Transcatheter Arterial Embolization Therapy for a Massive Polycystic Liver in Autosomal Dominant Polycystic Kidney Disease Patients

박혜인조,김치원,노한,오국환,김연수,이정상,인용후,재환준,정진욱,안규리,황영환,문주영 대한의학회 2009 Journal of Korean medical science Vol.24 No.1

Polycystic liver is the most common extra-renal manifestation associated with autosomal dominant polycystic kidney disease (ADPKD), comprising up to 80% of all features. Patients with polycystic liver often suffer from abdominal discomfort, dyspepsia, or dyspnea; however, there have been few ways to relieve their symptoms effectively and safely. Therefore, we tried transcatheter arterial embolization (TAE), which has been used in treating hepatocellular carcinoma. We enrolled four patients with ADPKD in Seoul National University Hospital, suffering from enlarged polycystic liver. We embolized the hepatic arteries supplying the dominant hepatic segments replaced by cysts using polyvinyl alcohol particles and micro-coils. The patients were evaluated 12 months after embolization for the change in both liver and cyst volumes. Among four patients, one patient was lost in follow up and 3 patients were included in the analysis. Both liver (33%; 10%) and cyst volume (47.7%; 11.4%) substantially decreased in two patients. Common adverse events were fever, epigastric pain, nausea, and vomiting. We suggest that TAE is effective and safe in treating symptomatic polycystic liver in selected ADPKD patients.

Lower Residual Renal Function is a Risk Factor for Depression and Impaired Health-Related Quality of Life in Korean Peritoneal Dialysis Patients

박혜인조,이하정,이정표,김동기,오국환,주권욱,임춘수,김연수,안규리,오윤규 대한의학회 2012 Journal of Korean medical science Vol.27 No.1

We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck’s Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/Vurea (< 0.2), and lower serum albumin level (≤ 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/Vurea was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/Vurea (β = 0.24, P = 0.005) and lower nPNA (β = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (β = 0.22, P = 0.03) and mental component summary (β = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.

Recurrent Thrombotic Events after Catastrophic Antiphopholipid Syndrome

박혜인조,윤현배,이태우,정지용,진호준,김연수,김성권 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.2

위성 자료를 이용한 지표면 흡수단파복사 산출 알고리즘들의 비교 분석

박혜인,이규태,조일성,김부요 대한원격탐사학회 2018 大韓遠隔探査學會誌 Vol.34 No.6

Absorbed shortwave radiation at the surface is an important component of energy analysis among the atmosphere, land, and ocean. In this study, the absorbed shortwave radiation was calculated using a radiation model and surface broadband albedo data for application to Geostationary Earth Orbit Korea Multi-Purpose SATellite (GEO-KOMPSAT-2A; GK-2A). And the results (GWNU algorithm) were compared with CERES data and calculation results using pyranometer and MODIS (Moderate Resolution Imaging Spectroradiometer) data to be selected as the reference absorbed shortwave radiation. This GWNU algorithm was also compared with the physical and statistical algorithms of GOSE-R ABI and two algorithms (Li et al., 1993; Kim and Jeong, 2016) using regression equation. As a result, the absorbed shortwave radiation calculated by GWNU algorithm was more accurate than the values calculated by the other algorithms. However, if the problem about computing time and accuracy of albedo data arise when absorbed shortwave radiation is calculated by GWNU algorithm, then the empirical algorithms explained above should be used with GWNU algorithm. 지표면 흡수단파복사(Absorbed Shortwave Radiation, ASR)는 대기와 육지 및 해양 사이의 에너지 수지 분석을 위한 필수 요소이다. 이 연구에서는 천리안위성 2A호(GEO-KOMPSAT-2A; GK-2A)에 적용하기 위하여 복사 모델과 지표면 알베도 자료를 이용하여 지표면 흡수단파복사를 산출(GWNU 방법)하였고, 그 결과는 기준 자료로 선정한 CERES (Clouds and the Earth’s Radiant Energy System) 위성 센서 및 지상 관측 자료와 비교하였다. 또한 이 연구 결과(GWNU 방법)는 미국 정지궤도위성 GOES-R의 ABI (Advanced Baseline Imager)에 의한 물리적 및 통계적 방법 그리고 Li et al.(1993) 및 Kim and Jeong (2016)의 회귀 방정식 방법들과 비교하였으며, 그 결과 GWNU 방법에 의하여 계산된 지표면 흡수단파복사는 다른 방법들에 의한 값보다 정확 하였다. 그러나GWNU 방법을 활용하여 지표면 흡수단파복사를 산출할 때 계산 시간과 지표면 알베도 자료의 정확성 문제가 발생될 경우 위에 제시된 경험적 방법들이 GWNU 방법과 함께 사용되어야 할 것이다.

강릉 지역에서 자동 전운량 장비와 GWNU 태양 복사 모델을 이용한 지표면 일사량 분석

박혜인,조일성,김부요,지준범,이규태 한국지구과학회 2017 한국지구과학회지 Vol.38 No.2

Global solar radiation was calculated in this research using ground-base measurement data, meteorological satellite data, and GWNU (Gangneung-Wonju National University) solar radiation model. We also analyzed the accuracy of the GWNU model by comparing the observed solar radiation according to the total cloud cover. Our research was based on the global solar radiation of the GWNU radiation site in 2012, observation data such as temperature and pressure, humidity, aerosol, total ozone amount data from the Ozone Monitoring Instrument (OMI) sensor, and Skyview data used for evaluation of cloud mask and total cloud cover. On a clear day when the total cloud cover was 0 tenth, the calculated global solar radiations using the GWNU model had a high correlation coefficient of 0.98 compared with the observed solar radiation, but root mean square error (RMSE) was relatively high, i.e., 36.62 Wm−2 . The Skyview equipment was unable to determine the meteorological condition such as thin clouds, mist, and haze. On a cloudy day, regression equations were used for the radiation model to correct the effect of clouds. The correlation coefficient was 0.92, but the RMSE was high, i.e., 99.50 Wm−2 . For more accurate analysis, additional analysis of various elements including shielding of the direct radiation component and cloud optical thickness is required. The results of this study can be useful in the area where the global solar radiation is not observed by calculating the global solar radiation per minute or time. 이 연구에서는 지표 관측 자료와 위성 자료 그리고 GWNU 단층 복사 모델을 이용하여 맑은 상태의 전천 일사량을 계산하였으며, 전운량에 따라 관측 및 모델의 일사량 값을 비교 분석하였다. 연구 자료는 2012년 강릉원주대학교복사 관측소의 전천 일사량, 기온, 기압, 습도, 에어로졸 등의 관측 자료와 OMI 센서의 오존전량 자료 그리고 구름의유무 및 전운량을 판단하기 위하여 자동 전운량 장비인 Skyview 자료를 이용하였다. 전운량이 0 할인 맑은 날의 경우관측 값과 모델 값이 0.98로 높은 상관계수를 나타내었으나 RMSE가 36.62Wm−2로 비교적 높게 나타났다. 이는Skyview 장비가 얇은 구름이나 박무 및 연무 등의 기상상태를 판단하지 못하였기 때문이다. 흐린 날의 경우 구름의 영향을 보정하기 위해 전운량과 두 값의 차에 대한 비율을 이용한 회귀식을 복사 모델에 적용하였으며, 장비의 오탐지를제외한 경우 상관계수가 0.92로 높은 상관성을 보였으나 RMSE가 99.50 Wm−2으로 높은 값을 보였다. 더 정확한 분석을 위해서는 직달 성분의 차폐 유무 및 구름 광학 두께를 포함한 다양한 구름 요소의 추가적인 분석이 요구된다. 이연구결과는 분 또는 시간에 따른 일사량을 산출하여 일사량이 관측되지 않는 지역에서 유용하게 사용될 수 있다.

혈액투석 : 유지 혈액 투석 환자에서의 우울증의 빈도 및 삶의 질에 영향을 미치는 요인들에 관한 연구

박혜인조 ( Hay Ne Cho Park ),윤현배 ( Hyun Bae Yoon ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Seok Han ),손민정 ( Min Jeong Son ),정은숙 ( Eun Sook Jung ),주권욱 ( Kwon Wook Joo ),임춘수 ( Chun Soo Lim ),채동완 ( Dong Wan Chae ) 대한신장학회 2008 춘계학술대회 초록집 Vol.28 No.1

지표면의 흡수 단파복사 산출

박혜인,이규태,조일성,김부요 한국기상학회 2016 한국기상학회 학술대회 논문집 Vol.2016 No.4

상염색체우성 다낭신에서 질병진행 예측인자로서 요중 안지오텐시노겐의 유용성

박혜인조 ( Hayne Cho Park ),황진호 ( Jin Ho Hwang ),백선하 ( Seon Ha Baek ),한미연 ( Mi Yeun Han ),윤유경 ( Yu Kyoung Yun ),윤명옥 ( Myeong Ok Yoon ),오국환 ( Kook Hwan Oh ),구자룡 ( Ja Ryong Koo ),김형직 ( Hyung Jik Kim ),노정우 ( 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.5

Purpose: The renin-angiotensin-aldosterone system activation has been suggested as a potential risk factor for renal progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to evaluate urinary angiotensinogen as a biomarker of renal progression in ADPKD. Methods: Patients with estimated glomerular filtration rate (eGFR) 30 mL/min/1.73m≥2 were enrolled in the study. Specimens (blood and urine) and computed tomography (CT) were taken from each subject. The eGFR was calculated by 4-variable MDRD equation and total kidney volume (TKV) was measured from CT images by modified ellipsoid method. Urinary angiotensinogen (AGT) and neutrophil gelatinaseassociated lipocalin (NGAL) were measured by ELISA. The concentration of AGT was adjusted with random urine creatinine (Cr). The association between urinary biomarkers, TKV and eGFR were evaluated. Results: A total of 59 (M:F=31:28) subjects were enrolled in the study and their mean age was 46 years. The eGFR and TKV at the enrollment were 77.3±15.6 mL/min/1.73m2 and 1389.8±925.1 mL, respectively. Log AGT/Cr was associated with TKV (r2=0.11p=0.01) in the earlier stage of disease (TKV<000 mL). However, it did not show significant correlation with eGFR. Log NGAL was not associated with either TKV or eGFR. Urinary AGT/Cr was closely related to the number of anti-hypertensive medication, TKV, and the presence of albuminuria, although there was no correlation with plasma renin activity or aldosterone level. Conclusion: Urinary angiotensinogen may be a useful biomarker of disease progression in ADPKD patients.

스테로이드를 투여 받는 환자에서 발생한 Nocardia farcinica 뇌 종양 1예

심성훈,박혜인조,김충종,전재현,김의종,오명돈,김남중,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.5

Nocardiosis occurs mostly in the immunocompromised patients. N. farcinica is known to have resistance to some antibiotics and significant increase in morbidity and mortality in patients requiring long-term treatment. Nocardia farcinica infection, especially brain abscess, has not been reported in Korea. Here, we report a case of N. farcinica brain abscess in a patient receiving steroid treatment. The patient was a 64 year-old male with gouty arthritis, He received steroid for more than two months, because of allopurinol-hypersensitivity syndrome with skin rash. After three months of steroid therapy, he visited other hospital with mild fever and left thigh pain and was diagnosed of intramuscular abscess due to gram positive bacilli. One month later, he visited our hospital with right side weakness and was diagnosed as brain abscess. The causative organism turned out to be N. farcinica, which was confirmed by means of 16S rRNA sequencing. Antibiotics were selected by E-test results and treatment was successful.

Effect of Simultaneous Nephrectomy on Perioperative Blood Pressure and Graft Outcome in Renal Transplant Recipients with Autosomal Dominant Polycystic Kidney Disease

조형아,박혜인조,김현숙,한미연,정종철,오국환,양재석,전희중,구태연,하종원,곽철,황영환,안규리 대한이식학회 2016 Korean Journal of Transplantation Vol.30 No.1

Background: For various reasons, kidney transplant recipients with autosomal dominant polycystic kidney disease (ADPKD) often undergo native nephrectomy in preparation for the transplantation. Simultaneous nephrectomy can result in hypotensive events perioperatively and affect transplant outcome adversely. Our aim was to evaluate the effect of simultaneous native nephrectomy (SNx) on perioperative blood pressure and graft outcome compared to non-nephrectomy (NNx) in renal transplant recipients with ADPKD. Methods: Data regarding renal function and blood pressure were collected from 42 renal transplant recipients with ADPKD. The primary outcome was graft function over 1 year post-transplant. The secondary outcomes were patient and graft survival, postoperative hypotensive events, and blood pressure control. We compared units of anti-hypertensive medication used by transplanted ADPKD patients in the SNx and NNx groups. Results: Patients with SNx during kidney transplantation showed similar rates of patient and graft survival and renal function. Although they had significantly more hypotensive events during the perioperative period (69.2% vs. 37.5% in NNx, P=0.045), no harmful influence on renal function was observed. No difference in mean blood pressure during the 1-year post-transplant period was observed between the two groups; however, the SNx group required fewer units of anti-hypertensive medication. Conclusions: SNx is a relatively safe procedure. Graft outcome in the SNx group was not inferior to that of the NNx group, and patients with SNx can have well-controlled blood pressure.