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김용화,주기산,서영환,조경상,김상도,정춘해 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2
Pleural effusion in a patient with multiple myeloma due to plasma cell involvement of the pleura has been reported infrequently. We report a case of multiple myeloma with pleural involvement presenting bone pain and dyspnea in a 69-year-o1d woman. On the physical examination, the patient looked chronically ill with bedridden state. There was a palpable mass on the left posterior lower chest, firm but not tender and decreased breathing sound in the left lower lung. Laboratory finding revealed amemia, elevation of ESR, globulin, and calcium. X-ray of the chest showed pleural effusion in the left lower lung, and multiple pathologic fractures in the both ribs. X-ray of the skull, and pelvis revealed multiple punched-out osteolytic fractures in the both ribs. X-ray of the skull, and pelvis revealed multiple punched-out osteolytic lesion, and compression fracture in the lumber spine. Serum and urine electrophoresis revealed a M-spike. Serum and urine immunoelectrophoresis demonstrated an IgA-kappa monoclonal protein. Thoracentesis revealed serosanguinous fluid but not containing atypical plasma cells. Bone marrow examination showed 16.7% of immature plasma cells. With first cycle of melphalan, prednisone chemotherapy, improvement of pain and disappearance of pleural effusion was observed.
대동맥 이첨판과 승모판 이탈증을 동반한 대동맥 판하부 협착 1예
김용화,장경식,양태영,임영국,안기완,홍순표 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1
Discrete subaortic stenosis is a rare cardiac disorder especially in Orientals which occupies eight to ten percent of aortic stenosis, It occurs mainly before age of eighteen and accompanies with aortic valve abnormalities such as aortic stenosis, supravalvrlar stenosis, bicuspid valve and muscular hypertrophic subaortic stenosis, and other cardiac abnormalities such as ventricular septal defect, pulmonary stenosis and coarctation of aorta. There is no report of discrete subaortic stenosis accompanied with mitral valve prolapse. The major complications of discrete subaortic stenosis are aortic insufficiency, and subacute bacterial endocarditis. We report a case of asymptomatic nineteen-year-old male of discrete subaotic stenosis with bicuspid aortic valve and mitral valve prolapse, which is comfirmed by two-dimensional and Doppler echocardiography including transesophaigeal echocardiography.
조영호,홍순표,양태영,조희충,정춘해,최연수,김용화 대한내과학회 1993 대한내과학회지 Vol.45 No.3
Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder involving multiple hematopoietic cell lines characterized by hemolytic anemia with accompanying hemoglobinuria usually occuring at night. exacerbation of the hemolytic process following the transfusion of whole blood or plasma, such as occurs in paroxysmal nocturnal hemoglobinuria has been reported to precipitate acute renal failure. We present here two cases of paroxysmal nocturnal hemoglobinuria developed acute renal failure (ARF) due to hemolytic transfusion reaction and treated by steroid, diuretics and fluid therapy. The first case was refered to the hospital that had been following up before and the second was discharged with symptomatic and hematologic improvement.