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신이식 환자에서 발생한 뇌 Aspergillosis 에서 Liposomal Amphotericin B 와 내시경적 수술을 이용한 성공적인 치료
우영식(Young Sik Woo),김미정(Mi Jung Kim),장재혁(Jae Heuk Jang),황수은(Soo Eun Hwang),정지성(Ji Sung Chung),신미정(Mi Jung Sin),양철우(Chul Woo Yang),김용수(Yong Soo Kim),방병기(Byung Kee Bang),박주현(Joo Hyun Park) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4
Aspergillosis involving central nervous system is a rare but life-threatening complication in renal transplant recipients. Its mortality rate approaches almost 100% in spite of various therapeutic regimens. We here report a case of successful treatment of brain aspergillosis with liposomal amphotericin B and endoscopic surgery. A 58-year- old renal transplant recipient admitted due to headache which was developed 5 months ago. He received renal transplant 10 years ago. After admission, brain MRI revealed brain abscess on frontal lobe and this was treated with antibiotics and amphotericin B. On 20 th hospital day, endoscopic surgery via intranasal approach was performed and pathologic finding was consistent with aspergillosis. During treatment, his graft function was progressively deteriorated(serum creatinine level 2.27 mg/dL4.1 mg/dL) and amphoterinc B was replaced with ambisome. Thereafter, renal function was improved(serum creatinine 2.0 mg/dL on 46 th hospital day). Second operation was performed on 50 th hospital day to remove remnant pathologic lesion, and ambisome was continously adminstered. The brain MRI which was performed on 70 th hospital day showed much improvement. He was discharged with oral antifungal drug(itraconazole). Our case demonstrates the successful treatment of brain aspergillosis with medial treatment and minimal invasive surgery.
위선암 환자의 말초혈액에서 역전사 중합효소 연쇄반응을 이용한 Cytokeratin 20 양성 미세 전이 암세포의 진단
이승훈(Seung Hoon Lee),진종률(Jong Youl Jin),송치원(Chi Won Song),이희진(Hee Jin Lee),박재후(Jae Hoo Park),박영세(Young Se Park),백창렬(Chang Nyol Paik),우영식(Yeong Sik Woo),김희정,김춘추(Chun Choo Kim),이준욱(Joon Wook Lee) 대한내과학회 2001 대한내과학회지 Vol.60 No.6
N/A Background : The development of metastasis in cancer is one of the main problems after primary tumor resection. The identification of metastases is only possible in the follow-up investigation when there is already a solid tumor mass. Subclinical tumor cell dissemination can be detected by immunocytological staining of cells or by other molecular biological methods, like PCR. We investigated 22 peripheral blood isolates from gastric cancer patients with a cytokeratin (CK) 20 specific nested reverse transcriptase PCR (RT-PCR) for the detection of disseminated tumor cells at the time of diagnosis. Methods : Fresh heparinized peripheral bloods (about 10 mL) were obtained from 22 gastric cancer patients and 10 healthy doctors as controls. Nucleated cells were isolated by a density gradient method. RNA was isolated and then subjected to RT-PCR with CK 20 specific primers. Results : In gastric cancer, 3 of 22 (13.6%) peripheral blood isolates yielded a CK 20 mRNA positive result in a stage undependent manner. Conclusion : We detected disseminated tumor cells in the peripheral blood isolated using CK 20 specific nested RT-PCR method. Studies on a larger scale are needed for further investigation on the relationship between positive rates of CK 20 mRNA and survival rates of stomach cancer, according to cancer stages.(Korean J Med 60:514-520, 2001)
홍창균,안유배,김설혜,우영식,이성구,고승현,송기호,윤건호,강무일,차봉연,이광우,손호영,강성구 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4
Pheochromocytoma is usually associated with a combination of various clinical manifestations caused by the overproduction of catecholamines. It is frequently accompanied by impaired glucose tolerance operating through 2 - and - adrenergic mechanisms. A 41-year-old-woman was admitted to the hospital because of poorly-controlled diabetes mellitus and hypertension. She had suffered intermittent paroxysmal attacks of headache and chest discomfort and had been treated intermittently over a 2 year period for diabetes mellitus and hypertension. At admission, the levels of serum epinephrine, norepinephrine urinary excretion of total metanephrine, and VMA were all abnormally elevated. Adrenal CT showed a well-defined, homogenous mass in the right adrenal region and the tumor was diagnosed as pheochromocytoma. After tumor resection, the increased blood level of catecholamines, the urinary excretion of total metanephrine, and VMA were normalized, as was the hyperglycemia state. Diabetes mellitus of the patient was considered permanently resolved after tumor removal by the result of glucose tolerance in 75 g oral glucose tolerance test