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한인미,기연경,이은영,이충근,한승규,허수진,유태현 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.1
Malakoplakia is an uncommon chronic granulomatous inflammatory disease which is associated with immunocompromised conditions such as malignancy, autoimmune disease, chronic alcohol intake, poorly controlled diabetes and long-term steroid use. Malakoplakia can occur at various sites, most commonly in the genitourinary tract including urinary bladder and the ureter. Renal parenchymal involvement is relatively uncommon, accounting for 15% of all malakoplakia. A few cases of renal malakoplakia have been reported in Korea, and only one case was accompanied by acute kidney injury. Here we report an 80-year-old female patient with renal parenchymal malakoplakia and acute interstitial nephritis presented as acute kidney injury with literature review.
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이은영,기연경,이정연,한인미,신재일,김명수,박성하 대한고혈압학회 2013 Clinical Hypertension Vol.19 No.2
Renovascular hypertension caused by renal artery stenosis is an uncommon but curative cause of hypertension in children. We report a case of recurrent severe hypertension caused by renovascular hypertension. After recurrence of hypertension after redo percutaneous transluminal renal angioplasty, the blood pressure was finally controlled by renal autotransplantation. This case demonstrates the importance of considering renovascular hypertension as a cause of severe hypertension in children. Also, renal autotransplantation should be considered as a viable treatment option for treatment of renovascular hypertension that is recurrent after renal angioplasty
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A case of fulminant community-acquired Acinetobacter baumannii pneumonia in Korea
오윤정,Sung Heon Song,백승희,이학현,한인미,오동현 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.4
Acinetobacter baumannii (AB) is a common pathogen found in patients with hospitalacquired pneumonia all over the world. Community-acquired AB pneumonia,however, is very rare and has seldom been reported in Asia-Pacific countries. Community-acquired AB pneumonia has a fulminant course and is associated with a higher mortality than hospital-acquired AB pneumonia. In Korea, no case of fatal community-acquired AB pneumonia has been reported to date. Here, we describe the first fatal case of fulminant community-acquired AB pneumonia in Korea.
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기윤경,오현정,김은진,박경숙,한승규,한인미,윤창윤,이은영,주영수,김대영,이미정,박정탁,한승혁,유태현,김범석,강신욱,최규헌 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.3
Purpose: Continuous renal replacement therapy (CRRT) has been established for critically ill acute kidney injury (AKI) patients. In addition, some centers consist of a specialized CRRT team (SCT) with physicians and nurses. To our best knowledge,however, ona a few studies have yet been carried out on the superiority of SCT management. Materials and Methods: A total of 551 patients, who received CRRT between January 2008 and March 2009, were divided into two groups based on the controller of CRRT. The impact of the CRRT management on 28-day mortalitywas compared between two groups by Kaplan-Meier curve and Cox analysis. Results: During the study period, the number of filters used, down-time per day, and intensive care unit length of day were significantly higher in non-SCT group than in SCT group (6.2 hrs vs. 5.0 hrs, p=0.042; 5.0 hrs vs. 3.8 hrs, p<0.001; 27.5 days vs. 21.1 days, p=0.027, respectively), while net ultrafiltration rate was significantlylower in non-SCT group than SCT group (28.0 mL/kg/hr vs. 29.5 mL/kg/hr, p=0.043, respectively). In addition, 28-day mortality rate was significantly lower in SCT group than with non-SCT group (p=0.031). Moreover, Cox regression analysisshowed that 28-day mortality rate was significantly lower in SCT control group, even after adjusting for age, gender, severity scores, biomarkers, risk, injury, failure, loss, and end-stage renal disease, and contributing factors (hazard ratio 0.91, p=0.046). Conclusion: A well-trained CRRT team could be beneficial for mortality improvement of AKI patients requiring CRRT.
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한승규,기연경,문성우,윤창연,이은영,주영수,한인미,이은영,김창오 대한노인병학회 2014 Annals of geriatric medicine and research Vol.18 No.2
연구배경: 하지부종은 여러 가지 다양한 기저질환을 가지고 있는 노인 환자들에게 나타나는 흔한 증상이다. 본 연구는노인 환자에서 하지부종의 원인 및 기저질환에 따른 차이를알아보기 위해 시행되었다. 방법: 2010년 1월부터 2012년 12월까지 서울의 3차 병원응급의료센터에 하지부종을 주소로 내원한 65세 이상의 환자247명의 의무기록을 후향적으로 분석하였다. 환자의 나이, 성별, 주증상, 퇴원 시의 진단명 등을 조사하였다. 결과: 임상 조사항목이 불충분한 21명을 제외한 226명의환자를 대상으로 하였다. 노인 환자에서 하지부종의 원인으로가장 많은 단일 질환은 신부전이었으며(42명, 18.6%), 다음으로는 심부전(37명, 16.4%)과 심부정맥혈전증(32명, 14.2%)의순이었다. 그러나 66명(29.2%)의 환자에서는 원인을 찾지 못하였다. 신부전과 심부전이 원인인 경우 기저질환으로 각각신장질환(40명, 95.2%)과 심혈관계질환(29명, 78.4%)을 동반한 경우가 많았으며, 그 외 당뇨와 외상을 동반한 경우도 적지않았다. 심부정맥혈전증의 경우 기저질환으로 고형암(13명, 40.6%)을 동반한 경우가 가장 많았으며, 외상과 1년 이내의수술 병력 및 당뇨도 높은 빈도를 보였다. 전체적으로는 만성양측성 하지부종(120명, 53.1%)이 가장 많았다. 심부정맥혈전증과 봉와직염 및 림프부종의 경우 일측성으로 발생한 경우가 많았으며, 신부전이나 심부전, 간경화와 같은 전신질환이원인인 경우에는 주로 양측성으로 하지부종이 발생하였다. 결론: 노인 환자에서 하지부종은 기저질환과 밀접한 관련이 있는 신부전과 심부전 등의 전신적 질환에 의해 발생하는경우가 많았다. 따라서 노인 환자에서는 다양한 기저질환을고려한 부종의 원인에 대한 접근 및 이에 따른 치료가 중요할것이다. Background: Leg edema is a common symptom among elderly patients with multiple underlying diseases. This study was aimed to investigate the etiologies and underlying diseases of leg edema in elderly patients. Methods: We retrospectively reviewed medical records of 247 patients aged over 65, who visited an Emergency Department of a tertiary hospital due to leg edema from January 2010 to December 2012. Results: A total of 226 patients with complete medical records were included. The most common cause of leg edema in elderly patients was renal failure (42 cases, 18.6%), followed by heart failure (37 cases, 16.4%), and deep vein thrombosis(32 cases, 14.2%). However, the etiologies were not established in 66 cases (29.2%). Patients with leg edema caused by renal and heart failure had renal (40 cases, 95.2%) and cardiovascular diseases (29 cases, 78.4%), respectively, while others had diabetes mellitus and trauma. Patients with leg edema caused by deep vein thrombosis had underlying conditions such as cancer (13 cases, 40.6%), trauma, surgery within 1 year, and diabetes mellitus. Overall, chronic bilateral edema (120 cases, 53.1%) was most commonly observed form of leg edema in elderly patients. Deep vein thrombosis, cellulitis, and lymphedema usually caused unilateral edema, whereas systemic diseases such as renal failure, heart failure, and liver cirrhosis caused bilateral edema. Conclusion: Leg edema in elderly patients is usually caused by systemic diseases such as renal and heart failure closely related to underlying diseases. Therefore, it is important to consider the variety of underlying diseases, when approaching the cause and treatment of leg edema in elderly patients.
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