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장기 투석치료 환자에서 투석유형별 임상지표에 관한 비교연구
이호영(Ho Yung Lee),함영환(Young Hwan Ham),윤여운(Yoe Wun Yoon),김형길(Hyung Kil Kim),정동균(Dong Kyoon Chung),최규헌(Kyu Hun Choi),한대석(Dae Suk Han) 대한내과학회 1989 대한내과학회지 Vol.36 No.2
N/A We investingated 71 cases with ESRD who had undergone CAPD or hemodialysis for more than 2 years without diabetic nephropathy, and the following results were obtained: 1. The mean age and male to female ratio for the patients in the hemodialysis group (n:38) were 50 and 2.8;1, respectively. The mean age of the CAPD group (n:33) was 43 and the male to female reatio was 1,2:l. The mean duration of dialysis in hemodialysis and CAPD was 3.6 and 2.9 years, respectively. 2. Hypertension and anemia associated with ESRD were more easily controlled in the CAPD patients than in the hemodialysis group. So, after 3 months of dialysis, both the systolic and diastolic blood pressures were lower in the CAPD group(p<0.05) The average value of annual transfusion requirements in hemodialysis patients was 1.9 pints and that in CAPD patients was 0.35 pints. 3. Values of BUN, serum potassium and CO, content were more stable in the CAPD group as compared to hemodialysis patients after 3 months of dialysis, However, serum cholesterol, triglyseride and HDL - cholesterol values were significantly higher in the CAPD group than in hemodialysis patients(p<0.05), 4 The number of days spent in the hosjpital during dialysis was longer in the CAPD group, probably due to peritonitis The annual duration of hospitalization per patient in the CAPD group was 6.3 days as compared to 1.9 days in hemodialysis patients, 5 The quality of life of the CAPD group, as assessed by the physical performance status, was superior to that of the hemodialysis group Based on these results, although CAPD still has the unsolved problems of a longer duration of hospitalization and hyperlipidemia, it seemed to have many advantages in controlling hypertension, electrolyte imbalance, acidosis and anemia Therefore it could be employed as a primary mode of treatment in ESRD patients, especially in Korea with shortage of hemodialyeis machines.
1987년 가을 서울·경기지역에서 발생한 쯔쯔가무시병 18예에 대한 임상적 고찰
김응,김영기,정동균,김준명,함영환,정윤섭,홍천수 대한감염학회 1988 감염 Vol.20 No.2
Tsutsrgamushi disease is an acute febrile disease which is characterized by fever, headache, rashes and eschar. In Korea it has been reported with increasing frequencies through the nation since 1986. We have conducted a survey on 18 clinically suspected and serologically confirmed case of tsutsugamushi disease in Seoul and Kyungki Do from October 1987 to November 1987 and came up with following results. Of 18 cases, 11 were females and 7 were males. The mean age of the patients was 52 years ranging from 27 to 82 years. Twelve patients were found to be residing in the urban areas and 11 of these patients had a history of recent travel before the onset of the disease, suggesting acquisition of the disease from traveling in rural areas, and we were able to predict nation wide distribution of the disease. The most frequent symptoms were headache(100%), fever (100%) and chills (100%). Eschar was observed in 17 of 18 patients studied (94%). Common laboratory features include leukocytosis in 6 cases(33%), SGOT elevation in 17 cases(94%), SGPT elevation in 16 cases (89%), LDH elevation in 15 of 15 studied cases(100%) and the elevation in CK level in 1 of 6 studied cases (22%). On chest X-ray films, interstitial pneumonia was observed in 9 cases (50%) and pleural effusion in 3 cases. Serum fibrinogen was decreased in 6 of 15 studied cases (31%), FDP was positive in 4 of 15 studied cases (25%), antithrombin-Ⅲ was decreased in 5 of 7 patients (71%) and prolonged PT, PTT were observed in 2 of 18 patients (11%), each. Clinical improvement was noticed in all but one patient with either tetracycline or cholramphenicol treatment. The mean duration from the start of the treatment to the defervescence of fever was 1.8 days with tetracycline therapy and 2.1 days with cholramphenicol. During their clinical course, DIC was observed in 2 patient who did not have other superimposed infection. The mortality had occured in 1 patient complicated with pneumonia and ARDS.
한대석,함영환,최수임,전재윤,박찬일,김형길,이호영,정동균,정석호 대한내과학회 1989 대한내과학회지 Vol.36 No.3
Iron overload from repeated blood transfusions and administration of iron agents in long term hemodialysis patients is a problem of increasing clinical significance, because eventually it can lead to secondary hemosiderosis and hemochromatosis. So it is important to diagnose iron overload early and restrict blood transfusions and administration of iron agents in these patients. Recently, we experienced two cases of hemochromatosis in long term hemodialysis, confirmed by serum ferritin level, bone marrow study and liver biopsy. One patient had received 110 pints of RBCs for 4 years, and the other patient received 120 pints of RBCs for 5 years. HLA typing was also studied and compared with hemochromatosis alleles (HA), HLA A3, B7, and B14. Treatment with desferrioxamine was started just after discharge, and we observed a reduction in the frequency of blood transfusions. We report these two cases with a brief review of the literature.