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오숙의 ( Sook Eui Oh ),정재헌 ( Jae Hun Jung ),윤성보 ( Seong Bo Yoon ),윤현영 ( Hyeon Young Yoon ),박종규 ( Jong Kyu Park ),이동훈 ( Dong Hun Lee ),홍성호 ( Sung Ho Hong ),우경희 ( Kung Hee Woo ),최성훈 ( Seong Hoon Choi ),이상학 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.62 No.3
Hyperhomocysteinemia is an independent risk factor for cardiovascular, cerebrovascular and peripheral vascular diseases that are complicated by atherosclerosis and a thromboembolism. An increased level of plasma homocysteine develops from a genetic defect in the of enzyme for the homocysteine metabolism or a vitamin deficiency. Hyperhomocysteinemia has direct toxic effect on the vascular endothelium and causes damages to the antithrombotic action of vascular endothelial cells. Most cases of hyperhomocysteinemia are asymptomatic, but cardiopulmonary or cerebrovascular incidents developin rare cases. In the case of a thromboembolism with an unknown cause, hyperhomocysteinemia should be considered in a differential diagnosis. The authors report a case of pulmonary thromboembolism in a patient with hyperhomocysteinemia with a review of the relevant literature. (Tuberc Respir Dis 2007; 62: 211-216)
저알부민혈증을 보이는 혈액투석 환자에서 혈청 알부민에 대한 케토스테릴의 효과
오숙의 ( Sook Eui Oh ),이영기 ( Young Ki Lee ),김진경 ( Jin Kyung Kim ),이동훈 ( Dong Hun Lee ),김수진 ( Soo Jin Kim ),김성균 ( Sung Gyun Kim ),오지은 ( Ji Eun Oh ),서장원 ( Jang Won Seo ),윤종우 ( Jong Woo Yoon ),구자룡 ( Ja Ryon 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Purpose: Malnutrition is a strong predictor of increased morbidity and mortality in patients on maintenance dialysis. Although a number of studies were performed to determine effective treatment, there is no proven medication for malnutrition. This study aimed to evaluate the effect of keto acids (ketosteril(R)) on serum albumin levels in hemodialysis patients with hypoalbuminemia. Methods: Hemodialysis patients with hypoalbumineia (serum albumin ≤3.8 g/dL) were enrolled. Exclusion criteria were previous supplementation of keto acids before the initiation of dialysis, acute infection, liver cirrhosis, malignancy and persistent hypercalcemia. Patients were treated with ketosteril for 6 months and serum albumin levels were compared to age- and gender-matched hemodialysis patients. Results: There were no significant differences in the baseline serum albumin levels between ketosteril group (n=19) and the control group (n=19). After 6 months, the mean (±SD) serum albumin level in the ketosteril group rose from 3.46±0.40 g/dL to 3.66±0.37 g/dL (p=0.01), but not the control group. However, the difference between the two groups was not significant (p=0.06). Multivariate analysis showed that the ketosteril supplementation (p=0.03) and the baseline serum albumin level (≤3.4 g/dL, p=0.04) were predictors of increased serum albumin. There was no severe hypercalcemia during the study period. Conclusion: There was an improvement of serum albumin levels in hemodialysis patients with hypoalbuminemia after the supplementation of keto acids.
증례 : 신동맥협착증 환자에서 신동맥 우회재건술 후에 재발한 급성 폐부종 1예
오숙의 ( Sook Eui Oh ),이영기 ( Young Ki Lee ),이해리 ( Hae Ri Lee ),노정우 ( Jeong Woo Noh ),신상준 ( Sang Joon Shin ) 대한내과학회 2006 대한내과학회지 Vol.71 No.3
저자들은 호흡 곤란으로 내원한 환자에서 우측 신동맥의 완전 폐쇄로 신동맥 우회재건술을 시행하였던 환자에서 재발한 flash pulmonary edema 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. 또한 신동맥 협착에 대해 수술적 처치를 한 후에도 드물게 재협착이 올 수 있으므로 지속적인 경과 관찰이 필요할 것으로 생각된다. Renal artery stenosis is a rare cause of acute pulmonary edema. So-called flash pulmonary edema is associated with bilateral renal artery stenosis or stenosis in a single functioning kidney. Flash pulmonary edema has been recognized as an absolute indication for vascular intervention. A 33-year old man was admitted with acute shortness of breath. Renal angiography showed occlusion of the right renal artery. He underwent a right renal artery bypass graft. However, after the renal artery bypass graft, episodes of pulmonary edema recurred. A renal angiography showed complete obstruction of the right renal artery and bypass graft. The left renal angiography showed an intact renal artery and decreased kidney size.(Korean J Med 71:322-327, 2006)
성인 미세변화신증후군 환자에서 스테로이드 충격요법의 효과
오숙의 ( Sook Eui Oh ),이영기 ( Young Ki Lee ),김진경 ( Jin Kyung Kim ),조성태 ( Sung Tae Cho ),전로원 ( Rho Won Chun ),윤종우 ( Jong Woo Yoon ),구자룡 ( Ja Ryong Koo ),김형직 ( Hyung Jik Kim ),노정우 ( Jung Woo Noh ),남은숙 ( Eun 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.6
Purpose : The incidence of complete remission is lower and the relapse is more frequent in adult-onset minimal change nephrotic syndrome (MCNS) are observed especially when compared with those in children. This study was designed to examine the effect of methylprednisolone pulse therapy in adultonset MCNS comparing to oral steroid as an initial therapeutic modality. Methods : We have retrospectively reviewed the clinical data of 25 adult-onset MCNS patients. Twelve patients were treated with three intravenous pulses of methylprednisolone (1 g daily) followed by oral prednisolone 1 mg/kg daily for 4-8 weeks and also by low doses of oral prednisolone for 4-6 months (MP group) Thirteen patients were initially treated with oral prednisolone 1 mg/kg daily for 4-8 weeks and then with low doses of oral prednisolone (PD group). Results : The response to therapy was similar between MP and PD group, with a complete remission obtained in 83.3% and 84.6%, respectively. No statistically significant difference between the two groups was observed in the rate of response at 8 weeks (58.3% versus 69.2%). The mean time to response was not different between MP group (37.9±28.0 days) and PD group (45.5±40.2 days). No difference was recognized between the two groups with respect to relapse rate. Conclusion : These data suggest that a short course of methylprednisolone pulse therapy followed by oral prednisolone is not superior to oral prednisolone therapy as an initial therapeutic modality in adult-onset MCNS.
이경민 ( Kyung Min Lee ),장주현 ( Joo Hyun Jang ),김진경 ( Jin Kyung Kim ),오숙의 ( Sook Eui Oh ),이동훈 ( Dong Hun Lee ),이영기 ( Young Ki Lee ),노정우 ( Jung Woo Noh ),남은숙 ( Eun Suk Nam ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
IgA nephropathy and thin basement membrane disease are common glomerular diseases in persistent microscopic hematuria with or without proteinuria. However, these two conditions cannot be easily distinguished on the biochemical or urinary findings alone. Therefore, renal biopsy is required for correct identification of the two conditions in most cases. Recently, it has been reported that thinning of glomerular basement membrane is accompanied with precipitation of electron dense deposits in some patients with IgA nephropathy. We report a case of IgA nephropathy associated with thin basement membrane disease in a 19-year-old male with microscopic hematuria and mild proteinuria. After 2 years` treatment with angiotensin II receptor blocker, the patient exhibited persistent microscopic hematuria but decreased proteinuria. Our finding concurs with the previous reports indicating that patients with both IgA nephropathy and thin basement membrane disease do not have different clinical features compared to those with IgA nephropathy alone. In addition, clinical outcome does not appear to be affected by thin basement membrane disease when these two conditions are combined.