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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.
이달의 X-선 : 흉부 질환 진단에서 소홀하기 쉬운 단순 흉부 X-선 사진의 중요성: 종격동 종양을 중심으로
김은영 ( Eun Young Kim ),임주은 ( Ju Eun Lim ),박병훈 ( Byung Hoon Park ),윤진영 ( Jin Young Yoon ),정지예 ( Ji Ye Jung ),손지영 ( Ji Young Son ),이경종 ( Kyung Jong Lee ),윤여운 ( Yoe Wun Yoon ),강영애 ( Young Ae Kang ),문진욱 ( 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.6
종격동은 다양한 기관들이 밀집되어 있는 구조라서 종양 등 질병이 발생하더라도 위치상 심장이나 대혈관의 음영과 중첩되어 보이기 때문에 단순 흉부 X-선 촬영상 정상소견으로 오인할 수 있다. 종격동 종양의 경우 주위조직의 침범 여부나 주위 림프절 크기 이외에도 환자의 연령, 종양의 크기 및 위치, 환자의 증세 유무가 중요한 고려사항이다. 저자들은 흉부 불쾌감이 지속되어 내원한 56세 여자 환자에게서 단순 흉부 X-선 사진의 면밀한 관찰을 통해 기관분지부의 종격동 종양을 발견한 증례를 통해, 다시 한번 단순 흉부 X-선 촬영의 진단적인 중요성을 임상의들에게 환기시키고자 한다. The middle mediastinum contains several important organs and pluripotent cells. It is difficult to make a definitive diagnosis in patients with middle mediastinal tumors due to a wide range of diseases. The likelihood of malignancy is influenced primarily by the following factors: patient age, size, tumor location, and the presence or absence of symptoms. We describe a case of a middle mediastinal tumor, which was suspected on chest x-ray; chest computed tomography revealed the eccentric mass of distal esophagus. This case emphasizes the diagnostic importance of the chest x-ray to the physicians. The possible differential diagnoses are reviewed.
이달의 X-선 : 다발 전이성 농양을 일으킨 편평상피세포암성 농양 1예
임주은 ( Ju Eun Lim ),김은영 ( Eun Young Kim ),장지은 ( Ji Eun Jang ),손지영 ( Ji Young Son ),정지예 ( Ji Ye Jung ),박병훈 ( Byung Hoon Park ),이경종 ( Kyung Jong Lee ),윤여운 ( Yoe Wun Yoon ),변민광 ( Min Kwang Byun ),이사라 ( Sa 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.5
기관지폐쇄에 의한 폐농양 혹은 공동성 병변에 발생한 암성 농양은 임상 양상 및 방사선학적 소견이 흡인성 폐농양과 흡사하여 감별이 어려워서 폐암을 조기 진단할 수 있는 기회를 놓치기 쉽다. 따라서 항생제에 대한 반응이 뚜렷하지 않거나 선행 요인이 없고 비전형적인 위치에 발생한 폐농양의 경우 악성 병변의 동반 가능성을 염두에 두고 적극적인 검사가 필요하다. 저자들은 발열, 기침, 혈담, 호흡곤란을 주소로 내원하여 폐농양 의심하에 항생제치료에도 불구하고 병변이 악화된 67세 남자 환자에서 간세침흡인생검을 통해 다발 전이성 농양을 일으킨 편평상피세포암성 농양으로 진단된 예가 있어 문헌 고찰과 함께 보고하는 바이다. Among the bronchogenic carcinomas, especially squamous cell carcinoma and large cell carcinoma frequently present with cavitation, which may result from tumor necrosis. Cavitary lesions of the tumor are occasionally associated with infection and misdiagnosed as benign lung abscess owing to the partial responsiveness to antibiotics. It is very difficult to distinguish the carcinomatous abscess from the benign lung abscess, because of their similar clinical and radiologic features. Delay in diagnosis of underlying lung cancer may result in poor outcome. Therefore, clinicians should remember that the patients with highly suspicious carcinoma of the lung should undergo further precise examinations to find out malignant cells.
간경변증 및 간세포암 환자에 있어서 문맥의 원간성 혈류
최흥재(Heung Jai Choi),박인서(In Suh Park),이상인(Sang In Lee),김원호(Won Ho Kim),이문형(Moon Hyung Lee),정재복(Jae Bock Jung),윤여운(Yoe Wun Yoon) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.3
N/A Hepatofugal flow (reversed flow) of portal vein is very rare, and its diagnosis is not so easy. Variable invasive procedures had been tried to demonstrate this rare hemodynamic change of portal vein, however there was many probrems in the routine clinical use of those procedures. Since clinical application of Doppler flowmetry system, repetitive observation of portal hemodynamics in physiologic condition has become easy. We observed 1 case of liver cirrhosis and 3 cases of bepatcellular carcinoma combined with liver cirrhosis who showed reversed flow of portal vein among 72 cases and 42 cases each other. All patients with hepatocellular carcinoma had thrombosis in main portal vein, and one of them showed hepatofugal flow of splenic vein. One patient with liver cirrhosis who had suffered spontaneous hepatic encephalopathy, had large splenorenal shunt and reversed flow of splenic vein.
김송이 ( Song Yee Kim ),이경종 ( Kyung Jong Lee ),이상훈 ( Sang Hoon Lee ),이상국 ( Sang Kook Lee ),박병훈 ( Byung Hoon Park ),정지예 ( Ji Ye Jung ),손지영 ( Ji Young Son ),윤여운 ( Yoe Wun Yoon ),심효섭 ( Hyo Sup Shim ),강영애 ( 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.1
We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.
간낭종 경화 치료 후 발생한 기관지담관루에 의한 담즙성 객담
이상훈 ( Sang Hoon Lee ),이경종 ( Kyung Jong Lee ),김송이 ( Song Yee Kim ),이상국 ( Sang Kook Lee ),정규식 ( Kyu Sik Jung ),박병훈 ( Byung Hoon Park ),정지예 ( Ji Ye Jung ),손지영 ( Ji Young Son ),윤여운 ( Yoe Wun Yoon ),강영애 ( 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.2
Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.