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포스터 전시 : 담도,췌장 ; 장기간 혈액투석을 시행받는 만성 신부전 환자에서 발생한 급성 괴사성 췌장염에 동반된 장 경색 1예
한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김한숙 ( Han Suk Kim ),이동근 ( Dong Keun Lee ),김효종 ( Hyo Jong Kim ),김병호 ( Byung Ho Kim ),장영운 ( Young Woon Chang ),이정일 ( Joung Il Lee ),장린 ( Rin Chang ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
만성신부전환자에서 발생하는 급성췌장염은 만성신부전이 없는 환자에서와 달리 원인이 알코올, 담석, 약물에서도 기타의 원인들이 많은 것으로 보고되고 있다. 혈액투석을 시행받는 만성신부전환자에서 급성췌장염의 발생기전은 대부분 전신적인 동맥경화증의 진행으로 인한만성 허혈성 손상에 의한 것이며 그 밖에 이뇨제, 고중성지방혈증, 고칼슘혈증, 저혈압 등이 관여하는 것으로 알려져 있다. 만성신부전환자는 동맥경화성 혈관을 가지고 있고 혈액투석증에 종종 저혈압을 경험하곤
백선경 ( Sun Kyung Bak ),김한숙 ( Han Suk Kim ),이승훈 ( Seung Hun Lee ),정지헌 ( Ji Heon Jung ),전정원 ( Jung Won Jeon ),박상도 ( Sang Do Park ),홍승재 ( Seung Jae Hong ),양형인 ( Hyung In Yang ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Sudden sensorineural hearing loss (SNHL) is a rarely reported clinical manifestation of systemic lupus erythematosus (SLE). Although the exact pathogenesis is still unclear, several reports suggest that circulatory immune complexes or anti-phospholipid antibodies might play a pathological role in hearing impairment in patients with SLE. We describe a 28-year-old female with SLE who presented with sudden SNHL. She was treated with highdose methylprednisolone and plasmapheresis. After 5 times of the plasmapheresis, her hearing ability was improved from 56 dB to 46 dB by measured of pure tone audiometery.
미만성 폐출혈을 동반한 Goodpasture 증후군 1예
김한숙,김희진,황유철,이태원,김명재,양문호,성동욱,이상호,임천규 대한내과학회 2002 대한내과학회지 Vol.63 No.1
Goodpasture syndrome is an autoimmune disease with a triad of acute renal failure due to rapidly progressive glomerulonephritis (RPGN), pulmonay hemorrhage and circulating anti-glomerular basement membrane antibody (anti-GBM Ab). It was commonly reported from Europe in male with a peak incidence in their 20's. If patients are affected with the disease, relief of symptoms can be expected by eliminating the anti-GBM Ab from the circulatory system through hemodialysis, plasmapheresis and immunoadsorption. However, if the diagnosis or treatment is delayed, the patients usually die from massive pulmonary hemorrhage. It has been revealed that the main target of anti-GBM Ab's is NC1 domain on the α3 chain of type Ⅳ collagen. Currently there are many studies underway using this information as a basis to identify the pathogenesis of Goodpasture syndrome and to develop new therapeutic approach. The patient was a 20-year-old male with a chief complaint of edema. Unlike patients in the two previous cases, reported in Korea who had massive hemorrhage, he showed diffuse pulmonary hemorrhage which improved in only one week by hemodialysis. Renal biopsy demonstrated crescents in over 90% of glomeruli and showed signs of acute renal failure due to RPGN, with 618 U/mL (normal range <19.9 U/mL) of anti-GBM Ab titer.