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윤채중,정승문,김영학,김동규,허광식,김태원,배학연,정종훈,이승일,김평남 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2
통풍은 Purine 대사의 이상으로 발생하는 질환으로, 고뇨산혈증인 사람의 전부가 통풍으로 발현되지 않고 증상의 출현 양상이 다양하여 진단과 치료에 주의가 필요하며, 조기에 적절한 조치를 한다면 충분히 조절이 가능한 질환이다. 본대학 내과학교실에서는 통풍으로 치료한 32명의 환자에서 임상양상, 병력과 검사소견을 분석하여 다음과 같음 결과를 얻었다. 1. 32명 모두 남자이며, 최초 발병 시기는 24세에서 72세로 평균 43.8±11.9세이었으며, 30대에서 40대까지가 19명(59.4%)으로 대부분을 차지하였다. 내원 당시 나이는 27세에서 75세까지로 평균 52.3±10.4세였으며, 내원시 까지 평균 유병기간은 8.5±6.8년으로 나타났다. 2. 동반 질환으로는 고지혈증 12례, 신장질환 10례, 고혈압 12례, 비만 8례, 당뇨 2례 등이었다. 3. 이환된 관절은 단관절 침범이 19례(59.4%), 다관절 침범이 13례 이었으며, 최초 이한된 관절은 족무지 중족골지골 관절로 19례(59.4%)로 가장 많았고, 통풍 결절은 20례(62.5%)에서 관찰되었으며, 유병기간이 10년 이상된 12례중 11례 (91.7%)에서 결절이 관찰되었다. 4. 평균 혈중 요산치는 9.17±1.75 ㎎/dl이었으며, 8.0 ㎎/dl에서 9.9 ㎎/dl 사이가 19명으로 전체의 59.4%를 차지하였다. Objective: The gout is a heterogeneous group of diseases resulting from tissue deposition of monosodium urate or uric acid crystals from extracellular fluids supersaturated with respect to this end product of human purine metabolism. The clinical manifestations are such as hyperuricemia, gouty arthritis, gouty nephropathy, uric acid nephrolithiasis. We analyze of clinical manifestations and associated factors in gout. Method: We have reviewed the medical records, radiologic findings and clinical results of thirty-two patients admitted at our department from April 1996 to July 1997. Result: 1) All patients were male. The mean age at initial attack was 43.8 years old, ranging from 24 to 72 years old. 2) The mean level of serum uric acid was 9.17mg/dl on admission. 3) The first metatarsopharyngeal joint was involved in 19 cases (59.4%). Tophus was observed in 20 cases (62.5%). 4) Hyperuricemia was associated with hypertension, obesity, nephrolithiasis and hyperlipidemia.
제4형 가족성 고중성지방혈증 임산부에서 발생한 급성 췌장염 1례
박관응,윤채중,김영학,진영기,윤성호,권용은,김태원,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2
Plasma levels of cholesterol (TC) and triglyceride(TG) physiologically increase during pregnancy. The lipid increment is 23-53% above the pregravidic level for TC and 2- to 3-fold of the prepregnancy level for TG. If the TC and TG are higher than normal values in pregnancy, the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and occurs either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). We report a case of 28 year-old pregnant woman at 29 weeks gestation with hypercholesterolemia (TC = 357 ㎎/dl) and severe hypertriglyceridemia (TG = 1300 ㎎/dl). The patient was admitted to the hospital because of severe epigastric pain, nausea and vomiting. Total serum cholesterol was increased and trigyleride was markedly increased. The electroporesis pattern of serum lipoprotein showed increase in pre-beta lipoprotein fraction, suggesting IV hypertriglyceridemia pattern. According to a review of the literature, the incidence of pancreatitis during pregnancy is 1 in 1000 to 3000 pregnancies. Severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat: for preventing acute pancreatitis, hospitalization for intravenous fluid therapy and plasma exchange must be required.
우심부전을 동반하지 않은 66세 Ebstein 기형 1례
김창욱,정승문,윤채중,유기동,허경무,조영신,김상용,장경식 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2
Ebstein's anomaly of the tricuspid valve is a rare congenital malformation, which has a wide spectrum of morphologic abnormalities. Varying, both as to nature and degree, from minimal displacement of the adjacent parts of the septal and inferior leaflets of the tricuspid valve to presence of an imperporate membrane or muscle shelf between the inlet and trabecular zones of the right ventricle. The clinical manifestations of Ebstein anomaly are also quite variable, depending upon the spectrum of pathology and the presence of associated malformations, It is well documented that a considerable proportion of these patients are able to survive into adult life. However, the patient who survives into the seventh decade without a sign of heart failure is extremely rare. We speculate that this patient had not developed right heart failure until her seventh decade because she had a milder form of Ebstein's anomaly and did not have any other congenital heart disease. As we experienced an Ebstein's anomaly which was confirmed by echocardiogram, we presented a 66-year-o1d female case with the literature review.
김태종,박치영,진영기,박관응,허경무,김영학,정승문,윤채중,배학연,이승일 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
저자들은 잘 조화되지 않는 당뇨병을 가진 49세 남자 환자에서 조기진단, 내과적치료만으로 호전된 폐형모균증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Mucormycosis is a rare, rapidly progressive and often fatal opportunisitic fungal infection, which occurs most commonly in patients with uncontrolled diabetes mellitus. We experienced pulmonary mucormycosis in a 49-year-old man with uncontrolled diabetes mellitus. He complained of dyspnea, nonproductive coughing, fever and cold sweating for lmonth. On the twenty-eighth hospital day, bronchoscopic examination with lung biopsy revealed broad, non-septate hyphae with right-angle branching, diagnostic of mucormycosis. Intravenous amphotericin B therapy was stated. The lesion decreased in sized after 4weeks of theatment and almost disappeared on follow-up chest X-ray l0weeks later.