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혈액투석 환자에서 경요도방광종양절제술 후 발생한 경요도절제후 증후군 2예
정은호 ( Eun Ho Jeong ),김은나 ( Eun Na Kim ),왕희배 ( Hee Bae Wang ),김태호 ( Tae Ho Kim ),박정석 ( Jeong Suk Park ),김태형 ( Tae Hyung Kim ),김진우 ( Jin Ou Kim ),서상렬 ( Sang Yeol Suh ),성원섭 ( Won Sub Seong ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.4
Transurethral resection syndrome (TURS) is one of the complications of endoscopic transurethral operation with irrigation fluid. TURS comprehensively refer to several clinical symptoms and signs caused by intravascular absorbtion of irrigation fluid, hypertension, bradycardia, arrhythmia, respiratory distress, hypotension, confusion, blindness, seizure, coma, hyponatremia, and hypoosmolarity. TURS is mainly known as the complication of the transurethral resection of prostate (TURP), and rarely found in the procedures such as transurethral resection of bladder tumor (TUR-BT), hysteroscopy, cystoscopy, and arthroscopy. Only a few cases of TURS after TUR-BT have been reported. The patients on maintenance hemodialysis were restricted in the amount of water intake for volume control. They were susceptible to the absorption of irrigation fluid during TUR-BT since they had anuria. We hereby report the 2 cases maintenance hemodialysis patients who were led to TURS after TUR-BT.
박민범 ( Min Bom Park ),김은나 ( Eun Na Kim ),정은호 ( Eun Ho Jeong ),김진우 ( Jin Ou Kim ),왕희배 ( Hee Bae Wang ),김태호 ( Tae Ho Kim ),이기조 ( Key Jo Lee ),서상렬 ( Sang Yeol Suh ),진소영 ( So Young Jin ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.
증례 : 소화기 ; 자발성 기복증으로 발현된 거대 공기집 1예
이기조 ( Key Jo Lee ),강석우 ( Seok Woo Kang ),박민범 ( Min Bom Park ),정은호 ( Eun Ho Jeong ),김진우 ( Jin Ou Kim ),왕희배 ( Hee Bae Wang ),김태호 ( Tae Ho Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.3
자발성 기복증이 보고된 증례는 흔하지 않으며 특히 거대 공기집에서 발현된 경우는 더욱 희귀한 경우라 할 수 있다. 대부분의 비수술적 기복증의 경우 의사의 진단 가능성을 높여 주는 환자의 과거 병력 또는 연관된 증상을 갖고 있다. 따라서 기복증 환자가 내원하였을 경우 자발성 기복증을 진단하는데 있어 방사선학적 관찰 및 환자의 과거 병력 조사가 선행되어야 하고, 확진되었을 경우 경과관찰 및 대증 치료로 호전을 기대해 볼 수 있다. 그러나 자발성 기복증 환자라도 방사선 사진에서 장파열의 확인, 복막염 징후, 저혈압, 빈맥, 임상 증상의 악화 또는 지속, 백혈구 증가증이 관찰될 경우에는 수술적 처치가 필요하다. 이와 같이 기복증의 비수술적 원인을 판단하는 것은 불필요한 수술적 처치를 피할 수 있고 이는 자세한 신체검사, 검사실 소견, 방사선학적 결과의 주의 깊은 재검토를 통해서 적절한 평가를 할 수 있다. A spontaneous pneumoperitoneum is air in the peritoneal space that is detectable radiologically and can be managed successfully by observation alone or a laparotomy. A 73-year-old man was admitted for low back pain. He had a giant bulla in the left upper lung, detected radiologically 7 years earlier. On admission, he had free air in the subphrenic area bilaterally, while the previous giant bulla was not seen. Based on the physical examination, we thought that the new free air did not indicate a surgical abdomen, and performed additional examinations to rule out other disease. There was no abnormal finding linked to the free air. The free air had almost disappeared on a subsequent chest X-ray. We report a rare case of spontaneous pneumoperitoneum caused by a giant bulla, with a literature review. (Korean J Med 2011;81:366-371)