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황은아(Eun Ah Whang),성정훈(Jung Hoon Sung),한승엽(Seung Yeup Han),박성배(Sung Bae Park),김현철(Hyun Chul Kim),강민경(Min Kyung Kang) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.5
Posttransplant diabetes mellitus, a complication due to corticosteroids and the calcineurin inhibitors, cyclosporine and tacrolimus, is commonly regarded as a form of type 2 diabetes mellitus. Diabetes ketoacidosis, which requires relative insulin deficiency to impair fatty acid metabolism, is a complication of type 1 diabetes mellitus. We report two patients who presented with diabetic ketoacidosis after kidney transplantation. Two patients presented with severe hyperglycemia, significant ketosis and metabolic acidosis of variable severity. One patient was treated with a cyclosporine-based regimen, and the other with a tacrolimus-based regimen. Both were found to have moderate to high serum levels of calcineurin inhibitors on presentation. Our experience suggests that post-transplant diabetes mellitus, in association with calcineurin inhibitor, may result in ketoacidosis either secondary to relative beta cell dysfunction, peripheral insulin resistance, or a combination of the two effects. Post transplant diabetes mellitus can be an atypical form of adult-onset diabetes with features of both type I and type 2 diabetes mellitus.
전자현미경 검사상 특징적인 기저막 변화를 나타낸 Nail - Patella 증후군 1 예
한승엽(Seung Yeup Han),강민경(Min Kyoung Kang),황은아(Eun Ah Whang),박성배(Sung Bae Park),김현철(Hyun Chul Kim),전시현(Si Hyun Jeon),강유나(Yu Na Kang),박관규(Kwan Kyu Park) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.5
Nail-patella syndrome is a relatively rare autosomal dominant disorder characterized by dysplastic nail, hypoplastic or absent patella, and dislocation of radial head and iliac horns. In addition, renal abnormalities have been reported. The usual clinical signs of the renal involvement are asymptomatic proteinuria, microscopic hematuria, and in some cases progression to end stage renal disease. We present the case of adult with nail-patella syndrome, who developed proteinuria. Electron microscopy revealed irregular thickening of the glomerular basement membrane with areas of rarefaction, giving rise to a pathognomonic moth-eaten appearance.