Castleman 씨 병에 동반된 신유전분증

김연수,한진석,이정상,김병국,이중건,정윤철,이진학,최영진,안규리,김성권,이현순 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Castlemam's disease is an asymptomatic and benign lymph node hyperplasia which is frequently manifested as mediastinal mass in over 70% of cases. Amyloidosis is rarely associated with Castleman's disease. Recently we experienced a patient with nephrotic syndrome due to renal amyloidosis who had been previously diagnosed as Castleman's disease of retroperitoneal lymph node enlargement. A 47-year old woman was admitted because of generalized edema and chest tightness. Five months ago she diagnosed as Castlman's disease-plasma cell type, of retroperitoneal lymph node enlargement. The patient was followed up through outpatient department without any specific medication. Physical examination showed pale conjunctivae, palpable mass on epigastric area and pretibial pitting edema. The hemoglobin, leukocyte count and erythrocyte sedimentation rate were 96 g/L, 5.9×109/L and 127 mm/hour, respectively. The blood urea nitogen was 3.6 mmol/L and creatinine was 88 umol/L. The urinalysis showed 3 positive for albumin. Twentyfour hour urine contained 16.6 grams of protein. A computerized tomographic (CT) scan of the abdomen disclosed multiple lymph node enlargement at mesentery. Percutaneous needle biopsy of kidney showed massive infiltration of pale pinkish amorphous material in the glomerular tuft forming large nodules. Ultrastructural examination exhibited heavy deposition of amyloid fibrils in the mesangium and perpendicular to glomerular basement membrane. Polarizing microscopy with Congo-red stain revealed prominent yellow green birefringence in glomeruli, tubules and interstitium.

운동후 측복통과 함께 발생한 급성 신부전 1 예

김종순,박영주,조종태,이정임,신민호,구천희,박태용,한승수,강진화 대한내과학회 1996 대한내과학회지 Vol.50 No.6

We report a case of acute renal failure with severe loin pain and patchy renal vasoconstriction after exercise. An immediate postcontrast computed tomogram of this case shows multiple patchy areas of poor contrast enhancement in the cortex of the both kidneys. A 24-hours delayed scan without further injection of contrast dye shows multiple wedge-shaped contrast enhancement in the coincident areas of poor enhancement in the immediate scan. The 2 and 5 days delayed scans show that wedge-shaped contrast enhancement becomes disappeared gradually to the renal cortex, and the 8 days delayed scan shows complete disappearance of contrast enhancement. The renal scintigrams with technetium-99m-methylene diphosphonate and dimercaptosuccinic acid show diffuse increased uptakes and multiple patchy photon deficient areas in the both kidneys respectively. The follow-up renal scintigrams show nearly normal findings, This patient had an uneventful hospital course and recovered completely without dialysis.

급성 골수성 백혈병(M6)에 합병된 중추성 요붕증 1 예

김성연,조보연,이홍규,고창순,민헌기,김병국,김노경,신찬수,이명식,강덕현,조종태 대한내과학회 1989 대한내과학회지 Vol.37 No.2

Leukemia is known to be an extremely rare cause of diabetes insipidus. We report a case of diabetes insipidus as a complication of leukemia. An 18 year-old man was admitted because of polyuria polydipsia and fever. Bone marrow aspiration and biopsy revealed the diagnosis of acute erythroleukemia (AML, M6). On the water deprivation test, the diabetes insipidus was confirmed to be of the central type. He was managed with intranasal vasopressin for diabetes insipidus with good response. Induction chemotherapy was administered without response, and the patient died of septicemia and respiratory failure 2 months after initial diagnosis. A short review of the literature related to this subject is also presented.

한글 WORD PROCESSOR 에 관한 연구

김현욱,김덕진,양정윤,김낙빈,김영천,이순흠 고려대학교 공학기술연구소 1984 고려대학교 생산기술연구소 생기연논문집 Vol.20 No.1

A Hanguel word processing software which could be ported into a general purpose microcomputer that has Z-80A CPU and FDOS operating system has been described in this paper. This software consists of input routine, processing routine, and output routine. In the input routine, Hanguel inputted linearly by the ASCII keyboard is combined into a character, and is displayed on the CRT screen in two-dimensional form. In the processing routine, any function among (1) editing (2) updating (3) printing (4) deleting could be selectively performed. In the output routine, Hanguel characters could be selectively printed in the 3 different sized character forms, i.e., 16×16 dot, 24×24 dot, and 32×32 dot size.

사료의 pH 및 단백질 수준이 자돈의 성장 및 영양소 소화율에 미치는 영향

김지훈,한인규,김진동,조원탁,현충남,이지훈 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.4

자돈사료내 pH와 단백질 수준의 효과를 알아보기 위하여 2개의 시험을 수행하였다. 시험 1에서는 pH 수준이 자돈의 성장과 영양소 소화율에 미치는 영향을 총 150두의 자돈(L×D×LW ; 8.82㎏ BW 30 ± 2일령)을 이용하여 1) pH 4.7, 2) pH 5.2, 3) pH 5.7 (basal diet), 4) pH 6.2, 5) pH 6.7의 다섯처리를 두었고, 시험 2에서는 pH와 단백질 수준의 효과를 알아보기 위하여 150두의 자돈을 (L×D×LW ; 5.46㎏ BW) 2×3 요인법으로 배치하였다. (조단백질 = 21.5, 24.5%, 사료 pH = 4.5, 5.5, 6.5). 또한 소화율의 측정을 위하여 시험 1에는 25두, 시험 2에는 24두의 자돈에 T-cannular를 설치하였다. 시험 1에서 pH는 자돈의 성장에 아무런 영향이 없는 것으로 나타났다. 낮은 pH사료를 급이한 구에서 사료효율이 약간 좋은 경향이 있었으나, 유의적인 차이는 발견되지 않았다. 회장 및 분소화율도 처리에 의한 효과가 발견되지 않았다. 시험 2에서는 낮은 pH 사료를 급이한 구에서 성장 및 사료효율이 개선되는 경향이 있었다 (P = 0.16). 사료효율은 단백질 수준에 의한 영향이 있었으며 (P<0.05), pH와 단백질 수준간의 상호작용이나 다른 효과는 발견되지 않았다. 회장 소화율도 단백질 수준에 의한 영향은 있었으나, pH의 효과는 methionine의 소화율에만 영향이 있는 것으로 나타났다. 전체적으로 소화율은 pH에 의한 일정한 경향이 발견되지 않았다. 본 시험의 결과는 사료의 pH 조절효과는 자돈의 나이나 사료의 종류에 따라 영향을 받는다는 것을 암시하며, 일반적으로 통용되고 있는 자돈사료는 특별한 산성화 처리가 필요하지 않은 것으로 나타났다. Two experiments were conducted to investigate the effect of diet pH and protein levels on the growth performance and nutrients digestibility in young piglets. In Exp. 1, a total of 150 piglets (Landrace × Duroc × Large White ; 8.82㎏ B W, 30 ± 2 days of age) were allotted into 5 treatments. Treatments were 1) pH 4.7, 2) pH 5.2, 3) pH 5.7 (basal diet), 4) pH 6.2 and 5) pH 6.7. In Exp. 2, the effect of dietary protein and diet pH levels on the growth performance and nutrient digestibility was examined with 150 crossbreds Landrace × Duroc × Large White ; 5.46㎏ BW) piglets in 2 × 3 factorial arrangement. (21.5 and 24.5% CP and diet pH (4.5, 5.5 and 6.5)). Each treatment has 5 replications, 5 heads per replicate. For the digestibility determination, 25 pigs for Exp 1. and 24 pigs for Exp. 2. were fitted with simple T-cannula and individually fed the experimental diet. In Exp. 1, no significant difference was found in any of the criteria measured. Pigs fed low pH diets showed slightly better feed efficiency, but the difference was not significant. Both ileal and fecal nutrient digestibility were not different. A small difference was found in major amino acids digestibility, but there was no constant trend detected. In Exp. 2, pigs fed low pH diet showed a trend (P = 0.16) to grow faster than those fed high pH diet. Feed efficiency was affected by protein level (P<0.05). No other main effect was detected. Protein level affected the ileal digestibility of energy, dry matter, crude fat, methionine and threonine. The effect of pH was found only in methionine digestibility. No other main effect was found in ileal digestibility. It appeared that age of pigs and type of diet could greatly influence the effect of diet pH manipulation. Acidification of commercially available diets might have minimal effect when diet contained high portion of high quality feed ingredients.

한국형 출혈열 후유증으로 발생된 만성 신우신염

김연수,한진석,이정상,김성권,진호준,안규리,오국환,오윤규 대한내과학회 1997 대한내과학회지 Vol.52 No.4

It has been known that most patients with Korean Hemorrhagic Fever (KHF) were recovered without any significant renal complication. But several cases of renal hypertension, chronic pyelonephritis, and chronic renal failure after KHF have been reported. Recently, we experienced one case of chronic pyelonephritis as a sequela of KHF, which has been diagnosed at the 78th month of illness. This case showed reduced thickness of renal parenchyme, small and irregular shaped kidney, focal loss of normal cupping of calyces, and accumulation of radiacontrast media at distal calyes by IVP. This case suggested that chronic pyelonephritis may develop as a sequela of KHF,

B 형 간염 Virus-Associated Hemophagocytic Syndrome 1 예

김진우,임경수,최영미,정인석,박두복,김호균,정영기 대한내과학회 1991 대한내과학회지 Vol.40 No.6

Virus-associated hemophagocytic syndrome (VAHS) is a nonneoplastic generalized histiocytic proliferation with marked hemophagocytosis associated with systemic viral infections such as Epstein-Barr virus, cytomegalovirus, adenovirus, herpes virus. etc. High fever, liver dysfunction, coagulation abnormality, and peripheral blood cytopenias are characteristic findings. Hepatosplenomegaly, lymphadenopathy, bilateral pulmonary infiltrations, and skin rash are often present. We report a case of Hepatitis B virus-associated hemophagocytic syndrome with a brief review of literature.

기관지내 전이암

김현수,이상수,오미희,이재갑,원구태,홍희승,용석중,신계철 대한내과학회 1991 대한내과학회지 Vol.40 No.4

The lung is the most common site of metastasis of extrapulmonary malignant tumor. According to past reports, metastatic cancer of the lung has been found in about 2% of all patients at autopsy. But these days, a diagnosis of endobronchial metastatic cancer utilizing bronchoscopy only is not easy. Thus we need other means of gathering more informaction, such as past history, discovery of other metastatic sites, and pathologic findings with special staining and electronmicroscope, especially in cases of poorly differentiated adenocarcinoma and epidermoid cancer, which are common types of primary lung cancer. We present 5 cases of endobronchial metastatic cancer. We found endobronchial metastatic cancer 2 cases of cervix cancer (epidermoid, adenocarcinoma), 1 case of colon cancer (adenocarcinoma), hypernephroma (renal cell carcinoma), and bladder cancer (transitional cell carcinoma). Since it was impossiole to diagnose the metastatic adenocarcinoma from the cervix only with lightmicroscopic findings, we could use past history and unusual radiologic and bronchoscopic findings which was thought to be the specific endoscopic finding of metastic endobronchial cancer. The interval between the diagnosis of the primary cancer and endobronchial metastatic cancer was 25.7 months. In the future, development of immunohistochemistry, monoclonal antibody, and molecular biologic techniques will give us diagnostic clue for differential diagnosis of metastatic endobronchial cancer from primary bronchogenic lung cancer.

급성췌장염에 의한 췌장가성남종에서 내시경적 배액술후 발생한 췌장가성남종과 십이지장 및 대장에 발생한 내부 췌장루 1예

김연수,이문성,김진오,조영덕,이영홍,봉형근,조주영,이준성,심찬섭,황성규,전기원,변재호,장재영 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

중등도 및 중증고혈압에서 Nifedipine 설하투여의 강압효과에 관한 연구

김영훈,서순규,최인석,김열홍,안희권,심완주,노영무 대한내과학회 1986 대한내과학회지 Vol.31 No.5

In order to assess the efficacy of sublingual nifedipine in the acute treatment of moderate to severe hypertension, a single blind test was done in 30 patients, 10 males and 20 females, aged 40 to 76 years, with moderate to severe hypertension. The patients with mean sitting blood pressure(BP) of more than J40 mmHg received sublingual placebo, and BP and pulse rate(PR) were measured in sitting position 10,20 and 30 minutes after the sublingual placebo was given. The patients with post-placebo 30 minutes sitting mean BP of less than 13pmmHg were excluded from the study. The placebo treatment period was followed by the administration of 10mg of sublingual nifedipine, and BP and PR were measured 10,20,30 and 45 minutes after nifedipine was given. BP decreased with placebo treatment(p$lt;0. 01 by paired t-test, preplacebo vs. post-placebo 30 minutes). With sublingual nifedipine BP started to fall in 10 minutes and reached the lowest levels in 30 or 45 minu1es. The systolic BP decreased from 198.0±21.4mmHg to 159±20.4mmHg, diastolic BP from 122.5±13.0 mmHg to 103.2±14.4 mmHg and mean from 147.7±13.4 mmHg to 121.7±14.8 mmHg 45minutes after nifedipine(p$lt;0.01 by paired t-test). The average fall in systolic BP/diastolic BP/mean BP 45 minutes after nifedipine was 39/19/26 mmHg(p$lt;0. 001, by paired t-test). The maximal fall in systolic BP correlated better with pretreatment value(r=0.42) than the maximal fall in diastolic pressure(r=0.21), PR increased from 79±12 to 87±11/minute with nifedipine(p$lt;0.001, by paired t-test). Side effects were mild facial flushing(16.7%) and palpitation (3.3%). The findings suggest that a dose of 10mg of sublingual nifedipine is a simple, effective and safe method for the acute treatment of moderate to severe hypertension and can be used as a non-injecting alternative agent for the treatment of hypertensive emergency.