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정석희 ( Seuk Hee Chung ),문승환 ( Seung Hwan Moon ),백정환 ( Jeung Hoan Paik ),김경태 ( Kyoung Tae Kim ),최세웅 ( Se Woong Choi ),이창재 ( Chang Jae Lee ),조용락 ( Young Rak Cho ),나서희 ( Seo Heui Ra ),안원석 ( Won Suk An ),김 대한내과학회 2006 대한내과학회지 Vol.70 No.6
목적: 막증식성 사구체신염은 혈뇨를 동반한 무증상성 요이상에서 신증후군, 만성신부전 등 다양한 임상증상을 나타내며 아직까지 그 원인이나 병인에 대한 정확한 기전이 알려져 있지 않고 확립된 치료방법도 없는 상태이다. 이에 저자들은 성인에서 특발성 막증식성 사구 체신염으로 진단된 환자들의 임상적 특징을 알아보고자 본 연구를 시행하였다. 방법: 연구 대상은 1990년 3월부터 2004년 11월까지 동아대학교병원 내과에서 시행한 조직검사 약 1,500예 중에서 Background: The manifestation of Membranoproliperative glomerulonephritis (MPGN) is variable from asymptomatic hematuria, nephrotic syndrome to advanced chronic kidney disease. The etiology, pathogenesis, and treatment of MPGN are unclear. The incidence of
오유정 ( You Jeong Oh ),한지선 ( Ji Sun Han ),김도경 ( Do Kyong Kim ),정석희 ( Seuk Hee Chung ),김상옥 ( Sang Ock Kim ),형건덕 ( Chien Ter Hsing ),목지영 ( Ji Young Mok ),안원석 ( Won Suk An ),김성은 ( Seong Eun Kim ),김기현 ( Ki 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Purpose: Recently the incidence of severe hyponatremia is increasing in old patients but there is no report about clinical findings of old patients with hyponatremia. We evaluated the cause and clinical manifestations of severe hyponatremia in old patients who had been admitted via emergency room. Methods: We retrospectively reviewed clinical records of the hyponatremic patients who had been admitted from 2000 to 2007. We enrolled 53 patients (Age>60 years, Na<125mEq/L) without severe liver cirrhosis, heart failure or chronic kidney disease. We analyzed data to evaluate the differences of clinical manifestations according to the presence of symptoms, taking diuretics, urine sodium concentrations and the degree of hyponatremia. Results: Mean serum sodium concentration was 111.4±6.9mEq/L and urine sodium concentration was 68.7±43.8mEq/L. There was no difference in serum sodium concentration according to age. Twenty-nine (54.7%) patients had nausea and vomiting and 19 patients (35.8%) had neurologic symptoms. Patients with neurologic symptoms showed lower serum and urine sodium concentration than patients without neurologic symptoms. The main causes of severe hyponatremia were poor oral intake (79.2%), diuretics use (37.7%) and recent operation (15.1%). The mean sodium concentration of the fluid administered to achieve 125mEq/L of serum sodium level was 336.5±160.6mEq/L. Conclusion: The urinary sodium loss, e.g., diuretics abuse, may be the main cause of severe hyponatremia in elderly patients over 60 years. In elderly patients, diuretics should be carefully administered with frequent electrolyte monitoring.
혈액투석 환자에서 관상동맥질환의 예측인자로서 단순방사선 촬영상 혈관 석회화 점수들간의 비교
김정민 ( Jung Min Kim ),안원석 ( Won Suk An ),김기현 ( Ki Hyun Kim ),김성은 ( Seong Eun Kim ),손영기 ( Young Ki Son ),정석희 ( Seuk Hee Chung ),오유정 ( You Jeong Oh ),김우재 ( Woo Jai Kim ),김동균 ( Dong Kyun Kim ),배숙향 ( Hyang 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
Purpose: Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) and mortality. The present study was designed to demonstrate a correlation between VC scores of the hands and pelvis, and feet and lateral lumbar spine on plain radiographs. In addition, we analyzed the usefulness of checking all the plain radiographs for assessment of pre-existing CAD. Methods: We recruited 61 hemodialysis (HD) patients from OO Dialysis Center. We checked the plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine and evaluated VC scores with previously reported methods. We defined CAD based on myocardial scans, echocardiography, or coronary angiography. Results: Positive associations were found between the VC scores of the feet, VC scores of the hands and pelvis, scores of abdominal aortic calcifications (AACs), and CAD. Approximately 30% of patients who had CAD could be missed based on a single VC scoring method. Patients who showed any one finding among the AAC scores >5, VC scores of the pelvis and hands >3 or arterial media calcifications of the feet on plain radiographs had a high sensitivity (93.8%) and a high negative predictive value (96.3%) for the presence of CAD. Conclusion: Each VC score was highly inter-correlated. All three VC scoring methods on plain radiographic films are useful screening tests for the presence of CAD in HD patients.
양측성 내인성 안구내염을 동반한 Group G 사슬알균 심내막염
최세웅,정동식,김경호,문승환,이창재,백정환,정석희,강아영,오원섭,이혁 대한감염학회 2005 감염과 화학요법 Vol.37 No.5
본 증례의 환자는 발열과 양측 시력소실을 주소로 내원하였으며, 양측성 내인성 안구내염을 동반한 group G 사슬알균 심내막염으로 진단되었고, 원인균은 Streptococcus dysgalactiae subsp. Equisimilis로 동정되었다. 전신적 항생제 치료중 패혈성 색전증으로 우측 후두엽의 뇌경색이 생겼으며, 내인성 안구내염의 급속한 악화로 결국 안구적출술을 시행하였다. group G 사슬알균 심내막염은 매우 드물고, 심각한 신경계 합병증을 일으키는 것으로 알려져 있으며, group G 사슬알균에 의한 내인성 안구내염 또한 예후가 좋지 않으며, 전세계적으로도 보고된 예가 수례에 불과하다. 저자들은 양측성 내인성 안구내염을 동반한 group G사슬알균 심내막염 1예를 경험하고 문헌고찰과 함께 보고하는 바이다. The group G streptococcal endocarditis is a rare form of infective endocarditis when present, and it is associated with serious neurological complications. Also, endogenous endophthalmitis due to group G streptococcal endocarditis has rarely been reported, and usually leads to total loss of vision. We report a case of group G streptococcal endocarditis which presented clinically as endophthalmitis unrelated to trauma or surgery in a 85-year-old diabetic man.