• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.420-424
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• 2014

The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.

• Radiation Oncology Journal
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• 제35권1호
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• pp.65-70
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• 2017

Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

• 한국임상수의학회지
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• 제28권2호
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• pp.262-266
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• 2011

체중 2.2 kg 4년령 수컷 Maltese 개가 호흡곤란과 고체온증 평가를 위해 건국대학교 부속 동물병원에 내원하였다. 신체 검사에서 호흡곤란을 확인 하였으며, 오른쪽 흉강 청진상에서 희미한 심음을 확인하였다. 방사선 검사와 CT검사에서 오른쪽 중간엽의 경화와 흉수 및 복수를 확인하였다. 탐색적 개흉술을 통해 $360^{\circ}C$ 염전 된 오른쪽 중간엽을 확인하였으며 TA 장치를 이용 염전된 폐엽을 절제하였다. 복수 원인을 확인하기 위해 탐색적 개복술을 통한 소장생검을 실시하였으며, 조직 검사를 통해 림프관 확장증을 확인 하였다. 림프관 확장증 치료를 위해 prednisone과 저지방 사료를 사용하였으며, 임상증상의 개선을 확인하였다.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.86-90
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• 2018

Non-infectious complications of peritoneal dialysis (PD) are relatively less common than infectious complications but are a potentially serious problem in patients on chronic PD. Here, we present a case of a non-infectious complication of PD in a 13-year- old boy on chronic PD who presented with symptoms such as hypertension, edema, dyspnea, and decreased ultrafiltration. Chest and abdominal radiography showed pleural effusion and migration of the PD catheter tip. Laparoscopic PD catheter reposition was performed because PD catheter malfunction was suspected. However, pleural effusion relapsed whenever the dialysate volume increased. To identify peritoneal leakage, computed tomography (CT) peritoneography was performed, and a defect of the peritoneum in the left lower abdomen with contrast leakage to the left rectus and abdominis muscles was observed. He was treated conservatively by transiently decreasing the volume of night intermittent PD and gradually increasing the volume. At the 2-year follow-up visit, the patient had not experienced similar symptoms. Patients on PD who present with refractory or recurrent pleural effusion that does not respond to therapy should be assessed for the presence of infection, catheter malfunction, and pleuroperitoneal communication. Thoracentesis and CT peritoneography are useful for evaluating pleural effusion, and timely examination is important for identifying the defect or fistula.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.91-96
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• 2018

Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.304-307
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• 2013

Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

• 대한한방부인과학회지
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• 제28권4호
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• pp.11-20
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• 2015

Objectives The purpose of this study was to examine the relationship between cold hypersensitivity and bone mineral density. Methods 28 outpatients who visited OO University Oriental Hospital from July 11th, 2013 to August 28th, 2013 were analyzed. Patients were subjected to thermometer, and those with thermal difference greater than 0.3 ℃ between upper arm and palm and also with more than VAS 4 of cold hypersensitivity were diagnosed with cold sensitivity. Lumba spine (L2-4) and heel bone measurement were obtained on dual energy X-ray absorptiometry (DEXA) and Quantitative Computed Tomography (QCT). Results 1. There was statistically significant correlation between T-score of DEXA and body weight (0.522), BMI (0.643), OSTA (Osteoporosis elf-assesment Tool for Asians, 0.579), BMI, T-score and Z-score of QCT. OSTA and T-score of QCT (0.521) also had statistically significance. 2. There was no statistically significant correlation between body fat, abdominal obesity rate, degree of cold hypersensitivity, upper arm and palm's temperature difference, palm temperature, height and Z-score, T-score of QCT or T-sore of DEXA. Conclusions Bone mineral density was lower in women who had cold hypersensitivity of hand and feet. But there was no statistically significant correlation between bone mineral density and degree of cold hypersensitivity, upper arm and palm’s temperature difference.

• 한국임상수의학회지
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• 제30권3호
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• pp.189-192
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• 2013

8년령 중성화된 암컷 한국 고양이가 심한 구토와 기력저하로 내원하였다. 방사선 사진상 복부 전방에 종괴음영이 관찰되었으며, 초음파상 혼합에코를 가지는 종괴가 우측 신장 안쪽으로 관찰되었다. 컴퓨터 단층촬영상 종괴는 연부조직 밀도의 감쇠를 보이며, 종괴주변으로 증강효과를 보이는 캡슐이 종괴를 둘러싸고 있는 것으로 관찰되었다. 조직병리학적 검사상 꽈리샘 구조들은 옅은 호산성 세포질과 원형 혹은 난원형 핵을 가지는 불규칙한 입방형 세포들로 구성되어 있었다. 영상진단학 및 조직병리학적 검사결과를 바탕으로, 본 증례는 췌장 외분비 선암종으로 진단하였다.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.186-191
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• 2017

The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

• Tuberculosis and Respiratory Diseases
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• 제62권2호
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• pp.149-153
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• 2007

폐모세포종은 폐종양으로 매우 드물게 나타나며 드물게 간, 흉외 림프절, 심장으로 전이된다고 보고되고 있다. 본 저자들은 복부의 팽만감과 통증 및 호흡곤란을 주소로 내원한 환자에서 간과 폐의 거대 종괴를 발견하였고, 조직 검사를 통하여 간, 횡격막, 심장 등 다발성 침범을 동반한 폐모세포종으로 진단받은 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.