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S-10 Acute pancreatitis as a extrarenal manifestation of hemorrhagic fever with renal syndrome
( Kyoo Ho Choi ),( Young Don Kim ),( Jae Hyuck Jun ),( Gab Jin Cheon ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Background/Aims:?Acute pancreatitis is one of the extrarenal manifestation of Hemorrhagic fever with renal syndrome (HFRS). The suggested pathophysiology is that increased vascular permeability during infection cause systemic expansion of capillary leakage, which can cause retroperitoneal edema, and may affect the pancreas resulted in acute pancreatitis. The aim of out study was to investigate the clinical significance of acute pancreatitis in patients HFRS.?Methods:?We retrospectively reviewed the medial records of the patients diagnosed as HFRS at our institute from November 1996 to May 2016. And we analyse the clinical characteristics and prognosis of patients focused on complicated acute pancreatitis.?Results:?A total of 62 patients was diagnosed as HFRS during the study period. The mean age was 52.1±16.4 years, and men comprised more than half (61.3%). Among them, 8% (5 of 62) patients were complicated with acute pancreatitis. All 5 patients showed acute kidney injury, and 2 of 5 needed hemodialysis (HD) treatment, but 1 of 2 patient was died despite of HD treatment (mortality rate 20%).?Conclusions:?In this retrospective study, acute pancreatitis is one of severe complication of HFRS and the mortality rate was very high. Therfore, early detection of complication including pancreatitis and timely intervention is mandatory in patient care with HFRS.
S-109 Clinical Characteristics of Ischemic Colitis: Focus on Predisposing Factors
( Kyoo Ho Choi ),( Hyun Il Seo ),( Sa Young Shin ),( Jong Kyu Park ),( Koon Hee Han ),( Young Don Kim ),( Gab Jin Cheon ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Background and Aim: Some ischemic colitis (IC) patients discuss with their healthcare provider about the predisposing factor or event before the onset of disease. However, studies on predisposing factors for IC are lacking. This study aimed to identify the characteristics of patients with IC, focusing particularly on the predisposing factor. Methods: A single-center retrospective analysis of 159 IC patients from 2000 to 2014 was conducted. Clinical characteristics, laboratory data, endoscopic findings, and medical records were reviewed. We defined a predisposing factor as the factor that was a temporal or an episodic event occurring within a week before the development of IC. The following events were included as predisposing factors for IC: colonoscopy, enema or episodic use of laxatives, heavy drinking, pancreatitis not related to alcohol consumption, shock (including cardiopulmonary resuscitation and sepsis), burn, and diarrhea unrelated to enema or use of laxatives. We excluded diarrhea if it occurred consecutive to hematochezia on the same day or between the onset of abdominal pain and hematochezia. According to the presence of these predisposing factors, patients were divided into two groups: predisposing factor (+) and (-) group. We compared the clinical characteristics of the two groups. Results: The predisposing factor (+) group had relatively higher male dominance (56.9% vs 33.3%, p=0.005), younger age (60.9±15.4 vs 67.2±13.4 years, p=0.010), lower incidence of hypertension (43.1 vs 60.2%, p=0.044), and less number of risk factors (1.24±1.18 vs 1.82±1.22, p=0.005) compared to the (-) group. Conclusions: In case of the predisposing factor (+) group, IC can potentially develop in a relatively younger population with less number of risk factors and can show relatively higher prevalence in males. This suggests that predisposing factors, mostly related to dehydration, contribute to the pathogenesis of IC. Therefore, it may be possible to prevent IC by controlling the predisposing factors in this group.
김종천,김윤홍,최영규 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.2
Acromegaly is a chronic,debilitating disease by excessive growth hormone production due to pituitary adenoma. Anesthesiologists are frequently confronted with problems such as excessive mandible protrusion, macroglossia and tracheal stenosis, which make intubation very difficult and risky in acromegalic patients.So, the authors tried to predict difficult intubation because acromegalic patients have anatomical change of airway.With X-ray film of acromegalic patient, measuring atlanto-occipital gap(2.5 mm), mandible ramus angle(8.4 cm), mandibulo-hyoid distance (35 mm), level of hyoid bone (between 4th and 5th cervical bone) provide clues to perceive difficult intubation. By abnormal data of these measurements, we can anticipate the difficult intubation with moderate accuracy compared with normal patient. It is prudent to consider using other methods such as fiberoptic bronchoscopic intubation, blind endotracheal intubation and transtracheal jet ventilation when difficult endotracheal intubation is predicted in those patients. (Korean J Anesthesiol 1995; 29: 310~314)
만경강 하천변 충적 지하수의 용존 Fe와 Mn 거동에 대한 산화-환원 과정과 용해 평형의 효과
최범규,고동찬,하규철,전수현,Choi, Beom-Kyu,Koh, Dong-Chan,Ha, Kyoo-Chul,Cheon, Su-Hyun 대한자원환경지질학회 2007 자원환경지질 Vol.40 No.1
전라북도 전주시 지역의 만경강 하천변 충적 대수층에 심도 30m까지 설치된 다중 심도 관정을 이용하여 산화-환원 환경과 관련된 지하수의 생물지구화학적 특성을 조사하였다. 대체로 용존 산소(DO)가 1 mg/L이하의 혐기성 환경이 지배적이었으며, 10-20m 구간에서는 높은 농도의 Fe($14{\sim}37mg/L$)와 Mn($1{\sim}4mg/L$)이 나타나고 그 하부에서는 S(-II) 이온이 검출되었다. 용존 Fe와 Mn이 높은 구간에서는 $O_2,\;NO_3$가 거의 없고, 퇴적물내의 Fe와 Mn의 함량은 심도에 따라 큰 차이 없이 분포하고 있어 전자수용체로서 이용된 Fe(III), Mn(IV)의 환원에 의해 지하수내의 용존 Fe와 Mn의 농도가 높아진 것으로 볼 수 있다. 용존 농도에서 Mn이 Fe에 비해 상대적으로 농도가 높게 나타나는 구간이 더 넓다. 환원 과정에서 전자공여체(electron donor)로 이용될 수 있는 유기 탄소(DOC) 농도가 지하수면 부근에서 급격히 감소하는 것으로 보아 지하수내 유기물은 상부에서 유입되는 것으로 보인다. 20m 하부에서는 $SO_4$가 감소하고 S(-II) 이온이 검출되는 것으로 보아 상부 구간보다는 하부구간에서 $SO_4$ 환원작용이 활발함을 지시한다. 여러 산화-환원쌍으로부터 계산된 산화-환원 전위는 Fe를 포함하는 쌍들간을 제외하고는 모두 일치하지 않아 전체적으로 산화-환원적으로 비평형 상태에 있다고 볼 수 있다. 지하수면 부근을 제외하고는 siderite, rhodochrosite 등의 탄산염 광물의 포화지수가 -2에서 +1의 범위를 보여 이들 광물에 의해 각각 Fe(II), Mn(II) 이온의 농도가 지하수내에서 조절될 수 있음을 보여주며, 20m 하부 심도 구간에서 S(-II) 이온이 검출되는 지점에서는 Fe(II)의 경우 FeS 광물에 의해서도 농도가 조절될 수 있다. Biogeochemical characteristics involving redox processes in groundwater from a riverine alluvial aquifer was investigated using multi-level monitoring wells (up to 30m in depth). Anaerobic conditions were predominant and high Fe ($14{\sim}37mg/L$) and Mn ($1{\sim}4mg/L$) concentrations were observed at 10 to 20 m in depth. Below 20 m depth, dissolved sulfide was detected. Presumably, these high Fe and Mn concentrations were derived from the reduction of Fe- and Mn-oxides because dissolved oxygen and nitrate were nearly absent and Fe and Mn contents were considerable in the sediments. The depth range of high Mn concentration is wider than that of high Fe concentration. Dissolved organics may be derived from the upper layers. Sulfate reduction is more active than Fe and Mn reduction below 20 m in depth. Disparity of calculated redox potential from the various redox couples indicates that redox states are in disequilibrium condition in groundwater. Carbonate minerals such as siderite and rhodochrosite may control the dissolved concentrations of Fe(II) and Mn(II), and iron sulfide minerals control for Fe(II) where sulfide is detected because these minerals are near saturation from the calculation of solubility equilibria.