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증례 : 류마티스 ; 저용량 adefovir dipivoxil에 의한 저인산염혈증과 다발성 근육통 1예
유기덕 ( Ki Deok Yoo ),정종헌 ( Jong Heon Jeong ),조수경 ( Soo Kyung Cho ),김근호 ( Gheun Ho Kim ),최호순 ( Ho Soon Choi ),김동선 ( Dong Sun Kim ),전재범 ( Jae Bum Jun ) 대한내과학회 2010 대한내과학회지 Vol.78 No.2
ADV는 고용량에서 신독성을 유발할 수 있으나 저용량에서는 매우 드물다. 류마티스 영역에서 다발성 근육통, 관절통을 호소하는 환자의 병력을 청취할 때 약물복용에 대한 자세한 문진도 중요하다는 사실을 인지하여야 하겠다. 저자들은 라미부딘 내성 만성 B형 간염 환자에서 10 mg의 ADV를 사용하던 중 저인산염혈증과 동반된 다발성 근육통이 발생하여, 혈액 검사 및 영상학적 검사 소견으로 골연화증으로 진단된 후 ADV 투여 중지 이후 자각증상과 검사 소견이 호 Adefovir dipivoxil (ADV) effectively inhibits lamivudine-resistant hepatitis B virus replication. Hypophosphatemia and elevated serum creatinine are ADV-related nephrotoxicity caused by high-dose ADV. Hypophosphatemic osteomalacia is very rare and is induc
유기덕 ( Ki Deok Yoo ),한동수 ( Dong Soo Han ),정승민 ( Seong Min Chung ),김선민 ( Sun Min Kim ),배중호 ( Joong Ho Bae ),은창수 ( Chang Soo Eun ),백승삼 ( Seung Sam Paik ),오영하 ( Young Ha Oh ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.2
Histiocytic sarcoma is a rare malignant neoplasm that originates from a histiocytic hematopoietic lineage characterized by histiocytic differentiation and its corresponding immunophenotypic features. Patients with histiocytic sarcoma usually have a poor prognosis due to its aggressive clinical behavior. Here we report a rare case of extranodal histiocytic sarcoma of the stomach which was confirmed through immunohistochemical staining. A 71-year- old man was presented with epigastric pain. Gastroscopy, abdominal CT, and EUS revealed a mass located on the posterior wall of upper body and fundus of the stomach. Grossly, grayish white solid masses were seen extending down to the submucosal layer. Microscopically, the tumor cells had eosinophilic cytoplasm, abundant vacuole, and mitosis. Immunohistochemical staining revealed that the tumor cells were positive for LCA, CD68, and lysozyme. Early detection and accurate diagnosis of this rare neoplasm is important because it can make a great difference in prognostic outcomes. To make an accurate and definitive diagnosis, immunohistochemical staining is essential in the confimation of histiocytic orign. (Korean J Gastroenterol 2010;55:127-132)
유기덕 ( Ki Deok Yoo ),전대원 ( Dae Won Jun ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease. The prevalence of NAFLD is growing gradually worldwide with increases in obesity, sedentary lifestyles, and an unbalanced diet. NAFLD ranges from simple steatosis without inflammation to steatohepatitis that can progress to cirrhosis. There is no single effective treatment that has widespread effects in NAFLD. The cornerstone of treatment is lifestyle modification, including weight reduction, diet, and physical activity. An approximately 7-10% weight reduction via diet or physical activity can improve the liver histopathology. Risk factors for NAFLD include a high-calorie diet, high-lipid diet, high-carbohydrate diet, saturated fatty acids, trans fatty acids, cholesterol, high fructose intake, and low-choline diet. Factors that protect against NAFLD include a low-calorie diet, low-carbohydrate diet, low-lipid diet, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), dietary fiber, coffee, green tea, and light alcohol consumption. Physical activity also helps to manage NAFLD with or without weight reduction. Recent reports found that resistance training is as effective as aerobic training. Lifestyle modification has very low compliance. To maintain a treatment program, a multidisciplinary team approach is required that includes physicians, dietitians, physical trainers, and psychologists. (Korean J Med 2014;86:416-424)