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노인에서 상기도 감염후 발생한 급성감염후 급속진행성 사구체신염
오병선 ( Byoung Sun Oh ),박철휘 ( Cheol Whee Park ),장세나 ( Se Na Jang ),정현정 ( Hyun Jung Jung ),김경희 ( Kyoung Hee Kim ),박건우,정현화 ( Hyun Wha Chung ),한상우 ( Sang Woo Han ),장윤식 ( Yoon Sik Chang ) 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.6
Postinfectious streptococcal glomerulonephritis (PSGN) presenting as a rapidly progressive glomerulonephritis (RPGN) and nephrotic syndrome (NS) is a rare disease in elderly patients. Here we report a case of PSGN with RPGN and NS in an elderly male patient with a complete recovery from his illness. A 73-year-old man was admitted for dyspnea, oliguria and generalized edema appearing after acute upper respiratory infection. On admission, he presented nephrotic range of proteinuria, decreased renal function with elevated ASO, and decreased C3 and CH50 concentrations. The renal biopsy showed marked cellular crescents in the glomeruli with collapsed glomerular tufts and inflammatory cell infiltration. There were prominent and various sizes of humps in subepithelial areas in electron microscopy. Under the diagnosis of PSGN with RPGN, we successfully treated the patient with steroid pulse therapy and hemodialysis. We would suggest that early diagnosis and aggressive steroid therapy should be indicated in the treatment of PSGN with RPGN. (Korean J Nephrol 2006;25(6):1025-1028)
증례 : 화농성 간농양으로 유발된 당뇨병성 케톤산증 2예
장석태 ( Suk Tae Jang ),오병선 ( Byoung Sun Oh ),손태서 ( Tae Seo Sohn ),손현식 ( Hyun Shik Son ),손호영 ( Ho Young Son ),이광우 ( Kwang Woo Lee ),강성구 ( Sung Ku Kang ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 화농성 간농양으로 유발된 당뇨병성 케톤산증 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Diabetic ketoacidosis as the most severe acute metabolic complication of diabetes mellitus, may herald the onset of type 1 diabetes but most often occurs in established diabetic patients as a result of intercurrent illness (e.g., infection), an inappropriate reduction in insulin dosage, or missed insulin injections. Diabetics are more prone to infections than non-diabetics and infection is the most common precipitant of diabetic ketoacidosis. Infection such as pneumonia, urinary tract infection, gastroenteritis and sepsis, is believed to precipitate episodes of diabetic ketoacidosis. We report two cases of diabetic ketoacidosis precipitated by pyogenic liver abscess caused by Klebsiella pneumoniae. (Korean J Med 69:S861-S866, 2005)
신부전이 동반된 허혈성 신증환자의 일측 신동맥 협착에 대한 성공적인 중재적 스텐트 삽입술
정현정 ( Hyun Jung Jung ),강경미 ( Kyung Mi Kang ),오병선 ( Byoung Sun Oh ),이상주 ( Sang Ju Lee ),장윤경 ( Yoon Kyung Chang ),김지창 ( Ji Chang Kim ),김석영 ( Suk Young Kim ),장윤식 ( Yoon Sik Chang ),방병기 ( Byung Kee Bang ) 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.6
Ischemic nephropathy is defined as renal dysfunction due to renal hypoperfusion mainly through renal artery stenosis. It is a common cause of chronic renal failure in old patients with atherosclerosis and is also a potentially correctable cause of renal failure if diagnosed earlier. We experienced a case of sudden Rt. main renal artery occlusion and renal failure after femoral artery angioplasty in an aged male patient with underlying atherosclerotic bilateral renovascular stenosis associated with ischemic nephropathy. He received successful Lt. renal artery angioplasty with stenting and restored Lt. renal artery blood flow. His blood pressure was more easily controlled with fewer antihypertensive drugs after renal artery revascularization. His renal function was recovered to his baseline level and became stabilized thereafter. Early diagnosis of ischemic nephropathy with MRA and timely renal angioplasty with stenting are beneficial to avoiding progression to irreversible renal failure. (Korean J Nephrol 2006;25(6):1047-1053)
Uhm, Jae-Sun,Oh, Byoung-Sun,Lee, Seung-Hwan,Kim, Sang-Il,Kim, Yang-Ree,Park, Yeon-Joon,Kang, Moon-Won 대한감염학회 2005 감염과 화학요법 Vol.37 No.2
Non-O1, non-O139 Vibrio cholerae usually causes gastroenteritis and bacteremia. It can also cause skin and soft tissue infection but the incidence is very rare. Patients who have been reported to have skin and soft tissue infection caused by non-O1, non-O139 V. cholerae had liver cirrhosis or chronic hepatitis. We present here a case of skin and soft tissue infection caused by non-O1, non- O139 V. cholerae in a patient with liver cirrhosis in Korea. After treatment of cefotaxime, doxycycline and debridement, the wound was clinically improved. This case suggests that non-O1, non-O139 V. cholerae infection should also be considered in addition to V. vulnificus infection when skin and soft tissue infections occurs in patients with liver cirrhosis, especially if they have had seawater or seafood exposure. Non-Ol, non-O139 Vibrio choleras는 위장관염 또는 균혈증을 발생시키고, 매우 드물게 피부 및 연부조직 감염을 일으킨다. Non-Ol, non-0139 V. cholerae에 의한 피부 및 연부조직 감염 환자는 대부분 간경변증 또는 만성 간염을 가지고 있는 것으로 보고되고 있다. 저자들은 간견병증 환자에서 해산물을 섭취한 후 발생한 non-Ol, non-O139 V. cholerae에 의한 피부 및 연부조직 감염의 증례를 보고하는 바이다. 환자의 경우 cefotaxime, doxycycline 등 항생제 투여와 괴사조직 제거술 후 회복되었다. 따라서 간경변증 환자에서 해산물 또는 바닷물에 노출된 후 발생한 피부 및 연부조직 감염의 경우 V. vulnificus에 의한 감염뿐만 아니라 non-Ol, non-O139 V. cholerae에 의한 감염도 고려해야 한다.