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정윤화 ( Yun Hwa Jung ),장정원 ( Jeong Won Jang ),지정선 ( Jeong Seon Ji ),김병욱 ( Byung Wook Kim ),최황 ( Whang Choi ),최규용 ( Gyu Yong Choi ),맹이소 ( I So Maeng ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1
본 저자들은 윌슨씨병으로 진단된 젊은 여자 환자에서 합병된 담도 결석을 내시경적 담석제거술로 제거한 1예를 경험하였기에 보고하는 바이다. 윌슨씨병은 병인론에서 보듯이 간, 신경계 외에도 혈액학적 합병증을 수반할 수 있으며 이에 따라 담도계의 결석을 이차적으로 수반할수 있음을 증례를 들어 제시하며 역으로 고위험요소가 없는 환자에 있어서의 담도결석은 혈액질환이나 대사질환의 가능성을 시사함을 인지해야 할 것으로 생각된다. Wilson`s disease is a rare autosomal recessive metabolic disease. The ATB7B gene mutation results in a defect of biliary copper excretion and subsequent accumulation of copper in the liver, brain, and sclera. The usual clinical signs of Wilson`s disease include hepatitis, liver cirrhosis, movement disorder, or a Kayser-Fleisher ring in the sclera, but patients occasionally present with hepatic failure or hemolytic anemia. Under such metabolic conditions, free copper induce chronic hemolysis with oxidative damage via free radical production, and chronic hemolysis, in turn, can cause secondary pigment bililary stone formation. Herein we report a case of Wilson`s disease associated with cholelithiasis in a young female. (Korean J Med 75:82-87, 2008)
이명철,김석기,이동수,정준기,김광명,최황 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.2
Purpose: As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested. Materials and Methods: In 35 children (18 males, 17 females), radiologic voiding cystourethrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined. Results: Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading. Conclusion: RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases. (Korean J Nucl Med 2000;34:135-143)
충수돌기염과 하부장관 궤양출혈을 동반한 알레르기성 육아종증(Churg-Strauss Syndrome) 1예
김재영,이상헌,김재광,김태균,선희식,문성배,이영재,추영미,노상영,최황 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.6
Churg-Strauss Syndrome is a disorder of hypereosinophilia and systemic vasculitis in subjects with asthma and allergic rhinitis. Clinically, a multiple organ system can be involved with various manifestations of disease of lung, heart, skin, musculoskeletal system, nervous system, gastrointestinal and hepatobiliary tract. We experienced a case of Churg- Strauss syndrome presenting as the appendicitis and the lower gastrointestinal bleeding in a 37-year-old male patient with acute lower abdominal pain. He also showed peripheral eosinophilia, bronchial asthma, and mononeuritis multiplex. He initially received a high dose corticosteroid and was maintained with low doses of corticosteroid, cyclophosphomide and exchange plasmapheresis.