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박성현 ( Sung Hyun Park ),강창돈 ( Chang Don Kang ),박진명 ( Jin Myung Park ),김지현 ( Ji Hyun Kim ),정재훈 ( Jae Hoon Jung ),정진선 ( Jin Seon Jeong ),김도준 ( Do Jun Kim ),문다해 ( Da Hye Moon ) 대한췌담도학회 2017 대한췌담도학회지 Vol.22 No.2
위암의 전이는 주로 혈행성 전파, 림프절을 통한 전이, 주위 장기를 통한 직접 침윤과 복강내 파종을 통해 이루어지며 장기로는 주로 간, 폐, 뼈로 전이가 된다고 알려져 있다. 위암의 담낭 전이는 흔하지 않고 예후가 좋지 않으며 담낭염으로 발현한 경우 더 예후가 나쁘다고 알려져 있다. 본 저자들은 위암의 담낭으로의 전이와 담낭염이 동반된 증례를 경험하여 보고하는 바이다. Gastric cancer mainly spreads to the liver, peritoneum, and lymph nodes and rarely metastasizes to the gallbladder. The prognosis of gastric cancer with metastasis to the gallbladder is reported to be very poor, and presentation with cholecystitis is a prognostic factor. Herein, we present a case of gastric cancer with metastasis to the gallbladder, accompanied by acute cholecystitis. Korean J Pancreas Biliary Tract 2017;22(2):98-101
증례 : 류마티스 ; 류마티스 관절염에서 발생한 급성 횡단척수염 치료 1예
김보라 ( Bo Ra Kim ),권혁이 ( Hyucki Kwon ),김지현 ( Ji Hyun Kim ),박성현 ( Sung Hyun Park ),정재훈 ( Jae Hoon Jeong ),정진선 ( Jin Seon Jeong ),문기원 ( Ki Won Moon ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
본 증례는 류마티스 관절염 환자에서 발생한 급성 횡단 척추염을 면역글로불린 정주로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다. Acute transverse myelitis (ATM) is a heterogeneous syndrome characterized by acute spinal cord dysfunction resulting in paresis and sensory and autonomic impairment below the level of the lesion. The etiology of ATM includes parainfectious, paraneoplastic, drug-induced, systemic autoimmune disorders, and acquired demyelinating diseases. ATM is very rare in patients with rheumatoid arthritis (RA). A 79-year-old woman with RA, a recurring peptic ulcer, and congestive heart failure presented with acute weakness of both upper and lower extremities. She was diagnosed with ATM based on the results of laboratory and radiological tests. ATM is usually treated with high-dose glucocorticoid. However, we treated her with intravenous immunoglobulin (IVIG) considering the adverse events of high-dose glucocorticoid, and she improved. We report a case of ATM in a patient with RA successfully treated with IVIG. (Korean J Med 2015,89:604-608)
소아청소년 복합만성질환자 수 및 진료비의 변화: 2011-2021년 건강보험청구자료 분석
오정윤,조수진,정진선,조진숙,박춘선 건강보험심사평가원 2023 HIRA RESEARCH Vol.3 No.2
Background: The number of children and adolescents has decreased by more than 3 million over the past 10 years. We analyzed changes in the number of children and adolescents with complex chronic conditions (CCCs) and their medical expenditures between 2011 and 2021. Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses. Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021. Conclusion: The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.