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( Su Yun Oh ),( Jong Min Lee ),( Jik Hwan Ha ),( Hyeon Hui Kang ),( Sang Haak Lee ),( Hwa Sik Moon ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Pulmonary cryptococcosis can occur in immunocompromized patients such as AIDS, organ transplantation, hematologic disorder, or diabetes mellitus. The most common radiographic manifestations of pulmonary cryptococcosis are solitary or multiple pulmonary nodules or mass, single or multiple patchy in. ltrations, or reticulonodular pattern. And cryptococcosis presented as endobronchial obstruction has rarely been reported. A 85-year-old Korean female patient with diabetes mellitus, hypertension, atrial fibrillation and asthma presented to the hospital with complaint of 2-weeks history of dyspnea, sputum and cough. She was taking 5 mg of prednisolone daily due to uncontrolled asthma. Chest radiography showed diffuse opacity in right lung field and chest computed tomography scan revealed marked narrowing of left main bronchus. Bronchoscopy confirmed narrowing and severe in. ammatory change such as whitish exudates and ulceration of left main bronchus. A biopsy specimen was taken from the mucosa of left main bronchus and showed encapsulated yeast forms consistent with cryptococcus infection. She was treated using amphotericin B and fiuconazole. After 2 weeks treatment, a follow-up bronchoscopy showed much improved state of endobronchial and endotracheal narrowing and in. ammatory change such as multiple exudate and ulceration. We have experienced a case of pulmonary cryptococcosis presented as endobronchial obstruction. We consider our case is worth discussing because it is the first report in Korea.
상염색체우성 다낭신에서 질병진행 예측인자로서 요중 안지오텐시노겐의 유용성
박혜인조 ( Hayne Cho Park ),황진호 ( Jin Ho Hwang ),백선하 ( Seon Ha Baek ),한미연 ( Mi Yeun Han ),윤유경 ( Yu Kyoung Yun ),윤명옥 ( Myeong Ok Yoon ),오국환 ( Kook Hwan Oh ),구자룡 ( Ja Ryong Koo ),김형직 ( Hyung Jik Kim ),노정우 ( 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.5
Purpose: The renin-angiotensin-aldosterone system activation has been suggested as a potential risk factor for renal progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to evaluate urinary angiotensinogen as a biomarker of renal progression in ADPKD. Methods: Patients with estimated glomerular filtration rate (eGFR) 30 mL/min/1.73m≥2 were enrolled in the study. Specimens (blood and urine) and computed tomography (CT) were taken from each subject. The eGFR was calculated by 4-variable MDRD equation and total kidney volume (TKV) was measured from CT images by modified ellipsoid method. Urinary angiotensinogen (AGT) and neutrophil gelatinaseassociated lipocalin (NGAL) were measured by ELISA. The concentration of AGT was adjusted with random urine creatinine (Cr). The association between urinary biomarkers, TKV and eGFR were evaluated. Results: A total of 59 (M:F=31:28) subjects were enrolled in the study and their mean age was 46 years. The eGFR and TKV at the enrollment were 77.3±15.6 mL/min/1.73m2 and 1389.8±925.1 mL, respectively. Log AGT/Cr was associated with TKV (r2=0.11p=0.01) in the earlier stage of disease (TKV<000 mL). However, it did not show significant correlation with eGFR. Log NGAL was not associated with either TKV or eGFR. Urinary AGT/Cr was closely related to the number of anti-hypertensive medication, TKV, and the presence of albuminuria, although there was no correlation with plasma renin activity or aldosterone level. Conclusion: Urinary angiotensinogen may be a useful biomarker of disease progression in ADPKD patients.