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김성욱 ( Sung Wook Kim ),민영훈 ( Young Hoon Min ),진희종 ( Hui Jong Chin ),이태유 ( Tae Yu Lee ),최창순 ( Chang Soon Choi ),정연손 ( Youn Son Chung ),김근숙 ( Gun Sook Kim ),김근호 ( Gheun Ho Kim ),김종현 ( Jong Hyun Kim ),박윤규 대한내과학회 2002 대한내과학회지 Vol.63 No.5
N/A Background : Acute renal failure (ARF) is not a rare occurrence in severe burns and is an important complication leading to an increase in mortality. This study was undertaken to characterize the ARF occurring in major burn patients and to investigate the impact of burn size and initial serum albumin concentration on the occurrence of ARF and patient survival in major burns. Methods : The clinical characteristics of 147 adult patients with second- and third-degree burns covering 30% or more of their body surface area were analyzed retrospectively. All patients were admitted over a 1-year period to a single burn intensive care unit in Seoul, Korea. Logistic regression was used to estimate of the relative risks of ARF and mortality associated with the larger burn size and the lower serum albumin level at admission. Results : Mean burned body surface was 60.0±21.8% (range, 30 to 100%). Twenty-eight (19.0%) out of 147 patients experienced ARF, defined as a serum creatinine > 2 mg/dL, during the admission. The ARF was preceded by significant hypotension (burn shock), rhabdomyolysis, sepsis or use of aminoglycosides. The occurrence of ARF was not associated with age, sex or burn type. The patients with ARF had larger burn size (79.5±15.4% vs. 55.3±20.5%, p<0.0001) and lower serum albumin concentration at admission (1.92±0.66 g/dL vs. 2.48±0.82 g/dL, p<0.0005) compared with those without ARF. All patients with ARF expired, whereas 29.4% (35/119) of the patients without ARF died. The burn size > 65% was associated with a risk of ARF that was 9.9 times and with a risk of death that was 14.2 times as high as that for the burn size < 65%. The initial serum albumin level < 2.5 g/dL was associated with a risk of death that was 2.7 times as high as that for the initial serum albumin level > 2.5 g/dL. Conclusion : When major burns are complicated by ARF, the mortality increases very high. Burn size is an independent predictor of ARF occurring in major burns. Initially depressed serum albumin level is associated with an increase in mortality in the major burn patients. (Korean J Med 63:539-545, 2002) Key Words : Acute renal failure, Burn, Albumin, Burn size, Mortality
혈액투석을 위한 내경정맥 도관 삽입 중 진단한 무형성 우상대정맥 및 지속성 좌상대정맥 1 예
이태유(Tae Yu Lee),김근숙(Keun Sook Kim),정연손(Youn Son Chung),진희종(Hee Jong Jin),민영훈(Young Hoon Min),조구영(Goo Yeong Cho),박홍석(Hong Suk Park),김근호(Gheun Ho Kim),김성욱(Sung Wook Kim) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.4
Persistent left superior vena cava(PLSVC) derives from abnormally persistent patency of an embryological vessel normally present during the early developmental period. The incidence of PLSVC is 0.3% in healty persons, 4.8% in patients with congenital heart anomaly. Most of the patients with PLSVC have normal right superior vena cava (RSVC), but PLSVC plus absent RSVC is very rare, especially in those without congenital heart anomalies. We experienced a case of PLSVC and absent RSVC during an insertion of internal jugular venous catheter for acute hemodialysis. A 53-year-old female was admitted due to uremia for initiation of dialytic therapy. She had long history of diabetic nephropathy but without congenital heart anomalies. We inserted a dual lumen catheter for acute hemodialysis via right internal jugular vein. On the chest x-ray film taken after the insertion of the catheter, we detected unusual course of the catheter curved to the left. PLSVC and absent RSVC was confirmed by normal saline contrast echocardiography and CT angiograpy.
조진원,송진영,김창억,민영훈,최창순,우흥정,현인규,김종현,유기철,채승완,손진희 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1
The Actinomyces species are normal flora of oral cavity and upper intestine characterized as gram-positive, non-spore-forming anaerobic or mjcroaerophilic rods. Actinomycosis is a chronic suppurative and granulomatous disease characterized by abscess, sinus, abundant granulation and mass. The appendix is the commonly involved site among abdominal actinomycosis. Abdominal actinomycosis is often difficult to diagnose before operation because of no reliable clinical features and infrequency of the disease. We report two cases of abdominal actinomycosis which were manifested as acute appendicitis. Those were detected Incidentally tv the pathologist after routine appendectomy. Both patients were successfully treated with appendectomy followed by proper antibiotics use.