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논문 : 금속성 응집제와 모노클로라민의 상호작용이 Polyamide계 RO막 성능에 미치는 영향
김경화 ( Kyung Hwa Kim ),홍승관 ( Seung Kwan Hong ),박찬혁 ( Chan Hyuk Park ),윤성로 ( Seong Ro Yoon ),홍성표 ( Seong Pyuo Hong ),이종화 ( Jong Hwa Lee ) 대한상하수도학회 2006 상하수도학회지 Vol.20 No.4
The bench-scale chlorine exposure study was performed to investigate the effect of pretreatment by free chlorine and monochloramine (NH2Cl) on the performance of RO membranes made of polyamide (PA). Feed monochloramination at 2㎎/L did not cause significant productivity loss compared to free chlorine. However, metal coagulants reacted with monochloramine, the PA membrane suffered from a gradual loss of membrane integrity by chlorine oxidation, which was characterized as a decrease in salt rejection. Especially, RO membranes exposed to alum coagulants with monochloramine revealed the salt rejection lower than those exposed to iron coagulants. XPS membrane surface analysis demonstrated that the chlorine uptake on the membrane surface increased and carbon peaks were shifted significantly when exposed to alum coagulants with monochloramine.
Cephalic arch stenosis에 삽입한 스텐트의 골절에 의한 동정맥루 기능이상
장진선 ( Jin Sun Jang ),윤성로 ( Seong Ro Yoon ),김현경 ( Hyun Gyung Kim ),안효준 ( Hyo Jun Ahn ),김영수 ( Young Soo Kim ),원유동 ( Yoo Dong Won ),김영옥 ( Young Ok Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3
Stent placement is widely used for vascular access stenosis in hemodialysis patients as well as coronary artery stenosis. As its complication, stent fracture is not uncommon and causes restenosis after stent placement in coronary artery stenosis, but it has been rarely reported in venous stenosis of hemodialysis patients. Here we report a case of arteriovenous fistula dysfunction due to stent fracture in the cephalic arch of a hemodialysis patient.
만성 C형 간염의 신이식 환자에서 페그인터페론 알파와 리바비린 병합치료로 치유한 1예
석민규 ( Min Gue Seok ),이태희 ( Tae Hee Lee ),윤성로 ( Sung Ro Yun ),황원민 ( Won Min Hwang ),윤세희 ( Se Hee Yoon ),최인수 ( In Soo Choe ),강성주 ( Seong Joo Kang ),홍주영 ( Ju Young Hong ),김대성 ( Dae Sung Kim ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2
Hepatitis C virus (HCV) infection is present in a high proportion of patients with kidney transplantation. Compared with uninfected kidney transplant recipients, HCV infected kidney recipient have higher prevalence of liver disease and worse allograft survival after transplantation. Interferon monotherapy before transplantation is standard therapy for HCV-infected kidney transplant candidates. If HCV infection is discovered after transplantation, interferon monotherapy is considered due to the limited critical situation. However, in this patient, who was a kidney recipient, HCV infection was treated after kidney transplantation with peginterferon-α and rivabirin. As a result, the patient achieved sustained virologic response.
임상 연구 : 한국인 혈액투석 환자에서 내경정맥의 해부학적 다양성에 대한 연구
김현경 ( Hyun Gyung Kim ),김형욱 ( Hyung Wook Kim ),윤성로 ( Seong Ro Yoon ),김병수 ( Byung Soo Kim ),송호철 ( Ho Cheol Song ),김영수 ( Young Soo Kim ),윤선애 ( Sun Ae Yoon ),김용수 ( Yong Soo Kim ),원유동 ( Yoo Dong Won ),김영옥 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3
목적: 혈액투석 환자에서 내경정맥은 쇄골하정맥이나 대퇴정맥에 비해 협착증이나 감염 등의 합병증 발생 빈도가 낮아 혈액투석 도관 삽입 시 우선적으로 선택된다. 내경정맥은 대부분 경동맥의 전방향-외측방향 (anterior-lateral)에 위치하고 있으나 일부 환자에서 이와는 다른 부위에 위치하고 있어 도관 삽입 시 시술 실패나 합병증의 원인이 될 수 있다. 저자들은 혈액투석 환자를 대상으로 내경정맥의 해부학적 위치 변이에 대해 조사하였다. 방법: 2007년 1월부터 2009년 2월까지 가톨릭대학교 의정부성모병원에서 급성신부전 혹은 만성신부전으로 도플러 초음파 유도 하에 혈액투석용 내경정맥 도관을 삽입한 358명의 혈액투석 환자를 대상으로 하였다. 도플러 초음파 검사를 통해 양측 내경정맥의 해부학적 위치를 경동맥을 기준으로 하여 조사하였다. 해부학적 위치는 경동맥의 전방-정중앙 방향 (anterior), 전방-외측부 방향 (anterior-lateral), 전방-내측부 방향 (anterior-medial), 그리고 경동맥과 평행한 외측부 방향 (lateral)으로 분류하였다. 또한 혈액투석용 도관을 삽입하는데 부적합한 내경정맥을 조사하였다. 결과: 대상 환자 358명의 평균 연령은 57±15세 (14-88세)였고, 남/여 비는 203/155명이었다. 내경정맥이 경동맥의 전방-외측부 방향에 위치한 환자는 좌, 우측이 각각 68.2%, 74.6%이었다. 그 외 전방-정중앙 방향이 좌, 우측 각각 23.7 %, 21.2%, 전방-내측부 방향이 좌, 우측 각각 7.0%, 2.5%, 외측부방향이 좌, 우측 각각 1.1%, 1.7%였다. 좌측 내경정맥에서 크기가 작아 도관 삽입이 부적합한 경우는 23예 (6.4%)였고 폐쇄된 경우는 없었다. 우측 내경정맥에서 도관 삽입이 부적합한 경우는 10예 (2.8%)로서 크기가 작은 경우 5예 (1.4 %), 폐쇄된 경우 5예 (1.4%)이었다. 결론: 한국인 혈액투석 환자의 약 1/3에서 내경정맥이 경동맥의 전방-외측부 방향 이외의 위치에 존재하는, 해부학적 위치 변이가 관찰되었고 (좌측 내경정맥 36.3%, 우측 27.1%) 일부 환자에서는 도관 삽입이 부적합한 내경정맥을 가지고 있었다. Purpose: The internal jugular vein (IJV) is a preferred site for central cannulation for hemodialysis (HD) because of its low incidence of central vein stenosis. Although anatomically IJV is commonly located on the anterior-lateral side of the carotid artery, some patients have anatomical variation of IJV, which can lead to difficulty and complication of cannulation. This study was performed to evaluate the incidence of anatomical variation of IJV in Korean HD patients. Methods: We enrolled 358 patients receiving IJV catheter cannulation for HD using doppler ultrasonography between January 2007 and February 2009. We examined the anatomical positions of IJV in relation to the position of carotid artery (CA) and incidence of anatomical variation on both sides. We also investigated incidence of inadequate IJV for cannulation, Results: The mean age of 358 enrolled patients was 57±15 years (14-88 years) (M:F=203:155). Anatomical variations of the left (Lt) and right (Rt) IJV position relative to the CA were found in 36.3% and 27.1%, respectively. Various anatomical variations of IJV position were discovered in the anterior side (Lt 23.7%, Rt 21.2%), anterior-medial side (Lt 7%, Rt 2.5%), and the lateral side (Lt 1.1%, Rt 1.7%) relative to CA. Inadequate Lt and Rt IJVs for cannulation, which can be too small sized or obstructed, were 6.4% and 2.8%, respectively. Conclusion: About one third of Korean HD patients had anatomical variations of IJV position relative to the CA. This study supports the use of doppler ultrasound guided technique for IJV cannulation in HD patients.
김현경 ( Hyun Gyung Kim ),김형우 ( Hyong Woo Kim ),김석환 ( Seok Hwan Kim ),윤유선 ( Yu Seon Yun ),이보희 ( Bo Hee Lee ),윤성로 ( Seong Ro Yoon ),김영수 ( Young Soo Kim ),윤선애 ( Sun Ae Yoon ),김영옥 ( Young Ok Kim ),원유동 ( Yoo 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Central venous stenosis or occlusion is commonly associated with placement of central venous catheters or devices. Although rare, central venous stenosis or occlusion may also develop without a history of previous central venous catheter placement. Here we report a case of central venous stenosis without a previous central catheter placement. A 76-year-old woman with hypertensive nephropathy was admitted due to deterioration of renal function. Tunneled cuffed catheter for hemodialysis was inserted in the right external jugular vein, and we intended to insert central venous catheter because of poorly functioning peripheral vein. But, left internal jugular vein was not cannulated. The patients had a history of pulmonary tuberculosis and chest x-ray revealed extensive calcified lesions mainly in left upper lung. Venography and CT angiogram showed complete occlusion at the confluent point of the left subclavian vein and left internal jugular vein, and left brachiocephalic vein by calcified lesion. The anterior cervical vein and jugular venous arch forming an anastomosis between the neck vein were marked dilated. The patient did not show any clinical symptoms and signs associated with central venous stenosis, and the central venous catheter functioned well, correction of central vein stenosis was not necessary. After the supportive care including temporary hemodialysis, the patient improved from renal dysfunction.