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선휘경,박봉건,이상준,양대열,고부준,문정섭,전영빈,유권,백인욱 인제대학교 2000 仁濟醫學 Vol.21 No.2
Chylous mesenteric cyst in adult is extremely rare and do not hale any specific signs or symptoms to facilitate their clinical diagnosis. Most cysts are noticed as a palpable abdominal mass or by nonspecific abdominal symptoms such as pain, nausea and vomiting. In some cases, they are detected incidentally by routine abdominal examination, but in symptomatic patient, the possibility of complication must be considered. The diagnosis can be done by radiologic studies such as sonography and computerized tomography but confirmative diagnosis is done by surgical excision. We describm a case of large mesenteric cyst which was cured by surgical excision in a 31-year-old man.
Phosphodiesterase Inhibitor Improves Renal Tubulointerstitial Hypoxia of the Diabetic Rat Kidney
선휘경,이윤미,한금현,김한성,안선호,한상엽 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.2
Background/Aims: Renal hypoxia is involved in the pathogenesis of diabetic nephropathy. Pentoxifyllin (PTX), a nonselective phosphodiesterase inhibitor, is used to attenuate peripheral vascular diseases. To determine whether PTX can improve renal hypoxia, we investigated its effect in the streptozocin (STZ)-induced diabetic kidney. Methods: PTX (40 mg/kg, PO) was administered to STZ-induced diabetic rats for 8 weeks. To determine tissue hypoxia, we examined hypoxic inducible factor-1α (HIF-1α), heme oxygenase-1 (HO-1), vascular endothelial growth factor (VEGF), and glucose transporter-1 (GLUT-1) levels. We also tested the effect of PTX on HIF-1α in renal tubule cells. Results: PTX reduced the increased protein creatinine ratio in diabetic rats at 8 weeks. HIF-1α, VEGF, and GLUT-1 mRNA expression increased significantly, and the expression of HO-1 also tended to increase in diabetic rats. PTX significantly decreased mRNA expression of HIF-1α and VEGF at 4 and 8 weeks, and decreased HO-1 and GLUT-1 at 4 weeks. The expression of HIF-1α protein was significantly increased at 4 and 8 weeks in tubules in the diabetic rat kidney. PTX tended to decrease HIF-1α protein expression at 8 weeks. To examine whether PTX had a direct effect on renal tubules, normal rat kidney cells were stimulated with CoCl2 (100 μM), which enhanced HIF-1α mRNA and protein levels under low glucose conditions (5.5 mM). Their expressions were similar even after high glucose (30 mM) treatment. PTX had no effect on HIF-1α expression. Conclusions: PTX attenuates tubular hypoxia in the diabetic kidney. Background/Aims: Renal hypoxia is involved in the pathogenesis of diabetic nephropathy. Pentoxifyllin (PTX), a nonselective phosphodiesterase inhibitor, is used to attenuate peripheral vascular diseases. To determine whether PTX can improve renal hypoxia, we investigated its effect in the streptozocin (STZ)-induced diabetic kidney. Methods: PTX (40 mg/kg, PO) was administered to STZ-induced diabetic rats for 8 weeks. To determine tissue hypoxia, we examined hypoxic inducible factor-1α (HIF-1α), heme oxygenase-1 (HO-1), vascular endothelial growth factor (VEGF), and glucose transporter-1 (GLUT-1) levels. We also tested the effect of PTX on HIF-1α in renal tubule cells. Results: PTX reduced the increased protein creatinine ratio in diabetic rats at 8 weeks. HIF-1α, VEGF, and GLUT-1 mRNA expression increased significantly, and the expression of HO-1 also tended to increase in diabetic rats. PTX significantly decreased mRNA expression of HIF-1α and VEGF at 4 and 8 weeks, and decreased HO-1 and GLUT-1 at 4 weeks. The expression of HIF-1α protein was significantly increased at 4 and 8 weeks in tubules in the diabetic rat kidney. PTX tended to decrease HIF-1α protein expression at 8 weeks. To examine whether PTX had a direct effect on renal tubules, normal rat kidney cells were stimulated with CoCl2 (100 μM), which enhanced HIF-1α mRNA and protein levels under low glucose conditions (5.5 mM). Their expressions were similar even after high glucose (30 mM) treatment. PTX had no effect on HIF-1α expression. Conclusions: PTX attenuates tubular hypoxia in the diabetic kidney.
투석 중인 말기신부전 환자에서 관동맥 우회로술과 관동맥 중재술의 장기 성적 비교
선휘경 ( Hui Kyoung Sun ),김나경 ( Na Kyoung Kim ),조유정 ( Yu Jung Cho ),강승대 ( Seung Dae Kang ),김태완 ( Tae Wan Kim ),한금현 ( Kum Hyun Han ),도준형 ( Joon Hyung Doh ),이성윤 ( Sung Yun Lee ),김창영 ( Chang Young Kim ),장우익 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.4
Purpose: Coronary artery disease is the main cause of morbidity and mortality in dialysis patients. Some observational studies proposed that coronary artery bypass graft (CABG) might provide higher survival benefit than percutaneous coronary intervention (PCI) in dialysis patients. There were not many studies of the comparison between the methods of coronary artery reperfusion therapy. Therefore, we compared the long term survival between PCI and CABG groups in dialysis patients. Methods: We selected 104 patients with end stage renal disease (ESRD) who had PCI (N=75) or CABG (N=29) in Ilsan-Paik Hospital from December 1999 to February 2010. We collected data from medical records and performed a retrospective analysis in ESRD patients hospitalized for the first coronary revascularization procedure. Results: There was no difference in the basic characteristics between the two groups. However, the frequency of more than 3-vessel lesions or less than 30% ejection fraction was higher in the group of CABG than that of PCI. One and three-year survival rates were higher in the PCI group than those in the CABG group. However, there was no difference in the 5 year survival rate between the groups. In subgroup analysis for severe patients with 3-vessel coronary diseases or less than 30% of ejection fraction, there were no statistical differences in the 1, 3 and 5 year survival rates between the groups. In subgroup analysis for the patients maintaining dialysis more than three months, 1, 3, and 5 year survival rates were not statistically different. Conclusion: In ESRD and dialysis patients, there was no difference in the long-term survival between PCI and CABG.
유지 혈액 투석환자의 혈중 포도당 농도 변화에 관한 연구
박재선,선휘경,박봉건,이상준,김은순,김희숙,정우경,권인순,고행일,정귀원 인제대학교 2000 仁濟醫學 Vol.21 No.2
Objectives: The study was done to investigate the changes of serum glucose concentrantion and glucose loss during hemodialysis with and without glucose in the dialysate. Method and Materials: Authors studied 23 patients(11 non-diabetes and 12 diabetes) with end-stage renal disease undergoing long-term maintainence hemodialysis. Hemodialysis was performed with glucose free and glucose containing dialysate. Each blood and dialysate outlet fluid sample was drawn for glucose concentration every hour. Results: 1) In non-diabetes and diabetes, serum glucose concentration was decreased during hemodialysis with glucose free dialysate. 2) Net glucose loss during the four hours of hemodialysis was 50-7lg. 3) There was no change in serum glucose concentration during hemodialysis with glucose containing dialysate in non-diabetic endstage renal disease. But, in diabetes, the serum glucose concentration was decreased during hemodialysis with glucose containing hemodialysate. Conclusion: This study suggested that blood glucose concentration was decreased during hemodialysis because of glucose loss in dialysate outlet fluid. Therefore, the addition of glucose to dialysis fluid may help the prevention of hypoglycemia and energy balance. But, in diabetes, further study is needed.
박봉건,선휘경,박재선,이상준,김은순,김희숙,문정섭 인제대학교 2000 仁濟醫學 Vol.21 No.2
Acute gastric dilatation is sudden and excessive distention of the stomach by fluid and gas, often accompanied by vomiting, dehydration, and peripheral vascular collapse. Most cases of acute gastric dilatation have occurred as a postoperative complication and other predisposing causes which have been documented include chronic illness, acute infections, emotional stress, physical injuries, diabetes mellitus, progressive muscular atrophy, excessive food intake, and body cast attachment. Early recognition of this condition is important, since the mortality is high if treatment is delayed. Decompression by continuos suction, together with careful restoration and maintenance of water and electrolyte balance, constitutes the essence of the therapy. We report a case of acute gastric dilatation developed after trauma with review of literatures.