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김주현(Ju Hyun Kim),이병호(Byoung Ho Lee),표희정(Hee Jung Pyo),최동섭(Dong Seop Choi),서동진(Dong Jin Suh),원남희(Nam Hee Won) 대한내과학회 1986 대한내과학회지 Vol.31 No.1
N/A Allopurinol-induced granulomatous hepatitis was found in a 66-yr-old man who developed generalized weakness, fever, and jaundice with abnormal liver function tests after taking allopurinol for 4 weeks, Biopsy of the liver revealed granulomatous hepatitis with fibrin ring. All clinical and biochemical abnormalities spontaneously resolved within 3 weeks after cessation of drug administration.
장미경(Mi Kyung Chang),이영호(Young Ho Lee),김난희(Nan Hee Kim),구자룡(Ja Ryong Koo),위경소(Kyoung So Wi),권영주(Young Joo Kwon),김형규(Hyung Gyu Kim),원남희(Nam Hee Won),이현순(Hyun Soon Lee),표희정(Heui Jung Pyo) 대한내과학회 1995 대한내과학회지 Vol.49 No.4
N/A Objectives: High proportion of the elderly patients with renal disease were found to have primary glomerular disease and their clinical entities may be modified by treatment, supporting the renal biopsy as a diagnostic aid to institute appropriate therapy. Methods: We have retrospectively reviewed 49 patients of 60 years old or older in whom renal biopsies were performed from September 1985 to July, 1994. We've analyzed the histopathologic distribution, clinical presentations, clinicopathologic correlations, complications related to renal biopsy and treatment, and clinical response to the immunosuppressive therapy. Results: 1) Patients were 34 men and 15 women, 60 to 79 years of age (mean, 64.8±45) 2) The most common clinical presentation was nephrotic syndrome (65%). 3) The pathologic diagnoses of primary renal disease (36.73%) were MGN (13), MPGN (5), IgA nephropathy (5), MCNS (4), FSGS (4), Crescentic GN (2), nephrosclerosis (2) and PSGN (1). 4) The pathologic diagnoses of secondary renal disease (13.27%) were amyloidosis (4), TIN (4), HBsAg associated GN (2), cryoglobulinemia (1) and TMA (1). 5) In the cases of nephrotic syndrome with immunosuppressive therapy (20), 5 (25%) patients showed complete remission and 11 (50%) showed partial remission. 6) No one has recovered in the cases of chronic renal insufficiency and rapidly progressive renal failure. Conclusion: The most common clinical presentation and pathologic finding in the elderly were nephrotic syndrome and membranous GN respectively. The response to immunosuppressive therapy in nephrotic syndrome was good, but the possible complications related to the immunosuppression should be considered prior to the therapy. Renal biopsy is a safe procedure even in the elderly, and essential for the definitive diagnosis and for the appropriate therapy.
이차성 부갑상샘항진증 환자에서 부갑상샘 전절제술 후 조영증가 MDCT로 진단된 이소성 부갑상샘 1예
윤기철 ( Ki Chul Yoon ),김정엽 ( Jeong Yup Kim ),김정선 ( Jung Sun Kim ),박상원 ( Sang Won Park ),왕준광 ( Joon Kwang Wang ),이영모 ( Young Mo Lee ),전은실 ( Eun Sil Jeon ),표희정 ( Heui Jung Pyo ),유병희 ( Byung Hee Yoo ),권영주 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
We report a case of a 25-year old man with chronic kidney disease with secondary hyperparathyroidism who had persistent elevation of serum parathyroid hormone level after the immediate total parathyroidectomy and autotransplantation. To localize supernumerary (ectopic) parathyroid gland, we checked Tc-99m MIBI scintigraphy, MDCT and PET-CT. Contrast-enhanced MDCT showed a small strong enhancing lesion over left bracheocephalic vein, and PET-CT showed multiple brown tumors. We removed the supernumerary parathyroid gland and got a rapid drop of parathyroid hormone level.
크론병 환자에서 인플릭시맵과 메살라진 치료 후 발생한 지연발생 급성 세뇨관간질 신염 증례
유양재 ( Yang Jae Yoo ),정상윤 ( Sang Yoon Chung ),구대회 ( Dae Hoe Gu ),고강지 ( Gang Jee Ko ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ),박영태 ( Young Tae Bak ),원남희 ( Nam Hee Won ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Infliximab is a chimeric anti-tumor necrosis factor-alpha monoclonal antibody. Infusion related reactions and infection are well known side effects of infliximab; however, renal complications have not been well recognized. We report on a patient with late onset-acute tubulointerstitial nephritis (ATIN) after treatment with infliximab and mesalazine for Crohn’s disease. A 25-year-old woman was admitted with a purpuric rash on both lower extremities and arthralgia. She had been diagnosed with Crohn’s disease 5.6 years previously and had been treated with mesalazine and infliximab. Serum creatinine level, last measured one year ago, was elevated from 0.6 mg/dL to 1.9 mg/dL. Results of urinalysis, ultrasound, and serologic examinations were normal. With a tentative diagnosis of Henoch-Schonlein purpura, oral prednisolone was given, and serum creatinine decreased to 1.46 mg/dL, but was elevated to 2.6 mg/dL again at two months after discontinuation of prednisolone. Renal biopsy indicated that ATIN was probably ind ced by drug, considering significant infiltration of eosinophils. Concomitant use of infliximab with mesalazine was supposed to trigger ATIN. Oral prednisolone was administered, and serum creatinine level showed partial recovery. Thus, ATIN should be suspected as a cause of renal impairment in Crohn’s disease even after a long period of maintenance treatment with infliximab and mesalazine.
흰 쥐에서 양측 요관 폐쇄 해제 후 신장의 Aquaporin-2와 Na-K-2Cl Cotransporter의 발현 변화 및 항이뇨호르몬 치료의 효과
신진호 ( Jin Ho Shin ),성수아 ( Su Ah Sung ),서지아 ( Ji A Seo ),한금현 ( Kum Hyun Han ),조원용 ( Won Yong Cho ),표희정 ( Heui Jung Pyo ),유기환 ( Kee Hwan Yoo ),원남희 ( Nam Hee Won ) 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.1
목적 : 혈액 용적 감소에 관련된 신장의 aquaporin-2 (AQP2) 수분 통로 발현 변화를 용적 감소 수 경과 시간에 따라 조사하였다. 방법 : Sprague-Dawley 숫쥐에서 몸무게의 약 2%에 이르는 급성 출혈을 일으키고 1시간 및 3시간 뒤에 신장 조직의 AQP2 mPNA 및 단백 발현을 각각 역전사 중합효소 연쇄반응법과 Western blot 분석법으로 조사하였다. 결과 : 출혈 후 1시간에 신장의 내수질에서 AQP2 mPNA 발혈은 유의하게 증가되었으나 AQP2 단백 이동 및 발현은 별화가 없?B다. 출혈 후 3시간에 AQP2 mRNA 발현 뿐 아니라 AQP2 단백 이동 및 발현이 모두 유의하게 증가하였다. 결론 : 혈액 종적 감소에 기인하여 신장에서 AQP2 수분 통로 발현이 증가되며 이는 체액용적 확보를 위한 보상 기전의 하나로서 작용하리라 추측되었다. Background : The present study was aimed to examine the regulation of aquaporin (AQP)-2 water channels in the kidney following blood volume depletion. Methods : Male Sprague-Dawley rats were acutely blood volume0depleted by withdrawal of arterial blood up to 2% of body weight. The expression of transcription - polymerase chain reaction and Westem blot analysis, respectively, in the inner medulla of the kidney 1 and 3 hours after the hemorrhage. Results : The mRNA expression if AQP2 was significantly increased 1 hour after thd bleeding However, neither the shuttling nor the total abundance of QQP2 proteins was significantly altered. On the contrary, 3 hours after the bleeding, the expression of AQP2 proteins as well as that of AQP2 mRNA was significantly incresaed. The shuttling of AQP2 proteins was also increased. Conclusion : These results sugest that an increased expression of AQP2 channels in the kidney may confer one of compensatory mechanisms restoring the circulation volume in an acute hypovolemic state.
방사성동위원소를 이용한 원발성간암의 진단적 의의에 관한 연구 - 방사면역측정법에 의한 혈청 Alpha - fetoprotein 의 정량적 측정 - (pp.390-400)
고창순 ( Chang Soon Koh ),김정용 ( Chung Yong Kim ),이문호 ( Mun Ho Lee ),이홍규 ( Hong Kyu Lee ),이중근 ( Joong Keun Lee ),박선양 ( Seon Yang Park ),표희정 ( Hee Jung Pyo ),최강원 ( Kang Won Choe ),김병국 ( Byung Kuk Kim ) 대한내과학회 1979 대한내과학회지 Vol.22 No.5
지속적 신대체요법 ( Continuous Renal Replacement Therapy ) 을 시행 받은 환자들의 임상적 특성에 대한 연구
강영선(Young Sun Kang),이소영(So Young Lee),한상엽(Sang Youp Han),조상경(Sang Kyung Jo),신진호(Jin Ho Shin),차대룡(Dae Ryong Cha),권영주(Young Joo Kwon),조원용(Won Yong Cho),표희정(Hee Jung Pyo),김형규(Hyoung Kyu Kim) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1
목 적 : 급성신부전 환자에서 지속적 신대체요법은 간헐적 혈액투석에 비해 많은 장점에도 사용이 적다. 저자는 지속적 신대체요법 환자의 생존·사망에서 각 특성과 신대체요법 상태를 조사하였다. 방 법 : 1992년 5월부터 2000년 2월까지 지속적 정정맥 혈액여과법(continuous venovenous hemofiltration, CVVH)을 받은 51명의 동반질환, 시작 후 저혈압정도를 조사하고, 사망여부에 따라 CVVH 시작시 혈압, APACHE Ⅲ score, 장기부전수를 비교하였다. 결 과 : 남녀 각 30명, 21명, 평균연령은 56.3±15.6세로 대부분의 환자가 사망하였다(44명, 86.3%). 동반질환은 패혈증 66.7%, 급성신부전 62.7%, 간부전 33.3%, 울혈성 심부전 17.6%, 성인형 호흡곤란증후군 9.8%였다. 시작 후의 평균 동맥압은 59.3±21.5 ㎜Hg로 시작 전에 비해 떨어졌으나 차이는 없었다(p=0.076). 다장기부전은 86.3%였고, 평균 장기부전수는 사망 2.6±1.0, 생존 1.9±1.3(p=0.072), APACHE Ⅲ score는 사망 59.5±13.5, 생존 56.0±20.9로 차이는 없었다. CVVH 시작시 평균 동맥압은 사망 63.49±17.04 ㎜Hg, 생존 87.86±23.15 ㎜Hg로 사망군이 낮았다(p=0.002). 결 론 : 지속적 신대체요법 시행 환자 상당수가 다장기부전을 동반하였다. APACHE Ⅲ score는 사망·생존간에 차이가 없으나 평균 동맥압은 사망자군에서 낮고 평균장기부전수는 사망자군에서 높은 경향으로 질병의 중한 정도가 예후와 관련을 보인다. Purpose : Continuous renal replacement therapy (CRRT ) has been developed and it has advant ages, although the patient s receiving CRRT still have a high mortality. This study was designed to compare the clinical char acteristics of patient s treated with CRRT between survivors and non - survivors. Methods : From May 1992 to February 2000, continuous venovenous hemofiltr ation (CVVH) treatment was applied to 51 patients . Underlying disease, duration of CVVH treatment , blood pressure before and after the treatment were reviewed and APACHE Ⅲ score, number of org an failures, blood pressure at the begining were compared between two groups. Results : The average age was 56.3±15.6 years and the mort ality was 86.3%(44 patient s ). The comorbid conditions were sepsis (66.7% of total patients ), hepatic failure (33.3%), congestive heart failure (17.6%) and adult respiratory distress syndrome (9.8%). Mean arterial pressure (MAP ) at the begining was 66.9±19.7 ㎜Hg and MAP 2 hour s after the treatment was 59.3±21.5 ㎜Hg (p=0.076). APACHE Ⅲ score was 59.5±13.5 in non - survivors and 56.0±20.9 in survivors and mean number of org an failures was 2.63±0.98 in non - survivors and 1.68± 1.34 in survivors, but there was no difference between two groups (p=0.072). MAP at begining was significantly higher in survivors than that of non- survivors (87.86±23.15 vs . 63.49±17.04)(p=0.002). Conclusion : Most of the patient s receiving CVVH have more than two org an failures . There were no significant difference in the number of organ failures and APACHE Ⅲ score between survivor group and non - survivor group. It may be due to underlying disease of patient s that MAP at the begining was lower in non - survivors than survivors . APACHE Ⅲ score would not be a good prognostic predictor