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증예(症例) : 감초 복용에 의한 저칼륨마비가 발생한 노인 1예
이근숙 ( Keun Sook Lee ),김상용 ( Sang Young Kim ),전용덕 ( Yong Deok Jeon ),조영중 ( Young Jung Cho ),남홍우 ( Hong Woo Nam ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
저자드은 전신 무력감과 양측 다리의 근무력감을 주소로 내원한 80세 여자 환자에서 감초에 의한 의인성 외견상 염류 코르티코이드 과다증후군(apparent mineralocorticoid excess syndrome)을 진단 하였고 환자의 임상경과를 기존의 문헌 고찰과 함께 보고하는 바이다. Prolonged ingestion of licorice can hypermineralocorticoidism with sodium retension and potassium loss, edema, increased blood pressure and depression of rennin-angiotensin-aldosterone system. We describe a 80-year old woman with muscle weakness with hypokalemia(serum K+: 1.6 mEq/L) and rhabdomyolysis(urine myoglobin> 2000 ng/mL) due to licorice tea. After quitting the licorice and potassium replacement therapy, hypokalemia and muscle weakness gradually improved within 5 days.
만성간질환에서의 혈청 procollagen 1/3 propeptides 농도비 측정의 의의
유용걸(Yong Keol Yoo),이숭환(Soong Hwan Lee),김병훈(Byoung Hun Kim),조영중(Young Jung Cho),백인규(In Kyu Paik),유병무(Byeong Moo Yoo),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),최호순(Ho Soon Choi),이동후(Dong Ho 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6
N/A Background/Aims: Most of Ihe chronic liver diseases of variable etiologies are accompanied by a pathobiochemical reaction So-called fibrosis. Liver fibrosis was recently recognized as all the complexity of dynamic changes of the hepatic extracellular matrix(ECM). And ECM consists of four major components: collagen, glycoprotein such as fibronectin and laminin, proteoglycan, and elastin. Among these, collagen I and III are the representatives of disproportion of synthesis and degradation in conjunction with fibrogenesis. To elucidate the clinical significance of procollagen propeptide I(PICP) and III(PIIINP) measurements among the sera out of patients with chronic liver diseases, radioimmunoassay 4vas employed in this investigation. Methods: Sera tested were obtained from pathologically-proven 54 patients; 4 cases of fatty liver, 11 cases of chronic persistent hepatitis, 13 cases df chronic active hepatitis, 15 cases of liver cirrhosis and 11 cases of hepatocellular carcinoma. All:the patients except 4 cases of fatty liver were shown positivity of HBsAg. PICP and PIIINP radioimmunoassay kits(Farmos Diagnostica, Oulunsalo, Finland)were purchased for this study. ResOlts: PICP concentration (mean+standard error) was highest in liver cirrhosis (280.06>39,83 pg/L). PICP in liver cirrhosis was significantly elevated in cornparison to that (109.30+14.58) in fatty:liver(p=0.045), that (122.22>10.26) in chronic persistent hepatitis (p=0.003), and that (158.59>21.58) in chronic active hepatitis(p=0.016), PICP in hepatocellular carcinoma was decreased to 1'94.05+ 29.89. Similarly, PIIINP concentration revealed highest level in liver cirrhosis(17.29+3.58 pg/L). This value was significantly higher than that of chronic persistent hepatitis(5.12+0.59)(p=0.008). Contrarily to these results, concentration ratio of PICP/PIIINP was high in fatty liver (29.27>6.29) and chronic persistent hepatitis (25.04+2.00), These value were statistically higher than that of chronic active hepatitis (17.632.67) (p=0.043). PICP/PIIINP ratio in liver cirrhosis (21.58+3.29) showed no statistical difference. Conclusions: On the basis of these data, it is suggested that the elevation of PICP and PIIINP in the sera of the patients with chronic liver diseases means emerging the liver cirrhosis. And the ratio of these markers can be helpful in differential diagnosis of chronic liver diseases. (Korean J Gastroenterol 1996; 28:815-823)
간경변증 환자에서 24 시간 심박동수변이를 이용한 자율신경 장애 측정
김철우(Chul Woo Kim),권재구(Jae Goo Kwon),채민수(Min Su Chae),안혜숙(Hye Sook Ahn),조영중(Young Jung Cho),이창원(Chang Won Lee),장덕환(Duk Whan Jang),이무용(Moo Yong Rhee),김학산(Hak San Kim),이홍순(Hong Soon Lee),유수웅(Soo Woong Yo 대한내과학회 1997 대한내과학회지 Vol.53 No.3
N/A Objective: Heart rate variability(HRV) is helpful to diagnosis autonomic disturbance and sympathetic-parasympathetic imbalance in patients with myocardial infarction and diabetes mellitus. Patients with liver cirrhosis demonstrate reduced blood pressure despite increased heart rate and increased cardiac output, indicating a fall in peripheral vascular resistance. Autonomic disturbance may contribute to this phenomenon. The aim of the present study is to evaluate the degree of autonomic disturbance and the circadian rhythm of autonomic nervous system by estimating HRV with 24 hour-Holter recorder, Methods : 24 hour-HRV with Del Mar Avionics 563 Holter recorder and cardiovascular reflex tests were carried out on 32 patients with liver cirrhosis and 20 control subjects. We evaluated the presence of autonomic disturbance, and assessed quantitatively the autonomic disturbance. Results: 1) Among cardiovascular reflex tests, Valsalva test, standing test and deep breathing test were showed a significantly decreased response in liver cirrhosis compared with control groups. 2) The standard deviation of 24hours average R-R intervals were showed a significantly decrease in liver cirrhosis than control groups(P<0.0001). The HRV of low frequency(LF. P<.D.001), high frequency(HF, P<0.0001) and total power spectral density (P<0.0001) in liver cirrhosis were statistically lower than control. 3) The LF/HF ratio of patients with liver cirrhosis was showed higher than control at night Conclusion: Non-invasive assessment of 24 hour-HRV has a few advantages in the diagnosis and degree of autonomic disturbance, evaluation of diurnal variation of autonomic tone.
고영민,김장원,문석준,김학산,문도호,조영중,백인석,배순철 대한내과학회 1997 대한내과학회지 Vol.53 No.5
Xanthogranulomatous cholecystitis is an extremely rare benign inflammatory disease of the gall bladder characterized by yellowish focal nodular appearance with tissue necrosis and lipid-containing histiocyte (xanthomacell). Recently, we experienced a case of xanthogranulomatous cholecystitis. A 71-year old woman was admitted with the complaints of RUQ pain for 1 month. On abdominal ultrasound examination, there were diffuse gallbladder wall thickening, echogenic nodule with acoustic shadow, the calculous cholecystiti and the gall badder cancer were strongly suspected and the operation was performed. At operation the gall bladder was marked enlarged and wall thickening with two brownish, oval shaped, smooth surfaced stones. The specimen was revealed a xanthogranulomatous cholecystitis by the pathology.
전신성 홍반성 루푸스 양상으로 발현된 Human Adjuvant Disease
김태환,정성수,유대현,송용호,김성윤,이인홍,문희식,전재범,배상철,조영중,정자헌,오광택 대한내과학회 1998 대한내과학회지 Vol.54 No.2
Human adjuvant disease means the autoimmune disease or autoimmune disease like syndrome developed after plastic surgery using foreign body implantation. After first report of HAD by Miyoshi at 1964, a number of cases have been reported especially from Japan. Silicone has been known as biologically inert material, but a couple of side reaction and experimental data argue against such conventional idea. It is impossible to identify the exact role of implanted substance in the occurrence of autoimmune disease, but there are a few indirect evidences for adjuvant effect of silicone. The spectrum of HAD are as follows: unclassifiable connective disease like syndrome, rheumatoid arthritis, SLE, polymyositis, adult Still's disease, ITP, Hashimoto's thyroiditis, ctc. We experienced two cases of HAD manifesting as SI.E who had been injected with silicone fluid with for augmentation mammoplasty and report this with a review of the literature.
당뇨병 환자의 생활사건과 관련된 스트레스의 양과 당뇨병 관리의 연관성
김현규,유재명,박성우,최경애,임성희,임정원,유형준,김두만,최문기,조영중,정유선,서승오,최철수 대한당뇨병학회 2001 Diabetes and Metabolism Journal Vol.25 No.3
Background: The life events which diabetic patients experience has an influence on conduct and communication pattern that is essential to control diabetes. The psychosocial life events which patients experienced in recently, as well as in the past has an important meanings in the process of the plan, implementation and evaluation of diabetic control. However, the most researches on this issues are scanty. Thus, we evaluated the relation of diabetic control to stress amounts associated with the life event which diabetic patients experience for the past one year. Methods: In this study, 81 diabetic patients admitted to H hospital from March, 1999 to February 2000 were examined in stress amounts associated with life events, blood sugar, HbA1C, duration, complication, family history, treatment to inspect the hypothesis that stress experiences for recent 1 year are related to diabetic control. The 'Life Psychosocial Event Scale' invented by Lee was used. To examine the hypothesis that diabetic control may be influenced by the amount of stress, we investigated the difference of the means between the two groups (upper 30% of patients vs. lower 30% of patients) by T-test. Results: The mean age was 56.9±15.1 years and the mean duration of diabetes was 8.9±7 years. Fasting plasma glucose (FPG) was 200.3±71.0 mg/dL, PP2 was 292.9±87.2 mg/dL, HbA_(1C) was 10.5±2.6%, complication was 0.8±0.9. The age showed negative correlation with stress amounts. The other variables did not show significant correlation with stress amounts. Thus, our study indicated that the hypothesis that stress experiences for recent 1 year are related to diabetic control was rejected. However, considering the perception-phenomenological approach on stress, if we study the relationship between stress with diabetic control inclusively, it seems that we can recognize such relationship. Conclusion: To address relation between stress with diabetic control inclusively, we need to consider stress factors in diversified aspects more than only one. Therefore, we must investigate how do patients perceive and cope with stress inclusively, because the crisis of life is influenced on the stress coping skill of patients. The study on this issue must be continued to identified the key factors associated with stress in diabetes.