http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례 : 간세포암종의 자연적 파열로 유발된 고삼투압성 고혈당 상태 1예
윤혜은 ( Hye Eun Yoon ),남성민 ( Sung Min Nam ),손태서 ( Tae Seo Sohn ),김창욱 ( Chang Wook Kim ),손현식 ( Hyun Shik Son ),이창돈 ( Chang Don Lee ),차봉연 ( Bong Youn Cha ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 간세포암종의 파열로 유발된 고삼투압성 고혈당 상태 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Ketoacidosis and hyperosmolar hyperglycemia are the two most serious acute metabolic complications of diabetes, even if managed properly. The mortality rate of patients with hyperosmolar hyperglycemic state still remains high at ~15%. Mortality is associated with advanced age and comorbidity and is usually due to an associated catastrophic illness or to acute complications. Treatment of hyperglycemic states depends critically on the detection and treatment of precipitating illness, as well as prompt attention to fluid and electrolyte disturbances. We report a case of hyperosmlar hyperglycemic state precipitated by spontaneous rupture of hepatocelluar carcinoma. (Korean J Med 69:S879-S883, 2005)
신장 ; 무증상의 고립성 혈뇨 환자에서 다검출기 CT로 진단된 방광암의 특성
윤혜은 ( Hye Eun Yoon ),김병수 ( Byung Soo Kim ),신영신 ( Young Shin Shin ),정현화 ( Jeong Hyeon Hwa ),김용균 ( Yong Gyun Kim ),신석준 ( Seok Jun Shin ),김영옥 ( Young Ok Kim ),송호철 ( Ho Cheol Song ),김용수 ( Yong Soo Kim ),최 대한내과학회 2009 대한내과학회지 Vol.77 No.3
목적: 현미경적 혈뇨는 건강검진이 일반화되면서 환자가 증가하고 있다. 최근 혈뇨의 원인 규명을 위한 단일검사 방법으로 신장, 요로, 방광을 동시에 조영하고 있는 다검출기 CT가 이용되고 있어 무증상의 고립성 혈뇨의 환자에서 MDCT를 이용하여 진단된 방광암의 유병율과 임상적 특성을 알아보고자 하였다. 방법: 본 연구는 2005년 3월부터 2008년 3월까지 고립성혈뇨로 가톨릭대학교 성가병원 신장내과와 비뇨기과 외래를 찾은 환자 1,819명을 대상으로 하여 그들의 임상적 특성을 알아보고 방광암으로 진단된 환자의 임상적 특성을 비교분석 하였다. 결과: 고립성 혈뇨로 MDCT를 시행한 환자는 1,819명으로 남자 564명(31%), 여성 1,255명(69%)이었고, 평균 연령은 47.2±16.8세였다. 전체 대상 환자 MDCT의 판독 결과는 정상소견(54.1%), 단순 신낭종(25.7%), 신결석(4.7%), 요로계악성종양(1.7%) 순이었다. 31명의 요로계 악성종양 환자 중방광암을 진단된 환자는 25명(1.3%)으로 이 중 남자는 20명(81%), 여성 5명(19%)이었으며, 방광암의 평균 연령은 74.5±7.3세였다. 방광암으로 진단된 25명의 환자의 경우 비종양환자에 비해 육안적 혈뇨, 연령, 남성의 비율 및 혈중크레아티닌 측정치과 높았으며(p<0.05), 혈색소과 알부민 측정치가 유의하게 낮았다(p<0.05). 전체 환자에서 육안적 혈뇨의 환자를 제외한 무증상의 현미경학적 혈뇨에서 방광암의 발생빈도 6명(0.3%)이었다. 결론: 무증상의 고립성 혈뇨 환자에서 MDCT 사용한 단일검사법이 유용한 수단으로 판단되나 특정한 임상양상을 가진 경우 적극적인 침습적 방법의 도입이 요구된다. Background/Aims: This report discusses the frequency and clinical characteristics of bladder cancer diagnosed with multi-detector computed tomography (MDCT) in outpatients visiting a nephrology and urology clinic with asymptomatic isolated hematuria. Methods: MDCT was performed on outpatients who presented to the nephrology and urology clinic at the Holy Family Hospital of the Catholic University of Korea with asymptomatic isolated hematuria from January 2005 to December 2007. Results: Of the 1,819 patients who underwent MDCT, the results were normal in 54.1%, showed a simple renal cyst in 25.7%, a renal calculus in 4.7%, and a malignant tumor of the urinary tract in 1.7%. Twenty-five patients (1.3%) were diagnosed with bladder cancer, including 20 (80%) men and 5 (20%) women. The average age of the patients with bladder cancer was 74.5±7.3 years. The 25 patients diagnosed with bladder cancer had a higher rate of gross hematuria, older age, and male gender (p<0.05) compared to the other patients. In addition, their hemoglobin and albumin levels were significantly lower (p<0.05). For all patients, the frequency of bladder cancer in those with asymptomatic microscopic hematuria, excluding those with gross hematuria, was extremely low (0.3%, 6 patients). Conclusions: MDCT may constitute an adequate diagnostic test for patients with asymptomatic hematuria. Older male patients with gross hematuria require a thorough urologic evaluation. (Korean J Med 77:328-332, 2009)
특집-만성 콩팥병, 적극적 치료가 필요하다 ; 말기 만성 콩팥병 환자에서 새로운 투석치료
윤혜은 ( Hye Eun Yoon ),김용수 ( Yong Soo Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5
말기 만성 콩팥병으로 신대체요법을 받는 환자의 사망률과 유병률을 줄이고 생존율을 향상시키기 위한 노력이 지속되어 왔으며, 이에 투석의 효율성과 생체적합성을 높이기 위한 많은 기술적인 개발과 발전이 있었다. 혈액투석에서는 기존의 저유량 혈액투석에서 고유량 혈액투석 및 혈액투석여과 방법이 개발, 시행되고 있으며, 복막투석에서는 기존의 포도당 투석액에서 GDP 생성이 적고 중성 pH를 유지하는 투석액 및 icodextrin과 같은 새로운 투석액과 자동복막투석 법이 개발되었다. 이러한 투석 치료 방법의 발전으로 투석환자의 생존율과 삶의 질은 향상되고 있으며 향후 새로운 투석치료 방법이 지속적으로 개발될 것으로 기대된다. Since the first hemodialysis and peritoneal dialysis were performed in humans in the early 1900s, the survival rates of patients with end-stage renal disease have increased. The number of patients in need of renal replacement therapy (RRT) is increasing, and there have been substantial advances in RRT modalities and technologies. To improve the patient outcomes requiring RRT, progress has been made to improve the efficiency and biocompatibility of dialysis in both hemodialysis and peritoneal dialysis. This review covers the basic principles of dialysis and the history of technological advances in hemodialysis and peritoneal dialysis. In addition, it includes the benefits of hemodiafiltration, new peritoneal dialysis solutions and automated peritoneal dialysis. (Korean J Med 76:528-537, 2009)
신은중 ( Eun Jung Shin ),추은호 ( Eun Ho Chu ),고선희 ( Sun Hee Ko ),정승민 ( Seung Min Jeong ),김수현 ( Su Hyun Kim ),윤혜은 ( Hye Eun Yoon ),김용균 ( Yong Kyun Kim ),최영진 ( Yeong Jin Choi ),양철우 ( Chul Woo Yang ),김용수 ( Yo 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.1
Replacement lipomatosis in grafted kidney is a rare complication, and it consists of abnormal fatty proliferation. We report a patient with replacement kidney lipomatosis in grafted kidney. Abdominal CT was performed for evaluation of vague abdominal pain, and 3.9 cm sized mass was incidentally detected in the grafted kidney. Presumptive diagnosis of mass was lymphoma or other tumorous conditions. Graft was removed surgically, and it was confirmed as lipomatosis. Renal lipomatosis is rare but it should be included as a differential diagnosis of mass in transplanted kidney.
신장 이식 환자의 만성 C형 간염에서 인터페론 치료 효과와 합병증
김용균 ( Yong Kyun Kim ),윤혜은 ( Hye Eun Yoon ),김수현 ( Su Hyun Kim ),최범순 ( Bum Soon Choi ),배시현 ( Si Hyun Bae ),최종영 ( Jong Young Choi ),윤승규 ( Seung Kew Yoon ),양철우 ( Chul Woo Yang ),김용수 ( Yong Soo Kim ),김석영 ( 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.6
Purpose : Chronic hepatitis C is a common cause of liver disease in kidney transplant (KT) recipients and lessens the chances of patients and graft survival. We evaluated the efficacy and safety of IFN-αatherapy in KT recipients with chronic hepatitis C. Methods : Ten KT recipients with chronic hepatitis C treated with recombinant IFN-α were enrolled. the patients had stable graft function, serum alanine aminotransferase (ALT) and positive HCV viremia were raised at the start of treatment. Eight patients received IFN alpha 3 million units three times weekly and 3 of them in combination with ribavirin in dose of 600mg daily. Two patients received pegylated INF-αa90 μg once weekly. Results : In 7 patients serum ALT levels were normalized and in 6 patients HCV-RNA became negative at the end of treatment. Five patients had sustained remission (persistently negative HCV-RNA) at the end of the follow-up. One patient relapsed at 15 months after discontinuation of INF. During the course of INF therapy one patient died due to sepsis with bowel perforation. Three patients developed graft dysfunction. In all of them graft function returned with discontinuing of INF and steroid therapy. In of three patients on INF plus ribavirin, hemolytic anemia was developed. After discontinuing of ribavirin hemolytic anemia was recovered and they were treated with INF alone. Conclusion : IFN-α therapy results in good biochemical response and virological clearance in KT recipients with chronic hepatitis C, but in about one third of the patients, the treatment had to do stopped prematurely due to graft dysfunction.