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임준영 ( Im Jun Yeong ),이승훈 ( Lee Seung Hun ),송언호 ( Song Eon Ho ),김현준 ( Kim Hyeon Jun ),서영훈 ( Suh Young Hoon ),이연희 ( Lee Yeon Hui ),김동희 ( Kim Dong Hui ),고재향 ( Go Jae Hyang ),박혜영 ( Park Hye Yeong ),박진완 ( 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.7
The endodermal sinus tumor (EST) is the second most common form of malignant germ cell tumor of the ovary. It accounts for 22% of germ cell lesions and the median age of the patients is 19 years. Three fourths of the patients are initially seen with a combination of abdominal pain and abdominal or pelvic mass. Acute pain is caused by torsion of the tumor and the symptoms are acute and may lead to the diagnosis of acute appendicitis or a ruptured ectopic pregnancy. The tumor is usually large with most tumors measuring between 10 and 30 ㎝ diameter. These neoplasms are highly malignant.^1 In the past, these tumors were once almost uniformly fetal within 2 years of diagnosis, but recent advances in treating the EST of the ovary with the combination chemotherapy result in improvement of the prognosis. Management of younger patients with early stage ovarian EST who desire to preserve fertility can be a challenging problem, and treatment strategies which can save ovarian function must be considered. We have experienced three cases of endodermal sinus tumor in three women (Ic, 18 years; Ⅱc, 20 years; Ic and right proximal femur metastasis, 21 years) and report them with eager review of literatures.
9 삼염색체성 mosaicism ( 47 , XX ,+ 9 / 46 , XX ) 1 예
이승훈(Seung Hun Lee),임준영(Jun Young Im),허의종(Eui Jong Hur),박진완(Jin Wan Park),이원기(Won Ki Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3
A rare but typical case of trisomy 9 shows the characteristic phenotype of this syndrome: microcephaly, low-set malformed ears, micrognathia, broad nose with bulbous tip, small and up-slanting palpebral fissures, deep-set eyes, congenital heart diseases, dislocation of joints, abnormal hands and feet, cryptorchidism, micropenis, mental retardation, and growth failure. In addition to karyotyping results, ultrasound findings are important in achieving diagnosis. We experienced a case of trisomy 9 mosaicism (47,XX,+9/46,XX)and so present it with a brief review of literature.
증례 : 류마티스 ; 베체트병 환자에서 발생한 특발성 혈소판증가증 1예
박미란 ( Mi Ran Park ),임준영 ( Jun Young Im ),정재식 ( Jae Shik Jung ),정민정 ( Min Jung Jung ),김태욱 ( Tae Wook Kim ),홍영미 ( Young Mi Hong ),이충원 ( Choong Won Lee ) 대한내과학회 2010 대한내과학회지 Vol.78 No.6
베체트병에서 혈액학적 질환이 연관된 증례들이 소수 보고되어 왔으나, 치료와 관련 없이 본태성 혈소판증가증이 동반된 예는 없었다. 저자들은 베체트병에 동반된 본태성 혈소판증가증을 경험하여 이에 보고하는 바이다. 베체트병은 정확한 병인은 완전히 알려지지는 않았으나, 유전적인 소인이 있는 환자에서 감염과 같은 환경적인 요인이 면역기능에 이상을 초래하는 것으로 알려져 있으며 이 가운데 일부는 본태성 혈소판증가증의 발생 원인과도 관련성이 있는 것으로 밝혀지고 있으므로 향후 지속적인 연구가 필요할 것으로 보인다. Beh?et`s disease (BD) is a chronic inflammatory disorder characterized by vasculitis of unknown cause and involving multiple organs. Its pathogenesis includes neutrophil hyperfunction and the overproduction of inflammatory cytokines, including INF-α. BD is often accompanied by leukocytosis, but is rarely associated with myeloproliferative disease. Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by marked thrombocytosis and marrow megakaryocytic hyperplasia. Only one case of ET associated with incomplete?type intestinal BD during hydroxyurea treatment has been reported. Here, we report a case of essential thrombocythemia in 53-year-old female with BD who had taken no medication. Based on the history, physical examination, and routine laboratory and bone marrow examination, we diagnosed her with ET. (Korean J Med 78:776-779, 2010)
증례 : 순환기 ; 국한된 ST 분절 상승을 보인 심근경색으로 오인된 급성 심근심막염 1예
김태욱 ( Tae Wook Kim ),정민정 ( Min Jeong Jeong ),임준영 ( Jun Young Im ),정재식 ( Jae Shik Jeong ),박미란 ( Mi Ran Park ),박주철 ( Ju Cheol Park ),정준호 ( Joon Hoon Jeong ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1
본 증례의 환자는 급성 상기도 감염의 증상 이후 발생한 흉부 불편감을 주소로 내원하였고, 국한된 ST 분절의 상승과 심근 효소의 상승으로 급성 심근경색증이 의심되었으나, 심장 초음파 및 관상동맥 조영술을 시행한 이후 급성 심근심막염으로 진단할 수 있었고, 이를 대증적 치료로 완치하였다. 이에 본 저자들은 급성 심근경색증의 소견을 보인 급성 심근심막염 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Although, with regard to diagnosis, history, physical examination, laboratory data, and electrocardiogram (ECG) are helpful, it can be difficult to distinguish between pericarditis, myopericarditis, and myocardial infarction. Typically, the ECG pattern evolves similarly in acute pericarditis and myopericarditis and includes diffuse ST elevation and PR depression, and then diffuse T wave inversion. Nevertheless, atypical ECG features are seen occasionally in both, especially in myopericarditis. They are characterized by localized ST elevation (inferolateral or anterolateral) and T wave inversion before ST segment normalization. This makes it difficult to distinguish acute myopericarditis from acute myocardial infarction. We report the case of a 27-year-old man with acute myopericarditis with localized ST elevation mimicking acute myocardial infarction. (Korean J Med 2011;80:92-96)
정민정 ( Min Jeong Jeong ),김태욱 ( Tae Wook Kim ),임준영 ( Jun Young Im ),정재식 ( Jae Sick Jeong ),박미란 ( Mi Ran Park ),김태우 ( Tae Woo Kim ),이충원 ( Choong Won Lee ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.3
Microscopic polyangiitis (MPA) is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. The kidney is the most often affected organ in the majority of patients with MPA, and renal manifestations are usually the first symptoms. Glomerular capillaries are affected most often, resulting in necrotizing glomerulonephritis, usually in a crescent formation, with no or few immune deposits able to be demonstrated at the sites of vasculitis and glomerulonephritis. We report a case of microscopic polyangiitis in both legs with pitting edema in a 50-year-old female. Laboratory findings showed hematuria, proteinuria, and a positive peripheral antineutrophil cytoplasmic antibody. A renal biopsy revealed pauci-immune splitting and necrotizing capillary loop walls necrotizing vasculitis and membranoproliferative glomerulonephritis (MPGN). With a diagnosis of MPA, she has been managed with high dose steroid and cyclophosphamide. To our knowledge, this is the first reported case of MPA with MPGN.
김태욱 ( Tae Wook Kim ),박미란 ( Mi Ran Park ),이충원 ( Choong Won Lee ),정민정 ( Min Jeong Jeong ),임준영 ( Jun Young Im ),정재식 ( Jae Shik Jeong ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.4
Human immunodeficiency virus infection is associated with a variety of rheumatic manifestations. The pathogenic mechanisms are not well defined, but evidences suggests multiple mechanisms, including direct or indirect human immunodeficiency virus involvement with a genetic, immunological, and environmental basis. Rheumatic manifestations can occur during the course of human immunodeficiency virus infection, and their presence is associated with an overall poor prognosis for the underlying human immunodeficiency virus infection. We report a case of a 37-year-old male who had ankylosing spondylitis with a human immunodeficiency virus infection.