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증례 : 혈액종양 ; 림프종 환자에서 리툭시맙 치료 후에 발생한 저감마글로불린혈증 1예
노현진 ( Hyun Jin Noh ),공봉한 ( Bong Han Gong ),김영신 ( Young Sin Kim ),정윤화 ( Yun Hwa Jung ),우인숙 ( In Sook Woo ),한치화 ( Chi Wha Han ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Rituximab, an anti-CD20 monoclonal antibody, is an effective target agent against the B lymphocytes in B-cell lymphoid malignancies and various lymphoproliferative diseases. Moreover, the toxicity of rituximab is less severe than that of conventional cytotoxic agents, which has promoted the widespread application of rituximab in the treatment of B-cell lymphoma. However, depletion of B lymphocytes by rituximab, which leads to secondary hypogammaglobulinemia, can cause deterioration of humoral immunity. Although immune reconstitution after hematopoietic stem cell transplantation is known to prevent prolonged hypogammaglobulinemia, very few cases of long-standing hypogammaglobulinemia have been reported. We report herein a case of prolonged hypogammaglobulinemia after rituximab-containing chemotherapy and splenectomy in a patient with non-Hodgkin`s lymphoma and discuss the clinical significance and pathogenetic mechanism of this phenomenon with a literature review. (Korean J Med 2014;87:357-362)
노현진 ( Hyun Jin Noh ) 대한내과학회 2014 대한내과학회지 Vol.86 No.2
More than thirty years after its introduction as a modality of renal replacement therapy (RRT), peritoneal dialysis (PD) has now become an established form of RRT. There were 70,211 patients receiving RRT at the end of 2,012 in Korea, and PD accounted for 10.8% of them. The rate for PD patients per million population has grown by 24% during the past 10 years. In this paper, physiology of peritoneal dialysis, assessment of peritoneal membrane transport function, updated target of solute removal, and potential complications of peritoneal dialysis will be discussed. (Korean J Med 2014;86:138-141)
정승규 ( Seung Kyu Chung ),전진석 ( Jin Seok Jeon ),김태형 ( Tae Hyong Kim ),김철 ( Chul Kim ),권순효 ( Soon Hyo Kwon ),노현진 ( Hyun Jin Noh ),한동철 ( Dong Chul Han ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.1
Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients. Although impaired tissue oxygenation is usually responsible for the rise in lactate production, lactic acidosis could be caused by drugs including metformin and the nucleoside reverse-transcriptase inhibitors. Linezolid, an oxazolidinone antibiotic, is currently indicated to treat serious infections caused by van-comycin-resistant enterococcus and other gram-positive organisms. A 74-year old woman was found to have pyogenic vertebral osteomyelitis and treated with linezolid. Thirty-one days after linezolid therapy, she developed severe lactic acidosis. We report a case of lactic acidosis associated with prolonged linezolid therapy.
복막투석 환자의 예후를 예측하는 인자로서 총 단백 복막 청소율의 의의
이설희 ( Sul Hee Yi ),이호영 ( Ho Young Lee ),김정현 ( Jung Hyun Kim ),정재면 ( Jae Myun Jung ),권순효 ( Soon Hyo Kwon ),전진석 ( Jin Seok Jeon ),한동철 ( Dong Cheol Han ),노현진 ( Hyun Jin Noh ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.6
Purpose: It has been reported recently that peritoneal protein clearance (Pcl) is a marker of endothelial dysfunction and cardiovascular disease in peritoneal dialysis patients. We evaluated whether baseline or longitudinal follow-up Pcl is a factor to consider in predicting the outcome in peritoneal dialysis patients for the follow-up period. Methods: Patients who initiated continuous ambulatory peritoneal dialysis at our center from September 1994 to January 2006 and had a baseline peritoneal equilibration test, measurement of dialysis adequacy, and 24-h dialysate Pcl (24hr dialysate protein loss/ [serum albumin/0.4783]) were included. Demography, comorbidities, and biochemical data were retrospectively collected. Follow-up was until death or the end of the period studied (November 2009). Results: A total of 203 patients (56% men, mean age 55.0±12.5; 55.2% with diabetes; 22.2% with cardiovascular disease) were included. The mean follow up period was 38 months (3-170 months). Baseline Pcl was 128.2 ml/day. Follow up data of Pcl were not changed from baseline period. Cox`s analysis revealed the predictors of mortality (and technical failure) were age and diabetes mellitus but not dialysate/plasma creatinine ratio (D/Pcr) and Pcl. On multivariate analysis, Pcl was negatively correlated with serum albumin and triglyceride and positively correlated with D/Pcr and peritoneal creatinine clearance. Conclusion: Our study showed that the changes in Pcl over time were not significant from baseline up to 53 months. Neither baseline nor mean Pcl during the follow-up period were independent predictors for technical or patient survival.