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- 저자 : 이설희 ( Sul Hee Yi ) (검색결과 5 건)
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복막투석 환자의 예후를 예측하는 인자로서 총 단백 복막 청소율의 의의
이설희 ( Sul Hee Yi ),이호영 ( Ho Young Lee ),김정현 ( Jung Hyun Kim ),정재면 ( Jae Myun Jung ),권순효 ( Soon Hyo Kwon ),전진석 ( Jin Seok Jeon ),한동철 ( Dong Cheol Han ),노현진 ( Hyun Jin Noh ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.6
Purpose: It has been reported recently that peritoneal protein clearance (Pcl) is a marker of endothelial dysfunction and cardiovascular disease in peritoneal dialysis patients. We evaluated whether baseline or longitudinal follow-up Pcl is a factor to consider in predicting the outcome in peritoneal dialysis patients for the follow-up period. Methods: Patients who initiated continuous ambulatory peritoneal dialysis at our center from September 1994 to January 2006 and had a baseline peritoneal equilibration test, measurement of dialysis adequacy, and 24-h dialysate Pcl (24hr dialysate protein loss/ [serum albumin/0.4783]) were included. Demography, comorbidities, and biochemical data were retrospectively collected. Follow-up was until death or the end of the period studied (November 2009). Results: A total of 203 patients (56% men, mean age 55.0±12.5; 55.2% with diabetes; 22.2% with cardiovascular disease) were included. The mean follow up period was 38 months (3-170 months). Baseline Pcl was 128.2 ml/day. Follow up data of Pcl were not changed from baseline period. Cox`s analysis revealed the predictors of mortality (and technical failure) were age and diabetes mellitus but not dialysate/plasma creatinine ratio (D/Pcr) and Pcl. On multivariate analysis, Pcl was negatively correlated with serum albumin and triglyceride and positively correlated with D/Pcr and peritoneal creatinine clearance. Conclusion: Our study showed that the changes in Pcl over time were not significant from baseline up to 53 months. Neither baseline nor mean Pcl during the follow-up period were independent predictors for technical or patient survival.
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임상 연구 : 간경변 환자의 신기능 평가에서 Cystatin C의 유용성에 대한 연구
김지형 ( Ji Hyeong Kim ),신동원 ( Dong Won Shin ),이설희 ( Sul Hee Yi ),최문한 ( Moon Han Choi ),최종효 ( Jong Hyo Choi ),김대용 ( Dae Yong Kim ),박무용 ( Moo Yong Park ),최수정 ( Soo Jeong Choi ),김상균 ( Sang Gyune Kim ),김진국 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6
목적: Cystatin C는 사구체 기저막을 자유로이 통과하여 세뇨관에서 재흡수 완전 분해되어 사구체 여과율 (glomerular filtration rate; GFR)을 노인, 간경변 환자처럼 근육 위축을 동반한 환자에서 creatinine 보다 정확하고 민감하게 반영하는 것으로 알려져 있다. 이에 저자들은 간경변증 환자에서 cystatin C를 근거로 하는 신기능 평가의 유용성을 연구하였다. 방법: 2007년 2월부터 9월까지 순천향대학교 부천병원에 입원한 안정된 간경변 환자를 대상으로 혈청 creatinine (MDRD와 Cockroft & Gault 공식), 24시간 소변 검사, 혈청 cystatin C (Hoek와 Larsson 공식)로 측정한 GFR 값을 크롬-EDTA로 측정한 GFR를 기준으로 비교하고, 신기능을 조사하였다. 결과: 총 46명의 환자 중 Child classification A가 10명, B가 17명, C가 19명이고, 평균 creatinine 1.1±0.56 mg/dL이며, 평균 cystatin C는 1.2±0.5 mg/L이었다. 평균 GFR은 크롬-EDTA로 67.8±29.4 mL/min/1.73m2이었다. MDRD 공식으로 81.6±29.6 mL/min/1.73m2, C&G로 79.9±29.3 mL/min/1.73m2, 24시간 소변의 Cr 배설율로 62.7±29.8 mL/min/1.73m2, Hoek 공식으로 77.0±28.6 mL/min/1.73m2, Larsson 공식으로 80.0±35.2 mL/min/1.73m2 이었다. Cystatin C는 당뇨, 연령, 성별에 따라 차이가 없었다. Cystatin C는 BUN (r=0.422), MDRD 공식 (r=-0.715), C&G 공식 (r=-0.659), 24시간 소변의 Cr 청소율 (r=-0.536), 크롬-EDTA 결과 (r=-0.617)의 GFR과 의미있는 상관 관계를 보였으며, MELD score, 혈청 albumin, Creatinine, PT, bilirubin과는 관련이 없었다. Cystatin C을 이용한 Hoek 공식 (r=0.657)과 Larsson 공식 (r=0.647)의 GFR은 MDRD (r=0.550)와 C&G 공식 (r=0.458)에 비해 크롬-EDTA와 높은 상관 관계를 보였다. Cystatin C의 크롬-EDTA GFR에 대한 회귀방정식은 -33.7×cystatin C+106.4 mL/min 이었다. 신기능의 차이는 없으나, cystatin C는 모든 간경병증 환자에게서 상관관계가 높았다. 결론: Cystatin C는 간경변증 환자에게서 혈청 Creatinine보다 정확하게 신기능을 반영하고, 간경변증 정도에 관계없이 상관관계가 높았다. Purpose: Cystatin C is known to predict the glomerular filtration rate (GFR) more precisely in patients with substantial muscle atrophy, such as liver cirrhosis, compared to creatinine. We evaluated the usefulness of cystatin C for prediction of renal function in liver cirrhosis patients. Methods: From February 2007 to September 2007, we evaluated the renal function in patients with liver cirrhosis who were admitted to Soonchunhyang University Bucheon Hospital. We compared renal function with GFR as estimated by creatinine (Modification of diet in renal diseases; MDRD, the Cockroft&Gault equation; C&G, Creatinine clearance; CCr) and cystatin C (the Hoek and Larsson equations) with that of the GFR as calculated by Cr-EDTA. Results: A total of 46 patients were enrolled. The mean GFR was 67.8±29.4, 81.6±29.6, 79.9±29.3, 62.7±29.8, 77.0±28.6, 81.0±35.2 mL/min/1.73m2 according to Cr-EDTA, MDRD, C&G, CCr, Hoek and Larsson equations, respectively. Cystatin C showed a correlation to MDRD (r=-0.715), C&G (r=-0.659), CCr (r=-0.536) and Cr-EDTA GFR (r=-0.617). GFR by the Hoek (r=0.657) and the Larsson (r=0.647) equation using cystatin C showed a higher correlation with Cr-EDTA GFR than GFR by MDRD (r=0.550) and C&G equation (r=0.458). Conclusion: Cystatin C is a more accurate predictor of renal function than creatinine in patients with liver cirrhosis.
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10년간 크기가 서서히 증가한 고립성 폐결절이 선암으로 진단된 1예
권기두 ( Ki Du Kwon ),김지형 ( Ji Hyeong Kim ),김대용 ( Dae Yong Kim ),최문한 ( Moon Han Choi ),최재혁 ( Jae Huk Choi ),신동원 ( Dong Won Shin ),최종효 ( Jong Hyo Choi ),이설희 ( Sul Hee Yi ),윤진아 ( Jin A Yun ),최재성 ( Jae Sung 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.4
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에이즈 환자에서 발생한 파종성 조류형 결핵균 감염 1예
이설희,최재혁,최문한,신동원,최종효,김태형,전민혁,고은석,추은주 대한감염학회 2008 감염과 화학요법 Vol.40 No.5
Nontuberculous Mycobacteria, especially Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS). In patients with AIDS, MAC infection more frequently presents as disseminated form rather than localized infection. Disseminated MAC infection is associated with a high mortality rate in patient with AIDS. We report a case of disseminated MAC infection in an AIDS patient involving bone marrow, mediastinal lymph node and lung.
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일개 대학 병원에서 경험한 뎅기열-뎅기출혈열 4예와 국내 문헌 고찰
최문한,추은주,김태형,전민혁,박의주,신동원,이설희,최종효 대한감염학회 2008 감염과 화학요법 Vol.40 No.6
Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed, In addition, relevant domestic literatures from Korean bibliographic databases, which matched 'dengue fever', 'dengue hemorrhagic fever' or 'dengue shock syndrome' as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82%) and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.
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