http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
급성 골수성 백혈병으로 항암 치료 후 환자에서 발생한 간과 소장 털곰팡이증: 증례보고 및 문헌고찰
양태언,김선화,최병광,이순욱,박주희,홍경욱,김인선,서유빈,최철원,김우주 대한감염학회 2012 Infection and Chemotherapy Vol.44 No.6
We present a case of a 64-year-old woman with acute myeloid leukemia who developed a hepatic abscess during the neutropenic period after induction chemotherapy. To treat the abscess, meropenem and ciprofloxacin were administered to target Klebsiella pneumoniae and percutaneous drainage performed. As a result, the patient’s fever and c-reactive protein (CRP) subsequently improved. After six weeks of antibiotic therapy, an abdominal computed tomography scan revealed remains of the liver abscess as well as an ileus in the small bowel. Molds from the Mucor genus were cultured from repeated liver abscess drainage and an abscess wall biopsy confirmed hepatic mucormycosis. Along with administration of amphotericin-B deoxycholate for four weeks, we performed lobectomy for hepatic mucormycosis and small bowel resection for a suspected small bowel mucormycosis. After these operations, the patient received liposomal amphotericin B for three weeks and was then maintained with oral posaconazole for more than four weeks. Our case report suggests that hepatic mucormycosis should be considered when a hepatic abscess exhibits a retarded response to antibacterial agents, especially for patients with risk factors. In addition,because an isolated hepatic mucormycosis is infrequent, a thorough search for the extent of the disease is necessary before surgical resection.
젊은 남성에서 버디키아리 증후군에 합병된 다발성 골다공증성 압박골절 1예
김선화,양태언,최병광,류혜진,서지아,최경묵,김난희,김신곤,백세현,최동섭,최혜윤 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.4
Osteoporosis in young men is extremely rare. In this report, we demonstrate a rare case of multiple vertebral fractures discovered in a young man with Budd-Chiari syndrome without prior history of trauma. A 29-year-old man was diagnosed as Budd-Chiari syndrome 12 years ago and underwent a mesocaval shunt to relieve the hepatic vein obstruction and was on warfarin therapy. He suffered from low back pain and it was not relieved by analgesics. A T-L spine X-ray revealed multiple compression fractures and the zscore at lumbar spine was -3.7 which is below the expected range for that age. The patient was treated with calcium, vitamin D and bisphosphonate, and showed clinical improvement. This case highlights the importance of the investigation for secondary osteoporosis in young adults with an underlying disease that alters bone metabolism.
서유빈,양태언,김인선,홍경욱,송준영,정희진,김우주 대한감염학회 2012 Infection and Chemotherapy Vol.44 No.5
Background: Recent data regarding the clinical epidemiologic characteristics of Mycoplasma pneumoniae pneumonia in Korean adults are insufficient. This study was conducted in order to compare epidemics in different ages and to identify the clinical characteristics in adults. Material and Methods: We investigated patients who visited Korea University Guro Hospital from January to December 2011 due to community acquired pneumonia and underwent mycoplasma antibody tests. M. pneumoniae pneumonia was diagnosed if mycoplasma antibody titer was ≥1:320 at any time, seroconversion or 4-fold rise was seen at convalescent phase. Patients under the age of 19 were classified as child and adolescent, otherwise adult. We investigated the number of monthly cases in all patients and reviewed the medical records of adult patients. Results: A total of 249 young patients aged ≤18 years and 29 adults were diagnosed with M. pneumoniae pneumonia. Among young patients, 75.5% were concentrated in the 0-6 years age group and 58.6% of adults belonged to the 26-40 years age group. The number of young patients began to increase in July and continued to increase in December, while the number of adult patients began to increase in August and occurred continuously until December. The correlation coefficient of the epidemic trend between the two groups was 0.682 (P=0.015). Median age of adult patients was 33.3 years. Fever was observed in all patients and 25 patients (86.2%)complained of purulent sputum. The average white blood cell count was 7,066/mm3. The average values for aspartate aminotransferase, alanine aminotransferase,creatinine, and sodium were within the normal range. In chest X-ray study, ipsilateral lower patchy consolidation was found in 24 patients (82.8%). Twenty one adult patients (72.4%) were hospitalized. The mean duration of hospitalization was 7.3days. Twenty three patients (79.3%) were initially treated with combinations of third generation cephalosporin and macrolide. Among them, five patients (17.2%)showed poor responses. Six cases (20.7%) were initially treated with quinolone, and treatment was maintained until the end without changing antibiotics. Development of cryptogenic organizing pneumonia occurred in one case and there was no occurrence of death. Conclusions: When M. pneumoniae pneumonia is epidemic among children and adolescents, it should also be suspected in adult patients with community-acquired pneumonia. Some patients showed poor responses to macrolide. Overall, it appears that additional studies are needed for evaluation of the effectiveness of macrolide in treatment of M. pneumoniae pneumonia in adults.
Acute Myopericarditis caused by Human Metapneumovirus
최민주,송준영,양태언,전지호,노지윤,홍경욱,정희진,김우주 대한감염학회 2016 Infection and Chemotherapy Vol.48 No.1
Human metapneumovirus is known to be similar to respiratory syncytial virus. Because of an incomplete protective immune response to new genotypes, re-infection occurs frequently, especially in the elderly. However, the clinical manifestations of human metapneumovirus need to be further characterized in adults. A 73-year-old woman presented to the emergency room with acute dyspnea, chest discomfort and influenza-like illness. The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis. With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae. Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.