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金聖權,朴正植,李重根,高昌舜 최신의학사 1977 最新醫學 Vol.20 No.8
A double blind study and 12 weeks follow-up of Clobazam were performed . from October 1976 to May 1977 in Seoul National University Hospital. They were 34 neurotic and 32 psychosomatic disorder patients. The results were followings. 1. Clobazam was more effective than placebo in both neurotic symptoms and psychosomatic symptoms, especially in anxiety, inner restlessness, depression, cardiovascular symptom, respiratory symptom and gastrointestinal symptoms. 2. There were neither difference in each disease of neurosis nor psychosomatic disorder. 3. In each disease there were neither specific change in 12 weeks follow-up period nor no drug dependence is noted after 12 weeks follow-up. 4. There were mild side effects such as fatigability, dry mouth, mild ataxia and mild impotence. but these were not clinically important. These results suggest that Clobazam is a good antianxiety drug in neurosis and psychosomatic disorder in OPD clinic. There are neither clinical significant side effect nor drug dependence.
스테로이드 'Pulse'요법뒤에 파종성 결핵과 Aspergillus 감염을 보인 낭창성 신염 1예의 임상상과 부검소견
김성권,백경란,이준성,최강원,오명돈,지제근,박원서,김용일 대한감염학회 1993 감염 Vol.25 No.2
Although steroids have been used for a long time in the treatment of systemic lupus erythematosus (SLE), steroids may result in a major defect in host defences and increased prevalence of a wide variety of infection. steroid ‘Pulse’therapy has been advocated for effective management of certain circumstance such as lupus nephritis, rapidly progressive glomerulonephritis, minimal change nephrotic syndrome but the use of high dose steroid is a problem because of the danger of mycobacterial and fungal infection. We report the clinical and pathological findings of a lupus nephritis patient with fulminant course of disseminated tuberculosis and aspergillosis after steroid ‘Pulse’therapy.
Predialysis hyponatremia and mortality in elderly patients beginning to undergo hemodialysis
백선하,Sejoong Kim,Ki Young Na,Suhnggwon Kim,Ho Jun Chin 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.5
Background/Aims: Predialysis hyponatremia has been recently reported to be associated with mortality in incident hemodialysis patients. However, whether hyponatremia is associated with unfavorable outcomes in elderly patients remains unknown. We hypothesized that nephrology referral inf luences hyponatremia, and aimed to define how nephrology referral affects the association between hyponatremia and mortality in the elderly. Methods: We retrospectively assessed mortality in 599 incident hemodialysis patients aged ≥ 70 at a tertiary university hospital, between 2000 and 2010. We analyzed 90-day and 1-year all-cause mortality (ACM) in relation to predialysis serum sodium (sNa). We divided the patients into two groups according to predialysis glucose-corrected sNa: hyponatremia (< 135 mmol/L) and normonatremia (135 to 145 mmol/L). Results: Low estimated glomerular filtration rate, high phosphorus, low albumin, nonpreparation of arteriovenous fistula or graft, and late referral were associated with a low sNa in the elderly. Among 599 patients, 106 and 174 patients died at the 90-day and 1-year follow-ups, respectively. Each 10-mmol/L increase in predialysis sNa tended to be associated with lower 90-day and 1-year ACM. When patients were stratified by nephrology referral, hyponatremia was associated with increased mortality in early referral group (90-day ACM: hazard ratio [HR] = 2.335, p = 0.041; 1-year ACM: HR = 1.790, p = 0.024). However, hyponatremia was not associated with mortality in late referral group. Conclusions: Predialysis hyponatremia at hemodialysis initiation is associated with late referra.
이식 전 B형 간염 바이러스 감염이 이식 신의 예후에 미치는 영향
김윤구,한진석,김성권,이정상,김상준,김수태 대한내과학회 1990 대한내과학회지 Vol.38 No.1
To evaluate the impact of HBV infection on graft survial following renal transplantation, we studied 161 recipients whose Hepatitis B surface antigen(HBsAg) status was identified before transplantation by actuarial life table method and log-rank analysis. We considered graft loss as patient'’s death, return to maintenance dialysis or removal of graft. 1) Survival in the HBsAg positive group(18 losses among 22 recipients) was significantly diminished(p=0. 0001) compared with the HBsAg negative group(40 of 139 recipients) and the difference was highly significant in recipients with cyclosporine therapy but not in those with azathioprine. 2) In the HBsAg negative group, no obvious differences in survival were found among the groups categorized by the presence of anti-HBs or anti-HBc prior to transplantation. 3) In the HBsAg positive group, those with no mismatch for HLA showed better survial and there were no differences in graft survival compared with the HBsAg negative group. 4) There were 4 deaths from hepatic failure which occurred only in the HBsAg positive group and only in recipients with cyclosporine therapy. We conclude that patients with pre-existing HBs antigenemia may be poor candidates for renal transplantation.