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다발성 골전이를 동반한 방광의 악성 크롬친화성 세포종 1예
이명석,최동섭,임기권,최인석,홍성노 대한내분비학회 1986 Endocrinology and metabolism Vol.1 No.1
Pheochromocytoma is a rare tumor usually arising within the adrenal medulla or in any location where chromaffin tissue may exist. About 10% or pheochromocytoma may occur in extraadrenal lesions and 10% of the tumor may be malignant. Pheochromocytoma of the bladder has the clinical triad of hematuria, hypertension, and syncope during or immediately after urination. The only critera of malignant potential is the demonstration of chromaffin cells in an organ such as lung, liver, bone and lymph node which normally does not contain them.We report a case of malignant pheochromocytoma of the bladder in 50-yr-old female patient who was taken operation for total cystectomy and ileal conduit 2 years ago. On readmission, high level of catecholamine and it's metabolite in serum and urine are suggestive of recurrence or metastasis, and the multiple metastases to the 2nd lumber vertebra, left 11th rib and hip bone are found by Gallium-scanning.
박민희,현진해,임기권 대한내과학회 1986 대한내과학회지 Vol.31 No.6
Esophageal strictures as complication of esophageal operation increase gradually, and the management of esophageal stricture is important because of dysphagia and regurgitation. It was well known that balloon dilatation and bougination are useful methods in esophageal stricture. We have treated a esophageal stricture occurred 7 months after Schiura operation with endoscopic electric resection in a 23-yr-old male patient, and report it as simple and effective management of esophageal stricture.
조원용,김민자,임기권,노정우,최원층,김형규 대한내과학회 1987 대한내과학회지 Vol.32 No.3
To see whether there is any clinical difference between urban residency and rural residency in KHF, and between oliguric type and non-oliguric type in urban residency KHF, we reviewed 123 KHF patients from Jan., 1981 to Dec., 1985 In urban residency, 28 patients lived in a city and have never been outside the city since last 2 months. In oliguric type of urban residency, 14 patients had lesser than 400 ml of urine in a day. We reviewed clinical findings, labratory findings, treatment and prognosis in cases of two types in urban residency KHF. The results were as follows; 1) The total number of urban residency was 28cases (22.8%) in 123cases of KHF. 2) In urban residency, male to female ratio was 4.6:1 and most common in 3rd decade. 3) The oliguric type in urban residency is 14cases (50%) 4) On clinical findings, there were fever, nausea and abdominal pain commonly, and which were milder in non-oliguric type. 5) There were facial flushing, CVA tenderness and petechia commonly, and which were milder in nonoliguric type, 6) On labratory findings most cases showed leukocytosis, proteinuria and hematuria, and renal function were more deteriorated in oliguric type. 7) The non-oliguric patients were cured by supportive care except one cases, oliguric patients needed dialysis treatment in half cases. 8) Except two cases (7.8%), which were discharged moribundly due to prolonged shock state in oliguric type, the prognosis were good in both types of urban residency KHF, relatively.
김인선,김형규,박지혁,최원충,임기권 대한내과학회 1987 대한내과학회지 Vol.32 No.3
The idiopathic hypereosinophilic syndrome is a disorder characterized by eosinophilia in peripheral blood, bone marrow and frequently associated with single or multiple organ resulting in systemic dysfunction. The diagnostic criteria includes eosinophilia in peripheral blood over 1500/mm³ for longer than 6 months, also the signs and symptoms of involved organ are lack of evidence for parasites, allergics or other known causes of eosinophilia. We have experienced a case of idiopathic hyper- eosinophilic syndrome in a 55 years old man who complained of slight coughing, dyspnea with palm sized palpable spleen. We confirmed it with biapsies of bone marrow, liver, lung and duodenum which showed diffuse eosinophilic infiltration, therefore he has been treated with prednisone and hydroxyurea with relative response. So we present a case with the brief review of literatures.
성인 신증후군 환자에 합병된 자발적 세균성 복막염 1 예
김형규,박지혁,김민자,최원충,임기권 대한내과학회 1987 대한내과학회지 Vol.32 No.5
A 21 years old male patient who had spontaneous bacterial peritonitis associated with the onset of recur- rent nephrotic syndrome is reported. SBP has long been a known complication of the childhood nephrotic syndrome but the case report in adult is rare. This patient showed the clincal finding compatible with acute peritonitis of which the peritoneal fluid contained WRC 1300/mm³ (PMN 80%) without a demonstrable source of infection in the abdominal cavity, Serum immunoglobulin G level was decreased. He was recovered completely from the SBP with the administration of broadspectrum antibiotics.
급성 신부전을 보인 한국형 출혈열에서 뇨중 Prostaglandin E2의 변화와 Na대사에 관한 연구
김민자,김형규,조원영,박지혁,임기권 대한신장학회 1986 Kidney Research and Clinical Practice Vol.5 No.2
In order to define the changes of urine prosta glandin and the changes of Na metabolism in Korean hemorrhagic fever with acute renal fenal failure, urinary excretion of PGE are measured in 14 Korean hemorrhagic fever patients. And to correlate these values to other renal functions, serum and urine sodium, serum creatinine and creatinine clearence are measured. The subjects of this study are classified as follows; 8 oliguric cases in oliguric phase, oliguric case in diuretic phase (follow up cases), 6 non-oliguric cases. The results obtained are as follows: 1) The value of urine PGE, in oliguric phase of oliguric group:2231.75±280.08(meanSD) pg/ ml, in diuretic phase of oliguric group:343.00± 189.64pg/ml, in non-oliguric group:536.67±149.24, In oliguric phase of oliguric phase of oliguric group, urinary PGE, is significantly higher than in diuretic phase of oliguric group and in non- oliguric group(P$lt;0. 01). 2) FENa in whole cases is 12. 03 ±12. 68%, in oliguric phase of oliguric group: 19.81±11.65 %, uretic phase of oliguric group:2.95 ±2.03% and in non-oliguric group:1.64±1.12%. In oliguric phase of oliguric group, FENa is significantly higher than diuretic phase of oligu- ric group and non-oliguric group(P(0.01). 3) Urine PGE, has significant relation to FENa(p=0.89) and singificant reversed relation to creatinine clearance(p= - 0.94) and urine volume (p= -0.9). In this result, it is considered that the increase in urine PGE in Korean hemorhagic fever with acute renal failure is due to protective effect of PGE, on acute renal failure. And high FENa in this study means that acute renal failure in Korean hemorrhagic fever may be acute tubular necrosie.