활동성폐결핵 환자의 치료에 따른 67Gallium 폐주사의 음전시기의 의의 ( 제 2 보 )

이숭구(Sung Ku Lee),이윤하(Yoon Ha Lee),김진곤(Jin Gon Kim),서대원(Dae Won Soe),장태종(Tae Jong Jang),김윤권(Yun Kwon Kim),김소연(So Yon Kim),박병익(Byong Yik Park),이권전(Gwon Jun Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.2

N/A Objectives: In the treatment of active pulmonary tuberculosis, it is difficult to determine when the active tuberculosis has became inactive. (67)Gallium lung scan is known to be useful in the diagnosis of active pulmonary tuberculosis. The grade of Galliumuptake, the time of loss of uptake and the relation to the stability of tuberculous lesion in the chest radiograph were followed to define the possibility of making early decision when active pulmonary tuberculosis became inactive Metheds: In 31 patients with active pulmonary tuberculosis, (67)Galliurn lung scan and chest radiograph were followed serially from June 1991 to October 1993. (67)Gallium lung scan and chest radiograph were followed serially from June 1991 to October 1993, (67)Gallium lung scan was performed 48 hours after intravenous injection of 3mCi of (67)Gallium citrate and classified into 4 grades according to the degree of up- take. Results: 1) In patients with active pulmonary tuberculosis, the grade of Gallium uptake in lung scan was proportional to the severity of lesion in chest radiograph. 2) The degree of (67)Gallium uptake in serial lung scan waned progressively while antituberculous chemotherapy was continued, and showed in loss of uptake in 83% of patients within 6 months of therapy 3) The loss of (67)Gallium uptake was observed simultaneously in most patients as the lesion in chest radiograph became stable. In 81% of patients, the interval between the time of loss of (67)Gallium uptake and Radiologic stabilization was less than one month. Conclusion : While antituberculous chemotherapy was given, the serial (67)Gallium lung scan might be useful in determining the activity of tuberculous lung lesion and in making earlier decision than chest radiograph. Conclusively, we consider Gallium lung scan as a valuable measure in assessing the effectiveness of antituberculous treatment.

경미한 급성 두부외상환자에서 SPECT , q - EEG 및 CT의 비교

김소연(So Yon Kim),김영중(Young Jung Kim),이석호(Suk Ho Lee),김진석(Jin Seok Kim),문희승(Hee Seung Moon),이숭구(Sung Ku Lee),박병익(Byung Yik Park),이권전(Gwon Jeon Lee),김갑득(Kap Deuk Kim),김호전(Ho Joeng Kim),조경형(Kyeung Hyeung 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

N/A Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes cannot be detected by the brain CT or MRI. Brain SPECT using Tc-99m-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. Results were as follows: The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT. SPECT would be more useful method than brain CT to investigate cerebral function after head injury.

간경변증 환자에서 혈청 4형 Collagen-7S의 의의

차경석(Kyoung Seok Cha),한영찬(Young Chan Han),김영태(Young Tae Kim),이숭구(Sung Ku Lee),서대원(Dae Won Seo),김영중(Young Jung Kim),박병익(Beong Yik Park),조민구(Min Koo Cho) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

N/A Background/Aims: Cirrhosis is defined anatomically as a diffuse process with fibrosis and nodule formation. Although liver biopsy provides the evaluation of the degree of fibrosis, a simpler diagnostic method would be helpful for its invasive nature. The serum type IV collagen is known recently to indicate the activity of collagen synthesis in the process of fibrosis. This study aims to evaluate the usefulness of serum type IV collagen with the clinical and laboratory findings. Methods: A number of abnormalities were found to be statistically associated with the levels of serum type IV collagen. Included among the clinical abnormalities were pitting edema, ascites, splenomegaly, jaundice, and encephalopathy. The laboratory tests include albumin, tota1 bilirubin, prothrombin time, and alkaline phosphatase. Results: Significant correlations were found between the serum type IV collagen and the grade of the modified Childs classification(p0.05: between class A and B, class B and C, respectively), as well as the CCLI(comhined clinical and laboratory index, r=0.74, Y=6.78 +0.71X, p0.001). Conclusions: These results suggest that the serum type IV collagen may be a sensitive marker of fibrotic process and may reflect the present state and prognosis in cirrhosis. (Korean J Gastroenterol 1995;27:331 337)

염화 제2수은이 흰쥐 신장에서의 지질 과산화와 Catalase 활성도에 미치는 영향

이숭구,하경란,고현철,신인철,서대규 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.2

In an attempt to define the early biochemical determinants that participate in the pathogenesis of mercuric chloride-induced nephrotoxicity, especially focusing on oxygen free radicals, we studies malondialdehyde(MDA) level and catalase activity in renal cortex of the rats at 24, 48 and 72 hr after the injection of mercuric chloride. Wistar albino rats weighing 180 to 220gm were injected subcutaneously with mercuric chloride(HgCl₂, 2mg/kg). The result obtained can be summarized as follows: 1.The group treated with mercuric chloride showed significantly lower MDA level at 24, 48 and 72hr after the infection as compared to that of control group. 2.The group treated with mercuric chloride showed significantly higher catalase activity at 24hr and lower catalase activity at 72hr after the infection as compared to that of control group. These results suggest that the excessive oxygen free radicals resulting from the depression of catalase activity is an important determinant in pathogenesis of mercuric chloride-induced nephrotoxicity.

위공장결장누공 후의 비타민 B₁₂ 결핍성 빈혈과 동반된 골수이형성증후군 1례

문희승,김영태,이숭구,한영찬,김윤권,김소연,조민구,이권전,김병국 大韓血液學會 1994 大韓血液學會誌 Vol.29 No.2

간경변증 환자에서 혈청 Ⅳ형 Collagen-7S의 의의

한영찬,김영태,이숭구,차경석,서대원,김영중,박병익,조민구 大韓消化器病學會 1995 大韓消化器病學會誌 Vol.27 No.3

복막투석액의 저류가 위배출시간에 미치는 영향

오하영,오동진,김범,이숭구,김윤구,강우헌,이방훈,김혜영,허우성,김대중 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.6

We evaluated gastric emptying time(GET) by using Tc99m-sulfur colloid gastric emptying scintigraphy in 11 patients with CAPD(6 male, 5 female) and 14 healthy volunteers. We investigated the effect of dialysate dwelling on GET by studying twice, once without dialysate in the abdomen(drained) and once with 2 L of dialysate in the abdomen(full), and the relationship between body surface area(BSA) and delayed gastric emptying. 1) The mean of gastric emptying rate in 120 minute in patients with CAPD when drained(67.8±13.4%) was not different from that in healthy volunteers(65.4±8.6%) 2) The mean of gastric emptying rate in 120 minute when full(55.6±14.6%) was significantly lower than that when drained(67.8±13.4%)(P$lt;0.05). In four of the 11 patients(36.4%), gastric emptying was extremely delayed from normal to abnormal range when full. 3) The BSA(1.5±0.11m2)of patients who had extremely delayed GET from normal to abnormal range was smaller than that(1.74±0.22m2) of patients who had minimal delayed or unchaET when full. This study showed the patient with CAPD had normal gastric emptying when drained, and that gastric emptying was delayed by dialysate dwelling, especially in the patients who has less than 1.5m2 of body surface area. Therefore, we suggest that intermittent nocturnal peritoneal dialysis or a small volume of dialysate may be considered for the patient with small body surface area based on the adequacy.

한국인에서 혈청 크레아티닌을 이용한 크레아티닌 청소율의 계측

김대중,오하영,오동진,김범,이숭구,서기현,강우헌,이방훈,김혜영,이윤하,허우성,김윤구 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.6

Cockcroft and Gault's formula is frequently used to estimate creatinine(Ccr) in clinical practice. To determine the accuracy of such estimation in Korean patients, we measured simultaneously, serum creatinine and 24-hour urinary creatinine excretion in 696 Korean patients(male:350, female:346). Measured Ccr was significantly different from estimated Ccr in several age groups and the decrease of creatinine excretion with age is less than Cockcroft and Gault's estimation. We assumed that this difference can be due to difference of the body habitus and difference of urinary creatinine excretion per body weight between different races. So we divided the sample population into two groups and derived the new formula in one group with regression analysis between age and 24 hour urinary creatinine excretion per body weight for estimation of Ccr as Cockcroft and Gault derived their formula and applied it to another group to compare the new formula with Cockcroft and Gault's formula in Korean patients. The new formula was Ccr(mL/min)=[(260-age)?weight(kg)]/[160?serumCr(mg/dL)] for male and Ccr (mL/min)?[(236-age)?weight(kg)]/[180?serum Cr(mg/dL)] for female. Predictive accuracy of the new formula was significantly better than the Cockcroft and Gault's formula in the other sample population and also in subgroup of the patients with azotemia.

β2-microglobulin의 복막이동 특성 및 복막 청소율에 관한연구

문지현,김대중,오하영,이숭구,이방훈,채영숙,김범,오동진,허우성,김윤구,강우헌 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.4

In addition to CAPD, various modalities of peritoneal dialysis such as CCPD and NIPD have been introduced recently. The adequacy in these peritoneal dialysis has been evaluated by clearance of small molecular weight solutes such as creatinine(molecular weight 113 Dalton) and urea(molecular weight 60 Dalton). The middle molecular weight solutes(molecular weight 3,000 to 12,000 Dalton) have been regarded as one of the uremic toxins. Relatively larger clearance of middle molecular weight solutes is one of the advantages of CAPD compared with HD. Although peritoneal transport of middle molecular solutes can be different from that of small molecular weight solutes because of its size, there are a few reports about peritoneal transport characteristics and clearance of middle molecular weight solutes in various modalities of PD. We wanted to analyze peritoneal transport characteristics and clearances of middle molecular weight solute in various modalities of peritoneal dialysis in comparison with small molecular weight solutes. To evaluate the potential differences in peritoneal transport characteristics and clearances of middle and small molecules in CAPD, CCPD and NIPD, we compared transport characteristics and clearance of β2-MG and creatinine. 35 CAPD patients, 9 CCPD patients, 7 NIPD patients were included in the study, who were clinically stable for at least one month without peritonitis. he β2-MG concentrations in serum and dialysate as measured by radioimmunoassay. Standard peritoneal equilibration test and a weekly peritoneal clearance for creatinine and β2-microglobulin were used. The results were as follows: 1)Dialysate to plasma ratio of β2-MG were 0.11±0.03, 0.13±0.05, 0.10±0.02, 0.08±0.03, respectively in high(N=6), high average(N=13), low average(N= 14), low(N=7) group according to PET. There were significant differences between high average and low average, high average and low group(p$lt;0.05). Correlation between D/Pβ2-MG ratio and D/Pcr ratio was significant(spearman's p=0.453, p$lt;0.05). 2)Ipatients, peritoneal creatinine and β2-MG clearance were 48.9, 8.2L/wk, respectively and there was a weak correlation between them (Spearman's p=0.294, p$lt;0.05). 3)The peritoneal creatinine clearance were 48.9, 41.0, 35.9L/wk and ?2-MG clearance were 8.2, 5.5, 4.1L/wk, respectively in CAPD, CCPD and NIPD. The ratio of peritoneal β2-MG clearance to creatinine clearance were 0.16, 0.14, 0.11, respectively in CAPD, CCPD and NIPD. Peritoneal β2-MG clearance in APD such as CCPD and NIPD is lesser than that in CAPD. In conclusion, peritoneal transport characteristics for β2-MG differ from that for creatinine, although peritoneal clearnce for β2-MG corrleated with that for creatinine. Perioneal clearance for β2-MG was better in CAPD than in APD.