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Mycobacterium Abscessus 폐질환의 치료
전병우 ( Byung Woo Jhun ),고원중 ( Won-jung Koh ) 대한내과학회 2019 대한내과학회지 Vol.94 No.4
Mycobacterium abscessus is the second most important pathogen in pulmonary disease caused by nontuberculous mycobacteria (NTM), following Mycobacterium avium. Mycobacterium abscessus is classified into three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. Mycobacterium abscessus is the most difficult to treat NTM due to its resistance to many antibiotics. Treatment should include an initial regimen of 2-3 injectable and oral antibiotics for several weeks or months, followed by inhaled amikacin and 1-3 oral antibiotics, depending on the subspecies and drug susceptibility patterns, including macrolide susceptibility. The continuation phase should be continued for a minimum of 12 months after culture conversion. Suitable injectable antibiotics include amikacin, imipenem, cefoxitin, and tigecycline, while oral antibiotics include macrolides (azithromycin or clarithromycin), clofazimine, linezolid, and moxifloxacin. Surgery can be a useful adjunctive therapy for some patients with refractory disease. However, the overall treatment prognosis is still unsatisfactory. Therefore, novel and more effective interventions are required for the treatment of M. abscessus pulmonary disease. (Korean J Med 2019;94:343-352)
전병우 ( Byung Woo Jhun ),김다민 ( Da Min Kim ),박지현 ( Ji Hyeon Park ),유홍석 ( Hong Seok Yoo ),심훈보 ( Hun Bo Shim ),김진국 ( Jhin Gook Kim ),한정호 ( Joung Ho Han ),권오정 ( O Jung Kwon ) 대한결핵 및 호흡기학회 2012 Tuberculosis and Respiratory Diseases Vol.72 No.1
Blastomyces dermatitidis is a dimorphic fungus that causes the systemic pyogranulomatous disease known as blastomycosis. Blastomycosis most often involves the lungs, skin, and may involve nearly every organ in the body. It is difficult, however, to diagnose blastomycosis in the early stage of pulmonary disease because clinical manifestations are varied from subclinical infection to acute respiratory distress syndrome. Since blastomycosis is often accompanied by granulomatous inflammation in histopathologic findings, differentiation from other etiologic diseases is important. We report a case of a 45-year-old male with pulmonary blastomycosis who had been misdiagnosed with tuberculosis for 3 months.
호흡 세기관지염 연관 간질성 폐질환환자에서 확인된 비소세포폐암
전병우 ( Byung Woo Jhun ),김다민 ( Da Min Kim ),박지현 ( Ji Hyeon Park ),정현애 ( Hyun Ae Jung ),송림화 ( Lim Hwa Song ),한정호 ( Joung Ho Han ),정만표 ( Man Pyo Chung ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.3
Respiratory bronchiolitis-associated interstitial lung disease is one of the smoking-related interstitial lung diseases. Histopathologically, it shows respiratory bronchiolitis, which is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles, accompanying peribronchiolar inflammation. Clinically, it is presented with respiratory symptoms such as a cough, sputum and dyspnea on exertion. It is well known that the incidence of malignancy in interstitial lung disease is high, but in respiratory bronchiolitis-associated interstitial lung disease the report of accompanying malignancy is rare. Here we report a case of a 60-year-old male heavy smoker presented with a cough, sputum and clubbing finger. A chest computed tomography (CT) of the patient did not show any shadow suspected of malignancy, but adenocarcinoma was found on a transbronchial lung biopsy and on a surgical lung biopsy with respiratory bronchiolitis-associated interstitial lung disease.
황련으로 만든 한약 복용 후 발생한 급성 간손상을 동반한 간질성 폐렴
전병우 ( Byung Woo Jhun ),김다민 ( Da Min Kim ),박지현 ( Ji Hyeon Park ),정현애 ( Hyun Ae Jung ),송림화 ( Lim Hwa Song ),한정호 ( Joung Ho Han ),정만표 ( Man Pyo Chung ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.6
So far more than 350 drugs have been reported to be the cause for lung injury and the incidence tends to increase. Although infiltrative lung disease is the most common pattern of drug-induced lung injury, it can appear in the form of alveolar changes, vasculitis and other injury. Herbal medicine also has been known as a cause for interstitial pneumonitis, but it is difficult to identify the key herbal medicine because of the complex components of the contents. Till date, there is no report of pneumonitis caused by golden thread. Here we report a case of a 54-year-old male who developed interstitial pneumonitis with acute liver injury caused by herbal medicine made from golden thread.
전병우 ( Byung Woo Jhun ),김세진 ( Se Jin Kim ),김강 ( Kang Kim ),이지은 ( Ji Eun Lee ),홍덕진 ( Duck Jin Hong ) 국군의무사령부 2014 대한군진의학학술지 Vol.45 No.1
Objective: A relationship between low vitamin D levels and development or outcomes of respiratory diseases has been identified. However, no data exists on the vitamin D status in South Korean military personnel with respiratory diseases Methods: We prospectively evaluated and compared the serum levels of total 25- hydroxyvitamin D [25(OH)D], 25(OH)D3, and 25(OH)D2 among patients with acute eosinophilic pneumonia (AEP), pulmonary tuberculosis (PTB), and community acquired pneumonia (CAP). Results: In total, 65 patients with respiratory diseases including AEP (n=24), PTB (n=19), and CAP (n=22) were identified. Of 24 patients with AEP, 2 (8%) patients had deficient total 25(OH)D levels (< 10 ng/mL) and 17 (71%) had insufficient total 25(OH)D levels (10 ≤ and < 30 ng/mL). Of 19 patients with PTB, one (5%) patients had deficient total 25(OH)D levels, and the remaining (n=18, 95%) had insufficient total 25(OH)D levels, and of 22 patients with CAP, one (4%) patient had deficient and 18 (82%) had insufficient total 25(OH)D levels. There were no significant differences in total 25(OH)D, 25(OH)D3, and 25(OH)D2 levels among patients with AEP, PTB, and CAP, except total 25(OH)D level between AEP and PTB (P=0.042) Conclusion: We investigated vitamin D status in South Korean military personnel with respiratory diseases including AEP, PTB, and CAP, and showed that low vitamin D levels are frequently found, thus further large studies on the relation between vitamin D deficiency and respiratory disease in military personnel are needed.
저위전방절제술 후에 발생한 특발성 후복막강 섬유증과 모자 용종증
송림화 ( Lim Hwa Song ),전병우 ( Byung Woo Jhun ),박지현 ( Ji Hyeon Park ),김다민 ( Da Min Kim ),장동경 ( Dong Kyung Chang ),김영호 ( Young Ho Kim ),김재준 ( Jae Jun Kim ),김진용 ( Jin Yong Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.5
An optimal treatment for cap polyposis has not been established. Several treatment approaches, including anti-inflammatory agents, antibiotics, immunomodulators, and endoscopic therapy have been described. Surgical resection of the affected colon and rectum may be indicated for patients with persistent disease. Repeat surgery is indicated in cases of recurrence after surgery. However, symptomatic polyposis may still recur, and spontaneous resolution of cap polyposis is possible. We report a case of recurrent cap polyposis complicated with retroperitoneal fibrosis after inadequate low anterior resection with a positive resection margin. Surgical approaches for the treatment of cap polyposis should be carefully considered before treatment. (Korean J Gastroenterol 2011;58:275-279)
증례 : 신장 ; 급성 신부전으로 발현한 거대 비장 가성 동맥류 1예
박지현 ( Ji Hyeon Park ),송림화 ( Lim Hwa Song ),전병우 ( Byung Woo Jhun ),정현애 ( Hyun Ae Jung ),장혜련 ( Hye Ryoun Jang ),오하영 ( Ha Young Oh ),김윤구 ( Yoon-goo Kim ) 대한내과학회 2012 대한내과학회지 Vol.82 No.1
비장 가성 동맥류는 발생 빈도는 낮지만 파열과 출혈 등의 합병증 발생률이 높으며 사망률이 매우 높은 질환이다. 생존율 향상을 위해서는 조기 진단과 적극적인 수술적 치료가 중요하나, 모호한 증상으로 인해 조기 진단이 어려운 경우가 있다. 저자들은 감염성 심내막염의 치료 4개월 후 발생한 급성 신부전의 원인을 규명하던 중 발견된 거대 비장 가성 동맥류를 수술적 치료로 완치한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Splenic artery pseudoaneurysm is a rare, but potentially lethal, vascular Lesion. The mortality rate may be 75-90%, if the aneurysm ruptures. The risk for rupture of an untreated splenic artery pseudoaneurysm is about 37%. Hence, early diagnosis and prompt surgical intervention are vital to improve survival. However, vague symptoms make early diagnosis difficult. We report here a case of a giant splenic artery pseudoaneurysm presenting with acute kidney injury. The patient had been treated previously for infective endocarditis, and after 4 months, acute kidney injury developed. Imaging studies revealed a giant splenic artery pseudoaneurysm. Splenectomy and distal pancreatectomy were performed. After surgery, renal function was improved. (Korean J Med 2012;82:100-104)