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노진희 ( Jin Hee No ),이인석 ( In Seok Lee ) 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Gastric mucosa-associated lymphoid tissue (MALT) lymphomas comprise over 50% of primary gastric non-Hodgkin lymphomas and show an increasing incidence. Pathogenesis is often related to Helicobacter pylori infection (HPI). Howevere, endoscopic findings of MALT lymphoma are nonspecific and diagnosis is difficult by the naked eye due to various endoscopic appearances such as erosion, erythema, ulceration, atrophy and submucosal mass. Diagnosis is based on the histopathologic evaluation of multiple, deep and repeated biopsies taken from normal and any abnormal appearing sites of the stomach. Endoscopic ultrasound (EUS) can aid in accurate diagnosis, staging, and prediction of prognosis in gastric MALT lymphoma. After treatment of primary gastric lymphoma, EUS produces conflicting results that are not as accurate as endoscopy with biopsy. Therefore, EUS is not mandatory during follow-up. A first evaluation of lymphoma regression should be performed 3-6 months after completion of treatment. Further follow-up should be performed every 4-6 months thereafter until complete remission of lymphoma is documented. Gastroscopy with multiple biopsies has to be performed. Additionally, the initial sites of lymphoma involvement should be checked by appropriate methods. If complete remission of gastric MALT lymphoma is achieved, follow-up gastroscopies with biopsies seem advisable. (Korean J Med 2012;83:699-705)
결핵성 심막염으로 항결핵약을 복용하던 중 발생한 혈구 탐식증후군
노진희 ( Jin Hee No ),강지영 ( Ji Young Kang ),이보희 ( Bo Hee Lee ),김윤지 ( Yun Ji Kim ),이정은 ( Jung Eun Lee ),민진수 ( Jin Soo Min ),강민규 ( Min Kyu Kang ),김경희 ( Kyung Hee Kim ),윤형규 ( Hyoung Kyu Yoon ),송정섭 ( Jeong S 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.6
A 63-year old woman was admitted to our hospital for an evaluation of thrombocytopenia. She had been diagnosed with tuberculous pericarditis three months earlier in a local clinic and treated with anti-tuberculosis medication. Two months later, thrombocytopenia developed. The medication was subsequently stopped because it was suspected that the anti-tuberculosis medication, particularly rifampin, might have caused the severe platelet reduction. However, the thrombocytopenia was more aggravated. A bone marrow biopsy was performed, which showed moderate amounts of histiocytes with active hemophagocytosis. This finding strongly suggested that the critical thrombocytopenia had been caused by hemophagocytic syndrome, not by the side effects of the anti-tuberculosis medication. Furthermore, the development of hemophagocytosis might have been due to an uncontrolled tuberculosis infection and its associated aberrant immunity. Therefore, she was started with both standard anti-tuberculosis medication and chemotherapy using etoposide plus steroid. One month after the initiation of treatment, the thrombocytopenia had gradually improved and she was discharged in a tolerable condition. At the third month of the follow-up, her platelet level and ferritin, the activity marker of hemophagocytic syndrome, was within the normal range. (Tuberc Respir Dis 2008;65:522-526)
혈액투석 도관과 관련된 다발성 폐렴을 동반한 우심방 거대 감염성 혈전증
이보희 ( Bo Hee Lee ),김현경 ( Hyun Gyung Kim ),이자영 ( Ja Young Lee ),강봉구 ( Bong Koo Kang ),정의성 ( Eui Sung Chung ),서광일 ( Kwang Il Seo ),노진희 ( Jin Hee No ),원유동 ( Yoo Dong Won ),김영수 ( Young Soo Kim ),윤선애 ( Sun 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
There has been an increase in the use of central venous catheters for temporary hemodialysis. Infected thrombus of right atrium is a rare but life-threatening complication of the central venous catheterization. A 35-year-old female hemodialysis patient was admitted with fever and dyspnea. She had been inserted tunneled hemodialysis catheter 2 months before. Blood cultures revealed methicillin-resistant Staphylococcus aureus. Chest CT showed multi-focal pneumonia and 4 cm sized huge thrombus in the right atrium. Echocardiography demonstrated same thrombus attached to the catheter tip in the right atrium. The catheter could not be removed because of high risk of pulmonary thromboembolism. Despite intravenous vancomycin treatment, the patient died from esophageal varix bleeding.