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강종명,박한철,안정경,이창화,강경원,김상목,박찬현 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2
To study the effect of metabolic acidosis, which is generally present on chronic hemodialysis patients, blood gas analysis of A-V fistula blood, chemical chemistry data, nutritional parameters, and illness outcome were correlated on 146 patients. The results : 1) 28 paired samples of A-V fistula blood pH(7.318 ±0.052) were different from femoral artery blood pH(7.332±0.048), but the two were closely correlated (p=0.000). The correlation on PO₂and PCO₂tests were also strong. 2) The average of A-V fistula blood gas studies were pH 7.282±0.061. 3) The values of A-V fistula blood pH were most closely related with serum CO₂content, followed by PCO₂BUN, PO₂and phosphate and not with nutri-tional status, frequencies of hospital admission and Karnofsky score. 4) During the 18 months observation, 8 of 146 patients died of medical causes. The expired cases were low in serum albumin, old in age, long in dialysis interval. The mortality rate was not related with blood gas parameters. 5) The nutritional parameterslthough loose, worse in the group of serum CC4 content more than 20mEq/L. 6) After sodium bicarbonate 1.5-3.0gm/day by mouth, there were insignificant rise in pH and in nutritional parameters. The incidence of gastrointestinal symptoms, however, increased significantly. In conclusion, nutritionally better patients were scattered in the serum CO₂content below 20mEq/L, and therefore, near normal acid-base stuatus may suggest poor nutritional status. However, in acidotic patients, treatment with alkali may improve nutritional state further.
신이식환자에서 shell vial 배양을 이용한 cytomegalovirus 검사
강경원,강종명 한양대학교 의과대학 1996 한양의대 학술지 Vol.16 No.2
Cytomegalovirus(CMV) infection occurs more frequently in renal transplant recipients than in the normal population. We studied the difference and usefulness of various detection methods including IgM CMV antibody boy ELISA, shell vial culture. This study included 36 patients, 20 males and 16 females, who received renal transplantation at Hanyang University Hospital between July, 1995 and March, 1996. IgG and IgM CMV antibodies were detected and shell vial cultures were performed in recipient candidates and donor candidates preoperatively. Postoperatively, we checked IgM CMV and performred shell vial cultures in renal transplant recipients every month after the operation and at times in which CMV infections were suspected. Ten patients had CMV infection and three patients had CMV disease. IgM CMV was positive in 8 patients and shell vial cultures in 6 patients. In all patients with CMV disease, CMV positively appeared by all three detection methods. But detection time and duration of positivity were different. Symptomatic patients were positive in shell vial culture at the time of symptom, but negative in IgM CMV antibody. There was no significant difference in graft survival between CMV infected and non-infected patients. In conclusion, shell vial culture with blood sample is better to detect CMV infections than IgM CMV antibody when patients has the symptoms of CMV infection.