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간성뇌증과 연관이 있는 생화학적 단백질-칼로리 영양 평가지표
정지성 ( Ji Sung Chung ),김진일 ( Jin Il Kim ),조세현 ( Se Hyun Cho ),박수헌 ( Soo Heon Park ),한준열 ( Joon Yeol Han ),김재광 ( Jae Kwang Kim ),이영석 ( Young Sok Lee ),정규원 ( Kyu Won Chung ),선희식 ( Hee Sik Sun ) 대한내과학회 2006 대한내과학회지 Vol.70 No.6
목적: 간경변 환자에서 단백질-칼로리 영양실조가 흔하며, 영양실조의 경우 면역력이 저하되어 감염의 위험성이 높아지고 예후도 나쁜 것으로 알려져 있다. 현증간성뇌증 환자의 경우, 단백질 제한을 하는 경우가 많으며, 장기간 단백질 제한을 하는 경우 영양실조가 악화될 뿐 아니라 예후에도 악영향을 미칠 수 있다. 간성뇌증에서 회복된 이후에는 단백질 공급이 필요할 것으로 생각되나, 이를 위한 기준은 미흡한 실정이다. 이에 간성 뇌증과 연관이 있는 영양평가 지표들을 Background: Most patients with hepatic encephalopathy have their protein intake restricted. Therefore, protein-calorie malnutrition becomes more severe and may cause more serious problems, such as infection and poor prognosis. The aim of this study is to d
신이식 환자에서 발생한 뇌 Aspergillosis 에서 Liposomal Amphotericin B 와 내시경적 수술을 이용한 성공적인 치료
우영식(Young Sik Woo),김미정(Mi Jung Kim),장재혁(Jae Heuk Jang),황수은(Soo Eun Hwang),정지성(Ji Sung Chung),신미정(Mi Jung Sin),양철우(Chul Woo Yang),김용수(Yong Soo Kim),방병기(Byung Kee Bang),박주현(Joo Hyun Park) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4
Aspergillosis involving central nervous system is a rare but life-threatening complication in renal transplant recipients. Its mortality rate approaches almost 100% in spite of various therapeutic regimens. We here report a case of successful treatment of brain aspergillosis with liposomal amphotericin B and endoscopic surgery. A 58-year- old renal transplant recipient admitted due to headache which was developed 5 months ago. He received renal transplant 10 years ago. After admission, brain MRI revealed brain abscess on frontal lobe and this was treated with antibiotics and amphotericin B. On 20 th hospital day, endoscopic surgery via intranasal approach was performed and pathologic finding was consistent with aspergillosis. During treatment, his graft function was progressively deteriorated(serum creatinine level 2.27 mg/dL4.1 mg/dL) and amphoterinc B was replaced with ambisome. Thereafter, renal function was improved(serum creatinine 2.0 mg/dL on 46 th hospital day). Second operation was performed on 50 th hospital day to remove remnant pathologic lesion, and ambisome was continously adminstered. The brain MRI which was performed on 70 th hospital day showed much improvement. He was discharged with oral antifungal drug(itraconazole). Our case demonstrates the successful treatment of brain aspergillosis with medial treatment and minimal invasive surgery.
Vacuolar Myelopathy가 동반된 후천성 면역결핍 증후군(AIDS) 환자 1예
정지성,김상일,조유경,최수미,위성헌,김양리,이광수,최규호,강문원 대한감염학회 2001 감염 Vol.33 No.5
The spinal cord is a commonly affected site in human immunodeficiency virus (HIV) infection. Even though the most common disease of the spinal cord is vacuolar myelopathy, there is no case report yet in Korea. We experienced a case of suspicious vacuolar myelopathy in a 33 year-old male patient with acquired immunodeficiency syndrome. The patient presented with progressive paraparesis, gait disturbance, urinary difficulty, and the loss of sensation below thoracic spine 6∼7 dermatome. Cerebrospinal fluid showed mild pleocytosis, increased protein level, and normal glucose content. The spine MRI showed extensive ill defined areas of increased signal intensity through the visualized lower cervical and thoracic spinal cord. Steroid therapy with antiretroviral drugs appeared to be ineffective to improve the symptoms of the patient. (Korean J Infect Dis 33:350∼353, 2001)
인슐린 치료중인 당뇨병환자에서 일시적 갑상선 기능 저하 상태로 발생된 양측성 전 경골 구획증후군
이정민,손호영,차봉연,윤건호,조유경,정지성,고승현 대한내과학회 2001 대한내과학회지 Vol.61 No.3
Acute compartment syndrome is usually caused by local vascular and traumatic involvement. Thyroid disease is not a common cause of compartment syndrome and only two cases of spontaneous compartment syndrome associated with hypothyroid myopathy have been reported. Diabetic muscular infarction is a rare microvascular complication usually occured in type 1 diabetes patients under pjoor diabetic control and intramuscular volume expansion caused by muscle necrosis and increased tissue fluid can iduce compartment syndrome.We report a case of atypical bilateral anterior tibial compartment syndrome and foot drop in a 51-year-old patient with type 2 diabetes in hypothyroid state.(Korean J Med 61:307-312, 2001)