학회지 Vol.75 No.3
Idiopathic portal hypertension (IPH) is characterized by portal hypertension and splenomegaly without portal vein obstruction or significant liver disease. Although IPH may occasionally be accompanied by portal vein thrombosis (PVT) and extrahepatic portal vein thrombosis (EHPVT), recurrent PVT and EHPVT are very rare in IPH. Herein, we report the case of a 30-year-old male who developed IPH with recurrent PVT and EHPVT. Eleven years earlier, the patient had undergone splenectomy and endoscopic sclerotherapy due to hypersplenism and esophageal variceal bleeding, respectively. Ten years earlier, the patient had suffered recurrent esophageal variceal bleeding, which was treated via band ligation, and was diagnosed with IPH via portography and liver biopsy. Then, 8 years prior to presentation, the patient complained of acute abdominal pain and was diagnosed with PVT and EHPVT. After a 6-month course of anticoagulation therapy, the PVT and EHPVT resolved completely. However, 8 years later, he complained again of abdominal pain and was diagnosed with recurrent PVT and EHPVT. (Korean J Med 75:337-342, 2008)
김지은 ( Ji Eun Kim ),방소영 ( So Young Bang ),안상봉 ( Sang Bong Ahn ),임금남 ( Keum Nam Rim ),김현수 ( Hyun Soo Kim ),엄완식 ( Wan Sik Uhm ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),유대현 ( Dae H 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.4
Objective: Juvenile rheumatoid arthritis (JRA) is classified as polyarticular, oligoarticular, and systemic onset type by clinical symptoms presented during first six months. This study was performed to investigate the clinical features and course of systemic onset JRA. Methods: We performed a retrospective study for patients who were diagnosed as JRA between March 2000 and March 2006 according to the JRA criteria of the International League of Association for Rheumatology (ILAR). Results: Of the 216 JRA patients, 33 patients (11 male/ 22 female) were systemic onset type. Because of insufficient data, 6 patients were excluded. Chief complaints at the time of diagnosis were fever (81.5%) and arthralgia (77.7%). During the disease course, all patients manifested fever and arthritis, rash (59.2%) and splenomegaly (22.2%) also occurred. Most patients had symmetric (81.5%) arthritis, and involved more than five joints (59.3%) including knee and wrist. Anemia, leukocytosis, and thrombocytosis were common laboratory abnormalities. Almost all patients had elevated level of C-reactive protein and erythrocyte sediment rate. Some patients had positive results about immunologic marker such as rheumatoid factor (3.8%), antinuclear antibody (57.7%), and antiperinuclear factor (9.5%). Therapeutic regimens included glucocorticoids (88.9%), nonsteroidal anti-inflammatory drugs (81.5%), methotrexate (81.5%), and hydroxychloroquine (55.6%). Biologic agents were applied in 5 patients, and 3 showed improvement of disease activity. Combination therapy was introduced in 18.5% of patients, and 63% of patients still required medications. Conclusion: In Korea, systemic onset JRA patients had variable clinical manifestations and chronic course of disease, which often extended into adulthood.
안상봉 ( Sang Bong Ahn ),한동수 ( Dong Soo Han ),은창수 ( Chang Soo Eun ),방소영 ( So Young Bang ),이영철 ( Young Chul Lee ),임금남 ( Keum Nam Rim ),이용구 ( Yong Gu Lee ),김태엽 ( Tae Yeob Kim ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.4
Intestinal hemorrhage, perforation, obstruction, and fistula formation are the common complications associated with intestinal tuberculosis. However, these complications usually occurr in active stage of intestinal tuberculosis. A 45-year-old man was diagnosed as intestinal tuberculosis and received anti-tuberculosis medications for 9 months. After the end of treatment, intestinal lesion was cured. However a deformed appendiceal orifice due to hypertrophic sear resulting in symptomatic appendictis was noted. We report a case of acute appendicitis due to intestinal stricture after the successful treatment of intestinal tuberculosis. (Korean J Gastroenterol 2007;50:277-279)