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RISS 인기검색어
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- 저자 : 곽귀철(Gue Chuel Kwak) (검색결과 2 건)
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곽귀철(Gue Chuel Kwak),오동진(Dong Jin Oh),이준승(Jun Seung Lee),박지현(Joe Hyoun Park),강응택(Eung Taek Kang),유석희(Suk Hee Yu) 대한내과학회 1995 대한내과학회지 Vol.48 No.4
N/A Objectives: Acute renal failure continues to be associated with a high mortality despite advances in dialysis and care of the critically ill patient. Although there have been many clinical studies on acute renal failure in Korea, none of them have investigated the prognostic factors in acute renal failure managed with hemodialysis. Methods : We reviewed retrospectively 115 patients with acute renal failure who had been hospitalized and hemodialyzed at the Department of Internal Medicine, Chung-Ang University Hospital between October 1984 and July 1993. Results: 1) The overall mortality was 50.4% with the mean age of nonsurvivors higher than that of survivors(54 ±7.2 vs 44±18.9 years, p<0.05). The mortality was higher in older age, especially patients over 60 years( p = 0.0031). 2) According to the complications, the mortality was 100% in acute myocardial infarction, 100% in coma, 93.1% in persistent hypotension, 86.2% in respiratory failure, 77.5% in infection, 73.3% in jaundice, and 38.3% in pneumonia. The presence of complications were closely related to the prognosis of acute renal failure(p<0.05). 3) The hematocrit and the increase of BUN during hemodialysis was closely related to the prognosis of acute renal failure(29.0 vs 32.3, 17.1mg/dL/day vs 11.9mg/dL/day, p <0.05). 4) According to Liano's discriminant score, our mean score was 0.343 in survivors & 0.565 in nonsurvivors, and our cutoff point was lower than that of Liano's score.(0.611 vs 0.856) Conclusion : The poor prognostic factors in acute renal failure managed with hemodialysis were old age, presence of infection, persistent hypotension, acute myocardial infarction, jaundice, respiratory failure, pneumonia, hematocrit and the increase of BUN during dialysis. Because Liano's discriminant score was insufficient as prognostic indices for itself, other objective prognostic indices should be studied.
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원위형 신세요관성 산증과 수질 신석회화증을 동반한 부갑상선 선종 1 예
이현순,한기수,김용한,이준승,김용성,오동진,이상표,유석희,곽귀철,강응택,신순현 대한내과학회 1994 대한내과학회지 Vol.47 No.3
The primary hyperparathyroidism is rare disease and cause the multiple systemic clinical symptoms such as generalized osteoporosis, nephrolithiasis and renal insufficiency. We has recently experienced one case of parathyroid adenoma associated with nephrocalcinosis and distal renal tubular acidosis. A 39 year old female was referred to our department becasue of nephrocalcinosis. The patient presented hypercacemia, hyperparathyroidism, decreased serum biacrbonate, and inabillity of urinary acidification. We studied NH₄Cl loading test to differentiate between proximal and distal renal tubular acidosis and radiologic study to know cause of hyperparathyroidism. The results suggested parathyroid adenoma, distal renal tubular acidosis and nephrocalcinosis. The patient was successfully treated with excision of parathyroid adenoma.
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