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Rifampicin 내성 결핵균의 검출에 있어서 PCR-line Probe법과 PCR-SSCP법의 비교
김호중 ( Ho Joong Kim ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김종원 ( Jong Won Kim ),심태선 ( Tae Sun Shim ),최동철 ( Dong Chull Choi ),권오정 ( O Jung Kwon ),이종헌 ( Chong H. Rhee ),한용철 ( Yong Chol Han ) 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.4
대퇴골두 골괴사증에서 시행한 인공 고관절 전치환술 -최소 10년 이상 추시-
정종원 ( Jong Won Chung ),박상원 ( Sang Won Park ),한승범 ( Seung Beom Han ),박종훈 ( Jong Hoon Park ),김호중 ( Ho Jung Kim ),이원석 ( Won Suck Lee ) 대한고관절학회 2010 Hip and Pelvis Vol.22 No.2
Purpose: The aim of this study was to assess the outcome of cementless total hip arthroplasty (THA) in cases of osteonecrosis of the femoral head. Materials and Methods: We studied long-term outcomes for 54 patients (72 hips). Mean duration of follow-up was 13.5 years. Clinical outcomes were evaluated by the Harris Hip Score. Radiographic evaluation from the preoperative and follow-up periods included assessment of the fixation of the femoral and acetabular components, polyethylene wear, osteolysis, and radiolucent line. Results: The mean Harris Hip Score improved from a preoperative value of 51.9 points to 89.4 at final follow-up. Regarding the femoral components, there was radiographic evidence of stable bony ingrowth in 69 hips, stable fibrous ingrowth in 2 hips and unstable fixation in 1 hip. There was a radiolucent line of less than 1 mm in 7 hips, and femoral osteolysis in 27 hips. Regarding the acetabular components, there was radiographic evidence of stable fixation in 68 hips, unstable fixation in 4 hips, and osteolysis in 39 hips. There was a significant correlation between (i) failure of components and (ii) femoral osteolysis, acetabular osteolysis, polyethylene thickness, linear wear rate per year, or total linear wear. Conclusion: The findings of this study show favorable long term results, both clinical and radiographic, using cementless total hip replacement arthroplasties. However, the revision rates for the Harris-Galante acetabular components were high. Wear of the load? weight? bearing surface continues to limit the long-term success rate of THA, and improved design of the acetabular components should be considered.
일반연제 발표 : Baxter 연구비 결과보고 ; N-acetylcysteine 투여가 Adriamycin 신증 백서의 사구체 Laminin과 Cytokine 발현에 미치는 영향
한상웅 ( Han Sang Ung ),유준호 ( Yu Jun Ho ),박일규 ( Park Il Gyu ),백승삼 ( Baeg Seung Sam ),박문향 ( Park Mun Hyang ),정호삼 ( Jeong Ho Sam ),김수완 ( Kim Su Wan ),이종은 ( Lee Jong Eun ),김호중 ( Kim Ho Jung ) 대한신장학회 2002 춘계학술대회 초록집 Vol.21 No.1
김정호 ( Kim Jeong Ho ),강경원 ( Kang Gyeong Won ),김지훈 ( Kim Ji Hun ),김호중 ( Kim Ho Jung ),박찬현 ( Park Chan Hyeon ),강종명 ( Kang Jong Myeong ),박한철 ( Park Han Cheol ) 대한내과학회 1993 대한내과학회지 Vol.44 No.3
연구배경 : 만성 신부전 환자의 치료에 혈액투석이 사용되면서 혈액투석 환자의 생존율과 이에 영향을 주는 요인에 대한 많은 연구가 이루어졌다. 이에 저자들은 한양대학병원 인공신장실에서 혈액투석 환자에 대해 생존율, 사망원인, 원인질환에 대해 조사하였다. 방법 및 대상 : 1982년부터 1991년까지 한양대학교병원인공신장실에서 정기적으로 혈액투석을 받은 만성 신부전 환자 548명에 대하여 후향적 방법을 통하여 조사하였다. 결과 : 1) 대상 환자는 총 548명 이었으며 연령은 17세부터 68세로 분포하였고 40~50대 환자가 전체의 55.8%로 가장 많았으며 남여의 비는 58 : 42로 남자가 많았다. 2) 만성 신부전 환자의 원인 질환은 만성 사구체신염이 전체의 23.5%로 가장 많았으며 그 다음으로 당뇨병성 신증이 15.9%, 고혈압성 신병증이 13.9%순 이였다. 또한 원인이 분명치 않은 경우도 36.9%나 되었다. 3) 관찰 기간중 사망한 108명에 대한 사망원인의 분석에서는 뇌졸중이 25.9%로 가장 많았으며 그 다음으로 심장질환이 19.4%, 감염 및 패혈증이 16.7%였으며 장출혈, 고칼륨증, 자살 순이었다. 원인이 분명치 않은 경우도 22.2%이었다. 4) 생존율은 혈액투석후 2년 생존율이 75.3%로 떨어졌으나 그 이후부터 거의 일정한 비율로 감소하였다. 당뇨병 환자의 경우는 투석 시작후 1년에 급격한 감소(78.4%)를 보였고 2년 생존율은 59.2%로 비당뇨병성군 보다 현저한 차이가 있었다(p<0.001). 고혈압성 신병증 환자의 생존율은 1년 생존율이 80.2%, 2년 생존율이 62.8%로 통계적으로 유의하게 감소를 보였고(p<0.001). 결론 : 혈액투석 환자의 사망에는 동맥경화증이 깊히 연관되어 있는 것으로 생각되며 투석후 1년 동안의 사망률이 높으므로 이 기간에 특히 세심한 주의를 기울일 필요가 있는 것으로 생각된다. Background : Regular hemodialysis had been established as a way of treatment for end stage renal failure. There are many report on long term follow-up for chronic hemodialysis patients. We analysed the patients with chronic renal failure on hemodiaysis. Methods : In a retrospective study, the survival rate and the causes of death were analysed in 548 patients with chronic renal failure on hemodilysis during the period of 1982 to 1991, treated at the Hanyang University hospital. The patients were mostly dialysed 2 to 3 times a week for 4 to 5 hours. Results : The demographic characteristics of these patients, male to female ratio was 58 : 42 and the mean age was 47.2±13.7 years. Underlying disorders of chronic renal failure consisted of mainly chronic glomerulonephritis (23.5%), followed by diabetic nephropathy (15.9%), and hypertensive nephrosclerosis (13.9%). The causes of death were most frequedntly cerebrovascular accidents (25.9%), including hemorrage and infarction, followed by cardiac disorders (19.4%), infections (16.7%), and gastrointestinal bleedings (6.5%). The overall of survival rates in hemodialysis patients were 85.6% for 1 year, 75.3% for 2 years, 62.3% for 5 years, 33.7% for 10 years. Dividing into subgroups, renal failure due to diabetus and hypertensive nephrosclerosis carried significantly poor outcomes. The survial rate of the older patients were shorter than the younger patients (p<0.001). Conclusion : We should pay attention to the hemodialysis patients during the first year because sur-vival rate of this period was shorter than other period.
골연부조직 종양 전공자가 아닌 일반 정형외과 전문의에 의해 치료된 연부조직육종
이순혁,박종훈,박상원,채인정,한승범,이석하,김호중,Lee, Soon-Hyuck,Park, Jong-Hoon,Park, Sang-Won,Choi, In-Chung,Han, Seung-Beom,Lee, Suk-Ha,Kim, Ho-Joong 대한근골격종양학회 2007 대한골관절종양학회지 Vol.13 No.2
목적: 저자들은 골연부조직 종양 전공자가 아닌 타 분야의 경험 있는 수련병원의 정형외과 전문의에 의해 치료된 연부조직육종 환자의 치료과정을 분석하여 치료의 적절성 여부를 보고자 하였다. 대상 및 방법: 1997년 7월부터 2006년 9월까지 본원을 방문하여 연부조직육종으로 진단받은 25명의 환자를 대상으로 하였다. 분석은 초진 방법과 수술적 치료와 보조적 치료 그리고 추시 관찰의 적절성 유무를 종양 치료의 원칙에 따라 조사하였다. 결과: 남자는 16례 여자는 9례였으며 최종 수술 전 생검을 시행한 경우는 9례(36%)였다. 광범위 절제술이 시행된 경우는 13(52%)례 였으며, 조직검사 결과를 근거로 악성도를 판명할 수 있었던 12례 중 수술과 술 후 보조적 치료가 동시에 적절했던 경우는 총 4(33.3%)례에 불과했다. 한편 적절한 검사 방법에 의해 이루어진 추시는 4례 (16%)였다. 결론: 예상외로 많은 수의 연부조직육종 환자들이 임상 경험이 풍부한 수련병원의 전문의들에게 조차 부적절한 치료를 받고 있다. 경험 많은 전문의를 포함한 모든 정형외과 전공자들에게 연부조직육종의 치료에 대한 전반적이고 강화된 교육이 필요 할 것으로 사료된다. Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.
윤종욱,황정혜,함형석,이한철,노길환,강수정,서지영,김호중,정만표,권오정,이종헌,손희정,Yun, Jong-Wook,Hwang, Jung-Hye,Ham, Hyoung-Suk,Lee, Han-Chul,Roh, Gil-Hwan,Kang, Soo-Jung,Suh, Gee-Young,Kim, Ho-Joong,Chung, Man-Pyo,Kwon, O-Jung,Rhee, 대한결핵및호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.49 No.6
저자들은 항결핵제중 rifampicin 사용 후 발생한 위막성 대장염 1예를 경험 하였기에 보고하는 바이며 전신상태가 좋지 않거나 간질환이 있는 고령의 환자에서 항결핵제 사용 중 심한 설사가 있을 때 이의 가능성을 생각해야 되며 필요한 경우 조기에 진단적 검사를 시행해야 한다고 생각된다. Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.
특발성 비특이성 간질성 폐렴 18례의 임상상 및 치료반응
강은해 ( Kang Eun Hae ),정만표 ( Jeong Man Pyo ),강수정 ( Kang Su Jeong ),안창혁 ( An Chang Hyeog ),안종운 ( An Jong Un ),한정호 ( Han Jeong Ho ),이경수 ( Lee Gyeong Su ),임시영 ( Im Si Yeong ),서지영 ( Seo Ji Yeong ),김호중 ( Kim 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.4
Gitelman 씨 증후군으로 오진된 Pseudo - Bartter 씨 증후군 1 예
이동규(Dong Kyu Lee),정재면(Jae Myun Jung),강준구(Jun Goo Kang),김태엽(Tae Yeob Kim),김태종(Tae Jong Kim),오호석(Ho Suk Oh),최창렬(Chang Youl Choi),한상웅(Sang Woong Han),김호중(Ho Jung Kim) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.3
A 31-year-old woman had a history of fatigue and hypokalemia and metabolic alkalosis and hypocalciuria. The patient had a subtotal thyroidectomy and denied ingestion of diuretic medication. Her clinical and laboratory findings were consistent with Gitelman`s syndrome. Normal blood pressure, hypokalemic metabolic alkalosis, hypocalciuria were present. She confessed to us that she had been taking a pill due to constipation for 7 years. She was afraid that her husband know it. But we don`t know the reason why she had concealed it Surreptious ingestion of diuretics must be excluded in any adult patient in whom a diagnosis of Bartter`s or Gitelman`s syndrome is considered.