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증 례 : 범발성 장염 소견으로 진단된 전신 홍반 루푸스
이한아 ( Han Ah Lee ),심혜기 ( Hye Gi Shim ),서영호 ( Young Ho Seo ),최성재 ( Sung Jae Choi ),이범재 ( Beom Jae Lee ),이영호 ( Young Ho Lee ),지종대 ( Jong Dae Ji ),김재훈 ( Jae Hoon Kim ),송관규 ( Gwan Gyu Song ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.2
Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE), needing prompt diagnosis and proper management. However, SLE rarely presents as lupus enteritis at the time of initial diagnosis. Thus, delayed diagnosis and misdiagnosis are common. We report a case of a 25-year-old woman with lupus panenteritis. The patient had multiple hospitalizations for abdominal pain, nausea, and diarrhea, initially without any other symptoms suggestive of SLE, but was later observed to have malar rash and oral ulcers. Laboratory investigations were compatible with SLE, including positive antinuclear antibody (1:320) with speckled pattern. CT revealed diffuse hypodense submucosal thickening of the stomach, the entire small bowel, colon, appendix, and rectum. Treatment with high-dose corticosteroids followed by maintenance therapy with mycophenolate mofetil, hydroxychloroquine, and azathioprine resulted in clinical improvement. Diagnosis of lupus enteritis requires a high index of suspicion given the low incidence and nonspecific clinical findings.
전한조 ( Han Jo Jeon ),김태형 ( Tae Hyung Kim ),엄순호 ( Soon Ho Um ),서연석 ( Yeon Seok Seo ),김현서 ( Hyun Seo Kim ),임기준 ( Ki Joon Lim ),박승운 ( Seung Woon Park ),이한아 ( Han Ah Lee ),김동식 ( Dong-sik Kim ) 대한간암학회 2016 대한간암학회지 Vol.16 No.2
Liver cancer is the 2nd most common cause of cancer related death in Korea. Especially, patients who present extrahepatic spread of hepatocellular carcinoma (HCC) have a shorter life expectancy (50% survival at 1 year and less than 4 months of median overall survival). Molecular target agent like sorafenib was usually mentioned as a treatment for them, but that was still not firmly established. We present a 75 year-old who had expanding nodular type of HCC. The mass was removed by resection and radiofrequency ablation. However, lung metastasis were revealed shortly after surgery. That lesions were treated with lenvatinib and systemic chemotherapy. (J Liver Cancer 2016;16:129-133)
재발한 혼합 간세포 담관상피암종 및 저혈관성 간세포암종 동시 절제 1예
김태형 ( Tae Hyung Kim ),엄순호 ( Soon Ho Um ),박상정 ( Sang Jung Park ),박승운 ( Seung Woon Park ),이한아 ( Han Ah Lee ),서연석 ( Yeon Seok Seo ),유영동 ( Young Dong Yu ),김동식 ( Dong-sik Kim ),김주영 ( Joo Young Kim ) 대한간암학회 2017 대한간암학회지 Vol.17 No.1
Liver cancer is more complex to treat compared to cancers in other organs, since liver function should be considered. In addition, only a few patients can be applied curative treatment due to advanced stage at diagnosis. Therefore, early stage detection is important and has been increased through screening and surveillance programs using image modalities recently. However, it is still difficult to diagnose small or hypovascular hepatocellular carcinoma (HCC) even using advanced image modalties. In particular, hypovascular HCCs do not show arterial contrast enhancement which is a typical finding of HCC on computed tomography (CT) and magnetic resonance imaging (MRI). Those also account for a considerable portion of early HCC. We present 54 years-old man who had recurrent hypervascular and hypovascular nodules on three phase CT and gadoxetic acid-enhanced MRI. The nodules were removed by surgical resection and confirmed as combined hepatocellular-cholangiocarcinoma and well differentiated HCC respectively. (J Liver Cancer 2017;17:94-99)
Miniscrew implant를 이용한 상악 구치부 압하와 개방교합 치료의 효과 및 안정성
이한아,박영철 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.1
최근 절대적인 고정원의 등장으로 다른 부작용 없이 구치부 압하 치료를 가능하게 하였고, 비수술적으로 개방교합의 심미적인 치료를 가능하게 하였다. 그러나, 이러한 치료법의 장기적인 안정성에 대한 연구는 많이 부족한 실정이다. 이에 본 연구에서는 miniscrew implant를 이용하여 상악 구치를 압하시켜 치료한 성인 개방교합 환자 11명 (남자 1명, 여자 10명)을 대상으로 치료 전후, 그리고 유지기의 골격성, 치아 치조성 변화를 측모 두부 방사선사진을 이용하여 평가하였으며 계측치의 치료 전후 변화량간의 상관관계와 치료에 의한 변화량과 재발량과의 상관관계를 규명하여 상악구치의 압하를 통해서 개방교합을 치료할 때의 안정성을 평가하였다. 그 결과로 상악 구치는 2.22mm 압하(P < 0.001)가 일어났고, 평균 17.4개월 유지 후 0.23 mm의 정출(P = 0.359)이 나타났으며, 재발율은 10.36%로 나타났다. 전치부의 수직피개는 평균 5.47 mm의 증가(P < 0.01)가 나타났고 평균 17.4개월 유지 후 0.99 mm의 감소(P < 0.05)가 나타나서, 재발량은 18.10%로 계산되었다. 치료 전후 수치 변화량의 상관분석을 통해 상악구치 압하량과 하악 평면각 변화량이 상관관계(P < 0.05)가 있었다. 치료 전의 개방교합량, 하악 평면각, 전하안면고경과 치료 후의 수직피개 재발량과는 상관관계가 없었다. 상악 구치 압하량과 수직피개 개선량에서 치료에 의한 변화량과 재발량이 통계적으로 유의한 상관관계를 보였고, 이를 토대로 재발량을 예측할 수 있었다. 이상의 결과를 통하여 성인 개방교합 환자에서 miniscrew implant를 이용한 상악구치부의 압하는 비수술, 심미적 접근방법으로 효율적이고 안정적인 치료방법으로 유용하게 사용할 수 있을 것으로 생각된다. Objective: This study investigated the skeletal and dentoalveolar changes after intrusion of maxillary posterior teeth using miniscrew implants during the treatment and posttreatment period. Method: The subjects consisted of 11 adults (1 male, 10 females) whose open bites were treated by posterior teeth intrusion with miniscrew. The lateral cephalometric x-rays of pre-treatment, post-treatment, and the retention period were evaluated. Results: The average intrusion of maxillary posterior teeth at the end of the treatment period was 2.22 mm (P < 0.001) and the average extrusion of maxillary posterior teeth at the end of the 17.4 month retention period was 0.23 mm (P = 0.359). The relapse rate was calculated at 10.36%. A decrease in overbite after the 17.4 month retention period was 0.99 mm (p < 0.05). The relapse rate was calculated at 18.10%. The skeletal changes and vertical height change of maxillary posterior teeth during the retention period was statistically insignificant, but there was a significant decrease in overbite (mean 0.99 mm, P < 0.05). The amount of intrusion and the overbite improvement from treatment significantly correlates to the degree of relapse. Conclusions: The results indicate that intrusion of the maxillary posterior teeth using miniscrews is an effective, non-surgical treatment modality which can reasonably be used to address adult open bite.