Castleman 씨 병에 동반된 신유전분증

김연수,한진석,이정상,김병국,이중건,정윤철,이진학,최영진,안규리,김성권,이현순 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Castlemam's disease is an asymptomatic and benign lymph node hyperplasia which is frequently manifested as mediastinal mass in over 70% of cases. Amyloidosis is rarely associated with Castleman's disease. Recently we experienced a patient with nephrotic syndrome due to renal amyloidosis who had been previously diagnosed as Castleman's disease of retroperitoneal lymph node enlargement. A 47-year old woman was admitted because of generalized edema and chest tightness. Five months ago she diagnosed as Castlman's disease-plasma cell type, of retroperitoneal lymph node enlargement. The patient was followed up through outpatient department without any specific medication. Physical examination showed pale conjunctivae, palpable mass on epigastric area and pretibial pitting edema. The hemoglobin, leukocyte count and erythrocyte sedimentation rate were 96 g/L, 5.9×109/L and 127 mm/hour, respectively. The blood urea nitogen was 3.6 mmol/L and creatinine was 88 umol/L. The urinalysis showed 3 positive for albumin. Twentyfour hour urine contained 16.6 grams of protein. A computerized tomographic (CT) scan of the abdomen disclosed multiple lymph node enlargement at mesentery. Percutaneous needle biopsy of kidney showed massive infiltration of pale pinkish amorphous material in the glomerular tuft forming large nodules. Ultrastructural examination exhibited heavy deposition of amyloid fibrils in the mesangium and perpendicular to glomerular basement membrane. Polarizing microscopy with Congo-red stain revealed prominent yellow green birefringence in glomeruli, tubules and interstitium.

한국형 출혈열 후유증으로 발생된 만성 신우신염

김연수,한진석,이정상,김성권,진호준,안규리,오국환,오윤규 대한내과학회 1997 대한내과학회지 Vol.52 No.4

It has been known that most patients with Korean Hemorrhagic Fever (KHF) were recovered without any significant renal complication. But several cases of renal hypertension, chronic pyelonephritis, and chronic renal failure after KHF have been reported. Recently, we experienced one case of chronic pyelonephritis as a sequela of KHF, which has been diagnosed at the 78th month of illness. This case showed reduced thickness of renal parenchyme, small and irregular shaped kidney, focal loss of normal cupping of calyces, and accumulation of radiacontrast media at distal calyes by IVP. This case suggested that chronic pyelonephritis may develop as a sequela of KHF,

급성췌장염에 의한 췌장가성남종에서 내시경적 배액술후 발생한 췌장가성남종과 십이지장 및 대장에 발생한 내부 췌장루 1예

김연수,이문성,김진오,조영덕,이영홍,봉형근,조주영,이준성,심찬섭,황성규,전기원,변재호,장재영 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

보행마취(步行麻醉)

김영석,김완식,황호성,이진근,유희구,김흥대 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

An imaginative innovation to shorten hospital stays as a means to reduce patient charges, is out-patient surgery. This procedure also minimized the inconvenience and disruption of the family unit, reduced the opportunities for cross-infection, and freed hospifal beds for the more serriously ill patienta Since the concept of out-patient surgical service was organized, managed, and performed in the Hanyang Medieal Center, we had experience of 132 ambulatory anesthetics during the last two years (from Jan. 1974. to Dec. 1975 ). The results are summarized as follower 1. Preanesthetic examination should be routinely cheeked with Hb., Hct., urinalysis and chest x-ray. 2. Premedication should be administered preanesthetically, atropine sulfate intravenously. 3. ASA class 1 patients should be rhnsen fnr short (less than 1 hour) procedures. 4. Anesthesia is induced with Epontol+S.C.C. and maintained with Halothane+N2O+O2. 5. We suggest that ambulatory anesthesia should be more carefully planned, organized, and managed.

기관지내 전이암

김현수,이상수,오미희,이재갑,원구태,홍희승,용석중,신계철 대한내과학회 1991 대한내과학회지 Vol.40 No.4

The lung is the most common site of metastasis of extrapulmonary malignant tumor. According to past reports, metastatic cancer of the lung has been found in about 2% of all patients at autopsy. But these days, a diagnosis of endobronchial metastatic cancer utilizing bronchoscopy only is not easy. Thus we need other means of gathering more informaction, such as past history, discovery of other metastatic sites, and pathologic findings with special staining and electronmicroscope, especially in cases of poorly differentiated adenocarcinoma and epidermoid cancer, which are common types of primary lung cancer. We present 5 cases of endobronchial metastatic cancer. We found endobronchial metastatic cancer 2 cases of cervix cancer (epidermoid, adenocarcinoma), 1 case of colon cancer (adenocarcinoma), hypernephroma (renal cell carcinoma), and bladder cancer (transitional cell carcinoma). Since it was impossiole to diagnose the metastatic adenocarcinoma from the cervix only with lightmicroscopic findings, we could use past history and unusual radiologic and bronchoscopic findings which was thought to be the specific endoscopic finding of metastic endobronchial cancer. The interval between the diagnosis of the primary cancer and endobronchial metastatic cancer was 25.7 months. In the future, development of immunohistochemistry, monoclonal antibody, and molecular biologic techniques will give us diagnostic clue for differential diagnosis of metastatic endobronchial cancer from primary bronchogenic lung cancer.

급성 골수성 백혈병(M6)에 합병된 중추성 요붕증 1 예

김성연,조보연,이홍규,고창순,민헌기,김병국,김노경,신찬수,이명식,강덕현,조종태 대한내과학회 1989 대한내과학회지 Vol.37 No.2

Leukemia is known to be an extremely rare cause of diabetes insipidus. We report a case of diabetes insipidus as a complication of leukemia. An 18 year-old man was admitted because of polyuria polydipsia and fever. Bone marrow aspiration and biopsy revealed the diagnosis of acute erythroleukemia (AML, M6). On the water deprivation test, the diabetes insipidus was confirmed to be of the central type. He was managed with intranasal vasopressin for diabetes insipidus with good response. Induction chemotherapy was administered without response, and the patient died of septicemia and respiratory failure 2 months after initial diagnosis. A short review of the literature related to this subject is also presented.

소장내용물의 위내역류 및 위내용물 배출시간에 관한 연구

김진호,박승철,이형호,안일민,박영태,김열흥,이창흥 대한내과학회 1986 대한내과학회지 Vol.30 No.2

Radionuclide enterogastric scintigraphy was done with (99m)Tc-DISIDA and (111)In-DTPA in 35cases; control group 5, gastric ulcer group 6, subtotal gastrectomy with Billroth g group 5, and functional gastrointestinal disorder group with or without grossly mixed bile in the gastric juice 19 cases. The results were: 1) Enterogastric reflux was very significantly increased in the subtotal gastrectomy with Billroth II group (p$lt;0, 001), 2) Gastric emptying was significantly delayed in the functional gastrointestinal disorder groups with or without grossly mixed bile (p$lt;0.05, p$lt;0. 001). 3) Enterogastric reflux was not significantly increased in the gastric ulcer group. 4) Enterogastric reflux was not significantly different between the functional gastrointestinal groups with or without grossly mixed bile in the gastric juice. 5) Inverse correlation between the gastric emptying indices and the enterogastric reflux indices was not proved (r=-0.37).

크롬 피콜린산 또는 카르니틴이 첨가된 사료급여가 비육돈의 성장 및 도체특성에 미치는 영향

김지훈,한인규,김대성,배극환,양종석,손현수,현영 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.5

본 시험은 여러 가지 광물질과 혼합된 크롬 피콜린산이나 카르니틴을 첨가한 사료의 급여가 비육돈의 성장 및 도체특성에 미치는 영향을 조사하기 위하여 실시되었다. 평균체중 60.69±1.11 kg인 삼원교잡종 (Yorkshire×Landrace×Duroc) 비육돈 암수 180마리를 대조구, CFC{CrP + Fe₂O₃ + CaCO₃}, CFZC{CrP + Fe₂O₃ + ZnO + CaCO₃}, CZC-1 {CrP (1/300) + ZnO(9/300) + CaCO₃(290/300)}, CZC-2(CrP(1/300) + ZnO(14/300) + CaCO₃ (285/300)} 그리고 카르니틴구 등 6처리구에 성별로 배치하였다. 크롬 피콜린산이나 카르니틴에 의한 성장개선은 발견되지 않았다. 수퇘지에 있어서는 CFZC 처리구가 CZC-2 처리구보다 유의적으로 사료효율이 좋았다 (p<0.05). 도체특성에 있어서도 전체적으로 처리구간의 유의적인 차이는 발견되지 않았으나, 수퇘지에서는 CFZC 처리구가 대조구에 비해 등지방두께가 않았고 (p<0.05), 가장 좋은 도체등급은 CZC-2 처리구에서 나타났다. A study was conducted to investigate the effect of feeding diets containing chromium picolinate (CrP) or carnitine on growth and carcass characteristics in finishing pigs. A total of 180 cross bred pigs (Yorkshire x Landrace x Duroc; initial body weight of 60.7±1.1 kg) were assigned to 6 treatments : Control, CFC{CrP + Fe₂O₃ + CaCO₃}, CFZC{CrP + Fe₂O₃ + ZnO + CaCO₃}, CZC-1 {CrP (1/300) + ZnO(9/300) + CaCO₃(290/300)}, CZC-2(CrP(1/300) + ZnO(14/300) + CaCO₃ (285/300)} and camitine. No significant improvement was found in average daily gain (ADG), average daily feed intake (ADFI), and feed/gain ratio (F/G) by feeding diets containing chromium picolinate. The feed efficiency of male pigs fed with CFZC was better than pigs fed CZC-2 diet during the entire period (p<0.05). No differences were found in carcass characteristics between treatments expect that backfat thickness was reduced in male pigs fed the CFZC diet compared to the control (p<0.05). The best carcass grade was found in pigs fed CZC-2 the diet.

중등도 및 중증고혈압에서 Nifedipine 설하투여의 강압효과에 관한 연구

김영훈,서순규,최인석,김열홍,안희권,심완주,노영무 대한내과학회 1986 대한내과학회지 Vol.31 No.5

In order to assess the efficacy of sublingual nifedipine in the acute treatment of moderate to severe hypertension, a single blind test was done in 30 patients, 10 males and 20 females, aged 40 to 76 years, with moderate to severe hypertension. The patients with mean sitting blood pressure(BP) of more than J40 mmHg received sublingual placebo, and BP and pulse rate(PR) were measured in sitting position 10,20 and 30 minutes after the sublingual placebo was given. The patients with post-placebo 30 minutes sitting mean BP of less than 13pmmHg were excluded from the study. The placebo treatment period was followed by the administration of 10mg of sublingual nifedipine, and BP and PR were measured 10,20,30 and 45 minutes after nifedipine was given. BP decreased with placebo treatment(p$lt;0. 01 by paired t-test, preplacebo vs. post-placebo 30 minutes). With sublingual nifedipine BP started to fall in 10 minutes and reached the lowest levels in 30 or 45 minu1es. The systolic BP decreased from 198.0±21.4mmHg to 159±20.4mmHg, diastolic BP from 122.5±13.0 mmHg to 103.2±14.4 mmHg and mean from 147.7±13.4 mmHg to 121.7±14.8 mmHg 45minutes after nifedipine(p$lt;0.01 by paired t-test). The average fall in systolic BP/diastolic BP/mean BP 45 minutes after nifedipine was 39/19/26 mmHg(p$lt;0. 001, by paired t-test). The maximal fall in systolic BP correlated better with pretreatment value(r=0.42) than the maximal fall in diastolic pressure(r=0.21), PR increased from 79±12 to 87±11/minute with nifedipine(p$lt;0.001, by paired t-test). Side effects were mild facial flushing(16.7%) and palpitation (3.3%). The findings suggest that a dose of 10mg of sublingual nifedipine is a simple, effective and safe method for the acute treatment of moderate to severe hypertension and can be used as a non-injecting alternative agent for the treatment of hypertensive emergency.

가토에서 CCNU 로 유발된 골수 저형성증의 혈액학적 소견과 골수스캔의 변화에 관한 연구

김승택,이명철,최두혁,고창순,김병국,이문호,박선양,최성재,김노경,최영희 대한내과학회 1986 대한내과학회지 Vol.30 No.1

To understand systematically the hematological changes including the bone marrow changes in chemotherapeutic agent-induced bone marrow hypoplasia and to define the relationship between hematological and bone marrow scan findings and prognosis of the hypoplasia, CCNU (lomustine) was given orally to 44 rabbits to induce hypoplasia of the bone marrow. And serial changes of peripheral blood and bone marrow findings and (111)In Cl(3)((111)In scan)/(99m)Tc tin colloid bone marrow scan((99m)Tc scan) were checked before and after induction of hypoplasia. With assessment of 28 evaluable rabbits, the following results were obtained: 1) Significant hypoplasia of the bone marrow developed around day 4 of CCNU administration and recovered around day 14(cellularity 51,4±13.5% and 24. 5±14.97o before and after CCNU respectively, p<005). Megakaryocyte count was significantly depressed from 95.67,26% to 36.7$gt;31.82%(P$lt;0.005). M: E ratio was decreased from 162±1.19 to 0, 0.5$lt;0. 43(p±0.005). Shift to left(475), maturation a(40%), naked nucleus and degenerated cells(20%), increase of lymphocytes(47%), monocytes and reticulum cells were also found. 2) The uptake ratio of the 99(m)Tc tin colloid bone marrow scan was markedly increased in contrast to the depression of the bone marrow(4.4±2.12 and 14.1±7.06 before and 4 days after CCNU, respectively, p40. 005). Tc scan uptake ratio was inversely related to the cellularity(r=-0.442, p$lt;0.05) and megakaryocyte number of the bone marrow(r= 0.89, p< 0.01) and peripheral blood granulocyte (r = 0. 54. Pg0.01) and platelet count(r=0.40, p$lt;0.05). There was not significant correlation between (111)In scan uptake ratio and hematologic parameters. 3) The amplitude of the change of the (99m)Tc scan uptake ratio was significantly related to the prognosis of the rabbits with experimentally induced hypoplasia of the bone marrow(dead 5.1±2,67, survivors 2,5±0.96, P<0.01). The change of the (111)In scan uptake ratio was not related to the prognosis of these rabbits. In experimentally induced rrow hypoplasia, morphologic changes in addition to the numerical changes of the bone marrow elements were observed. And serial (99)Tc scan of the bone marrow appears to be helpful assessing the severity and predicting the outcome of bone marrow hypoplasia.