• The Korean Journal of Nuclear Medicine
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• v.21 no.1
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• pp.55-60
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• 1987

$Digoxin^{(R)}$을 복용하고 있지 않는 각27명의 만성 신부전 환자 및 신생아의 혈청에서 Gammacoat $Digoxin^{(R)}$ kit와 Amerlex Digoxin $RIA^{(R)}$ kit를 이용하여 digoxin과 교차 면역반응을 보이는 내인성 물질(이하 DLI: Digoxin-like Immunoreactivity)을 측정하여 다음의 결과를 얻었다. 1) Gammacoat $Digoxin^{(R)}$ kit로 측정시 27명의 만성 신부전 환자중 12명에서 신생아의 경우는 27명 전원에서 측정 하한치 이상의 DLI가 검출된 반면, Amerlex Digoxin $RIA^{(R)}$ kit로는 1명을 제외한 양 군의 전원에서 DLI가 관찰되지 않았다. 만성 신부전 환자에서 Gammacoat $Digoxin^{(R)}$ kit로 측정된 DLI와 혈청 BUN/Creatinine 값 사이에는 유의한 상관 관계가 없었다. 2) 만성 신부전 환자 및 신생아의 pooled sera에 가한 digoxin의 수거율은 각각 49%, 40%였다. 3) 만선 신부전 환자 및 신생아의 pooled sera에서 측정되는 DLI의 희석 curve는 정상 희석 curve와 다르다고 할 수 없었다. 4) 만성 신부전 환자의 pooled sera에서 측정되는 DLI의 16%, 그리고 신생아의 pooled sera 에서 측정되는 DLI의 20%가 trypsin에 sensitive하였다. 5) 만성 신부전 환자의 pooled sera에서 측정되는 DLI의 56%가, 그리고 신생아의 pooled sera에서 측정되는 DLI의 경우는 전체의 20%미만이 methylene chloride로 추출되었다. 이상에서 만성 신부전 환자 및 신생아의 혈청에서는 방사면역 kit의 증류에 따라 DLI가 검출되며 그 실체를 알기 위해서는 더욱 연구가 필요하다고 할 수 있었다.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.494-501
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• 1998

From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass(CPB). Because we were interested in new development of ARF(prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation(serum creatinine level less than 1.5 mg/dL) was registered in 198(74%) patients. Of these, 27(14%) patients showed postoperative renal complication, including 20(10%) patients classified as renal dysfunction(serum creatinine level between 1.5 and 2.5 mg/dL) and 7(4%) patients as acute renal failure(serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed(p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality(odd ratio 2.52∼11.25), along with cardiovascular(odd ratio 4.20) and respiratory(odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age(odd ratio 1), need for emergency operation(odd ratio 3.78), low-output syndrome(odd ratio 3.66), respiratory complication(odd ratio 1.30), need for deep hypothermic circulatory arrest(odd ratio 1.4). The 13 patients(7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.166-166
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• 1993

만성 신부전환자에서 isoniazid(INH)의 약동학적 변화여부를 검토하고 특히 N-acetylation 대사능의 억제 여부를 평가함으로써 만성신부전환자에서 적정 INH 항결핵 요법율 위한 기본자료를 제공코자 하였다. 본 연구는 pararell group 디자인에 의한 일차 연구와 sequential 디자인에 의한 2차연구로 진행하였다. 일차 연구는 37명의 정상 성인군과 14명의 만성신부전 환자군을 대상으로 INH 400 mg 경구 투여 후 INH 및 AcINH의 약동학적 성상을 비교하였다. 이차연구는 만성신부전 환자에서 신이식에 따른 INH의 acetylation 대사능의 변화를 관찰코자 1차연구에 참여하고 성공적인 신이식을 받은 환자 10명을 대상으로 INH 및 AcINH의 약동학적 검토를 재시행하였으며, 이러한 연구 방법을 통하여 만성 신부전 환자에서 Acetylation 대사능의 변화를 검토하였다.

• The Monthly Diabetes
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• s.261
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• pp.18-21
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• 2011

만성신부전증 환자 절반가량에서 당뇨병이 원인인 것으로 드러나면서 당뇨병성 신증에 대한 심각성이 제기되고 있다. 당뇨병에 의한 말기신부전은 생명을 이어가려면 투석과 신장이식이 불가피한 질병으로 일상에 불편을 가져오는 것은 물론 결국 사망에 이르게 하는 치명적인 질환이다. 중앙대학교 병원 신장내과 유석희 교수는 "당뇨로 인한 반성신부전은 다른 원인으로 인해 발생하는 신부전보다 생존율이 낮다"며 "당뇨병이 오래된 환자일수록 신장합병증이 발병률이 높아지는데, 당뇨병환자가 늘 혈당관리에만 매달리다보면 신장기능이 나빠지는 신호를 놓칠 수 있다"고 전했다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.4
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• pp.1728-1736
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• 2013

The purpose of this study is to identify prognostic predictors of postoperative acute renal failure(ARF) for the patient undergoing cardiac surgery. Retrospectively review the electronic hospital database at a A hospital from Jan 2008 to Dec. 2011. 483 patients were included in this study. They were divided into a occurrence of ARF group(n=59) and a non occurrence of ARF group(n=424). ARF occurred in 59 cases (12.2%). Multi-variable logistic regression analysis identified that preoperative risk factors include creatinine(OR 3.92, p=<.001), advanced age(OR 2.142, p=.015), female(OR 2.165, p=.015), hypertension(OR 2.513, p=.005), NYHA(New York Heart Association) class II(OR 3.081, p=.003), and III(OR 6.759, p=.004), and intraoperative risk factor includes blood transfusion(OR 3.753, p=<.001), and postoperative factors include bilirubin(OR 4.541, p=.028), creatine(OR 8.554, p=.003), and cardiac output(OR 0.214, p=.033) as a prognostic predictors. The development of postoperative ARF could be a reason for increase in rate of complication and mortality after cardiac surgery. therefore the prevention of ARF is of paramount importance and treatment strategies are urgently needed.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.588-590
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• 1999

It is now generalized to perform cardiac surgery in the patients with end-stage renal disease. The growing number of patients with chronic renal failure wake us up to the need to prepare for proper management. There are not only the prevalence of coronary artery disease, but also a great amount of valve dysfunction exist in this group. Peritoneal dialysis may be one of the obstacles for cardiopulmonary bypass but it is not a great hindrance in cardiac surgery with careful preparation and well organized perioperative care. The author has performed mitral valve replacement in a 33-year-old anuric female patient with chronic renal failure and severe mitral insufficiency. Preoperatively, the patient was kept in adequate fluid and electrolyte balance using peritoneal dialysis. Peritoneal dialysis continued and regulated according to the laboratory data in this patient during and after the surgery. She recovered well showing an uneventful course and was discharged on postoperative 1 th day.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.34-38
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• 2016

A 13-year-old castrated male mixed breed dog and a 12-year-old castrated male mixed breed cat were referred to the hospital for the treatment of pulmonary edema and azotemia at the same time. To resolve the pulmonary edema and azotemia, intermittent hemodialysis (HD) was performed using ultrafiltration (UF), and the pulmonary edema, azotemia, other electrolyte and acid-base imbalances were improved. This case study demonstrated that when we encountered pulmonary edema patients with diuretic resistance, severe electrolyte imbalance, and impaired renal function complicated by decongestive therapy using diuretics, UF therapy can be considered a life-saving intervention.

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.277-283
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• 2007

Purpose : Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. Methods : A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. Results : Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. Conclusion : Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.125-132
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• 2001

배경 및 목적: Stand A형 급성대동맥박리증의 박리 시발점이 수술치환부위 내에 있는 경우와 그렇지 않은 경우의 임상적 차이점을 분석하여 치료에 도움을 주고자 하였다. 방법: 1991년 3월부터 1999년 7월까지 본원에서 급성상행대동맥박리증으로 진단되어 상행대동맥치환술을 받은 40명의 환자를 대상으로 병력기록을 근거로 수술 소견 상 찢어진 부위를 발견한 환자 27명을 1군, 발견 못한 나머지 13명을 2군으로 나누고 환자의 술 전 상태와 수술소견 및 술후 경과의 임상적 차이점을 분석하였다. 결과: 1군에서 술전에 저혈압, 대동맥판막부전, 심허혈, 신부전 등이 더 많이 발생되었다. 수술 소견 상 대동맥근부 이상은 1군에서 많았다. 가성 내강 내 혈종은 2군에서 더 많이 관찰되었지만 통계적으로 유의하지는 않았다. 술후에 2군에서는 신부전이 더 많이 발생하였고 술후 출혈로 인한 재수술은 1군에서 더 많았다. 조기 수술사망은 1군에 6명으로 사망률은 22.2%이었고 2군에는 사망 례는 없었다. 결론: 본 연구를 통하여 상행대동맥에서 내막 파열이 발견된 1군에서는 2군에 비해 술전 상태가 불량하였고 대동맥판막 병변으로 수술이 복잡해져 사망률이 높다고 생각된다. 반면 원위부 하행대동맥에서 박리가 진행되어 상행대동맥으로 이어진 2군에서는 1군에 비해 순환 장애로 인해 술후에 신부전이 더 많이 발생되었다. 결론적으로 상행대동맥내막에 파열점이 없었던 군에서 수술 예후는 상행대동맥내막에 파열점이 있는 군보다 더 좋았다.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.402-408
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• 1998

A 56-year old female underwent total aortic arch replacement March 1995, because of an expanding chronic Debakey type I aortic dissection. This aortic dissection had an intimal tear at the origin of the right carotid artery. Retrograde and antegrade propagation of dissection resulted in aortic arch blood flow separation and expanding pseudolumen to the abdominal aorta. Sudden anuria(ARF) developed 3 hours later postoperatively and renal doppler ultrasonography and aortography showed diminished blood flow of renal arteries. We performed balloon aortic dilatation but failed. She could be restored good renal flow after intimal flap fenestration resection and thrombectomy of the abdominal aorta. This patient could be discharged in a state of mild CRF after 2 months of ICU care for respiratory and renal failure.