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혈액투석 환자의 산욕기 동안 생체전기 임피던스법을 통해 체액조절한 1예
최성한 ( Shung Han Choi ),신동수 ( Dong Su Shin ),최현석 ( Hyun Seok Choi ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1
저자들은 혈액투석을 시작한 환자가 산욕기에 직면했을 때 생체전기 임피던스법을 통하여 적절한 건체중 설정 및 혈액투석을 혈역학적으로 안정한 상태에서 시행한 예를 경험하였다. 본 증례는 출산을 한 혈액투석 환자를 볼 때 참고할 만한 증례이고, 향후 혈액투석 환자의 산욕기에 대한 추가 연구가 더 필요하다. Accurate volume assessment and proper volume management in hemodialysis patients are important, as volume status can affect mortality. There are several available methods of volume assessment. One of these, Bioelectrical Impedance Analysis (BIA), has been shown to provide an precise assessment of volume status. A 32-year-old woman in her fifth pregnancy, who had chronic renal failure, started hemodialysis treatment 10 days before delivery and experienced a severe change in body fluid status in the puerperium. Her volume status was assessed by BIA during the puerperium, and volume management conducted on the basis of these results enabled the patient to be maintained hemodynamically stable throughout this period.
정석후 ( Seok Hu Jeong ),오경용 ( Kyong Yong Oh ),신동수 ( Dong Su Shin ),최성한 ( Shung Han Choi ),정을식 ( Eul Sik Jung ),박진선 ( Jin Sun Park ),나선영 ( Sun Young Na ),성지윤 ( Ji Yoon Sung ),정지용 ( Ji Yong Jung ),김세중 ( S 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Kaposi`s sarcoma (KS) is an unusual multifocal neoplasm of vascular endothelial cell origin. The trunk, arms, head, and neck are the most common sites. It is common in men and has four distinct variants: classic, Africa-endemic, immunosuppressive drug-associated, and acquired immunodeficiency syndromeassociated KS. KS appears to develop immunosuppressed patients, but is uncommon in patients on dialysis. A 79-year-old man on hemodialysis for 2 months presented with pruritus over the entire body and multiple, discrete, variable-sized, dark blue papulonodules (papuloplaques, maculopapules) on the left arm and shoulder. A biopsy specimen form the left arm showed spindle cells with slit-like spaces and extravasated red blood cells. The specimen was positive for CD 34 antigen, and human herpesvirus 8 was detected. We report a case of KS that occurred in a 79-year-old patient on hemodialysis.
증례 : 신장 ; 트라넥사민산에 의해 유발된 급성 신피질 괴사 1예
성지윤 ( Ji Yoon Sung ),정을식 ( Eul Sik Jung ),최성한 ( Shung Han Choi ),신동수 ( Dong Su Shin ),이현희 ( Hyun Hee Lee ),정우경 ( Woo Kyung Chung ),장제현 ( Jae Hyun Chang ) 대한내과학회 2012 대한내과학회지 Vol.82 No.4
Kidney cortex necrosis is a relatively rare cause of acute kidney injury and is characterized by complete or partial destruction of the renal cortex, but sparing of the medulla. Tranexamic acid has antifibrinolytic activity and is used to reduce bleeding. We report a rare case of kidney cortex necrosis caused by tranexamic acid. A 49-year-old woman complained of coughing up blood-tinged sputum. She had a history of bronchiectasis and was treated with tranexamic acid for 3 days. Four days after admission, she developed anuria and azotemia. Computerized tomography showed enhancement of the renal medulla, but not the bilateral renal cortex. The patient was treated with hemodialysis, and has since been maintained on hemodialysis for 6 months. Due to the development of kidney cortex necrosis in patients treated with tranexamic acid, all its potential complications should be considered. (Korean J Med 2012;82:503-506)