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제4형 가족성 고중성지방혈증 임산부에서 발생한 급성 췌장염 1례
박관응,윤채중,김영학,진영기,윤성호,권용은,김태원,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 1997 The Medical Journal of Chosun University Vol.22 No.2
Plasma levels of cholesterol (TC) and triglyceride(TG) physiologically increase during pregnancy. The lipid increment is 23-53% above the pregravidic level for TC and 2- to 3-fold of the prepregnancy level for TG. If the TC and TG are higher than normal values in pregnancy, the patient must be carefully monitored. Acute pancreatitis is the main consequence of hyperlipidemia and occurs either during pregnancy, in the third trimester, or in the puerperium. Mortality is high both for the mother (21%) and the fetus (20%). We report a case of 28 year-old pregnant woman at 29 weeks gestation with hypercholesterolemia (TC = 357 ㎎/dl) and severe hypertriglyceridemia (TG = 1300 ㎎/dl). The patient was admitted to the hospital because of severe epigastric pain, nausea and vomiting. Total serum cholesterol was increased and trigyleride was markedly increased. The electroporesis pattern of serum lipoprotein showed increase in pre-beta lipoprotein fraction, suggesting IV hypertriglyceridemia pattern. According to a review of the literature, the incidence of pancreatitis during pregnancy is 1 in 1000 to 3000 pregnancies. Severe hypertriglyceridemia in pregnancy should be treated with a careful restriction of calories and fat: for preventing acute pancreatitis, hospitalization for intravenous fluid therapy and plasma exchange must be required.
모성환,박관응,김창욱,김미자,정회상,박유환,정춘해,이호영,이호준 朝鮮大學校 附設 醫學硏究所 1996 The Medical Journal of Chosun University Vol.21 No.2
Miliary tuberculosis is commonly associated with various hematologic changes, such as, anemia, leukopenia, leukocytosis, monocytosis, leukemoid reaction, basophilia, dissemianted intravascular coagulation, and rarely pancytopenia. Pancytopenia in miliary tuberculosis has proved to be a grave prognostic indicator. The precise mechanism of pancytopenia in miliary tuberculosis is not yet known, so there is still much controversy. Bone marrow invasion is accepted as one of the possible mechanisms of pancytopenia acompanied with miliary tuberculosis. Authors experienced a rare case of pancytopenia and bone marrow invasion associated with miliary tuberculosis in a 47-year-o1d female. The bone marrow examination revealed caseous granulomas with a reactive plasmacytosis. The pancytopenia and symptoms were resolved by anti-tuberculosis chemotherapy and active supportive care. Tuberculosis os a common infection. Therefore, in the presence of pancytopenia, accompanied with pyrexia, milliary tuberculosis should always be considered.
김태종,박치영,진영기,박관응,허경무,김영학,정승문,윤채중,배학연,이승일 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
저자들은 잘 조화되지 않는 당뇨병을 가진 49세 남자 환자에서 조기진단, 내과적치료만으로 호전된 폐형모균증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Mucormycosis is a rare, rapidly progressive and often fatal opportunisitic fungal infection, which occurs most commonly in patients with uncontrolled diabetes mellitus. We experienced pulmonary mucormycosis in a 49-year-old man with uncontrolled diabetes mellitus. He complained of dyspnea, nonproductive coughing, fever and cold sweating for lmonth. On the twenty-eighth hospital day, bronchoscopic examination with lung biopsy revealed broad, non-septate hyphae with right-angle branching, diagnostic of mucormycosis. Intravenous amphotericin B therapy was stated. The lesion decreased in sized after 4weeks of theatment and almost disappeared on follow-up chest X-ray l0weeks later.