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임응훈,김성수,김치홍,추원오,김용수,박인석,구완서,장윤식,방병기,송경섭,박영하 대한내과학회 1992 대한내과학회지 Vol.42 No.2
저자들은 혈액투석을 시행하고 있는 다낭신 환자에서 발생한, 수혈을 요하는 대량혈뇨를 신동맥색전술을 이용하여 성공적으로 치료한 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Polycystic kidney disease is one of the most common inherited autosomal dominant disease with variable clinical prsentations. The disease may manifest abdominal pain, bilateral flank masses, hypertension, hematuria, nephrolithiasis and azotemia. Massive hematuria may occur in polycystic kidney requiring transfusions or rarely surgical intervention. However, renal arterial embolization has been applied for the control of massive hematuria recently. We have experienced two cases of massive hematuria in polycystic kidney disease controlled by percutaneous renal arterial embolization successfully without any serious complications.
응급실에 내원한 불안정성 발작성 심실상성 빈맥환자에서 정맥내 Adenosine 투여효과
이원재,박규남,채장성,강동헌,임응훈,김세경,황주일,승기배,박승현,오동렬,이기중,최규보 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2
Study purpose : To evaluate the efficacy of adenosione in the treatment of emergency department patients with unstable paroxysmal supraventricular tachycardia. Design : A ten-months prospective outcome study. Population : Patients with 16 or more old with unstable PSVT(systolic blood pressure of less than 90mmHg, chest pain, pulmonary edema, and/or altered mental status) by surface ECG criteria. Measurements : Patient's preadenosine and postadenosine heart rates, symptoms, and blood pressure, complications and recurrence of PSVT. Results : Fourteen patients mets inclusion criteria. After IV adenosine, One patient was found to have atrial flutter. PSVT were diagnosed in remaining thirteen patients. There were five male and eight female patients with a mean age 35.2(range, 16-52). Six patients presents with hypotension(mean systolic blood pressure, 78.6mmHg), four with chest pain, and three with both chest pain and hypotension. There were no patients with altered mental status or pulmonary edema. Eleven patients(85%) converted to sinus rhythm with adenosine therapy (initial 6mg adenosine : eight patients, additional 12mg : three patients). The remaining two patients required electrical cardioversion. Two patients converted to sinus rhythm by electrical cardioversion. In all cases, chest pain and hypotension resolved within minutes of conversion to sinus rythm. There were no clinically significant adverse effects or recurence of PSVT during emergency department observation period. Conclusion : In the unstable patient with PSVT, adenosine appears to be a safe and effective alternative to current advanced cardiac life support-recommended immediate electrical cardioversion.
송경섭,박인석,김석영,김치홍,장윤식,방병기,우제영,임응훈 대한신장학회 1991 Kidney Research and Clinical Practice Vol.10 No.3
Recently therapeutic trial using selective arterial embolization has been applied with increasing frequency to the bleeding control in a variety of medical fields. We experienced a case of control of massive hematuria with selective renal arterial embolization. A 19-year-old man developed massive hematuria six months after percutaneous renal biopsy. Percutaneous transfemoral renal angiography revealed an AU fistula with pseudoaneurysm at the mid-portion of left kidney. Selective renal arterial embolization was performed and the massive hematuria was controlled successfully.
사지 근무력증을 동반한 Lidde `s syndrome 1예
김화영,이덕기,이창후,김종형,신현민,임응훈,강정협,한성민,박해규,곽경근,소순찬 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.1
Liddle's syndrome was described in 1963 by Liddle, et aL, as the disease featuring a hypertension and hypokalemia but with negligible secretion of aldosterone. This syndrome, which morphologically belongs to an abnormal intrinsic tubular disorder with normal renal function, is characterized by hypokalemia, metabolic alkalosis, and hypertension due to the abnormal increase in excretion of potassium in distal tubules or collecting duct and the increase in reabsorption of sodium in distal tubules. This syndrome, which is rare disease, is observed with the low level of plasma and urinary aldosterone and su- ppressed plasma renin level and is known as dominant mode of inheritance with a family background. The authors paid attention to a 79-year-old man who showed a high blood pressure of 210/130mmHg as well as musle weakness, especiaUy lower extre- mities due to metabolic alkalosis featuring a hypokalemia level of 2.0mEq/L when he was admitted to our hospital, Because his serum potassium were not improved with the medication of intravenous potassium supply, and his blood pressure continued to be high without the improvement of muscle weakness, we prescribed 300mg of spironolactone for two weeks. His symptom, however, was not cured. Then, instead of spironolactone, we prescribed 150mg of triamterene and a low salt diet which finally im- proved his symptoms. Because there has been no reported case in the Korean medical literature, we report a case of successfully treated Liddles syndrome due to triamterene administration.
신조직검사로 진단된 급성백혈병 세포의 침윤에 의한 신부전
박석영,김판규,김석영,한지연,서광선,박지원,임응훈,방병기,양철우,김종률,이정득 대한내과학회 1993 대한내과학회지 Vol.45 No.5
Infitration of the kidneys in acute 1ymphocytic leukemia is thought to cause rarely functional imparment or lead to renal failure. When renal failure occurs in acute lymphocytic leukemia(ALL), it is secondary to complications such as tumor lysis syndrome, uric acid nephropathy, obstruction, haemolysis and glomerulone-phritis. We report a 56 year-old female patient with ALL who presented with renal failure and was found to have extensive infitration of the kidney with leukemic infiltrates. The absence of other causes of renal failure and the presence of large kidneys with extensive infiltration of the interstitum with tumor cells makes it highly likely that renal failure was caused by leukemic infiltration.
신영신,정인식,양진모,김판규,심상인,정규원,김부성,선희식,이교영,채현석,임응훈 대한소화기내시경학회 1991 Clinical Endoscopy Vol.11 No.2
Gastric cancer is the most common malignancy in Korea. Although five years survival rate of gestric cancer has been gradually improved due to advances in the diagnostic technique and therapeutic modalities, the advanced gastric cancer remains a disease with poor pragnosis. At the time of diagnosis, the disease, is usually advanced and longterm survivor is uncommon without a proper surgical treatment or chemotherapy. We experienced a case of advanced gastric cancer who lived for more than 6 years after making a diagnosis, without curative surgical therapy or chemotherapy. The patient at age of 76 year-old, was seen in St. Mary's hospital due to gastroinestinal bleeding in January of l985. A large ulcerating cancer in the diameter of 2.0 cm was found at the posterior wall of body with endoscopy and confirmed the diagnosis of stomach cancer by the endoscopic biopsy. He was recommended the surgical intervention of gastric cancer but he denied the operation due to his age, He had been treated symptomatically with H2 receptor antagonist and antacid with relief of symptoms. Thereafter he had been followed-up clinically at every 2-4 weeks, and the lesion was examined 3-4 times in a year endoscopically, In May l990, an endoscopic esophageal dilation was done due to esophageal stricture with tumor invasion at the lower esophageal sphincter. He was expired in July, 1991 in this hospital. Here we report a case of long term survived advanced gastric cancer who had been followed-up for 6 and half years clinically and endoscopically with review of literatures.