http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
한지숙(Jee Sook Hahn),김영준(Young Joon Kim),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko) 대한내과학회 1989 대한내과학회지 Vol.36 No.3
N/A The combination of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura, Evans syndrome, is rare and the treatment of this has been generally unsatisfactory. We experienced 8 cases of Evans` syndrome from January 1976 to May 1988 and reviewed their clinical findings. 1) The incidence of Evans` syndrome was 10.7% in all 75 cases of autoimmune hemolytic anemia patients. The age ranged from 20 to 82 years with a mean age of 46.5, and a female predominance was observed (M:F=1:7). 2) In all cases except one, autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura were found simultaneously at the time of diagnosis. Leukopenia also was observed in 2 cases. 3) In the direct Coombs` test, both anti-IgG antibody and anti-C3 antibody were positive in 6 cases, and anti-IgG was positive in only 1 case. The reaction to polyspecific antibody was positive in all 8 cases. 4) Steroid was the initial therapy in all 8 cases and danazole was given concomitantly in 4 of them. In all cases except one, remission was induced with initial therapy, but during the follow-up period (2~66+months, median; 18.4 months) 5 cases relapsed without any deaths. Based upon the above results, a thorough diagnostic approach and follow-up are emphasized with the reevaluation of treatment.
한지숙(Jee Sook Hahn),곽승민(Sueng Min Kwak),이선주(Sun Ju Lee),김응(Eung Kim),고윤웅(Yun Woong Ko) 대한내과학회 1989 대한내과학회지 Vol.36 No.5
N/A Subacute necrotizing lymphadenitis (SNL), first de- scribed in 1972 by Kikuchi, is characterized by benign cervical lymphadenopathy of unknown etiology with unique histologic features in young female patients. We reviewed the clinical features of 35 cases with SNL at Yonsei Medical Center from January 1980 to September 1987. The results obtained were as follows: 1) The median age was 27 years (range: 9~73 years) and the male to female ratio was 1:4, with 19 females (54 %) under 30 years. 2) The common chief complaints were neck mass (89 %) and fever (49%), and the duration of symptoms was generally less than 4 weeks, Cervical lymphadenopathy was noted in all cases. However, hepatosplenomegaly was not observed. The tentative diagnoses were tuberculous lymphadenitis in 7, fever of unknwon origin in 5, lymphoma in 2 and cervical lymphadenopathy in the remaining 21. 3) Lymph node enlargement was limited to the cervical area in most cases (91%). In addition to the cervical area, the axillary and inguinal area lymph nodes were also affected in 3 cases. The involved lymph nodes were multiple, small sized and often tender in character. 4) Leukopenia (47%), neutropenia (40%) and relative lymphocytosis (30%) were the relatively common hematologic abnormalities, while elevation of ESR (71 %) and LDH (54%) and a positive reaction for CRP (60 %) were also frequently seen. 5) No specific treatment was given in 21 cases and the median duration of fever was 20 days (mean: 34 days) in 17 febrile cases. 6) Systemic lupus erythematosis was confirmed in 1 case and strongly suspected in another case after diagnosis of SNL. In conclusion, a biopsy for cervical lymphadenopathy in young women with fever suggestive of SNL should be done in Koresa to exclude tuberculous lymphadenitis. A thorough examination by an experienced pathologist for the differential diagnosis with malignant lymphoma is recommended and furthemore, meticulous clinical follow-up is emphasized.
한지숙(Jee Sook Hahn),정경섭(Kyung Sup Chung),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko),조장환(Chang Hwan Cho),박정수(Cheong Soo Park) 대한내과학회 1991 대한내과학회지 Vol.40 No.1
With improved management in the patient of aplastic anemia, complications that require surgical intervention are becoming more frequent. In the past, conventional management of complications that require surgical intervention in patients with pancytopenia were mainly conservative and nonoperative. Because of the presumed high mortality and morbidity, surgery has often been avoided. However, advance in supportive techniques such as transfusion of platelet and leukocyte and introduction of new broad-spectrum antibiotics has made surgical approach possible. Fourteen cases of aplastic anemia who underwent major or minor surgery for surgical complications or diagnostic purpose in the department of internal medicine from December 1972 to February 1989 were evaluated. The results obtained were as follows. 1) The incidence of surgery in 217 cases of aplasic anemia was 6.5 percent. Their median age was 29.5 years with female preponderance (M:F=1:2.5). The severe aplastic anemia (SAA) were 4 cases and non-severe aplastic anemia (non-SAA) 10 cases. 2) Eighteen surgical procedures have been performed, of which the major surgery were 10, and minor surgery 8 cases. Of the major surgery 3 (30%) occasions were undertaken in 2 SAA cases. 3) The types of major surgery included 2 cases of appendectomy, and 1 case of subtotal gastrectomy, cholecystectomy with T-tube drainage, cholecystostomy, hernioplasty, amputation of leg in each, and 3 cases of Cesarean section. Those of minor surgery presented 3 cases of incision and drainage, 1 case of implantation and removal of intravenous injection port, skin biopsy, wound repair, and dilatation and evacuation in each. 4) Of the 10 major surgical procedures, seven were emergent surgery and three elective surgery. The median duration from the diagnosis to the major surgical procedure was 0.5 months (4 days~47.3 months), and the median survival of the surgery was 12.3 months (4 days~38+ months). 5) The mean platelet count before the major surgery was 27,400/㎣ (8,000~94,000/㎣), and it rose to 94,400/㎣ (34,000~166,000/㎣) after average 6.8 units of platelet transfusion. 6) Three surgical complications were encountered in 2 cases, comprising of 1 case of sepsis, and pneumonia, and atelectasis in another 1 without any bleeding complications. The one SAA case complicating the both sepsis and pneumonia was dead within 30 days after surgery. 7) Total 3 cases were dead, whose causes were infection, stomach cancer, and periampullary cancer, respectively. It is concluded that the surgical intervention should be strongly considered in patients with aplastic anemia requiring surgery unless they are terminally ill, which could be attributable to the development of supportive care and would offer enough chance for definite treatment of aplastic anemia and reasultant longer survival. The surgeon and the hematologist must work together to facilitate a major operation when it is indicated.
증례 : 급성 D. D. S. 중독증으로 유발된 특이합병증 1 예
한지숙 ( Jee Sook Hahn ),정석호 ( Suk Ho Chung ),박호길 ( Ho Kil Park ),김성규 ( Sung Kyu Kim ),박희철 ( Hi Chull Park ),김홍길 ( Hong Gill Kim ) 대한내과학회 1970 대한내과학회지 Vol.13 No.5
D.D.S. (Diaminophenyl sulphone) is very effective for the treatment of leprosy. Chronic D.D.S. intoxications have been reported in many countries. Their manifestations were hematologic changes, skin lesions, abnormal liver function tests and neuropsychiatr
한지숙(Jee Sook Hahn),홍명기(Myeong Ki Hong),이선주(Sun Ju Lee),고윤웅(Yun Woong Ko) 대한내과학회 1989 대한내과학회지 Vol.36 No.4
N/A Infected anal lesions occur not infrequently in patients with acute leukemia and they have been associated with a relatively high mortality. The proper management of infected anal lesions has been a subject of controversy in many reports. Therefore, we evaluated the clinical aspects and management of 19 cases of infected anal lesions in patients with acute leukemia from January 1980 to June 198H. The results were as follows: 1) Among 296 patients with acute leukemia, 19 cases (6.4%) of infected anal lesions were observed. 2) The most frequent symptom and sign were anal pain (73.7%) and anal mass (57.9%). 3) At the time of occurrence of the infected anal lesions, 63.1% of patients were granulocytopenic ( < 500/ mm3) and 84.2% of patients had fever. 4) Nine cases (47.7%) were treated by operative procedures, 1 case by radiotherapy and electrocauterization and 3 cases ruptured spontaneously. 5) The most common microorganism isolated was E. coli, both from wound culture (83.2%) and blood culture (21.1%). 6) Infected anal lesions were improved in 52.6% (10/ 19). The death rate of sepsis resulting from infected anal lesions was 31.6% (6/19) which was significantly low (p = 0.003) and it was 66.7% (6/9) in patients whose infected anal lesions did not improve. The complete remission rate of acute leukemia was significantly high (p = 0.02) in patients with improved infected anal lesions in comparison to those with unimproved infected anal lesions. 7) Complete remission was obtained in 41.7% (5/12). It is concluded that in spite of the high mortality associated with septicemia from infected anal lesions, the importance of prophylactic anal care and meticulous management for infected anal lesions in acute leukemia should be further stressed