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불응성 요독성 심낭 삼출에서 검상돌기하 심낭절개술 치험 2예
김문재,인현호,믹순혜 대한신장학회 1993 Kidney Research and Clinical Practice Vol.12 No.2
Pericardial diseases often cause morbidity and mortality as potentially major complication in patient with chronic renal failure. The primary treatment of uremic pericarditis has been to start dialysis in previously undialyzed patients or to intensify dialysis, particularly when pericardial effusion is small or moderate amount. Surgery should be initiated in patient with uremic pericarditis in whom a moderate to large effusion does not diminish or actually increases in size following dialysis. We experience with subxiphoid pericardiostomy for massive pericardial effusion in two patients on maintenance hemodialysis. A 31-year-old man in maintenance hemodialysis was hospitalized for increasing shortness of breath for one month. Echocardiogram demonstrated a massive pericardial effusion. A subxiphoid pericar- diostomy was performed in the operating room. The pericardial drainge tube was removed 3 days later, and a repeated echocardiogram revealed no more accumula- tion of the effusion. A 37-year-old man with chronic renal failure on hemodialysis was hospitalized for increasing shortness of breath, chest pain, and low blood pressure. The symptoms were aggravated during the dialysis. An emergency echocardiogram done at the patients bedside showed moderate amount of pericar- dial effusion and pericardial tamponade. Emergency subxiphoid pericardiostomy was performed using local anesthesia. There were immediate improvements from tamponade state after pericardiostomy drainage.
Bezafibrate에 의한 급성 신부전을 동반한 횡문근 융해증 1예
김문재,장재남,인현호 대한신장학회 1995 Kidney Research and Clinical Practice Vol.14 No.3
Bezafibrate is a lipid-lowering agent which belongs to the fibric acid derivatives. Bezafibrate is chemically similar to clofibrate, the latter is known to induce occasinally acute muscular syndrorne with or without renal failure. We report a patient with diabetic nephropathy who had massive rhabdomyolysis with acute renal failure due to bezafibrate. A 47-year-old woman was admitted with complaints of general weakness and red urine. She has had rheumatoid arthritis and diabetes mellitus 5 years ago, and mild proteinuria and slight elevation of serum creatinine were noticed since last year. She was given bezafibrate for the control of hypercholesterolemia for 1 week. Sudden general myalgia, anorexia, and red urine developed before admissing. Rapid increase in BUN, serum creatinine and muscle enzymes were noted. Increased muscle uptake of technetium-99m MDP were noticed on bone scan. These findings suggest that bezafibrate had provoked rhabdomyolysis with acute renal failure.
Diphenylhydantoin 투여중 발생한 용혈성 빈혈을 동반한 순수 적혈구 형성 부전증 1 예
김진주,장동섭,인현호,박재후,최민준,김순혜,윤혜령 대한내과학회 1994 대한내과학회지 Vol.46 No.2
Pure red cell aplasia is an uncommon disease characterized by findings of abscence of reticulocytes in the peripheal blood, and abscence of erythroblasts and normal leukocytes and platelet production in the marrow. Its cause and mechanism is obscure but immunologic mechanism is strongly suggested because of the wide variety of immunologic abnormalities and successful treatment with immunosuppressive agents. A 34 year-old female was admitted to our hospital due to general weakness, dizziness and dark-colored urine. She was taking diphenylhydantoin against epilepsy. The peripheral blood smear and bone marrow examination showed normocytic normochromic anemia reticulocytopenia, marked hypoplasia of the erythroid series, and the hematologic and urinary examination showed severe hemolytic evidence. After diphenylhydantoin withdrawal and steroid therapy, the hemolytic anemia and red cell aplasia recovered completely. We are reporting a patient with diphenylhydantoin induced pure red cell aplasia with simultaneous occurrence of hemolytic anemia following administration of diphenylhydantoin with brief review of literature.
이관우,홍성빈,주영채,조영업,김명식,김미림,인현호,김경래 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.2
Hashimotos thyroiditis and Graves disease have been thought to be the autoirnmune diseases having their distinct and separate clinical and pathologic features. Because of the partial and complete simi1arity in histologic feature, it has been hypothesized that Hashimoto's thyroiditis and Oraves disease may be interrelated. Several patients who had been diagnosed as Graves disease showed features of hypothyroidism, and were proven to have histologie features of Hashimotos thyroiditis in their thyroid tissue. Two meehanisms had been suggested to explain tbis phenomenon. One is that the combined Hashimotos thyroiditis in Graves' disease may become predominant with time, The other is that the amount of TSH receptor blocking antibody may increase in the course of Graves disease. Early recognition of these patients would be impartant to estabilish therapeutic plan. Futhermcee, extensive study of these patients would give more understanding of the mechanism of these diseases. Here we report 5 cases of clinically diagnosed Graves disease with pathologic features of Hashimotos thyroiditis or focal lymphocytic thyroiditis(J Kor Soc Endocrinol 11:182 188, 1996).
김영수,장재남,박기수,김인한,신용운,조영업,장동섭,정석,김선후,인현호,문태훈 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.4
Hemorrhage into a pancreatic pseudocyst is a rare, but increasingly recognized as a cause of massive gastrointestial bleeding. Bleeding pseudocysts may rupture into the stomach, duodenum, common bile duct, and splenic vein, or can be decompressed via the duct of Wirsung. Also it will result in upper gastrointestinal bleeding. This represents a life-threatening and frequently unrecognized complication of pancreatic disease. Proper diagnostic workup and prompt surgical management afford the patient the best chance for survival . We report a patient with pseudocyst bleeding into the gastrointestinal tract via the duct of Wirsung and discuss the current diagnostic and therapeutic approach.
결핵성 복수 환자에 있어서 복수 Adenosine Deaminase 활성도의 진단적 가치에 관한 연구
문태훈(Tai Hoon Moon),박기수(Ki Soo Park),인현호(Hyun Ho In),최민준(Min Joon Choi),이관우(Kwan Woo Lee),김영수(Young Soo Kim),신용운(Yong Woon Shin) 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A Objectives: In other to establish the etiology of ascites, routine analysis of fluid, bacteriologic studies, cytolgic tests and peritoneal biopsy are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in more than 10% of cases. The purposes of our study are to determine the diagnostic significance of adenosine deaminase (ADA) activity in ascitic fluids which their etiologies have confirmed, and to determine the correlation between ADA activity and other biochemical data in tuberculous ascites. Methods: We have studied 21 cases of tuberculous ascites, 9 cases of malignant ascites, 32 cases of cirrhotic ascites, and 11 cases of miscellaneous etiologies. We have measured the ADA activity and values of routine examinations in ascites in each cases. Results: 1) The mean ascites ADA activity was 115.8±61.1 U/L in tuberculous ascites, 11.3±11.1U/L in cirrhotic ascites, 19.2±16.0 U/L in malignant ascites, and 13.7±12.6 U/L in miscellaneous ascites. 2) At a cutoff value of > 50 U/L, the sensitivity and the specificity for diagnosing tuberculous ascites were 95.2% and 98.4%, respectively. 3) In tuberculous ascites, the ascites ADA activity showed significant correlation with the ascites LDH activity (r=0.60), but other values of routine examination were not showed such correlation. Conclusion: It is suggested that the measurement of ascites ADA activity is simple and useful test in the diagnosis of tuberculous ascites. However, falsenegative results may occur in those in which ascites LDH activity is low.