Re:Re:Re:Re: gastric bypass수술후 비타민 B9,12, 구리결핍으로 인한 시신경 질환

<p><span style="font-size: 11pt;">beyond reason</span><br></p><p><span style="font-size: 11pt;"><br></span></p><h1 class="heading-title" style="box-sizing: inherit; font-size: 2.6rem; margin: 0px 0px 1.6rem; clear: both; font-family: Merriweather, Georgia, Cambria, "Times New Roman", Times, serif; line-height: 1.4; overflow-wrap: break-word;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Gastric Bypass Surgery 후에 비타민, 미네랄 흡수장애가 발생하는데 특히 비타민 b 9, 12 결핍. 구리결핍이 발생하고 ...  그 결과 시신경 손상, 시력장애가 이어서 발생한다는 논문...</span></h1><p><span style="font-size: 11pt;"></span><br></p><p style="text-align: center;"><img src="https://t1.daumcdn.net/cfile/cafe/99B29C4A5EF73E9905" class="txc-image" hspace="1" vspace="1" border="0" actualwidth="657" width="657" exif="{}" data-filename="스크린샷 2020-06-27 오후 9.41.29.png" style="clear:none;float:none;" id="A_99B29C4A5EF73E9905AD57"/></p><p><span style="font-size: 11pt;"><br></span></p><header class="heading" id="heading" style="box-sizing: inherit; margin: 0px 0px 3.6rem;"><div class="full-view" id="full-view-heading" style="box-sizing: inherit;"><h1 class="heading-title" style="box-sizing: inherit; font-size: 2.6rem; margin: 0px 0px 1.6rem; clear: both; font-family: Merriweather, Georgia, Cambria, "Times New Roman", Times, serif; line-height: 1.4; overflow-wrap: break-word;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Optic Neuropathy Associated With Copper Deficiency After Gastric Bypass Surgery</span></h1><div class="inline-authors" style="box-sizing: inherit; line-height: 1.5; color: rgb(91, 97, 107); margin-bottom: 1.2rem;"><div class="authors" style="box-sizing: inherit;"><div class="authors-list" style="box-sizing: inherit; display: inline; line-height: 1.5;"><span class="authors-list-item " style="box-sizing: inherit; display: inline;"><a class="full-name" href="https://pubmed.ncbi.nlm.nih.gov/?term=Shah+AR&cauthor_id=25372214" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Ankoor R Shah" style="box-sizing: inherit; background-color: transparent; color: rgb(0, 113, 188); display: inline;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Ankoor R Shah</span></a><span class="affiliation-links" style="box-sizing: inherit; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; top: -0.5em;"><span class="author-sup-separator" style="box-sizing: inherit; font-family: Batang, 바탕, serif; font-size: 11pt;"> </span><a class="affiliation-link" href="https://pubmed.ncbi.nlm.nih.gov/25372214/#affiliation-1" ref="linksrc=author_aff" style="box-sizing: inherit; background-color: rgb(241, 241, 241); color: rgb(50, 58, 69); font-size: inherit; display: inline-block; line-height: 1; padding: 0.1rem 0.3rem; border-radius: 2px; transition: color 0.3s ease 0s; margin-right: 0px;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">1</span></a></span><span class="comma" style="box-sizing: inherit; font-family: Batang, 바탕, serif; font-size: 11pt;">, </span></span><span class="authors-list-item " style="box-sizing: inherit; display: inline;"><a class="full-name" href="https://pubmed.ncbi.nlm.nih.gov/?term=Tamhankar+MA&cauthor_id=25372214" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Madhura A Tamhankar" style="box-sizing: inherit; background-color: transparent; color: rgb(0, 113, 188); display: inline;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Madhura A Tamhankar</span></a></span></div></div></div><div class="short-article-details" style="box-sizing: inherit; margin-bottom: 0.3rem;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Affiliations</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span><button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore="" style="box-sizing: inherit; color: rgb(50, 58, 69); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; font-size: 1.6rem; font-style: inherit; font-variant-caps: inherit; font-stretch: inherit; line-height: 2.4rem; margin-top: auto; overflow: visible; text-transform: lowercase; -webkit-appearance: none; cursor: pointer; -webkit-font-smoothing: antialiased; background-color: rgb(255, 255, 255); border-width: 0px; border-style: initial; border-radius: 3px; padding-right: 1rem; padding-left: 2.5rem; text-align: center; width: auto; transition: color 0.3s ease 0s, background-color 0.3s ease 0s; position: relative; height: 2.4rem;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">expand</span></button></div><ul class="identifiers" id="full-view-identifiers" style="box-sizing: inherit; margin-top: 0px; margin-right: 0px; margin-bottom: 0px; padding: 0px; line-height: 1.5; list-style: none;"><li style="box-sizing: inherit; line-height: 1.5; margin: 0px 1rem 0px 0px; display: inline-block; padding: 0px;"><span class="identifier pubmed" style="box-sizing: inherit;"><span class="id-label" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">PMID:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></span><span class="current-id" title="PubMed ID" style="box-sizing: inherit; color: rgb(33, 33, 33); font-family: Batang, 바탕, serif; font-size: 11pt;">25372214</span></span></li><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span><li style="box-sizing: inherit; line-height: 1.5; margin: 0px 1rem 0px 0px; display: inline-block; padding: 0px;"><span class="identifier doi" style="box-sizing: inherit;"><span class="id-label" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">DOI:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></span><a class="id-link" target="_blank" ref="linksrc=article_id_link&article_id=10.1097/ICB.0000000000000008&id_type=DOI" href="https://doi.org/10.1097/icb.0000000000000008" data-ga-category="full_text" data-ga-action="doi" style="box-sizing: inherit; background-color: transparent; color: rgb(0, 113, 188); font-size: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">10.1097/ICB.0000000000000008</span></a></span></li></ul></div></header><div class="abstract" id="abstract" style="box-sizing: inherit; margin: 3.6rem 0px 0px; word-break: break-word; position: relative;"><h2 class="title" style="box-sizing: inherit; clear: both; font-family: Merriweather, Georgia, Cambria, "Times New Roman", Times, serif; line-height: 2.4rem; margin-bottom: 1.2rem; margin-top: 3.6rem; font-size: 2rem;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Abstract</span></h2><div class="abstract-content selected" id="en-abstract" style="box-sizing: inherit; clear: left;"><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Purpose:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></strong><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Patients undergoing gastric bypass procedures are predisposed to many vitamin and mineral deficiencies including copper, which can lead to optic neuropathy.</span></p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Methods:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></strong><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">A 35-year-old woman complained of progressive vision loss bilaterally 3 years after gastric bypass surgery (GBS).</span></p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Results:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></strong><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Ophthalmic examination revealed the presence of subnormal visual acuity and pale optic nerves bilaterally. Laboratory testing showed copper deficiency. Complete improvement in vision was noted after copper was replenished.</span></p><p style="box-sizing: inherit; line-height: 1.5; margin-top: 1.2rem; margin-bottom: 1.2rem;"><strong class="sub-title" style="box-sizing: inherit;"><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Conclusion:</span><span class="Apple-converted-space" style="font-family: Batang, 바탕, serif; font-size: 11pt;"> </span></strong><span style="font-family: Batang, 바탕, serif; font-size: 11pt;">Nutritional deficiencies occurring after gastric bypass procedures are well reported. They happen and occur due to reduced gastric and enteral absorption and cause many systemic and neurologic manifestations. <b><span style="color: rgb(255, 0, 0);">Optic neuropathy occurring after GBS is often due to vitamin B12 and folic acid deficiency. Copper deficiency causing systemic symptoms is very rare and usually takes decades to manifes</span></b>t. Our case is unique in that copper deficiency was noted as early as 3 years after GBS. Moreover rapid copper replenishment led to a dramatic recovery of vision. Our case underscores the need for maintaining high suspicion when eval‎uating patients with suspected optic neuropathy occurring after GBS since prompt diagnosis and treatment may lead to reversal of visual loss.</span></p></div></div><div class="similar-articles" id="similar" style="box-sizing: inherit; margin: 3.6rem 0px 0px; word-break: break-word; position: relative; padding: 0px 0px 0.4rem;"></div><p><br></p>