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Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content
전홍길,나승원,박주환,박혜민,권운정,차희정,이용직,박창렬,재갈영진,안종준 대한결핵및호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.76 No.2
We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.
신생아 패혈증의 양상을 보인 신생아 루푸스 증례와 문헌 고찰
박혜민 ( Hye Min Park ),전홍길 ( Hong Gil Jun ),박주환 ( Ju Hwan Park ),최승원 ( Seung Won Choi ),오기원 ( Ki Won Oh ),오지선 ( Ji Seon Oh ) 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.3
저자들은 출생 당시 피부발진을 보인 신생아에서 범혈구 감소증 및 발열과 함께 심한 황달을 포함한 간기능 이상 소견을 보여 신생아 루푸스로 진단된 환아에서 전신적인 고용량의 스테로이드와 면역글로불린 치료 후 완전히 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Neonatal lupus is an uncommon autoimmune disease that results from transplacental passage of the maternal anti- SSA/Ro and/or anti-SSB/La antibodies. Pancytopenia or severe jaundice is a rare manifestation of neonatal lupus, respectively, and could be misdiagnosed with other neonatal illnesses, such as infection, hematologic disease, or hepatobiliary disease. Here, we report an unusual case of a premature newborn with severe neonatal lupus manifested with skin rash, fever, pancytopenia, and severe jaundice with abnormal liver function tests. His mother had been clinically asymptomatic before delivery; however, she revealed peripheral edema, bilateral pleural effusion, and ascites after delivery and diagnosed with systemic lupus erythematosus based on positive anti-nuclear and anti-cardiolipin antibodies, proteinuria, and serositis. The newborn and his mother had anti-SSA/Ro and anti- SSB/La antibodies. His pancytopenia and jaundice were progressively aggravated, and his illness was confused with neonatal sepsis or biliary obstruction. We decided to treat with high dose of corticosteroid and intravenous immunoglobulin, and he gradually recovered completely with the treatment. His corticosteroid was stopped at 5 months of age without relapse or complication.
불응성 용혈성 빈혈을 지닌 소아 전신홍반루푸스에서의 Rituximab 치료 1례
박주환 ( Ju Hwan Park ),임재욱 ( Jae Wook Im ),전홍길 ( Hong Kil Jun ),박혜민 ( Hae Min Park ),최승원 ( Seung Won Choi ),박상규 ( Sang Kyu Park ),오지선 ( Ji Seon Oh ) 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.4
Autoimmune hemolytic anemia (AIHA) is a relatively common cause of anemia in children and adults with systemic lupus erythematosus (SLE). Although AIHA responds to steroids, in case of refractory or steroid-dependent AIHA, immunosuppressants and intravenous immunoglobulin have been used as second line agents. Rituximab, an anti-CD20 monoclonal antibody, is emerging in the treatment of SLE refractory to conventional therapy. Herein, we report a case of delayed and sustained remission of refractory hemolytic anemia in a child with SLE, post rituximab treatment. A 12-year-old female child with dizziness was referred to our department and was diagnosed with SLE combined with hemolytic anemia and renal tubular acidosis. Since frequent relapse of hemolytic anemia had occurred during the steroid tapering course, even though she had been treated with additional immunosuppressants (azathioprine, mycophenolate mofetil), the patient received 2 doses of rituximab 500 mg at 2 weeks interval at 18 months post diagnosis. After 15 months of rituximab administration, her anemia and renal tubular acidosis were fully recovered, enough to stop all medications. She remained well without recurrence for up to 3 years and 4 months after rituximab treatment.
임재욱 ( Jae Uk Im ),김은혜 ( Eun Hye Kim ),전홍길 ( Hong Gil Jun ),오지선 ( Ji Seon Oh ),최승원 ( Seung Won Choi ),강병성 ( Byeong Seong Kang ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
The gastrointestinal tract is commonly involved in patients with systemic sclerosis. The manifestations include motility disorder, pseudo-obstruction, malabsorption, bacterial overgrowth, diverticuli, and, less commonly, pneumatosis cystoides intestinalis (PCI). PCI is characterized by the presence of air in the submucosal or subserosal layer of the bowel wall and is often accompanied by pneumoperitoneum. Although PCI is a benign condition that often responds to conservative management, it is a poor prognostic factor of systemic sclerosis. We report a case of PCI in a patient with systemic sclerosis. The chest and abdominal radiographic findings comprised pneumoperitoneum, marked dilation of the bowels, and intramural air, compatible with PCI. The patient`s symptoms improved spontaneously. It is important to recognize PCI as a gastrointestinal manifestation of systemic sclerosis, and physicians should differentiate it from serious complications-such as intestinal perforation-based on clinical manifestations. (Korean J Med 2013;84:868-872)