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출혈성 신증후군 환자의 혈장 Atrial Natriuretic Polypeptide 농도 변화
박정의(Jeong Euy Park),차대룡(Dae Ryong Cha),김종웅(Jong Woong Kim),표희정(Heui Jung Pyo),이호왕(Ho Wang Lee),문정식(Jung Sik Moon),황흥곤(Heung Kon Hwang),김대중(Dai Joong Kim) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A Hemorrhagic fever with renal syndrome (HFRS) is characterized clinically by acute renal failure and pathologically by dense hemorrhage in the right atrium and medulla of the kidneys. To investigate whether there is any significant relationship between the changes of plasma atrial natriuretic polypeptide (ANP) and the clinical course, the plasma ANP was measured in 21 patients with HFRS. The plasma ANP was normal to low during the early oliguric phase (94.6±37.0 pg/ml), went up to a very high level (292.4±190.4 pg/ml) at the beginning of diuresis, then fell to a near normal level in a few days. The plasma renin activity (PRA) was very high during the early oliguric phase and fell rapidly in an opposite direction to the plasma ANP as the patients began diuresis. The rapid increase of plasma ANP and decrease of PRA seem to play an important role in the beginning of diuresis in HFRS.
Cuprophane과 Polysulfone 투석막의 생체적합성의 비교
이소영(So Young Lee),신진호(Jin Ho Shin),권영주(Young Joo Kwon),표희정(Heui Jung Pyo),한상엽(Sang Yup Han),오경식(Kyung Shik Oh),강영선(Young Sun Kang) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3
N/A Objective: It has been proposed that the contact between blood and dialysis membrane during hemo-dialysis therapy induces harmful reactions to patients. Membrane biocompatibility is the characteristic that makes less adverse reaction. We tried to compare the biocompatibility between Cuprophane and Polysulfone membranes. Methods: Nine chronic renal failure patients who have undergone maintenance hemrodialysis therapy with Hemophan membrane three times per week were included in this study. Cuprophane membranes were used in the first week: Hemophan membranes in the second week; Polysulfone membranes in the third week. Each membrane was used three times a week. On the day of third dialysis with the Cu-prophane membrane(first week) and Polysulfone membrane(third week), serial blood sampling was obtained from the afferent line at hemodialysis initiation, 15 minutes, 30 minutes, 60 minutes, 120 minutes and 30 minutes to measure serum complement activity(C3a, C5a), blood polymorphonuclear leukocyte and platelet count, and arterial oxygen pressure which have been regarded as biocompatibility par- ameters. The parameters measured during the first week(Cuprophane) and the third week(Polysulfone) were compared to evaluate the difference in bio-compatibility of both membranes. Results: 1) C3a desArg In both groups, the level of C3a desArg increased significantly from basal level and the Cuprophane group showed significantly higher level of C3a desArg than that of Polysulfone group. 2) C5a desArg : In both groups, the level of C5a desArg did not increased sigpificantly from basal level. Only at 30 minute after hemodialysis, Cupro- phane group showed significantly higher level of C5a desArg than that of Polysulfone group(p=0.037). 3) Polymorphonuclear leukocyte : In both groups, the polymorphonuclear leukocyte counts decreased significantly at 15 minutes and 30 minutes from basal level. The polymorphonuclear leukocyte count was lower in Cuprophane group than that of Polysulfone group at 15 minute after hemodialysis(p=0.001). 4) Platelet: In Cuprophane group, the platelet count was decreased significantly at 15 minute(p=0.004) but there were no difference in platelet counts between the two groups. 5) Arterial oxygen pressure Both group showed no consistent pattern of variation of oxygen pressure and there was no significant difference between the two groups. Conclusion: The biocompatibility of Polysulfone membrane was superior to the Cuprophane membrane with respect to the increased activation of complement C3a. decrease of polymorphonuclear leu-kocyte and decrease of platelet count.
크론병 환자에서 인플릭시맵과 메살라진 치료 후 발생한 지연발생 급성 세뇨관간질 신염 증례
유양재 ( Yang Jae Yoo ),정상윤 ( Sang Yoon Chung ),구대회 ( Dae Hoe Gu ),고강지 ( Gang Jee Ko ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ),박영태 ( Young Tae Bak ),원남희 ( Nam Hee Won ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Infliximab is a chimeric anti-tumor necrosis factor-alpha monoclonal antibody. Infusion related reactions and infection are well known side effects of infliximab; however, renal complications have not been well recognized. We report on a patient with late onset-acute tubulointerstitial nephritis (ATIN) after treatment with infliximab and mesalazine for Crohn’s disease. A 25-year-old woman was admitted with a purpuric rash on both lower extremities and arthralgia. She had been diagnosed with Crohn’s disease 5.6 years previously and had been treated with mesalazine and infliximab. Serum creatinine level, last measured one year ago, was elevated from 0.6 mg/dL to 1.9 mg/dL. Results of urinalysis, ultrasound, and serologic examinations were normal. With a tentative diagnosis of Henoch-Schonlein purpura, oral prednisolone was given, and serum creatinine decreased to 1.46 mg/dL, but was elevated to 2.6 mg/dL again at two months after discontinuation of prednisolone. Renal biopsy indicated that ATIN was probably ind ced by drug, considering significant infiltration of eosinophils. Concomitant use of infliximab with mesalazine was supposed to trigger ATIN. Oral prednisolone was administered, and serum creatinine level showed partial recovery. Thus, ATIN should be suspected as a cause of renal impairment in Crohn’s disease even after a long period of maintenance treatment with infliximab and mesalazine.
신진호(Jin Ho Shin),이영기(Young Ki Lee),김상욱(Sang Wook Kim),권영주(Young Joo Kwon),표희정(Heui Jung Pyo) 대한내과학회 1998 대한내과학회지 Vol.54 No.5
N/A Background: Up to now, no study have been reported about clinical features of ESRD patients at the initiation of dialysis and their outcomes in Korea. We studied the clinical features and survival predictors of ESRD patients at the initiation of dialysis therapy and their outcomes and we tried to identify the optimal point of starting dialysis therapy according to age, underlying disease, and other variables. Methods: We studied retrospectively clinical and laboratory variables of initiation in 364 patients who started dialysis therapy first at Korea University Guro hospital from 1987 to 1997. We divided patients into 3 groups by age, into 2 groups by underlying renal disease (DM vs. nonDM) and compared thc above variables between 3 or 2 groups. We evaluated the outcome (alive vs. death) in 258 patients whoes outcomes were identified. We identified the poor survival predictors of outcome according to alive/death group, and analized the relative risk of death according to level of serum creatinine (reference: 12.5~15.0mg/dL) and serum albumin (reference: 4.0~4.5g/dL). Results: 1) The distribution of patients by age, young age group, middle age group, old age group were 135.l% and 89. Those of patients by underlying renal disease, DM and nonDM were 80 and 284 respectively. 2) The most common underlying renal disease of young age group was chronic glomerulonephritis but that of old age group was diabetes mellitus. In old age group, levels of BUN, scum creatinine, and serum phosphate were lower than those in young age group (p<0.001). In old age group, the indication of dialysis tended toward relative (p=0.098) and early referral was more common than in young age group. 3) DM group was older and more early referred than nonDM group. In DM group, blood cholesterol level was higher, but level of BUN, serum creatinine, albumin, phosphate and uric acid were lower than those in nonDM group. 4) In 258 patients whose outcomes were identified, elderly and DM had poorer outcomes in the respect of mortality and survival by Kaplan-Meier survival analysis method. In the comparison of death group and alive group, death group was older and had more DM as underlying renal disease and lower level of setum creatinine than alive group. 5) Relaive risk of death was higher in lower concentrations comparing to reference level of albumin and creatinine. Conclusion: Old age, DM as underlying renal disease, hypocreatinemia and hypmmatinemia were poor survival predictors. Then close observation and follow-up are warranted in patients with old age, DM, hypoalbumine-mia, and hypocreatinemia. For more favorable prognosis in ESRD patients, early initiation of dialysis must be considered in patients who have these characteristics.