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양수현,양영표,이근,박봉철,채동호,이홍복,변종훈,계경채,박선양 대한내과학회 1992 대한내과학회지 Vol.42 No.1
혈전증과 색전증의 발생빈도는 하지마비 환자에서 높은 것으로 알려져 있다. 이런 환자들에서 혈전 발생에 섬유소 용해계의 변화가 어떤 작용을 하는가를 밝히기 위해 저자들은 1년에서 21년 동안 하지마비 상태에 있는 환자 11명의 혈중 섬유소 용해계 변화를 조사하였다. 환자군과 정상대조군 16명의 상지와 하지로부터 정맥혈을 채혈했다. PA 활성도는 ^(125)I-fibrin plate 방법으로 PAI 활성도는 Z-Lys-S-B키 assay로 각각 측정하였다. tPA와 PAI-1 항원은 ELISA법으로 측정했다. 환자군에서 상지와 하지 PA 활성도는 정상대조군에 비해 의미있게 감소했다. (상지 ; 0.13±0.09AU/㎖ vs 0.45±0.25AU/㎖, P=0.0001 : 하지 ; 0.18±0.18AU/㎖ vs 0.31±0.24AU/㎖, P=0.025). 환자군의 PAI-1 농도는 정상대조군에 비해 상지에서만 증가하는 경향을 보였다(23.46±10.39AU/㎖ vs 16.67±8.70AU/㎖, P=0.061). 환자군의 tPA 농도와 PAI 활성도는 정상대조군에 비해 의미있는 차이는 없었다. SDS-PAGE와 섬유소 Auto-graphy 분석에서 환자군에서 섬유소 용해대의 감소를 보였으나 분포형태는 본질적으로 정상대조군과 같았다. 하지마비 환자의 PA 활성도는 감소되고 PAI-1 농도는 증가하는 경향이 있는 것으로 나타나서 하지마비 환자에서 심부정맥 혈전증 발생과 관련이 있을 것으로 생각하였다. The incidence of thromboembolic complication has been shown high in paraplegic patients. To elucidate the possible role of changes in the fibrinolytic system in these patients to the development of thrombotic disorders, we evaluated the parameters of the blood fibrinolytic system in 11 patients who had been suffering from paraplegic limbs for one to 21 years. Venous blood samples were obtained from the upper and lower extremities of the patients and 16 normal volunteers as a control. Plasminogen activator (PA) and plasminogen activator inhibitor (PAI) activities were measured by the ^(125)I-fibrin plate method and Z-Lys-SBzl assay, respectively. Plasma concentrations of tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were determined by ELISA methods. PA activities in both upper and lower extremities of the paraplegic patients were significantly decreased compared to those in normal controls (upper extremities; 0.13±0.09AU/㎖ vs 0.45±0.25AU/㎖, P=0.0001: lower extremities; 0.18±0.18AU/㎖ vs 0.31±0.24AU/ ㎖, P=0.025). Plasma PAI-1 concentrations of the paraplgic patients showed increasing tendency only in the upper extrmities compared to those in normal subjects (23.46±10.39AU/㎖ vs 16.67±8.70AU/㎖, P=0.061). Plasma tPA concentrations and PAI activities in paraplegic patients were not significantly different from those in normal controls. SDS-PAGE and fibrin autographic analysis of the euglobulin fractions demonstrated decreased fibrinolytic bands in paraplegic patients. However, the patterns of distribution for the fibrinolytic bands were essentially the same as those in normal subjects. In conclusion, plasma PA activities from the paraplegic patients were demonstrated to be decreased with the increasing tendency in PAI-1 concentrations. We suggest that decreased fibrinolytic activity possibly resulting from an increase in PAI-1 concentrations might be a predisposing factor to deep vein thrombosis frequently associated in paraplegic patients.
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박봉철,박문향,변종훈,이근,양영표,채동호,양수현,정윤형,김형직,조준구 대한내과학회 1992 대한내과학회지 Vol.43 No.1
Bartter's syndrome is characterized by hypokalemia, metabolic alkalosis, hyperreninemia, hyperaldosteronism, normal blood pressure, hyperplasia of the juxtaglomerular apparatus of the kidney. We have experienced a case of Batters syndrome in 54-year-old woman and diagnosed by means of the above mentioned biochemical and pathalogical studies and we have witnessed a successful response to captopril and indomethacin and spironolactone treatment. Literature was reviewed briefly.
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이근,조준구,박봉철,변종훈,양수현,채동호 대한신장학회 1991 Kidney Research and Clinical Practice Vol.10 No.1
Chronic renal failure is a common complication of spinal cord injury patients. When spinal cord jnjured patients with chronic renal failure need dialysis, hemodialysis has almost exclusively been selected for its long-term management. Peritoneal dialysis has not been advocated in spinal cord injured patients due to several limitions including peritonitis, basal lung atelectasis, excessive dialysate protein loss, hyperglycemia, and gastrointestinal complincations. However, we tried peritoneal dialysis in a spinal cord injured patient with end-stage renal disease and experienced a successful use of peritioneal dialysis.
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99mTc - phytate 간스캔을 이용한 간 경변증의 예후 평가
박성기(Sung Ki Park),변종훈(Jong Hoon Byun),양수현(Soo Hyun Yang),박봉철(Bong Chul Park),채동호(Dong Ho Che),조준구(Jun Koo Cho),송태원(Tae Won Song) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1
N/A To evaluate the prognostic significance of 99mTc-phytate liver scintigraphy in patients with cirrhosis, we measured the grade of extrahepatic uptake (EHU) of 99mTc-phytate, from 0 (absent EHU) to 5 (irnportant EHU), according to the relative distribution of the radiotracer among liver, spleen and bone marrow. The results were as follows: 1) EHU score was correlated to the Pugh score (r=0.64) and to survival. 2) The ROC curve on an observed status of death was superior for EHU score. In conclusion, 99mTc-phytate liver scintigraphy may be a useful prognostic method in patients with liver cirrhosis.
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99mTc - DISIDA 간담도 스캔상 담도폐쇄로 진단된 환자의 임상적 특성 - 초음파 검사상 정상 소견을 보인 9예를 중심으로 -
박성기(Sung Ki Park),변종훈(Jong Hoon Byun),양수현(Soo Hyun Yang),박봉철(Bong Chul Park),채동호(Dong Ho Che) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1
N/A To evaluate the role of hepatobiliary (DISIDA) scan in the diagnosis of biliary obstruction, we studied the clinical characteristics of 9 cases with biliary obstructuon, whose hepatobiliary scans and ultrasonography were not concordant (normal ultrasonography and abnormal hepatobiliary scan). The results were as follows; 1) The main chief complaints (89%) were abdominal pain, especially in RUQ area. The levels of serum bilirubin were elevated in 67% of patients (normal∼5.9 mg/dl) and those of alkaline phosphatase were elevated in 78% of patients (normal∼724 U/L). 2) The final diagnoses were CBD stones (67%), tumor (22%) and 3 cases were associated with C. sinensis. 3) The major obstruction sites were in distal CBD (89%). From the above results we concluded that hepatobiliary scan is a useful diagnostic method of biliary obstruction, especially in distal CBD lesion and early stage, in spite of normal ultrasonography.
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