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Erdheim Chester Disease (ECD): A Case Report
이진호,정성택,최유덕,Lee, Jin-Ho,Jung, Sung-Taek,Choi, Yoo Duk The Korean Musculoskeletal Tumor Society 2013 대한골관절종양학회지 Vol.19 No.1
Erdheim chester disease (ECD)은 골격계 및 다발성 장기에 발생하는 매우 드문 비 랑거한스세포 조직구증(Langerhans cell histiocytosis,LCH)으로 구분되는 질환으로 진행성이며 때론 치명적인 결과를 야기한다. 하지만 이는 LCH 혹은 다발성 골 전이로 오인되기 쉬우며 진단 또한 극히 어렵다. 국내에서는 1999년에 10예가 처음으로 보고되었을 뿐이며 특히 정형외과적으로 접근 및 보고는 문헌상 영어권에서 극히 소수의 문헌만이 존재하며 국내에는 보고된 예가 없다. 저자들은 슬관절 및 하지통은 주소로 본과에 협진된 환자에 대해 골 조직검사 시행하였으며 이에 대한 진단적 경험을 문헌 고찰과 함께 보고하고자 한다. Erdheim Chester disease (ECD) is very rare non-Langerhans cell histiocytosis (LCH) which occurs in the skeletal system and multiple organs. As it is progressive, sometimes it causes fatal results. However, it is often misdiagnosed as LCH or multiple bone metastasis and, thus, is very difficult to diagnose. In Korea, only 10 cases were first reported in 1999. In particular, there have been a few orthopedic approaches or reports in English-speaking literatures, and no report has been issued in Korea. The authors performed bone biopsy in patients with knee and lower extremity pain who were referred for the integrated treatment. We attempts to report this diagnosis experience with literature review.
증례 : 혈액종양 ; 제1형 신경섬유종증 환자에서 신경내분비종양과 위장관기질종양 2예
최원영 ( Won Young Choi ),홍승덕 ( Seung Dok Hong ),김하나 ( Ha Na Kim ),최유덕 ( Yoo Duk Choi ),황준일 ( Jun Eul Hwang ),심현정 ( Hyun Jeong Shim ),배우균 ( Woo Kyun Bae ) 대한내과학회 2011 대한내과학회지 Vol.81 No.6
제1형 신경섬유종증 환자에서 신경내분비종양과 위장관 기질종양의 발생률이 일반인구에 비해 높다는 것은 잘 알려져 있지만 이들이 함께 발병한 경우는 전 세계적으로도 보고된 증례들이 매우 드물며 국내에서는 저자들이 알기에는 아직 보고된 바가 없다. 이에 저자 등은 제1형 신경섬유종증환자에서 비기능성 고분화 신경내분비종양과 위장관기질종양이 함께 발생한 2예를 경험하여 문헌고찰과 함께 보고하는 바이다. Patients with neurofibromatosis type 1 (NF1) are at increased risk of developing tumors throughout the gastrointestinal tract, including neuromas, gastrointestinal stromal tumors (GISTs), and periampullary somatostatin-rich carcinoids. The simultaneous occurrence of a GIST and a well-differentiated neuroendocrine carcinoma in a patient with NF1 is very rare. Here, we report two cases of the coexistence of a low-risk GIST in the jejunum with a well-differentiated neuroendocrine carcinoma in the duodenum in patients with NF1. These cases strengthen the known association of GIST with neuroendocrine carcinoma in patients with NF1. (Korean J Med 2011;81:786-791)
김광준(Gwang Jun Kim),김용욱(Yong Yook Kim),최유덕(Yu Duk Choi),최태행(Tae Haeng Choi),손문성(Moon Sung Son),김재유(Jae Yoo Kim),신종호(Jong Ho Sin) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1
We experienced a case of Ebstein's anomaly prenatally by fetal sonography. Ebstein's anomaly is a rare congenital heart defect characterized by abnormally downward displacement of the septal and posterior leaflets of the tricuspid valve. In the absence of tricuspid regurgitation, this condition may be completely asymptomatic. On the other hand, symptomatic newborns often develop life-threatening congestive heart failure. A 30-year-old multiparous woman was referred for the evaluation of fetal cardiac defect at 26th gestational week from a private clinic. Fetal ultrasonography showed markedly enlarged right atrium and downward displacement of tricuspid valve into the right ventricle. After discussion with the patient, the pregnancy was terminated and Ebstein's anomaly was confirmed by autopsy.
오인재 ( In Jae Oh ),주진영 ( Jin Young Ju ),최유덕 ( Yoo Duk Choi ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.3
We treated a rare case of TO that presented with recurrent massive hemoptysis that resulted in total obstruction of the bronchus intermedius by very large blood clots. Bronchoscopic intervention resulted in a full recovery from the atelectasis. However, there are no guidelines for preventing recurrence of the hemoptysis or disease progression. Conservative and expectant management are used to treat these patients and most do well.
재발성 비소세포폐암에서 Pemetrexed 치료 효과와 Thymidylate Synthase 발현의 관계
박철규 ( Choel Kyu Park ),김규식 ( Kyu Sik Kim ),오인재 ( In Jae Oh ),최유덕 ( Yoo Duk Choi ),권용수 ( Yong Soo Kwon ),김유일 ( Yoo Il Kim ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ),( Manaljav Tseden Ish ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.3
Background: Pemetrexed, a multi-targeted antifolate has been used as a second line treatment against non-small cell lung cancer (NSCLC). We aimed to clarify the efficacy and survival according to line of treatment, histologic type, and expression of thymidylate synthase (TS). Methods: Ninety-eight patients were treated with pemetrexed as a second line treatment (n=43) or as an additional course of treatment (n=55). TS expression was studied with immunohistochemistry and graded as 0 to 3 based on the extent of expression. Results: The response rate (RR) in 98 subjects was 10.2% and the disease control rate (DCR=PR+SD) was 30.6%. RR and DCR were 12.7% and 32.7% in non-squamous cell carcinoma (NSQC) compared to 7.0% and 27.9% in squamous cell carcinoma (SQC) (p>.05). No significant differences in RR and DCR were observed between a second line group (4.7%, 20.9%) and a further line group (14.5%, 38.2%). A similar trend was observed in the 88 response evaluable subjects. TS was expressed in 28.6% (grade 1), 24.5% (grade 2) and 7.1% (grade 3), respectively, and it was not expressed in 39.8% of subjects. TS expression rate was significantly higher in the SQC (72.1%) compared to NSQC (50.9%, p=0.033). However, the efficacy of pemetrexed was not significantly different by the extent of TS expression. Conclusion: Pemetrexed showed efficacy, not only in a second-line setting, but also in further lines of treatment for NSCLC. The efficacy of pemetrexed tended to be higher in patients with NSQC compared to SQC. TS expression rate was significantly higher in SQC compared to NSQC.
Tuberculosis and Respiratory Diseases : Pulmonary Oxalosis Caused By Aspergillus Niger Infection
박경화 ( Kyung Hwa Park ),김수옥 ( Soo Ok Kim ),오인재 ( In Jae Oh ),최유덕 ( Yoo Duk Choi ),김규식 ( Kyu Sik Kim ),고영춘 ( Young Chun Ko ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ),박경옥 ( Kyung Ok Park ),남종희 ( Jong 대한결핵 및 호흡기학회 2002 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.95 No.-
김연주 ( Yeon Joo Kim ),김현수 ( Hyun Soo Kim ),박선영 ( Seon Young Park ),박상우 ( Sang Woo Park ),최유덕 ( Yoo Duk Choi ),박창환 ( Chang Hwan Park ),최성규 ( Sung Kyu Choi ),류종선 ( Jong Sun Rew ) 대한소화기학회 2012 대한소화기학회지 Vol.60 No.3
We report herein a case of intestinal amyloidosis with grave prognosis that caused intractable diarrhea and intestinal pseudo-obstruction, alternately in spite of intensive conservative treatment. A 44-year-old woman was admitted for fever, diarrhea, and crampy abdominal pain which had been continuned during 6 months. Abdomen CT scan showed edematous wall thickening of the small bowel and right colon, and colonoscopic biopsy revealed amyloid deposition in the mucosa. Monoclonal light chains in serum and/or urine were not detected and highly elevated serum amyloid A was shown. In spite of intensive treatment including oral prednisolone and colchicine, diarrhea and intestinal pseudo-obstruction developed alternately, general status rapidly got worsened and died after two months. (Korean J Gastroenterol 2012;60:172-176)
증례 : 호흡기 ; 양어장 근무자에서 Mycobacterium terrae에 의해 발생한 과민성폐렴 1예
김은영 ( Eun Young Kim ),권용수 ( Yong Soo Kwon ),오인재 ( In Jae Oh ),임성철 ( Sung Chul Lim ),김영철 ( Young Chul Kim ),최유덕 ( Yoo Duk Choi ),선현주 ( Hyun Ju Seon ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
NTM에 의한 과민성 폐렴은 주로 MAC에 오염된 온수에 노출된 후 폐에 감염 또는 과민반응에 의해 발생하는 폐질환으로 알려져 있다. 저자들은 양어장에서 근무하던 중 호흡곤란, 기침, 가래 등의 증상으로 내원한 54세 남자 환자의 객담과 양어장 물에서 Mycobacterium terrae가 동정되었던 과민성 폐렴 1예를 경험하여 보고하는 바이다. 흉부 전산화단 층촬영에서 다발성 공기포획을 동반한 미만성 간유리 음영과 중심소엽성 결절들이 관찰되었고, 경기관지폐생검상 폐실질에 육아종성 염증 소견을 보였다. 환자는 코르티코스테 로이드 투여 후 증상 및 방사선 소견의 호전을 보였다. Hypersensitivity pneumonitis caused by exposure to non-tuberculous mycobacteria in indoor hot tubs has been called "hot tub lung." Most of these cases of hypersensitivity pneumonitis were, in fact, caused by Mycobacterium avium complex. We describe a case of hypersensitivity pneumonitis caused by M. terrae. A 54-year-old man presented with a 4-month history of exertional dyspnea, cough, and sputum. The patient had been working in a fishery for 5 years. Approximately 3 months before the onset of symptoms, he began working at another fishery. His chest CT scans showed diffuse ground-glass opacities with multifocal air trappings and centrilobular nodules in both lungs. Transbronchial lung biopsy specimens revealed hypersensitivity pneumonitis. M. terrae was isolated from a mycobacterial culture of his sputum and the water at the fishery. (Korean J Med 2011;80:S204-S208)
혈액종양 : 맹장암 간전이와 유사한 양상을 보인 개회충증 1예
김재용 ( Jae Yong Kim ),서형원 ( Hyeong Won Seo ),기명서 ( Myung Seo Ki ),정승연 ( Seung Yeun Jung ),김진웅 ( Jin Woong Kim ),최유덕 ( Yoo Duk Choi ),배우균 ( Woo Kyun Bae ) 대한내과학회 2015 대한내과학회지 Vol.89 No.6
Toxocariasis is a common helminth infection and the most common cause of peripheral blood eosinophilia. The clinical presentation of liver toxocariasis is often confused with primary or metastatic hepatic tumors. Here, we report on a 52-year-old man admitted with cecal cancer and eosinophilia. Computerized tomography (CT) scans revealed multiple lesions with peripheral enhancement in the liver, and T1- and T2-weighted images revealed isointensity. The patient underwent right hemicolectomy and an exploratory laparotomy with a liver biopsy. Resection of the cecal specimen revealed an adenocarcinoma, while the liver biopsy revealed an eosinophilic abscess with no evidence of malignancy. A serologic test showed a marked increase in specific immunoglobulin G antibody concentrations against Toxocara canis and daily antiparasitic treatment with albendazole (800 mg per day for 7 days) was initiated. Follow-up CT scans indicated that all liver masses and eosinophilia were resolved. (Korean J Med 2015;89:714-718)