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A Case Primary Osteosarcoma Originating in the Sacrum
Park, Eun-Joo,Ahn, Myung-Ju,Rhu, Jun-Ho,Shin, Sung-Jun,Wi, Hyung-Jung,Choi, Jung-Hye,Lee, Young-Yeol,Jung, Tae-Joon,Choi, Il-Young,Kim, Im-Soon 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.2
골육종은 주로 장관골의 골 성장 부위인 골간단(metaphysis)에 주로 발생하며 경골 근위부, 대퇴골 원위부 및 상완골 근위부가 호발 부위인 것으로 알려져 있다. 편평골인 천골에 발생한 예는 극히 드물고, 또한 원발성 보다는 Paget's disease나 국소적 방사선 요법 후 속발성으로 발생했던 경우가 많은 것으로 알려져 있다. 사지에 발생한 골육종에서는 술전 및 술후의 항암 화학 요법과 수술을 포함한 현재 치료 전략으로 60-70%의 장기 생존률을 보이고 있는 반면, 천골에서 발생한 골육종은 위치상 넓은 변연을 가지고 있어 종양 절제가 용이하지 않고, 절제 시 주위의 내부장기, 교감 및 부교감 신경 손상이 많으며, 또한 전이의 위험도가 높아서 불량한 예후를 보이고 있다. 이 병변의 희소성 때문에 수술적인 발전이 어려웠고 사지 골육종의 치료 경험의 적용에 대한 종양학적인 성과가 현재도 확립되지 못한 상태이다. 이에 저자들도 원발성 골육종이 천골에 침범한 1예를 경험하였기에 보고하는 바이다.
만성 신부전증 환자의 중증 고혈당에 따른 의식변화 결핍에 대한 연구
박은주,강성귀,한상웅,김호중,이창범,임천규,박성광,윤경택,위형중,안유헌 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.6
In diabetic patients who were being treated with hemodialysis, coma and other neurological deficits did not occur in spite of extremely elevated serum glucose levels. In this report, we compared diabetic patients with renal failure in severe hyperglycemia with nonketotic hyperosmolar coma patients with normal renal function to know what affect mental changes. Mental changes were not present in diabetic patients with renal failure. These patients with renal failure showed more severe hyperglycemia, but corrected serum sodium concentration and calculated effective serum osmolality were low. So it is suggested that corrected serum sodium concentration and effective serum osmolality are more important factor affecting mental changes than high blood glucose levels in diabetic patients with renal failure, due to absence of osmotic diuresis.
급성 신우신염 치료시 아미노글라이코사이드(Micronimicin Sulfate)에 의한 유사 Bartter씨 증후군의 발생에 관한 평가
장우영,김진영,최낙원,한상웅,김호중,박석규,문중돈,나경선,윤경택,위형중,최창렬,조형도,안유현 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5
The aminoglycoside antibiotics is widely used in the treatment of infectious caused by gram-negative bacteria and for synergistic effect with(β-lactam antibiotics. However, its therapeutic usefulness is limited by this potential nephrotoxicity and by disturbance of electrolyte homeostasis resulting in hypomagnesemia, hypokalemia, hypocalcemia such as Bartter-like syndrome. Many case repots have been reported on development of Bartter-like syndrome after aminoglycosides administration. But these reports had the many differences of such as types of aminoglycosides, age of patients, duration and total dose of treatment, combined antibiotics and baseline diseases. Therefore, the purpose of this study is to assess the effects of micronomocin sulfate on magnesium, calcium and potassium status of patients in acute pyelonephritis. Twenty one patients in acute pyelonephritis(18 female/3 male, ages 20-75) was treated with single or combined antibiotics. Eleven of twenty one patients as study group were treated with boh micronomicin sulfate(aminoglycoside, 4mg/kg/day, during 5-8days) and flomoxef sodium (3rd cephalosporine, 2g/day, during 5-8days), and ten of twenty one patients as control group were treated only with flomoxef sodium(3rd cephalosporine. 2g/day. during 5-8days). Renal values, plasma and urinary electrolytes were measured before and at the end of IV antibiotic therapy. After micronomicin sulfate administrated for 6.4±1.5days, serum Mg, Ca, K, FEMG (fractional excretion of Mg), TTKG(transtubular K concentration gradient) and FEca.(fractional excretion of Ca) did not significantly change(p$gt;0.05). Therefore, those results suggest that micromonicin sulfate therapy within dose of 24mg/day(4mg/kg/day) for 6.4±1.5days may not cause disturbance of electrolyte homeostasis such as Bartter-like syndrome in acute pyelonephritis. Howerever, electrolyte disturbance is an important complication when aminoglycosides is given in larges doses over extended periods. Therefore, monitoring of blood concentration and urinary loes of electrolyte should be carried out along with careful observation of Bartter-like syndrome.