골반 골절에 동반된 동맥 출혈에서의 경피적 동맥색전술의 유용성

양승부,임한혁,최교창 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Purpose : To determine the usefullness of transcatheter embolization of arterial bleeding in patients with pelvic bone fracture. Materials and Methods : Between March 2003 and December 2004, we evaluated 13 injuried arteries of eight patients with pelvic bone fracture, All patients underwent angiography, followed by transcatheter arterial embolization using gelfoam. We investigated the vital sign, survival rate and complication of transcatheter arterial embolization. Results : Angiography revealed extravasation of cantrast media in six patients; extravasation and abrupt cut-off of an artery in two. The injured arteries involved(n=13) were internal pudendal(n=4), obturator(n=3), inferior gluteal(n=3), iliolumbar(n=2) and superior gluteal artery(n=1). Transcather arterial embolization was technically successful and there was no complication in all cases. Old age patients(n=2, >60years) died due to hypovolemia and pulmonary complication. Conclusion : Transcatheter arterial embolization of arterial bleeding is a useful procedure in lowering the mortality and complication in pelvic bone fracture.

경도관 동맥색전술을 이용한 비정상 자궁출혈의 치료

양승부,최교창,이상진,정영진,임한혁,한효상,황인철,조환성 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Objective : Our purpose of this study is to evaluate the effectiveness of the transcatheter arterial embolization for the management of abnormal uterine bleeding. Materials and Methods : 14 patients with massive or recurrent uterine bleeding underwent percutaneous transcatheter arterial embolization between February 2003 and September 2004. We reviewed 14 cases of uterine artery or internal iliac artery embolization using gelfoam or PVA particles. Results : Good management of uterine bleeding was achieved in 13 of 14(93%) cases. The cause of abnormal uterine bleeding was myoma(5 case), post D & E bleeding(3), acquired vascular malformation(3), pseudoaneurysm(1), adenomyosis(1), and endometrial hyperplasia(1). Conclusion : Transcatheter artery embolization is an effective and life-saving procedure in massive or recurrent uterine bleeding. Early diagnosis and prompt transcatheter arterial embolization is a useful mangement of uterine bleeding.

기관골 신생증 1예

오영상,이은우,정종혁,문승원,김수현,김동한,양혁승,박정환,박경옥,강성수,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Tracheobronchopathia osteoplastica is a rare disorder of unknown cause characterized by the projection of numerous bony or cartilaginous submucosal nodules into the tracheobronchial lumen with sparing of the posterior membranous portion of tracheobronchial tree. In the past, most of the cases were diagnosed as secondary finding at autopsy. Nowaday, the key component of the evaluation is flexible fiberoptic laryngoscopy and bronchoscopy, which typically demonstrates irregular spicules of subrnucosal bone and cartilage projecting into the tracheobronchial lumen and causing various degrees of airway obstruction. A 45 years old man was visited Sunchon St. Carollo hospital due to discomfort on throat. We saw several nodules just below vocal cord via laryngoscope. The computed tomography revealed multiple small calcified nqdules on trachea and both main bronchi. Pathologic finding of bronchoscopic biopsy showed abnormal proliferation of bony and cartilagious nodules in the tracheal submucosa. These fingdings were consistent with tracheobronchopathia osteoplastica. We report here on a case of tracheobronchopathia osteoplastica with review of literature.

Rifampicin에 의한 것으로 추정되는 위막성 대장염1예

김수현,이은우,정종혁,문승현,김동한,양혁승,오영상,김호동,김도현,박혁,박정환,박경옥,이영직 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Pseudomembranous colitis, caused by altering the normal colonic flora and allowing the multiplication of Clostridium difficile, is an deleterious adverse effect of antibiotics. But it is rarely reported by rifampicin. Rifampicin is one of the first line drug in the treatment of tuberculosis and many patients are exposed to its potential adverse effects. We experienced a patient that had abdominal discomfort and hematochezia due to pseudomembranous colitis after receiving antituberculous medication, and which was probably caused by rifampicin. A 82 years old man was admitted with abdominal discomfort and hematochezia for one week. On the past history he had been diagnosed as endobronchial tuberculosis about 4 months ago. Colonoscopy revealed multiple discrete whitish mucosal lesion on rectosigmoid colon, and histologic findings were consistent with pseudomembranous colitis. The antituberculous agents were discontinued and vancomycin was administered. The patient's symptoms were resolved within several days. There was no recurrence after reinstitution of the antituberculous agents excluding rifampicin. We report here on a case of pseudomembranous colitis probably due to rifampicin.

Risk Factors for Postoperative Urinary Retention after Laparoscopic Cholecystectomy : A Retrospective Observational Study

Seung Hyeok Han(한승혁),Soon Chan Hong,Chi Young Jeong,Jin Kyu Cho 대한외과학회 2021 대한외과학회 학술대회 초록집 Vol.2021 No.5

Influential Factors on Patient Satisfaction and Intent to Revisit Emergency Medical Services for Cardio-Cerebrovascular Conditions in Gwangju and Jeonnam

Seung Ju HAN,Da Hyeok WI,Hee Seung YANG,Hae Joo PARK,Hyunju YANG,Tag HEO,Ju Han KIM,Chul-Ho CHO,Soo-Young YU 한국간호과학회 2023 한국간호과학회 학술대회 Vol.2023 No.11

Long-term clinical outcomes of peritoneal dialysis patients: single center experience from Korea.

Han, Seung Hyeok,Lee, Jung Eun,Kim, Dong Ki,Moon, Sung Jin,Kim, Hyun-Wook,Chang, Jae Hyun,Kim, Beom Seok,Kang, Shin-Wook,Choi, Kyu Hun,Lee, Ho Yung,Han, Dae Suk Pergamon Press ; Multimed Inc 2008 Peritoneal dialysis international Vol.28 No.suppl3

<P>Of a large body of literature reporting clinical outcomes for patients maintained on peritoneal dialysis (PD), most publications have focused on relatively short-term results. Few reports have focused on long-term survival in PD patients. Here, we present our experience with long-term patient outcomes and further analyses of the trends in demographics and clinical outcomes of 2301 end-stage renal disease (ESRD) patients treated with continuous ambulatory PD (CAPD) during a 25-year period (1981 - 2005) at our institute. Outcomes were analyzed for 1656 patients, excluding those younger than 15 years of age at initiation of CAPD, those having less than 3 months' follow-up, or those who had been on hemodialysis or who received a kidney graft before starting CAPD. In the study patients, technique survival at 5 and 10 years was 71.9% and 48.1% respectively. Patient survival was 69.8% and 51.8%. Mean age at the start of PD (50.4 +/- 13.9 years vs. 44.2 +/- 13.9 years, p < 0.01), ESRD incidence as a result of diabetic nephropathy (30.5% vs. 19.5%, p < 0.01), and incidence of cardiovascular comorbidities (26.6% vs. 20.5%, p < 0.01) were all significantly greater in patients who started PD during the second half of the study period (1993 - 2005) as compared with the first half (1981 - 1992). A multivariate analysis adjusting for these changes in demographics and comorbid conditions revealed that PD therapy starting in 1993 - 2005 was associated with a significant reduction in technique failure [hazard ratio (HR): 0.65; p < 0.01] and mortality (HR: 0.68; p < 0.01) as compared with the earlier period. However, in subgroup analyses, technique survival was not observed to be significantly improved in patients with diabetes. In summary, technique and patient survival have significantly improved despite increases in patient age, cardiovascular comorbidity, and ESRD caused by diabetes. Although diabetes, older age, and cardiovascular comorbidities are not factors that are easily modifiable to improve PD outcomes, results at our institution are encouraging in an era of declining PD utilization.</P>

Reduced Residual Renal Function is Associated with Endothelial Dysfunction in Patients Receiving Peritoneal Dialysis

Han, Seung Hyeok,Lee, Sang Choel,Kang, Ea Wha,Park, Jung Kyung,Yoon, Hyang Sook,Yoo, Tae-Hyun,Choi, Kyu Hun,Han, Dae-Suk,Kang, Shin-Wook SAGE Publications 2012 Peritoneal dialysis international Vol.32 No.2

<B>♦Background</B><P> Endothelial dysfunction, which contributes to atherosclerosis and arteriosclerosis, commonly accompanies end-stage renal disease (ESRD). However, little is known about the role of residual renal function (RRF) in endothelial protection in ESRD patients. This study aimed to investigate the relationship between endothelial function and RRF in patients undergoing peritoneal dialysis (PD). </P><B>♦Methods</B><P> This was a cross-sectional study involving 72 prevalent PD patients. Demographic and clinical data were recorded and residual glomerular filtration rate (GFR), Kt/V urea, and serum concentrations of inflammatory markers were measured. Endothelial function was assessed by brachial artery endothelium-dependent vasodilation [flow-mediated dilation (FMD)] to reactive hyperemia following 5 minutes of forearm ischemia. </P><B>♦Results</B><P> In patients with FMD% above the median value (FMD @@>@@ 2.41%), residual GFR was significantly higher compared to that in patients with FMD% below the median [1.50 (0 - 9.64) vs 0.48 (0 - 3.89) mL/min/1.73 m<SUP> 2</SUP>, P = 0.026]. Correlation analyses revealed that residual GFR (p = 0.381, P = 0.001) and total Kt/V urea (γ= 0.408, P @@<@@ 0.001) were positively correlated with FMD%, whereas PD duration (γ = -0.351, P = 0.003), high-sensitivity C-reactive protein (p = -0.345, P = 0.003), pulse pressure (γ = -0.341, P = 0.003), and age (γ = -0.403, P @@<@@ 0.001) were inversely correlated with FMD%. In contrast, there was no correlation between peritoneal Kt/V urea and FMD%. In multivariate linear regression analysis adjusted for these factors, residual GFR was found to be an independent determinant of FMD% (β = 0.317, P = 0.017). </P><B>♦ Conclusion</B><P> This study shows that RRF is independently associated with endothelial dysfunction in ESRD patients on PD, suggesting that RRF may contribute to endothelial protection in these patients. </P>

Improving Outcome of Capd: Twenty-Five Years’ Experience in a Single Korean Center

Han, Seung Hyeok,Lee, Sang Choel,Ahn, Song Vogue,Lee, Jung Eun,Choi, Hoon Young,Kim, Beom Seok,Kang, Shin-Wook,Choi, Kyu Hun,Han, Dae Suk,Lee, Ho Yung SAGE Publications 2007 Peritoneal dialysis international Vol.27 No.4

<B>Background</B><P> Continuous ambulatory peritoneal dialysis (CAPD) is an established treatment for end-stage renal disease (ESRD). We investigated the outcome of CAPD over a period of 25 years at our institution. </P><B>Methods</B><P> CAPD has been performed in 2301 patients in 25 years. After excluding patients with less than 3 months of follow-up and missing data, we evaluated 1656 patients who started peritoneal dialysis between November 1981 and December 2005. Data for sex, age, primary disease, co-morbidities, follow-up duration, cause of death, and cause of technique failure were collected. We also examined data for urea kinetic modeling (UKM), beginning in 1990, and peritonitis episodes, including causative organisms, starting in 1992. </P><B>Results</B><P> Compared to incident patients from 1981 - 1992, mean age and incidence of ESRD caused by diabetic nephropathy increased in patients from 1993 to 2005. Technique survival after 5 and 10 years was 71.9% and 48.1% respectively. Technique survival was significantly higher in patients who started CAPD after 1992 than in those who started before 1992. Peritonitis was the main reason for technique failure. Overall peritonitis rate was 0.38 episodes per patient-year, with a significant downward trend to 0.29 per patient-year over 10 years, corresponding to a decrease in gram-positive peritonitis. Patient survival after 5 and 10 years was 69.8% and 51.8% respectively. Patient survival improved significantly during 1992 - 2005 compared to 1981 - 1992 after adjustment for age, gender, diabetes, and cardiovascular comorbidities [hazard ratio (HR) 0.68, p @@<@@ 0.01]. Subgroup analysis based on UKM revealed that dialysis adequacy did not affect patient survival. However, diabetes (HR 2.78, p @@<@@ 0.001), older age (per 1 year: HR 1.06; p @@<@@ 0.001), serum albumin level (per 1 g/dL: increase, HR 0.52; p @@<@@ 0.05), and cardiovascular comorbidities (HR 2.32, p @@<@@ 0.01) were identified as significant risk factors. </P><B>Conclusion</B><P> Technique survival has improved due partly to a decrease in peritonitis, which was attributed to a decrease in gram-positive peritonitis. Patient survival has also improved considering increases in aged patients and ESRD caused by diabetes. The mortality rate of CAPD is still high in older, diabetic, malnourished, and cardiovascular diseased patients. A more careful management of higher risk groups will be needed to improve the outcome of CAPD patients in the future. </P>

Elevated Cardiac Troponin T Predicts Cardiovascular Events in Asymptomatic Continuous Ambulatory Peritoneal Dialysis Patients without a History of Cardiovascular Disease

Han, Seung Hyeok,Choi, Hoon Young,Kim, Dong Ki,Moon, Sung Jin,Lee, Jung Eun,Yoo, Tae Hyun,Kim, Beom Seok,Kang, Shin-Wook,Choi, Kyu Hun,Lee, Ho Yung,Han, Dae-Suk S. Karger AG 2009 American journal of nephrology Vol.29 No.2

<P><I>Background:</I> Recent studies revealed that elevated cardiac troponin T (cTnT) could predict all-cause mortality and cardiovascular diseases in end-stage renal disease patients. This study aimed to evaluate cTnT as a prognostic value in asymptomatic continuous ambulatory peritoneal dialysis patients. <I>Methods:</I> This is a prospective observational study with 107 prevalent peritoneal dialysis patients. cTnT, high-sensitive C-reactive protein (hsCRP) and IL-6 were measured at baseline. Based on cTnT level, patients were classified as higher cTnT group (HT, n = 21, cTnT ≥0.1 ng/ml) and lower cTnT group (LT, n = 86, cTnT <0.1 ng/ml), and were followed for 3 years. Primary endpoint was cardiovascular events. <I>Results:</I> The HT group had a significantly higher level of log hsCRP and log IL-6 than the LT group (p < 0.05). Kaplan-Meier survival demonstrated worse cardiovascular event-free survival for the HT group. Multivariate analysis adjusted for age, cTnT, IL-6 and hsCRP level revealed that age (per 1-year increase, HR 1.07, p < 0.05), elevated cTnT (vs. <0.1 ng/ml, HR 5.89, p < 0.05) and hsCRP (vs. <3.0 mg/l, HR 4.15, p < 0.05) were identified as significant determinants of cardiovascular events. <I>Conclusion:</I> This study suggests that cTnT may be an aid in risk stratification of continuous ambulatory peritoneal dialysis patients.</P><P>Copyright © 2008 S. Karger AG, Basel</P>