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왕준광 ( Joon Kwang Wang ),박의순 ( Ui Soon Park ),이혜순 ( Hye Soon Lee ),엄완식 ( Wan Sik Uhm ),김태환 ( Tae Hwan Kim ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),안유헌 ( You Hern Ahn ),최윤영 ( Yun Young Choi ),주경빈 ( 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.4
Objective: Decrease in bone mineral density (BMD) occurs relatively early and is known to be correlated with disease activity in patients with ankylosing spondylitis (AS). We investigated BMD and its correlation factors in Korean patients with AS. Methods: Fifty patients with AS fulfilling modified New York criteria and age-, sex-, and body mass index-matched 100 normal controls were selected. Medical records were reviewed retrospectively. Lumbar and femur BMD was measured using a dual energy X-ray absorptiometry. Results: Both lumbar and femur BMD in patients with AS were significantly lower than BMD in control group. Although Bath ankylosing spondylitis disease activity index, C-reactive protein and erythrocyte sedimentation rate showed no correlation with BMD, lumbar BMD in patients with high disease activity in terms of inflammatory factors was significantly lower than that in patients with low disease activity. Conclusion: BMD in patients with AS was significantly lower than those in control group. Early detection and appropriate management will be necessary in patients with AS.
유지 혈액투석 환자에서 단일풍선 소장내시경으로 치료한 소장출혈
김정엽 ( Jeong Yup Kim ),왕준광 ( Joon Kwang Wang ),김미나 ( Mi Na Kim ),김선철 ( Sun Chul Kim ),김혜원 ( Hye Won Kim ),이영모 ( Young Mo Lee ),권영주 ( Young Joo Kwon ),표희정 ( Heui Jung Pyo ),박자인 ( Ja In Park ),오주연 ( Joo 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6
Anemia is a common complication of hemodialysis. It reduces the quality of life and is recognized as adverse risk factor. The cause of anemia in CKD (chronic kidney disease) include lack of erythropoietin, gastrointestinal (GI) bleeding, hypothyroidism, hidden infection, and blood loss in hemodialysis. GI bleeding is not unusual complication in patient on maintenance hemodialysis, caused by uremia, medicine (NSAIDS, antiplatelet agents, anticoagulants), angiodysplasia, and ulcer. In CKD patients, GI bleeding is found in various sites over the whole bowel. Small bowel bleeding is one of the most common causes of obscure GI bleeding and constitutes 2-10% of all GI bleeding. Regarding the small bowel bleeding, diagnosis and treatment are much improved recently with the help of wireless capsule endoscopy and double or single balloon enteroscopy. We report a case of GI bleeding due to erosion of small bowel, which was diagnosed and treated with the single-balloon enteroscopy in patients on maintenance hemodialysis.
이차성부갑상샘항진증을 가진 만성신부전 환자에서 하악골 종대 및 폐, 위점막 석회 침착 1예
김정엽 ( Jeong Yup Kim ),김정선 ( Jeong Seon Kim ),왕준광 ( Joon Kwang Wang ),박상원 ( Sang Won Park ),이영모 ( Young Mo Lee ),이지은 ( Ji Eun Lee ),전은실 ( Eun Sil Jeon ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ),이재복 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
Secondary hyperparathyroidism is one of the most common complications of patients with chronic kidney disease (CKD). Mandibular enlargement, metastatic pulmonary calcification, and gastric mucosal calcinosis are rare complications in these patients. The defect of calcium and phosphorus metabolism may precipitate pathologic calcification at diverse organs and soft tissue, and change bone architecture. In case of involving periarticular area, patients usually present with localized swelling, pain, and reduced mobility in affected sites. However, in case of organ involvement, except in an advanced stage of disease, there are no specific symptoms. Among these patients, treatment strategies include tight control of calcium and phosphate levels, parathyroidectomy for hyperparathyroidism, renal transplantation, and local excision of calcific lesions. We report a case of mandibular enlargement, metastatic pulmonary calcification, and gastric mucosal calcinosis due to CKD with improvement 3 months after medical and surgical treatment.
만성콩팥병 환자의 25-Hydroxyvitamin D 상태에 대한 단일기관 연구
이영모 ( Young Mo Lee ),박상원 ( Sang Won Park ),김정선 ( Jung Sun Kim ),왕준광 ( Joon Kwang Wang ),김정엽 ( Jeong Yup Kim ),박만식 ( Man Sik Park ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Purpose: We checked the levels of serum 25-hydroxyvitmain D (25OHD) in the patients with chronic kidney disease (CKD) to survey the status of vitamin D levels, to see the seasonal variations of 25OHD, and to evaluate the relationships among the levels of intact PTH, corrected calcium, and phosphorus. Methods: We defined vitamin D insufficiency and vitamin D deficiency as serum 25-hydroxyvitamin D levels between 20 and 30 ng/mL and below 20 ng/mL, respectively. 185 patients in a single center were enlisted who categorized into 3 groups, CKD2-3, CKD4, and CKD5 by eGFR using MDRD7 equation. To see the seasonal differences of the levels of 25OHD, we collected laboratory data two times per each patient during summer division (April to September) and winter division (October to March). Results: Prevalences of hypovitaminosis D were 42.8% (CKD2-3), 66.1% (CKD4), 92.8% (CKD5) in summer division and 48.7% (CKD2-3), 73.1% (CKD4), 92.8% (CKD5) in winter division. Seasonal difference of the levels of 25OHD was evident only in CKD stage 2-3 (p=0.018). Negative correlations were recognized between 25OHD and intact PTH (r=-0.2048, p<0.001), phosphorus (r=-0.1711, p=0.0011). Conclusion: Hypovitaminosis D is prevalent even in patients with early stages of CKD. The levels of 25OHD decreased significantly in winter division in patients with CKD stages 2-3. The levels of 25OHD were inversely correlated with those of intact PTH, phosphorus, respectively.