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RISS 인기검색어
- 검색키워드
- 저자 : ( Yalcin Onem ) (검색결과 3 건)
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( Omer Tekin ),( Veysel Ozalper ),( Mesut Tiglioglu ),( Yalcin Onem ),( Fehim Diker ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Gastrointestinal foreign bodies(GFB) may cause problems in all age groups. After gastrointestinal bleeding, they are second common indication for urgent gastrointestinal endoscopy. Case Report: A 20-year-old male was admitted to our Emergency Service complaining of vomiting and severe abdominal pain. The patient reported postprandial nausea and vomiting for last 2 days and a repair operation for perforated duodenal ulcer a year ago. Physical examination revealed an abdominal distension with the lack of peritoneal irritation signs (e. g. rebound, rigitidy). Laboratory tests including complete blood count, acute phase reactants, serum electrolytes, liver function tests, amylase and lipase levels were normal. Plain abdominal X-ray showed that the stomach was distented with intestinal gas and 3 signifi cant air-fi uid levels were seen in bowels at different heights(fi gure-1). Upper gastrointestinal endoscopy was performed for ruling out the mechanical obstruction. Endoscopy revealed that infi ammation and edema caused by three silky stitchs remained ex-surgery. Infi ammation and edema caused to subileus were seen on the duodenal mucosal wall affected by silky suture materials( fi gure-2). Patient required a therapeutic intervention with proper methods of extraction to alleviate the symptoms. Non absorbable surgical suture material was taken out by endoscopic procedure. After the endoscopic intervention patient`s complaints decreased signifi cantly. He was treated with a proton pump inhibitor and a prokinetic agent. The symptoms improved by treatment. Conclusion: Long standing GFB may conclude infiammation, edema, ulceration or perforation in the gastric and duodenal wall. Many foreign bodies pass the gastrointestinal tract, spontaneusly. But iatrogenic foreign body (silky suture-mediated) need urgent intervention.
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Polyglandular Autoimmune Syndrome Type-Ii Presented with Acute Renal Injury
( Veysel Ozalper ),( Ibrahim Cetindagli ),( Omer Tekin ),( Yalcin Onem ),( Yusuf Hancerli ),( Eylem Cagiltay ),( Barbaros Basbug ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: Polyglandular autoimmune syndrome (PAS) is a rare disease, characterized by failure of more than two endocrine glands. Type-II of this syndrome is the most common of the immunoendocrinopathy syndromes and characterized by the obligatory occurrence of autoimmune Addison disease in combination with thyroid autoimmune diseases and/or type-I diabetes mellitus. We report a case of PAS-TypeII presented with prerenal acute renal failure. Case Report: A twenty-two-year-old man had a hyperpigmentation of gingiva within three months, fatigue and amnesia within two months, emesis and vomit within one months, admitted because of persistent vomiting and ten kilogram weight loss. Initial laboratory fi ndings were: urea:87mg/dl, kreatinin:1.31mg/dl, sodium:125mmol/L, potassium: 5.6mmol/L, albumin:4.16g/dl, calcium:123mg/dl. In his arterial blood gas analyse, he had a normal anion gap metabolic asidosis. pH:7.24, HCO3:12.8mEq/L, pCO2:30mm- Hg. He had a prerenal acute renal injury because of persistent vomiting. Other laboratory fi ndings were Hemoglobine:12.9g/dl, TSH:0,004 uIU/ml, FreeT4:2,16ng/dl, Anti-TPO:876 IU/ml, AntiThyroglobulin:9,72IU/ml, Cpeptid:0,27ng/ml, Kortizol:0,1ug/dl, ACTH:22,8pg/ml, HbA1c: %4,7.. A thyroid-scintigraphy showed diffuse homogenous thyroid involvement. His pituitary magnetic-resonance-imaging, thoracoabdominal- tomography and esophagogastroscopy was normal. Based on his fi ndings above and intravenous ACTH stimulation test, adrenal insuffi ency and otoimmune thyroiditis were diagnosed. General condition improved gradually following the administration of hydrocortisone, fl udrocortisone, thyromazol, propranolol. Conclusions: As a conclusion, in persistant vomiting patients, endocrine functions must be performed. A patient who presents with a single autoimmune diseases must be considered at risk of other autoimmune diseases. High index of suspicion, early recognition and treatment can be life-saving, particularly when there is adrenal and thyroid component.
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Poster Session:PS 0195 ; Endocrinology : Acute Renal Failure Due to Vitamin D Intoxication
( Yusuf Hancerli ),( Veysel Ozalper ),( Ibrahim Cetintagli ),( Barbaros Basbug ),( Seyid Ahmet Ay ),( Ramazan Arikan ),( Yalcin Onem ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Vitamin D defi ciency is associated with multpl diseases.Vitamin D becomes more popular every day with the increasing studies. Vitamin D replacement therapy cases increase as well as Vitamin D intoxication cases. We present a 80-old-female patient who developed acute renal failure due to vitamin D intoxication. Case: Patient came to the emergency room with the complaints of 4-day continuing nausea, vomiting and loss of appetite. Mucosa of the patient was dry and she was dehydrate.Tests results were urea:186mg/dL, creatinine:3.64mg/dl, albumin:3.26 g/dL, calcium:12.7mg/dL and venous blood gas results were pH:7,41,pCO2:41.9 HCO3:26.6. Calcium,urea and creatinine levels were normal in a test that was performed 2 months ago. She was diagnosed with acute pre-renal failure connected to dehydration. A detailed medical history showed that 2.5 months ago, the patient was tested vitamin d3-25-0H (kalsifediyol):6.2 ng/ml and vitamin d3 300 000 IU bulb total of 3 was prescribed to her to be taken orally once a week, however, it was realized that the relatives of the patient gave her total of 10, once a week. After this fi nding, performed test results were detected as vitamin d3-25-0H (kalsifediyol):365 ng/ml, parathyroid hormone:16.8pg/ml. The patient was hospitalized with a diagnosis of vitamin D intoxication and intravenous hydration with saline and IV furosemide infusion therapy was applied. At the end of second day her complaints have decreased and at the end of third day calcium level were 9.3mg/dl. At the tenth day test results were urea:30 mg/ dL,creatinine:1.12 mg/dL, and the patient was discharged. Conclusion: Due to growing interest in vitamin D, it is very important that clinicans should be aware and alerted of that overdose vitamin D replacement therapy can cause vitamin D intoxication.
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