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2형 당뇨병과 정신지체를 동반한 염색체 6번 장완의 간질성 결손(q21q23)1예
김학준,박정기,이지현,손호상,정의달,조선주,윤원찬,여동근 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.2
Chromosomal abnormalities such as Klinefelter syndrome, Down syndrome, Turner syndrome, Prader-Willi, Bardet-Biedi syndrome were associated with diabetes mellitus. Over 30 cases of interstitial deletions of the long arm of chromosome 6 with vastly variable breakpoints and clinical features have been reported in the literature. The clinical findings varies and most often includes mental retardation, microcephaly, and craniofacial anomalies. We report a case of interstitial deletion (del(6)(q21q23)) with type 2 diabetes mellitus and mental retardation
잉어 담낭 생식 후 병발된 횡문근융해증 및 급성신부전과 급성간염 1예
김학준,김용진,이인희,박정기,정의달,여동근,윤원찬,조선주,안기성 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5
Sevral cases of acute renal failure and acute hepatitis after ingestion of raw carp gall bladder have been reported. We experienced for the first time 1 case of acute renal failure and acute hepatitis associated with rhabdomyolysis, which has not been seen in previous studies, after ingestion of the raw carp gall bladder. Serum creatine phosphokinase, myoglobin and urine myoglobin were increased and 99mTc-MDP bone scan showed diffusely increased uptake of isotope in soft tissue of whole body. The other laboratory data corresponded to acute tubular necrosis and acute toxic hepatitis. The kidney pathology showed the recovery phase of acute tubular necrosis. Etiologic factor for rhabdomyolysis was not found except carp gall bladder. We considered that carp gall bladder was etiologic factor for rhabdomyolysis and that rhabdomyolysis acted as agravatting factor for developing acute tubular necrosis due to carp bile toxicity in this case.
류마티스 관절염의 관절액 Total Fibronectin의 임상적 의의
김학준 ( Hak Jun Kim ),박정기 ( Jeong Ki Park ),여동근 ( Dong Geun Yoe ),윤원찬 ( Wern Chan Yoon ),정의달 ( Ye Dal Jung ),조선주 ( Sun Joo Cho ),김상경 ( Sang Gyung Kim ),전창호 ( Chang Ho Jeon ),김채기 ( Chae Ki Kim ),송용호 ( Yo 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.3
목적: 류마티스 관절염에서의 염증 자극에 대한 활막 또는 관절액의 fibronectin에 관한 연구는 염증 기전이나 RA의 병인을 규명할 수단이 될 수 있다. 최근에 단클론성 항체의 개발로 체액중 total fibronectin의 측정이 가능하게 되어 RA와 OA의 관절액의 그 농도를 측정하였고, RA 환자를 대상으로 하여 이 측정값의 임상적 가치를 살펴 보고자 하였다. 방법: 무릎 관절 종창을 보이는 RA 및 OA 환자 68명을 대상으로 하여 약 2mL의 관절액을 채취하고 total fibronectin을 단클론성 항체를 이용하여 측정하였고, RA 환자 38명을 대상으로 6가지 기존의 질병활성도를 횡단면연구로 조사하였다. 결과: 1. RA 환자와 OA 환자의 관절액내 total fibronectin의 농도(mean±SD)는, RA가 148.4±72.6μg/ml, OA가 39.5±16.9μg/ml로 OA 환자에 비하여 RA 환자에서 유의하게 증가되어 있다 (p<0.001). 2. RA 환자의 관절액내 total fibronectin의 농도는 질병이환 기간(r=-0.272, p=0.199), 조조강직 기간(r=0.252, p=0.313), ESR (r=0.082, p=0.711), Ritchie index (r=0.217, p=0.359), CRP (r=0.131, p=0.550), 류마티스 인자(r=-0.010,p=0.963)와는 유의한 연관성을 보이지 못했다. 결론: 이상에서 RA 환자에서 관절액 중 total fibronectin의 농도는 OA 환자에서 보다 명확히 높기 때문에 원발성 OA 환자의 그것과 병인론적으로 구별됨을 알 수 있었으나, 임상적으로는 RA의 활성도를 나타내는 지표로 쓰일 수는 없다고 생각된다. Objective: A study on fibronectin, which is synthesized in response to inflammatory process of joint destruction, can be of great value in identifying the mechanism of inflammation or disease activity of rheumatoid arthritis (RA). This study attempts to measure the concentrations of total fibronectin in synovial fluid of patients with RA and osteoarthritis (OA), and compare it with the clinical disease activity parameters of RA available. Methods: A total 68 patients suffering from knee pain and joint effusion was examined. Synovial fluids of thirty-eight RA patients and thirty OA patients were measured by using monoclonal fibronectin antibody. Cross-sectional analysis was undertaken to correlate the fibronectin levels of the RA patients with the clinical disease activity parameters available. Results: 1. Mean synovial fibronectin level of RA (148.4±72.6㎍/ml) was significantly higher than that of OA (39.5±16.9㎍/ml)(p<0.001). 2. The fibronectin levels in RA do not seem to have significant relationship with the parameters such as disease duration, the duration of morning stiffness, Ritchie index, ESR, CRP, and rheumatoid factor. Conclusion: In conclusion, the synovial total fibronectin concentration can clearly distinguish RA from OA. However, it would be unlikely to be used as a parameter of disease activity.
살모넬라 Group C 감염에 동반된 횡문근융해증 및 급성신부전
안기성(Ki Sung Ahn),박정기(Jeong Ki Park),여동근(Dong Keun Ye),윤원찬(Wern Chan Yoon),김학준(Hak Jun Kim),정의달(Ye Dal Jeong),조선주(Sun Ju Jo) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2
Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. Rhabdomylosis can be precipitated by different causes, such as trauma, extraordinary physical exer- tion, metabolic disorder, drugs, toxins, infection, or endocrinopathy. Salmonellosis is another rare cause of rhabdomyolysis. We report a 62-year-old male who developed severe diarrhea and vomitting, one day after boiled pork & raw octopus ingestion. The diagnosis of rhabdomyolysis was established primarily by the elevated serum CPK and myoglobin level. There were no other traumatic, metabolic, toxic, or enzymatic causes for the rhabdomyolysis. Stool cultures received at the first day of hospitalization yielded Salmonella Group C. Salmonella sp. is suggested to cause muscle damage by direct bacterial invasion as well as by decreasing the oxidative and glycolytic enzyme activity of skeletal muscles and by activating lysosomal enzymes. We wish to draw attention to these serious complication of salmonella gastroenteritis, and to institute of prompt measures for preventing the development of ATN. We report a case of acute renal failure associated with rhabdomyolysis and gastroenteritis caused by salmonella Group C with review of literatures.