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포스터 발표 : 막성 사구체신염 환자에서 스테로이드 치료 중 발생한 Kaposi 육종 치험 1예
이호철 ( Lee Ho Cheol ),김향 ( Kim Hyang ),박정식 ( Park Jeong Sig ),이규백 ( Lee Gyu Baeg ),유재학 ( Yu Jae Hag ),박문향 ( Park Mun Hyang ) 대한신장학회 2002 춘계학술대회 초록집 Vol.21 No.1
Membranous glomerulonephropathy is a common cause of nephrotoc sundrome in adults. Kaposi sarcoma is a well-known entity with distinct clinical forms such as nodular cutaneous lesions, generalized lymphadenopathy and visceral involvement. Incidence of Kaposi sarcoma is greater in patients with immunosuppression, particularly those having undergone renal transplantation, but also in patients with other underlying disorders treated with immunosuppressive therapy, notably, corticosteroids. We present a case of Kaposi sarcoma in patient with membranous glomerulopathy during corticosteroid therapy. A 49-year-old man was admitted with a complain of facial and leg edema, 5-kg weight gain for 1 month and foamy urine. Kidney biopsy showed membranous glomerulopathy. We started corticosteroid therapy to the patient. Two month later, his 24 hrurinary protein was decreased to 2.1 g/day. But, the well defined, various-sized, purple-colored papules and plaque appeared on the both hands and feet. He underwent skin biopsy, which revealed abnormally proliferated and dilated vessels, vascular slits, spindle-shaped cells and extravasated erythrocytes in the dermis. The findings were in accordance with Kaposi sarcoma. So he received cryotherapy with discontinuing corticosteroid. Four months after cryotherapy, skin lesions were cleared leaving slight hypopigmentation and amount of proteinuria was preserved without definite aggravation.
자발적 복강내 출혈로 사망한 P-ANCA 양성 소혈관염
임성호 ( Im Seong Ho ),이규백 ( Lee Gyu Baeg ),박범준 ( Park Beom Jun ),김현승 ( Kim Hyeon Seung ),박은미 ( Park Eun Mi ),김지연 ( Kim Ji Yeon ),김향 ( Kim Hyang ),임시영 ( Im Si Yeong ),정은철 ( Jeong Eun Cheol ),이영래 ( Lee Ye 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.6
P-ANCA small vessel vasculitis is multisystemic disease, especially frequently involving the kidney. Diagnosis is delayed because it`s non-specific clinical manifestation. Recently ANCA becomes available tools for diagnosis of vasculitis. Infection and gastrointestinal complications are relatively common in vasculitis. But spontaneous rupture of gastrointestinal artery is a rare complication. A 61-year-old housewife was admitted due to poor oral intake, weight loss and microscopic hematuria. Renal biopsy showed an extensive necrotizing glomerulonephritis, consistent with Wegener`s granulomatosis or microscopic polyangitis. Serum test showed positive for P-ANCA. Despite steroid therapy, she expired due to spontaneous rupture of right gastroepiploic artery.