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김고흔,정성애,송현주,김성은,심기남,유권,김광호,한운섭 대한소화기내시경학회 2009 Clinical Endoscopy Vol.39 No.5
특발성 만성 궤양성 소장염은 특별한 기저질환 없이 소장의 궤양성 병변을 보이는 드문 질환으로 장의 조직검사를 통해 확진되며, 사망률이 75% 이상인 예후가 나쁜 질환이다. 10년 전부터 수회 복통으로 입원치료를 받았던 31세 남자가 10일간의 복통 및 발열을 주소로 내원하였다. 상부 위장관 내시경에서 십이지장 제2부에서 원위부로 연속되는 활동성 궤양들이 보였으며 대장내시경에서는 회장 말단에서 미만성 궤양들이 관찰되었다. 환자는 항생제, 스테로이드 및 보존적 치료를 받았으나, 내원 10일째에 혈변이 시작되어 쇽에 빠져 개복술을 시행 받았다. 메켈 게실이 관찰되어 제거하였으나 장출혈이 지속되어 다음날 다시 개복술을 시행하여 공장을 부분 절제하였다. 조직검사에서 궤양과 가성용종 및 육아조직이 보이며 혈관염 소견은 보이지 않아 특발성 만성 궤양성 소장염으로 진단하였다. 저자들은 심한 장출혈로 소장절제술을 시행하고 특발성 만성 궤양성 소장염으로 진단한 1예를 문헌 고찰과 함께 보고한다. Idiopathic chronic ulcerative enteritis (ICUE) is a rare disease with a mortality rate exceeding 75%, which manifests as an ulceration of the small bowel in the absence of a recognizable cause. It is diagnosed by biopsy. A 31-year-old man who had a 10-year history of recurrent episodes of abdominal pain was admitted with a 10-day occurrence of abdominal pain and fever. Upper endoscopy showed multiple active ulcers from duodenal second to distal portion. Colonoscopy revealed diffuse ulcerations at the terminal ileum. Colonic findings were normal. The patient was treated with intravenous antibiotics, systemic steroids, and total parenteral nutrition in the intensive care unit. Ten days after admission, the patient fell into shock due to massive hematochezia and underwent an emergency surgical resection, which revealed Meckel’s diverticulum. Bleeding was uncontrolled and the following day surgical resection and intraoperative endoscopy of the highly involved jejunum revealed severe ulcerative bleeding. Microscopic examination revealed ulcerations with pseudopolyps and granulation tissue and no evidence of vasculitis, suggestive of ICUE.
전윤희,김고흔,윤소윤,편욱범,문영철,송동은,최희정 대한감염학회 2010 감염과 화학요법 Vol.42 No.1
AIDS related malignancies have gradually decreased after the introduction of highly active antiretroviral therapy (HAART). Nevertheless, non-Hodgkin’s lymphoma is still a major malignancy in resource limited countries that have difficulty supplying HAART, and same holds true for Korea. We report a case of non-Hodgkin’s lymphoma involving the heart in a Korean AIDS patient, who presented with sudden arrhythmia and superior vena cava syndrome. He was diagnosed with AIDS in 2008, but refused to receive HAART. Immunohistologic findings were compatible diffuse large B cell lymphoma, and futher studies demonstrated involvement of the liver, adrenal gland, heart, and pericardiac space. HAART was initiated and non Hodgkin’s lymphoma was successfully managed with intensive chemotherapy. This is the first cardiac involvement non Hodgkin’s lymphoma in AIDS patients in Korea.
전윤희,김고흔,윤소윤,편욱범,문영철,송동은,최희정 대한감염학회 2010 Infection and Chemotherapy Vol.42 No.1
AIDS related malignancies have gradually decreased after the introduction of highly active antiretroviral therapy (HAART). Nevertheless, non-Hodgkin’s lymphoma is still a major malignancy in resource limited countries that have difficulty supplying HAART, and same holds true for Korea. We report a case of non-Hodgkin’s lymphoma involving the heart in a Korean AIDS patient, who presented with sudden arrhythmia and superior vena cava syndrome. He was diagnosed with AIDS in 2008, but refused to receive HAART. Immunohistologic findings were compatible diffuse large B cell lymphoma, and futher studies demonstrated involvement of the liver, adrenal gland, heart, and pericardiac space. HAART was initiated and non Hodgkin’s lymphoma was successfully managed with intensive chemotherapy. This is the first cardiac involvement non Hodgkin’s lymphoma in AIDS patients in Korea.
증례 : 호흡기 ; 간질성 폐부종으로 발현한 좌심방 점액종 1예
권경주 ( Kyoung Joo Kwon ),김고흔 ( Ko Hun Kim ),천은미 ( Eun Mi Chun ),류연주 ( Yeon Ju Ryu ),이진화 ( Jin Wha Lee ),장중현 ( Joong Hyun Jang ),심성신 ( Sung Shin Sim ) 대한내과학회 2010 대한내과학회지 Vol.79 No.2
심장의 원발성 종양은 드문 질환으로, 대부분의 경우 점액종이다. 심장의 점액종은 중추신경계와 혈관계통에 발생하는 색전의 원인이나 그 임상 증상은 비특이적이다. 비특이적인 전신 증상과 경미한 색전에 의한 증상은 심장 병력이 없는 환자에서 쉽게 지나칠 수 있다. 그러나 치명적인 색전을 예방하기 위해서는 점액종의 임상증상에 대한 이해와 적절한 치료가 필요하다. 저자들은 간질성 폐부종 증상으로 내원하여 좌심방 점액종을 진단받고 수술을 앞두고 있던 중다발성 색전으로 인해 사망한 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary neoplasm of the heart is rare. Benign tumors, the majority of which are myxomas, comprise up to 50% of cardiac neoplasms. Although cardiac myxoma is a source of emboli to the central nervous system and elsewhere in the vascular tree, its clinical signs and symptoms may be nonspecific. These nonspecific systemic symptoms and minor embolic phenomena may be overlooked in patients without a previous history of cardiac problems. Thus, we need to recognize the signs of myxoma and begin treatment immediately. We encountered a case of left atrial myxoma, presenting as pulmonary interstitial edema of unknown cause, in a 50-year-old female patient. Excision of a mass located on the left atrium was scheduled but she developed a cerebral embolism that led to her death. (Korean J Med 79:191-194, 2010)