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심한 복수를 동반한 간경변 환자에서 대량 복수천자시 사용되는 혈장증량제로서 Albumin과 Hydroxyethyl Starch 효과의 비교
김병호,김효종,장린,이정일,동석호,장영운,강경의 대한소화기학회 1998 대한소화기학회지 Vol.31 No.5
Background/Aims: Albumin is widely used as plasma expander to prevent circulatory dysfunction developed after large volume paracentesis (LVP) in cirrhotics with tense ascites. Considering the high cost of albumin, we decided to investigate prospectively whether hydroxyethyl stareh (HES) can prevent circulatory and renal dysfunction after paracentesis. Methods: Twelve cirrhotics with tense ascites were randomly assigned to receive albumin (group I, n=6) or HES (group II, n=6). Salt and fluid were restricted and diuretics were withdrawn at least for two days. Then, LVP was performed and followed by slow infusion of plasma expander, 8 g/L ascites. Circulatory and renal dysfunction were monitored before, one and two days after LVP. Results: Clinical characteristics, liver function and etiologies of cirrhosis in both groups were not different. The average amount of ascites removed from hoth groups was 4.3±0.98 L and 4.4±0.55 L, respectively. After LVP, hepatic encephalopathy, hemodynamic and renal dysfunction were not developed and the vital signs were not changed in any patients. Compared with the basal level, the amount of urine output increased immediately and two days after LVP in all patients of group I (592±80 → 816±392 → 1166±671 mL/day) and in group II (441±211 → 683±354 → 667±280 mL/day). No patients died of LVP cornplications during the admission. Conclusioes: These results suggest that HES is as effective and safe as albumin to prevent hemodynamic and renal dysfunction complicated by LVP in cirrhotics with tense ascites, and may be an alternative to albumin, the expensive plasma expander.
김병호,이정일,김효종,장린,동석호,강경의,장영운,김윤화,박현주 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.6
Ulcerative colitis (UC) is an inflammatory disease primarily involving the colonic mucosa. The extension of classic UC is uniform and continuous with no intervening areas of normal mucosa. The rectum is usually involved and the inflammation extends proximally in a continuous fashion for a variable distance. However, as more patients get colonoscoped, it had been reported that there is a wide spectrum to what is called UC. There appear to be a few patients with otherwise typical UC but with rectal sparing. And also there are patients with classic distal UC who have an isolated area of cecal disease and segmental UC with skipped area. We have experienced a case of atypical UC initially presented as a isolated lesion around the appendiceal orifice with the segmental distribution of inflammatory change without an active inflammatory lesion in the rectum. It was considered that understanding of the significance of an isolated lesion in the appendix would contribute to the elucidation of the pathogenesis of UC.