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정의성 ( Eui Sung Chung ),김정호 ( Jeong Ho Kim ),정진환 ( Jin Hwan Jung ),신주영 ( Ju Young Shin ),염주옥 ( Ju Ok Yeom ),강지영 ( Ji Young Kang ),윤형규 ( Hyoung Kyu Yoon ),송정섭 ( Jeong Sup Song ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.5
Crohn`s disease, a major form of inflammatory bowel disease (IBD), is a chronic inflammatory condition that is characterized by microvascular and macrovascular involvement. Some extraintestinal complications can occur due to chronic systemic inflammation in IBD. Among them, a pulmonary thromboembolism is a rare manifestation of IBD but is associated with a high morbidity and mortality. To our best of knowledge, there is only one case report of a pulmonary thromboembolism as a complication of Crohn`s disease in Korea. We present another rare case of pulmonary thromboembolism as complication in a 25-year-old man with underlying Crohn`s disease.
전신홍반루푸스 환자에서 발생한 자발성 두개내 저혈압 증후군
신주영 ( Ju Young Shin ),박윤정 ( Yun Jung Park ),김선영 ( Sun Young Kim ),정의성 ( Eui Sung Chung ),고선희 ( Sun Hee Ko ),박정화 ( Chung Hwa Park ),김찬준 ( Chan Joon Kim ),김정호 ( Jeong Ho Kim ),조철수 ( Chul Soo Cho ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.3
Headaches are not only one of the 19 different neuropsychiatric syndromes in SLE but also the most common chief complaint of patients with neuropsychiatric lupus. Approximately 50% of patients with SLE are presumed to have neuropsychiatric phenomena during their illness. There`re no specific serological, radiological or histological biomarkers to confirm the clinical diagnosis of neuropsychiatric lupus. Therefore, physicians tend to try controlling lupus activity especially when the origins of the headache in patients with lupus are difficult to define. However, neuropsychiatric lupus can only be diagnosed after excluding other causes which is the point. A 47-year-old woman with lupus presented to the emergency department with the sudden onset of postural headache with nausea and vomiting. Through CSF tapping and CT myelography, intracranial hypotension with spontaneous CSF leakage was revealed. Her symptoms promptly improved after therapy using an epidural blood patch. Intracranial hypotension with spontaneous CSF leakage is rare disease, and it has never been reported in patients with SLE before. This case emphasizes the importance of finding out the origin of a headache in patients with lupus.
혈액투석 도관과 관련된 다발성 폐렴을 동반한 우심방 거대 감염성 혈전증
이보희 ( Bo Hee Lee ),김현경 ( Hyun Gyung Kim ),이자영 ( Ja Young Lee ),강봉구 ( Bong Koo Kang ),정의성 ( Eui Sung Chung ),서광일 ( Kwang Il Seo ),노진희 ( Jin Hee No ),원유동 ( Yoo Dong Won ),김영수 ( Young Soo Kim ),윤선애 ( Sun 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
There has been an increase in the use of central venous catheters for temporary hemodialysis. Infected thrombus of right atrium is a rare but life-threatening complication of the central venous catheterization. A 35-year-old female hemodialysis patient was admitted with fever and dyspnea. She had been inserted tunneled hemodialysis catheter 2 months before. Blood cultures revealed methicillin-resistant Staphylococcus aureus. Chest CT showed multi-focal pneumonia and 4 cm sized huge thrombus in the right atrium. Echocardiography demonstrated same thrombus attached to the catheter tip in the right atrium. The catheter could not be removed because of high risk of pulmonary thromboembolism. Despite intravenous vancomycin treatment, the patient died from esophageal varix bleeding.
중증 급성췌장염 환자에서 급성신부전증의 발생빈도와 임상경과에 대한 연구
이수림 ( Su Lim Lee ),김현경 ( Hyun Gyung Kim ),김병수 ( Byung Soo Kim ),송호철 ( Ho Cheol Song ),강봉구 ( Bong Koo Kang ),권혁민 ( Hyuk Min Kwon ),정의성 ( Eui Sung Chung ),윤혜은 ( Hye Eun Yoon ),김영수 ( Young Soo Kim ),김성수 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
Purpose: Although acute renal failure (ARF) commonly develops in patients with severe acute pancreatitis (SAP), the impact of ARF on disease severity is rarely reported in Korea. This study was performed to compare the clinical findings, morbidity and mortality between SAP patients with and without ARF. Methods: We retrospectively evaluated the medical records of 102 patients with SAP between January 2001 and June 2008 in 3 hospitals. We investigated the incidence and clinical course of ARF in SAP patients. Then, we compared morbidity and mortality between the patients with ARF and normal renal function (NRF). Results: Of the total 102 SAP patients, ARF was observed in 39 patients (38.2%). The peak serum creatinine level in ARF patients was 4.5±2.3 mg/dL. Eight of the 39 ARF patients (20.5%) received hemodialysis and ten patients (25.6%) died. When compared to NRF patiens, ARF patients (n=39) had higher incidence of dyspnea (17.9% vs 3.2%, p=0.011), loss of consciousness (17.9% vs 1.6%, p=0.003), and APACHE II scores more than 8 (92.3% vs 0%, p<0.001). The ARF group had also higher incidences of sepsis (35.9% vs 7.9%, p<0.001), multiorgan failure (15.4% vs 0%, p=0.001), respiratory failure (28.2% vs 4.7%, p=0.001) and mortality (25.6% vs 3.2%, p=0.001). Multivariate analysis demonstrated thrombocytopenia, hemoconcentration, and high LDH as independent risk factors of ARF in SAP patients. Conclusion: The incidence of ARF was high (38.2%) and ARF patients showed higher morbidity and mortality, compared to NRF patients. We suggest that early management of ARF should be performed for reducing the mortality in SAP patients.