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자발성 비장 파열이 발생한 혈액투석 환자에서 보존요법 치험
유숙희 ( Suk Hee Yoo ),박재근 ( Jae Geun Park ),김성무 ( Sung Moo Kim ),김정은 ( Jeong Eun Kim ),권순길 ( Soon Kil Kwon ),배장환 ( Jang Whan Bae ),김혜영 ( Hye Young Kim ),정진욱 ( Jin Uk Jeong ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3
Spontaneous splenic rupture is a rare disease but can cause a life threatening situation. It can occur under a pathological spleen such as infection, neoplastic, infiltrative and inflammatory disease. Although splenectomy is the treatment of choice for splenic rupture, it is uncertain that the effectiveness of non- surgical treatment in the hemodynamically stable patient. We report a case of a 66-year-old male undergoing hemodialysis for 4 years who presented to the emergency department with abdominal pain and distention. Blood pressure was 130/80 mmHg, heart rate was 108 bpm. White blood cell count was 7,130/mm3, hemoglobin was 6.7 g/dL, platelet was 156,000/mm3. PT INR was elevated up to 2.01 because he had taken warfarin due to splenic infarction. Abdominal CT scan revealed hemoperitoneum due to splenic rupture. We performed angiography but there was no active bleeding. We decided conservative management without embolization because of stable condition and increased bleeding risk in operation. He received 6 pints of packed red blood cell transfusion during continuous renal replacement therapy for 24 hours on ICU. He was discharged with complete recovery on the 21st hospital day. We suggest that non-surgical treatment in splenic rupture also could be considered in hemodynamically stable patients with a high risk of postoperative complication.
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김성무 ( Sung Moo Kim ),유숙희 ( Suk Hee Yoo ),김미경 ( Mi Kyeong Kim ) 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.2
Food-dependent exercise-induced anaphylaxis (FDEIA) is a kind of exercise-induced anaphylaxis, which is characterized by anaphylactic symptoms only after eating certain foods. In Korean patients, wheat flour, apple, parsley, and crown daisy have been reported as causative foods. We report the case of an 18-year-old male with squash-dependent, exercise-induced anaphylaxis. The patient had urticaria, angioedema and chest discomfort during walking after taking roasted pork belly, green onion, lettuce, sesame leaf, mushroom and squash. He had also experienced the same event 4 months before this presentation. Skin prick test showed a strong positive reaction only to squash. Exercise provocation test turned out to be a negative result. However, exercise provocation test performed 30 minutes after ingestion of boiled squash resulted in hives with itching. Even though exercise provocation test performed just after ingestion of squash did not show any typical anaphylaxis reactions, this patient can be diagnosed with squash-dependent, exercise-induced anaphylaxis, based on his typical medical history and development of urticaria after the provocation test. (Korean J Asthma Allergy Clin Immunol 2011;31:140-143)
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성문혁 ( Mun Hyuk Seong ),김성무 ( Sung Moo Kim ),유숙희 ( Suk Hee Yoo ),박우리 ( Woo Ri Park ),안진영 ( Jin Young An ),최강현 ( Kang Hyeon Choe ),이기만 ( Ki Man Lee ),김시욱 ( Si Wook Kim ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.3
Cholethorax is a bilious pleural effusion caused by a pleurobiliary fistula or leakage of bile into the pleural space. Most cases of cholethorax arise from a complication of abdominal trauma, hepatobiliary infection, or invasive procedures or surgery of hepatobiliary system. However, we experienced a case of a patient with cholethorax of unknown origin. There was no evidence of pleurobiliary fistula or leakage of bile from the hepatobiliary system although we examined the patient with various diagnostic tools including chest and abdominal computed tomography, endoscopic retrograde cholangiopancreatography, tubography, bronchofiberscopy, hepatobiliary scintigraphy and video-assisted thoracoscopic surgery. Herein we report a case of cholethorax for which the specific cause was not identified. The patient was improved by percutaneous drainage of pleural bile.
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흰쥐 결장운동에서 Neurotensin의 수축작용과 자율신경계의 영향
지정훈 ( Jeong Hoon Ji ),김성무 ( Sung Moo Kim ),서의근 ( Euikeun Seo ),조영심 ( Young Shim Cho ),유숙희 ( Suk Hee Yoo ),한정호 ( Joung Ho Han ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Background/Aims: Although neurotensin (NT) stimulates colon motility and the passage of intestinal contents, the associated mechanism of action remains unclear. The objective of this study was to investigate the effects of NT on colon motility using isolated rat colon. Methods: Intraluminal pressure was measured at both the proximal and distal portions of the isolated colon. An isolated rat colon was perfused with Krebs solution via the superior mesenteric artery. After stabilization, NT was administered in concentrations of 14, 28, 138 and 276 pM. After pretreatment with phentolamine, propranolol, hexamethonium, atropine or tetrodotoxin, NT was administered at a concentration of 276 pM, and then the intraluminal pressure was monitored. Results: NT significantly increased colon motility at concentrations of 14, 28, 138, and 276 in the proximal colon (25.1±6.5%, 175.4±117.0%, 240.8±115.1% and 252.3±110.6%, respectively) and in the distal colon (35.6±11.8%, 97.5±35.1%, 132.7±36.7% and 212.1±75.2%, respectively). The stimulant effect of NT was more potent in the proximal colon, in a concentration-dependent manner (P<0.05). The stimulant effect of NT was significantly inhibited by atropine at both the proximal and distal colon and by tetrodotoxin at the proximal colon, but not by tetrodotoxin at the distal colon and not by propranolol, phentolamine, or hexamethonium at both the proximal and distal colon. Conclusions: NT increased colon motility at both the proximal and distal portions of the rat colon. The effects were more prominent at the proximal portion. The results of this study suggest that the stimulant action of NT may be mediated by local cholinergic muscarinic receptors. (Intest Res 2010;8:162-171)
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