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외과영역에서의 간질환 : 수술 전 위험 평가 및 수술 후 간기능이상
오쌍용 ( Ssang Yong Oh ),박능화 ( Neung Hwa Park ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.2(S)
It is common for patients with liver disease to undergo surgery. Asymptomatic patients with undiagnosed chronic liver disease might also undergo surgery. These patients have an increased risk of morbidity and mortality that is related to their underlying liver disease. Appropriate preoperative evaluation and management of patients with liver disease is essential for counseling and selection of patients for surgical treatment, and might reduce the risks of surgery and improve outcomes for these patients. The most useful indicators of surgical risk are indices that predict advanced disease, such as the Child-Turcotte-Pugh score, or such as the Model for End-stage Liver Disease score. In this lecture, we will review the pathophysiology, morbidity and mortality associated with patients with liver disease, and then recommend an algorithm for risk assessment and evidence based management strategy to optimize postsurgical outcomes.
오쌍용 ( Ssang Yong Oh ),차희정 ( Hee Jeong Cha ),김민수 ( Min Su Kim ),조현 ( Hyun Cho ),정현철 ( Hyun Chul Chung ),이종수 ( Jong Soo Lee ),박종하 ( Jong Ha Park ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.4
Sjogrens syndrome is a slowly progressive autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, resulting in the xerostomia and xerophthalmia. In this syndrome, renal involvement includes interstitial nephritis, clinically manifested by hyposthenuria and renal tubular dysfunction with or without acidosis. Glomerulonephritis, however, is a rare finding and there have been few reports of membranous glomerulopathy or membranoproliferative glomerulonephritis (MPGN). We report a 31-year-old female diagnosed as MPGN associated with primary Sjogren`s syndrome. She suffered from recurrent epigastric pain, and revealed a moderate proteinuria. Renal biopsy findings were consistent with type I MPGN and thereafter Sjogren`s syndrome was diagnosed by further evaluation. She did not meet the criteria to systemic lupus erythematosus or other connective tissue disease. To our knowledge, this is the first report of MPGN associated with Sjogrens syndrome in Korea.
박찬성 ( Chan Sung Park ),이순정 ( Soon Jung Lee ),도기원 ( Gi Won Do ),오쌍용 ( Ssang Yong Oh ),조현 ( Hyun Cho ),김민수 ( Min Su Kim ),홍일기 ( Il Ki Hong ),방성조 ( Sung Jo Bang ),제갈양진 ( Yang Jin Jegal ),안종준 ( Jong Joon 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2
Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones. (Tuberc Respir Dis 2008;65:131-136)