untitled

Size: px
Start display at page:

Download "untitled"

Transcription

1 Korean J Hematol Vol. 44, No. 3, September, 2009 Case Report 원발성자가면역골수섬유증 1 예 가천의과학대학교길병원 1 진단검사의학과, 2 혈약종양내과 박순호 1 ㆍ서일혜 1 ㆍ박필환 1 ㆍ안정열 1 ㆍ송영희 1 ㆍ김정은 1 ㆍ박진희 2 ㆍ김경희 1 A Case of Primary Autoimmune Myelofibrosis Soon-Ho Park, M.D. 1, Yiel-Hea Seo, M.D. 1, Pil-Hwan Park, M.D. 1, Jeong-Yeal Ahn, M.D. 1, Young-Hee Song, M.D. 1, Jung-Eun Kim, M.D. 1, Jinny Park, M.D. 2 and Kyung-Hee Kim, M.D. 1 Departments of 1 Laboratory Medicine, 2 Internal Medicine, Gachon University Gil Hospital, Incheon, Korea Myelofibrosis is usually observed in association with hematologic malignancies or metastatic solid tumors, but it has rarely been reported in patients who suffer with autoimmune disorders. Autoimmune myelofibrosis is a distinct clinicopathologic entity and it can occur alone or in association with autoimmune disorders, and the final result is chronic peripheral cytopenia. Primary autoimmune myelofibrosis, in which the autoimmune myelofibrosis is not preceded by a well-defined autoimmune disease, has recently been defined as a distinct clinicopathologic syndrome. We report here on a case of an 18-year-old woman who was diagnosed with primary autoimmune myelofibrosis, and she manifested peripheral pancytopenia, positivity for autoantibodies and Grade III myelofibrosis without having any preceding autoimmune or hematologic disorders. (Korean J Hematol 2009;44: ) Key Words: Myelofibrosis, Primary, Autoimmune disorder 서론골수섬유증 (myelofibrosis) 은종양세포혹은반응성세포에서합성된섬유소생성시토카인 (cytokine) 에의해골수기질의섬유모세포 (fibroblast) 가자극됨으로써유발되는질병으로서, 1) 골수증식성종양외에급ㆍ만성골수성혈액종양, 림프구성혈액종양및고형종양의골수내전이등을포함한종양성원인에의해일차적혹은이차적으로발생할수있고, 자가면역질환, 바이러스감염등의비종양성원인에의해이차적으로유발될수있다. 2) 비종양성원인중자가면역골수섬유증 (autoimmune myelofibrosis) 은대부분전신홍반루푸스 (systemic lupus erythematosus, SLE) 와같이잘알려진 자가면역질환이나드물게쇼그렌증후군, 피부근염에의해이차적으로발생하며, 원발성골수섬유증 (primary myelofibrosis) 과달리비장종대나클론성염색체이상은나타나지않고, 스테로이드치료에대한반응과예후가좋다고알려져있다. 3-6) 최근 SLE와같은잘알려진자가면역질환의선행없이자가면역골수섬유증이발생하는경우를원발성자가면역골수섬유증 (primary autoimmune myelofibrosis) 이라고하며구별되는임상적, 병리학적특징을갖는증후군으로평가되고있다. 7,9) 저자들은선행자가면역질환이없는환자에서자가면역골수섬유증을경험하였기에간단한문헌고찰과함께보고하고자한다. 접수 :2009 년 6 월 19 일, 수정 :2009 년 9 월 11 일승인 :2009 년 9 월 11 일교신저자 : 김경희, 인천시남동구구월동 1198 번지 , 가천의과학대학교길병원진단검사의학과 Tel: , Fax: khkim74@gilhospital.com Correspondence to:kyung-hee Kim, M.D. Department of Laboratory Medicine, Gachon University Gil Hospital 1198, Guwol-dong, Namdong-gu, Incheon , Korea Tel: , Fax: khkim74@gilhospital.com 157

2 158 Korean J Hematol Vol. 44, No. 3, September, 2009 증례환자 : 18세, 여자주소 : 월경과다, 잇몸출혈과거력및현병력 : 환자는멍이자주드는외에특이병력없었으며내원전약물복용력은없었다. 1개월전월경과다로타병원에서실시한혈액검사에서빈혈, 혈소판감소증이관찰되었고내원하루전부터잇몸출혈이멈추지않아본원응급실을통하여입원하였다. 신체검사 : 결막은창백하였고황달이나두경부림프절종대는없었다. 흉부청진상심음과폐음은정상이었고복부진찰에서간비종대소견은없었고사지에서자반은관찰되지않았다. 검사소견 : 복부컴퓨터단층촬영에서간비종대관찰되지않았고 PET-CT와위내시경검사에서특이소견없었다. 내원당시일반혈액검사에서혈색소 5.7 g/dl, 백혈구 2,860/μL, 혈소판 4,000/μL, 교정망상적혈구수 4.19% 였다 (Table 1). 말초혈액도말검사에서정구성정색소성빈혈과적혈구부동증, 눈물방울적혈구 (tear drop cell), 구상적혈구가관찰되는변형적혈구증및유핵적혈구와골수세포 (myelocyte) 가출현한백적아구증 (leukoerythroblastosis) 이관찰되었고 (Fig. 1A, B) 호산구증가증이나호염기구증가증은관찰되지않았다. 혈청검사에서항카디오리핀항체 (anti-cardiolipin antibody) IgG와 IgM 양성, platelet associated antibody IgG 양성이었고, 류마티스인자 (rheumatoid factor) 는 6.7 IU/mL로정상, 항핵항체와루푸스항응고인자 (lupus anticoagulant) 및항인지질항체 (anti-phospholipid antibody) 는음성이었다 (Table 2). 직접항글로불린검사 (direct antiglobulin test) 양성, LDH 811/IU, CA-125와 CEA 종양표지자검사음성, 유세포분석을이용한발작 야간혈색뇨증검사에서정상소견이었다. 골수검사에서세포충실도정상이면서 (60 90%) 적혈구계와거대핵세포 (megakaryocyte) 증식을보였으나거대핵세포무리나골수이형성은관찰되지않았으며, 림프구증가증이나종양성림프구의침윤은보이지않았다 (Fig. 1C, D). 골수생검에대한레티쿨린 (reticulin) 염색에서산재된거친섬유를동반한미만성섬유망이관찰되고 Masson s trichrome 염색에서아교질 (collagen) 음성으로서 (Fig. 1E, F), modified Bauermeister scale 8) 에따라 Grade 3의골수섬유증으로판단하였다. 골수염색체검사결과정상핵형이었다. 임상경과 : 프레드니솔론 3 mg/kg로치료 40일후일반혈액검사에서혈색소와백혈구수치가정상화되고혈소판수치가호전되었으며, 말초혈액도말에서관찰되던변형적혈구증도감소하였다 (Table 1, Fig. 2A, C). 혈청검사에서항카디오리핀항체 IgG와 IgM 및 platelet associated antibody IgG가음성화되었으나, 직접항글로불린검사는양성이었다 (Table 2). 추적골수검사에서각각 Grade 2 ( 치료 40일째 ) 와 Grade 1 ( 치료 4개월째 ) 의골수섬유증을보였다 (Table 1, Fig. 2B, D). 지속적스테로이드치료 13개월후현재혈액검사소견상진단시보다호전된양상보이며외래추적관찰중이다 (Table 1). 고 골수섬유증은 1879년 Heuck 등에의해처음소개된이래다양한질환과의연관성이알려져있고, 1) 원인은크게종양성과비종양성질환으로나눌수있다. 종양성질환에는급성골수성종양, 골수와연관된림프구성종양, 형질세포질환과악성종양의골수침범등이있다. 2,10) 비종양성원인에는 SLE외에드물게쇼그렌증 찰 Table 1. The changes of CBC, blood smear findings and bone marrow fibrosis after steroid treatment Pretreatment After 40 days After 4 M After 13 M Hgb (g/dl) Hct (%) WBC (/μl) 2,860 4,280 8,480 10,180 Platelet (10 3 /μl) Tear drop cells/hpf* Spherocytes/HPF Leukoerythroblastosis + BM fibrosis Grade 3 Grade 2 Grade 1 NA Abbreviations: M, months; BM, bone marrow; NA, not available. *Under 1,000 magnification, Modified Bauermeister scale.

3 박순호 외: 원발성자가면역골수섬유증 1예 후군, 피부근염, 원발성담즙성간경변, 궤양성대장염, 3-6,11) 결절성다발동맥염 같은 자가면역질환과 그외바 이러스감염, 신성골이영양증, 비타민D결핍증, 갑상선 159 2,12) 기능이상과도 연관되어 있다고 알려져 있다. 골수섬유증의 가장 흔한 원인은 골수증식성종양의 하나인 원발성골수섬유증(primary myelofibrosis)으로 Fig. 1. Blood and bone marrow findings of the patient at diagnosis. (A, B) Peripheral blood smears showed marked anisopoikilocytosis with tear drop cells and spherocytes, and leukoerythroblastosis with a nucleated RBC (arrow) and a myelocyte (arrowhead) (Wright-Giemsa stain, 1,000). (C) The touch print smear showed erythroid hyperplasia without myelodysplastic features (W right-giemsa stain, 1,000). (D) The bone marrow biopsy section showed normocellularity with erythroid and megakaryocytic hyperplasia (Hematoxylin & eosin stain, 400). (E) The reticulin stain showed diffuse reticulin fiber network with scattered coarse fibers (Reticulin silver stain, 400). (F) trichrome stain (Masson s trichrome stain, 400).

4 160 Korean J Hematol Vol. 44, No. 3, September, 2009 Table 2. The changes of the results of autoantibodies after steroid treatment Anti-cardiolipin Ab IgG Anti-cardiolipin Ab IgA Anti-cardiolipin IgM Platelet associated Ab IgG Direct antiglobulin test Rheumatoid factor (IU/mL) Antinuclear antibody Lupus anticoagulant Anti-phospholipid Ab IgG, IgM (U/mL) Pretreatment After 40 days Normal value Positive Positive , Positive , Abbreviation: Ab, antibody. Fig. 2. Findings of blood smears and the reticulin stain of bone marrow biopsy in 40 days (A, B) and in 4 months (C, D) after treatment. (A) Mild poikilocytosis with tear drop cells. (B) Fine fiber network throughout most of the section and no coarse fibers. (C) More decreased tear drop cells than those observed in Fig. 2A. (D) Occasional fine individual fibers and foci of a fine fiber network. (A and C, Wright-Giemsa stain, 1,000; B and D, Reticulin silver stain, 400). 종양성 거대핵세포가 platelet-derived growth factor (PDGF), transforming growth factor-β (TGF-β), basic fibroblast growth factor와 vascular endothelial growth factor (VEGF) 등을 생성하여 골수 기질의 섬 1) 유아세포를 자극하여 발생하며, 환자의 1/3에서 무증 상이고, 증상이 있는 경우에도 피로, 미열, 야간발한,

5 박순호외 : 원발성자가면역골수섬유증 1 예 161 체중감소, 가려움증등비특이적증상을호소하는경우가대부분이다. 그러므로대개우연히시행한일반혈액검사에서이상소견이나말초혈액도말검사에서미성숙과립구와유핵적혈구, 눈물방울적혈구를보이거나신체검사상비장종대를보여추가로시행한확진검사를통해진단되는경우가많다. 13) 자가면역골수섬유증은 1994년 Paquette 등이처음소개하였으며, 골수의섬유화는자가면역질환진행의한양상으로알려져왔다. 자가면역골수섬유증은원발성골수섬유증과비교하여, 조혈장애와더불어특징적인 reticulin과 collagen 다발의증가는있지만, 골수의세포충실도는다양하고거대핵세포무리나골수구계, 적혈구계와거대핵세포의이형성은관찰되지않으며, 호산구증가증이나호염기구증가증도없다. 혈액도말에서눈물방울적혈구나백적아구증이보이기는하나비교적드문편이다. 또한자가면역골수섬유증으로진단하려면골수외조혈과연관된비장비대와골수섬유증의원인이될수있는다른질환은배제되면서, 자가면역질환과연관된혈청학적검사는양성을보여야한다. 14) 2003년 Pullarkat 등 9) 은 SLE나다른자가면역질환의선행없이발생하는자가면역골수섬유증에대해서독립적인임상병리적증후군으로평가하였으며 7개의증례를통하여다음의특징적기준을제시하였다 : (1) Grade 3 또는 4의골수섬유증이있고 (2) 거대핵세포무리나이형성이없으며 (3) 골수구계나적혈구계의이형성이나호산구증가증, 호염기구증가증이없고 (4) 골수의림프구침윤이있으며 (5) 골경화증의증거가없고 (6) 비장종대가없거나경하며 (7) 자가항체가존재하고 (8) 골수섬유증의원인으로알려진다른선행질환이없어야한다. 본증례는선행자가면역질환이없는환자에서범혈구감소증과함께 Grade 3의 reticulin 골수섬유증이관찰되었고거대핵세포와적혈구의증식은있었지만거대핵세포무리나골수이형성을보이지는않았으며, 호산구증가증과호염기구증가증은없었고, 림프구의골수침윤은뚜렷하지않았으며골경화증은관찰되지않았다. 신체검사에서촉지되는림프절이나비장종대가없었고컴퓨터단층좔영에서도비장종대나종양은없었으며 PET-CT에서다른원발성종양의증거가없었다. 환자는 anti-cardiolipin antibody IgG와 IgM, platelet associated antibody IgG, 직접항글로불린검사에서양성을보여 Pullarkat 등이제시한원발성자가면역골수섬유증의기준에서, 림프구침윤을제외한나머지특징 에모두부합하는소견을보였다. 자가면역골수섬유증에서골수섬유화의원인으로자가항체에의해자극을받은반응성골수침윤림프구에서분비된사이토카인을들고있으며, 따라서 Pullarkat 등은원발성자가면역골수섬유증에서도비종양성림프구의골수침윤을특징적양상으로보고진단기준에포함시켰다. 그러나골수섬유증을일으키는사이토카인은림프구뿐만아니라반응성또는종양성거핵구, 혈소판, 단핵구등여러혈액세포에의해서분비되며아직자가면역골수섬유증에서골수섬유화의확실한면역병리학적기전은밝혀지지않은상태이다. 1,8) 본증례에서림프구의침윤은뚜렷하지않았으나, 종양성거핵구증식과는달리이형성이나무리를이루고있지않은반응성거핵구의증가가있었으며이로인해골수섬유증이유발될수있으므로원발성자가면역골수섬유증에합당한것으로보인다. 본증례와비슷한임상및검사소견을보이는질환으로자가항체에의한면역성용혈성빈혈과면역성혈소판감소증을특징으로하는에반증후군 (Evans syndrome) 에서드물게골수섬유증이동반되는경우가있지만, 대부분기저질환으로자가면역질환특히 SLE가동반되며, 용혈성빈혈과혈소판감소증그리고골수섬유증은 SLE의임상경과의한양상으로나타난다. 4) SLE 등의기저질환이없는에반증후군도아주드물게있지만골수섬유증이같이있는보고는없었다. 에반증후군은특정한기전을통해진단하는질환이아니라증상과다른질환을배제하여내리는진단이므로 15) 기저자가면역질환없이골수섬유증이동반된에반증후군은원발성자가면역골수섬유증진단을고려하여야할것이다. 원발성자가면역골수섬유증의치료는코르티코스테로이드에잘반응하며, 불응성이거나부분반응을보일경우면역억제제가치료에사용될수있다. Pullarkat 등이발표한일곱증례에서치료는프레드니솔론 1 mg/kg으로시작하여 1 3개월에걸쳐천천히줄여일곱환자중여섯증례에서일반혈액검사결과가정상화되었으며, 한증례에서는스테로이드에부분반응을보여면역억제제를추가하여좋은효과를보였다. 9) 원발성골수섬유증은특별한치료가없으며증상에따라비장절제술이나화학요법등을시행할수있으나치료의반응과예후가불량하고, SLE와관련된골수섬유증은코르티코스테로이드에잘반응하지않거나고용량의스테로이드나면역억제제에만반응한다고알려져있는것에비해원발성자가면역골수섬유증은보다적은용량의스테로이드치료에도반응이양호함을알

6 162 Korean J Hematol Vol. 44, No. 3, September, 2009 수있다. 본증례는프레드니솔론 3 mg/kg으로치료를시작한지 40일째검사에서혈색소와백혈구수가정상화되었고혈소판수역시진단시보다상승하였으며골수검사에서 Grade 2의골수섬유증으로서진단시보다호전을보여스테로이드에대한치료반응이우수하였으며면역억제제사용은필요하지않았다. 원발성자가면역골수섬유증은현재까지확실한명칭이나진단기준이없고혈액질환의독립적인범주로정립되어있지않은드문질환이며국내에 SLE나류마티스관절염에의한골수섬유증의증례는있으나기저질환이없이발병한경우는보고된적이없다. 본증례와같이골수섬유증이있는환자에서중등도이상의비장종대가없으면서위에서언급한특징적소견을보일경우원발성자가면역골수섬유증을고려하여다른혈액질환, 특히원발성골수섬유증이나 SLE에의한골수섬유증과의감별을통해조기에보다적은용량의코르티코스테로이드를사용함으로써양호한임상반응을기대할수있을것이다. 요 골수섬유증은혈액종양이나전이성고형종양에서주로나타나며자가면역질환에서는드물게나타난다. 자가면역골수섬유증은종양성골수섬유증과는별개의임상적, 병리학적범주로서, 단독으로혹은자가면역질환과연관되어발생하며결과적으로말초혈액의혈구감소증을보인다. 최근자가면역질환의선행없이자가면역골수섬유증이발생하는경우를원발성자가면역골수섬유증이라고하며구별되는임상적-병리학적특징을갖는증후군으로평가되고있다. 저자들은 18 세여자가선행자가면역질환이나혈액질환없이범혈구감소증과자가항체양성을보이며 Grade 3의골수섬유증이관찰되어원발성자가면역골수섬유증으로진단하였기에보고하는바이다. 약 참고문헌 1) Tefferi A. Pathogenesis of myelofibrosis with myeloid metaplasia. J Clin Oncol 2005;23: ) McCarthy DM. Fibrosis of the bone marrow: content and causes. Br J Haematol 1985;59:1-7. 3) Kiss E, Gál I, Simkovics E, et al. Myelofibrosis in systemic lupus erythematosus. Leuk Lymphoma 2000; 39: ) Ramakrishna R, Kyle PW, Day PJ, Manoharan A. Evans' syndrome, myelofibrosis and systemic lupus erythematosus: role of procollagens in myelofibrosis. Pathology 1995;27: ) Marie I, Levesque H, Cailleux N, et al. An uncommon association: Sjögren s syndrome and autoimmune myelofibrosis. Rheumatology 1999;38: ) Muslimani A, Ahluwalia MS, Palaparty P, Daw HA. Idiopathic myelofibrosis associated with dermatomyositis. Am J hematol 2006;81: ) Bass RD, Pullarkat V, Feinstein DI, Kaul A, Winberg CD, Brynes RK. Pathology of autoimmune myelofibrosis. A report of three cases and a review of the literature. Am J Clin Pathol 2001;116: ) Kuter DJ, Bain B, Mufti G, Bagg A, Hasserjian RP. Bone marrow fibrosis: pathophysiology and clinical significance of increased bone marrow stromal fibres. Br J Haematol 2007;139: ) Pullarkat V, Bass RD, Gong JZ, Feinstein DI, Brynes RK. Primary autoimmune myelofibrosis: definition of a distinct clincopathologic syndrome. Am J Hematol 2003;72: ) Kasahara S, Tsurumi H, Yoshikawa T, et al. Plasma cell leukemia with myelofibrosis. J Clin Exp Hematopathol 2008;48: ) Arellano-Rodrigo E, Esteve J, Giné E, Panés J, Cervantes F. Idiopathic myelofibrosis associated with ulcerative colitis. Leuk Lymphoma 2002;43: ) Stéphan JL, Galambrun C, Dutour A, Freycon F. Myelofibrosis: an unusual presentation of vitamin D-deficient rickets. Eur J Pediatr 1999;158: ) Mesa RA, Schwager S, Radia D, et al. The myelofibrosis symptom assessment form (MFSAF): an evidence-based brief inventory to measure quality of life and symptomatic response to treatment in myelofibrosis. Leuk Res 2009;26: ) Paquette RL, Meshkinpour A, Rosen PJ. Autoimmune myelofibrosis. A steroid responsive cause of bone marrow fibrosis associated with systemic lupus erythematosus. Medicine (Baltimore) 1994;73: ) Norton A, Roberts I. Management of Evans syndrome. Br J Haematol 2006;132:

Jksvs019(8-15).hwp

Jksvs019(8-15).hwp Grade I Grade II Grade III 12 대한혈관외과학회지 : 제 20 권 제 1 호 2004 Control Group A Group B Fig. 4. Microscopic findings of vein wall in control, group A and group B on the day of 7 after venous occlusion. The

More information

Lumbar spine

Lumbar spine Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical

More information

7.ƯÁýb71ÎÀ¯È« š

7.ƯÁýb71ÎÀ¯È« š J KMA Special Issue Myelodysplastic Syndrome June Won Cheong, MD Yoo Hong Min, MD Department of Internal Medicine, Yonsei University College of Medicine E mail : jwcheong70@yumc.yonsei.ac.kr minbrmmd@yumc.yonsei.ac.kr

More information

김범수

김범수 Analysis of Outcomes after Resection of Sarcomatous Hepatocellular Carcinoma Purpose: Sarcomatous hepatocellular carcinoma (HCC) is rare. Therefore, the clinicopathologic characteristics and prognosis

More information

( )Kju269.hwp

( )Kju269.hwp 만성세균성전립선염모델흰쥐에서 의항염효과 Anti-inflammatory Effect of Lycopene on Chronic Bacterial Prostatitis Rat Model Cho Hwan Yang, Dong Wan Sohn, Yong-Hyun Cho From the Department of Urology, The Catholic University

More information

Kaes017.hwp

Kaes017.hwp 갑상선의 Poorly Differentiated (Insular) Carcinoma Insular Carcinoma: An Aggressive Subtype of Differentiated Thyroid Neoplasms Seok-Jin Nam, M.D., Sang-Dal Lee, M.D., Hal-lin Park, M.D., Young-Ryun Oh, M.D.

More information

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar

More information

Jkbcs016(92-97).hwp

Jkbcs016(92-97).hwp Expression of bcl-2 and Apoptosis and Its Relationship to Clinicopathological Prognostic Factors in Breast Cancer - A Study with Long Term Follow-up correlated with the survival rate.(journal of Korean

More information

Kaes010.hwp

Kaes010.hwp 갑상선자극호르몬이갑상선암세포의 VEGF, 신생혈관형성, 성장, 침윤및전이에미치는영향 Effects of TSH on the Production of VEGF, Angiogenesis, Growth, Invasion and Metastasis in Thyroid Cancer Cells Euy Young Soh, M.D., Hee Boong Park, M.D.,

More information

untitled

untitled 대한내과학회지 : 제 7 권제 3 호 6 만성호중구성백혈병 예 국립경찰병원내과, 진단검사의학과 홍순창 김지훈 이정민 정준오 김윤권 김소연 이경인 =Abstract= A case of chronic neutrophilic leukemia Sun Chang Hong, M.D., Ji Hoon Kim, M.D., Jung Min Lee, M.D., Jun Oh Chung,

More information

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee University College of Medicine & Hospital E mail : ycell2@yahoo.co.kr Abstract

More information

Korean J Lab Med 2010;30: DOI /kjlm Original Article Diagnostic Hematology Myelodysplastic Syndrome Mimicking Idiopathic Th

Korean J Lab Med 2010;30: DOI /kjlm Original Article Diagnostic Hematology Myelodysplastic Syndrome Mimicking Idiopathic Th Korean J Lab Med 2010;30:105-10 DOI 10.3343/kjlm.2010.30.2.105 Original Article Diagnostic Hematology Myelodysplastic Syndrome Mimicking Idiopathic Thrombocytopenic Purpura Yusun Hwang, M.D. 1, Jung-Won

More information

388 The Korean Journal of Hepatology : Vol. 6. No COMMENT 1. (dysplastic nodule) (adenomatous hyperplasia, AH), (macroregenerative nodule, MR

388 The Korean Journal of Hepatology : Vol. 6. No COMMENT 1. (dysplastic nodule) (adenomatous hyperplasia, AH), (macroregenerative nodule, MR 6 3 2000 ; 387-392 (3) Dysplastic Nodule Young Nyun Park, M.D., Chanil Park, M.D. Department of Pathology, Yonsei University College of Medicine BRIEF HISTORY 56. AST/ALT 72/73 IU/L, total bilirubin 0.7

More information

인사말 과거에 불치의 병으로만 알려져 있던 백혈병 등 여러 혈액 질환들이 현재에는 표적치료제를 포함한 항암화학요법과 조혈모세포이식의 발전으로 많은 경우 완치 또는 장기간 관리가 가능합니다. 하지만, 혈액암 진단을 받은 환우분과 가족들은 누구나 엄청난 충격과 혼란을 경험

인사말 과거에 불치의 병으로만 알려져 있던 백혈병 등 여러 혈액 질환들이 현재에는 표적치료제를 포함한 항암화학요법과 조혈모세포이식의 발전으로 많은 경우 완치 또는 장기간 관리가 가능합니다. 하지만, 혈액암 진단을 받은 환우분과 가족들은 누구나 엄청난 충격과 혼란을 경험 대한혈액학회 The Korean Society of Hematology 인사말 과거에 불치의 병으로만 알려져 있던 백혈병 등 여러 혈액 질환들이 현재에는 표적치료제를 포함한 항암화학요법과 조혈모세포이식의 발전으로 많은 경우 완치 또는 장기간 관리가 가능합니다. 하지만, 혈액암 진단을 받은 환우분과 가족들은 누구나 엄청난 충격과 혼란을 경험하게 됩니다. 치료

More information

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교 충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~5 2017 Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교의과대학마취통증의학교실, 의학연구소 (28644), happycat19@hanmail.net

More information

<30382EC0C7C7D0B0ADC1C22E687770>

<30382EC0C7C7D0B0ADC1C22E687770> 대한내과학회지: 제 76 권 제 2 호 2009 의학강좌-개원의를 위한 모범처방(Current Clinical Practice) 간기능검사의 이해와 적용 인제대학교 의과대학 일산백병원 내과학교실 김 경 아 Understanding and application of liver function tests Kyung-Ah Kim, M.D. Department of

More information

76 유수진 강수경 서을주외 3 인 증 례 증례 년 3월부터 2001년 3월까지서울중앙병원에서 acml로진단된 4예의현병력, 치료및경과는다음과같으며, 그들의임상소견, 말초혈액및골수검사결과는 Table 2 및 Table 3과같다. Table 1. The per

76 유수진 강수경 서을주외 3 인 증 례 증례 년 3월부터 2001년 3월까지서울중앙병원에서 acml로진단된 4예의현병력, 치료및경과는다음과같으며, 그들의임상소견, 말초혈액및골수검사결과는 Table 2 및 Table 3과같다. Table 1. The per 대한임상병리학회지 : 제 22 권제 2 호 2002 Korean J Clin Pathol 2002; 22: 75-9 진단혈액학 비전형만성골수성백혈병 4 예 유수진 강수경 서을주 박찬정 이규형 * 지현숙 울산대학교의과대학서울중앙병원임상병리학교실, 내과학교실 * Four Cases of Atypical Chronic Myeloid Leukemia Soo Jin

More information

05.Kaes001.hwp

05.Kaes001.hwp 혈액투석환자에서삼차성부갑상선기능항진증으로부갑상선절제술후발생한 Hungry Bone Syndrome 1 예 A Case of Hungry Bone Syndrome after Parathyroidectomy in Patient with Tertiary Hyperparathyroidism and Hemodialysis Patient Myoung Won Son, M.D.,

More information

<313320C1F5B7CA D B9DAC7D8BFAD2DB1E8C0AFB8AE292E687770>

<313320C1F5B7CA D B9DAC7D8BFAD2DB1E8C0AFB8AE292E687770> 대한내과학회지 : 제 91 권제 1 호 2016 http://dx.doi.org/10.3904/kjm.2016.91.1.70 갑상선암환자에서방사성요오드치료후발생한만성골수성백혈병 2예 연세대학교의과대학강남세브란스병원 1 내과, 2 병리과, 3 핵의학과, 4 외과 박해열 1 최성은 2 유영훈 3 장항석 4 박정수 4 이경화 1 김유리 1 Chronic Myeloid

More information

Korean J Lab Med 2010;30:244-8 DOI /kjlm Case Report Diagnostic Hematology Acquired Amegakaryocytic Thrombocytopenia after Thymec

Korean J Lab Med 2010;30:244-8 DOI /kjlm Case Report Diagnostic Hematology Acquired Amegakaryocytic Thrombocytopenia after Thymec Korean J Lab Med 21;3:244-8 DOI 1.3343/kjlm.21.3.3.244 Case Report Diagnostic Hematology Acquired Amegakaryocytic Thrombocytopenia after Thymectomy in a Case of Pure Red Cell Aplasia Associated with Thymoma

More information

04조남훈

04조남훈 Received : 2011. 11. 16 Reviewed : 2011. 11. 25 Accpeted : 2011. 12. 5 A Case Report of Prescribing Yanghyeolgeopung-tang(yangxuequfeng-tang) to Two Patients with Cervical Disc Herniation and Headache

More information

<323320C1F5B7CA D B9DAC2F9B0C92DC0AFC0CEBCB32E687770>

<323320C1F5B7CA D B9DAC2F9B0C92DC0AFC0CEBCB32E687770> 대한내과학회지 : 제 89 권제 6 호 2015 http://dx.doi.org/10.3904/kjm.2015.89.6.746 전신홍반루푸스로오인된혈관내 대세포림프종 1 예 충남대학교병원 1 내과, 2 류마티스내과, 3 혈액종양내과, 4 병리과 박찬걸 1 이정찬 1 강성욱 2 심승철 2 윤환중 3 김진만 4 유인설 2 Case of Intravascular

More information

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, )

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, ) Abstract Kim Dal-Rae, Kim Sun-Hyung* Dept. of Sasang Constitutional Medicine, College of Oriental Medicine, Kyung-Hee Univ. *Dept. of Sasang Constitutional Medicine, East-West Neo Medical Center, Kyung-Hee

More information

ECG & EP CASES Young-Keun On, MD, PhD Division of Cardiology, Department of Medicine Cardiac & Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea A case of

More information

156 Korean J Clin Lab Sci. 2011, 43(4) : ISSN Change of Blood Cells Number from Capillaries and Venous Blood of 20 s Healthy Adults

156 Korean J Clin Lab Sci. 2011, 43(4) : ISSN Change of Blood Cells Number from Capillaries and Venous Blood of 20 s Healthy Adults 156 ISSN 1738-3544 Change of Blood Cells Number from Capillaries and Venous Blood of 20 s Healthy Adults Ji-Yeong Seon and Jae Sik Lee Department of Clinical Laboratory Science, Hyejeon College, Hongseong

More information

(53-57)kjh004.hwp

(53-57)kjh004.hwp Korean J Hematol Vol. 42, No. 1, March, 2007 Case Report 자가면역성용혈성빈혈을동반한특발성 CD4+ T 림프구감소증 1 예 분당제생병원 1 진단검사의학과, 2 소아과 이성규 1 변성환 2 최종운 2 김현수 1 A Case of Idiopathic CD4+ T-lymphocytopenia Associated with

More information

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770>

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770> 대한안과학회지 제 49 권 제 5 호 2008 J Korean Ophthalmol Soc 49(5):727-731, 2008 DOI : 10.3341/jkos.2008.49.5.727 다초점 소프트콘택트렌즈의 노안의 시력보정에 대한 유용성 평가 김현경 1 김효명 2 정성근 1 가톨릭대학교 의과대학 성모병원 안과학교실 1, 고려대학교 의과대학 안암병원 안과학교실

More information

( )Kjhps043.hwp

( )Kjhps043.hwp Difference of Fistula Maturation Degree and Physical Property by the Types of Tube Material: An Experimental Study Sang Koo Kang, M.D. 1, Hee Chul Yu, M.D. 1,4, Woo Sung Moon, M.D. 2,4, Ju Hyoung Lee,

More information

Can032.hwp

Can032.hwp Chromosomal Alterations in Hepatocellular Carcinoma Cell Lines Detected by Comparative Genomic Hybridization Sang Jin Park 1, Mahn Joon Ha, Ph.D. 1, Hugh Chul Kim, M.D. 2 and Hyon Ju Kim, M.D. 1 1 Laboratory

More information

ºÎÁ¤¸ÆV10N³»Áö

ºÎÁ¤¸ÆV10N³»Áö case of brugada syndrome presented as chest pain STRCT rugada syndrome was described in 1992 as a new clinical entity characterized by electrocardiographic STsegment elevation in the right precordial leads

More information

139~144 ¿À°ø¾àħ

139~144 ¿À°ø¾àħ 2 139 DOI : 10.3831/KPI.2010.13.2.139 2 Received : 10. 04. 08 Revised : 10. 04. 26 Two Case Report on Wrist Ganglion Treated with Scolopendrid Pharmacopuncture Accepted : 10. 05. 04 Key Words: Wrist Ganglion,

More information

untitled

untitled Korean J Hematol Vol. 44, No. 4, December, 2009 Case Report CD5 음성만성림프구백혈병 1 예 울산대학교의과대학 1 서울아산병원진단검사의학교실, 2 강릉아산병원진단검사의학교실, 3 서울아산병원병리학교실, 4 서울아산병원내과학교실 황금록 1 ㆍ박찬정 1 ㆍ박서진 1 ㆍ장성수 1 ㆍ지현숙 1 ㆍ차충환 2 ㆍ허주영 3

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI: : Researc

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI:   : Researc Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp.251-273 DOI: http://dx.doi.org/10.21024/pnuedi.27.2.201706.251 : 1997 2005 Research Trend Analysis on the Korean Alternative Education

More information

untitled

untitled 대한내과학회지 : 제 70 권부록 2 호 2006 전신성홍반성루푸스에서면역글로불린과 etoposide 투여에의해호전된혈구탐식증후군 1예 전남대학교의과대학류마티스내과, 광주기독병원내과 2 윤현정 황승환 박용욱 김윤아 2 이신석 =Abstract= Successful treatment with intravenous immunoglobulin and etoposide

More information

<B0E6C8F1B4EBB3BBB0FAC0D3BBF3B0ADC1C E687770>

<B0E6C8F1B4EBB3BBB0FAC0D3BBF3B0ADC1C E687770> 개원의와함께하는임상강좌 2011 역류성식도질환제대로이해하기 Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea Jae-Young Jang, M.D., PhD. 개원의와함께하는임상강좌 2011 109 최신치료

More information

1..

1.. Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University :

More information

005송영일

005송영일 Received : 2015. 12. 09 Reviewed : 2015. 12. 16 Accepted : 2015. 12. 16 Sternal Fracture occurred after Thai Massage : A Case Report Young-Il Song, K.M.D. 1, Dong-Eun Kim, K.M.D. 1 1 Department of Rehabilitation

More information

Jkbcs032.hwp

Jkbcs032.hwp Clinical Correlation of HER-2/neu Overexpression in Patients with Breast Cancer Sung Yong Kim, Tae Yoon Kim, Jae Jun Kim, Chang Ho Kim, Ok Pyung Song, Min Hyuk Lee, Eui Han Kim 1, and Moo Sik Cho Departments

More information

석사논문.PDF

석사논문.PDF ABO Rh A study on the importance of ABO and Rh blood groups information in Public Health 2000 2 1 ABO Rh A study on the importance of ABO and Rh blood groups information in Public Health 2000 2 2 ABO Rh

More information

l l l l l l l l l Lee, Geon Kook None This project was designed to establish the Tumor Bank of National Cancer Center in 2000. From the first tumor sample in 2000, the total of tumor and tumor-related

More information

Kaes025.hwp

Kaes025.hwp 고위험군유두상갑상선암환자에대한방사성옥소최대허용선량측정법및치료법의검증 Verification of Measurement Methods and Therapeutic Efficacy of Maximum Permissible Dose of I-131 in High Risk Patients with Differentiated Papillary Thyroid Cancer

More information

증례 Lab Med Online Vol. 1, No. 4: , October 진단혈액학 JAK2V617F 돌연변이를보인비정형만성골수성백혈병 1 예 A Case of Atyp

증례 Lab Med Online Vol. 1, No. 4: , October 진단혈액학 JAK2V617F 돌연변이를보인비정형만성골수성백혈병 1 예 A Case of Atyp 증례 Lab Med Online Vol. 1, No. 4: 232-236, October 2011 진단혈액학 JAK2V617F 돌연변이를보인비정형만성골수성백혈병 1 예 A Case of Atypical Chronic Myeloid Leukemia with the JAK2V617F Mutation 김주연 1 이세련 2 남명현 1 윤수영 1 임채승 1 이창규 1

More information

<323020C1F5B7CA D C0CCC5C2C7D12DB1E8BBF3C7F62E687770>

<323020C1F5B7CA D C0CCC5C2C7D12DB1E8BBF3C7F62E687770> 대한내과학회지 : 제 89 권제 4 호 2015 http://dx.doi.org/10.3904/kjm.2015.89.4.482 혈전성혈소판감소성자반증이동반된성인형스틸병 1 계명대학교의과대학내과학교실, 2 계명대학교동산의료원류마티스내과 이태한 1 이지민 1 이소연 1 조난희 1 손창남 1,2 김지민 1,2 김상현 1,2 Adult-Onset Still s Disease

More information

<5B30325DC8ABBDC2BAB92E687770>

<5B30325DC8ABBDC2BAB92E687770> 대한임상검사학회지 : 37 권제 3 호, 143-148, 25 Coulter LH 75 TM 에의한백혈구감별계산및 Suspect Flags 의평가 분당제생병원진단검사의학과 홍승복 최종태 이성규 김현수 Evaluation of Coulter LH 75 TM on Leukocyte Differential Count and Suspect Flags Seung-Bok

More information

: B 1 = A bs trac t= A cas e of de nov o B - ce ll proly mphoc ytic le ukemia as s oc iated w ith f als e - pos itiv e dire ct antig lobulin

: B 1 = A bs trac t= A cas e of de nov o B - ce ll proly mphoc ytic le ukemia as s oc iated w ith f als e - pos itiv e dire ct antig lobulin : 59 4 2000 B 1 = A bs trac t= A cas e of de nov o B ce ll proly mphoc ytic le ukemia as s oc iated w ith f als e pos itiv e dire ct antig lobulin te s t Ji Soo Kim, M.D., Cheol Su Poo, M.D., Sung Min

More information

975_983 특집-한규철, 정원호

975_983 특집-한규철, 정원호 Focused Issue of This Month Gyu Cheol an, MD Department of Otolaryngology ead & Neck Surgery, Gachon University of College Medicine E - mail : han@gilhospital.com Won-o Jung, MD Department of Otolaryngology

More information

황지웅

황지웅 Comparison of Laparoscopy and Exploration in the Distal Pancreatectomy BACKGROUND: To determine the benefits of laparoscopic surgery compared with exploration, the clinical outcomes of open and laparoscopic

More information

<313520C1F5B7CA C0CCB9CEBFB52DBFF8C1BEC8A D E687770>

<313520C1F5B7CA C0CCB9CEBFB52DBFF8C1BEC8A D E687770> 대한내과학회지 : 제 85 권제 4 호 2013 http://dx.doi.org/10.3904/kjm.2013.85.4.430 비호지킨림프종환자에서자가조혈모세포이식후발생한자가면역질환 순천향대학교의과대학내과학교실종양혈액내과 이민영 유시내 김경하 이상철 이남수 박희숙 원종호 Autoimmune Diseases after Autologous Hematopoietic

More information

untitled

untitled 대한수혈학회지 : 제 24 권제 3 호, 2013 The Korean Journal of Blood Transfusion Vol. 24, No. 3, 286-290, December 2013 ISSN 1226-9336 Case Report 면역혈소판감소자색반병환자에서치료용면역글로불린투여후항 -D 항체가분리된 1 예 장정현ㆍ김희정ㆍ양회주ㆍ권석운 울산대학교의과대학서울아산병원진단검사의학과

More information

<4D F736F F F696E74202D203920B9E6BCF6B9CC28B0F8B0B3292E BC8A3C8AF20B8F0B5E55D>

<4D F736F F F696E74202D203920B9E6BCF6B9CC28B0F8B0B3292E BC8A3C8AF20B8F0B5E55D> MPD MPN in WHO 2008 Chronic myelogenous leukemia, BCR-ABL1 positive Chronic neutrophilic leukemia Polycythemia vera Primary myelofibrosis Essential thrombocythemia Chronic eosinophilic leukemia, not otherwise

More information

대한진단검사의학회지제 27 권제 2 호 2007 Korean J Lab Med 2007;27: 원저 진단혈액학 골수전이암에대한진단검사의학적검색 - 단일기관연구 - 윤형기 1 신명근 1 정파 2 김다운 1 조덕 1 신종희 1 서순팔 1 양동욱 1 전남대학교의과

대한진단검사의학회지제 27 권제 2 호 2007 Korean J Lab Med 2007;27: 원저 진단혈액학 골수전이암에대한진단검사의학적검색 - 단일기관연구 - 윤형기 1 신명근 1 정파 2 김다운 1 조덕 1 신종희 1 서순팔 1 양동욱 1 전남대학교의과 대한진단검사의학회지제 27 권제 2 호 2007 Korean J Lab Med 2007;27:96-101 원저 진단혈액학 골수전이암에대한진단검사의학적검색 - 단일기관연구 - 윤형기 1 신명근 1 정파 2 김다운 1 조덕 1 신종희 1 서순팔 1 양동욱 1 전남대학교의과대학진단검사의학교실 1, 2006 년도 2 단계두뇌한국 21 사업전남대학교의생명인력사업단 2

More information

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental

More information

untitled

untitled 대한수혈학회지 : 제 27 권제 2 호, 2016 The Korean Journal of Blood Transfusion Vol. 27, No. 2, 183-187, August 2016 http://dx.doi.org/10.17945/kjbt.2016.27.2.183 pissn 1226-9336 eissn 2383-6881 Case Report 항 -S 항체에의한태아신생아용혈성질환

More information

Trd022.hwp

Trd022.hwp 김신태, 이선녕, 이석정, 정필문, 박홍준, 신명상, 김종환, 이부길, 김상하, 리원연, 신계철, 용석중 Shin-Tae Kim, M.D., Shun Nyung Lee, M.D., Seok Jeong Lee, M.D., Pil Moon Jung, M.D., Hong Jun Park, M.D., Myung Sang Shin, M.D., Chong Whan Kim,

More information

( )Jkstro011.hwp

( )Jkstro011.hwp 비인강암의방사선치료결과및생존율에관한예후인자분석 2005 2 1 2005 3 28. :, Tel: 053)250-7665, Fax: 053)250-7984 E-mail: jhkim@dsmc.or.kr 정영연외 2 인 : 비인강암의예후인자분석 정영연외 2 인 : 비인강암의예후인자분석 Carcinoma of the nasopharynx treated by radiotherapy

More information

대한진단검사의학회지제 27 권제 3 호 2007 Korean J Lab Med 2007;27:162-8 원저 진단혈액학 자동혈구분석기 Cell-Dyn Sapphire 의평가 박윤희 송재우 송성욱 송경순 안미숙 양미숙 김일 최종락 연세대학교의과대학진단검사의학교실 Eval

대한진단검사의학회지제 27 권제 3 호 2007 Korean J Lab Med 2007;27:162-8 원저 진단혈액학 자동혈구분석기 Cell-Dyn Sapphire 의평가 박윤희 송재우 송성욱 송경순 안미숙 양미숙 김일 최종락 연세대학교의과대학진단검사의학교실 Eval 대한진단검사의학회지제 7 권제 호 7 Korean J Lab Med 7;7:1-8 원저 진단혈액학 자동혈구분석기 Cell-Dyn Sapphire 의평가 박윤희 송재우 송성욱 송경순 안미숙 양미숙 김일 최종락 연세대학교의과대학진단검사의학교실 Evaluation of the Abbott Cell-Dyn Sapphire Hematology Analyzer Younhee

More information

Kbcs002.hwp

Kbcs002.hwp Does Real-time Compound Imaging Improve Evaluation of reast Cancer Compared to Conventional Sonography? o Kyoung Seo, M.D., Yu Whan Oh, M.D., Kyu Ran Cho, M.D., Young Hen Lee, M.D., Hyung Joon Noh, M.D.,

More information

고등급원발성림프절변연부 B- 세포림프종 283 A B C D Fig. 1. (A) Primary nodal marginal zone B-cell lymphoma in the cervical lymph node shows a parafollicular infiltrati

고등급원발성림프절변연부 B- 세포림프종 283 A B C D Fig. 1. (A) Primary nodal marginal zone B-cell lymphoma in the cervical lymph node shows a parafollicular infiltrati 대한병리학회지 : 제 37 권제 4 호 2003 The Korean Journal of Pathology. 2003; 37: 282-6 고등급림프종으로형질전환된원발성림프절변연부 B- 세포림프종 - 1 예보고 - 김주헌 강동욱 박미자 김진만 1 을지대학교의과대학병리학교실 1 충남대학교의과대학병리학교실 High-grade Transformation of Primary

More information

<323020C1F5B7CA B1E8C8A3C3B62DC0CCC1A6C8AF2E687770>

<323020C1F5B7CA B1E8C8A3C3B62DC0CCC1A6C8AF2E687770> 대한내과학회지 : 제 87 권제 4 호 2014 http://dx.doi.org/10.3904/kjm.2014.87.4.496 Azacitidine 치료후폐손상이발생한골수형성이상증후군 1 예 울산대학교의과대학내과학교실 김호철ㆍ김상형ㆍ안지환ㆍ권혜미ㆍ최종한ㆍ김태형ㆍ이제환 Azacitidine-Induced Lung Injury in a Patient with Myelodysplastic

More information

(

( 317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,

More information

May 10~ Hotel Inter-Burgo Exco, Daegu Plenary lectures From metabolic syndrome to diabetes Meta-inflammation responsible for the progression fr

May 10~ Hotel Inter-Burgo Exco, Daegu Plenary lectures From metabolic syndrome to diabetes Meta-inflammation responsible for the progression fr May 10~12 2012 Hotel Inter-Burgo Exco, Daegu Plenary lectures From metabolic syndrome to diabetes Meta-inflammation responsible for the progression from obesity to metabolic syndrome originates in the

More information

Kjtcs324( ).hwp

Kjtcs324( ).hwp 과오종과유사한폐상피모양혈관내피종 -1 예보고 - Pulmonary Epithelioid Hemangioendothelioma Mimicking Hamartoma -A case report- Epithelioid hemangioendothelioma, originating from the vascular endothelium, is a very rare and

More information

슬라이드 1

슬라이드 1 Gastric MALT Lymphoma 성균관대학교의과대학내과이준행 모든사람은죽는다. 모든사람은세금을내야한다. 림프종분류는항상변한다. Biologically rational classification morphology immunophenotype genetic features clinical features Clinically useful classification

More information

- i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - 1) 통계청고시제 2010-150 호 (2010.7.6 개정, 2011.1.1 시행 ) - 4 - 요양급여의적용기준및방법에관한세부사항에따른골밀도검사기준 (2007 년 11 월 1 일시행 ) - 5 - - 6 - - 7 - - 8 - - 9 - - 10 -

More information

(49-54)Kjhps004.hwp

(49-54)Kjhps004.hwp Biliary Cystadenoma and Cystadenocarcinoma of the Liver Jae Hoon Lee, M.D., Dong Ho Choi, M.D. 1, Kyeong Geun Lee, M.D., Hwon Kyum Park M.D. and Kwang Soo Lee, M.D. Department of Surgery, College of Medicine,

More information

ORIGINAL ARTICLE Evaluation of the Sysmex XN-20 Complete Blood Count Analyser Eun Jin Lee, Kwongu Lee,

ORIGINAL ARTICLE   Evaluation of the Sysmex XN-20 Complete Blood Count Analyser Eun Jin Lee, Kwongu Lee, ORIGINAL ARTICLE http://dx.doi.org/10.15263/jlmqa.2014.36.3.140 Evaluation of the Sysmex XN-20 Complete Blood Count Analyser Eun Jin Lee, Kwongu Lee, Miyoung Kim, Han-Sung Kim, Hee Jung Kang, and Young

More information

Microsoft PowerPoint - Labs and Lupus Bev2 24

Microsoft PowerPoint - Labs and Lupus Bev2 24 Beverly Johnson MD Rheumatologist Urban Health Plan 1 In the US, it is estimated as many as 1.5 million people have lupus. 1.8 to 7.6 people per 100,000 are diagnosed with lupus each year. Most cases are

More information

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R

More information

노인정신의학회보14-1호

노인정신의학회보14-1호 제14권 1호 통권 제23호 www.kagp.or.kr 발행인 : 정인과 / 편집인 : 이동우 / 발행처 : 정인과 (152-703) 서울특별시 구로구 구로동 80번지 고려대학교 구로병원 정신과 / TEL : 02-818-6608 / FAX : 02-852-1937 발행일 : 2008년 4월 30일 / 제 작 : (주)엠엘커뮤니케이션 140-846 서울특별시

More information

Yn-U-Medicine#(27#1#13) 오명진(증례).hwp

Yn-U-Medicine#(27#1#13) 오명진(증례).hwp 영남의대학술지제27권제1호 Yeungnam Univ. J. of Med. Vol.27 No.1 p78-84, June. 2010 증례 성인발병성스틸병 (Adult-onset Still's disease) 으로오인된전신홍반루푸스 (Systemic Lupus Erythematosus) 1 예 오명진 김현제 이한솔 허지안 홍영훈 이충기 영남대학교의과대학내과학교실

More information

<38BFF93238C0CF28B1DDBFE4C0CF2920BFB9BBF3B9E8B4E72E786C7378>

<38BFF93238C0CF28B1DDBFE4C0CF2920BFB9BBF3B9E8B4E72E786C7378> [부산 ] 2009년 08월 28일 ( 金 ) 1경주 국 5(마령)1000M 발주 13:00 종합 인기도 출전 착순 출주 10 11 5 검은요정 국5 한2 암 김재섭 영준 53 3착 선행 5 5 5 15 1 6 3 0.3 주 10 랜드레이디 국5 한2 암 강형곤 현명 53 3착 선행 10 5 6.3 10 10 4 8 4 2 4 주 11 일맥상통 국5 한3 암

More information

歯간학회지6-2.PDF

歯간학회지6-2.PDF 6 2 2000 ; 223-228 IgA 1 A bs tract Primary Biliary Cirrhosis Associated with Multiple Renal Abscess and IgA Nephropathy : A Case Report Jung Woo Shin, M.D., Il Han Song, M.D., Myoung Ju Ki, M.D., Chang

More information

<34352EB1E8B0E6C8C62E687770>

<34352EB1E8B0E6C8C62E687770> 대한내과학회지 : 제 75 권부록 3 호 2008 베체트병에동반된골수형성이상증후군 1 예 경북대학교의과대학내과학교실 김경훈 김지민 한승우 남언정 강영모 A case of Behçet s disease complicated with myelodysplastic syndrome Kyung Hoon Kim, M.D., Ji Min Kim, M.D., Seung Woo

More information

대한진단검사의학회지제 27 권제 6 호 2007 Korean J Lab Med 2007;27:383-7 DOI /kjlm 원저 진단혈액학 세계보건기구분류에근거한악성림프종의골수침습빈도및양상 - 단일기관연구 정소연 1 장윤환 1 이진경

대한진단검사의학회지제 27 권제 6 호 2007 Korean J Lab Med 2007;27:383-7 DOI /kjlm 원저 진단혈액학 세계보건기구분류에근거한악성림프종의골수침습빈도및양상 - 단일기관연구 정소연 1 장윤환 1 이진경 대한진단검사의학회지제 27 권제 6 호 2007 Korean J Lab Med 2007;27:383-7 DOI 10.3343/kjlm.2007.27.6.383 원저 진단혈액학 세계보건기구분류에근거한악성림프종의골수침습빈도및양상 - 단일기관연구 정소연 1 장윤환 1 이진경 1 홍영준 1 홍석일 1 이승숙 2 원자력의학원원자력병원진단검사의학과 1, 병리과 2 Incidence

More information

2012년_임상연구논문(교정2).hwp

2012년_임상연구논문(교정2).hwp 2012 년도 국립소록도병원논문집 제 37 권 국립소록도병원 Sorokdo National Hospital 한센병 노인병의학연구소 Research Institute of Leprosy and Geriatrics 2012 임상연구논문집 목차 (CONTENTS) 1. 5 Prevalence Study of Anemia Patients affected by Leprosy

More information

PowerPoint Presentation

PowerPoint Presentation 덕성여자대학교약학과 조효선교수 Chapter 16; 면역관용 (Immunologic tolerance) T 세포관용 1. 중추관용 1) 음성선택 ; elimination of self-reactive immature T cells in thymus 2) 조절 T 세포로분화 ; FoxP3 발현증가 그림 16-7 그림 16-6 최신면역학 ( 라이프사이언스, 2011)

More information

Korean J Lab Med 2010;30: DOI /kjlm Case Report Diagnostic Hematology Flow-Assisted Differential Diagnosis of Hemolytic Ane

Korean J Lab Med 2010;30: DOI /kjlm Case Report Diagnostic Hematology Flow-Assisted Differential Diagnosis of Hemolytic Ane Korean J Lab Med 21;3:339-44 DOI 1.3343/kjlm.21.3.4.339 Case Report Diagnostic Hematology Flow-Assisted Differential Diagnosis of Hemolytic Anemia with Spherocytosis: A Case Report Dong Il Won, M.D. Department

More information

untitled

untitled 대한류마티스학회지 Vol. 14, No. 4, December, 2007 증례 원발성항인지질증후군과연관된문맥혈전증 1 예 연세대학교의과대학내과학교실 임현철ㆍ이윤범ㆍ김명현ㆍ장재훈ㆍ박민찬 =Abstract= Portal Vein Thrombosis Associated with Antiphospholipid Syndrome Hyun Chul Lim, M.D., Yoon

More information

untitled

untitled Kikuchi 병에동반된성인형스틸병 1 예 연세대학교의과대학내과학교실, 병리학교실 * 강은진ㆍ최상태ㆍ이상원ㆍ정상윤ㆍ손명균ㆍ이광훈ㆍ양우익 * ㆍ박용범ㆍ이수곤 =Abstract= Kikuchi-Fujimoto's Disease with Adult Onset Still's Disease Eun-Jin Kang, M.D., Sang Tae Choi, M.D., Sang-Won

More information

18. 증례 KJM hwp

18. 증례 KJM hwp 대한내과학회지 : 제 91 권제 3 호 2016 http://dx.doi.org/10.3904/kjm.2016.91.3.325 혈구탐식성림프조직구증이동반된중증열성혈소판감소증후군 1 예 부산대학교의과대학양산부산대학교병원내과학교실 김형진 강래형 장진호 김준현 배광욱 김은정 이수진 Severe Fever with Thrombocytopenia Syndrome Accompanied

More information

Microsoft PowerPoint - 발표자료(KSSiS 2016)

Microsoft PowerPoint - 발표자료(KSSiS 2016) Sang Jun Kim, MD, PhD Application of 3D Printing in the Orthotic Fields Hallux Valgus, Charcot Marie Tooth, ADL Kit, Foot Insole, Wrist Pain, Foot Drop Development of Automated Program for Ankle Foot Orthosis

More information

( )05.Kjh035.hwp

( )05.Kjh035.hwp Korean J Hematol Vol. 40, No. 2, June, 2005 Case Report 표준치료에불응한자가면역혈구감소증환자 2 명에서 Rituximab 치료에의한장기관해효과 가톨릭대학교의과대학성모자애병원혈액 - 종양내과 박수정 한치화 The Long Term Remission Effect of Rituximab in Two Patients with

More information

ÀÇÇа�ÁÂc00Ì»óÀÏ˘

ÀÇÇа�ÁÂc00Ì»óÀÏ˘ Common Allergic Diseases in Children Sang - Il Lee, M.D. Department of pediatrics Sungkyunkwan University School of Medicine, Samsung Medical Center E - mail : silee@smc.samsung.co.kr Abstract Allergy

More information

임상병리검사과학회지 : 제 30 권제 2 호 CELL-DYN 에서표적적혈구로언한 위백혈구증가중을보안 2 예 - 광학현미경및주사전자현미경척관찰 - 영남대학교의료원임상병리과 계명대학교의과대학중앙전자현미경설 * 이정우 김영호 * The Light Mic

임상병리검사과학회지 : 제 30 권제 2 호 CELL-DYN 에서표적적혈구로언한 위백혈구증가중을보안 2 예 - 광학현미경및주사전자현미경척관찰 - 영남대학교의료원임상병리과 계명대학교의과대학중앙전자현미경설 * 이정우 김영호 * The Light Mic 임상병리검사과학회지 : 제 30 권제 2 호 1998. CELL-DYN 3000@ 에서표적적혈구로언한 위백혈구증가중을보안 2 예 - 광학현미경및주사전자현미경척관찰 - 영남대학교의료원임상병리과 계명대학교의과대학중앙전자현미경설 * 이정우 김영호 * The Light Microscope and Scanning Electron Microscope observation

More information

- iii - - i - - ii - - iii - 국문요약 종합병원남자간호사가지각하는조직공정성 사회정체성과 조직시민행동과의관계 - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - α α α α - 15 - α α α α α α

More information

16_이주용_155~163.hwp

16_이주용_155~163.hwp 사상체질의학회지 2008;20(2):155-163 J of Sasang Constitutional Medicine Vol. 20, No. 2, 2008:155-163 http://www.esasang.com 腦 梗 塞 으로 발생한 少 陽 人 半 身 舞 蹈 病 患 者 치험 1례 이주용 이한얼 한경수 안택원 Abstract 대전대학교 한의과대학 사상체질과 A Soyangin

More information

Journal of Educational Innovation Research 2016, Vol. 26, No. 3, pp.1-16 DOI: * A Study on Good School

Journal of Educational Innovation Research 2016, Vol. 26, No. 3, pp.1-16 DOI:   * A Study on Good School Journal of Educational Innovation Research 2016, Vol. 26, No. 3, pp.1-16 DOI: http://dx.doi.org/10.21024/pnuedi.26.3.201612.1 * A Study on Good School and School Evaluation Purpose: This study was to examine

More information

Àå¾Ö¿Í°í¿ë ³»Áö

Àå¾Ö¿Í°í¿ë ³»Áö Disability & Employment 55 Disability & Employment 56 57 Disability & Employment 58 59 Disability & Employment 60 61 Disability & Employment 62 63 Disability & Employment 64 65 Disability & Employment

More information

Jkss hwp

Jkss hwp 급성복증을보이는감염성요막관기형 Infected Urachal Remnants with Symtoms of the Acute Abdomen: The Differential Diagnosis & Proper Management Jan Dy Lee, M.D., Chee Young Lim, M.D. 1, Hyoung Il Kim, M.D. 1, Chul Woon Chung,

More information

노영남

노영남 Purpose: Delayed massive hemorrhages from pseudoaneurysm rupture of the peripancreatic large arteries, after pancreaticoduodenectomy, are fatal. We reviewed the clinical course and outcome of bleeding

More information

대한진단검사의학회지제 27 권제 1 호 2007 Korean J Lab Med 2007;27:1-6 원저 진단혈액학 미성숙혈소판분획을이용한혈소판감소증진단법의임상적유용성 조용곤 1,2 이재현 1 김달식 1,2 이혜수 1,2 최삼임 1,2 전북대학교의과대학진단검사의학교실

대한진단검사의학회지제 27 권제 1 호 2007 Korean J Lab Med 2007;27:1-6 원저 진단혈액학 미성숙혈소판분획을이용한혈소판감소증진단법의임상적유용성 조용곤 1,2 이재현 1 김달식 1,2 이혜수 1,2 최삼임 1,2 전북대학교의과대학진단검사의학교실 대한진단검사의학회지제 27 권제 1 호 2007 Korean J Lab Med 2007;27:1-6 원저 진단혈액학 미성숙혈소판분획을이용한혈소판감소증진단법의임상적유용성 조용곤 1,2 이재현 1 김달식 1,2 이혜수 1,2 최삼임 1,2 전북대학교의과대학진단검사의학교실 1, 전북대학교임상의학연구소 2 Clinical Usefulness of the Simple

More information

12 증례 KJM hwp

12 증례 KJM hwp 대한내과학회지 : 제 94 권제 3 호 2019 https://doi.org/10.3904/kjm.2019.94.3.303 크론병에서인플릭시맵투약후발생한전신홍반루푸스 1 예 울산대학교의과대학서울아산병원내과 최수진ㆍ김소현ㆍ김혜영ㆍ이용준ㆍ현동곤ㆍ양석균ㆍ김용길 Infliximab-Induced Lupus in Crohn s Disease Su Jin Choi, Sohyun

More information

( )kjh060.hwp

( )kjh060.hwp Korean J Hematol Vol. 41, No. 4, December, 2006 Case Report 자가면역간염과관상동맥류를동반한만성활동성 Epstein-Barr Virus 감염 1 예 충남대학교의과대학소아과학교실 김미진 이지정 박경수 김선영 길홍량 A Case of Chronic Active Epstein-Barr Virus Infection with

More information

연하곤란

연하곤란 2015.03.04 부울경소화기내시경지회 Intramucosal gastric cancer: The rate of lymph node metastasis in signet ring cell carcinoma was as low as that in welldifferentiated adenocarcinoma 인제대부산백병원 소화기내과 지삼룡 Signet ring

More information

歯채민병.PDF

歯채민병.PDF Patient number Sex Age Animal contact 1 F 36 No 2 F 31 Cat scratch Result of biopsy/aspiration cytology of lymph nodes Chronic granulomatous inflammation with caseation necrosis, compatible with tuberculous

More information

-07-......

-07-...... A Depth Interview on Qualification, Role, and Professionalism of Infant/Toddler Teachers Department of Child & Family Studies, Kyung Hee University Associate Professor : Ahn, Sun Hee Department of Early

More information

°Ç°�°úÁúº´6-2È£

°Ç°�°úÁúº´6-2È£ K O R E A C E N T E R S F O R D I S E A S E C O N T R O L & P R E V E N T I O N PHWR Vol. 6 No. 2 www.cdc.go.kr 2013 1 11 6 2 ISSN:2005-811X Flavivirus surveillance in mosquitoes collected from the quarantine

More information

Click to add title

Click to add title Genetic and Conventional Tests of PNH 2010. 8. 25. 원자력병원진단검사의학과 장윤환 Agenda 1. Mutation analysis of the PIGA gene 2. Cytogenetic study 3. Ham test and sucrose hemolysis test 4. Gel microtyping system (Gel

More information

<4D F736F F F696E74202D20332D3220C7F7BCD2C6C7BCF6C7F75FB9DABFEB205BC0D0B1E220C0FCBFEB5D>

<4D F736F F F696E74202D20332D3220C7F7BCD2C6C7BCF6C7F75FB9DABFEB205BC0D0B1E220C0FCBFEB5D> 혈소판수혈의실제 박용 고려대학교의과대학안암병원혈액종양내과 목적 혈액종양내과전문의로서혈소판관련문제에대한컨설트해결능력배양 혈액은행소속의료진과혈소판수혈관련문제에대한토의능력배양 혈액종양환자의혈소판감소증에대한적절한치료전략습득 Lim YA, et al. Vox Sanguinis, 2004;86:54 61 구성 1. 역사적고찰 2. 혈소판제제생산및특징 3. 혈소판수혈의부작용및예방전략

More information

19. 증례 KJM hwp

19. 증례 KJM hwp 대한내과학회지 : 제 92 권제 2 호 2017 https://doi.org/10.3904/kjm.2017.92.2.219 뇌혈관혈전없이벨마비로나타난일차성항인지질항체증후군 1 강릉아산병원내과, 2 순천향대학교의과대학내과학교실 김보영 1 채준원 2 김현숙 2 Primary Antiphospholipid Syndrome Presenting as Bell Palsy

More information