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급성 A형 간염 이환 후에 만성신장병이 합병된 1예와 막사구체신염이 합병된 1예
송인걸 ( In Geol Song ),강민규 ( Min Gyu Kang ),나운태 ( Woon Tae Na ),김성태 ( Sung Tae Kim ),박문일 ( Moon Il Park ),윤세희 ( Se Hei Yun ),윤성로 ( Sung Ro Yun ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Acute A viral hepatitis is a mild, self-limiting disease of liver and acute renal failure (ARF) is a rare complication. We report two cases of chronic renal failure (CRF) in nonfulminant acute A viral hepatitis and ARF. A 40-year-old man was admitted with ARF and acute A viral hepatitis, and underwent temporary hemodialysis therapy. The renal biopsy showed acute tubular necrosis with tubulointerstitial nephritis. At 13 months after discharge serum creatinine was 1.33 mg/dL and protein-creatinine ratio of spot urine was 0.47 (mg/mg Cr). The second case was a 28-year-old man and was managed conservatively. At discharge the serum creatinine was 3.14 mg/dL and the urinalysis showed hematuria, and protein-creatinine ratio 0.56 (mg/mg Cr). Thirty-nine months after discharge, the creatinine was 1.23 mg/dL, the urinalysis showed persistent nephritis findings and the protein-creatinine ratio 1.28. Kidney biopsy revealed the membranous glomerulopathy with mild tubulointerstitial nephritis, and all of findings suggested the systemic disease-associated secondary glomerulopathy. To our knowledge our case is the first one of chronic glomerulapathy that is confirmed by kidney biopsy.
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배장호 ( Jang Ho Bae ),송인걸 ( In Geol Song ) 대한내과학회 2010 대한내과학회지 Vol.79 No.3
Acute coronary syndrome (ACS) consists of unstable angina, non-ST segment elevation myocardial infarction (NSTEMI), and STEMI. The pathology underlying ACS is acute thrombosis in a coronary artery, which is usually caused by plaque rupture in a mild stenotic lesion. A rupture-prone plaque is known as a vulnerable plaque (VP), although recently the definition of VP has been expanded to include rapidly progressive plaque. Although no single method can predict future cardiac events in mild stenotic lesions, there have been big advances in detecting VP, such as virtual histology-intravascular ultrasound and optical coherence tomography. These techniques look for thin cap fibroatheromas, which is the most common type of VP, characterized by a thin fibrous cap <65 μm, a large necrotic core, and marked macrophage infiltration of the fibrous cap. The recent concept of VP, the methods for detecting VP, and the treatment of VP are discussed. (Korean J Med 79:241-249, 2010)
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