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이차성 부갑상샘항진증 환자에서 부갑상샘 전절제술 후 조영증가 MDCT로 진단된 이소성 부갑상샘 1예
윤기철 ( Ki Chul Yoon ),김정엽 ( Jeong Yup Kim ),김정선 ( Jung Sun Kim ),박상원 ( Sang Won Park ),왕준광 ( Joon Kwang Wang ),이영모 ( Young Mo Lee ),전은실 ( Eun Sil Jeon ),표희정 ( Heui Jung Pyo ),유병희 ( Byung Hee Yoo ),권영주 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
We report a case of a 25-year old man with chronic kidney disease with secondary hyperparathyroidism who had persistent elevation of serum parathyroid hormone level after the immediate total parathyroidectomy and autotransplantation. To localize supernumerary (ectopic) parathyroid gland, we checked Tc-99m MIBI scintigraphy, MDCT and PET-CT. Contrast-enhanced MDCT showed a small strong enhancing lesion over left bracheocephalic vein, and PET-CT showed multiple brown tumors. We removed the supernumerary parathyroid gland and got a rapid drop of parathyroid hormone level.
만성콩팥병 환자의 25-Hydroxyvitamin D 상태에 대한 단일기관 연구
이영모 ( Young Mo Lee ),박상원 ( Sang Won Park ),김정선 ( Jung Sun Kim ),왕준광 ( Joon Kwang Wang ),김정엽 ( Jeong Yup Kim ),박만식 ( Man Sik Park ),표희정 ( Heui Jung Pyo ),권영주 ( Young Joo Kwon ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Purpose: We checked the levels of serum 25-hydroxyvitmain D (25OHD) in the patients with chronic kidney disease (CKD) to survey the status of vitamin D levels, to see the seasonal variations of 25OHD, and to evaluate the relationships among the levels of intact PTH, corrected calcium, and phosphorus. Methods: We defined vitamin D insufficiency and vitamin D deficiency as serum 25-hydroxyvitamin D levels between 20 and 30 ng/mL and below 20 ng/mL, respectively. 185 patients in a single center were enlisted who categorized into 3 groups, CKD2-3, CKD4, and CKD5 by eGFR using MDRD7 equation. To see the seasonal differences of the levels of 25OHD, we collected laboratory data two times per each patient during summer division (April to September) and winter division (October to March). Results: Prevalences of hypovitaminosis D were 42.8% (CKD2-3), 66.1% (CKD4), 92.8% (CKD5) in summer division and 48.7% (CKD2-3), 73.1% (CKD4), 92.8% (CKD5) in winter division. Seasonal difference of the levels of 25OHD was evident only in CKD stage 2-3 (p=0.018). Negative correlations were recognized between 25OHD and intact PTH (r=-0.2048, p<0.001), phosphorus (r=-0.1711, p=0.0011). Conclusion: Hypovitaminosis D is prevalent even in patients with early stages of CKD. The levels of 25OHD decreased significantly in winter division in patients with CKD stages 2-3. The levels of 25OHD were inversely correlated with those of intact PTH, phosphorus, respectively.
출혈성 신증후군 환자의 혈장 Atrial Natriuretic Polypeptide 농도 변화
박정의(Jeong Euy Park),차대룡(Dae Ryong Cha),김종웅(Jong Woong Kim),표희정(Heui Jung Pyo),이호왕(Ho Wang Lee),문정식(Jung Sik Moon),황흥곤(Heung Kon Hwang),김대중(Dai Joong Kim) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A Hemorrhagic fever with renal syndrome (HFRS) is characterized clinically by acute renal failure and pathologically by dense hemorrhage in the right atrium and medulla of the kidneys. To investigate whether there is any significant relationship between the changes of plasma atrial natriuretic polypeptide (ANP) and the clinical course, the plasma ANP was measured in 21 patients with HFRS. The plasma ANP was normal to low during the early oliguric phase (94.6±37.0 pg/ml), went up to a very high level (292.4±190.4 pg/ml) at the beginning of diuresis, then fell to a near normal level in a few days. The plasma renin activity (PRA) was very high during the early oliguric phase and fell rapidly in an opposite direction to the plasma ANP as the patients began diuresis. The rapid increase of plasma ANP and decrease of PRA seem to play an important role in the beginning of diuresis in HFRS.
Cuprophane과 Polysulfone 투석막의 생체적합성의 비교
이소영(So Young Lee),신진호(Jin Ho Shin),권영주(Young Joo Kwon),표희정(Heui Jung Pyo),한상엽(Sang Yup Han),오경식(Kyung Shik Oh),강영선(Young Sun Kang) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3
N/A Objective: It has been proposed that the contact between blood and dialysis membrane during hemo-dialysis therapy induces harmful reactions to patients. Membrane biocompatibility is the characteristic that makes less adverse reaction. We tried to compare the biocompatibility between Cuprophane and Polysulfone membranes. Methods: Nine chronic renal failure patients who have undergone maintenance hemrodialysis therapy with Hemophan membrane three times per week were included in this study. Cuprophane membranes were used in the first week: Hemophan membranes in the second week; Polysulfone membranes in the third week. Each membrane was used three times a week. On the day of third dialysis with the Cu-prophane membrane(first week) and Polysulfone membrane(third week), serial blood sampling was obtained from the afferent line at hemodialysis initiation, 15 minutes, 30 minutes, 60 minutes, 120 minutes and 30 minutes to measure serum complement activity(C3a, C5a), blood polymorphonuclear leukocyte and platelet count, and arterial oxygen pressure which have been regarded as biocompatibility par- ameters. The parameters measured during the first week(Cuprophane) and the third week(Polysulfone) were compared to evaluate the difference in bio-compatibility of both membranes. Results: 1) C3a desArg In both groups, the level of C3a desArg increased significantly from basal level and the Cuprophane group showed significantly higher level of C3a desArg than that of Polysulfone group. 2) C5a desArg : In both groups, the level of C5a desArg did not increased sigpificantly from basal level. Only at 30 minute after hemodialysis, Cupro- phane group showed significantly higher level of C5a desArg than that of Polysulfone group(p=0.037). 3) Polymorphonuclear leukocyte : In both groups, the polymorphonuclear leukocyte counts decreased significantly at 15 minutes and 30 minutes from basal level. The polymorphonuclear leukocyte count was lower in Cuprophane group than that of Polysulfone group at 15 minute after hemodialysis(p=0.001). 4) Platelet: In Cuprophane group, the platelet count was decreased significantly at 15 minute(p=0.004) but there were no difference in platelet counts between the two groups. 5) Arterial oxygen pressure Both group showed no consistent pattern of variation of oxygen pressure and there was no significant difference between the two groups. Conclusion: The biocompatibility of Polysulfone membrane was superior to the Cuprophane membrane with respect to the increased activation of complement C3a. decrease of polymorphonuclear leu-kocyte and decrease of platelet count.