메틸렌 불루 색소내시경법을 이용한 장상피화성의

윤견일,이혜성,한명자,박이갑 大韓消化器內視鏡學會 1982 Clinical Endoscopy Vol.2 No.1

주40시간제 시행과 병원경영

윤견일,Yun, Gyeon-Il 대한병원협회 2004 대한병원협회지 Vol.33 No.4

2006년, 노사상생을 위한 변화의 시기

윤견일,Yun, Gyeon-Il 대한병원협회 2006 대한병원협회지 Vol.35 No.4

네프로제症候群의 病態生理

尹堅一 藥業新聞社 1978 醫藥情報 Vol.1978 No.2

위암에 속발한 발작성야간혈색소뇨증 : 양의 골수섬유증 1예 Like Secondary Myelofibrosis with Gastric Cancer

윤견일 梨花女子大學校 醫科大學 醫科學硏究所 1982 EMJ (Ewha medical journal) Vol.5 No.4

A case of PNH-like secondary myelofibrosis associated gastric cancer is presen-ted with brief literal view. This 45 years old Korean male who had gastric cancer, was admitted to Ewha University hospital with marked pallor and bone pain. On hematologic examination, hemoglobin 4.0 gm/dl, hematocrit 8%, and RBC count was 92×10^4/㎣. WBC count was 16,200/㎣, with normal differentiation and platelet count was 18,000/㎣. Reticulocyte count was 5%. Peripheral blood smear showed anisocytosis, poikilocytosis and schistocytes including tear-drop cell. Two attempts of bone marrow biopsy disclosed island-shape of gastric cancer call infiltration and reticulin strands. After transfusion with 4 units of whole blood over the night, his early morning urine color was dark reddish-brown. The HAM test was positive and the value of the leukocyte alkaline phosphatase was very high. But there was no specific change of urine after administration of Iron-dextran. The author assure that this case was accompanied by Paroxysmal Nocturnal Hemoglobinuria-like red cell defect rather than microangiopathic hemolytic anemia.

고혈압에 의한 신질환

윤견일 대한신장학회 1992 추계학술대회 초록집 Vol.1992 No.-

혈액투석 환자에서 혈중 Endothelin-1(ET-1)및 Lipoprotein(a)(Lip(a)) 농도에 동정맥루 폐쇄의 상관 관계에 관한 연구

윤견일,강걷희 대한신장학회 1996 Kidney Research and Clinical Practice Vol.15 No.4

Reliable vascular access has been described as the Achilles heel of modern hemodialysis (HD) patients. In spite of the improved technology in vascular surgery, vascular access occlusion (VAO) by thrombosis and stenosis has been a constant problem, accounting for 10-40% of all hospital admissions of dialysis patients. Runoff vein stenosis due to vascular smooth muscle (neointimal') hyperplasia has been found to be one of the most common pathologic findings in cases with anatomic lesions of VAO. ET-1 is a naturally occurring vasoactive substance which has an intense mitogenic effect on cultured vascular smooth muscle cells and Lp(a) is known to be an independent predictor of coronary risk and coronary bypass stenosis. However, the clinical significance of the increased ET-1 and Lp(a) in relation to VAO is uncertain in HD patients. The present study was undertaken to evaluate the clinical significance of Lp(a) and ET-1 as a possible risk factor for VAO in 50 HD patients (male:'female 29:21, mean age 48 years, mean HD duration 47 months). The frequency of VAO in entire subjects was 0.47±1.03 episodes/patient-year. The median value of Lp(a) was 10.8mg/dl (1.9-87.6mg/dl) and the median value of ET-1 was 8,3 pg/ml (3.2-29.3 pg/ml). Fourteen patients (28% of subjects) were found to have at least one episode of VAO. There was no statistically significant difference in sex, age, blood pressure, % of patients receiving rHuEpo between VAO and non-VAO group. Biochemical parameters including Lp(a) & ET-1 were not different between VAO and non-VAO group. Six out of 50 patients (12%) had increased levels of ET-1 above mean±2SD. In those patients with increased ET-1, the frequency of VAO was higher (1.83±1.65 vs. 0.38±0.54 episodes/patient-year, p$lt;0.05). The median survival of vascular access for this high ET-1 group was 14.5 months, which was significantly lower compared to 77.8 months in patients whose ET-1 level was below 16pg/mL However, there was no significant difference in vascular access survival according to thvel of Lp(a). In conclusion, the level of ET-1 can affect the event free vascular access survival in HD patients, while the Lp(a) level seems to be unrelated to the VAO in our Korean HD patients. Further prospective studies are necessary to know the exact clinical significance of increased ET-1 and Lp(a) in the occurrence of access occlusion in maintenance HD patients.

새해 맞이를 위한 지난해 돌아보기

윤견일,Yun, Gyeon-Il 대한병원협회 2005 대한병원협회지 Vol.34 No.1

Urea Kinetic Modeling의 임상적 응용

윤견일,정성애,최규복,홍영선 대한신장학회 1994 Kidney Research and Clinical Practice Vol.13 No.3

Background: To evaluate the adequacy of hemo- dialysis in patients with chronic renal failure, the KT/V urea has been used as a guideline on the Dose of Dialysis. But the UKM was frequently influenced by errors in measuring blood flow and dialysis time, in sampling technic and in BUN analysis. And practically it was not feasible to avoid above errors which resulted in inappropriate deviation of urea distribution volume (UKM vol) from Anthropometric volume. We tried to correct the deviation of UKM vol after the UKM in 22 patients undergoing regular hemodialysis (12 males, 10 females), and then performed dialysis prescription, and finally evaluated the validity of that prescription. Methods: We recorded dialysis time and measured body weight and BUN before and after hemodialysis. On the next dialysis, predialysis body weight and BUN were measured. Also we calculated residual renal function, recirculation of blood in arteriovenous fistula and bloodside In-Vivo clearance of dialyzer. Initially we performed the UKM by using blood-side In-Vivo clearance with TherAps program (single-pool variable volume model, Cobe laboratories) to obtain the Profile 1 and 2. The Profile 1 include Anthropometric volume and KT/V urea. In the Profile 2, UKM vol, KT/V urea (UKM-KT/V) and protein catabolic rate (PCR) were included. When the difference between UKM vol and Anthropometric volume (Vol-Dev) exceeded the acceptable range ( -15%-+15%), we tried to correct the Profile 2. If corrected, profile 2 was calculated. But if not, only profile 1 was calculated. The UKM-KT/V was compared with the KT/V urea calculated by percent reduction of urea (PRU) (PRU-KT/V) as an index. According to the method of profile composition for dialysis prescription, two uncorrected profile 2 were used in Group 1, two profile 2 of which one was corrected in Group 2, and profile 1 and 2 regardless of correction in Group 3. Result: 1) Among 44 cases of the UKM, Vol-Dev exceeded the acceptable range in 21 cases (48%) and 11 cases of them (52%) was corrected. 2) Uncorrected group (23 cases) and corrected group (before and after correction) showed no significant differences in Vol-Dev, KT/V ratio, degree of recirculation, blood-side dialyzer clearance and in dialyzer KoA. 3) The SD of Vol-Dev was decreased from 23.44 to 9 .86 after profile correction. 4) Corrected and uncorrected groups showed highly significant positive correlations between UKM-KT/V and PRU-KT/V (r=0.95 & r=0.98; p$lt;0.000) (2-tail prob.). 5) Between In-Vivo clearance and effective clearance, uncorrected group showed strong positive correlation (r =0.94, p$lt;0,000) but corrected group did not (2-tail prob.). 6) KT/V urea deviation, pre- and post-BUN deviation from prescribed value, and Vol-Dev had no significant differences among 3 Groups. And pre-and post-BUN and KT/V urea had no significant differences between measured and prescribed value within each group. 7) In 11 cases of the UKM performed after prescription, there were positive correlation between pre-BUN or post-BUN deviation and NPCR deviation from prescribed value (r=0.76, p$lt;0.01; r=0.55, p$lt;0. 05) (1-tail prob). Conclusion: If the Vol-Dev exceeds the acceptible range, there is the possibilities of errors. In unavoidable situation it maybe feasible to use corrected profile for dialysis preseription. So, we can lessen the frequency of the UKM and make prescription more easily by correction of the Profile.

急性腎不全

尹堅一 藥業新聞社 1978 醫藥情報 Vol.1978 No.3