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성혜영,조세현,심성보,김진일,정대영,박수헌,한준열,이세민,노치호,박용범,정승은,이선희,최규용 대한의학회 2009 Journal of Korean medical science Vol.24 No.3
A 70-yr-old woman complained of left sided chest pain and non-bilious vomiting for four days after taking a gastric bloating agent for an upper gastrointestinal study. The chest radiography revealed gastric air-fluid levels and bowel loops in the left thoracic cavity. An emergency thoracotomy was performed. The abdominal organs (stomach, spleen, splenic flexure of the colon) were in the left thorax and the entire left hemidiaphragm was absent. There were no diaphragmatic remnants visible for reconstruction of the left diaphragm. We provided warm saline irrigation and performed a left lower lobe adhesiotomy. Thirteen days after surgery, the chest radiography showed improvement in the herniation but mild haziness remained at the left lower lung field. Here we present the oldest case of congenital diaphragmatic agenesis presenting with transient gastric volvulus and diaphragmatic hernia.
MEN1 유전자 돌연변이로 진단된 가족성 제1형 다발성내분비선종 1예
성혜영,전연주,이혁,권범준,박건우,이정민,문성대,장상아,한제호 대한내분비학회 2006 Endocrinology and metabolism Vol.21 No.6
Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant disorder that's characterized by the combined occurrence of primary hyperparathyroidism, endocrine pancreatic tumors and anterior pituitary adenomas, but such manifestations as carcinoid tumors, adrenal adenoma and lipoma are also seen. We report here on a case of a 52-years old man with MEN type 1. He had a parathyroid adenoma, empty sella and a non-functioning pancreatic and adrenal mass. On the genetic analysis, he was proven to have a mutation in the MEN1 gene (exon 2, 200-201, INS AGCCC). On the family study for the mutation, one of his siblings and his son proved to have the same mutation. (J Kor Endocrinol Soc 21:560~566, 2006) 저자들은 무증상의 신장결석을 동반한 고칼슘혈증, 부신 우연종과 췌장 종양을 가진 52세 환자를 대상으로 제1형 다발성 내분비 선종에 대한 검사를 시행하였다. 검사결과 부갑상선 선종, 공터키안 증후군, 비기능성 부신 및 췌장 종양을 발견하였고, 환자와 가족을 대상으로 제 1형 다발성 내분비 선종에 대한 유전자 검사를 통하여 MEN1 유전자에 AGCCC가 삽입된 변이를 확인하였다. 이에 문헌 고찰과 함께 보고하는 바이다.
Clinical Features of Abdominal Actinomycosis: A 15-year Experience of A Single Institute
성혜영,이인석,김상일,정승은,김상우,김수영,정문경,김원철,오승택,강원경 대한의학회 2011 Journal of Korean medical science Vol.26 No.7
This study was designed to evaluate the clinical features of abdominal actinomycosis and to assess its therapeutic outcome. We reviewed patients with abdominal actinomycosis in Seoul St. Mary hospital, between January 1994 and January 2010. Twenty-three patients (5 male and 18 female, mean age, 47.8 yr; range, 6-75 yr), with abdominal actinomycosis were included. Emergency surgery was performed in 50% due to symptoms of peritonitis. The common presentation on preoperative computerized tomography was a mass with abscess, mimicking malignancy. The mean tumor size was 7.0 cm (range, 2.5-10.5). In all patients, actinomycotic masses were surgically removed. Mean duration of hospital stay was 17.8 days (range, 5-49). Long term oral antibiotic treatment (mean 4.2 months;range, 0.5-7.0 months) were administered to all patients. All patients were free of recurrence after a median follow up of 30.0 months (mean 35.5 ± 14.8 months, range,10.0-70.0 months); recurrence was not seen in any patient. In conclusion, abdominal actinomycosis should be included as a differential diagnosis when an unusual abdominal mass or abscess presents on abdominal CT. Assertive removal of necrotic tissue with surgical drainage and long term antibiotic treatment provide a good prognosis in patients with actinomycosis.