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김지은 ( Ji Eun Kim ),장명희 ( Myung Hee Chang ),정경희 ( Kyoung Hee Jung ),이창화 ( Chang Hwa Lee ),강종명 ( Chong Myung Kang ),김근호 ( Gheun Ho Kim ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.2
Autosomal dominant polycystic kidney disease (ADPKD) is usually accompanied with cystic change of other organs, especially in liver. Although hepatic cysts may be presented with abdominal pain or infected cysts, rupture of hepatic cyst is rarely encountered. A 74-year-old female undergoing maintenance hemodialysis for ADPKD-induced end stage renal disease was admitted because of abdominal pain. She recently received intermittent urokinase instillation into her cuffed internal jugular venous catheter. During the admission, a sudden onset of diffuse abdominal pain occurred after hemodialysis and repeated urokinase instillation. The abdominal CT revealed rupture of hepatic cysts with perihepatic fluid collection. With supportive care and heparin-free hemodialysis, symptoms were improved. The abdominal CT taken after 3 weeks showed no evidence of hepatic cyst rupture. The possibility of hepatic cyst rupture should be considered when abdominal pain occurs in dialysis patients with ADPKD. We need to be very cautious when they are exposed to anticoagulants or thrombolytic agents.
간 , 담도 및 췌장 : 간기능 검사가 정상인 환자들의 간조직내 B 형 간염 바이러스의 분포
함준수(Joon Soo Hahm),박경남(Kyung Nam Park),이민호(Min Ho Lee),강종명(Chong Myung kang),이중달(Jung Dal Lee),안명주(Myung Ju Ahn),기춘석(Choon Suck Kee) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2
N/A A variety of hepatitis B virus (HBV) specific markers have been proposed for the diagnostic and prognostic assessments of patients with HBV infection. So, serum HBV viron markers (HBV DNA, DNA polymerase), expression of HBc Ag and HBs Ag in liver, free HBV DNA in liver and serum HBe Ag tend to coexist in the same patient and are generally considered to be markers of active viral replication. But the correlation of the above markers with histologic assessment has yielded conflicting results. In some studies, tissue HBs Ag or HBc Ag has been demonstrated in liver of some patients who do not have serum HBs Ag detectable by RIA method. In this report, liver specimens from 35 human subjects with normal liver function who complained nonspecific symptom and hepatic area tenderness by punch and had abnormal finding in liver scan were studied for the detection of tissue distribution of two HBV antigenic markers and histologic change as well as serum HBV viron markers. The results were as follows: 1) 14 of the 35 (40%) liver specimens with normal liver function showed abnormal histopathologic changes such as fatty change or chronic persistent hepatitis. 2) Among the 35 patients, only 1 (2.9%) showed hepatitis B core antigen (HBcAg) positive in hepatocytes. 3) 11 of the 35 (31.4%) patients had HBs Ag positive in hepatocytes. 6 of the 11 HBs Ag positive patients had normal liver and 7 of the 11 had HBs Ag negative in serum. 4) The distribution of HBsAg in hepatocytes could be classified as diffuse type (72.8%), inclusion type (18.2%) and membranous type (9%). 5) On follow-up exam, one of the two HBs Ag postivie in hepatocyte had changes in liver function test.
고혈압과 신경색으로 발현하여 복부 전산화단층촬영으로 진단된 자발성 신동맥 박리 2예
박준성 ( Joon Sung Park ),이창화 ( Chang Hwa Lee ),강종명 ( Chong Myung Kang ),김근호 ( Gheun Ho Kim ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.4
Spontaneous renal artery dissection (SRAD) is a rare event, which may be a challenge to physicians due to its rarity and nonspecific clinical presentation. We report two cases of SARD who were previously healthy men and complicated with renal infarction. Both presented with acute flank pain and high blood pressure. One was diagnosed by abdominal computed tomography and treated conservatively. The other was confirmed to have right renal artery dissection by selective arteriography and underwent renal artery stenting. Conservative treatment with antihypertensives and anticoagulantion usually bring up satisfactory results in most cases, but revascularization may be indicated for patients who have uncontrolled hypertension, renal insufficiency as a consequence of the dissection, or bilateral renal artery dissection.