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이시래,최창필 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2
Over the years results with all types of treatment have progressively improved, which allows for encourgement and optimism. CAPD is increasingly used not only because of econornic advantages but also the improved clinical and metabolic results. An excellent control of blood glucose level is made possible by using the intraperitoneal route three to four times a day for administration of insulin. Since the insulin delivered intraperitoneally in absorbed from the peritoneal cavity via the hepatic portal system which is the site of entry for pancreatic insulin, it seem likely that this would be a $quot;physiologic$quot; delivery route. Because of certain similarties between physiological insulin secretion and intra- peritoneal insulin administration, it is expected that the intraperitoneal administration of insulin during CAPD will give excellent diabetic control and achieve more desirable long term results in diabetic end stage renal disease. We reviewed some authors articles for the administration of insulin in diabetics during CAPD and shared our experiences in this article. During the last 4 years, we have treated 17 diabetics with CAPD. Good control of blood sugar was achieved by intraperitoneal administration of insulin. Average period required to control blood sugar was 13 days. After our patients blood sugar was stablized, their daily average insulin requirement was 46 units, ranged from 8 to 162 units.
고칼슘혈증 및 골용해성 병변을 동반한 급성 골수성 백혈병 1 예
박경식,이상도,최덕호,현명수,최창필,김덕희,전진종 대한내과학회 1996 대한내과학회지 Vol.50 No.1
A case of hypercalcemia and osteolytic bone lesions complicating acute myelogenous leukemia, is described with review of literature. The patient was admitted with a 15-day history of nausea, vomiting, and multiple joint pain. On admission, laboratory studies revealed Hb 10.6g/dL, Hct 31.7%, WBC 2,100/mm³, Platelet 93,000/mm³, BUN 32.6㎎/dL, Creatinine 2.8㎎/dL, serum calcium 13.3mg/dL, serum phosphate 3.1mg/dL, serum radioimmuno reactive parathyroid hormone 0.17ng/dL. Bone marrow study showed blast as much as 84%. Simple X-ray showed multiple scattered osteolytic bone lesions on skull and pelvis. The patient was treated with Daunorubicin 45㎎/M² to 3 day, Cytarabine 100㎎/ M² to 7 day as remission induction chemotherapy, and achieved normal range of serum calcium and renal function with complete remission hematologically, and received 3 times of consolidation chemotherapy thereafter. The patient was re-adimitted with headache, nausea, intermittent seizure, and loss of consciousness during follow-up. With CNS involvement of the leukemic cell by cerebrospinal fluid(CSF) study, laboratory studies showed recurrence of the AML and hypercalcemia. He was treated with emergency radiotherapy(total 2,400cGy) and chemotherapy. He was improved symptomatically and hypercalcemia was disappeared, but the bone marrow aspiration revealed incomplete remission (blast 10%). The patient with his family refused further therapy, and discharged. He died about 1 month after discharge.
파라티푸스 경과중 발생한 세뇨관간질신염에 의한 급성신부전증 1예
송준희,김용진,한재호,김원근,최창필,성영호 대한신장학회 1991 Kidney Research and Clinical Practice Vol.10 No.2
Tubulointerstitial nephritis (TIN) is one of the several important causes which induce acute renal failure. The two most common causes of acute renal failure due to TIN are infection and drugs. However TIN has been rarely reported in typhoid and paratyphoid fever. Renal biopsy was done in a 27years old male patient with documented paratyphoid fever who had clincical evidence of nonoliguric acute renal failure. Histological findings consistent with TIN were seen. The occurrence of TIN with typhoid and paratyphoid fever must be suspected in patient with acute renal failure.