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신경섬유종증 환자에게서 발생한 특발성 혈소판 감소증 1예
권세훈,김형호,강지인,장재혁,원경준,장재현,김상용,배학연 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Idiopathic thrombocytopenic purpura is a disease characterized by thrombocytopenia in peripheral blood with positive anti-platelet antibody titer, no splenomegaly, the presence of megakarocyte. The causes of idiopathic thrombocytopenic purpura were usually related to autoimmune disease, infection and drugs. A 46-years-old man was admitted for evaluation of abdominal mass. He has many cafe-au-lait spots and nodules in almost skin for 30 years. Several years ago, he palpated mass in Lt. inguinal area. hIe has known the abdominal mass after checking abdomen CT in local clinic and visited our hospital for evaluation of abdominal mass. At admission, laboratory tests showed hemoglobin 12.5 g/dL, hematocrit 38.4 %, WBC 5,460 /㎣ (neutrophil 64.5%, lymphocyte 21.7%, monocyte 4.1%, eosinophil 5.4%), reticulocyte 0.7%, Platelet 52,000 /㎣, total protein 6.51 g/dL, albumin 3.80 g/dL, alkaline pohsphatase 161 IU/L, AST 110.7 IU/L, ALT 64.9 IU/L, total bilirubin 0.44 ㎎/dL, BUN 18.4 ㎎/dL, creatinine 0.79 ㎎/dL. Peripheral blood smear showed normocytic normochromic anemia, thrombocytopenia. Bone marrow aspiration smear showed normoplastic myeloid and erythroid precursor. The bone marrow biopsy section shows normocellular marrow (35%) for his age and mildly increasing myeloid cell lineage. We have experienced a case of idiopathic thrombocytopenic purpura in a patient being in neurofibromatosis and therefore reporting it with documentary records. 저자들은 신경섬유종증 환자에서 특별한 원인을 발견할 수 없었음에도 특발성 혈소판 감소증이 발생한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
고순도 AlN분체 합성을 위한 Al-N-H-Cl 반응계의 열역학적 평형조성
현상훈,김준학 연세대학교 산업기술연구소 1984 논문집 Vol.16 No.2
Thermodynamic equilibrium compositions in the Al-N-H-Cl system were determined to predict the theoretical equilibrium yields of AlN by the vapor phase reaction of NH₃ and AlCl₃. The calculation procedure of the equilibrium composition was to determine the mixture composition which corresponds to the minimum total Gibbs free energy of the reacting system. The equilibrium yields of AlN at 600-1200 K showed above 90% when the initial amounts of AlCl₃and of NH₃were equal and below ?? moles, respectively. The effect of the total pressure on the equilibrium yields was insignificant. The domain above 95% yields according to the initial ratio of AlCl₃to NH₃at 1200 K and 1300 K was also given. The theoretical aspects for the synthesis of high-purity AlN powders by the gas phase reaction of AlCl₃and NH₃were discussed.
박종빈,김학렬,주현준,유태양,신성남,신정현,송정섭,황기은,김소영,양세훈,정은택 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.2
최근 흡연을 시작한 젊은 성언에서 급성 호산구성 폐렴의 발생에 대한 증례가 보고되고 있다. 급성 호산구성 폐렴은 대개 발열을 동반하기 때문에 초기에는 감염성 폐렴으로 잘못 진단, 치료되는 경우가 많다. 아직 정확한 병태 생리 및 조직학적 소견은 밝혀져 있지 않지만 병력 청취 및 임상 양상, 방사선 소견의 관찰을 통해 급성 호산구성 폐렴을 의심하고, 진단을 위해 기관지 폐포 세척액 검사를 시행한다면 좀 더 쉽게 진단 내릴 수 있을 것이다. 본 저자들은 최근 처음 시작한 흡연에 의해 발생한 급성 호산구성 폐렴을 진단하고, 스테로이드를 투여하여 성공적으로 치료한 환자 2예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Acute eosinophilic pneumonia(AEP) is characterized by acute febrile respiratory illness associated with diffuse pulmonary infiltration and pulmonary eosinophilia. The specific etiology for acute eosinophilic pneumonia is elusive. By some investigators, cigarette smoking is suggested as a causative substance which can cause AEP. In recent, the authors experienced two cases of AEP following cigarette smoking. Both cases had characteristic features including age around 20 years, new onset smoking before occurance of AEP, diffuse infiltration on chest radiography, pulmonary eosinophilia based on bronchoalveolar lavage and acute improvement after steroid therapy. These clinical features are resemble with previous smoking induced AEP case reports. Base on these clinical features, cigarette smoking associated AEP could be diagnosed more easily.
Cervical bronchogenic cysts mimic metastatic lymph nodes during thyroid cancer surgery
Hak Hoon Jun,Seok Mo Kim,Yong Sang Lee,Soon Won Hong,Hang-Seok Chang,Cheong Soo Park 대한외과학회 2014 Annals of Surgical Treatment and Research(ASRT) Vol.86 No.5
Purpose: Although congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are rare, distinguishing them from other cervical cystic lesions (e.g., thyroglossal duct and branchial cleft cysts) and metastatic cervical lymph nodes is difficult preoperatively. Additionally, cystic degeneration of metastatic lymph nodes is common in patients with thyroid cancer. We investigated the clinical characteristics and proper treatment for individuals with cervical bronchogenic cysts. Methods: Of the 18,900 patients treated for thyroid cancer, 18 patients with pathologically confirmed bronchogenic cysts were retrospectively reviewed. Bilateral total thyroidectomy or less than total thyroidectomy with central compartment node dissection, including cystic mass excision was done and cystic mass was confirmed by postoperative pathologic examination. Results: All cervical bronchogenic cysts were asymptomatic. Their mean size was 1.2 cm (range, 0.3 to 3 cm). Of these 18 patients, 15 did not have any abnormal radiological findings, except for lymphadenopathy during preoperative evaluations. Most bronchogenic cysts were detected around the thyroid and paratracheal areas. On preoperative imaging and intraoperatively, most were indistinguishable from metastatic cervical lymph nodes or other cystic lesions. Conclusion: Although cervical bronchogenic cysts are rare and benign, they should be distinguished from other cystic cervical masses, especially metastatic cervical lymph nodes associated with thyroid cancer. Possible cervical bronchogenic cysts found during thyroid cancer evaluation or surgery should be surgically excised.
갑상선절제술을 시행 받은 고령의 갑상선암 환자의 임상적 특징에 대한 고찰
이근희(Keun Hee Lee)전학훈(Hak Hoon Jun),김종우(Jong Woo Kim),김승기(Seung Ki Kim),허진형(Jin Hyung Heo) 대한갑상선-내분비외과학회 2016 The Koreran journal of Endocrine Surgery Vol.16 No.4
Purpose: This study analyzes the clinical characteristics of thyroid cancer patients over 70 years of age following thyroidectomy. We identified the differences among previous studies and investigated the significance of thyroidectomy for elderly thyroid cancer patients. Methods: Information was abstracted from the charts of fifty-six patients treated during the period of Jan. 1995 to Dec. 2015. The abstraction included gender, age, surgical method, location with size of the main lesion, extent of lymph node metastasis, pathological features, gene mutation, complication, stage and most recent visit. Results: Our study showed a frequent occurrence (96.4% of the study group) of papillary thyroid cancers in elderly patients. There were three cases of postoperative complications. None had recurrence, and there was only one death due to complications of pneumonia. There were 11 advanced cases of cancer stage IV. Conclusion: Previous studies show that postoperative prognosis of elderly thyroid cancer patients is favorable. Average life expectancy is rising in South Korea, and therefore, the number of elderly thyroid cancer patients is increasing. Our study is meaningful in that it confirms the results of previous studies by surveying elderly patients over a 20 year period. It is deemed necessary that thyroidectomy be performed on elderly patients.
A rare cause of painful neck mass: submandibular gland flstula
( Hak-jun Kim ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Sung-min Par 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1
Salivary gland fistula is a fistula involving a salivary gland or duct. Most salivary gland fistulae are related to the parotid gland. Submandibular fistulas on the other hand are very rare entities with only few cases reported till date. Most of submandibular gland fistulas are known to be congenital in origin, but acquired cases can rarely occur. Herein, we report a rare case regarding submandibular gland fistula in dermatologic literatures. A 53-year-old woman presented with erythematous patch with painful subcutaneous mass on lt. side of neck, which had developed over the course of 3 weeks. Symptom persisted despite treatment with empirical oral antibiotics. The computed tomography neck scan revealed enhancing tubular structure from submandibular gland to anterior aspect of platysma muscle and abscess, which was consistent with submandibular gland fistula. The patient was managed conservatively with antibiotic therapy for 3 months and the symptoms improved markedly. Submandibular gland fistula is rare condition and might be easily misdiagnosed, because it usually presents nonspecific symptoms like painful neck swelling. Accurate diagnosis may be achieved by means of through clinical manifestation, radiographic findings, and sometimes surgical exploration. Dermatologist should be kept in mind the possibility of a submandibular gland fistula when a painful mass arising in the neck does not respond to initial treatment.