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RISS 인기검색어
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- 저자 : 장규만(Kyu Man Jang) (검색결과 2 건)
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장규만(Kyu Man Jang),하기수(Ki Soo Ha),문현창(Hyun Chang Moon),이문철(Moon Chul Lee),유병희(Byung Hee Yu),이홍순(Hong Soon Lee),문성수(Seong Soo Moon) 대한내과학회 1988 대한내과학회지 Vol.35 No.6
N/A Plasma atrial natriuretic peptide (ANP) has been known to be a kind of peptide hormone and to have actions of natriuresis, diuresis and vasodilatation. It has been suggested that plasma ANP may be secreted from the cardiac atrium in response to extracellular fluid volume expansion to maintain blood volume homeostasis, and its level may be raised in volume overloaded conditions, such as congestive heart failure, chronic renal failure and the syndrome of inappropriate antidiuretic hormone secretion. We investigated the effect of fluid removal by sequential ultrafiltration and hemodialysis on circulating plasma ANP in 14 volume overloaded patients with chronic renal failure. The results were as follows: 1) The mean dry weight of patients was 58.3±0.4 kg and the predialytic weight gain was 3.4±0.9 kg. The amount of fluid removal by sequential ultrafilt-ration was 1176±31.7 ml (about 2% of predialytic body weight) and postdialytic weight loss was 3.1±0.3 kg. Systolic and diastolic blood pressures were not significantly changed during sequential ultrafiltration and hemodialysis, Plasma osmolality, BUN and K+ levels were not significantly changed after ultrafiltration but were significantly decreased after hemodialysis. 2) Plasma ANP levels were raised in all patients (mean±SE 205.3±30.7pg/ml, n=l4) compared with healthy contro1s (40.9±4.4 pg/ml, n=16), but showed considerable interpatient variability. 3) Plasma ANP levels fell with fluid removal during ultrafiltration (123.4±4.2 pg/ml, p<0.025) and again as fluid was removed during hemodialysis (88.7±3.1 pg/ml, p<0.05). 4) There was no significant correlation between predialytic weight gain and plasma ANP levels, and between postdialytic weight loss and plasma ANP levels. In conclusion, this study showed that the plasma ANP level was raised as body fluid volume increased in patients with chronic renal failure and fell with fluid removal after dialysis. These findings suggest that changes in body fluid volume play an important role in the regulation of ANP secretion.
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김성희,박종원,김관우,이문철,박원,이범우,김춘추,홍영선,김동집,한창순,장대환,장규만 대한내과학회 1989 대한내과학회지 Vol.36 No.3
Two cases of paroxymal nocturnal hemoglobinuria (PNH) were treated with allogeneic bone marrow transplantation. With respect to rejection, they were in a high risk group, because of sensitization to the allo-antigen by multiple transfusions for several years. The sex of the donors differed from that of the recipients. The conditioning regimen consisted of cyclophosphamide, procarbazine and brsrlfan, and cyclosporin A was administered for the purpose of preventing graft versus host disease (GVHD). Engraftment was observed on the 16th and 15th day (WBC$gt;1000/㎣). Acute and chronic GVHD were noted in both cases. The first case expired on the 184th day, because of chronic GVHD-associated sepsis and the second case is alive on the 529th day with 100% karnofsky status. Although our experience was limited, we could make the following conclusions: 1) Our conditioning regimen was sufficient to allow engraftment with total chimerism, which was confirmed by conventional clinical guides and the cytogenetic study. 2) Post-transplantation clinical courses were eventful with bacterial and viral infection, as well as chronic GVHD-associated morbidity or mortality, possibly because of previous massive transfusion and buffy coat, etc. 3) We observed hematuria in both cases and dissemination of viral warts, possibly due to reactivation of the papilloma virus. 4) PNH may be treated by bone marrow transplantation, with careful selection of the cases.
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