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그레이브스병 환자에서 양측성 경동맥-해면정맥동루에 의한 안구병증
하종건,석지혜,조아라,정찬우,김봉재,박성오,김상수,김미경 대한내분비학회 2011 Endocrinology and metabolism Vol.26 No.4
Graves’ disease (GD) can lead to specific eye afflictions including proptosis, periorbital swelling, conjunctival injection, chemosis,and opthalmoplegia, which then become a condition called Graves’ ophthalmopathy or thyroid-associated ophthalmopathy (TAO). A carotid cavernous fistula (CCF) is an abnormal vascular communication between the carotid artery and the cavernous sinus. The clinical signs of CCF are very similar to TAO and should be considered as a differential diagnosis of TAO. We would like to present an interesting case of a bilateral ophthalmopathy induced by CCF in a GD patient. A 54-year-old man with a 6-year history of GD presented with bilateral exophthalmos and conjunctival injection for two months. The orbital CT scan findings were consistent with CCF, and an angiography revealed bilateral CCF. He received a bilateral coil embolization for the CCF and his ophthalmic signs were immediately improved. We recommend orbital imaging to exclude other coexisting diseases in patients who are suspected of TAO, especially when the diagnosis is uncertain or when determining whether medical or surgical intervention is appropriate.
An Extremely Rare Case of Gastric Subepithelial Tumor: Gastric Endometriosis
하종건,최철웅,김형욱,강대환,박수범,김수진,홍정범 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.1
Endometriosis is a disease characterized by the presence of endometrial tissue outside of the uterine cavity. It is common in women of childbearing age, and is most frequently located in the pelvic cavity. Approximately 10% of endometriosis cases occur outside of the pelvic cavity in locations such as the intestines, genitourinary system, kidneys, lungs, and skin. However, there have been few reports of endometriosis in the stomach. Here, we report a rare case of endometriosis that presented as a subepithelial stomach tumor.
A Case of Central Pontine Myelinolysis in a Type 2 Diabetic Patient without Electrolyte Changes
조아라,석지혜,하종건,정찬우,김봉재,박성오,황선출,최현욱,김미경 대한내분비학회 2011 Endocrinology and metabolism Vol.26 No.3
Central pontine myelinolysis (CPM) by complicating rapid correction of severe hyponatremia has been widely reported. Additionally,CPM was occasionally reported among patients with post-liver transplantation, burns, chronic renal failure with dialysis, or other diseases associated with or not associated with other electrolyte changes or hyperosmolarity. However, there have been a few reports of CPM occurring in diabetic patients without documented electrolyte changes. This report is, to the best of our knowledge,the first report of CPM in type 2 diabetic patients without electrolyte changes in Korea. A 40-year-old man with type 2 diabetes mellitus with abruptly developed dysarthria and ataxia was admitted to our facility. He suffered from poor glucose control and multiple diabetic complications. Brain magnetic resonance imaging (MRI) revealed a well-defined bilateral symmetric hyperintense lesion in the central portion of the pons on T2- and diffusion-weighted images, which was consistent with CPM. After the patient’s blood glucose and blood pressure normalized, his dysarthria and ataxia improved. Six months after discharge, follow-up MRI showed a persistent, but greatly reduced symmetric lesion in the central pons. It is certainly possible for CPM to be overlooked clinically in diabetic patients, but more cases could be diagnosed if careful attention was paid to this syndrome.
증례 : 신장 ; 혈액투석 환자에서 HbsAg의 자연소실
전지민 ( Ji Min Jeon ),하종건 ( Jong Kun Ha ) 대한내과학회 2014 대한내과학회지 Vol.87 No.6
저자들은 면역저하 환자라 할 수 있는 말기신부전 혈액투석 환자에서 HBsAg의 자연소실 및 B형 간염의 회복 소견을 보이는 증례를 경험하였기에 이를 보고하는 바이다. The incidence of hepatitis B has been reported to be high in dialysis centers. Dialysis patients are at increased risk of acquiring hepatitis B due to their immunodeficient state, which impairs elimination of the hepatitis B virus, chronic dialysis patients rarely clear hepatitis B surface antigen (HBsAg) spontaneously. Hepatitis B virus infection is associated with a high risk of hepatic complications. We report the case of a 66-year-old HBsAg-positive female patient who had undergone hemodialysis for 58 months due to end-stage renal failure and became HBsAg-negative followed by the development of hepatitis B surface antibody. (Korean J Med 2014,87:747-749)
결핵성 복막염 치료 중 역설적 반응에 의해 발생한 결핵성 간농양
김태경 ( Tae Kyung Kim ),최철웅 ( Cheol Woong Choi ),하종건 ( Jong Kun Ha ),장형하 ( Hyung Ha Jang ),박수범 ( Su Bum Park ),김형욱 ( Hyung Wook Kim ),강대환 ( Dae Hwan Kang ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1
Tuberculous liver abscesses are rare. Paradoxical response in tuberculosis is common and occurred between 2 weeks and 12 weeks after anti-tuberculous medication. We report here a case of tuberculous liver abscess that developed in a paradoxical response during chemotherapy for tuberculous peritonitis in a 23-year-old male. He was hospitalized, complaining of ascites, epigastric pain. He was diagnosed tuberculous peritonitis by expiratory laparoscopic biopsy and took medication for tuberculosis. After 2 months, a hepatic lesion was detected with CT scan incidentally. Chronic granulomatous inflammation was seen in ultrasound-guided liver biopsy, and tuberculous liver abscess was diasnosed. It was considered as paradoxical response, rather than treatment failure or other else because clinical symptoms of peritoneal tuberculosis and CT scan improved. After continuing initial anti-tuberculous medication, he was successfully treated. Herein, we report a case of tuberculous liver abscess as paradoxical response while treating peritoneal tuberculosis without changing anti-tuberculous treatment regimen. (Korean J Gastroenterol 2013; 62:64-68)
정찬우 ( Chan Woo Jung ),김봉재 ( Bong Jae Kim ),박성오 ( Sung Oh Park ),조아라 ( A Ra Jo ),하종건 ( Jong Kun Ha ),박승근 ( Seung Keun Park ),김혜숙 ( Hye Sook Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.6
Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. Cholesterol granuloma is histologically characterized as fibrous granulation tissue containing cholesterol crystals within surrounding giant cells. Cases of cholesterol granuloma of the pancreas are very rare. We report a case of a 47-year old male who had a cholesterol granuloma of the pancreas. Abdominal CT showed 24 mm-sized cyst in the pancreas and peri-pancreatic regional mass infiltrating to the stomach. PET-CT revealed increased 18F-FDG uptake at the cyst and peri-pancreatic mass. Thus, Whipple`s operation was done. The disease was confirmed by surgical pathologic examination of the tissue. Pathologic examination of resected specimen showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells. We report on this case and give a brief review of the literature. (Korean J Gastroenterol 2011;58:353-356)