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투석환자에서 C-reactive protein과 심혈관계 질환의 발생과의 관계
이균상 ( Kyun Sang Lee ),이연경 ( Youn Kyoung Lee ),박병석 ( Byoung Seok Park ),정택균 ( Taek Kyun Jeong ),정균호 ( Gyun Ho Jeong ),마성권 ( Seong Kwon Ma ),김수완 ( Soo Wan Kim ),김남호 ( Nam Ho Kim ),최기철 ( Ki Chul Choi ) 대한내과학회 2002 대한내과학회지 Vol.63 No.6
배경: 동맥경화는 투석치료를 받고 있는 말기 신질환 환자에서 중요한 문제이고 이는 하나의 염증질환으로 대별된다. 심혈관계 질환은 만성 신부전 환자의 주요한 사인이고 사망원인의 약 50%를 차지한다. 본 연구는 대표적인 염증반응의 표지자인 CRP와 투석환자에서 심혈관계 위험과의 상관관계를 알아보고자 하였다. 방법: 투석환자에서 후향적 연구를 시행하였다. 환자는 CRP치가 상승된 군 (CRT>8 mg/L; n=11)과 CRP치가 정상인 군(CRP≤8mg/L Background: Atherosclerosis, a major problem in patients undergoing chronic dialysis treatment, has been characterized as an inflammatory disease. Cardiovascular disease is the major cause of mortality, accouting for approximately half of all deaths in th
지속성 외래 복막투석 환자에서 발생한 당뇨병성 근육 경색증
정택균 ( Taek Kyun Jeong ),이연경 ( Youn Kyoung Lee ),정균호 ( Gyun Ho Jeong ),박병석 ( Byong Seok Park ),마성권 ( Seong Kwon Ma ),김수완 ( Soo Wan Kim ),김남호 ( Nam Ho Kim ),최기철 ( Ki Chul Choi ) 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.1
Diabetic muscle infarction (DMI) is a rare condition occurring in subjects with long-standing complicated diabetes mellitus. We report DMI in a 65-vear-old man with type 2 diabetes mellitus undergoing continous ambulatory peritoneal dialysis (CAPD) with review of this condition in the literature. He had been suffered from type 2 diabetes mellitus for 21 years. In 1997, he reached end-stage renal disease and had received on renal replacement therapy with CAPD since then. In June 2002, he presented with sudden and spontaneous onset of severe pain in the right thigh region. He was afebrile, and the right thigh was swollen and tender but not erythematous. Laboratory data on admission included white blood cell count of 15,800/㎣, hemoglobin 9.0g/dL, platelet count 264,000/㎣, BUN 102.3mg/dL, serum creatinine 9.9 mg/dL, fasting blood glucose 85 mg/dL, postprandial 2 hours blood glucose 162 mg/dL, hemoglobin AIC 5.84%, ESR 125 mm/h (it was 52 mm/h one month earilier), CRP 18.9 mg/dL, and normal levels of creatinine kinase. Magnetic resonance imaging (MRI) showed asymmetry of the muscle in T1-weighted images and increased signal intensity involving the medial portion of right thigh (adductor longus, adductor magnus, vastus intermedius muscle, etc) in T2-weighted images with no contrast enhancement. Radioistope venography of the ileo-femoral veins was was normal, excluding deep venous thrombosis as a cause. The right thigh was explored surgically and a biopsy taken from the vastus intermedius muscle was consistent with chronically inflammed scar tissue with no evidence of malignancy. A biopsy taken from the vastus intermedius muscle showed hemorrhagic necrosis of skeletal muscle, with lymphcytic infiltration. Most of the blood vessels appeared normal. The swelling resolved spontaneously following a few weeks of bedrest and analgesia. To our knowledge, this is the first reported case of DMI in patients undergoing renal replacement therapy in Korea.
당뇨병성 신증 환자에서 저분자량 헤파린 Dalteparin Sodium 사용 중 발생한 후복막강 혈종 1예
정택균,정균호,박병석,마성권,김수완,김남호,최기철 대한내과학회 2003 대한내과학회지 Vol.64 No.3
신대체 요법의 유무에 관계없이 신기능 장애가 있는 환자에서 항응고 치료로 저분자량 헤파린 (dateparin, enoxaparin 등)을 사용할 경우에는 제제에 관계없이 심한 출혈의 위험성이 높아질 수 있기 때문에 세심한 주의를 요한다. 6~8일 이상 투여하는 것은 삼가고 심각한 출혈을 일으킬 수 있음을 항상 주지하여야 하며 , 특히 항응고 치료 과정 중에 치료 전 없었던 옆구리, 서혜부, 하요부 및 하지의 통증 , 빈혈, 저혈압 등이발생하였을 때 후복막강 혈종의 가능성을 항상 고려하여야 할 것이다. Retroperitoneal Hematoma is a rare intraabdominal bleeding occurring in patients with low-molecular weight heparin anti-coagulant therapy. we report a case of dalteparin sodium-associated retroperitoneal hematoma in a 70-year-old man with diabetic nephropathy with review of this condition in the literature. He had been suffered from type 2 diabetes mellitus and hypertension for 15 years. In July 2002, he was admitted to our hospital because of unstable angina and left pleural effusion. He was treated with dalteparin sodium and aspirin for unstable angina. On the second hospital day, he was referred to division of nephrology for diabetic nephropathy. Laboratory data on admission included white blood cell count of 4,500/㎣, hemoglobin 9.6 g/dL, platelet count 294,000/㎣, BUN 58.1 mg/dL, serum creatinine 4.1 mg/dL, blood glucose 178 mg/dL, hemoglobin A1c5.9T, PT 13.9 sec (INR: 1.09), and aPTT 50 sec, On days 6 through 8, he had lower back pain, lower extremity pain and neuropathy, anemia and hypotension. Abdominal ultrasound showed 6×6 cm-sized well marginated mixed echogenic lesion in psoas muscle and fluid collection in retroperitoneal cavity. Magnetic resonance imaging (MRI) showed increased signal intensity and thickening of the right psoas muscle including 4.7×2.3×21 cm-sized cytic lesion and 6.2×5.3×3.7 cm-sized cystic lesion on the lateral portion of right psoas muscle in T2-weighted images. Percutaneous drainage of cystic lesion was performed by right lateral approach. Hemodialysis was begun without heparinization. Abdominal CT showed 5.5×5 cm-sized high attenuated lesion in right psoas muscle and 5×3 cm, 3×2 cm, 4.5×2.5 cm, 4×2.5 cm-sized heterogeneous, slightly high attenuated lesions in the right lower abdomen and cul-de-sac in the scans with no enhancement. He was treated by conservative therapy. He recovered gradually. Patients with kidney diseases receiving low molecular weight heparin (dalteparin, enoxaparin, etc) should be closely monitored to prevent serious bleeding complications. The possibility of retroperitoneal hematoma should be considered, whenever symptoms including lower back pain, inguinal pain, leg pain, anemia, or hypotension occurred during the lower molecular weight heparin anticoagulant therapy. To our knowledge, this is the first reported case of retroperitoneal hematoma in a patient during dalteparin sodium (Fragmin^??) anticoagulant therapy. (Korean J Med 64:322-327, 2003)
Jeong, Gwi-Taek,Hong, Yong-Ki,Lee, Hyung-Ho,Kong, In-Soo,Kim, Joong Kyun,Park, Nam Gyu,Kim, Sung-Koo,Park, Don-Hee Humana Press 2014 Applied biochemistry and biotechnology Vol.174 No.1
<P>In this study, the recovery of algal oil from Enteromorpha intestinalis based on an acidic-hydrothermal reaction was investigated. Overall, the algal oil yield after the acidic-hydrothermal reaction was increased under the conditions of high reaction temperature, high catalyst concentration, and long reaction time within the tested ranges. Significantly, catalyst concentration, compared with reaction temperature and time, less affected algal oil recovery. The optimal acidic-hydrothermal reaction conditions for production of algal oil from E. intestinalis were as follows-200 C reaction temperature, 2.92 % catalyst concentration, 54 min reaction time. Under these conditions, an 18.6 % algal oil yield was obtained. By increasing the combined severity factor, the algae oil recovery yield linearly increased.</P>
Surgical anatomy for Asian rhinoplasty: Part III
Taek Kyun Kim,Jae Yong Jeong Korean Cleft Palate-Craniofacial Association 2023 Archives of Craniofacial Surgery Vol.24 No.1
This article, which comprises the third part of a series on surgical anatomy for Asian rhinoplasty, addresses the lower one-third of the nose, including the alar cartilage and tip-supporting structures, known as distal mobile framework. As discussed in earlier parts of this series, diversity in surgical anatomy results in different surgical techniques in Asian rhinoplasty compared to rhinoplasty in Caucasian patients. Nasal tip structures are especially important due to their crucial importance for changing the nasal shape in Asians. This article, along with the previous ones, will provide both basic and advanced knowledge of practical surgical anatomy for Asian rhinoplasty.
Nam, Taek-kyun,Park, Seung-won,Park, Yong-sook,Kwon, Jeong-taik,Min, Byung-kook,Hwang, Sung-nam The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.46 No.6
Objective : This study investigates the role of a burr hole and calvarial bone marrow-derived stem cells (BMSCs) in a transient ischemic brain injury model in the rat and postulates a possible mechanism for the efficacy of multiple cranial burr hole (MCBH) surgery in moyamoya disease (MMD). Methods : Twenty Sprague-Dawley rats (250 g, male) were divided into four groups : normal control group (n=5), burr hole group (n=5), ischemia group (n=5), and ischemia+burr hole group (n=5). Focal ischemia was induced by the transient middle cerebral artery occlusion (MCAO). At one week after the ischemic injury, a 2 mm-sized cranial burr hole with small cortical incision was made on the ipsilateral (left) parietal area. Bromodeoxyuridine (BrdU, 50 mg/kg) was injected intraperitoneally, 2 times a day for 6 days after the burr hole trephination. At one week after the burr hole trephination, brains were harvested. Immunohistochemical stainings for BrdU, CD34, VEGF, and Doublecortin and Nestin were done. Results : In the ischemia+burr hole group, BrdU (+), CD34 (+), and Doublecortin (+) cells were found in the cortical incision site below the burr hole. A number of cells with Nestin (+) or VEGF (+) were found in the cerebral parenchyma around the cortical incision site. In the other groups, BrdU (+), CD34 (+), Doublecortin (+), and Nestin (+) cells were not detected in the corresponding area. These findings suggest that BrdU (+) and CD34 (+) cells are bone marrow-derived stem cells, which may be derived from the calvarial bone marrow through the burr hole. The existence of CD34 (+) and VEGF (+) cells indicates increased angiogenesis, while the existence of Doublecortin (+), Nestin (+) cells indicates increased neurogenesis. Conclusion : Based on these findings, the BMSCs through burr holes seem to play an important role for the therapeutic effect of the MCBH surgery in MMD.