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영남대학교 의과대학> 영남의대학술지> 증례 : 애디슨병 환자에게 리팜핀 투여 후 발생한 급성 부신피질기능 저하증 1예

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증례 : 애디슨병 환자에게 리팜핀 투여 후 발생한 급성 부신피질기능 저하증 1예

Case Reports : A Case of Rifampin-Induced Recurrent Adrenal Insufficiency During the Treatment of Pulmonary Tuberculosis in a Patient with Addison`s Disease

강종식 ( Jong Sik Kang ) , 고광범 ( Gwang Beom Ko ) , 이재준 ( Jae June Lee ) , 전성진 ( Min Soo Kim ) , 김민수 ( Sung Jin Jeon ) , 최광현 ( Gwang Hyeon Choi ) , 김선목 ( Sun Mok Kim ) , 이우제 ( Woo Je Lee )
  • : 영남대학교 의과대학
  • : 영남의대학술지 29권1호
  • : 연속간행물
  • : 2012년 06월
  • : 19-23(5pages)
피인용수 : 16건

(자료제공: 네이버학술정보)

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Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Further- more, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treat- ment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison`s disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

UCI(KEPA)

I410-ECN-0102-2012-510-003094631

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  • : 2384-0293
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  • : 연속간행물
  • : 1984-2020
  • : 1452


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1종설 : 폐렴구균백신의 효과

저자 : 박호선 ( Ho Sun Park )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 1-8 (8 pages)

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Streptococcus pneumonia is a very important pathogen for children and elderly people. Two types of pneum- ococcal vaccines are available in the market: pneumococcal polysaccharide vaccine (PPSV) and pneumo- coccal conjugate vaccine (PCV). PPSVs have been used for more than 30 years, and PCVs for about 10 years. There have been many reports concerning the evaluation of the vaccines` efficacies in preventing pneumo- coccal diseases such as meningitis, pneumonia, and otitis media and bacteremia, but the clinical trials had been performed with different conditions, such as diverse vaccine valencies, age groups, races, target out- comes, immunological cut-off values, and follow-up periods. PPSV is recommended for elderly people and chronic disease patients such as asthma, diabetes mellitus, chronic renal failure, and hyposplenic patients. According to the data from several systemic reviews and population-based surveillances, PPSV is effective for pneumococcal pneumonia and vaccine-type bacteremia among healthy adults. Until now, however, there is insufficient evidence of the effectiveness of PPSV among high-risk adults. PCV is very effective in preventing vaccine-type invasive pneumococcal disease (IPD) among children, but its efficacy for pneumonia is very low among children. The incidence of vaccine-related or non-vaccine-type IPDs is increasing after the introduction of 7-valent PCV (PCV7) as a routine immunization for children. Recently, 10- and 13-valent PCVs have been used for children, instead of PCV7. Therefore, continuous surveillance for serotype change among pneumococcal diseases is necessary to evaluate the vaccines` efficacy.

2종설 : 폐절제술을 시행받은 환자의 수술 전후 관리

저자 : 이장훈 ( Jang Hoon Lee )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 9-13 (5 pages)

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Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Periopera- tive management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

3원저 : 나선식 CT를 이용한 혐색소형 신세포암과 투명세포형 신세포암의 감별

저자 : 김홍철 ( Hong Chul Kim ) , 조재호 ( Jae Ho Cho )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 14-18 (5 pages)

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Background: The purpose of this study was to differentiate chromophobe renal cell carcinoma and clear cell renal cell carcinoma on helical CT. Methods: The CT images of 9 patients histopathologically proven to have chromophobe renal cell carcinoma and 20 patients with clear cell renal cell carcinoma were reviewed. The tumor sizes, margins, enhancement degrees and patterns, presence or absence of calcification, and tumor spread patterns (including perinephric changes, venous invasion, lymphadenopathy, and distant metastasis) were compared. Results: All the chromophobe renal cell carcinomas showed well-demarcated margins. Thechromophobe renal cell carcinomas showed milder enhancements than the clear cell renal cell carcinomas. The sensitivity and specificity for differentiating the chromophobe renal cell carcinoma from the clear cell renal cell carcinoma were 100 and 88%, respectively, when 101 Hounsfield units was used as the cut-off value in the corticomedullary phase, and 95 and 100% when a less-than-three-time enhancement change was used as a cut-off value in the corticomedullary phase (p<0.05). The chromophobe renal cell carcinomas (67%) tended to show a homogeneous enhancement whereas the clear cell renal cell carcinomas (85%) usually showed a heteroge- neous enhancement (p<0.05). Statistical analysis revealed that the frequencies of the tumor spread pattern and calcification in the two subtypes didnot differ significantly (p>0.05). Conclusion: The CT findings of the chromophobe renal cell carcinomascompared to those of the clear cell renal cell carcinomas showed that there were mild enhancements in the corticomedullary phase, homoge- neous enhancements, and well-demarcated margins.

4증례 : 애디슨병 환자에게 리팜핀 투여 후 발생한 급성 부신피질기능 저하증 1예

저자 : 강종식 ( Jong Sik Kang ) , 고광범 ( Gwang Beom Ko ) , 이재준 ( Jae June Lee ) , 전성진 ( Min Soo Kim ) , 김민수 ( Sung Jin Jeon ) , 최광현 ( Gwang Hyeon Choi ) , 김선목 ( Sun Mok Kim ) , 이우제 ( Woo Je Lee )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 19-23 (5 pages)

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(기관인증 필요)

초록보기

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Further- more, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treat- ment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison`s disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

5Case Reports : A Case of Ruptured Mycotic Hepatic Artery Aneurysm Successfully Treated Using Arterial Embolization

저자 : Gi Ae Kim , Han Chu Lee , Young Joo Jin , Jee Eun Yang , Min Jung Lee , Ji Hyun Park , Bo Young Lee

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 24-27 (4 pages)

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Mycotic hepatic artery aneurysms (HAAs) have become very rare due to antibiotics. Untreated, they have a high possibility of rupture and mortality. In this paper, on the case of a 67-year-old male who had severe right-upper- quadrant abdominal pain and a history of infective endocarditis is reported. The computed tomography (CT) and arterial angiography findings led to a diagnosis of a ruptured mycotic HAA. The CT showed an HAA and the formation of an intrahepatic hematoma caused by aneurysmal rupture. The arterial angiography showed a mycotic HAA that arose from the right posterior hepatic artery. Percutaneous transcatheter arterial embolization was used to success- fully treat the HAA. Since then, the patient has been doing well, without symptoms.

6증례 : 횡문근융해증과 경한 신손상을 동반한 급성 A형 간염 1예

저자 : 조규민 ( Gu Min Cho ) , 김창욱 ( Chang Wook Kim ) , 성현진 ( Hyeonjin Seong ) , 허준 ( Joon Hur ) , 전부석 ( Bu Seok Jeon ) , 이종환 ( Jonghwan Lee ) , 심은희 ( Eun Hui Sim ) , 이석종 ( Seok Jong Lee ) , 이창돈 ( Chang Don Lee )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 28-30 (3 pages)

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A 48-year-old male visited the emergency room of the authors` hospital due to nausea, vomiting, and myalgia for four days. Acute hepatitis A was identified from the serologic marker of the hepatitis A virus. Mild elevation of the serum creatinine and creatinine phosphokinase (CPK) suggested rhabomyolysis, which was confirmed with the serum aldolase, myoglobin, and urine myoglobin. With supportive care, both the liver and renal func- tions were recovered gradually and fully. This case shows that rhabdomyolysis can be one of the mechanisms of renal complication in cases of acute symptomatic hepatitis A.

7Case Reports : Contralateral Tension Pneumothorax during One Lung Ventilation by a Univent(R) Tube

저자 : Min Young No , Sung Ha Moon , Hyun Soo Kim

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 31-34 (4 pages)

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Tension pneumothorax during one-lung ventilation (OLV) is a rare but life-threatening complication. A 79-year-old male patient who was diagnosed with lung cancer underwent Univent(R) Tube (Fuji Systems Corporation, Tokyo) intubation for left upper lobectomy. Two hours after the initiation of OLV, the patient could not tolerate it. Thus, one- and two-lung ventilation were alternatively applied to continue the operation. After the operation, an emergent chest radiograph was taken, and pneumothorax was found at the right (dependent) lung field.

8Case Reports : A Case of Traumatic Bilateral Adrenal Hemorrhage Mimicking Bilateral Adrenal Adenomas

저자 : Min Jung Lee , Gi Ae Kim , Jung Eun Jang , Hyo In Choi , Seo Hyun Lee , Gwang Beom Koh , Ga Hee Kim , Min Seon Kim

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 35-37 (3 pages)

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Adrenal hemorrhages caused by blunt abdominal trauma have been frequently reported, and most of the lesions are unilateral. In contrast, bilateral hemorrhage of the adrenal glands after trauma rarely occurs in subjects with predisposing conditions such as coagulopathy, thromboembolism, and sepsis. Furthermore, bilateral hemorrhage of the adrenal glands is potentially fatal by inducing acute adrenal insufficiency. Here,a case of a 40-year-old man who developed traumatic bilateral adrenal hemorrhage after a car accident, without any predisposing condition, is reported. The spontaneous shrinkage of the bilateral lesions revealed in the follow-up abdominal computed tomography (CT) scansupported the aforementioned diagnosis. Fortunately, the patient had no clinical or biochemical evidence suggesting acute adrenal insufficiency. To these authors` knowledge, this is the first South Korean report of traumatic bilateral adrenal hemorrhage in a subject with no predisposing factors.

9Case Reports : Superior Vena Cava Syndrome Without Thrombosis Found in Behcet`s Disease

저자 : Hyun Soo Kim , Hyung Jun Kim , Ki Hwan Hur , Kyung Rok Kim , Jae Won Choi , Dong Woo Kang

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 38-41 (4 pages)

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Behcet`s disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet`s disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a three- day history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

10증례 : 두개 내를 침범한 형질세포골수종 1예

저자 : 이수현 ( Su Hyun Lee ) , 정윤영 ( Yoon Yung Chung ) , 임예지 ( Ye Jee Lim ) , 고선영 ( Sun Young Ko ) , 최유아 ( Yoo A Choi ) , 김영운 ( Young Woon Kim ) , 이성은 ( Sung Eun Lee ) , 박종원 ( Chong Won Park )

발행기관 : 영남대학교 의과대학 간행물 : 영남의대학술지 29권 1호 발행 연도 : 2012 페이지 : pp. 42-44 (3 pages)

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Plasma cell myelomas generally manifest as bone or soft-tissue tumors with variable mass effects, pain, and infiltrative behavior. Extramedullary involvement occurs most commonly in the spleen, liver, lymph nodes, and kidneys, but intracranial involvement in plasma cell myeloma is a rare extramedullary manifestation. These authors recently encountered a case of intracranial involvement of plasma cell myeloma. A 69-year-old man was hospitalized for headache and mental changes. Brain CT showed subdural hemorrhage caused by plasma cell myeloma. Plasma cell myeloma with intracranial involvement has poor prognosis, and the patient in this case died from acute complications, such as subdural hemorrhage. Based on this case report, it is suggested that more effective treatment regimens of plasma cell myeloma with intracranial involvement be developed. Moreover, a screening method and decision on the appropriate time for intracranial involvement are needed for plasma cell myeloma patients.

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