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김두일 ( Doo Il Kim ),이주원 ( Joo Won Lee ),김동기 ( Dong Kie Kim ),박승현 ( Seung Hyun Park ),김기훈 ( Ki Hun Kim ),설상훈 ( Sang Hoon Seol ),박보민 ( Bo Min Park ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Acute myocarditis can be caused by viral, bacterial, or protozoal infection, or drug toxicity. Fulminant myocarditis progresses rapidly and frequently leads to cardiogenic shock, so patients should be supported by extracorporeal membrane oxygenation (ECMO), an intra-aortic balloon pump (IABP), mechanical ventilation, or a temporary pacemaker to maintain hemodynamic status. Most patients recover with supportive therapy. However, a few patients have persistent atrioventricular (AV) block. We report the case of a 34-year-old male with persistent complete atrioventricular block after the regression of acute myocarditis. Ultimately, a permanent pacemaker was implanted. (Korean J Med 2012;83:629-632)
제2형 당뇨병 환자에서 우연히 발견된 기종성 방광염 1례
박보민,김윤정,이영태,노정현,권수경,김동준,고경수,이병두,임경호,이순희,박정현 白中央醫療院 2005 仁濟醫學 Vol.26 No.1
Emphysematous cystitis is an uncommon disease in which bacterias produce gas within the bladder wall and surrounding tissue. Patients with diabetes, neurogenic bladder and chronic urinary tract infection are predisposed to the disease. It is usually caused by E.coli and Klebsiella. Severity of illness ranges from an asymtomatic condition to life threatening cystitis. Succesful management depends on early diagnosis with correction of underlying causes, administration of appropriate antibiotics, establishment of adequate bladder drainage and surgical excision of involved tissue when required. We report a case of 52-year-old woman who did not compain of symtoms of cystitis but epigastric pain, nausea, and vomitting. Emphysematous cystitis was revealed on the abdominal X-ray series incidentally. CT scans of the pelvis showed mottled gas bubble within the bladder. After treatment, the symtoms subsided and plain abdominal film showed no evidence of gas shadow in the pelvic cavity.
특발성 과호산구 증후군 환자의 치료 도중 발생한 간혈종 1례
이영태,김동기,박지훈,김윤정,김기향,박보민,권민정,김애란,이원식,주영돈,손창학 白中央醫療院 2005 仁濟醫學 Vol.26 No.1
Idiopathic hypereosinophilic syndrome is characterized by marked elevation of eosinophil count ( >1,500/㎣) in peripheral blood without explaining etiology. It shows tissue involvement in many organs such as liver, G-I tract, myocar dium, lung, skin, kidney and nerve. Some case of hypereosinophilic syndrome with hepatic involvement have been reported, but not much. We have recently experienced a case with idiopathic hypereosinophilic syndrome of a 40 year old man who presented with RUQ pain. By abdominal CT, ill- defined subcapsular hematoma was detected. Liver biopsy showed eosinophilic infiltration within the portal tract and sinusoid. Drain procedure and corticosteroid adminiiatbrought marked improvement of clinical manifestation, hematologic abnormality and radiologic abnormality.
베체트병 환자에서 Azathioprine으로 유발된 급성 췌장염 1례
김기향,권민정,김동기,김애란,김윤정,박지훈,이영태,박보민,김동욱 白中央醫療院 2005 仁濟醫學 Vol.26 No.1
Although many drug are thought capable of initiating acute pancreatitis, following azathioprine administration represents the 5% incidence by far the highest recorded incidence to date. We report a 35-year-old male who developed acute pancreatitis in the course of treatment with azathioprine for Behcet's disease. He was admitted due to abdominal pain, diarrhea, and fever for 10 days. Serum amylase and lipase levels were 510U/L and 3702U/L respectively. The abdominal CT scan revealed diffuse enlargement of the pancreas. There was no history of alcohol use or gall bladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. We diagnosed it as acute pancreatitis. The patient was treated conservatively with hydration and analgesics. The symptom subsided within four days. Five days later, azathioprine was resumed. And the patient complained of abdominal pain. The elevated levels of serum amylase and lipase confirmed the recurrence of pancreatitis. His symptom subsided when azathioprine intake the stopped, and the serum amylase and lipase levels returned to normal level within five days.