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김용수,박인석,김석영,우제영,윤영석,방병기,구완서,장윤식 대한신장학회 1990 Kidney Research and Clinical Practice Vol.9 No.4
Carpal tunnel syndrome (CTS) is a late complication of chronic hemodialysis. This complication results from the deposition of ?2-microglobulin as an amyloid-like substance. CTS results from entrapment of the medial nerve at the wrist. ?2-microglobulin deposits have been reported in bones, kidney, liver, bowels, and vasculature. We report here our experience with carpal tunnel syndrome in 47-year-old women treated exclusively with hemodialysis over a period of 14 years. She showed pain/paresthesia at night, weakness, burning pain in palm of right hand and right shoulder pain. Also, she showed decreased sensation to light touch and pin prick, positive Tinnels sign of the right hand. Nerve condnction studies showed an increased terminal latency of the right median nerve. Management of the carpal tunnel syndrome have not been altogether satistactory. Surgical decompression of the median nerve has been of the greatest benefit to patients with marked disability and pain from the carpal tunnel syndrome. A brief review of the literature was made.
동위원소 ( 99mTc - DTPA ) 를 이용한 신사구체 여과율 측정의 유용성
추원오(Won Oh Choo),우제영(Je Young Woo),김용수(Yong Soo Kim),구완서(Wan Suh Koo),장윤식(Yoon Sik Chang),윤영석(Young Suk Yoon),방병기(Byung Kee Bang),정수교(Soo Kyo Chung) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Background: Although creatinine clearance is most commonly used to evaluate renal function, it overestimates glomerular filtration rate and needs 24 hour urine collection. In the last several years, it was reported that glomerular filtration rate using radioisotope has advantages of creatinine clearance. Methods: Glomerular filtration rate estimated by fractional accumulation of 99mTc-DTPA (CDTPA), creatinine clearance (Ccr), predicted creatinine clearance estimated by the formula devised by Cockcroft and Gault (PCcr) and 100/serum creatinine (100/Scr) were measured simultaneously in 89 medical outpatients whose serum creatinines ranged from 0. 6 mg/dl to 11, 2 ma/dl. Results: 1) CDTPA were closly correlated to Ccr (r=0.84), PCcr (r=0.88) and 100/Scr (r=0.86). 2)CDTPA were inversely correlated to Scr. 3) In patients with normal renal function (Scr<1.2 mg/dl) or mild to moderate renal insufficiency (1,2< Scr < 4. 0 mg/dl), CDTPA A were significantly lower than Ccr and 100/Scr, and simmilar to PCcr. 4) In patients with severe renal insufficiency (Scr>4. 0 mg/dl), CDTPA were significantly higher than Ccr, PCcr and 100/Scr. 5) Cm of left kidney were closely correlated to those of right kidney (r=0.91). The absolute differences of CDTPA between right and left kidneys were 5,1±4.9ml/ min/l. 73 M2, which were not significant statistically. 6) In 4 patients who had a past history of unilateral nephrectomy, DDTPA were measured falsely by 7.4±4.9 ml/min/1,73 M2 in nephrectomized side. 7) This procedure needs only 6 minutes of patient time. Conclusion: These observations suggest that determining glomerular filtration rate using 99mTc-DTPA is a rapid, accurate method in patients with normal or mild to moderate renal insufficiency, both as a total value and individually for each kidney. But it overestimates glomerular filtration rate in patients with severe renal insufficiency.