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항생제 치료로 유발된 혈액응고 제V인자에 대한 후천적 억제인자
임두호 ( Doo Ho Lim ),김태오 ( Tae Oh Kim ),정유문 ( Yumun Jeong ),김원장 ( Won Jang Kim ),박승정 ( Seung Jung Park ),이제환 ( Je Hwan Lee ),장성수 ( Sung Soo Jang ) 대한내과학회 2014 대한내과학회지 Vol.87 No.1
후천성 제V인자 억제인자는 드문 응고 장애 질환으로 무증상에서 중증 출혈 혹은 혈전증과 같은 다양한 임상 상을 보인다. 수술 전과 수술 중 우형 트롬빈의 사용, 항생제, 수혈, 최근의 수술, 악성 종양, 자가 면역 질환 등과 연관되어 발생하는 것으로 알려져 있으며 특별한 선행요인 없이 특발성으로 발현되기도 한다. 저자들은 다른 선행요인 없이 항생제 투여 후 제V인자 억제인자가 유발된 증례를 경험하였고 이는 국내에서 보고된 예가 없기에 문헌고찰과 함께 보고하는 바이다 Acquired factor V inhibitor is a rare condition with a variety of clinical manifestations that range from no bleeding symptoms to life-threatening hemorrhage or thromboembolic events. Treatment is determined by the clinical course and focuses on controlling the hemorrhagic event and decreasing the antibody titer if bleeding symptoms are present. We report herein a case involving a 70-year-old man who developed acquired factor V inhibitor after antibiotic administration (11-day course of ceftriaxone and successive 5-day course of piperacillin-tazobactam) for pneumonia. His condition was characterized by elevated prothrombin and activated partial thromboplastin times without bleeding events. Coagulation factor assays revealed undetectable factor V activity and a factor V inhibitor level of 3.29 Bethesda units. After cessation of the antibiotics, both the prothrombin and activated partial thromboplastin times gradually normalized. (Korean J Med 2014;87:105-109)
Invasive Thyroid Gland Aspergillosis in a Patient with Systemic Lupus Erythematosus
정지원,전재범,임두호 대한의학회 2018 Journal of Korean medical science Vol.33 No.20
A 29-year-old woman who was diagnosed with lupus nephritis and treated with steroid pulse therapy and cyclophosphamide two months ago, readmitted to our hospital because of fever. A computed tomography (CT) scan showed multiple cystic lesions in the thyroid gland and necrotic cervical and mediastinal lymphadenopathies. However, no parenchymal abnormalities were noted in either of the lungs (Fig. 1). We underwent an ultrasonography-
증례 : 호흡기 ; 낭종성 폐병변으로 내원하여 진단된 Birt-Hogg-Dube 증후군 2예
서명숙 ( Myeong Sook Seo ),임두호 ( Doo Ho Lim ),송준선 ( Joon Seon Song ),박찬식 ( Chan Sik Park ),채은진 ( Eun Jin Chae ),송진우 ( Jin Woo Song ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
Birt-Hogg-Dube (BHD) syndrome is a rare autosomal-dominant disease caused by germline folliculin (FLCN) mutations, characterized by fibrofolliculoma or trichodiscoma, renal tumors, and multiple lung cysts with or without spontaneous pneumothorax. Here, we report two cases of BHD syndrome that presented with bilateral pulmonary cysts. One patient was a 39-year-old woman who had a history of pneumothorax, multiple papules on her cheeks, and a family history of the same skin lesions and renal cell carcinoma in her father. BHD syndrome was confirmed by molecular tests that revealed a missense mutation in FLCN gene (exon 4, c.31T > C). The other patient was a 56-year-old man who showed FCLN gene polymorphism and typical radiopathological features of multiple cysts in the lung, but apparently no other manifestation. (Korean J Med 2014;87:477-483)
박수헌,김재광,정규원,최황,조성원,한준열,선희식,박두호,고승현,문건웅,임현선 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Eosinophilic gastroenteritis is a rare disorder of the stomach, small intestine and colon, characterized by variable eosinophilic infiltration of the bowel wall and peripheral blood eosinophilia, abnormal gastrointestinal symptoms and signs. The pathogenesis of this dis- ease still remains unknown, but several studies support allergic or immunologic etiology. Considerable variability in clinical presentation depends on the site of the gastrointestinal tract and the depth of bowel wall involvement. Herein we experienced a case of eosinophilic gastroenteritis confined to small intestine presenting progressive weight loss, abdominal pain and diarrhea. Enteroscopic findings showed diffuse multiple nodularity of mucosal folds in small bowel, especially duodenum and proximal jejunum. Jejunal and duodenal biopsy specimen demonstrated marked eosinophilic infiltration. These symptoms and signs were improved within 3 weeks after short course of prednisone therapy.
Kim Yena,Ahn Eunyoung,Sunggun Lee,임두호,Aran Kim,이승근,소민욱 대한의학회 2020 Journal of Korean medical science Vol.35 No.48
Background: The main barrier to the effective rheumatoid arthritis (RA) therapy is poor adherence. Coronavirus disease 2019 (COVID-19) pandemic have led to a significant change in the pattern and the number of medical visits. We assessed changing patterns of medical visits and no-show, and identified factors associated with no-show in patients with RA during COVID-19 pandemic. Methods: RA patients treated with disease-modifying antirheumatic drugs at least 6 months who had been in remission or those with mild disease activity were observed for 6 months from February to July 2020. No-show was defined as a missed appointment that was not previously cancelled by the patient and several variables that might affect no-show were examined. Results: A total of 376 patients and 1,189 appointments were evaluated. Among 376 patients, 164 patients (43.6%) missed appointment more than one time and no-show rate was 17.2% during COVID-19 pandemic. During the observation, face-to-face visits gradually increased and no-show gradually decreased. The logistic regression analysis identified previous history of no-show (adjusted odds ratio [OR], 2.225; 95% confidence interval [CI], 1.422–3.479; P < 0.001) and fewer numbers of comorbidities (adjusted OR, 0.749; 95% CI, 0.584–0.961; P = 0.023) as the independent factors associated with no-show. Conclusion: Monthly analysis showed that the no-show rate and the pattern of medical visits gradually changed in patients with RA during COVID-19 pandemic. Moreover, we found that previous history of no-show and fewer numbers of comorbidities as the independent factors associated with no-show.