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부갑상선 절제술 후 골밀도의 증가를 보인 만성 신부전증에 병발된 신성 골 이영양증 1 예
박한철,김호중,안유헌,박찬현,정파종,박문향,강경원,강종명,장대국,채현기 대한내과학회 1995 대한내과학회지 Vol.48 No.4
$quot;Renal osteodystrophy$quot;, a term introduced over 51 years ago, is still used to describe any bone disease occuring in a patient with renal disease. In actually, a very wide spectrum of bone disease can occur in renal failure patients, ranging from states of makedly impaired bone formation and mineralization (such as low-turnover bone disease, osteomalacia) to states of markedly increased bone turnover (hyperparathyroidism). We had experienced one case of renal osteodystrophy and secondary hyperaparathyroidism, especially combined with advanced renal failure, who was admitted to Hayang University Hospital due to severe bone pain on both lowe extremites. Skull X-ray showed decreased bone density with so called $quot;salt and pepper$quot; appearance. Subperiosteal bone resorptions along the ribs and the proximal medial tibial metaphysis were noted on chest PA and both knee X-rays. Serum calcium level was 8.9mg/ dl, serum phosphorous level was 5.6mg/dl, serum alkaline phosphatase was 1872IU/L, serum parathyroid hormone level was 6.54ng/dl(normal; 0.22-0.66ng/dl). Dual photon bone densitometry showed marked decreased total body bone density. Renal osteodystrophy(osteitis fibrosa) was confirmed by bone biopsy stained with Haematoxylin & Eosin and double tetracycline labelling, and secondary hyperparathyroidism was confirmed by parathroid gland biopsies. She was treated with CaCO3, Al(OH)3, Cholecalcitriol after parathyroidectomy.
박한철,엄대용,이상돈 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.1
1. With glass microelectrode technique specific for calcium ion, measurements were made for serum ionized calcium. The calibration curve was linear for pCa(2-4) and the tests were reproducible. 2. For five persons each with normal health and with uremia, serum creatinine above 10㎎/㎗, ionized calcium, total calcium, total protein, albumin, and inorganic phosphate were measured in the sera. The results are as following: 1) There were significant differences in serum phosphate and ionized calcium levels between healthy group and uremic patients. The differences were not significant in total calcium, total protein, and albumin contents. 2) The values of ionized calcium, total calcium, total protein and albumin were scattered, but individually some with uremia had lower values. 3. Preliminary tests for ionized calcium assay gave the experience that the ways of collecting and storing samples would alter the data significantly. 4. It is, therefore, felt that further studies on simplification of the sample handing before the measurement of ionized calcium is desirable.
박한철,방효원,조성일,엄대용,이상돈 중앙대학교 의과대학 의과학연구소 1987 中央醫大誌 Vol.12 No.3
Effects of ditiazem on staircase phenomenon were investigated in rabbit papillary mucles partially depolarized by 19mM K-Tyrode solution. The following results were obtained: 1. Contractile forces were increased in paralle with the increase of stimulation frequencies from 0.2㎐ to 2㎐ in the muscle preparation partially depolarized around -50㎷ by 19mM K-Tyrode solution. 2. Contractile forces induced by various frequencies of electrical stimulation were markedly changed in high Ca^2+ solution, while those were not remarkable in low Ca^2+ solution. 3. The relationship between developed tension and stimulation frequency were negatively inverted in low concentration of diltiazem(0.05 and 0.1㎎/l). 4. Amplitudes of action potentials were reduced in administration of low calcium and ditiazem which affected calcium flux during action potential. 5. Durations of action potential were prolonged in low calcium solution and those were shortened in low concentration of ditiazem. 6. Amplitudes of action potential in ditiazem-treated 19mM K-Tyrode solution were continuously reduced by change in stimulation frequencies from low to high rate. Above results suggests that amplitudes of action potential closely related with contractility of rabbit papillary muscle in 19mM K-Tyrode solution and decreased influx of calcium during action potential could be related with nagatives staircase phenomenon.