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만성 신부전 환자에서 clopidogrel에 의해 유발된 호중구감소증 1예
홍기연 ( Gi Youn Hong ),선한경 ( Han Gyung Seon ),정준구 ( Joon Gu Cheong ),주세경 ( Sae Kyung Joo ),강민경 ( Min Kyoung Kang ),이지은 ( Ji Eun Lee ),김주환 ( Ju Hwan Kim ),구승원 ( Seung Won Koo ),박경미 ( Kyoung Mi Park ),이소영 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Clopidogrel, a thienopyridine derivative, is an anti-platelet agent that acts as an antagonist of the platelet adenosine diphosphate receptor and considered for essential prophylaxis for intracoronary stent thrombosis in the treatment of ischemic heart disease. Clopidogrel is considered as safe as aspirin but a few cases of severe hematologic adverse reactions associated with clopidogrel had been reported such as neutropenia, aplastic anemia, thrombocytopenic purpura, and thrombocytopenia. We report a rare case of neutropenia induced by clopidogrel in chronic renal failure in a patient who underwent percutaneous coronary intervention.
김정호,홍기연,김기석,최정훈,민부기,Kim, Jung-Ho,Hong, Gi-Youn,Kim, Kie-Sock,Choi, Jung-Hoon,Min, Bu-Kie 대한생식의학회 1994 Clinical and Experimental Reproductive Medicine Vol.21 No.1
To improve in vitro embryonic cell development, this study was desigend to culture in vitro fertilized early embryos of mouse in two different systems; conditioned medium alone and ampullary cells co-culture. Thirty two of 83 embryos(38.6%) were blocked in the 2 cell stage by co-culture, as compared to forty of 42 embryos(95.2%) in control group for 24hours culture. And all the embryonic cells cultured for conditioned medium alone were blocked for 48 hours culture. Twenty seven of 46 embryos (58.7 %) which overcome culture block in 2 cell stage by cocultured were developed morular and expanded blastocyst, and ninteen of 46 embryos(26.1 %) underwent hatching for 96 hours culture. The cellular fragmented rates for embryo were 26.2% in medium alone; 10 fragmented blastomere were graded mild status and 1 fragmented blastomere in severe status. On the other hand, the fragmented rate for 48 hours co-cultured were 15.7%03/83); 8 fragmented embryos were graded mild status, moderate status in 3 fragmented embryos and severe in 2 fragmented embryos respectively. In conclusion, the co-culture of embryos with ampullary cells is good to improve quality of embryos and overcome of culture block as well as development of cell cleavage.
SILS 포트를 이용한 단일공법 복강경하 질식자궁절제술과 삼공법 복강경하 질식자궁절제술의 비교
박성남 ( Seong Nam Park ),홍기연 ( Gi Youn Hong ),김훈영 ( Hoon Young Kim ),김병륜 ( Byoung Ryun Kim ),이철 ( Cheol Lee ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.1
목적 SILS포트를 이용한 단일공법 복강경하 질식자궁절제술을 수술 결과들과 환자 만족도 측면에서 삼공법과 비교하기 위함이다. 연구방법 2010년 4월부터 2011년 5월까지 원광대학교병원에서 자궁경부와 자궁체부의 양성질환으로 복강경하 질식자궁절제술을 시행받은 총 138명의 환자를 대상으로 하였다. 각각의 수술법은 환자 동의 아래 직접 선택하였고, SILS을 이용한 단일공법 복강경하 질식자궁절제술이 시행된 환자 65명과, 삼공법으로 시행된 환자 73명이 대상이 되었다. 결과 수술시간(93.4±20.2분 vs. 95.1±28.7분, P=0.696), 혈색소변화(1.91±0.68 g/dL vs. 1.85±0.87 g/dL, P=0.667), 절제된 자궁 무게(288.2± 241.1 g vs. 311.8±268.3 g, P=0.225), 재원기간(5.9±0.9일 vs. 6.4±1.6일, P=0.063), 추가적인 포트삽입(1.5% vs. 0%, P=0.471), 개복술로의 전환(0% vs. 4.1%, P=0.098), 수술 후 통증(시각통증등급)은 두 군 간에 유의한 차이를 보이지 않았다. 하지만 수술 6주 후 조사된 환자 만족도는 단일공법군이 만족(52.3% vs. 34.2%, P=0.032)과 매우 만족(33.8% vs. 17.8%, P=0.031)에서 통계학적으로 유의하게 높았다. 결론 SILS포트를 이용한 단일공법 복강경하 질식자궁절제술은 복강경하 질식자궁절제술을 시행받는 환자에서 삼공법 복강경하 질식자궁절제술에 견줄만한 방법이며, 환자 만족도 측면에서는 삼공법 복강경하 질식자궁절제술에 비해 우수하다. Objective The purpose of this study was to compare surgical outcomes and patients` satisfaction between single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and conventional three-port access LAVH (TPA-LAVH) group. Methods A prospective analysis was performed in patients who underwent laparoscopically assisted vaginal hysterectomy at a Wonkwang University Hospital between April 2010 and May 2011, a total of 138 women were enrolled in this study. One of these procedures was chosen by patient and was performed with their consent. Sixty-fi ve women underwent SPA-LAVH using transumbilical SILS port access (SPA-LAVH group), and 73 women underwent conventional three-port LAVH (TPA-LAVH group). Results There were no statistical differences between groups in the patients` demographic characteristics, mean operating time (93.4±20.2 minutes vs. 95.1±28.7 minutes, P=0.696), postoperative changes in hemoglobin concentration (1.91±0.68 vs. 1.85±0.87 g/dL, P=0.667), weight of the resected uterus (261.7±205.3 g vs. 311.8±268.3 g, P=0.225), hospital stay (5.9±0.9 day vs. 6.4±1.6 day, P=0.063), the rate of using an additional trocar (1.5% vs. 0%, P=0.471), the rate of conversion to laparotomy (0% vs. 4.1%, P=0.098) and postoperative pain scores (visual analogue scale) for 48 hours. However, patients` satisfaction after 6 weeks later was signifi cantly greater in SPA-LAVH group than in conventional group, as evidenced by higher rate of fairly satisfactory (52.3% vs. 34.2%, P=0.032) and very satisfactory (33.8% vs. 17.8%, P=0.031). Conclusion SPA-LAVH using transumbilical SILS port access is comparable with TPA-LAVH in women undergoing LAVH. However, SPA-LAVH is better than TPA-LAVH in terms of satisfaction of patient.