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소훈섭 ( Hoon Sub So ),문민영 ( Min Young Moon ),이정수 ( Jung Su Lee ),김호철 ( Ho Cheol Kim ),강병철 ( Byung Chul Kang ),고윤석 ( Youn Suck Koh ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
Botulinum toxin type A is widely used for functional improvement of muscles and aesthetic plastic surgery. It paralyzes the injected muscle by inhibiting acetylcholine release from synapses of neuromuscular junctions. We herein report a case of progressive respiratory distress after botulinum toxin injection at both the gastrocnemius and soleus muscles. The patient also showed ptosis, dysphonia, dysphagia, and general weakness. Vocal cord dysfunction was observed by laryngoscopy. Other neurologic examination findings, including those of the physical examination, brain MRI, and Jolly`s test, were normal. To our knowledge, this is the first report of botulinum toxin injection associated with dyspnea (MRC dyspnea scale, grade 3) in Korea. (Korean J Med 2013;84:851-854)
쿠싱 증후군으로 발현한 이소성 ACTH 분비 담낭 신경내분비암종
박상우 ( Sang Woo Park ),김명환 ( Myung Hwan Kim ),김진희 ( Jin Hee Kim ),김태오 ( Tae Oh Kim ),김태형 ( Tae Hyung Kim ),소훈섭 ( Hoon Sub So ),이성구 ( Sung Koo Lee ) 대한내과학회 2014 대한내과학회지 Vol.87 No.1
이 증례에서 영상 검사 및 조직 검사를 통해 담낭 신경내분비암종을 진단하였으며, 호르몬 검사 및 면역조직화학 염색으로 담낭 신경내분비암종에 의한 이소성 ACTH 분비 쿠싱 증후군을 확인할 수 있었다. 이소성 ACTH 분비가 있으나 그 원인이 뚜렷하지 않은 쿠싱 증후군 환자에서 신경내분비종양이 존재한다면 신경내분비종양이 이소성 ACTH 증후군을 일으킬 수 있는 가능한 원인 중의 하나로서 고려되어야 할 것이다 Neuroendocrine tumors of the gallbladder are rare, and typically found incidentally after a cholecystectomy. Few data are available on adrenocorticotrophic hormone (ACTH)-producing neuroendocrine tumors originating specifically from the gallbladder. We experienced the case of a patient with a gallbladder mass who presented with Cushing`s syndrome, who was subsequently diagnosed as an ACTH-producing neuroendocrine carcinoma of the gallbladder. Despite being rare, hormoneproducing neuroendocrine tumors should be part of the differential diagnosis in patients with Cushing`s syndrome. (Korean J Med 2014;87:67-71)