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펜타미딘으로 치료 받은 후천성 면역 결핍증 환자에서 발생한 저혈당 1예
송기호 ( Kee Ho Song ),황용 ( Yong Hwang ),최홍석 ( Hong Seok Choi ),기현균 ( Hyun Kyun Ki ),정혜숙 ( Hae Suk Cheong ),서정웅 ( Jung Woong Seo ),정현아 ( Hyun Ah Chung ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Trimethoprim-sulfamethoxazole (TMX-SMZ) is the initial treatment for Pneumocystis jiroveci pneumonia in human immunodeficiency virus (HIV) patients. About 20% of patients do not complete the TMX-SMZ treatment due to treatment failure or adverse reactions. Pentamidine isethionate has been used for P. jiroveci pneumonia as a second-line regimen. Although hypoglycemia is a common adverse effect of pentamidine, pentamidine-induced hypoglycemia has not been reported in Korea. We present an HIV patient with grand mal seizures caused by pentamidine-induced hypoglycemia who was managed successfully with IV dextrose infusion. Mental changes can occur during pentamidine treatment, but hypoglycemia is often ignored and misdiagnosed as epilepsy or stroke. It can result in seizures, coma, and even death. We should be aware of pentamidine-induced hypoglycemia, which can lead to severe neurologic deficits and diabetes mellitus. (Korean J Med 2012;83:679-682)
증예(症例) : 복막 투석 및 HIV 감염 환자에서 Stenotrophomonas maltophilia peritonitis: Colistin 치료와 결과 1예
곽동명 ( Dong Myoung Kwak ),전용덕 ( Yong Deok Jeon ),방지환 ( Ji Hwan Bang ),최광준 ( Gwang Jun Choi ),정현일 ( Hyun Il Cheong ),양성욱 ( Seong Wook Yang ),박상민 ( Sang Min Park ) 전북대학교 의과학연구소 2009 全北醫大論文集 Vol.33 No.2
Stenotrophomonas maltophilia is increasingly being recognized as an important cause of infection on immunodeficient patients. But S. maltophilia peritonitis in continuous ambulatory peritoneal dialysis (CAPD) are not common. Here, we report the case of a 40-year-old male with HIV infection and end-stage renal disease treated with CAPD. The patient had frequent previous history of peritonitis and known HIV infection. He presented with chilling, abdominal pain, and cloudy peritoneal effluent. White blood cell and neutrophil count were elevated at the initial peritoneal fluid analysis, so we diagnosed him as having CAPD-associated peritonitis. On the seventh hospital day, the organism isolated from the effluent was S. maltophilia. We changed the antibiotics to trimethoprim-sulfamethoxazole (TMP-SMX). But it was happened severe nausea, vomiting due to TMP-SMX complication. Thus, TMP-SMX was changed to colistin. after 8 days, He recovered completely, with no need for catheter removal. No recurrence was observed.
조철희(Chul-Hee Jo),김성준(Sung-Jun Kim),정현(Hyun Cheong) 한국해양공학회 2009 韓國海洋工學會誌 Vol.23 No.1
As the demands of ocean resource development increase, many offshore structures are required. To cope with the active ocean developments, many types of construction methods have been applied for offshore facilities, including oil, gas and harbors. One of the challenges is to transport and install the heave bridge caisson. Several construction methods are well understood. However, for the sake of safety and reliability, the F/D installation method can be utilized. While the caisson is carried by an F/D, the mooring force of the tug boat and the structure stability from exiting motions in the dock should be checked against external loadings and sea conditions. The external loads can be classified with wind force, current force, and wave force. In the stability analysis, transportation velocity and draft of F/D are important factors. The dynamic stability and hook load for crane barge installation for the same caisson are also studied. Considering external loads and dominant factors, the stability of caisson during transportation has been investigated.