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복막 투석 환자에서 Brevundimonas vesicularis에 의한 복막염 1예
곽성동 ( Seong Dong Kwak ),최성열 ( Sung Yeol Choi ),박재영 ( Jae Young Park ),임주견 ( Ju Kyeon Yim ),천재홍 ( Jae Hong Chun ),김태우 ( Tae Woo Kim ),서보정 ( Bo Jung Seo ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.4
A 53-year-old male was hospitalized with abdominal pain and turbid peritoneal fluid. He was diagnosed with hypertension, diabetic nephropathy and started continuous ambulatory peritoneal dialysis (CAPD) 4 years ago. Initial peritoneal fluid analysis demonstrated CAPD peritonitis. As initial antibiotic therapy, ceftazidime/vancomycin were injected intraperitoneally. But drug sensitivity test revealed these regimens were ineffective. On sixth hospital day, Brevundimonas vesicularis (B. vesicularis) was cultured from peritoneal fluid, this strain was susceptible to imipenem, piperacillin and resistant to ceftazidime. Accordingly we changed the antibiotics to imipenem, which was administered for 14 days, but analysis of peritoneal fluid was seldom improved. Finally, CAPD catheter was removed, and hemodialysis was started. After CAPD catheter removal, peritonitis improved rapidly. B. vesicularis is a rare opportunistic organism in CAPD peritonitis. Because this peritonitis may not improve in spite of medical treatment with susceptible antibiotics, CAPD catheter must be removed finally.
증례 : 순환기 ; 임시형 심박조율기 삽입 후 발생한 조율 허용성 다형 심실빈맥 1예
박재영 ( Jae Young Park ),곽성동 ( Seong Dong Kwak ),임주견 ( Ju Kyeon Yim ),정재식 ( Jae Shik Jeong ),천재홍 ( Jae Hong Chun ),최성열 ( Sung Yeol Choi ),정준훈 ( Joon Hoon Jeong ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
저자들은 하벽의 급성 심근경색증 환자에서 VVI 방식의 임시형 심박조율기를 삽입한 후 심박조율기 오작동으로 인한 조율 허용성 다형 심실빈맥을 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. A 74-year-old man was admitted with sudden-onset chest pain. Electrocardiography showed ST segment elevation in leads II, III, and aVF; in addition, the levels of several cardiac enzymes were elevated. The patient received a VVI temporary pacemaker due to bradycardia (45 beats/min) and was subjected to primary percutaneous coronary intervention. After percutaneous coronary intervention for the RCA infarction, the patient was admitted to the coronary care unit. Six hours later, polymorphic ventricular tachycardia occurred following a short-long-short sequence. This is the first case of temporary pacemaker-permitted ventricular tachycardia in Korea. Here we present a case of pacemaker-permitted polymorphic ventricular tachycardia in a patient with inferior acute myocardial infarction. (Korean J Med 77:S1157-S1161, 2009)
복막투석 환자에서 발생한 후두부 가역적 뇌병증 증후군 1예
최성열 ( Sung Yeol Choi ),박재영 ( Jae Young Park ),곽성동 ( Seong Dong Kwak ),임주견 ( Ju Kyeon Yim ),천재홍 ( Jae Hong Chun ),김태우 ( Tae Woo Kim ),서보정 ( Bo Jung Seo ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
Posterior reversible encephalopathy syndrome (PRES) is a clinical radiologic syndrome which is characterized by reversible neurological and radiological findings. It is associated with an abrupt and severe increase in blood pressure, eclampsia, chronic kidney disease with hypertension and using various immunosupressive drugs. Patient with chronic kidney disease could be especially vulnerable to this syndrome because they are frequently exposed to several possible causes as uremia, hypertension, or electrolyte imbalance. We report a case of posterior reversible encephalopathy syndrome in a patient having continuous ambulatory peritoneal dialysis.
후드캡을 이용한 대장내시경 검사의 유용성 일반 대장내시경 검사와의 비교 연구
최성원 ( Sung Won Choi ),박희승 ( Hee Seung Park ),이재승 ( Jae Seung Lee ),황상연 ( Sang Yon Hwang ),곽성동 ( Sung Dong Kwak ),최성호 ( Seong Ho Choi ) 대한장연구학회 2012 Intestinal Research Vol.10 No.3
Background/Aims: A few studies showed that hood-cap assisted colonoscopy (CAC) had improved cecal intubation rate and cecal intubation time but did not help in finding colon polyps in comparison with conventional colonoscopy (CC). However, other studies have shown different results. Therefore, we investigated the efficacy of CAC for the cecal intubation time and polyp detection rate. Methods: Patients for colonoscopy in Busan St. Mary`s Medical Center were enrolled to this randomized controlled trial between July 2010 and September 2010. The evaluated outcomes were polyp detection rate, adenoma detection rate, and cecal intubation time in all patients, in difficult cases (history of previous abdominal or pelvic surgery, obesity, old age), and in the expert and non-expert groups. Results: A total of 260 patients enrolled in this study were randomly allocated to the CAC group (n=130), or CC group (n=130). The overall cecal intubation time was shorter in the CAC group (5.7±3.4 min vs. 7.8±5.7 min, P<0.001). The polyp detection rate was higher in the CAC group (58.4% vs. 43%, P=0.008). The cecal intubation time in the expert and non-expert groups were shorter in the CAC group (expert: 4.1±2.2 min vs. 5.5±2.0 min, P=0.001; non-expert: 6.7±3.7 min vs. 9.4±5.9 min, P=0.001). Conclusions: The use of CAC improved the detection rate of colon polyps and shortened the cecal intubation time for both the expert and non-expert groups. (Intest Res 2012;10:280-288)