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RISS 인기검색어
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- 저자 : 은연기(Yeon Gee Eun) (검색결과 2 건)
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복수를 동반한 간경변증 환자에서 대량복수천자가 혈장량에 미치는 영향
홍성표(Seong Pyo Hong),은연기(Yeon Gee Eun),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),장린(Rin Chang) 대한내과학회 1991 대한내과학회지 Vol.40 No.2
N/A Large volume paracentesis (LVP) has been avoided because of complications such as intravascular volume depletion, renal insufficiency, portosystemic encephalopathy, and hepatic failure. But recent studies showed that systemic hemodynamics were not adversely affected during the 24hr following LVP. In this study, 6 edematous patients with liver cirrhosis and tense ascites underwent large volume paracentesis (3 liter). Plasma volume was measured by a dilution method with 125I-labeled human serum albumin prior to and at 24 hours after the LVP. And serum sodium, creatinine, blood urea nitrogen, and hematocrit were also measured prior to and at 24 hours and 48 hours after the LVP. The results were as follows. 1) All patients felt better after paracentesis and no hypotension, tachycardia, and encephalopathy occurred. 2) Mean plasma volume was 3381±127ml preparacentesis and 3340±116ml postparacentesis (p<0.1). 3) There was no change in serum sodium, creatinine or blood urea nitrogen and hematocrit during the 48 hours following LVP. 4) Urine volume tended to increase during the 24 hours after LVP. We concluded that 3 liter paracentesis in cirrhotic patient with tense ascites and peripheral edema is not associated with a decrease in plasma volume at 24 hours after the paracentesis and expected complications such as renal insufficiency and encephalopathy did not occur.
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24시간 요중 Catecholamine 및 그 대사산물들에 관한 임상적 고찰
은연기,김성운,양인명,김진우,김영설,김광원,최영길 대한내과학회 1990 대한내과학회지 Vol.38 No.1
Measurements of 24-hour urinary catecholamines and their metabolites provide the most reliable screening test for pheochromocytoma. 245 patients were suspected of having pheochromocytoma clinically and 24-hour urinary VMA, metanephrine, epinephrine and norepinephrine of these patients were measured as a screening test for pheochromocytoma at the Kyung Hee Medicial Center and other hospitals, over the 4-year period from July 1984 to June 1988. We performed a retrospective study to defermane the incidence of pheochromocytoma, which is the single most reliable screening test and what are the clinical characteristics of the patients who were not confirmed as pheochromocytoma but had elevated levels of more than one item. We analyzed the data of 245 cases and the results were as follows: 1) 1.6 percent of patients who were suspected of having pheochromocytoma clinically and 1% of hypertensive patients were diagnosed as pheochromocytoma. The 24-hour urinry VMA, metanephrine, epinephrine and norepinephrine were elevated remarkably in all cases. 2) All the patients who were not confirmed as pheochromocytoma but showed elevations of 3 itmes were found to have an acute serious disease such as cerebral infarction or angina pectoris. 3) The number of patients with elevated levels of at least two items was 27 out of 245(10.9%). Among these 27 patients, the patients who were diagnosed as pheochromocytoma or neuroblastoma were 4(14.8%). Therefore, it seems to be worthwhle to do fuarther evaluation in the patients with elevated levels of at least two items. 4) The elevation of norepinephrine or metanephrine seems to be more useful in the diagnosis of pheochromocytoma. 5) Between the three hypertensive groups(systolic, diasfolic, and both) and normotensive group, there was no significant difference in 24-hour urinary VMA, metanephrine, epinephrine and norepinephrine. There was no significant correlation between mean blood pressure and the levels of 24-hour urinary catecholamines and their metabolites. But the group of patients with elevated levels of VMA, metanephrine and epinephrine had significantly high systolic blood pressure.
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