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정홍순,김정호,조세현,한준열 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
혈색소증은 유전적 또는 후천적인 철 대사 이상 질환으로 부적절한 철 흡수 증가로 인하여 과도한 철분이 실질세포 내에 침착되어 결국에는 조직 손상과 장기 부전을 일으키게 된다. 그러나 과도한 비경구적 철 부하로 발생하는 경우는 매우 드물다. 저자들은 철 결핍성 빈혈을 치료하기 위하여 비경구적 철분 주사 후 발생한 혈색소증을 경험하였기에 보고하는 바이다. 44세 여자 환자가 우측 복부 통증을 주소로 응급실 경유하여 입원하였다. 신체검사에서 간비대와 피부의 색소 침착이 관찰되었으며 검사실 소견에서는 헤모글로빈 10.0 g/dl, 헤마토크릿 31.2%, MCV 75 fL, MCH 24 pg, 혈소판 28,000/mm3, 철 187 ug/dL, 페리틴 7680 ug/dL이었다. 과거력에서 10년 전 진행성 위암으로 위 전 절제술을 시행 받은 바 있으며 5년 전부터 철 결핍성 빈혈로 비경구적 철분 복합제제(Venoferrum(R))를 매주 5400 mg씩 투여 받았다. 조영 전 복부 CT 영상에서 고밀도의 간 및 비종대가 관찰되었다(Figure 1). 간 생검에서는 만성 간염 및 간경화 소견과 심한 헤모시데린 침착이 관찰되었다 (Figure 2). 이에 Deferasirox(Exjade(R))를 즉시 투여하였다. 10 병일 째, 환자가 호흡곤란을 호소하였으며 가슴 방사선 사진에서 심장비대와 양측 흉수가 관찰되었다. 심전도에서 심방세동이 관찰되었으며 심장 초음파에서는 심한 좌심실 수축기능 저하 및 수축기말 심실 확장이 관찰되었다. 이후 집중 치료에도 환자는 점차 활력 징후 및 전신상태가 악화되었으며 전신성 혈색소증으로 인한 심부전 및 심실성 빈맥으로 사망하였다.
정홍순,정우백,양근석,양혜경,권태근,이국진,홍지형,정정임,송현,윤호중 한국심초음파학회 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.4
Left ventricle-coronary sinus fistula and left ventricular pseudoaneurysm are unusual and frightening complications after mitral valve replacement. A 27-year-old female patient underwent mitral valve replacement 5 years previously and trans-thoracic echocardiography showed an outpouching lesion at the atrioventricular groove. It was difficult to differentiate whether the lesion was a left ventricle-coronary sinus fistula or a left ventricular pseudoaneurysm by two-dimensional echocardiography. Cardiac computed tomography confirmed a left ventricular pseudoaneurysm compressing the coronary sinus.
선인오,고유미,김은영,박경선,정홍순,고선혜,정병하,최범순,박철휘,김용수,양철우 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.3
Background/Aims: We investigated the incidence and clinical characteristics of renal cell carcinoma (RCC) in the native kidney of renal transplant recipients. Methods: Between 1991 and 2010, 1,425 patients underwent kidney transplantation at our institution. We retrospectively evaluated the clinical features and outcomes in renal transplant patients with RCC in the native kidney after renal transplantation. Results: The patients included three males and two females with a mean age of 63 years (range, 52 to 74). The incidence of RCC was 0.35%. The median interval between renal transplantation and RCC occurrence was 16.2 years (range, 9 to 20). All of our patients with RCC had developed renal cysts either before (n = 3) or after (n = 2) renal transplantation. The mean duration of dialysis was 12 months (range,2 to 39). Of the five patients, four underwent dialysis treatment for less than 8months. All the RCCs were low grade at the time of diagnosis. Four patients underwent radical nephrectomy, and one patient refused the operation. The four patients who underwent radical nephrectomy showed no evidence of local recurrence or distant metastasis during the median follow-up of 2.9 years. However,the patient who did not undergo surgery developed spinal metastasis from the RCC 6 years later. Conclusions: This study suggests that the follow-up period is an important factor for the development of RCC in renal transplant recipients, and more vigorous screening with a longer follow-up period is required in renal transplant recipients.
직장에 삽입된 큰 직장 이물의 항문을 통한 추출 도중 발생한 장 천공 1예
양근석,한정호,김선영,최우형,정홍순,정은,전현정,윤세진 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.6
Rectal foreign bodies are rare clinical problem in South Korea. Although many foreign bodies can be extracted safely using endoscopic procedures, some patients require surgery. Here we describe the case of a 35-year-old male who presented with a rectosigmoid foreign body, a large carrot measuring 28×7 cm. Sigmoidoscopy revealed a carrot in the upper rectum extending to the sigmoid colon. Endoscopic removal failed. The surgeon unsuccessfully attempted to extract the carrot using various tools without spinal anesthesia. During the extraction attempt, the patient complained of sudden abdominal pain, and a simple x-ray revealed pneumoperitoneum. An emergency colotomy and removal of the foreign body was performed, followed by primary repair of the perforation and a colostomy. Three months later, the colostomy was repaired. 국내에서 크기가 큰 경항문 직장 이물의 증례를 만나기는 매우 드물다. 하지만 외국인의 유입으로 다문화 사회가 되고 있으며, 문화 및 성적 취향이 서구화되고 있으므로, 직장 이물의 유병률은 점차 증가할 것이다. 직장 이물의 제거 중 다양한 합병증을 유발할 수 있으므로 이의 진단과 치료에 대한 소화기내시경 의사의 지식과 경험이 중요하다. 저자들은 직장을 거쳐 하행결장까지 삽입된 당근(7×28 cm)을 항문을 통하여 제거하던 도중 직장 천공이 발생하였고 이를 개복술로 치료한 1예를 문헌 고찰과 함께 보고한다.
Coenzyme Q10 Inhibits Th17 and STAT3 Signaling Pathways to Ameliorate Colitis in Mice
이선영,이승훈,양은지,김재경,김은경,정경아,정홍순,이경진,이한희,이보인,박성환,신동윤,조미라 한국식품영양과학회 2017 Journal of medicinal food Vol.20 No.9
Coenzyme Q10 (CoQ10) is a powerful antioxidant substance synthesized in the body. The current study aimed to determine whether CoQ10 suppresses inflammation and inhibits p-STAT3 expression in an experimental colitis mouse model. The mice were orally fed with CoQ10 once a day for 13 days. Histological analysis of the colons was performed by immunohistochemistry. Expression of IL-17, FOXP3, p53, AMPK, and mTOR and activation of p-STAT3 and p-STAT5 in lymph node and spleen tissues were detected by confocal microscopy of stained tissue sections. The relative mRNA expression was measured with real-time PCR, and protein levels were examined by western blot. CoQ10 reduced the disease activity index score and the colon histological score. It also reduced inflammatory mediators in the colon and increased the colon length. The expression of IL-17 and p-STAT3 was decreased with CoQ10 treatment. In contrast, CoQ10 treatment increased the expression of p-AMPK and FOXP3. Expression of anti-inflammatory cytokines was shown to increase in colitis mice treated with CoQ10. These results suggested that CoQ10 may reduce the severity of colitis and suppress inflammation through the inhibition of p-STAT3 and IL-17. These results support the use of CoQ10 as a potential targeted therapy for the treatment of colitis.