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지속성 외래 복막투석 환자에서 발생한 흉강 내 그물막 탈장 1예
최승호 ( Seung Ho Choi ),오준석 ( Joon Seok Oh ),정필 ( Peel Jung ),김한새 ( Han Sae Kim ),이강훈 ( Kang Hun Lee ),김중경 ( Joong Kyung Kim ),박종현 ( Jong Hyun Park ) 대한내과학회 2014 대한내과학회지 Vol.86 No.6
복막투석 환자에서 대부분의 탈장은 복강으로 발생하며 위장관의 탈장이 없는 흉강 내 그물막 탈장은 매우 드문 질환이다. 저자들은 복막투석 환자에서 생긴 흉강 내 그물막 탈장을 전산화 단층촬영으로 진단 후 복강경 수술로 치료하여 복막투석을 재개한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Intrathoracic omental herniation through the esophageal hiatus is extremely rare. Here, we report a case of a 57-year-old male with continuous ambulatory peritoneal dialysis (CAPD) who was admitted to our hospital after experiencing nausea and abdominal discomfort for 3 days. Computed tomography (CT) revealed a fatty mass, extended continuously through the esophageal hiatus into the thoracic cavity. Laparoscopic surgery revealed an omental herniation through the esophageal hiatus. There was no herniation of the stomach or intestines. Peritoneal dialysis was resumed six weeks later. This is a report of omental herniation through the esophageal hiatus in a patient with CAPD. (Korean J Med 2014;86:766-769)
신장 이식 환자와 말기 신부전 환자의 심박수 변이도 비교
김성민 ( Sung Min Kim ),최승호 ( Seung Ho Choi ),오준석 ( Joon Seok Oh ),홍택종 ( Taek Jong Hong ),신용훈 ( Yong Hun Sin ),배우형 ( Woo Hyung Bae ),김중경 ( Joong Kyung Kim ),이희룡 ( Hee Ryong Lee ),정필 ( Peel Jung ),류태현 ( T 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Background/Aims: Heart rate variability (HRV) is a method for evaluation of autonomic nervous system activity by expressing the balance of sympathetic and parasympathetic tones. Some studies of HRV in patients with end-stage renal disease (ESRD) have been performed in Korea. However, few have examined kidney transplantation (KT) patients. Therefore, we investigated autonomic nervous system activity by means of HRV in patients with KT due to ESRD. Methods: We compared the pattern of cardiac sympathetic and parasympathetic activity by time- and frequency-domain analysis of HRV with 24-h Holter monitoring of 23 KT and 56 dialysis patients. Patients underwent KT between January, 2008 and June, 2011. Results: The mean ages of KT and dialysis patients were 54.2±12.3 and 53.7±12.6 years, respectively. The KT group showed increased time- and frequency-domain HRV (including HRV index), very low frequency (VLF), means and standard deviations of all normal R-R intervals for all 5-min segments of the entire recording (SDNNi), low frequency (LF), LF in normalized units (LF norm), and LF to high-frequency power ratio, compared with the dialysis group. Conclusions: Autonomic tone in patients with KT is higher than that in patients with ESRD on dialysis. (Korean J Med 2012;83:606-612)