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김기원(Ki Won Kim),안규리(Cu Rie Ahn),오국환(Kook Hwan Oh),이경이(Kyung Yi Lee),이중건(Jung Geon Lee),오명돈(Myung Don Oh),김연수(Yon Su Kim),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),장인진(In Jin Jang),신상구(Sa 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.1
N/A Background : Tuberculosis is more prevalent in dialysis patients than in the general population, and more difficult to make a diagnosis, and often leads to death, Moreover, extra-caution is needed in prescribing anti-tuberculosis medications as dose modification is frequently needed in patients with renal insufficiency. Several pharmacokinetic studies have been performed for antimycobacterial regimens in patients with renal insufficiency, including under hemodialysis. However, the anti-mycobacterial regimens of patients on peritoneal dialysis have been made based on empirical methods because of few pharmacokinetic studies. Methods : To elucidate the pharmacokinetic profiles of anti-mycobacterial regimens for peritoneal dialysis, we measured both plasma and peritosol concentrations of anti- tuberculous drugs including isoniazide, rifampin and pyrazinamide in 9 patients maintained on chronic ambulatory peritoneal dialysis(CAPD). Results : After a conventional oral dose of anti-tuberculosis medication, their plasma concentrations were in the therapeutic range, but the peritosol concentration of rifampin was below the therapeutic range. Conclusion : No dose adjustments are required for isoniazid, rifampin and pyrazinamide for the treatment of systemic or peritoneal tuberculosis in CAPD patients. On the contrary, oral rifampin is not expected to be effective in the treatment of tuberculous peritonitis, because of its low peritosol concentration. (Korean J Nephrol 2002; 21(1):67-73)
경구 Colchicine 의 과복용에 의한 전신적 독성 1 예
김현규(Hyeon Kyu Kim),김원석(Won Seok Kim),김근호(Gheun Ho Kim),안규리(Cur Le Ahn),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),오미혜(Mee Hye Oh),지제근(Je Geun Chi) 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A administered orally over 7 days for an acute attack of gouty arthritis. The resultant multi-organ diseases, including gastrointestinal toxicity, acute renal failure, bone marrow suppression, sepsis, acute respiratory failure, hepatic dysfunction, myopathy, and alopecia, were managed sucessfully with fluid resuscitation, antibiotic treatment, mechanical venatilation, hemodialysis and other supportive therapies. For pathologic confirmation of colchicine myopathy, we performed quadriceps femoris muscle biopsy and electron microscopic examination, in which some sarcolemmal vacuoles were found but sarcolemmal membranous bodies characteristic to colchicine myopathy were not seen. We report the first case of colchicine toxicity in Korea with literature review and emphasize that severe systemic toxicity can be induced by inadvertent oral administration of colchicine in patients with risk ractors such as renal insufficiency, hepatic dysfunction, or old age.
이세한(Se Han Lee),이정표(Jung Pyo Lee),김세중(Se Joong Kim),김성균(Seong Gyun Kim),김연수(Yon Su Kim),하종원(Jong Won Ha),안규리(Curie Ahn),김승협(Seung Hyup Kim),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이현순(Hyun Soon Lee),이정상( 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.5
Renal lymphangiectasia is a rare cystic kidney disorder. This disorder has been termed renal lymphangioma, renal lymphangiomatosis, pararenal lymphatic cyst. We report on a 32-year-old man admitted with complaints of abdominal discomfort, in whom unilateral renal lymphangiectasia with renal vein thrombosis was diagnosed. Abdominal computed tomography revealed left perirenal fluid collection with multiloculation. Left renal vein was completely obliterated due to thrombosis and inferior vena cava (IVC) was partially obliterated. Perirenal fluid collection and renal vein thrombosis were treated initially with percutaneous drainage and anticoagulation therapy. The biochemical features of the drained fluid were compatible with lymphatic fluid. Since there was no decrease in the amount of daily drainage, left nephrectomy and IVC thrombectomy was performed on the 34th day of hospitalization. Left kidney was enlarged (15×10×18 ㎝, 750 g) and composed of numerous smooth, thin-walled cysts. Pathologic diagnosis was renal lymphangiectasia.
김근호(Gheun Ho Kim),조종태(Jong Tae Cho),양원석(Won Suk Yang),김윤구(Yoon Goo Kim),한진석(Jin Suk Han),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee) 대한내과학회 1991 대한내과학회지 Vol.40 No.1
N/A In order to observe the sequential changes of the urine electrolytes and urine anion gap (UAG) during the course of Korean hemorrhagic fever (KHF), we measured spot urine electrolytes and urine osmolality in 16 patients with KHF, and calculated UAG from them as an index of the renal tubular dysfunction. Also, we observed the relationships between the initial value of spot urine anion gap and the clinical findings and severity in each patient. Spot urine sodium and potassium concentrations were higher in the early phases (oliguric to early diuretic phase) than in the late phases. Spot UAG values were highest in the oliguric phase and decreased sequentially. Urine osmolality decreased sequentially from the oliguric to the convalescent phase. The initial spot UAC values of each patient were related with the clinical severity in the early phases and with the degrees of hyponatremia, azotemia and metabolic acidosis as well. Spot UAG was elevated when spot urine sodium or potassium concentration was higher, and was lowered when urine osmolality was decreased or polyuria occurred. From the above results, we concluded that the changes of spot UAG through the phases might be related with the renal tubular damage in KHF.
소영(Young So),이동수(Dong Soo Lee),현인영(In Yong Hyun),강원준(Won Jun Kang),이원우(Won Woo Lee),정준기(June Key Chung),김성권(Suhng Gwon Kim),이명철(Myung Chul Lee),이정상(Jung Sang Lee),고창순(Chang Soon Koh) 대한내과학회 1997 대한내과학회지 Vol.53 No.2
N/A Objectives: It is suggested that frequency of low turnover bone disease is much higher in diabetic renal osteodystrophy. We tried to find out whether bone scan images show less 99mTc-MDP uptake in diabetic renal ostwdystrophy. Methods: We compared bone scan images of renal failure patients with and without diabetes. The number of patients studied was 134 (43 patients had diabetes and 91 patients did not). Two experienced nuclear physicians read Tc-99m-MDP bone scan twice separately and gave the score either 1 or 0 on 6 areas; axial skeleton, long bone, skull & mandible, periarticular areas, costochondral junction and sternum. The means of summed scores were compared using Students t-test. To exclude the effects of sex, age and serum creatinine concentration, we analysed these factors together with the effect of diabetes using analysis of covariance. We also interpreted on bone scan images, as classical renal osteodystrophy, renal failure and normal. Results: The intra- and interobserver variations were very low. Patients of diabetes group showed significantly lower mean of summed score(2.0±0.95) compared to patients of non-DM group(3.3±1.2). Analysis of covariance revealed that lower score of diabetes group was independent of sex, age and serum creatinine level. of diabetes group, 2 nuclear physicians interpreted bone scans as classical renal osteodystrophy in 60% and 56%, However, they interpreted bone scans of non-DM group in 80%, 88%(between-observer k: 0.74). Chi-square test showed that this difference was statistically significant (p<0.05). Conclusion: Bone scan image of diabetic renal osteodystrophy showed less 99mTc-MDP uptake, which meant low osteoblastic activity. This influence of diabetes upon bone uptake was significant after considering other confounding factors.
반월형 사구체신염이 병발된 T 림프구 기원의 원발성 간림프종 1 예
김용일,정철원,이현순,김홍빈,박동영,이효석,김성권,소영,김노경,김병관,김선미,이기형,허대석 대한내과학회 1997 대한내과학회지 Vol.53 No.1
The primary lymphoma of the liver is a rare disease. We report a case of primary hepatic T-cell lymphoma associated with crescentic glomerulonephritis. The case, a 53-year-old male was presented with a 2-year history of hepatic mass and a 1-month history of foamy urine, rapidly progressive azotemia, and oliguria. The kidney biopsy revealed diffuse crescentic glomerulonephritis. The result of immunohistochemical study of liver biopsy specimen was consistent with non-Hodgkin's lymphoma in T-cell lineage. Because renal function was deteriorated rapidly and there were signs of volume overload, hemodialyses were performed. Although the patient received 2 cycles of combination chemotherapy with CHOP(cyclophosphamide, vincristine, prednisolone, and doxorubicin), he did not respond and died of sepsis.