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Bowel Perforation after Erlotinib Treatment in a Patient with Non-Small Cell Lung Cancer
천윤홍,이경원,김문진,강민규,김희진,이상수,김차영,전대홍,김유은 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.4
Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
콜라겐 유도성 관절염 마우스모델에서 레스베라트롤 식이요법의 류마티스관절염 완화효과
천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),서영선 ( Young Sun Suh ),허재형 ( Jae Hyung Hur ),조원용 ( Won Yong Jo ),임혜송 ( Hye Song Lim ),하영술 ( Young Sool Hah ),성미정 ( Mi Jeong Sung ),권대용 ( Dae Young Kwon ),이상일 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.2
Objective. Resveratrol is well-known for its anti-inflammatory, anti-oxidant effects on several diseases. We investigated whether dietary supplementation with resveratrol may suppress joint inflammation and destruction in a mouse model of collagen-induced arthritis (CIA). Methods. Mice were randomly divided into two groups; CIA mice with normal diet-fed and CIA mice fed a 0.05% resveratrol diet. The effect of resveratrol on arthritis was assessed by clinical scoring system. The plain radiographs of paws were obtained to evaluate the effects on preventing bone destruction. Joint inflammation, cartilage damage, and osteoclastic bone resorption were checked by staining with H&E, Safranin-O, and tartrate resistant acid phosphatase (TRAP). Levels of pro-inflammatory cytokines were checked by enzyme-linked immunosorbent assay. The level of expression of nuclear factor (NF)-κB was measured by electrophoretic mobility shift assay (EMSA). Results. Dietary supplementation with resveratrol led to mitigated severity of arthritis compared to the normal diet group (6.7±0.8 vs. 2.7±0.6, p<0.01). Resveratrol-fed mice showed decreased bone destruction on radiograph (3.4±0.3 vs. 2.0±0.2, p<0.01), and showed significantly inhibited pathological changes (inflammation 2.0±0.3 vs.3.2±0.2, p<0.01; cartilage damage 1.5±0.3 vs. 3.2±0.2, p<0.01; pannus formation 1.4±0.3 vs. 3.0±0.3, p<0.01; erosion; 1.4±0.2 vs. 3.3±0.3, p<0.01). Generation of TRAP-positive osteoclasts was inhibited in the resveratrol-fed mice (55.3±12.7 vs. 3.27±0.8, p<0.01). Resveratrol-fed mice showed decreased levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6,monocyte chemoattractant protein 1, and the soluble receptor activator of NF- κB ligand in joint tissues and sera. Expression of NF-κB, measured by EMSA, was decreased in resveratrol-fed mice. Conclusion. Dietary supplementation with resveratrol mitigates inflammation and bone destruction in CIA mice. (J Rheum Dis 2015;22:93-101)
Streptococcus agalactiae와 Streptococcus dysagalactiae에 의한 사슬알균 독소충격증후군 2례
서영선,천윤홍,김민교,안종화,이상수,임민희,김병훈,김선주,조명제,배인규 대한감염학회 2011 Infection and Chemotherapy Vol.43 No.5
Streptococcal toxic shock syndrome (STSS) is an acute, progressive illness that manifests with fever, hypotension, and accelerated multi-organ failure. It is usually caused by Group A Streptococcus (Streptococcus pyogenes ). STSS due to nongroup A streptococci is rare, but its incidence has recently increased. We report here on two cases of STSS caused by Group B Streptococcus (Streptococcus agalactiae) and Group G Streptococcus (Streptococcus dysagalactiae).
서영선,천윤홍,김민교,임민희,김선주,조명제,배인규 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
서론: 독소충격증후군은 세균독소에 의해 유발되는 급성 다장기부전 증후군으로 황색포도알균에 의해 흔히 발생한다. 사슬알균에 의한 독소충격증후군은 드물게 발생하지만 황색포도알균에 의한 독소충격증후군보다 사망률이 높다. B군 사슬알균은 대개 신생아, 주산기 감의 원인균으로 이에 의한 독소충격증후군은 아직 국내에서는 보고가 없다. 저자들은 B군 사슬알균에 의한 독소충격증후군을 경험하고 성적으로 치료하여 이에 대해 보고하고자 한다. 증례: 47세 남자가 내원 3주전부터 우측 하지의 부종과 통증, 발적이 발생하였고 내원 3일부터 발열이 있었으며 내원 당일 의식이 저하되어 내원하였다. 내원 당시 혈압 80/40 mmHg, 맥박수 110회/분, 호흡수 24회/분, 체온은 38.℃였고 우측 발목부터 무릎까지 발적과 부종, 표피 박리가 있었다. 수포음, 심잡음은 없었고 뇌척수액 검사상 특이소견은 없었다. 말초혈액사에서 백혈구 12,960/mm3 (호중구 75.2%), 혈소판 55,000/mm3였고 PT 19.8 초, aPTT 64.6 초로 연장되어 있었다. 혈청 생화학검사상 BUN/Cr각각40.9/ 6.35 mg/dL, CK 827 IU/L, LDH 215 IU/L로 측정되었고 C-반응단백 219.9 mg/L, procalcitonin 154.95 ng/mL이었다. 우측 하지의 혈관조영단층촬영에서 종아리 부위의 연조직에 침윤소견이 관찰되었다. 독소충격증후군을 의심하여 혈액배양검사를 시행하고 경험적 항생로 penicillin G 와 clindamycin을 투여하였다. 내원 8시간 후 환자의 의식이 명료해졌으며 내원 3일째 혈압 안정화되어 승압제 투여를 중단하였고 혈청 Cr 수치도 1.03 mg/dL로 정상화 되었다. 내원 4일째에 혈액배양검사에서 Streptococcus agalactiae 가 동정되었고, 항생제 수성 검사에서 penicillin G에 감수성이었다. 환자는 2주간의 항생제 치료 후 C-반응단백 수치가 정상화 되고 하지의 병변도 호전되어 항생제치료를 종결하였다. 결론: 본 증례는 B군 사슬알균인 S. agalactiae이 혈액배양검사에서 동정되었고 혈압저하를 동반한 신기능이상, 혈액응장애,피부 발적 소견으로 B군 사슬알균에 의한 독소충격증후군으로 진단할 수 있었으며 경험적 항생제로 추천되는 penicillin G와lincosamide를 병용하는 용법으로 호전된 예이다.
분선충과 거대세포바이러스 중복감염에 의한 십이지장 궤양 1예
김현옥,김재희,천윤홍,서영선,임민희,허상택,손운목,고경혁,배인규 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.6
Gastrointestinal strongyloidiasis and Cytomegalovirus infection mostly occur in patients receiving cancer chemotherapy, undergoing immunosuppressive therapy after organ transplantation, and suffering from acquired immune deficiency syndrome. A 56-year-old man was admitted to the hospital because of abdominal pain and constipation. He had a 10-year history of chronic obstructive pulmonary disease and has been treated intermittently with systemic steroid. The gastroduodenoscopic examination showed a single ulcer on the duodenal bulb and microscopic finding of the biopsy specimens from the ulcer revealed Strongyloides stercoralis and cytomegalovirus immunohistochemical stain positive intranuclear inclusion body on the mucosal surface. The patient was successfully treated with albendazole and ganciclovir.