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Gastric Calcifying Fibrous Tumor : A Rare Cause of Gastric Subepithelial Lesion
박상훈;오태훈;김병규;강미선;허란;김정연 인제대학교 2011 仁濟醫學 Vol.32 No.-
석회화 섬유종양은 원인 미상의 흔하지 않은 양성 중앙이다. 이 종양은 복강이나 복막에서 기원하는 경우가 많으나 위에서 기원한 석회화 섬유종양은 매우 드물 다. 건강검진시 위내시경에서 우연히 발견된 위 점막하 종양 평가를 위해 28세 여성이 본원으로 전원되었다. 본원에서 시행한 위 내시경에서 위 중간체부에 1.2cm의 평탄한 표면의 위 점막하 종양이 관찰되었다. 초음파 내시경을 시행하였고 점막하층에 위치한 불균질한 저에코성의 병변과 함께 종양 내부에는 음향 음영을 동반한 다수의 고 에코성의 부위가 관찰되었다. 위 점막하 중앙은 악성종양을 완전히 배제할 수 없기 때문에 내시경적 점막하 절제술을 시행하였다. 조직 검사결과 종양은 석회화률 동반하는 호산구성 콜라겐 섬유가 풍부한 위 석회화 섬유 종양으로 진단되었다. 이에 위 점막하 중앙에 관한 다른 문헌을 고찰하면서 본 증례를 보고하는 바이다.
강미선;박상훈;박지영 서희영;허란;김상현 인제대학교 백병원 2011 仁濟醫學 Vol.32 No.-
Acute fatty liver of pregnancy (AFLP) was first described as a specific clinical entity in 1940 and thought to be universally fatal. Maternal mortality in the past approached 75 percent. However early diagnosis and prompt delivery have dramatically improved the prognosis, and maternal mortality rate is now less than 18 percent. A early diagnosis, a prompt delivery, and a intensive supportive care have improved maternal and perinatal outcome. We report a 30—year—old woman at 37 weeks gestation who have multiple complications including acute pancreatitis in AFLP. She was complicated with acute renal failure, disseminated intravascular coagulation, duodenal ulcer bleeding, spontaneous bacterial peritonitis, pulmonary edema and acute pancreatitis.
Heo, Jaesung,Oh, Young-Taek,Noh, O Kyu,Chun, Mison,Park, Jun-Eun,Cho, Sung-Ran The Korean Society for Radiation Oncology 2016 Radiation Oncology Journal Vol.34 No.4
Purpose: The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer. Materials and Methods: From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT. Results: Among 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count - cell count at 4 weeks) was associated with node down staging (p = 0.034). Conclusion: Our results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.
Heo, Ran;Kim, Byung-Ok;Kim, Jeong-Hoon;Kang, Mi-Seon;Jang, Won;Seo, Hee-Young;Park, Ji-Young;Park, Sang-Hoon;Cho, Sung-Woo 인제대학교 2011 仁濟醫學 Vol.32 No.-
알코올의 과다 섭취는 심근 경색의 드문 원인으로, 저자들은 알코올의 과다 섭취 후 발생한 ST 분절 상승 심근 경색 환자에서 정상 관상동맥 소견을 보이는 증례를 보고하는 바이다. 70세 남환이 과음 후 반혼수 상태로 내원하였다. 당시 심전도 및 심근 효소치는 정상이었으나, 2일 후 심전도에서 II, III, aVF, V4-6에 ST 분절 상승과 함께 심근 효소치의 상승을 보였다. 관상동맥 조영술에서 이상 병번은 없었으며, 경흉부 심초음파에서 구혈률은 61.7%였고, 국소 벽운동 장애는 관찰되지 않았다. 알코을은 관상동맥의 연축, 혈견 유발 및 혈관 내피 세포 손상과 연관이 있으나, 알코올에 의한 심근 경색의 기전은 명확하지 앉은 상태이다. 본 증례는 기존의 보고와는 달리 고령에서 발생한 첫 증례로서 ST 분절 상승 상태에서도 정상 관상 동맥 및 정상 심기능을 보였다는 점에 특이성이 있다고 할 수 있다.
Aspergillus fumigatus에 의한 요추 척추염 1예
허상택,정숙인,김연숙,오원석,조황래,김성민,백경란,송재훈,이남용 대한감염학회 2001 감염 Vol.33 No.2
Aspergillus fumigatus is the most common pathogen causing invasive aspergillosis. Although invasive aspergillosis mainly involves lung, brain, and sinus, Aspergillus fumigatus osteomyelitis of the spine has been reported very rarely. We experienced a case of vertebral Aspergillus osteomyelitis and report it with a review. A 70-year-old women was admitted due to progressive lower back pain, which had begun 1 month before admission. Although she had diabetes and hypertension, no other underlying disease or immune dysfunction was fecund. MRI of spine showed severely destroyeded lumbar spines. Debridement and bone graft was done for correction of unstable spine, and Aspergillus fumigatus wsa grown from surgical specimen. Amphotericin B was given up to total 2 g, and was switched to oral itraconazole maintenance therapy. She is well until now, 120 days after operation. On the other hand, anthracofibrosis due to Mycobac-Terium tuberculosis was found through bronchoscopic study, which was done because of atelectasis in left lower lobe of lung. Therefore she was treated with anti-tuberculous agents also. (Korean J Infect Dis 33: 153∼156, 2001)
Kim, Sung-Min,Kim, Ji-Soo,Heo, Young Eun,Yang, Hye-Ran,Park, Kyung Seok SAGE Publications 2012 Multiple sclerosis journal: clinical and laborator Vol.18 No.2
<P> Neuromyelitis optica (NMO), mainly affecting optic nerve and spinal cord, can also manifest diverse ocular symptoms due to brain abnormalities. We present a cortical oscillopsia without nystagmus or head tremor in a patient with neuromyelitis optica spectrum disorder (NMOSD) with anti-aquaporin 4 antibody. This rare ocular manifestation, which is easily underestimated owing to absence of the typical nystagmus, can be an initial manifestation of NMOSD. </P>
허상택 ( Sang Taek Heo ),박미연 ( Mi Yeoun Park ),최영실 ( Young Sill Choi ),오원섭 ( Won Sup Oh ),고관수 ( Kwan Soo Ko ),백경란 ( Kyong Ran Peck ),송재훈 ( Jae Hoon Song ) 대한내과학회 2008 대한내과학회지 Vol.74 No.1
Q열은 국내에서도 드물지 않은 질환으로 생각되며, 조기에 진단하지 못하는 경우에 심내막염이나 혈관염 등의 만성 Q열로 진행하여 사망에 이를 수 있다. 물론 급성 Q열은 비특이적 증상에서 폐렴이나 간염 소견으로 내원하는 환자가 대부분이나 발열의 원인이 확실한 경우 원인균이 밝혀지지 않아도 Q열의 혈청학적 의뢰를 요하는 경우는 흔하지 않다. 하지만 발열을 주소로 내원한 환자들에 대하여 상기 증례들처럼 불명열의 경우 가축이나 이들의 부산물에 접촉력이 있는 경우 뿐만 아니라 특별한 접촉력이나 직업력이 없더라도 불명열로 내원한 환자들의 감별진단에서 Q열의 가능성을 고려하여 혈청학적 검사 및 핵형 분석을 시행해야 하겠다. 향후 국내에서도 사람뿐만 아니라 가축에서의 대규모의 역학적 조사가 추가적으로 필요할 것으로 생각된다. Q fever is an orthozoonotic infection caused by Coxiella burnetii, which was recently reclassified from the order Rickettsials to the order Legionellales. Although Q fever is usually mild and self-limiting, it may be manifested as a serious disease, such as pneumonia, endocarditis, or meningoencephalitis. We describe three separate cases of acute Q fever, which were diagnosed by an indirect micro-immunofluorescence assay (MIFA) test and DNA amplification (PCR). Three adult patients were admitted between December 2004 and August 2006 because of a fever of greater than three weeks duration. Only one patient had contact history with a dog. Of the three patients, two patients had myalgia, headache, skin rash, lymphadenopathy, and hepatosplenomegaly. Although all sets of blood cultures were negative, anti-phase II antibody titers by using an indirect MIFA (IgG 1:512-1,024 and IgM 1:320) were markedly increased in sera from all of three patients. Concomitant PCR assays also demonstrated the presence of OMP com1 for C. burnetii in blood from all of the three patients. Two patients had complete resolution of symptoms and signs with a two-week course of doxycycline, while one patient had spontaneous defervescence. Although the incidence of Q fever is not well known yet in Korea, it should be considered in the differential diagnosis of patients with fever of unknown origin. (Korean J Med 74:100-105, 2008)
Jaesung Heo,Young Taek Oh,O Kyu Noh,Mison Chun,Jun Eun Park,Sung Ran Cho 대한방사선종양학회 2016 Radiation Oncology Journal Vol.34 No.4
Purpose: The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer. Materials and Methods: From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT. Results: Among 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count − cell count at 4 weeks) was associated with node down staging (p = 0.034). Conclusion: Our results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.