노인 환자에게 투석이 필요한가?

선인오 대한내과학회 2024 대한내과학회지 Vol.99 No.4

Initiating dialysis at an advanced age is both a clinical challenge and an ethical dilemma, because the benefits in older adults with advanced chronic kidney disease may be offset by high rates of dialysis-related morbidity. Geriatric conditions, such as aging, frailty, functional impairment, and cognitive impairment, significantly influence the prognosis of elderly patients. Therefore, it becomes important to provide patients and families with prognostic information regarding timing of initiation, which is further complicated by the competing mortality risk. Shared decision-making by clinicians and patients can yield better clinical outcomes and quality of life. Through this approach, patients can opt for the most appropriate treatment based on their personal values, which often entails conservative management.

파라쿼트 중독환자의 혈중 파라쿼트 농도를 이용한 예후 판정 및 치료 대상군의 결정

선인오,이영희,신성혜,김바울,최진화,이신은,최혜은,김정화,이광영 대한내과학회 2003 대한내과학회 추계학술발표논문집 Vol.2003 No.1

페이징 에이전트를 이용한 페이징 방법의 개선 및 성능 분석

선인오,김경미,백장현 한국정보기술응용학회 2005 한국정보기술응용학회학술대회 Vol.2005 No.1

Cyclophosphamide dose: how much is needed to win the war against paraquat poisoning?

선인오,이광영 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.4

Clinical Usefulness of Contrast-Enhanced Computed Tomography in Patients with Non-Obstructive Acute Pyleonephritis

선인오,임지혜,오주환,조아영,김범진,이광영,이미숙 고신대학교(의대) 고신대학교 의과대학 학술지 2020 고신대학교 의과대학 학술지 Vol.35 No.1

Objectives: The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CECT) in patient with non-obstrcutive acute pyelonephritis (APN). Methods: From 2007 to 2013, 537 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients into greater (50% or greater involvment, n = 143) and lesser (less than 50% involvement, n = 394) groups based on renal parenchymal involvement in CE-CT examination. We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan as a reliable marker for predicting clinical severity and disease course in patient with non-obstructive APN. Results: The mean estimated glomerular filtration rate was 70.6 ± 25.5 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater group had lower serum albumin levels (3.5 ± 0.5 vs 3.8 ± 0.6, P < 0.01) and longer hosptal stay (10.1 ± 4.7 vs 8.8 ± 4.5, P < 0.05). In addition, acute kidney injury (AKI) (23.1% vs 11.4%, P < 0.005) and bacteremia (36.4% vs 26.8%, P = 0.02) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.8% based on RIFLE criteria. In a multivariate logistic regression analysis for predciting AKI, age, presence of diabetes mellitus and the presence of renal parenchymal involvement of greater than 50% in CE-CT were significant predictors of AKI. Conclusions: The CE-CT scan could be useful to predict the clinical severity and course in non-obstructive APN patients with preserved renal function.

Experience of Anti-Viral Therapy in Hepatitis B-Associated Membranous Nephropathy, Including Lamivudine-Resistant Strains

선인오,홍유아,박훈석,최선령,정병하,박철휘,양철우,김용수,최범순 대한내과학회 2012 The Korean Journal of Internal Medicine Vol.27 No.4

Background/Aims: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBVMN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. Methods: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. Results: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e.,development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. Conclusions: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains. Background/Aims: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBVMN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. Methods: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. Results: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e.,development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. Conclusions: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.

Clinical characteristics and outcomes in renal transplant recipients with renal cell carcinoma in the native kidney

선인오,고유미,김은영,박경선,정홍순,고선혜,정병하,최범순,박철휘,김용수,양철우 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.3

Background/Aims: We investigated the incidence and clinical characteristics of renal cell carcinoma (RCC) in the native kidney of renal transplant recipients. Methods: Between 1991 and 2010, 1,425 patients underwent kidney transplantation at our institution. We retrospectively evaluated the clinical features and outcomes in renal transplant patients with RCC in the native kidney after renal transplantation. Results: The patients included three males and two females with a mean age of 63 years (range, 52 to 74). The incidence of RCC was 0.35%. The median interval between renal transplantation and RCC occurrence was 16.2 years (range, 9 to 20). All of our patients with RCC had developed renal cysts either before (n = 3) or after (n = 2) renal transplantation. The mean duration of dialysis was 12 months (range,2 to 39). Of the five patients, four underwent dialysis treatment for less than 8months. All the RCCs were low grade at the time of diagnosis. Four patients underwent radical nephrectomy, and one patient refused the operation. The four patients who underwent radical nephrectomy showed no evidence of local recurrence or distant metastasis during the median follow-up of 2.9 years. However,the patient who did not undergo surgery developed spinal metastasis from the RCC 6 years later. Conclusions: This study suggests that the follow-up period is an important factor for the development of RCC in renal transplant recipients, and more vigorous screening with a longer follow-up period is required in renal transplant recipients.

구연 : 신장 ; 파라쿼트 중독환자의 혈중 파라쿼트 농도를 이용한 예후 판정 및 치료 대상군의 결정

선인오,이영희,신성혜,김바울,최진화,이신은,최혜은,김정화,이광영 대한내과학회 2003 대한내과학회 추계학술대회 Vol.65 No.10

이동통신망에서 핸드오버 호 제어방식의 개선 및 성능평가

선인오,장희선,백장현 조선대학교 공학기술연구원 2022 공학기술논문지 Vol.15 No.3

In the current and future mobile communication networks, the cell size is reduced to increase the radio channels' efficiency and cope with the ever-increasing number of subscribers and high-speed services. In this study, a new handover call control method called Handover Duration First (HDF) is proposed to serve a handover call with the smallest handover duration, primarily considering the directionality in the handover area among queued handover calls. In order to analyze the performance of the proposed HDF method, a simulation is performed to obtain the blocking probabilities of new and handover calls when new and handover calls are generated and compared with the existing First In, First Out (FIFO) method. Simulation results show that the proposed HDF method performs better from blocking probability and forced termination probability than the conventional method. The results of this study can contribute to various studies to increase the efficiency of handover on radio channels.

신장 질환에서 생체표지자로서의 소변의 세포외 소포체의 역할

선인오 ( In O Sun ) 대한내과학회 2021 대한내과학회지 Vol.96 No.1

Extracellular vesicles (EVs) are membrane-bound vesicles produced and released into the extracellular fluid by cells under physiological and stressful conditions. They play a role as intracellular communicators by carrying and delivering biomolecules, such as proteins, lipids, or nucleic acids. Urinary EVs have gained important recognition as potential diagnostic biomarkers in renal disease, as they can originate from diverse cell types, including glomerular podocytes, tubular epithelial cells, or endothelial cells. Accumulating evidence has emphasized the feasibility of using EVs as biomarkers for diagnostic, prognostic, and therapeutic purposes in several forms of renal disease, such as acute kidney injury, glomerulonephritis, and renal transplantation. In this review, we introduce recent studies that attempt to identify urinary EVs as candidate biomarkers for human kidney diseases and consider their potential implications as a therapeutic option in significant kidney diseases. (Korean J Med 2021;96:36-41)