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RISS 인기검색어
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- 저자 : 홍화정(Hwa Jeong Hong) (검색결과 4 건)
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홍화정(Hwa Jeong Hong),이정환(Chung Hwan Lee),박종오(Chong Oh Park),정일우(Il Woo Jung),이승호(Seung Ho Lee),고경식(Kyung Sik Ko),김구엽(Koo Yeop Kim),서환조(Hwan Jo Suh) 대한내과학회 1997 대한내과학회지 Vol.53 No.3
Objective: Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. Nosocomial infection caused by methicillin-resistant S.aureus(MRSA) is a major problem which may be connected with heavy or prolonged use of antibiotics S.aureus bacteremia caused acute complications, which occasionally resulted in death, and infectious/suppurative complications, which necessitated prolonged antibiotic therapy, sometimes in conjunction with surgery. Therefore, S.aureus bacteremia is a serious medical problem in association with high morbidity and mortality. Methods: 130 patients with S.aureus bacteremia who were admitted in the Kyung Hee University Hospital from January, 1991 to December, 1994 were analyzed retrospectively. We compared the clinical and laboratory characteristics, and antibiotics resistances between MRSA and MSSA bacteremia and also we evaluated risk factors that contribute to fatal outcome in patients with S.aureus bacteremia. Results : 1) of 130cases, 80 were male and 50 were female. The mean age was 44.5±25.1 years. 2) 84(65%) of S.aureus bacteremia were nosocomial and 46(35%) were community-acpuired. The percentage of MRSA stains studied was 55%(71/130) and The percentage of MRSA bacteremia in hospital-acpuired and community-accquired S. aureus bacteremia were 64% (54/84) and 36%(17/46), respectively. Sources of bacteremia were uncertain in 85(65%) with intravascular catheter(20%) and skin wound sites (8%) being the most common sources in remainder(35%) 3) 110(85%) of 130 patients had one or more underlying diseases. Common underlying dieases were cerebrovascular disease(33%), malignancy(17%), Diabetes mellitus(15%), chronic renal failure(8%) and liver cirrhosis(6%). 4) Acute complications occurred in 35 patients and were fatal in 21 5) The risk factors associated with MRSA bacteremia were various severe underlying diseases, vairous invasive procedures, IV catheter-associated infection, hypoalbuminemia, previous use of antibiotics, male sex and old age. 6) The Case fatality rate for patients with S. aureus bacteremia was 18% and those for patients with MRSA and MSSA bactermia were 20% and 12%, respectively. The risk factors that contribute to the increment of mortality rate in patients with S. aureus bacteremia were acute complication, low serum level of total protein, hypoalbuminemia, various invasive procedures and IV catheter-associated infection, 7) In the antibiotic sensitivity test S. aureus was resistant to penicillin in 98.5%, ofloxacin in 73%, cefotaxime in 67%, erythromycin in 58%, aztreonam in 56%, clindamycin in 52%, vancomycin in 0%. 8) In the multiple antibiotic resistance of S. aureus, 43(68%) of MRSA was resistant to more than 10 antibotics, revealing multiply resistant nature of strains, While all but one MSSA was resistant to 1 to 4 antibiotics, one revealing resistance to 8 antibiotics. Conclusion: S. aureus bacteremia is a cause of considerable morbidity and mortality in hospitalized patients who especially, exposed to various risk factors. MRSA revealed higher resistance rate to most antibiotics tested and more marked multiply resistant nature than MSSA. But there was no significant difference in case fatality rate between patients with MRSA and MSSA bacteremia.
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성인 국소성 분절성 사구체 경화증의 임상경과 및 치료반응
홍화정(Hwa Jeong Hong),임천규(Chun Gyoo Ihm),최태진(Tae Jin Choi),이성배(Sung Bae Lee),최남수(Nam Soo Choi),홍성표(Sung Pyo Hong),이태원(Tae Won Lee),김명재(Myung Jae Kim),양문호(Mun Ho Yang) 대한내과학회 1998 대한내과학회지 Vol.54 No.2
Background: The response to therapy in adult patients with nephrotic syndrome caused by primary focal segmental glomerulosclerosis (FSGS) was discouraging, but recent reports have shown high remission rate. Of these patients in remission, few progressed to end stage renal disease. Methods : we analyzed author's experiences in 42 Korean adults with primary FSGS between January 1986 and December 1995 in attempt to know the response to therapy and outcome. Results: 1) Twenty-six of 42 patients(62%) had nephrotir range proteinuria, and renal insufficiency (serum creatinine>1.4 mg/dL ) was present in 14 patients(34%). Nephrotic patients had higher serum level of creatinine than that of nonnephrotic patients, and there was no difference between the two groups in blood pressure, age, and hematuria. 2) Twenty-six patients with nephrotic range proteinuria received combined treatment with prednisolone and cyclophosphamide. Complete remission (proteinuria≤300 mg/d) was observed in 10 cases(39%), and partial remission(≤2.50g/d) in 10 cases(42%), with mean remission time of 4.1±2.2 months after initiation of treatment. They had remission within 6 months of therapy except one. Relapse was noticed in 11 cases (52%) during follow-up. 3) None of responder group progressed to ESRD, while two of 5 non-responders progressed to ESBD, but there was no significant difference in slope of inverse creatinine between two groups. 4) The degree of proteinuria, initial serum creatinine, age, and sex did not affect the patient's response to therapy 5) The risk factors related to progression of renal failure were the initial serum creatinine level and degree of proteinuria. Conclusion: Nephrotic adult patients with primary FSGS may benefit from a more prolonged course of therapy with prednisolone and cyclophosphamide.
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이승호,김병호,이정일,김효종,이성배,홍화정,장린,동석호,장영운,박종오,최욱선 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3
In spite of advances in the management of the victim of trauma, the reported incidence of mortality and significant morbidity after pancreatic and/or duodenal injuries is still remained high. The key to treatment is thought to be early, accurate evaluation and proper management according to the degree of injury. We experienced a case of 26-year-old man who had melena after surgery for gun-shot wound of abdomen. In operation, it was noted that duodenum, superior mesenteric artery, and inferior vena cava were lacerated. He was treated by primary suture and drainage. But, 9 months later, hematochezia was developed. Duodenoscopic findings showed buldging mass with blood oozing at the medial side of duodenum second portion. Abdominal CT and angiography revealed pseudoaneurysm of superior mesenteric artery in the pancreas head. The surgery was postponed because severe adhesion between adjacent structures and pseudoaneurysm was suspected. So we decided medical treatment for him and melena was stopped spontaneously. We report this case with a review of literatures.
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