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급성 A형 간염 환자에서 발생한 간질성 신염과 IgA 신병증의 병발에 의한 급성 신부전 : 1예 보고
한승석 ( Seung Seok Han ),김민경 ( Min Kyung Kim ),최병용 ( Byoung Yong Choi ),민희석 ( Hee Suk Min ),김학령 ( Hack Lyoung Kim ),정용진 ( Chun Soo Lim ),임춘수 ( Chun Soo Lim ),이현주 ( Hyun Ju Lee ),문경철 ( Kyung Chul Moon ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.6
최근 18년간 단일 기관 진료 자료를 바탕으로 분석한 복막투석 환자의 생존율 및 예후 인자 탐색
윤현배 ( Hyun Bae Yoon ),박혜인조 ( Hayne Cho Park ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Suk Han ),김세중 ( Se Joong Kim ),주권욱 ( Kwon Wook Joo ),김연수 ( Yon Su Kim ),안규리 ( Cu Rie Ahn ),한진석 ( Jin Suk Han ),김성권 ( Suhn 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1
목적: 복막투석은 말기신부전증의 신대체요법으로 널리 사용되고 있으나, 국내 생존 관련 자료가 부족한 실정이다. 이에 저자들은 1990년 이후 서울대병원에서 시행한 복막투석 환자의 생존 및 복막염 관련 자료를 분석함으로써, 향후 진료와 연구에 기초 자료로 활용하고자 하였다. 방법: 1990년 1월 1일부터 2007년 6월 30일 사이에 서울대병원에서 복막투석을 시작한 15세 이상의 환자 가운데, 3개월 이상 복막투석을 시행한 670명을 대상으로, 2007년 12월 31일까지 관찰하였다. 이들의 성별, 나이, 신부전의 원인, 당뇨병, 심혈관 질환, Davies Comorbidity Score, 사망이나 복막투석 중단의 원인, 그리고 복막염에 대한 자료를 분석하였다. 생존율은 Kaplan-Meier 방법으로 분석하였고, 생존율에 영향을 미치는 독립적인 인자들을 구하기 위하여 multivariate Cox proportional hazard model을 이용하였다. 결과: 말기신부전증의 원인은 당뇨병이 33.7%로 가장 많았고, 심혈관계 질환은 20.4%에서 동반되었다. 사망 원인을 알 수 있는 58명 중, 심혈관계 질환이 24명 (41.3%), 감염이 20명 (34.4%)이었으며, 복막투석 중단의 원인으로는 복막염이 66.1%로 가장 많았다. 1995년부터 2007년까지 전체 연간 환자당 복막염 발생률은 0.270회였고, 1995년부터 1999년까지 0.365회인 반면, 2000년부터 2007년까지의 발생률은 0.230회로 감소한 것으로 나타났다. 복막염의 원인균은 그람 양성균이 42.6%로 가장 많았고, 그람 음성균이 23.8%, 균이 동정되지 않는 경우는 26.9%를 차지하였다. 평균 생존 기간은 107.5±4.2개월이었고, 5년 환자 생존율은 71.7%, 10년 생존율은 48.2%이었다. 한편, 평균 복막투석 기간은 106.5±4.3개월이었고, 5년 기술 생존율은 72.8%, 10년 기술 생존율은 43.8%였다. 복막투석 환자 사망에 영향을 미치는 독립적인 인자는 당뇨 (HR 1.973, p=0.001), 심혈관 질환 (HR 2.040, p<0.001), 복막투석을 시작할 당시 나이인 것으로 나타났으며, 40세 미만에 비하여 40세 이상 60세 미만의 위험도는 2.427 (p=0.016), 60세 이상의 위험도는 7.397 (p<0.001)이었다. 한편, 기술 실패에 영향을 미치는 독립적인 인자는 60세 이상의 나이 (HR 1.791, p=0.025)와 0.270회/년보다 높은 복막염 발생률 (HR 2.361, p<0.001)이었다. 결론: 서울대병원에서 시행한 복막투석의 환자 및 기술 생존율과 복막염 발생률은 국내외 보고에 비하여 비슷하거나 우수하였고, 당뇨병, 심혈관계 질환, 그리고 복막투석 시작 당시 나이가 환자 생존율에 영향을 미치는 독립적인 인자로 나타났으며, 나이와 복막염 발생률이 기술 생존율에 영향을 미치는 독립적인 인자로 나타났다. Purpose: We investigated the survival rate, factors associated with survival, and peritonitis incidence in PD patients who commenced PD at our center since 1990. Methods: We investigated 670 patients who started PD between January 1990 and June 2007. Data for sex, age, etiology of ESRD, comorbidities, follow-up duration, cause of death, and peritonitis were analyzed. Kaplan-Meier method was used to determine patient survival and technique survival rate. Results: The most common cause of death was cardiovascular disease, while peritonitis was the main reason for technique failure. The overall incidence of peritonitis between 1995 and 2007 was 0.270 episodes per patient-year, and there was a significant drop of peritonitis rate from 1995-1999 (0.365) to 2000-2007 (0.230). Patient survival after 5 and 10 years was 71.7% and 48.2% respectively. Technique survival after 5 and 10 years was 72.8% and 43.8%. Older age (age 40-59: HR 2.427, p=0.016; age≥60: HR 7.397, p<0.001), diabetes (HR 1.973, p=0.001), and cardiovascular disease (HR 2.040, p<0.001) were the independent risk factors of mortality, while older age (age≥60: HR 1.791, p=0.025) and higher peritonitis rate (HR 2.361, p<0.001) were the independent risk factors of technique failure. Conclusion: The patient survival, technique survival and peritonitis incidence of PD patients in our center showed outcomes comparable to other centers worldwide. Older age, diabetes, and cardiovascular disease were associated with lower patient survival, while older age and higher peritonitis rate were associated with higher technique failure.
윤현배 ( Hyun Bae Yoon ),박혜인조 ( Hayne Cho Park ),이하정 ( Ha Jeong Lee ),한승석 ( Seung Suk Han ),박규주 ( Kyu Joo Park ),문주영 ( Ju Young Moon ),안규리 ( Cu Rie Ahn ),오국환 ( Kook Hwan Oh ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.3
Encapsulating peritoneal sclerosis (EPS) is a rare but fatal complication of continuous ambulatory peritoneal dialysis (CAPD). There are some reports on the effect of immunosuppressant therapy including steroid, but the results have not always been promising. Recently, owing to the advance of surgical techniques, there are some reports of the EPS cases significantly improved after successful surgery. A 30-year old man developed EPS after 9 years of peritoneal dialysis, and switched to hemodialysis. In spite of repetitive conservative management and immunosuppressant therapy, there was no improvement. His body weight decreased from 50 kg to 40 kg (BMI 14.2 kg/m2) due to severe malnutrition, so we decided to perform surgery. Total intestinal enterolysis was done successfully without concomitant enterectomy, and his general condition improved dramatically. Four months after surgery, the serum albumin concentration increased from 3.1 g/dL to 4.3 g/dL, cholesterol from 92 mg/dL to 208 mg/dL, and hemoglobin from 9.2 g/dL to 12.5 g/dL. His body weight increased to 61 kg (BMI 21.6 kg/m2), and there was not any fluid collection or bowel obstruction seen on the abdominal CT scan. We experienced a case of EPS which was significantly improved after enterolysis. We report this case with review of the literature.
Cone 상태의 resonance 에너지 : A Complex Rotation Approach
한승석 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-
Complex scaling has been developed and applied to problems of resonances in atomic and molecular physics and in chemistry. Using the complex scaling in the square integrable (L^(2)) basis calculation we approach cone state problem to get resonances. Resonances in conical intersections have bound state characters embedded in continuum. Complex scaling이
Resonance Energies of Cone States : A Complex Rotation Approach 복소 회전 접근
Han, Seung-Suk 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-
Complex scaling이 개발되어 원자, 분자 물리 및 화학에서의 resonance 문제에 적용되어졌다. 제곱적분이 가능한 basis에 complex scaling을 사용함으로써 cone 상태의 resonance를 구했다. Cone 모양 접합에서의 resonance는 연속 에너지 속에 잠긴 구속 상태의 성격을 갖는다. Complex scaling has been developed and applied to problems of resonances in atomic and molecular physics and in chemistry. Using the complex scaling in the square integrable (L^(2)) basis calculation we approach cone state problem to get resonances. Resonances in conical intersections have bound state characters embedded in continuum.
L^(2) Analytic Continuation and Photoionization Cross Section
Han, Seung-Suk 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-
본 연구는 원자나 분자의 광이온화 단면적을 구하기 위해 L^(2) 해석적 연속법을 사용하는 실연이다. Equivalent-quadrature 방법, numerical analytic continuation 방법, complex scaling 방법이 수소 원자의 광이온화 단면적을 구하는데 사용되었다. This work is a demonstration of the use of L^(2) analytic continuation to obtain photoionization cross sections of atoms and molecules. Equivalent-quadrature technique, numerical analytic continuation technique and complex scaling technique are used for the photoionization cross section of a hydrogen atom.
임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2
Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values