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현일식,이창범,박용수,김동선,최웅환,김태화,안유헌 대한내분비학회 2005 Endocrinology and metabolism Vol.20 No.4
There have been a few reports on rhabdomyolysis caused by thyroid storm, but no cases of thyrotoxicosis related rhabdomyolysis have been reported until now. Here, a rare case of rhabdomyolysis, accompanied by thyrotoxicosis, is reported. A 21-year-old man was admitted to our hospital with severe pain and weakness in both legs. The initial laboratory findings revealed a high muscle enzyme level and severe hypokalemia. In evaluation of the rhabdomyolysis, the thyroid function test was compatible with that of Graves' disease, with the rhabdomyolysis subsequently diagnosed, presenting as thyrotoxicosis. The possible mechanisms for this complaint were hypokalemia-induced muscle ischemia, a thyrotoxicosis-induced excessive hypermetabolic state and pressure-induced muscle ischemia. Therefore, the work up for the cause of rhabdomyolysis should include thyrotoxicosis. The management of rhabdomyolysis is hydration, prevention of acute renal failure, correction of aggravating factors and treatment of the underlying cause, for example, thyrotoxicosis 횡문근 융해증이 발생하면 갑상선 중독증을 반드시 감별진단에 포함시켜야 하며 또한 저칼륨혈증 주기적 마비 동반 여부를 살펴야 한다. 특히 갑상선 기능항진증에서 주기적 마비가 횡문근 융해증과 동반되면 응급이므로 신속한 진단과 함께 유발인자 규명, 급성 신부전의 예방, 빠른 갑상선 기능의 회복이 필요하다.
현일식,한동수,배중호,박혜선,은창수 대한의학회 2013 Journal of Korean medical science Vol.28 No.5
Accurate diagnosis of gastric intestinal metaplasia is important; however, conventional endoscopy is known to be an unreliable modality for diagnosing gastric intestinal metaplasia (IM). The aims of the study were to evaluate the interobserver variation in diagnosing IM by high-definition (HD) endoscopy and the diagnostic accuracy of this modality for IM among experienced and inexperienced endoscopists. Selected 50 cases,taken with HD endoscopy, were sent for a diagnostic inquiry of gastric IM through visual inspection to five experienced and five inexperienced endoscopists. The interobserver agreement between endoscopists was evaluated to verify the diagnostic reliability of HD endoscopy in diagnosing IM, and the diagnostic accuracy, sensitivity, and specificity were evaluated for validity of HD endoscopy in diagnosing IM. Interobserver agreement among the experienced endoscopists was “poor” (κ = 0.38) and it was also “poor’’ (κ = 0.33)among the inexperienced endoscopists. The diagnostic accuracy of the experienced endoscopists was superior to that of the inexperienced endoscopists (P = 0.003). Since diagnosis through visual inspection is unreliable in the diagnosis of IM, all suspicious areas for gastric IM should be considered to be biopsied. Furthermore, endoscopic experience and education are needed to raise the diagnostic accuracy of gastric IM.
현일식 ( Hyeon Il Sig ),조경란 ( Jo Gyeong Lan ),백상현 ( Baeg Sang Hyeon ),김진배 ( Kim Jin Bae ),최호순 ( Choe Ho Sun ),이오영 ( Lee O Yeong ),한동수 ( Han Dong Su ),손주현 ( Son Ju Hyeon ),함준수 ( Ham Jun Su ),이민호 ( Lee Min 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-
원발성 간세포암종은 간 외로 전이하는 경우가 드문 암이다. 전이가 있는 경우 주로 폐, 복부 임파선, 뼈, 뇌 순으로 전이된다. 그러나, 전이성인 경우라도, 간 종물 없이 전이 병변만 발견된 경우는 보고된 바가 없었다. 이에 간 종물 없이 흉벽에서만 발견된 전이성 간세포암종을 경험하였기에 보고하는 바이다. 51세 남자로, 좌상부 흉벽에 약 12×10㎝ 크기로 단단한 종물이 촉지되고 8개월 전부터 크기가 증가되어 내원하였다. 환자는 10년 전 만성 B형