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원저 : 국소적 흉부 병변에서 세침 흡입 생검의 진단 성적 및 합병증
양석철 ( Suck Chul Yang ),김연수 ( Yeon Soo Kim ),김순길 ( Soon Kil Kim ),김태화 ( Tae Wha Kim ),이경상 ( Kyung Sang Lee ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),이정희 ( Jung Hee Lee ),전석철 ( Se 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.5
혈액투석 환자의 고칼륨혈증 치료에 대한 칼륨의 세포 내 이동방법에 의한 단일 및 병합 치료요법
김병훈(Byoung Hun Kim),양석철(Suck Chul Yang),김호중(Ho Jung Kim) 대한내과학회 1998 대한내과학회지 Vol.54 No.2
N/A Objectives : We evaluate the efficacy of transcellualr K-lowering effect at 1 hour following mono-therapy compared to that of dual-therapy, and aimed to find the sage and rapid method for acute therapy of hyperkalemia before dialysis in 10 F5RD patients with maintenance hemodialysis. Method: For ten patients of end stage renal failure with body weight between 55 and 65 Kg and a predialysis plasma potassium greater than 5.5 mEq/I., we studied in three separated phases separated from one another by at least 1 week. After 1 hour following mono-therapy (2mEq/Kg of NaHCO3 in interavenous infusion, 10 units of regular insulin with 50ml of 50% glucose in i.v. push, or 15mg of salbutamol in nebulizer) or dual therapy(NaHCO3 + Insulin with glucose, NaHCO3 + salbutamol, or salbutamol + insulin with glucose) for hyperkalemia, we compared the efficacy and safety of each transcellular K shifting methods. Results Bicarbonate infusion induced a signigicant raise in plasma bicarbonate and pH from baseline values in both mono-therapy and dual-therapy without any significant difference each other. Among mono-therapeutic regimens, bicarbonate alone failed to lower plasme K from baseline levels (-0.11±0.15 mEcq/L, P=NS) whereas two other regimens effectively lowered plasma K (-0.62±0.06 mEq/L in insulin with glucose, -0.57±0.04 mEq/L in salbutamol, P vs. basal <0.05 in both). The K-lowering effects in the three combined regimeds of dual therapy were more prominent as compared to that of three regimens of monotherapy (-0.96±0.08 mEq/L in NaHCO3 + salbutamol, -1.20±0.6 mEq/l. in NaHCO3 + insulin with glucose, and -1.20±0.10 mEq/L in salbutamol + insulin with glucose, respectively)(P<0.05). Two patients in mono- y with salbutamol alone were resistant to the hypokalemic effect, however in dual therapy with simultaneous administration of salbutamol and bicarbonate resolved it. Also, hypoglycemia (<60mg/dL of fasting glucose) was noted in 4 patients in mon-therapy of insuli with glucose alone, 2 in dual-therapy of insulin with glucose + NaHCC3, but none in insulin with glucose + salbutamol. Conclusion: Dudal-therapeutic regimens lowered plasma potassium more effectively than mono-therapeutic regimens, and among them, the combination of insulin with glucose plus salbutamol could be recommended as an efficacious and safe modality in the acute therapy of hyperkalimia in ESBD patients.
1996년 춘계학술대회 학술퀴즈 : 다발성 임파절 이상증을 동반한 비대칭적 폐 간질성 병변
이경상 ( Kyung Sang Lee ),양석철 ( Suck Chul Yang ),윤호주 ( Ho Joo Yoon ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),이정희 ( Jung Hee Lee ),김혁 ( Hyuk Kim ),최요원 ( Yo Won Choi ),전석철 ( Seok Chol Jeon ) 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.4
이재웅(Jae Ung Lee),이오영(Oh Young Lee),양석철(Suck Chul Yang),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),김순길(Soon Kil Kim),김호중(Ho Jung Kim),고희관(Hee Kwan Koh),정자헌(Ja Hun Jung),남승우(Seung Woo Nam),백인규(In Kyu Paik),이창 대한내과학회 1997 대한내과학회지 Vol.52 No.1
N/A Objectives: The degree of hyperkalemia and effects of potassium removal by hemodialysis on the plasma potassium concentration to see the influence of nonselective beta-adrenergic blockade(carteolol) and ACE inhibitor(captopril) on patients in maintenance hemodialysis were evaluated. Methods: This study was done on 16 patients with end-stage renal disease undergoing maintenance hemodialysis. These patients were classified two groups; group 1-patients with carteolol or captopril(9 patients) and group 2-patients without medication(7 patients). Measurement of plasma potassium and arterial blood gas analyses were performed at pre-dialysis and during hemodialysis(4 hours). To analysis the distribution of potassium kinetics during hemodialysis, dialysis potassium clearance rate was introduced in this study. Results: 1) Among 16 patients studied, the mean age was 43 years old and the ratio of male to female was 2: 1 and the mean duration of hemodialysis was 17.9 months. The underlying cause of end-stage renal disease was chronic glomerulonephritis in the most patients. 2) The mean predialysis plasma potassium concentration of all patients, group 1 on medication, and group 2 without medication was 5.13±1.04mEq/L, 5.67±1.01mEq/L and 4.410.55mEq/L, with high significance(p<0.001) between groups 1 and 2. 3) The mean postdialysis plasma potassium concentration of group 1 on medication and group 2 without medication was 348±0.40mEq/L and 3.39±0.56mEq/L with insignificance between groups 1 and 2. 4) The pre- and post-dialysis concentration of plasma sodium, pH and bicarbonate between group 1 and group 2 was similar except glucose. 5) Despite the fall in absolute plasma concentration in group 1 more than twice than in group 2, the difference in dialysis potassium clearance rate measured at 1 hour of hemodialysis in group 1 compared to that of group 2 was only 12M. Conclusion: These data are consistent with at least a two-compartment distribution of plasma potassium rather than single pool in addition to frequent hyperkalemia on maintenance hemodialysis on nonselective beta-adrenergic blocker or ACE inhibitor contributed to partial impairment of extrarenal transcellular shifts of potassium during inter- and intra-dialytic phase.