급성 Paraquat 중독환자의 임상적 고찰 및 혈액투석요법으로 생존한 2 예

정철호,강종식,이준상,황순철,전건웅 대한내과학회 1987 대한내과학회지 Vol.33 No.5

Paraquat has been widely as a herbicide in Korea since 1970. Human ingestion results in transient impairment of liver and kidney function and a characteristically progressive respiratory failure with a high mortality rate. Hemodialysis has been used as a treatment for paraquat poisoning. To the beet of our knowledge the use of hemodialysis in the treatment of paraquat poisoning has not been reported in Korea, however. We have analyzed 12 cases of paraquat poisoning who were admitted to W.M.B.H. from January 1985 to June 1986. Four cases were treated by hemodialysis with ultrafiltration; two of them died and two have survived without complications. All eight cases not treated by hemodialysis died. We suggest that early and prolonged hemodialysis with ultrafiltration may prove to be helpful in saving lives of patients with paraquat poisoning.

성인 낭종신 31예 중 다낭종신 11예의 임상적 고찰

이준상,김재하,김재헌,김승영,황순철,강종식,전건웅,신윤원 대한신장학회 1989 Kidney Research and Clinical Practice Vol.8 No.1

The adult polycystic kidney disease (APCKD) is inherited by autosomal dominant trait and is uncommon. We analysed the clinical characteristics of 11 patients with the APCKD retro-spectively among 31 patients with the cystic disease of the kidney among 338 hosptalized patients with the renal disease in the same period to develop the profile of Korean APCKD. They were diagnosed by clinical manifestations, laboratory data, intravenous pyelogram, ultrasonogram of the kidney, and abdominal CT scanning. The results were below; 1) We found the patient with APCKD after 4th dec-ade, and the frequency was 3.3% of all hospitalized patients with the adult cystic renal disease, and the frequency of dinical manifestations were palpable flank mass (63.6%), flank pain (54.5%), anemia (54.5%), hypertension (45.5%), hematuria (18.2%), and peripheral ede- ma (9.I%). 2) 4 cases(36.4%), of the extrarenal organ involvement were observed in the liver and 3 cases of them had abnormal hepatic functions(increased levels of SGOT and SGPT). 3) Among the initial clinical manifestations we observed abnormal urinalysis in 10 cases(90.9%) and decreased renal functions in 7 cases(63.7%) and 5 cases of these patients with decreased renal functions were already in end-stage renal disease at admission and accounted for 1.5% of all cases of the hospitalized patients with the kidney disease and 6.4% of the end- stage renal failure. Hemodialysis, peritoneal dialysis, or renal transplantation was done for 4 cases of these patients. 4) Complications were anemia, hypertension, endstage renal failure, and etc. Finally we think that prospective studies of APCKD should be done for assessment of APCKD by research of pedigree and family history and by follow-up checks of the renal function of APCKD.

Digoxin을 投與받는 成人患者에 있어서 藥物動態學的 計算에 의한 Digoxin의 血中濃度豫測

김미영,박연주,Sands, Charles D.,오용식,전건웅 한국병원약사회 1987 병원약사회지 Vol.4 No.2

Four different pharmacokinetic methods of predicting steady state digoxin serum concentrations were compared retrospectively with measured steady state digoxin serum concentrations in ten adult patients with normal renal function undergoing digoxin therapy. All four methods predicted remarkedly similar results. The correlation between predicted steady state concentration and measured steady state concentrations was statistically significant. It would appear that any of the four methods is accurate enough for clinical use in patients with normal renal function, remembering that these methods may overestimate digoxin clearance and underpredict steady state concentrations in some elderly patients. Prediction of digoxin steady state concentrations by pharmacokinetic calculations in adults with normal renal function appears to be sufficiently accurate to be helpful in the interpretation of the measured steady state concentration and in the design of dosage regimens. It should be emphasized that monitoring of the digoxin serum concentration and the patient's clinical condition are the most reliable methods for ensuring efficacy and avoiding toxicity.

후천성 면역결핍증 환자 경험 1 예

김재하,이준상,강종식,황순철,최호정,백옥지,전건웅,신윤원,오용식 대한내과학회 1988 대한내과학회지 Vol.35 No.2

A 32-year-old sailor was studied who had a history of sexual intercourse with multiple heterosexual partners in foreign countries including Africa. We suspected that he had been infected by the Human Immunodeficiency Virus 2 years prior to our study. His wife tested positive and his two children tested negative for the Human T-cell Lymphotropic Virus type III antibody. We experienced the first Korean patient who was classified by the Center for Disease Control as having AIDS stage IV, and had candidal esophagitis, Kaposi`s sarcoma and bilateral retinitis but no generalized lymphadenopathy. We report this case with a review of the literature.

성인형호흡장애증후군을 동반한 속립성결핵 1 예 보고

김진호,김한일,강종식,박종하,이준상,정철호,전건웅 대한내과학회 1986 대한내과학회지 Vol.31 No.4

Miliary tuberculosis is an unusual cause of adult respiratory distress syndrome. In this case, We described one patient with miliary tuberculosis who developed adult respiratory distress syndrome. The chest radiography on admission was normal. During hospitalization repeated chest X-rays revealed a miliary pattern followed by diffuse pulmonary infiltration, and severe respiratory distress developed. The disgnosis of tuberculosis was suspected early, appropriate therapy was initiated, and he survived. The experience with this case serves to emphasize that miliary tuberculosis should be considered in patients presenting with adult respiratory di8tress syndrome of unknown causes.

한국인 만성위염의 (慢性胃炎) 조직학적 (組織學的) 관찰

이정인(Jeong In Lee),박노춘(Noh Choon Park),고영덕(Young Duck Koh),전건웅(Geon Olng Jeon),김경오(Kyung Oh Kim),백옥지(Ok Ji Baik),양웅석(Oong Sheuck Yang) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.2

N/A The authors analyzed the endoscopic and histologic findings in 45 cases of idiopathic chronic gastritis who had taken gastrofiberscopy with 4-point fiberscopic biopsy of the gastric mucosa(pyloric antrum, incisura angularis along the lesser curvature and anterior & posterior wall of the body of the stomach) at Busan Wallace Memorial Baptist Hospital from February 1980 to October 1980. The results obtained were as follows; I) The incidence of idiopathic chronic gastritis was more common in 30-40 age group, male to female ratio being 22: 1. The most frequent type of chronic gastritis was superficial gastritis(71. 1%) and the next was atrophic gastritis(24.4%) 2) There was no difference between younger and elderly group in superfical & hypertropic gastritis but elderly group was more common in atrophic gastritis in relation to type and age incidence. 3) The diagnostic reliability of gastrofiberscopic and histologic diagnosis in view of types of chronic gastritis; superficial gastritis: 71. 9%, atrophic gastritis: 27. 3%. All cases of hypertrophic gastritis was proved as chronic atrophic gastritis histologically. In view of incidence of gastritis at each biopsy site histologically; superficial gastritis was more common at the angle 8: posterior wall of the body, superficial atrophic gastritis, at the posterior wall of the body and atrophic gastritis, at the angle. Normal finding was very common at the anterior wall of the body, 4) The incidence of intestinal metaplasia in chronic gastritis svas 2p. 9% and more oommon above 40 years of age on histologic finding, Those findings suggest increasing frequency of intestinal metaplasia with aging process. The rate of incidence was 32. 6% in male and 21. 5% in female. 5) The incidence of intestinal metaplasia on the natomical location of the stomach was 14. 3% at the angle as the highest incidence, 11. 1% at the antrum, 9. 8% at the anterior wall of the body and 7 1% at the posterior wall of the body. 6) The incidence of intestinal metaplasia in the type of gastritis was 16. 0% in superficial gastritis, 30.O% I:z sup.fic gastritis and 83. 3% in atrophic gastritis. The diagniosis of chronic gastritis would be cofirmed by gastrofiberscopy with direct vision biopsy.

우리나라 투석요법의 현황 - 1985 -

방병기,구완서,윤영석,장윤식,최의진,김영우,김승수,임천규,김명재,김형규,이시래,김현철,이영규,정영,원대식,나하연,전건웅,이정상,황승덕,이희발,이호영,한대석,이광훈,윤경우,윤견일,고행일,강영준,강성귀,채종구,유석희,홍세용,박정식,한민희,강종명,박한철 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.1

In 1981, the Korean Society of Nephrology started annual report on dialysis therapy in Korea. Thereafter, the brief summary of Combined report on hemodialysis in Korea during the period 1981-1984 was reported in 1984. In 1985, the annual number of new patients rose from 17.4 to 20.4 per million, and also the total number of patients on dialysis theraphy rose from 20.7 to 29.1 per million. Total 808 patients (20.0 per million) were being on hemodialysis, 370 patients (9.1 per million) on CAPD and 330 patients (8.2 per million) with functioning renal graft on 31th Dec. 1985. The common causes of renal failure of new patients in order were chronic glomerulonephritis (40.0%), diabetic nephropathy (9.7%), hypertensive nephrosclerosis (6.3%) and so on. The common causes of death in dialytic patients were cardiac (33.7%), vascular (14.1%) and infection (9.8%), and social death due to refuse further treatment or suicide was 20.7% of all. Now the number of patients requiring dialysis therapy is increasing rapidly, largely due to expanded medical insurance coverage and improved economic status. But, dialysis equipment and personnel were increased rela- tively slower than explosion of number of patients requiring renal replacement therapy. Therefore we have to consider counterplan for this rapid growth of patients such as expansion of regular training for dialysis members, establishment of home and satellite dialysis system, and lawful background ready for cadaver renal transplantation.

급성신우신염 466 예의 임상적 고찰

이상용 ( Sang Yong Lee ),박노춘 ( Noh Choon Park ),권영걸 ( Young Girl Kweon ),고영덕 ( Young Duck Koh ),전건웅 ( Gun Ung Jeon ),김경오 ( Kyung Oh Kim ) 대한내과학회 1983 대한내과학회지 Vol.26 No.3

급성 DDS ( Dapsone ) 중독환자에 대한 임상적 고찰

김기호 ( Ki Ho Kim ),이상용 ( Sang Yong Lee ),박노춘 ( Noh Choon Park ),오용식 ( Yong Sik Oh ),전건웅 ( Gun Ung Jeon ),김해성 ( Hae Seong Kim ) 대한내과학회 1984 대한내과학회지 Vol.27 No.2

당뇨병환자의 CAPD현황과 환자 및 기술생존율

박성배,김기현,김영호,김현철,김형규,이시래,한대석,이영규,강성구,이호영,정석호,홍관수,방병기,이희발,고행일,박한철,최의진,원대식,강종명,황승덕,전건웅,최창필,허용진 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2

The Korean Society of Nephrology reports the Multicenter Study on CAPD in diabetics with ESRD. This report based on the analysis of the questionairs distributed to fourteen centers throughout the nation. The results were as follows; 1) As of September, 1987, 626 patients are on CAPD in Korea. Of these, 14.1 per cent of the patients are comprised of diabetics. 2) Diabetics with ESRD were older than non diabetic patients with ESRD, and it was most prevalent in the fifties. 3) Most of the centers considered CAPD as the treat- ment of choice for the diabetics with ESRD. 4) It takes 14.6 years on average for diabetics to get in end stage renal failure. 5) Most centers tend to start diabetics on dialysis earlier than in nondiabetics, that is, when their serum creatinine reach 9.83 mg/dl on average. 6) Blood sugar levels were reduced after 24 months of CAPD compared to pre CAPD level, but it was not statistically significant. 7) Various hematologic and biochemical indexes such as hemoglobin level, serum albumin level, Ca and phosphorus levels were improved after starting CAPD. 8) Peritonitis is still a major complication. Each patient experiences 1.9 episodes of peritonitis on average per year. 9) Sizable number of the patients suffered from gastrointestinal complications, particularly nausea and vomiting and cardiovascular complications. 10) 43 patients succumbed to death while on CAPD. Main cause of death were peritonitis and cardiovascular complications. 11) 26 patients stopped peritoneal dialsysis for various reasons other than death or lost to follow-up, and the major reason was peritonitis comprising of 15 patients. 12) Diabetics with ESRD are not doing well in terms of the rehabilitation. This is partly attributable to old age and to cardiovascular complications. 13) The actuarial survival rate were 95.4%, 90.2%, 79. 2% and 61.0% at 3 months, 6 months, 12 months and 24 months respectively. This is lower than that in non diabetics with ESRD. We conclude that continuous ambulatory peritoneal dialysis is a good alternative treatment for diabetics with end-stage renal disease.