http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례 : 류마티스; 류마티스 관절염 환자에서 발생한 혈구탐식성 림프조직구증
최인아 ( In Ah Choi ),이은영 ( Eun Young Lee ),이은봉 ( Eun Bong Lee ),송영욱 ( Yeong Wook Song ) 대한내과학회 2014 대한내과학회지 Vol.86 No.3
Hemophagocytic lymphohistiocytosis (HLH) is a condition caused by excessive activation and expansion of T lymphocytes and macrophagic histiocytes that exhibit hemophagocytic activity. It is a life-threatening condition, and the reported mortality rates reach 20% to 30%. It is usually associated with infection, malignancy, or autoimmune disease, but rarely with rheumatoid arthritis (RA). We recently experienced a case of HLH with rapid progression resulting in mortality in a 38-year-old female patient with long-standing RA. She visited the clinic for evaluation of a common cold-like illness. She had hypotension, liver enzyme elevation, and pancytopenia. After admission, her hypotension continued and disseminated intravascular coagulation and metabolic acidosis developed and progressed with the appearance of azotemia. Despite supportive management, she died on the fifth hospital day. HLH should be considered as a differential diagnosis when patients with RA show acute illness with fever, cytopenia, hepatic failure, and coagulopathy.
최인아 ( In Ah Choi ),홍승재 ( Seung Jae Hong ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2
Gout is the most common inflammatory arthritis in men over 40 years old and the prevalence is increasing. Asymptomatic hyperuricemia is predisposing condition of gout but the frequency of progression to acute gout is not high enough to need prophylactic treatment. In acute gout flare, first line therapy is non-steroid anti-inflammatory agents (NSAIDs) or corticosteroids, depending on comorbidities. Colchicine is now second line therapy. Urate lowering therapy for gout needs to be initiated when the second attack occurs in a year. Allopurinol, a xanthine oxidase inhibitor, has been the most widely used agent for the treatment of chronic gout. Now, febuxostat has emerged as a new xanthine oxidase inhibitor that is expected to be useful in patients with mildly decreased renal function. Uricosuric agents are alternative therapies for patients with preserved renal function and no history of nephrolithiasis. During urate lowering therapy, the dose should be titrated upward until the serum uric acid level is kept less than 6mg/dL. When initiating urate lowering therapy, concurrent prophylactic therapy with NSAIDs or low dose colchicine for more than six months is recommended for reducing flare-ups. In chronic gout treatment, dietary modification seems to have minimal effect, but alcohol drinking and weight control can be recommended. (Korean J Med 76:151-162. 2009)
최인아 ( In Ah Choi ),송영욱 ( Yeong Wook Song ) 대한내과학회 2017 대한내과학회지 Vol.92 No.3
Korean society is aging rapidly. Overall, 13.1% of the Korean population was elderly (age ≥ 65 years) in 2015, and this rate is expected to reach 40.1% in 2060. To prepare for this change, the Korean government has developed a long-term care insurance service and supports regional medical centers for the aged. It has established laws about life-sustaining treatment and directives to improve end-of-life care. Although the long-term care insurance currently provides `in-home service` and `aged care facilities,` it does not cover rehabilitation hospitals, which can prevent elderly individuals from accessing certain medical services. With the changing demographics, medical care requires change. Conventional medical care must be upgraded to provide suitable care for an aged society. It is important to support the activities of daily living, rather than simply prolonging life. This will require providing home- and community-oriented medical care to improve quality of life. It will also be necessary to train more geriatricians who understand the characteristics of elderly patients, provide comprehensive geriatric assessments, and lead other physicians in team-based medicine. Internists are already engaging in multidisciplinary collaboration and end-of-life care, which are critical qualities of leading geriatricians. Further discussion and consensus is needed regarding the training of geriatric medicine specialists in Korea. (Korean J Med 2017;92:225-234)
증례 : 류마티스 ; Methotrexate로 치료한 불응성 육아종성 유방염 1예
유종진 ( Jong Jin Yoo ),강은하 ( Eun Ha Kang ),이윤종 ( Yun Jong Lee ),김성원 ( Sung Won Kim ),최인아 ( In Ah Choi ),이은봉 ( Eun Bone Lee ),송영욱 ( Yeong Wook Song ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Granulomatous mastitis (GM) is an uncommon chronic inflammatory disease of the breast that can mimic breast carcinoma or infection. The treatment options include expectant management, complete resection, and corticosteroid therapy, although no standard treatment has been established. Recently, several case reports have suggested that methotrexate is another effective treatment for GM. Here, we describe the first Korean case of recurrent GM successfully treated with low-dose weekly methotrexate and review the relevant literature. (Korean J Med 2012;82:386-391)