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노인에서 상기도 감염후 발생한 급성감염후 급속진행성 사구체신염
오병선 ( Byoung Sun Oh ),박철휘 ( Cheol Whee Park ),장세나 ( Se Na Jang ),정현정 ( Hyun Jung Jung ),김경희 ( Kyoung Hee Kim ),박건우,정현화 ( Hyun Wha Chung ),한상우 ( Sang Woo Han ),장윤식 ( Yoon Sik Chang ) 대한신장학회 2006 Kidney Research and Clinical Practice Vol.25 No.6
Postinfectious streptococcal glomerulonephritis (PSGN) presenting as a rapidly progressive glomerulonephritis (RPGN) and nephrotic syndrome (NS) is a rare disease in elderly patients. Here we report a case of PSGN with RPGN and NS in an elderly male patient with a complete recovery from his illness. A 73-year-old man was admitted for dyspnea, oliguria and generalized edema appearing after acute upper respiratory infection. On admission, he presented nephrotic range of proteinuria, decreased renal function with elevated ASO, and decreased C3 and CH50 concentrations. The renal biopsy showed marked cellular crescents in the glomeruli with collapsed glomerular tufts and inflammatory cell infiltration. There were prominent and various sizes of humps in subepithelial areas in electron microscopy. Under the diagnosis of PSGN with RPGN, we successfully treated the patient with steroid pulse therapy and hemodialysis. We would suggest that early diagnosis and aggressive steroid therapy should be indicated in the treatment of PSGN with RPGN. (Korean J Nephrol 2006;25(6):1025-1028)
만성신부전증 환자에서 Vancomycin 투여 후 발생한 무과립구증 G-CSF를 이용한 성공적 치료
이병오 ( Byung Oh Lee ),김영옥 ( Young Ok Kim ),김기조 ( Ki Jo Kim ),고명범 ( Myoung Beom Koh ),정현화 ( Hyun Wha Chung ),윤선애 ( Sun Ae Yoon ),이혜경 ( Hae Kyung Lee ),이종욱 ( Jong Wook Lee ),장윤식 ( Yoon Sik Chang ),방병기 ( 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.2
Vancomycin induced agranulocytosis is a rare but life-theratenign complication. We here report a case of vancomycin induced agranulocytosis in a patient with chronic renal failure. A 36-year- old woman receiving hemodialysis via jugular cannulation developed staphylococcus sepsis. The catheter was removed and she was started on vancomycin therapy (1.0 g/week). New catheter was inserted for next hemodialysis. Second sepsis of same organism developed 12 days after initial sepsis inspite of vancomycin therapy. We removed this catheter and continued vancomycin therapy. After 19 days of vancomycin treatment, the patient developed a severe agranulocytosis with white blood cell count of 1,600/mmm^3 and the complete absence of neutrophil. Vancomycin was discontinued and teicoplanin was substituted for vancomycin therapy and G-CSF (granulocyte colony stimulating factor) therapy was begun. White blood cell count including neutropil was completely recovered after 13 days of discontinuation of vancomycin.
하부요로 폐색 증상을 보인 고령 환자에서 진단된 원발성 전립선 림프종 1예
박만원,정현화,심병용,변재호,홍영선,이경식,강창석 대한내과학회 2004 대한내과학회지 Vol.66 No.2
본 예는 전립선 비대로 인한 하부요로 폐색증상을 호소하는 고령의 환자에서 방사선 검사 및 생검을 통해 원발성 전립선 림프종을 진단한 에로 국내에서 아직 보고된 증례가 없기에 문헌고찰과 함께 보고하는 바이다. Malignant lymphoma involving the prostate, whether presenting as primary extranodal lymphoma or as secondary spread to the prostate from other site, are rare. Most are secondary, so primary lymphoma of the prostate is extremely rare. We report a case of primary prostate non-Hodgkin's lymphoma who presented with symptoms of lower urinary tract obstruction and constipation. The patient underwent cyclophosphamide, vincristine, prednisone combination chemotheraphy for 3 cycles and than now under involved-filed radiotheraphy.
비스테로이드성 소염진통제의 장기 사용으로 유발된 하행십이지장 협착 1 예
박수헌,김진일,임동준,정인식,김재광,정규원,선희식,최규용,지정선,정현화,백창렬,노치호,민도준,한준열 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.2
In endoscopic clinical research studies of patients who take NSAIDs, 10% to 20% of patients develop gastric ulcers and 4% to 10% develop duodenal ulcers. Ulcers associated with chronic NSAIDs use are typically painless and are located in the prepyloric region of the stomach. These characteristics make NSAIDs potential causes of gastric outlet obstruction. There were multiple cases of single or multiple strictures that were found in the esophagus, small bowel and colon. Most of duodenal strictures were confined to bulbar area. Only one case of duodenal second portion diaphragmlike stricture was reported in association with acetylsalicylic acid. We experienced one case of chronic NSAIDs induced duodenal 2nd portion stricture in ankylosing spondylitis and rhemathoid arthritis patient and reported with a review of literature.