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지속외래복막투석 환자에서 잔여신기능의 감소에 영향을 미치는 인자
박선희 ( Sun Hee Park ),김건현 ( Gun Hyun Kim ),현승혜 ( Seung Hyea Hyun ),서혜진 ( Hye Jin Seo ),최지영 ( Ji Young Choi ),조지형 ( Ji Hyung Cho ),김찬덕 ( Chan Duck Kim ),김용림 ( Yong Lim Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Preservation of residual renal function (RRF) after initiation of peritoneal dialysis (PD) is beneficial for patient survival. It is unclear that same risk factors of pre-dialysis chronic kidney disease (CKD) patients affect RRF in PD patients. This study was aimed to evaluate factors affecting RRF after commencement of PD. Methods:Data from 80 patients commencing CAPD at Kyungpook National University Hospital between January 2001 and December 2008 were retrospectively collected. After PD commencement, biochemical and clinical data at baseline (1 month), 6, and 12 month were obtained. RRF was calculated as the average of creatinine clearance and urea nitrogen clearance from 24-hour urine collection and normalized with body surface area and mean RRF decline rate was calculated by dividing RRF difference between baseline to 12 month by period. Results:Mean RRF decline rate (mL/min/1.73m2/month) was negatively correlated with left ventricular posterior wall thickness (LVPWT) (R2=0.097, p=0.023) and proteinuria (R2=0.126, p=0.003), whereas positively correlated with hematocrit (R2=0.076, p=0.013) at baseline. Comparison between the two groups divided by median RRF decline rate (-0.082 mL/min/1.73m2/ month) showed that baseline proteinuria (p<0.001), the number of antihypertensive agents (p=0.030) and LVPWT (p=0.039) were higher in the decline group. In addition, the number of antihypertensive agents was higher in the decline group at 1 year, although there was no difference of blood pressure between the two groups. Using multiple binary logistic regression, it was shown that more rapid RRF decline (<-0.082 mL/min/ 1.73m2/month) was likely to have higher proteinuria [adjusted odd ratio (AOR) 3.310, 95% confidence interval (CI) 1.363-8.041], and thicker LVPWT [AOR 1.682, 95% CI 1.043-2.711] at baseline. Conclusion:Decline of RRF during a year after commencement of PD was associated with baseline proteinuria and LVPWT.
손혁수 ( Hyuk Su Son ),김건현 ( Gun Hyun Kim ),김민선 ( Min Seon Kim ),여주천 ( Ju Chun Yeo ),이봉렬 ( Bong Ryeol Lee ),정병천 ( Byung Chun Jung ),이종주 ( Jong Joo Lee ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 좌측 옆구리 통증을 주소로 입원한 환자에게서 발견된 원발성 유미 심낭증을 심장막천자술과 배액으로 진단 및 치료하였고, 특별한 재발없이 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Chylopericardium is a particularly rare clinical entity, generally related to thoracic and cardiac surgery, chest trauma, mediastinal tumor, mediastinal radiation, thrombosis of the subclavian vein, congenital lymphangiomatosis and large granular lymphocytosis. Unlike chylopericardium, primary chylopericardium is more rare disorder and should be diagnosed after exclusion of the known causes. We present a case of a 51-year-old male who was discovered to have a primary chylopericardium confirmed by an echocardiography & fluid analysis by pericardiocentesis. Primary chylopericardium was managed successfully with pericardiocentesis and drainage. We present the case with a review of literature. (Korean J Med 69:S824-S829, 2005)
기관지 탄분 섬유화증에서 동반된 기관지 협착에 따른 환기역학
정승욱 ( Seung Wook Jung ),김연재 ( Yeon Jae Kim ),김건현 ( Gun Hyun Kim ),김민선 ( Min Seon Kim ),손혁수 ( Hyuk Soo Son ),김준철 ( Jun Chul Kim ),류현욱 ( Hyon Uk Ryu ),이수옥 ( Soo Ok Lee ),정치영 ( Chi Young Jung ),이병기 ( Byu 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.4