당뇨병성 신증 환자 20예에서 복합한약전탕액이 신기능에 미치는 영향

최우정,김동웅,신선호,이언정,최진영,신학수,조권일,이광석 대한동의생리학회,대한동의병리학회 2003 동의생리병리학회지 Vol.17 No.2

Diabetic Nephropathy is one of the major causes of chronic renal failure. It is a common microvascular complication and clinically defined as the presence of persistent Proteinuria. We studied the effects and change of the renal function of Complex Herbal medication of the 20Diabetic Nephropathy patients. We measured the initial levels of Total Protein, Creatinine Clearance Rate(Ccr), Serum Creatinine(Serum-Cr), Urine Creatinine(Urine-Cr) and HbA1C on admission and followed up the level changes of Total Protein, Ccr, Serum-Cr and Urine-Cr on discharge. The results are following : Complex Herbal Medication does not cause the renal toxicity. The longer hypertension period is, the higher Serum-Cr level and Urine-Cr level. In an older age group, Urine-Cr is lower. 4.From the "Deficiency in Origin and Excess in Superficiality(本虛表實)“points of view, Complex Herbal Medication improves the Serum-Cr in Diabetic Nephropathy patients. According to this results, it could be suggested that Complex Herbal Medication does not cause the renal toxicity in Diabetic Nephropathy patients and intensive controls of blood sugar, blood pressure and Complex Herbal Medication prevent the renal failure in Diabetic Nephropathy patients with early stage of Microalbumiuria.

대퇴동맥을 통한 경피적 관동맥 중재시술 환자의 천자부위 지혈을 위한 Angioseal^(�) 사용과 고식적 용수 압박법의 비교 : 전향적 연구

김용훈,권현철,김필호,안석진,유철웅,최진호,이상철,김준수,김덕경,전은석,이상훈,홍경표,박정의,서정돈 대한내과학회 2004 대한내과학회지 Vol.66 No.5

목적 : 경피적 관동맥 중재술은 최근 양적 및 질적으로 급격한 발전을 보였지만 시술 시 천자부위의 혈관 합병증은 아직 해결해야 할 문제점이다. 저자들은 대퇴동맥을 통한 경피적 관동맥 중재술을 환자에게 천자부위 지혈을 위한 혈관폐쇄기구인 안지오실의 안전성과 유용성을 고식적인 용수 압박법과 비교 연구하고자 하였다. 방법 : 2002년 4월부터 2003년 5월 사이에 삼성서울병원 심장혈관센터에서 대퇴동맥을 통한 경피적 관동맥 중재술을 성공적으로 시행한 200명의 환자(안지오실 사용군: A군, 100명, 고식적 용수압박법 사용군 B군, 100명)를 대상으로 시술 후 주요 합병증 및 경한 합병증, 지혈 후 환자가 자리에 앉기까지의 시간, 보행개시 가능시간, 총 재원 기간과 시술 1주 후의 합병증을 전향적으로 조사하여 비교 연구하였다. 결론 : 두 군에서 연령, 성별, 기저질환, 심혈관 질환의 위험요소, 시술의 종류, 시술 중 사용한 헤파린의 양, clopidogrel의 양, ticlopidine의 양, 지혈 시 수축기와 확장기혈압, ACT (activated clotting time)는 차이가 없었다. A군이 B군에 비해 시술 후 자리에 앉기까지의 시간 (A군: 4.3±0.3시간, B군: 13.7±0.8시간, p=0.004) 및 보행개시까지의 시간(A군: 6.8±0.5시간, B군: 18.8±2.1시간, p=0.013)이 유의하게 짧았다. 시술 후 주요 합병증은 두군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 A군에서 유의하게 적었다(A군: 28명, B군: 19명, p=0.003). 반상출혈의 경우는 A군에서 유의하게 낮았지만(A군: 3명, B군: 12명, p=0.01), 혈종, 출혈의 발생은 두군간에 차이가 없었다. 총 재원기간에는 두 군간에 차이가 없었다(p=0.239). 시술 1주 후 경과관찰에서 주요합병증은 역시 두 군 모두에서 관찰되지 않았으며, 경한 합병증의 전체발생은 두 군에서 차이가 없었다(A군: 15명, B군: 13명 p=0.418), 반상출혈의 빈도는 차이가 없었지만 혈종의 발생은 A군에서 더 낮았다(A군: 2명, B군:6명, p=0.004). 두 군 모두에서 출혈은 발생하지 않았다. 결론 : 대퇴동맥을 통한 경피적 관동맥 중재술을 시행한 환자에서 안지오실의 사용은 고식적 용수 압박법에 비해 환자의 침상 안정시간을 줄여 조기 활동개시가 가능하게 하였으며 국소합병증의 위험도를 일부 낮추어, 시술에 따른 환자의 불편을 현저하게 감소시킬 수 있다고 할 수 있을 것으로 기대된다. Background : Although the number and the quality of percutaneous coronary intervention have been recently increased dramatically, the vascular complication at puncture site is still the major cause of patients' morbidity. We evaluated the safety and efficacy of newly of newly-developed collagen-based arterial closure device, Angioseal after transfemoral percuatenous coronary intervention. Methods : This study was designed as a prospective single center non-randomized comparative study. A total 200 patients undergoing transfemoral percutaneous coronary intervention were enrolled between April 2002 and May 2003. They were divided into two groups; Angioseal group (group A, n=100) and manual compression group (group B, n=100). The baseline clinical and angiographic characteristics were reviewed. The time to sit up, the time to ambulation, the duration of hospital stay, major and minor vascular puncture site complications were monitored. The patients were followed-up for 1 week after procedure by telephone. Results : The baseline clinical characteriwtics, clinical diagnosis, cardiocascular risk factors, typesof procedure, doses and numbers of anticoagulants were similar between two groups. The blood pressure and activated clotting time were also similar. The time to sit up (group A: 4.3±0.3 hours, group B: 13.7±0.8 hours, p=0.004) and the time to ambulation (group A: 6.8±0.5 hours, group B: 18.8±2.1 hours, p=0.013) were shorter in group A. No major vascular complications were noted. The incidence of hematoma and bleeding were not significantly different between two groups. The incidence of ecchymosis, however, was significantly lower in group A (group A:12%, group B: 3%, p=0.001) The duration of gospital stay was similar between groups. During 7 days of follow-up period incidence of hematoma was significantly lower in group A (p=0.004). Although the incidence of ecchymosis was not significantly different between two groups. Conclusion : The angioseal may be associated with earlier ambulation and less patients' morbidity with low incidence of local complication rate compared to manual compression after transfemoral percutaneous coronary intervention.

A Case of Obscure Bleeding from a Proximal Jejunal High-risk Gastro-intestinal Stromal Tumors Diagnosed with Double-balloon Enteroscopy

Se Gwon Moon · Jung Min Lee · Young Ho Seo · Bong Kyu Lee · Hee Jong Kim · Kyung Hwan Kim · Sung Hwan Song · Jae Woo Park 조선대학교 의학연구원 2012 The Medical Journal of Chosun University Vol.37 No.2

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춘천 지역에서 발생한 쯔쯔가무시병의 임상적 특징

이호권 ( Ho Gwon Lee ),민슬기 ( Seul Ki Min ),공승진 ( Seung Jin Kong ),이수정 ( Su Jung Lee ),송헌호 ( Hun Ho Song ),윤종우 ( Jong Woo Yoon ),이명구 ( Myung Goo Lee ),신동훈 ( Dong Hoon Shin ),강성하 ( Sung Ha Kang ),이정열 ( Jeo 대한내과학회 2005 대한내과학회지 Vol.69 No.2

목적 : 쯔쯔가무시병 환자의 일부는 중증감염으로 중환자실 집중치료를 필요로 하며 이 중 사망하는 환자들도 있다. 본 연구는 춘천 및 인근 지역에서 발생한 쯔쯔가무시병 환자의 임상적인 특징과 이 중 중증환자들의 특징을 분석하여 지역사회의 쯔쯔가무시병의 진단과 치료 및 교육에 도움이 되고자 하였다. 방법 : 1997년 4월부터 2002년 12월까지 한림대학교 부속 춘천성심병원에서 쯔쯔가무시 병으로 진단되었던 81예의 환자들의 의무기록 열람을 통한 후향적 분석을 시행하였다. 81예 환자들의 내원시 임상소견을 분석하였고, 이 중 본 병원에서 치료 받았던 79예의 환자들의 치료결과를 분석하였으며, 내원시 일반병실로 입원한 환자와 중환자실로 입원하였던 환자의 임상소견을 비교하여 중증환자들의 특징을 비교하였다. 결과 : 73예의 환자가 가을에 발생하였으며, 70예에서 발열이 있었고, 가피가 발견된 경우는 58예(71.6%)였다. Doxycycline 치료 후 45예의 환자가 48시간내 열이 없어졌으나 13예에서는 5일이상 열이 지속되었다. 79예 중에서 중환자실로 입원한 경우가 25예 였으며 이 중 8예에서 기계환기 치료를 받았고, 3예가 다발성 장기부전으로 사망하였다. 중환자실에 입원한 중증환자들은 백혈구수가 많았고, BUN과 크레아티닌이 높았고, 알부민 수치가 낮았다. 결론 : 쯔쯔가무시병은 중증질환으로 이환될 수 있으며 특히 고령이거나 만성질환을 가지고 있는 환자에게서는 치명적인 결과를 초래할 수 있으므로 감염발생의 위험이 있는 지역사회에서 유행 시기에 발열 등의 증상이 있을 때 조기 진단이 필수적이며 이를 위한 교육이 필요하다. 그리고 중증환자에서 백혈구수, 혈청 알부민, BUN, 크레아틴 등에서 차이를 나타내어 쯔쯔가무시 병의 예후를 예측하는 요소로 사료된다. Background : Tsutsugamushi disease is an acute febrile disease in Korea. Some patients with tsutsugamushi disease have severe illness, which needs care in intensive care unit, and may die due to the disease. We analyzed the cases with tsutsugamushi disease who lived in Chuncheon and neighboring communities to find out clinical manifestations, laboratory findings especially in severe cases. Methods : We reviewed the clinical records of the 81 cases who were diagnosed as tsutsugamushi in Chuncheon Sacred Heart Hospital from April, 1997 to December, 2002. We analyzed the clinical and laboratory findings of the 81 cases, and the treatment results of 79 cases who recieved the treatment in this hospital. We also compared the characteristics of the patients between admission to general ward and intensive care unit (ICU). Results : Seventy three cases developed the disease in autumn. Seventy cases had fever. 58 cases had eschar in their bodies. With the doxycycline treatment, forty five cases subsided the fever within 48 hours, but in 13 cases, fever continued after 5 days of treatment. Twenty five cases were admitted to ICU, 8 cases among them were treated with ventilator, 3 cases died due to the multi-organ failure. When we compared the clinical characteristics of the patients admitted to ICU with those to general wards, leukocyte count, the level of BUN and creatinine were higher, the albumin level was lower in ICU patients than those of general ward patients. Conclusion : Tsutsugamushi disease can progress to severe disease, and be fatal to the patients. So it is necessary to diagnose early and treat carefully. We suggest that leukocyte count, BUN, creatinine, or albumin can be used to predict the prognosis.(Korean J Med 69:190-196, 2005)

Comparing Two-Stent Strategies for Bifurcation Coronary Lesions: Which Vessel Should be Stented First, the Main Vessel or the Side Branch?

Shin, Dong-Ho,Park, Kyung Woo,Koo, Bon-Kwon,Oh, Il-Young,Seo, Jae-Bin,Gwon, Hyeon-Cheol,Jeong, Myung-Ho,Seong, In-Whan,Rha, Seung Woon,Yang, Ju-Young,Park, Seung-Jung,Yoon, Jung Han,Han, Kyoo-Rok,Park The Korean Academy of Medical Sciences 2011 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.26 No.8

<P>This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family:109, S-family:140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, <I>P</I> = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, <I>P</I> = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, <I>P</I> = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; <I>P</I> = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'.</P>

지속성 외래 복막투석 환자에서 영양상태와 투석의 적절도

박미정(Mi Jung Park),이균상(Kyun Sang Lee),조민석(Min Seok Cho),김정기(Jeong Ki Kim),박병석(Byoung Seok Park),마성권(Seong Kwon Ma),고정희(Jung Hee Ko),나명윤(Myong Yun Nah),염충호(chung Ho Yeum),정권(Jung Gwon),김수완(Soo Wan Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4

Purpose - Malnutrition is common in CAPD patients and depends on many factors such as dialysis-related and nondialysis-related factors. The present study aimed to assess nutritional status, dialysis adequacy and their relationships with overall mortality and morbidity. Methods - We studied 102 patients who had been receiving CAPD for at least 6 months. Dialysis adequacy was assessed by parameters derived from urea kinetic modeling(UKM) and nutritional status was assessed by serum biochemical measurement, normalized protein catabolic rate(nPCR), normalized protein equvalent of total nitrogen appearance(nPNA) and urea kinetic studies. Spearman's simple correlation and multiple linear stepwise regression analysis were used to assess correlation between dialysis adequacy and nutritional status in CAPD patients. We compared the differences between patients who suffered morbid events, defined as either an infectious complication or hospitalization, and patients who remained well. Results : The results showed that the total dialysis dose(total weekly Kt/Vurea ) has statistically significant correlation with nPCR(r=0.234, p=0.028), nPNA (r=0.246, p=0.021), total weekly creatinine clearance (WCC)(r=0.479, p=0.0001), serum albumin levels(r= 0.233, p=0.029), serum cholesterol(r=0.266, p=0.013), serum BUN(r=-0.290, p=0.006) and serum creatinine levels(r=-0408, p-0.0001). nPNA was positively correlated with serum cholesterol(r=0.217, p=0.045), serum transferrin(r=0.218, p=0.042) and serum ferritin levels(r=0.220, p=0.043). Patients who suffered morbid events had an old age(p=0.001), long duration of CAPD(p=0.0001), higher CRP(p=0.021), lower serum albumin level(p=0.020), lower hematocrit(p=0.049) and lower WCC(p=0.017). Conclusions: These results indicate that adequate dialysis is very important for the maintenance of adequant nutrition because nutritional status positively correlated with dialysis dose, which is best assessed by UKM. In addition, assessment of nutritional status and dialysis adequacy are important in predicting clinical outcomes in CAPD patients.

래버린스 실, 브러쉬 실, 하이브리드 동압 실에 대한 누설 유량의 실험적 비교

정진우(Jin Woo Jung),황성호(Sung Ho Hwang),정권종(Gwon Jong Jung),김태호(Tae Ho Kim) 한국유체기계학회 2022 유체기계 연구개발 발표회 논문집 Vol.2022 No.11

태양광발전 시스템용 인버터의 계통연계 제어

정영석(Young-Seok Jung),이정태(Jung-Thae Lee),정명웅(Myung-Woong Jung),유권종(Gwon-Jong Yu),송진수(Jin-Soo Song),최재호(Jae-ho Choi) 대한전기학회 1996 대한전기학회 학술대회 논문집 Vol.1996 No.7

원위부 신세뇨관성 산증에서 산-염기 운반체의 결손

김혜영,한진석,이정상,김현리,김진,이중건,이서진,김근호,진호준,전은실,주권욱,나기영,정우경,오지은,엄재호,궁성수 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5

The purpose of this study was to elucidate whether the molecular defect of acid-base transporters in renal tubules is related to the functional defect of urinary acidification in distal renal tubular acidosis(RTA). We performed NH₄Cl, furosemide, or bicarbonate loading test to evaluate renal acidification function, and immunohistochemistry using antibodies to H^+ -ATPase, Cl^-/HCO₃^- exchanger(band-3 protein), and Na^+/K^+ -ATPase in kidney tissue in 6 patients with RTA and renal cell carcinoma patients as normal controls. Kidney tissue was obtained either by percutaneous needle biopsy(RTA) or nephrectomy(NC). The results were as follows; 1) In all six RTA patients, proton secretory defect of distal acidification was shown by a failure to lower the urine pH after NHC1 loading or furosemide test or abnormally low urine-blood pCO₂ difference during bicarbonate loading. In two patients with RTA, proximal acidification defect was combined, which was demonstrated by increased fractional excretion of bicarbonate. 2) In mal control, intense H^+ -ATPase and band-3 protein staining was observed in collecting ducts. 3) In distal RTA patients, H6+ -ATPase and band-3 protein staining was not demonstrable or markedly decreased in the intercalated cells of distal nephron. 4) In two patients who had both proximal and distal RTA, H^+ -ATPase staining was markedly decreased in the brush border of proximal tubules as well as the distal nephron. In conclusion, the defect of acid-base transporters in renal tubule was related with the functional defect of urinary acidification in distal RTA.

Amelioration of amyloid β‐FcγRIIb neurotoxicity and tau pathologies by targeting LYN

Gwon, Youngdae,Kim, Seo-Hyun,Kim, Hyun Tae,Kam, Tae-In,Park, Jisu,Lim, Bitna,Cha, Hyunju,Chang, Ho-Jin,Hong, Yong Rae,Jung, Yong-Keun Federation of American Society for Experimental Bi 2019 The FASEB Journal Vol.33 No.3