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김성권 ( Suhng Gwon Kim ),박재윤 ( Jae Yoon Park ),이성우 ( Seong Woo Lee ),안신영 ( Shin Young Ahn ),정종철 ( Jong Cheol Jeong ),( Sung Hae Chang ),이태원 ( Tae Woo Lee ),오국환 ( Kook Hwan Oh ),진호준 ( Ho Jun Chin ),주권욱 ( 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: This report examines a patient with pulmonary adenocarcinoma that developed on a previous lesion from microscopic polyangiitis. A 59-year-old woman had been diagnosed with microscopic polyangiitis in October of 1988 based on her clinical symptoms and serological tests, which were positive for anti- neutrophil cytoplasmic antibodies. Her glomerulonephritis had been well controlled with low-dose prednisolone. She presented in October of 2005 with vague chest discomfort and dyspnea on exertion. Physical examination was unremarkable. A non-contrast computed tomography (CT) scan of the chest showed patch ground-glass opacity at the right lower lobe of the lung. Because we did not believe the lesion to be a definite malignancy, we decided to follow up with chest images over a short interval. During the 18 months following the images, the lesion did not change. However, the opacity of the lesion increased slightly over the last two months, and a non-contrast CT scan of the chest was therefore performed. A CT scan showed persistent ground-glass opacity with a slightly solid portion. To diagnose the previous finding and possibly to provide treatment, a right lower lobectomy of the lung via video-assisted thoracoscopic surgery was performed. The pathologic review of the resected lung revealed an adenocarcinoma, stage pT1N0. After one year, fluorodeoxyglucose positron emission tomography was performed, and no evidence of a recurrent malignancy was found.
신혈관성 고혈압의 진단에 있어서 캅토프릴 신스캔의 의의
김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),최창운(Chang Woon Choi),배상균(Sang Kyun Bae),양형인(Hyung In Yang),김승철(Sung Chul Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2
N/A To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of Tc-99m-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.
조수헌,강대희,김성권,김익상,홍성태,주영수,Cho, Soo-Hun,Kang, Dae-Hee,Kim, Suhng-Gwon,Kim, Ik-Sang,Hong, Sung-Tae,Ju, Young-Su 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.3
Background : In April 6, 1990, a male researcher who has worked at a research unit at the Basic Research Building of Seoul National University(SNU) College of Medicine admitted to SNU Hospital due to persistent fever. He was diagnosed serologically as hemorrhagic fever with renal syndrome(HFRS). Another female researcher in the same unit was also diagnosed as HFRS at the same hospital several days later. Epidemic investigation of HFRS was conducted to determine the magnitude of the problems since these two cases were strongly suspected to have laboratory-acquired infections of HFRS. Methods : All researchers and employees working at the Basic Research Building(BRB) of SNU College of Medicine as of April 1, 1996 were recruited for the study, information on symptoms of HFRS and history of contact to experimental animals were collected by self-administered questionnaires and serological tests among study subjects were also conducted by indirect immunofluorescent antibody(IFA) to hantavirus. The experimental animals were also serologically tested for infection with hantavirus by IFA. Results : Among 218 surveyed, six researchers and an animal caretaker had hantavirus antibodies above 1:20 in IFA titer. Five of seven sero-positive subjects had antibodies above 1:640 in IFA titer and had shown clinical symptoms compatible to HFRS during Jan. 1 to Apr, 20, 1996. The sero-positive persons had handled animals more frequently than sero-negative persons (OR, 19,68; 95% Cl, 1.11-350.40) and handling animals at the animal quarter at School of Public Health(SPH) had shown consistently higher risk to get infected with hantavirus irrespective of types of animals handled (OR, 4.90-6.37). Sero-positivity of rats of the aniamal quarter at BRB was 30-60%, whereas 80% of rats at SPH tested were shown sero-positivity. Conclusion: There was a epidemic of HFRS in research units of a medical school during the period from Jan. through Apr, Further investigation is needed to determine the extent and the mode of transmission of the laboratory-acquired infection with hantavirus in other research facilities.
특집-만성 콩팥병, 적극적 치료가 필요하다 : 우리나라의 만성 콩팥병
진호준 ( Ho Jun Chin ),김성권 ( Suhng Gwon Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5
Chronic kidney disease (CKD) is an important problem worldwide. CKD is defined as either a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 body surface area (BSA) or the presence of kidney damage, most commonly assessed by the presence of albuminuria for at least three consecutive months. In Korea, the reported overall prevalence of CKD is 13.7%, and the prevalence of CKD according to stage is 2.0, 6.7, 4.8, 0.2, and 0.0% for stages 1 to 5, respectively. This review emphasizes the importance of awareness, making an early diagnosis, and an appropriate management strategy for CKD. (Korean J Med 76:511-514, 2009)
한경희,이현경,이성하,조희연,정해일,최용,배현미,김성권,하일수,Han, Kyoung-Hee,Lee, Hyun-Kyung,Lee, Sung-Ha,Cho, Hee-Yeon,Cheong, Hae-Il,Choi, Yong,Bae, Hyun-Mi,Kim, Suhng-Gwon,Ha, Il-Soo 대한소아신장학회 2006 Childhood kidney diseases Vol.10 No.2
Diarrhea-associated hemolytic uremic syndrome(D+ HUS) is induced by enterohemorrhagic Escherichia coli(EHEC) and is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. The disease is usually transmitted by meat and water contaminated by excreta of domestic animals. We report a son and his mother with diarrhea-associated hemolytic uremic syndrome that spread within the family.
한국형출혈열에서 Kallikrein - Kinin 활성에 관한 연구
한진석(Jin Suk Han),이정상(Jung Sang Lee),이상구(Sang Koo Lee),김성권(Suhng Gwon Kim),고창순(Chang Soon Koh),이문호(Mun Ho Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.2
N/A Although it has been suggested that the basic lesion of hemorrhagic fever with renal syndrome in Korea (Korean hemorrhagic fever) is the vasculopathy consisted of dilatation of generalized small vessels, increased permeability, permeation of plasma components and diaphedesis of blood cells, its pathophysiologic mechanism has been under debate. We purposed to investigate the role of kallikrein-kinin in the vasculopathy and its relation with the clinical findings of Korean hemorrhagic fever. We measured serially plasma prekallikrein, kallikrein and kallikrein inhibitor activities by amidolytic assay with synthetic substrate and compared with the variable clinical indices that has been regarded as the prognostic factors. The results obtained as follows; 1) The plasma prekallikrein activities were significantly reduced and kallikrein activities were significantly elevated in the group of the 5~7th day of illness compared to those of .15~21st and over 22nd day (p<0. 05, Scheffe's test). But those of kallikrein inhibitor were elevated in the earlier day of illness without significant change during the course. 2) The plasma prekallikrein activities were significantly reduced in the hypotensive phase compared to those of the febrile phase, and in the hypotensive and oliguric phases compared to those of the diuretic and convalescent phases (p<0.05, Scheffb's test). The plasma kallikrein activities were significantly elevated in the hypotensive phase compared to those of all the other phases, and in the oliguric phase compared to the diuretic and convalescent phases (p<0.05, Scheffe's test), But those of kallikrein inhibitor were elevated without significant change in each phase. 3) The plasma prekallikrein activities were significantly reduced in the groups with primary shock, severe azotemia, leukocytosis and thrombocytopenia. Those of kallikrein were significantly elevated in the group with primary shock, hemoconcentration, leukocytosis, thrombocytopenia and higher scores of clinical severity. 4) In the 11 cases with kallikrein activation, clinical characteristics were shorter days from onset to admission, higher scores of clinical severity, hematocrit, leukocyte counts, and lower thrombocyte couots and initial creatinine. 5) The plasma Cl inhibitor were elevated without significant change in the day of illness or each phase. And there was a good correlation between plasma kallikrein inhibitor and C1 inhibitor (r=0.76, p<0.01). Thus we concluded that the activation of kallikrein-kinin in Korean hemorrhagic fever plays significant role in the pathophysiologic mechanism and is related with primary shock, hemoconcentration, leukocytosis, thrombocytopenia and clinical severity.
전신질환의 조갑변화에 대한 임상적 관찰 - 제1보 : 만성 신부전증 -
김선훈(Seon Hoon Kim),조광열(Gwang Yeol Joh),이유신(Yoo Shin Lee),김성권(Suhng Gwon Kim) 대한피부과학회 1985 大韓皮膚科學會誌 Vol.23 No.1
The present study was performed to evaluate the characteristics and incidence of the nail changes in chronic renal failure patients. Sixty-six patients who were admitted to the Department of Internal Medicine between March and December, 19R3 and thirtyn'ine patients who were receiving hemodialysis therapy at the hemodialysis unit during June, 1983 in Seoul National University Hospital, were examined. The results were as follows; 1. The brown band just proximal to the free margin of the nail is a frequent nail change in chronic renal failure patients. The term half-and-half nail can be used when the band is wide enough to call it half and the term brown distal arc may be apposite for the whole. 2 .Among the 66 admitted patients, 21 cases(31.8%,) had half-and-half nails,26 cases(39.5%) had brown arcs and 3 cases(4.5%) had white nails. Overall the brown distal arc was present in 47 cases(71.2%,). 3, Among the 39 patients receiving hemodialysis, 3 casesp. 7p,) had half-and-half nails, 9 cases(23. 1%) had brown arcs and 5 cases(23,l%) had white nails. The brown distal arc was present in 12 cases(30.8%) over all. 4. There was no correlation between the level of impaired renal function and the presence or the width of a brown distal arc.