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권영기 ( Young Kee Kwon ),장혁수 ( Hyuk Soo Chang ),김병훈 ( Byung Hoon Kim ),박철희 ( Choal Hee Park ),김천일 ( Chun Il Kim ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.1
Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury. (J Korean Soc Traumatol 2010;23:16-20)
김현철(Hyun Chul Kim),이강욱(Kang Wook Lee),이원기(Won Kee Lee),박성배(Sung Bae Park),조원현(Won Hyun Cho),박철희(Choal Hee Park),전동석(Dong Seok Jeon),김재룡(Jae Ryong Kim) 대한내과학회 1991 대한내과학회지 Vol.40 No.5
N/A Disorders of renal tubular function following renal transplantation are being recognized with increasing frequency. The incidence of hyperkalemia following renal transplantation has significantly increased in cyclosporine treated patients compared to those treated with azathioprine. The inpatient and outpatient records of 115 consecutive cyclosporine-treated patients, who underwent renal transplantation at Keimyung University Medical Center from December 1984 to December 1989, were reviewed for the development of hyperkalemia during the 3-month period immediately following renal transplantation. Unexplained hyperkalemia developed in 33 out of the 115 (28.7%) cycloporine-treated renal transplant recipients. The average onset of hyperkalemia was 15.4 days (range: 8~35), and the mean duration of hyperkalemia was 17.5 days. Hyperkalemia was mild-to-moderate in most case, but only 3 cases were severe (K>6.5 mEq/L) enough to require emergency treatment. The mean dosage of cyclosporine was 9.0 ±1.8 mg/kg, and whole blood (serum) cyclosporine levels were in the higher range 694±268ng/ml (268±70ng/ml). Hyperkalemia was frequently associated with hyperchloremic acidosis and normal anion gap, which is consistent with type IV renal tubular acidosis. Despite hyperkalemia, plasma aldosterone levels were in the lower normal range, and plasma renin activity levels were normal. Further studies are needed to establish the exact mechanism of hyperkalemia after renal transplantation.
김광세,김상규,박철희 啓明大學校 醫科大學 1989 계명의대학술지 Vol.8 No.1
Multilocular renal cyst having a distinctive gross feature of multiple, variable sized, noncommunicating cysts is uncommon and uncertain natured lesion. As a treatment modality of multilocular renal cyst, local excision or partial nephrectomy could be done. However, simple or radical nephrectomy might have been performed because of the documented association with malignancy such as Wilms tumor. Herein, we report a case of multilocular renal cyst in an 11-month old infant treated by radical nephrectomy with possibility of combined malignancy.
이성준,최호철,류동수,박철희,김거환 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3
Ureteral triplication is an extremely rare congenital anomaly of the urinary tract, which was first described in 1870 by Wrany. A review of the literature revealed only 92 cases published to date 1992. Herein we report a case of ureteral triplication, type Ⅲ in 54 years old woman. She was admitted to the hospital because of incidentally detected left hydroureteronephrosis on transabdominal ultrasonogram which was performed due to vague epigastric discomfort for 2 years. After radiologic study, under the impression of left incomplete duplicating system with nonfunctioning obstructive megaureter, left nephroureterectomy was performed.
여성복압성요실금환자에서 Valsalva Leak Point Pressure와 증상정도의 상관관계
김천일,박철희,최봉기 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.3
Purpose: The Valsalva leak point pressure testing is a valuable tool in the diagnosis of female stress urinary incontinence, especially intrinsic sphincter deficiency. The purpose of this study is to correlate clinical parameters of stress urinary incontinence with Valsalva leak point pressure which represents intrinsic sphincter activity. Materials and Methods: We examined sixty consecutive women with stress urinary incontinence including symptom grade(SEAPI-QMN classification), Q-tip test, 1 hour pad test and Valsalva leak point pressure. The clinical parameters of stress urinary incontinence were compared each other and the correlation coefficients were analyzed between them. Results: The mean patient age was 50 years(range 27 to 75 years). Their symptom grade was grade 1 in 17 patients (28.3%), 2 in 30 (50%) and 3 in 13 (22.7%). According to Blaivas and Olsson classification, they were type Ⅰ in 10 patients (16.7%), Ⅱ in 43 (71.7%) and Ⅲ in 7 (12.6%). The patients who have Valsalva leak point pressure of greater than 60cm. water and the urethral hypermobility were grade 1 in 17 patients (100%) and 14 patients (82.4%), 2 in 28 (93.3%) and 26 (86.7%), 3 in 4 (30.8%) and 7(53.8%). There was a statistically significant difference between the number of patients with Valsalva leak point pressure of greater than 60cm. water and 60cm. water or less among the 3 symptom grades (p<0.01). The Valsalva leak point pressure in patients with urethral hypermobility was significantly higher than in those without urethral hypermobility (p<0.05). The Valsalva leak point pressure was highly correlated with the symptom grades among clinical parameters of stress urinary incontinence. Conclusion: Women with higher symptom grades of stress urinary incontinence were significantly more likely to have a low Valsalva leak point pressure which indicate intrinsic sphincter deficiency.