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위경소,최태승,이석준,조원용,김형규,최원충 대한내과학회 1990 대한내과학회지 Vol.38 No.1
Nowadays, the incidence of heavy metal posisoning is increasing, especially in developing countries. The authours experienced and managed 6 patients highly suspected of chronic mercury poisoing. These patients were workers in a small electric lamp company, ballooning the lamps by mouth. They inhaled mercury vapor during their work. The authours evaluated these patients by EMG, MMPI, kidney and liver needle biopsy and measured the blood and urine mercury concentration by atomic absorption spectrophotometry. The results are as follows: 1) The mean duration of exposure to mercury was 40. 8±35.0 months and the mean duration of symptom and signs was 13.0±4.2 months. 2) The main symptoms of these patients were headache(5/6), generalized weakness(4/6) and tremor(2/6). 3) On routine laboratory evaluatioin including MMPI and EMG, we couldn't find any specific abnormal finding. 4) In liver biopsy, diffuse hepatocyte swelling and sinusoidal dilatations was found in 5 patients. In the EM finding of kidney biopsy, dark-black-round pigments of the lysosomes of the proximal tubular epithelial cells are found in 2 patients. 5) After chelation therapy, the blood mercury decreased and urinary excretion of mercury increased, esplcially in 2 patients who excrete little amounts of mercury before chelation therapy.
김병수,김형규,위경소,권영주,구자룡 대한내과학회 1988 대한내과학회지 Vol.35 No.4
In recent years, the frequency of heavy metal poisoning is increasing, especially as a cause of renal dysfunction. In general, the diagnosis of heavy metal poisoning is difficult due to the result of many factors. In this study, the patients was a 52-year old male, cable worker who had worked underground for 15 years and frequently inhaled lead fume during lead melting. His main symptoms were hypertension (200/140mmHg), mild hyperuricemia (7.3~9.2 mg/dl) and moderately disturbed renal function (Ccr: 37.5 ml/min). As a step of diagnosis, we measured blood lead and urine lead, blood delta aminolevulinic acid concentrations by atomic absorption spectrophotometry, We also practised the EDTA mobilization test. The results of the measurements were as follows, Blood lead: 63.49mg/dl, Urine lead: 190.4mg/mg, Blood delta-ALA: 32.88 mg/dl and EDTA-chelation test: 0.83mg/dl, With general supportive care, including EDTA chelation therapy, the status of the patients improved. In this case report, we once recall the importance of obtaining an accurate report of the patients occupational history and consider heavy metal poisoning to be a cause of renal dysfunction of equivocal etiology.
만성 신부전 환자에서 Catecholamine 의 제거율
이은주(Eun Joo Lee),위경소(Kyoung So Wee),최태승(Tae Seung Choe),차대룡(Dae Ryong Cha),조원용(Won Yong Cho),김형규(Hyoung Kyu Kim),김형건(Hyoung Gun Kim),최원충(Won Chung Choi) 대한내과학회 1989 대한내과학회지 Vol.37 No.5
N/A The adrenergic system interacts with a vaiety of tissues and organs, including the kidney. However, there is little known about the renal clearance of catecholamine (CAs) in man. To obtain this information, 4 normal subjects and 6 patients with chronic renal failure (CRF) were studied. Plasma and urinary CAs concentrations were measured by high performance liquid chromatography with an electrochemical detector. Plasma CAs concentrations (pg/ml) were norepinephrine (NE) 44.62±83.29 (pg/ml) end DOPAC 585.58±462.47 in normal subjets, and NE 632.20±290.40 and DOPAC 990.55±69.05 in CRF. Plasma CAs concentrations of the CRF group were higher than those of normal subjects, but did not differ significantly among the groups (p<0.05). Urinary CAs excretion amounts were NE 59.3±34.9 (pg/ml), E 11.9±10.2. DOPAC 27.l±61.4, and dopamine 13.4±11.2 in normal subjects, and NE 100.0±90.1, E 135.5±147.4, DOPAC 401.7±500.7, and dopamine 163.9±115, 7 in CRF. Urinary CAs and CAs clearance levels were lower in the CRF group than in normal subjects, but did not differ significantly between the groups. It is concluded that a chronic reduction in excretory kidney function may have no relevant impact on circulatory levels of CA per se, although their urinary excretion falls distinctly at the stage of advanced renal failure. These aspects deserve consideration when pathogenetic or diagnostic studies of catecholamines are performed in normotensive or hypertensive patients with impaired kidney function.