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폐암과 병발한 류마티스 관절염 환자에서 항암요법에 따른 임상경과
최선욱 ( Son Ook Choi ),정재규 ( Jae Gu Jung ),형복진 ( Bok Jin Hyoung ),박상미 ( Sang Mi Park ),정현정 ( Hyun Jung Jung ),박보형 ( Bo Hyoung Park ),심병용 ( Byoung Yong Shim ),김완욱 ( Wan Uk Kim ),김훈교 ( Hoon Kyo Kim ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.2
A 54-year-old male was admitted due to lung cancer and polyarthralgia involving wrist, hand, shoulder, and ankle joints. Five months ago, he had been diagnosed as adenocarcinoma of the lung, and treated with three cycles of chemotherapy using gemcitabine and cisplatin. In the course of chemotherapy, he had complained symmetrical polyarthralgia of hand and shoulder joints, resembling rheumatoid arthritis (RA). After treatment with chemotherapeutic agents, he still had severe polyarthritis refractory to anti-rheumatic drugs, including prednisolone, hydroxylchloroquine, and methotrexate, and thus referred to our hospital. We changed the previous anti-cancer regimens to cisplatin plus docetaxel, a semisyntheic taxane molecule, which is known to suppress experimental polyarthritis. With additional three cycles of cisplatin plus docetaxel, RA disease activity as well as polyarthralgia was nearly completely resolved, and the extent of lung cancer was not aggravated. Although RA patients have an increased risk of malignancy, the outbreak of RA was very rare in lung cancer patients. Here we report a case of coincident lung cancer and rheumatoid arthritis, which was successfully treated by docetaxel plus cisplatin chemotherapy.
증례 : Rituximab으로 치료한 불응성 특발성혈소판감소성자반증 1예
서석민 ( Suk Min Seo ),임창훈 ( Chang Hoon Lim ),최선욱 ( Son Ook Choi ),김희제 ( Hee Je Kim ),이종욱 ( Jong Wook Lee ),민우성 ( Woo Sung Min ),김춘추 ( Chun Choo Kim ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
ITP는 원인을 찾을 수 없이 혈소판의 수적 감소로 발생되는 질환으로 혈소판이 30,000/μL 이하이거나 출혈이 있는 경우에 치료가 요구된다. 부신피질호르몬, 비장절제술이 대표적인 치료 방법이며 이에 반응이 없을 경우 면역억제제, 혈장반출법, 고용량 면역글로불린, 다나졸, 콜키친 등의 다양한 치료 방법을 시도할 수 있으나 반응이 매우 낮은 반면 부작용이 문제가 된다. Rituxi-mab은 B 림프구의 표면에 발현되는 CD20 항원에 특이적인 인간-생쥐 키메라 단클론항체로 만성 ITP에서 반응이 좋은 것으로 보고되고 있다. 저자들은 기존의 치료에 반응이 없던 불응성 ITP로 계속되는 질출혈과 폐출혈이 있었던 32세의 여자 환자에게서 Rituximab을 사용하여 치료에 성공한 증례를 경험하였기에 보고하는 바이다. Idiopathic thrombocytopenic purpura (ITP) is an immune disorder in which platelets are opsonized by autoantibodies and prematurely destroyed by the reticuloendothelial system. Among adult patients, approximately 25~30% develop a chronic disease that will become refractory to corticosteroids and splenectomy, as well as other available agents. Rituximab is a human-murine chimeric monoclonal antibody specific for the CD20 antigen, found on the surface of B lymphocytes. It acts via complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and induction of apoptosis. We report a case of 32-year-old female with severe, refractory ITP, who presented with generalized petechiae, intractable vaginal bleeding, and pulmonary hemorrhage. After multiple conventional therapeutic trials, the patient was finally placed on weekly infusion of rituximab that resulted in a favorable response. (Korean J Med 69:S934-S938, 2005)
결핵 후유증과 진균덩이를 가진 객혈환자에서 발견된 기관 게실 1례
김진우 ( Jin Woo Kim ),송선화 ( Sun Wha Song ),최선욱 ( Son Ook Choi ),지병수 ( Byoung Soo Jie ),권순석 ( Soon Seog Kwan ),김영균 ( Young Kyoon Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.60 No.4
We experienced a rare case of trachea diverticula combined with the sequela of tuberculosis and a fungus ball. The patient had complained of coughing and hemoptysis for a long time after experiencing tuberculosis. He was admitted due to hemoptysis and the aggravation of coughing. The CT scan showed a variable sized trachea diverticula combined with tuberculosis sequela and a fungus ball in the right lung fields. The diagnosis was made by bronchoscopy and a CT scan. After bronchial artery embolization and conservative treatment, the patient`s symptoms improved and the patient was discharged. (Tuberc Respir Dis 2006; 60: 469-472)
이달의 X-선 : 면역기능이 정상인 환자에서의 폐 효모균증 1례
노은숙 ( Eun Suk Roh ),박민경 ( Min Kyung Park ),안지원 ( Ji Won An ),이승재 ( Seung Jae Lee ),손혜숙 ( Hye Suk Son ),성혜영 ( Hye Young Sung ),최선욱 ( Son Ook Choi ),김길선 ( Guil Sun Kim ),형복진 ( Bok Jin Hyoung ),이상훈 ( San 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.6
함주호 ( Joo Ho Ham ),김태호 ( Tae Ho Kim ),한석원 ( Sok Won Han ),조근종 ( Keun Jong Cho ),최선욱 ( Son Ook Choi ),백정선 ( Jung Sun Pack ),양성은 ( Seong Eun Yang ),김상희 ( Sang Hee Kim ),양승아 ( Seung Ah Yang ),이윤정 ( Yune 대한소화기학회 2007 대한소화기학회지 Vol.50 No.5
Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas filled cysts in the intestinal wall. The diagnosis of PCI is usually made by colonoscopy, histology, or radiologic findings. We report a case of PCI in a 35-year-old man. The patient initially complained of watery diarrhea and abdominal bloating for 2 weeks. Simple abdominal X-ray demonstrated numerous, small, round, air densities on the right upper abdomen along the ascending and proximal transverse colon. Colonoscopy revealed numerous, 5-20 mm sized, sessile poly-poid, balloon-like distended, protruding subepithelial masses covered with normal colonic mucosa from cecum to proximal transverse colon. We performed a CT colonoscopy and confirmed PCI with multiple air-filled cystic masses along the colonic wall from cecum to proximal transverse colon. The patient was treated with antibiotics and oxygen inhalation for 2 weeks. Follow-up CT colonoscopy revealed marked regression in the number and size of the air-filled cystic masses. Herein, we report the first case of the PCI in Korea diagnosed by CT colonoscopy. Follow-up evaluation with CT colonoscopy was performed after the treatment of the PCI. CT colonoscopy is a useful non-invasive diagnostic tool for the diagnosis of pneumatosis cystoides intestinalis. (Korean J Gastroenterol 2007;50:334-339)