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김병수,박진호,김준석,신상원,김열흥,김석진,오상철,서재흥 대한내과학회 1996 대한내과학회지 Vol.51 No.2
All-trans-retinoic acid(ATRA) is the very efficaceous drug to acute promyelocytic leukemia (APL). This drug can induce complete remission at APL without fatal risk of disseminated intravascular coagulation. But, ATRA treatment, sometimes, produces the symptoms of fever, weight gain, myalgia, arthralgia, acute respiratory distress and renal funcation impairment. These findings are called as retinoic acid syndrome. The causes of these symptoms are not fully proved, but supposed as the result of leukostasis and capillary leak syndrome from excessive leukocyte differentiaion & cytokine release. Recently, we experienced a 44-years-old woman who complained gum bleeding for 7 days. At bone marrow biopsy, she was diagnosed as APL. So, we tried ATRA therapy. But, 2 days after ATRA treatment, she was suffered from the symptoms of high fever, weight gain, general ache, respiratory distress, oligouria. At laboratory examination, total leukocyte count was 38,000/㎕, PaO₂ was 55 mmHg and chest PA revealed the findings compatible with pulmonary edema. Therefore, we could diagnose this patient as retinoic acid syndrome and treatment with low dose ara-C, dexamethasone and general supportive cares were tried. But, this patient was died at 25 days after treatment for retinoic acid syndrome. Lung necropsy was done for searching the cause of respiratory distress. We could see the findings of diffuse alveolar damage with type 2 pneumocyte hypertrophy and pink-colored materials at intra-alveolar space without the invasion of leukemic cells at alveolar septum, And so, we present this case with a review of related literatures.
현진해(Jin Hai Hyun),김열흥(Yeul Hong Kim),이형호(Hyung Ho Lee),황일순(Il Soon Whang),송치욱(Chi Wook song),류호상(Ho Sang Ryu),최진학(Jin Hak Choi) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2
N/A Clinical observation was performed of 229 cases of acute cholecystitis who admitted to Department of Internal Medicine Korea University Hospital for 5 years from Jan. 1980 to Dec. 1984. The following results were obtained: 1) The total number of cases of acute cholecystitis was 229 which was 0.46% of total admission cases during the same period. 2) The age incidence was the highest in 6th decade. The ratio of male and female was 1: 1.3. 3) On admission the most common clinical symptom was pain in the R.U.Q. and epigastrium(75.5%), the remainders were fever(40.2%), chill(36.2%), indigestion (34.1%), and nausea with vomiting(28.0%) in order of frequency. 4) The most common physical finding was tenderness on the R.U.Q ((81. 2%), and the remainders were tenderness on the epigastrium(33. 6%), jaundice(27.l%), and fever with palpable liver(23.6%) in order of frequency. 5) Laboratory examination showed leukocytosis(45.4%), elevated E.S.R. (91.0%), elevated alkaline phosphatase(55.9%), and elevated serum total bilirubin(36.9%). 6) On the radiological examinations the gallstones were presented in 9.3% by plain abdomen. On the sonographic examination of abdomen gallbladder stones were noted in 54.2% common bile duct stone in 15.O%, and intrahepatic duct stone in 6.0% 7) The 46.3% percent were improved by the medical conservative treatment. The 49.8% percent were improved by the surgical treatment and the 1.7percent was expired. 8) The complications of acute cholecystitis were 3. 1 percent.
소장내용물의 위내역류 및 위내용물 배출시간에 관한 연구
김진호,박승철,이형호,안일민,박영태,김열흥,이창흥 대한내과학회 1986 대한내과학회지 Vol.30 No.2
Radionuclide enterogastric scintigraphy was done with (99m)Tc-DISIDA and (111)In-DTPA in 35cases; control group 5, gastric ulcer group 6, subtotal gastrectomy with Billroth g group 5, and functional gastrointestinal disorder group with or without grossly mixed bile in the gastric juice 19 cases. The results were: 1) Enterogastric reflux was very significantly increased in the subtotal gastrectomy with Billroth II group (p$lt;0, 001), 2) Gastric emptying was significantly delayed in the functional gastrointestinal disorder groups with or without grossly mixed bile (p$lt;0.05, p$lt;0. 001). 3) Enterogastric reflux was not significantly increased in the gastric ulcer group. 4) Enterogastric reflux was not significantly different between the functional gastrointestinal groups with or without grossly mixed bile in the gastric juice. 5) Inverse correlation between the gastric emptying indices and the enterogastric reflux indices was not proved (r=-0.37).