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RISS 인기검색어
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- 저자 : 육동민(Dong Min Yook) (검색결과 2 건)
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육동민(Dong Min Yook),곽시영(Si Young Kwak),김성식(Seong Sik Kim),이성숙(Seong Sook Lee),홍관표(Kwan Pyo Hong),최창필(Chang Pil Choi),이재우(Jae Woo Lee),이시래(Si Rhae Lee) 대한내과학회 1987 대한내과학회지 Vol.33 No.2
N/A Clinical studies were carried out in the 110 cases of severe hypertension who had been admitted from January 1979 to August 1985 and the following results were obtained: 1) Underlying diseases of severe hypertension were essential hypertension in 67 cases, renal parenchymal hypertension in 36 cases, and renovascular hypertension in 7 cases. 2) Plasma renin activity was the highest in the group of renovascular hypertension which was 22.07±9.20 ng/ ml/hr, and as a whole, the higher diastolic blood pressure, the higher plasma renin activity was. Plasma renin activity in the group of K-W grade IV retinopathy was higher than those of the other groups. 3) The incidence of ventricular hypertrophy fullfilling voltage criteria and with accompanying ST-T changes on electrocardiolgram was 81.5% in the group of essential hypertension and there was no difference in relation to the level of pressure or fundoscopic changes. 4) The serum creatinine level was the highest in the group of renal parenchymal hypertension (7.93±2.98 mg/dl), and in the group of K-W grade IV retinopathy (6.86±3.50mg/dl), but there was no significant difference in relation to the level of diastolic blood pressure, 5) There were no significant difference in cardiothoracic ratio on chest X-ray in relation to underlying diseases, diastolic blood pressure or fundoscopic changes. 6) The major complications were congestive heart failure (49.1%), hypertensive encephalopathy (17.3%), and cerebrovascular accident (8.2%). 7) In the group of essential hypertension blood pressure was controlled by conservative treatment in 81.0% but in 35.7% in the group of renal hypertension. The patients of chronic renal failure who were treated with dialysis blood pressure was controlled in 87.0%. In all 6 cases with renal transplantation, nephrectomy or renal angioplasty blood pressure was well controlled. 8) In cases refractory to triple antihypertensive regimen blood pressure was controlled by minoxidil in 66.7% and by captopril in 75.0%. 9) In 45 cases who were followed up for more than 6 months diastolic blood pressure was controlled under 100mmHg in 77.8% and there were improvement of renal function, fundoscopic findings and electrocardiographic findings in 20.0%, 33.3% and 16.7%, respectively.
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쓰쓰가무시병 유행지역 일차진료 병원에 있어서의 임상진단의 정확성
이강수,정윤섭,유승근,전기환,배진기,홍관식,육동민,양상호,임정식 대한감염학회 1996 감염 Vol.28 No.2
목 적 : 쓰쓰가무시병 유행지역에 위치한 일차진료기관에서 임상소견을 근거로 이 병을 진단하였을 때 그 정확성을 검토하고자 하였다. 방 법 : 1994년 10월과 11월에 진해소재 의료기관에 내원한 쓰쓰가무시병이 의심된 환자의 임상진단의 정확도를 치료경과 및 IFA 시험 성적을 근거로 검토하였다. 결 과 : 쓰쓰가무시병으로 임상진단된 18명 환자중 발진은 모두에서, 농포는 1명에서, 가피는 15명에서, 림프절염은 13명에서 관찰되었다. 이 환자 중 17명에 대해서는 IFA 항체가 시험되어 15명에 있어서는 높은 항체가나 항체가의 상승을 보여 쓰쓰가무시병임이 확인되었다. 2명에 대해서는 각각 발병 제3일과 제4일에 시행된 1회의 항체시험이 음성이었으나 치료결과로 볼 때 쓰쓰가무시병으로 판단되었다. IFA 시험을 위해 polyvalent conjugate를 사용하여도 발병초기에는 양성결과를 얻을 수 없음을 보였다. 결 론 : 쓰쓰가무시병 유행지역에 있는 일차진료기관에서 임상소견을 근거로한 진단은 대부분 정확하였으며, 적절한 항균제로 치료되어 환자들이 회복된다는 결론을 얻었다. 또한primary lesion은 흑색 가피 상태로만 관찰되는 것이 아니고 발병초기에는 농포상태로도 관찰되며 발진은 모든 환자에서 관찰되었고 발병과 동시에 생긴다고 추측되었다. Background : Scrub typhus is endemic in many parts of Korea including Chinhae. Accurate and rapid diagnosis for effective treatment is usually based on clinical diagnosis without laboratory aids in endemic area. The aim of the study was to assess the accuracy of clinical diagnosis at primary-care clinics in an endemic area. Methods : During the period of October through November, 1994, 18 patients were clinically diagnosed as scrub typhus at primary-care clinics in Chinhae city. Clinical diagnosis was based on the presence of fever, rash, lymphadenitis and eschar (primary lesion). The accuracy of clinical diagnosis was assessed by the serological test and efficacy of treatment with tetracycline. Results : Among the 18 patients, rashes were noted in all patients, whereas lymphadenitis in 13 patients, eschars in 15 patients, and a pustule in one patient. Serologic studies showed high or rising IFA titer to Rickettsia tsutsugamushi in 15 patients. Clinical diagnosis of 3 patients without serologic evidences were considered accurate based on the clinical response to antimicrobial therapy. Two patients showed negative serology because of taking blood samples on the 3rd or 4th day of illness, respectively, and serologic test was not done in one patient. IFA test with ployvalent conjugate did not give faster positive results. Conclusion : Accurate and rapid clinical diagnosis of scrub typhus at primary-care clinics in endemic area is possible mainly based on clinical features, which makes early treatment with appropriate antimicrobial agents possible.
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