Propylthiouracil에 의한 중증 급성간염 1예

임종주,심미령,이명수,김태현,오석규,안선호,박무림,김남호,박병현,조성구 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

PTU에 의한 간염의 발생은 매우 드물게 발생하는 것으로 알려져 있으나 저자들은 Graves씨 병으로 진단 받고 propylthiouracil 투여를 받고있던 환자에서 중증의 급성 간염이 발생한 1예를 경험하였기에 보고하는 바이다. Propylthiouracil is widely used to treat patients with hyperthyroidism. This drug has been associated with severe hepatotoxicity rarely. We presented the case of jaundice and profound liver dysfunction from a 23-year old woman treated with propylthiouracil for hyperthyroidism. Viral, metabolic, and autoimmune liver disease could be excluded and liver biopsy revealed a pattern of acute hepatitis. After discontinuing the drug, there was a progressive resolution of hepatic symptoms and decrease in biochemical data of the liver. Despite propylthiouracil induced hepatitis in rare case, patients receiving propylthiouracil are exposed to develope severe hepatotoxicity. Therefore it might be advisable to monitor level of the transaminase on regular base from patients receiving propylthiouracil.

외상 후 근관내로의 치조골 함입

임예진,김영진,김현정,남순현 大韓小兒齒科學會 2011 大韓小兒齒科學會誌 Vol.38 No.4

영구치의 외상성 손상은 전체 외상 환자 중 높은 빈도로 발생하며 사고의 대부분은 치근이 미완성되어 있는 시기에 발생하 여 치수, 치주인대, 치조골, Hertwig 상피 근초(HERS)에 다양한 영향을 주게 된다. 손상 정도에 따라 치수의 완전한 재혈관 화, 근관 석회화, 근관내 치조골 함입 등의 다양한 치유 양상을 나타내며, 치근단의 성장 정지 및 치수 괴사로 인한 염증성 치 근 흡수 등의 합병증을 나타낼 수 있다. 본 증례에서는 미성숙 영구치 치근단을 가진 세 환아에서 외상에 의한 Hertwig 상피 근초의 손상으로 발치와 기저부에 존 재하는 치근막 세포와 골세포의 치수강내로의 증식으로 인해 치근 발육 정지 및 근관내로의 치조골 함입을 나타내어 보고하 고자 한다. 외상 후 Hertwig 상피 근초의 손상에 의한 근관내로의 치조골 함입 치유 양상은 치수는 정상적인 기능을 하는 것으로 생각 되며, 유착 등의 합병증이 동반되지 않는 경우 특별한 치료를 필요로 하지 않으므로 감별 진단이 요구되며, 외상 받은 치아의 치료시 Hertwig 상피 근초에 대한 부가적인 외상을 가하지 않도록 주의해야 한다. Traumatic injury on tooth occurs frequently among trauma patients, and mainly occurs on tooth with premature roots which influences pulp tissue, periodontal ligament, alveolar bone, and Hertwig’s epithelial root sheath. According to the degree of trauma, a number of kinds of healing process can be observed, such as complete re-vascularization of pulp, root canal obliteration, growth suspension of root apex, and invasion of alveolar bone into root canal, and there can be some complications such as necrotic change of inflammatory root resorption and partial pulp necrosis due to pulp necrosis toward complete necrosis. In this clinical case, 3 patients who had traumatic injury showed root growth suspension and alveolar bone invasion into root canal due to proliferation of periodontal ligament cell and osteocyte at the base of extraction socket into pulp chamber because of the injury on Hertwig’s epithelial root sheath. If intrusion of alveolar bone into root canal due to injury on Hertwig’s epithelial root sheath after having traumatic injury doesn’t show any complication, the pulp may be considered to have normal vitality and doesn’t need any further treatment, therefore differential diagnosis is very necessary. However, it may be accompanied with suspension of root growth, therefore, additional trauma during the treatment of injured tooth should not be applied.

폐경기 여성에서 1년간 호르몬 대치 요법이 혈청 지질에 미치는 영향

이해혁,남계현,김승형,이임순,이권해,최승도 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Cardiovascular disease is one of the most common cause of death in postmenopausal women. After the onset of menopause, the risk of cardiovascular disease is increased. Several risk factors of cardiovascular disease are well known to us. Among the risk factors, the changes of lipid profiles are roles for cardiovascular disease. Estrogen appears to protect the development of cardiovascular disease, by several mechanism. Especially the protective effect is believed to be mediated by the changes of lipid profiles. Decreased high-density lipoprotein (HDL)-cholesterol and increased low density lipoprotein (LDL)-cholesterol are important factors for development of cardiovascular disease. The purpose of this study was to evaluate the effect of hormone replacement therapy on the lipid profiles to include total cholesterol (TC), high density lipoprotein(HDL)-cholesterol, low density lipoprotein(LDL)-cholesterol, and triglycerides. We measured lipid profiles in 31 postmenopausal women and gave each conjugated equine estrogen (CEE, 0.625mg, day 1-30) plus medroxyprogesterone acetate (MPA, 5mg, day 1-12) for 12months. The levels of serum TC, LDL-cholesterol, and triglycerides were decreased significantly (p<0.05) and HDL-cholesterol was increased significantly (p<0.05) after 12months of hormone replacement therapy. These data suggest that hormone replacement therapy appears to protect agianst the development of cardiovascular disease by the changes of lipid profiles.

자궁내 태아사망의 임상적 고찰

이권해,이정재,조현철,이석민,이임순,이해혁,김권대,이순곤,남계현 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.2

Objective: This study was designed to evaluate diagnosis and complication, prognosis during clinical study of cases of intrauterine fetal death. Methods and materials: This is a clinical study of 56 cases of the intrauterine fetal death among 8064 deliveries at Seoul Sunchunhyang university hospital during 5 years from January, 1994 to December, 1998. Results: The incidence was 0.7%. The age distribution of mothers was 18 - 44 years and was highest in the 25 - 29 years range(46.4%). The parity was the most highest in the nulliparous group(51.8%). The most common gestational weeks was 20 - 28 weeks gestational period(46.4%), and most common presentation was cephalic(73.5%). The most common weights of the intrauterine fetal death was from 5,00gm to 1,000g(48.2%). The mode of the most common delivery was the induction of delivery(57.2%). The etiologic factors were: unknown(42.9%), preeclampsia(17.9%), chorioamnionitis(14.3%), congenital anomaly(12.5%), abruptio placenta(7.1%), cord complication(3.6%), placenta previa, death of one for twin. There were 2 cases of maternal complication(DIC, Uterine atony). Conclusion : Intrauterine fetal death should be diagnosised early and treated properly to reduce risk of the maternal complication.

임신 종결 후 발생한 자궁 동정맥 누공에서 자궁동맥색전술로 치료한 1예

김종민,이해혁,김태희,남계현,심일구,이권해,김형문,이임순,장종호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Arteriovenous fistula of uterus is rarely reported disease. This vascular malformation is very dangerous condition because Dilatation & curettage can cause massive uterine bleeding without accurate diagnosis. The diagnosis is made by angiography, gray scale ultrasonography, color and duplex doppler ultrasonography, computed tomography, and magnetic resonance imaging is helpful. Especially color and duplex doppler ultrasonography is allows convincing detection and diagnosis of arteriovenous fistula. Recently transcatheter uterine artery embolization is treatment of choice. We have experienced a case of arteriovenous fistula of uterus. Which is presented with a brief review of literature.

여호와의 증인 환자에서 산과적 출혈 후 무수혈 치료 2예

김재령,여소진,이해혁,김정식,김태희,남계현,이권해,이임순,박진화,황경호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Jehovah's Witness comprise a unique obstetric population. Their refusal of blood stems from an interpretation of a literal translation of the Bible, and it is this belief that puts them at an increased risk of morbidity and mortality if hemorrhage occurs. We report two cases of a Jehovah's Witness who bled massively due to obstetric hemorrhage, refused blood transfusion and had profound anemia. The patients were treated with recombinant human erythropoietin, parenteral iron and oxygen. And they were treated on an intensive care unit with intermittent positive pressure ventilation. We reviewed with literature considering the therapy for acutely anemic patients who refuse transfusion to decrease the duration of the most severe anemia.

자궁선근증의 고찰

조환성,이해혁,정성윤,김성욱,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: This study was designed to estimate the frequency and risk factor for edenomyosis Methods: The clinical records of 623 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital, during 5 years, from Jan. 1995 to Dec. 1999. Results: The following result were obtained. 1. Adenomyosis was found in 247 of 623 patients(39.6%) 2. The highest incidence was 40-49 years of age group, an incidence of 46.6% and mean age was 44.7 years. 3. Adenomyosis was more frequently observed in parous women than non-parous women, such as 93.1% and 6.9%, respectively. 4. Dysmenorrhea, metrorrhagia, pelvic pain and vaginal bleeding were common symptom of adenomyosis, an incidence of 28.7%, 19.0%, 18.2% and 16.2%, respectively. 5. Myoma was the most combined disease in adenomyosis, showing the incidence of 54.7%. 6. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 61.9%. 7. Preoperative diagnostic accuracy of adenomyosis was 6.9%. Conclusion: The results show that deeply understanding of the common symptoms and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.

조산의 예측 지표로서의 fetal fibronectin의 유용성

정집광,이해혁,이정재,이석민,이순곤,남계현,이임순,이권해 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Objective: The purpose of this study was to evaluate clinical efficacy of fetal fibronectin as a marker to predictor of preterm labor. Materials & Methods: The study group consisted of sixty-eight healthy pregnant women, at gestational age between 24 and 36 weeks, who visited our department with vaginal discharge from April, 1995 to December, 1997. For comparison, we divided all of the pregnant women into two groups by the result of ROM-Check^®, positive groups(N=21) and negative groups(N=47). When preterm labor appeared, 50mg of ritodrine hydrochloride(Yutopar^®) mixed I liter of 5% dextrose solution was administered slowly intravenously. Results: 1) The gestational age at delivery and the interval time from admission to delivery in the positive groups were significantly shorter than those of the negative groups(p<0.05). 2) The positive groups had significantly lower birth weight and Apgar scores than the negative groups(p<0.05). 3) Among the negative groups, in case of tocolytics administration, the interval time from admission to delivery significantly delayed more than that time in case of no tocolytics administration(p<0.05). Conclusions: The detection of the fetal fibronectin in vaginal discharge had a useful method as a predictor of preterm labor. Tocolytics was more effective in the negative groups than in the positive groups.

전치태반의 임상적 고찰

정갑인,이해혁,이효환,유정완,남계현,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose was to make preparations of what for proper emergency care and delivery in order to improve maternal and fetal well-being. Methods : The study was undertaken for the clinical evaluation and statistical analysis on the patients with placenta previa who had been admitted and delivered at Soonchunhyang University Hospital from January, 1994 to May, 1998, retrospectively. Results : The incidence of placenta previa was 2.0%. Placenta previa has occurred more often in multigravida(92%) than primigravida(8%). Vaginal bleeding was most frequent(37.3%) presentation. The mean gestational age at the first bleeding episode was 31~35 weeks(46.4%). The type of placenta previa was totalis (31.3%), Partialis(18%), marginalis(32.7%), low lying(18%). Conclusion . This study indicates that the obstetrician and the pediatrician should be prepared for emergency care and delivery of the placenta previa patients, with the improvement of delivery room and neonatal intensive care unit.

골반 내 농양 1예

조인숙,이해혁,김태희,이권해,남계현,이임순,김정식,박성진 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Pelvic inflammatory disease (PID) is a disease that affects young, sexually active, reproductive age women. Most pathogens are Chlamydia trachomatis and Neisseria Gonorrheae transmitted sexually. One of serious acute complication of PID is tubo-ovarian abscess (TOA) that involves the fallopian tube, ovary and adjacent structures (eg, bowel, pelvic peritoneum). The microbiology of TOAs is polymicrobial with anaerobic organisms and causal organisms of PID. Common anaerobic organisms are Peptostretococcus spp, Bacteriodes spp, Prevotella spp, Escherichia coli and aerobic streptococci. Treatment is necessary to admission for intravenous broad-spectrum antibiotics and surgery is often reserved for patients with suspected rupture or patients who fail to respond to antibiotics. So, we reported this case found pelvic abscess due to ruptured tube-ovarian abscess.