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윤나리 ( Na Ri Yoon ),최정란 ( Joung Ran Choi ),심병주 ( Byung Joo Shim ),강현희 ( Hyun Hee Kang ),김영수 ( Young Soo Kim ),윤선애 ( Sun Ae Yoon ),김영주 ( Young Joo Kim ),박정욱 ( Jung Wook Park ),김영옥 ( Young Ok Kim ) 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.5
Uremic patients undergoing hemodialysis (HD) therapy are prone to develop encephalopathy, but the cause is often unclear. Clinical signs of encephalopathy in the uremic patient often overlap with several other affections causing neurological disorders. Chorea or hemichorea occurs very rare, when basal ganglia are injured in HD patients. We hereby report a case of hemichorea of unknown cause in a hemodialysis patients. A 57-year-old diabetic HD patient was presented with sudden onset of right hemi-chorea. We could not find causes of hemichorea such as hyperglycemia, hepatic failure, drug, hyponatremia, and thiamine deficiency. T1-weighted MRI demonstrated hyperintense lesion limited to the left basal ganglion. Hemichorea disappeared completely 6 months after the onset with support care. (Korean J Nephrol 2006;25(5):847-850)
혈액투석 환자에서 Staphylococcus aureus 감염에 의한 감염성 복부 대동맥류 파열
문동규 ( Dong Gyu Moon ),박성민 ( Sung Min Park ),문설경 ( Sul Kyung Moon ),심병주 ( Byung Joo Shim ),신석준 ( Seok Joon Shin ),송호철 ( Ho Cheol Song ),최의진 ( Eui Jin Choi ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.1
Infectious aneurysms in hemodialysis patients are very rare. It is assumed that injuries on atherosclerotic vessel walls are involved in the development of aneurysms associated with septicemia. Rupture of infectious aneurysms carries a high mortality rate because it often leads to hemorrhagic shock. Here we report the case of a hemodialysis patient with rupture of an abdominal aortic infectious aneurysm secondary to Staphylococcus aureus septicemia. A 72 year-old male hemodialysis patient presented with diarrhea and fever. Staphylococcus aureus was identified in his blood culture. On the sixth day after admission, he developed sudden abdominal pain, distension and hypotension, so we assumed hypovolemic shock due to intraabdominal hemorrhage. On abdominal CT, he was found to have a ruptured, 2.4×2 cm infrarenal abdominal aortic aneurysm with a large amount of retroperitoneal hemorrhage. His final diagnosis was rupture of an infectious aneurysm based on the presence of Staphylococcal bacteremia. He underwent a percutaneous stent graft in the infrarenal aorta successfully. However, two weeks later, he developed septic shock due to a newly developed intestinal perforation and died of multiorgan failure.