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한태균,류대식,김홍철,허헌,엄경태,남궁숙,박만수,황우철,이관섭,Han, Tae-Kyun,Ryu, Dae-Sik,Kim, Heung-Chul,Hur, Hun,Eom, Kyeung-Tae,Namkung, Sook,Park, Man-Soo,Hwang, Woo-Chul,Lee, Kwan-Seop 대한영상의학회 1996 대한영상의학회지 Vol.34 No.5
Purose: To discribe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Material and Mathods: Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a cntrol subject with liver cirrhosis. Results: Portographic findings of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. Conclusion: A portogram of idiopathic portal hypertension may be useful in differentiating this andliver cirrhosis.
내과적 치료에 반응하지 않은 Lemierre 증후군 1예
허태윤 ( Tae Yun Heo ),정복현 ( Bock Hyun Jung ),유내선 ( Nae Sun Ryou ),정형주 ( Hyoung Chu Joung ),조민형 ( Min Hyung Cho ),김미혜 ( Mi Hye Kim ),류대식 ( Dae Sik Ryu ) 대한내과학회 2008 대한내과학회지 Vol.74 No.2
Lemierre 증후군은 구 인두염 후에 내경정맥의 혈전 정맥염이 발생하고 이로 인한 이차적 전이성 감염이 초래되는 드물지만 치명적 질환으로 특징적인 임상양상을 통하여 조기에 진단하고 적절한 항생제를 사용한다면 사망률을 현저히 낮출 수 있다. 그러나 antiphospholipid 증후군과 같이 혈전 형성의 고 위험 질환이 동반된 경우 내과적치료에 반응이 없을 수 있으므로 항 응고제 및 외과적 치료가 필요할 수 있다. 최근 비교적 전형적인 Lemierre 증후군의 임상양상을 보였고, antiphospholipid 증후군을 동반한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Lemierre syndrome is a rare clinical condition that is characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein and frequent secondary metastatic infections. The accurate diagnosis and treatment, for early stage disease, is important because it may be associated with a high mortality rate if untreated. We present the case of a 34-year-old man who presented with a history of typical for the diagnosis of Lemierre syndrome. Supportive care with antibiotics did not improve the clinical condition. The clinical course improved after treatment with IV anticoagulant and surgical thrombectomy. In addition, he had the antiphospholipid syndrome, which is known to be a common cause of acquired arterial or venous thrombosis. Therefore, in this patient the associated antiphospholipid syndrome might precipitate an internal jugular venous thrombophlebitis after an oropharyngeal infection or might account for the poor response to medical treatment. (Korean J Med 74:203-207, 2008)
장현규,원경숙,제갈양진,류대식 대한내과학회 2000 대한내과학회지 Vol.59 No.5
Behcet's disease is a nonspecific vasculitis characterized by exacerbations and remissions of unpredictictable duration. The commom clinical features in most patients are orogenital ulcers, uveitis and skin lesions-especially erythema nodosum-like lesions or positive pathergy test. Among the systemic manifestations of Behcet's disease, pulmonary involvement is very rare and only a few cases have been documented. The main event of pulmonary involvement is vasculitis forming multilocular aneurysms and thrombosis of the pulmonary artery. The commom pulmonary manifestations are hemoptysis, dyspnea, pleuritic chest pain, cough and fever. The prognosis of pulmonary vasculitis is very poor. A 30-year-old male patient with Behcet's disease presented with fever and dyspnea for 10 days. In the past years, his vision of the left eye was lost due to chorioretinitis. He took right hemicolectomy because of the perforation of colonic ulcer. Also he has been suffered from left hemiparesis due to multiple cerebral infarction. We describe a case with Behcet's disease with pulmonary infarction improved with prednisolone and cyclosporine.(Korean J Med 59:535-539, 2000)
김수희,박성오,고혁,박완,류대식,김종욱,정재걸,정복현 대한내과학회 2002 대한내과학회지 Vol.63 No.1
Aspergilloma and Allergic Bronchopulmonary Aspergillosis (ABPA) are different types of spectrum of pulmonary aspergillosis. ABPA results from hypersensitivity reaction to Aspergillus species and is known to be usually associated with bronchial asthma and cystic fibrosis. Aspergilloma results from simple colonization of this fungus within cavitary lung lesion or bronchiectasis. But rarely some patients can present together with ABPA and aspergilloma. We experienced a case of ABPA associated with aspergilloma in a 38 year-old male. The diagnosis was confirmed by asthma, immediate cutaneous reactivity to A. fumigatus, IgG antibody to A. fumigatus, elevated total and specific IgE antibodies to A. fumigatus, central bronchiectasis and peripheral eosinophilia coincident with radiographic infiltrates. During follow-up management with steroid, left pneumonectomy was done because of spontaneous pneumothorax with persistent air-leak and multidrug resistance pulmonary tuberculosis in association with aspergilloma. His respiratory symptoms and ABPA activity was much more improved after removal of aspergilloma. These findings suggest that surgical resection of aspergilloma can be considered to reduce antigenic source of colonized fungi in ABPA patients when associated with aspergilloma.