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인슐린 비의존형 당뇨병환자에서 중식성 망막증 발생에 관한 종적연구
조구영(Goo Yeong Cho),김상욱(Sang Wook Kim),이미화(Mee Wha Lee),박중열(Joong Yeol Park),제수정(Soo Jung Je),이기업(Ki Up Lee),김기수(Ghi Su Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.4
N/A Background: Proliferative diabetic retinopathy (PDR), a late stage of diabetic retinopathy, is the com- monest cause of acquired blindness in adults. Despite many previous studies, the risk factors for the development of PDR in Korean NIDDM patients have not been precisely defined yet. The aims of the present study were to evaluate the incidence and the risk factors of PDR. Method: From April to June 1993, we retrospectively studied 243 NIDDM outpatients (duration of diabetes 7.9±7.1, age 54.5±10.8, male 110 and fema1e 133) who had undertaken fundoscopic examination for diabetic retinopathy before April 1991. At the time of the examination, 70 patients had nonproliferative diabetic retinopathy (NPDR). Of those, 12 patients progressed to PDR and 58 patients did not. Clinical characteristics and laboratory findings of progressed group were compared with non-progressed group. Results: Of the 162 patients who were free of diabetic retinopathy at the initial examination, 18 patients progressed to diabetic retinopathy; the incidence rate of diabetic retinopathy was 34.9/1,000 person-yr. Of these, 1 patients had PDR (1.9/1,000 person-yr). After 2.6 years of mean follow-up, 12 out of 70 patients with initial NPDR progressed to PDR. The incidence rate of PDR in the patients with NPDR was 63.2/1,000 person-yr. Microalbuminuria, more severe weight loss, lower level of C-peptide and insulin therapy were associated with an increased 2.6-year risk of developing PDR. However, sex, smoking, use of antihypertensive drugs or aspirin, age, duration of diabetes and the mean fasting serum glucose, hemoglobin Al, cholesterol, systolic or diastolic blood pressure levels during the follow-up period were not associated with the progression to PDR. Forward stepwise multiple logistic regression analysis revealed that initial microalbuminuria and delta BMI are significant independent predictor for the progression to PDR. Conclusion: Microalbuminuria can be used as a predictor for progression to PDR. Lower level of C-peptide, more severe weight loss and current insulin use may be also the risk factors for progression to PDR in Korean NIDDM patients with nonproliferative retinopathy. However, long-term prospective study is warranted to answer the question more properly.
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.
김제열,조상호,김건일,허경림,김현숙,조구영,최영진,이원용,임종윤 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2
Cardiac tumors, especially the primary tumors involving any part of the heart are extremely rare and its relative incidence has been reported to be approximately 0.02%. We report a patient with huge cardiac hemangioma who complained of shortness of breath, general weakness, and dizziness, Imaging study by echocardiography and computed tomography of thorax revealed a huge lobulating mass like a bunch of grapes in the right chamber of heart. The surgical exploration of thorax was performed and a histological diagnosis of spindle cell hemangioma was obtained by microscopy. The patient was treated by surgical resection of the tumor and doing well after surgery. Our experience indicated that prompt diagnosis and treatment of cardiac hemangioma is imperative for patients' prognosis.
화상 환자에서 발생한 외과적 중재술을 요하는 감염성 심내막염 2예
김근숙,이태유,정연손,최창순,최민호,류제헌,김철홍,조구영,우흥정 대한감염학회 2003 감염과 화학요법 Vol.35 No.3
감염성 심내막염은 화상 후에 발생할 수 있는 치명적인 합병증이다. 임상 증상은 일반적으로 없는 경우가 대부분이고 지속되는 발열과 양성 혈액 배양 검사가 유일하다. 감염의 다른 확실한 원인 없이 발열과 양성 혈액 배양 검사가 있을 때는 감염성 심내막염을 강력하게 의심해야 하며 심장 초음파로 진단 가능하다. 감염성 심내막염은 사망률은 높지만 초기에 진단하면 항생제 정주를 지속하는 것으로 치료할 수 있다. 저자들은 화상환자에서 발생한 수술적 처치를 필요로 하는 감염성 심내막염 2예를 경험하였기에 보고하는 바이다. Infective endocarditis is a rare but fatal complication following burn injury. The clinical presentation is silent, but with persistent fever and positive blood culture. The manipulation of clinical care as well as the burn wound itself and immunosuppression caused by extensive bums puts the burn patients at risk of bacteremia. Staphylococcus aureus and Gram-negative bacilli are most common pathogens of infective endocarditis following burns. We report herein two cases of infective endocarditis in the burn patients who requires surgical intervention. The first case was caused by Pseudomonas aeruginosa with complication of multifocal pneumonia, and the second case by coagulase-negative stapylococcus with cerebral hemorrhage.
그람양성균 감염에 대한 Teicoplanin의 임상적 효과
최강현,송재훈,조구영,유빈,김형호,서철원,배직현 대한감염학회 1993 감염 Vol.25 No.1
Backgrounds: Gram-positive cocci have been an increasing cause of nosocomial infections in recent years. Treatment of these infections is often difficult, particularly infections by methicillin-resistant Staphylococcus aureus (MRSA). Teicoplanin, a new glycopeptide antibiotic, has been reported to have an excellent in vitro and in vivo effect against various gram-positive infections. To evaluate the clinical efficacy of teicoplanin in the treatment of patients with gram-positive bacterial infection and to compare the in vitro susceptibility of teicoplanin with other antimicrobials, we performed a prospective open trial of teicoplanin. Methods: Twenty patients with infections by gram-positive organism were enrolled. The patients were received 400mg of teicoplanin followed by 200 mg from next day as maintenance dose. During the follow-up period, clinical features and laboratory parameters were ckecked to evaluate clinical efficacy and appropriate cultures were followed to determine the microbiologic efficacy. The adverse effects of teicoplanin were also observed. Results: The enrolled patients were 16 males and 4 females, whose mean age was 51±13 years. The categories of infections were bacteremia (5), skin and soft tissue infection (4), empyema (3), UTI (2), pneumonia (1), catheter associated infection (1) and infective endocarditis (1). The etiologic organisms isolated were MRSA (9), coagulase-negative Staphlycoccus (5), S. viridans (2), group D streptococcus (2), S. pneumoniae (1), and E. faecalis (1). All 20 patients treated with teicoplanin showed clinical cure (13/20) or clinical improvement (7/20), whereas 90% of isolated organisms were eradicated after teicoplanin therapy. The adverse effect of teicoplanin was minimal. Conclusion: Teicoplanin is safe and effective in the therapy of many different infections caused by gram-positive oragnisms.