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범뇌하수체저하증의 호르몬 대체요법 중단 후 발생한 스트레스 심근병증
남승완 ( Seoung Wan Nam ),이준원 ( Jun-won Lee ),심정한 ( Jeong Han Sim ),백현성 ( Hyun Sung Pack ),임창조 ( Changjo Im ),임정수 ( Jung Soo Lim ),안성균 ( Sung Gyun Ahn ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2
Stress induced cardiomyopathy (SC) is characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. We report on a patient with panhypopituitarism who developed SC resulting from withdrawal of hormonal replacement therapy (HRT). A 52-year-old male visited our hospital for progressively worsening dyspnea. The patient had discontinued HRT 7 days ago, which had been administered for 18 months after transsphenoidal adenomectomy for pituitary macroadenoma. Initial electrocardiogram showed marked sinus bradycardia. Transthoracic echocardiography showed apical ballooning with an LV ejection fraction of 25%. No significant obstructive lesions were observed on coronary angiography. With a clinical diagnosis of SC associated with panhypopituitarism, HRT was restarted, including glucocorticoid and thyroxine, along with standard heart failure management. His LV function had normalized at 2-month follow-up. He remains asymptomatic and administration of beta-blocker and angiotensin converting enzyme inhibitor were discontinued He currently only requires HRT.
복강경 담낭절제술 10년 경과 후 외과용 클립에 의해 발생한 총담관결석
하성삼 ( Sung Sam Ha ),임유리 ( Yoo Ri Lim ),이지현 ( Ji Hyeon Lee ),심정한 ( Jeong Han Sim ),유진세 ( Jin Sae Yoo ),이경주 ( Kyong Joo Lee ),김동현 ( Dong Hyun Kim ),김재우 ( Jae Woo Kim ) 대한췌장담도학회 2015 대한췌담도학회지 Vol.20 No.1
Rarely, surgical clips can migrate into the biliary tract after laparoscopic cholecystectomy and work as a nidus for biliary stone formation. We report a case of the development of a common bile duct (CBD) stone induced by surgical clip in a 57-yearold man who underwent laparoscopic cholecystectomy 10 years ago. On computed tomography, a CBD stone with a metallic material was found, and endoscopic retrograde cholangiopancreatography (ERCP) revealed a CBD stone including a metallic clip. The stone was removed completely by ERCP, and the surgical clip was found along with the stone.