김호중 교수

A rare case of bilateral renal cortical necrosis (BRCN) diagnosed only by the characteristic and specific findings of a contrast-enhanced CT scan during the acute initial phase of the disease is presented in this paper. Furthermore, twenty-eight patients of BRCN in the world literatures in English after 1980 were analyzed to investigate the changes in its clinical features over the past 15 years in comparison with the reported data before 1980 from two large centers in France (F) and India (I).

The thromboembolic complications of nephrotic syndrome are reasonably common, including spontaneous peripheral venous and/or arterial, pulmonary arterial, and renal venous occlusions. However, in comparison to the relatively high incidence of the venous thromboembolic complications with hypercoagulable status, arterial thromboses have been reported much less and it was only 20 cases in the English literature so far. Furthermore, the most cases were pediatric patients rather than adults. Therefor

Following the acute diarrhea in patients (n = 24) overnight with commonly used laxatives for bowel preparation, the changes in electrolytes and acid-base balance in blood and urine were investigated. Though no alterations of serum sodium or potassium concentrations were noted, mild but significant reduction of mean values (+/- SEM) of plasma pH and HCO3 after diarrhea when compared to those before it developed (pH, from 7.42 +/- 0.01 to 7.39 +/- 0.01, p < 0.01; HCO3, from 25.8 +/- 0.6 to 23.7 +/

We report a case of patient with documented SLE who displayed dysuria, gastrointestinal (GI) symptoms and renal insufficiency associated with the unusual occurrence of bilateral hydroureteronephrosis due to urterovesical junction stricture (obstructive uropathy). Pathologic investigations disclosed chronic interstitial cystitis (IC) with evidence of focal immune complex deposition in the blood vessel walls of the bladder. The GI symptoms and dysuria regressed with initial therapy for SLE with st

Ultrasound-guided cannulation of a large-bore catheter into the internal jugular vein was performed to provide temporary hemodialysis vascular access for uremia in a 65-yr-old woman with acute renal failure and sepsis superimposed on chronic renal failure. Despite the absence of any clinical evidence such as bleeding or hematoma during the procedure,a chest x-ray and computed tomographic angiogram of the neck showed that the catheter had inadvertently been inserted into the subclavian artery. Wi

Arterial thrombosis is relatively rare compared with venous thrombosis in nephrotic syndrome. However, the assessment of its pathogenesis and risk factors in indi-vidual patient with nephrotic syndrome is necessary to allow appropriate prophylactic management because it is a potentially serious problem. Hereby, with review of the literature, we report a case of a 53 yr-old man with cerebral infarction associated with nephrotic syndrome due to focal segmental glomerulosclerosis during the course

Background: The aim of this multicenter study was to evaluate the safety and efficacy of tolvaptan (TLV) in Korean patients with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Methods: Of 51 enrolled patients with SIADH, 39 patients (16 female patients, aged 70.8 ± 11.3 years) were included in an intention to treat analysis. All patients received 15 mg/day as the initial dose, and the dose was then increased up to 60 mg/day (as needed) until day 4. Results: Serum sodium

This study was aimed at investigating the mechanisms of clinically important overt hyperkalemia in diabetes mellitus with underlying hyporeninemic hypoaldosteronism known as a classic model of the syndrome of hyporeninemic hypoaldosteronism (SHH). Rats (Sprague-Dawley, male) were streptozotocin-treated (60 mg/kg, ip) and used after 60 days. Rats with plasma glucose levels higher than 300 mg/dL (mean +/- SEM, 423 +/- 20 mg/dL, n = 8) were selected as the diabetic group. Age-matched normal rats se

The osmotic demyelination syndrome (ODS) is a distinctive clinical entity with characteristic MR features in the central pons (central pontine myelinolysis, CPM) and other locations (extrapotine myelinolysis, EPM). ODS is mainly seen following rapid correction of the serum sodium level in hyponatremic patients. In the past, ODS used to be considered as fatal. However, some recent reports have described cases of survival from this syndrome, but most survivors seem to suffer irreversible neurologi

Purpose:The purpose of this study was to look for possible changes from typical clinical features of 5 sequential clinical phases described in 1950s. Methods:The clinical features and laboratory data of hemorrhagic fever with renal syndrome (HFRS) with acute renal failure (ARF) and its subdivided 2 groups of correct and incorrect impression of HFRS on admission before the serological confirmation were reevaluated in 35 patients admitted at a single tertiary center from 1995 to 2000. Results:We e

후복막 섬유증이란 후복막강 내 결체 조직의 섬유성 증식 질환으로 1905년 Alberran 등이 처음 보고하였고, 국내에서는 1967년 박1)에 의해 처음 보고된 이후 현재까지 20예 미만으로 보고되었다. 과반수에서 원인을 규명할 수 없는 특발성으로 생각되었던 경우가 최근에는 대동맥 등의 죽상판으로부터 외부로 누출된 불용성 인지질에 대한 자가 면역성의 혈관염으로 인식되고 있다2). 이차 원인으로는 ergot의 유도체 (methysergide) 투여, 감염, 대동맥류, 후복막 출혈, 신장, 요관 손상과 소변의 누출 등이 있다3). 요관, 복부 대동맥의 압박 및 폐쇄를 유발하며 폐쇄성 요로질환, 고혈압, 복통 또는 발열과 부종을 일으킬 수 있어 급격한 신손상 또는 불가역적 신손상을 막기 위해 조기 진단과 요로 확보가 무엇보다 중요하다. 과거에는 수술적 처치가 주요한 치료 방법이었으나 현재는 스테로이드를 포함한 면역억제 요법 등의 약물 치료가 증가되고 있다. 저자들은 급성 신부전으로 발현

Background Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Secondary amyloidosis can occur as a complication of chronic systemic inflammatory and infectious diseases. Until now there has been no report of secondary amyloidosis associated with MS. We report herein a case of renal biopsy-proven secondary amyloidosis in a patient with MS. Case Report A 41-year-old woman with MS was hospitalized due to aggravated quadriparesis and edema in both lower extremities. La

전신적 혈관염은 침범된 혈관크기에 따라 세분되고 소혈관혈관염 중 ANCA와 관련된 혈관염은 웨게너 증후군, 현미경적다발혈관염, 쳐그 스트라우스 증후군, 약제 유발성 혈관염 등이 있다. ANCA 양성 혈관염의 신장 침범은 대개 초점성 괴사, 초승달 형성과 면역복합체의 침착이 없거나 매우 적은 사구체 신염으로 나타난다. 갑상선기능항진증 치료 약제인 프로필티오유라실 (Propylthiouracil, PTU)에 의해 유발된 p-ANCA 양성 혈관염은 1992년 Stankus 등1)이 급성 호흡부전을 동반한 전신적 혈관염을 보고한 이후 특히 일본을 중심으로 최근 여러 예가 보고되고 있다. 국내에서는 1996년 이 등2)이 PTU 투여 정지와 스테로이드 충격요법 후에도 요독증이 진행하여 혈액투석을 시행한 1예와 1999년 이 등3)이 프레드니솔론 투여 후 호전된 1예를 보고하였다.

당뇨병성 근육 경색증은 당뇨병의 드문 합병증으로 대부분 당뇨병의 표적 장기 침범이 있는 환자에게서 주로 발생한다. 전형적으로 대퇴부의 급작스런 통증과 부종을 호소하고, 진찰 소견에서 압통과 열감이 있는 등 임상양상이 감염성 질환 등과 비슷하므로 이와의 감별이 필요하다. 특히, 만성 신부전 환자들은 여러 가지 감염성 질환 및 많은 합병증을 경험하게 되므로 이 질환을 인지하는 것은 비슷한 임상양상을 보이는 환자들에 있어서 올바른 진단 및 치료에 중요하다. 저자들은 혈액투석 치료 중이던 44세 여자에서 당뇨병성 근육 경색증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic