• Journal of Korean Critical Care Nursing
• /
• v.15 no.1
• /
• pp.24-34
• /
• 2022

Purpose : This descriptive survey aims to identify the prevalence of factors associated with sarcopenia among hemodialysis patients. Methods : The study subjects were 137 patients with chronic kidney failure undergoing hemodialysis in three artificial kidney centers in B and Y cities. Data were collected from August 1 to September 30, 2020, using the SARC-F (Strength, Assistant walking, Rising from a chair, Climbing stairs, Falls) questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF), International Physical Activity Questionnaire (IPAQ-SF), Bioelectrical Impedance Analysis (BIA), and a grip dynamometer. The collected data were analyzed using t-tests, crossover analysis, and logistic regression using the IBM SPSS 23 program. Results : The prevalence of sarcopenia among hemodialysis patients, determined using the SARC-F questionnaire, was 16.1%. The associated factors of sarcopenia among hemodialysis patients were found to be gender (OR=6.44, p =.002), age (OR=1.07, p =.015), nutritional status (OR=10.37, p =.027), and albumin level (OR=0.10, p =.014). These findings are supported by an explanatory power of 46.3% (p =.597). Conclusion : The identified risk factors for sarcopenia in hemodialysis patients were; sex, age, nutritional status, and albumin level. The findings of this study can serve as clinical evidence for the development of an intervention program for preventing and managing sarcopenia in patients undergoing hemodialysis.

• Childhood Kidney Diseases
• /
• v.3 no.1
• /
• pp.64-71
• /
• 1999

Purpose : The protective effects of dietary protein on the progression of renal failure were studied in subtotally nephrectomized rats. Methods : Treatment groups were as follows; 5/6 nephrectomy and a normal protein ($18.5\%$) diet (NP); 5/6 nephrectomy and a low protein ($6\%$) diet (LP): 5/6 nephrectomy, a normal protein diet and converting enzyme inhibitor, enalapril (NPE): 5/6 nephrectomy, a low protein diet and enalapril (LPE). Both diets were isocaloric and had the same phosphorus content. Proteinuria, remnant kidney weight, mesangial matrix expansion score and glomerular volume were assessed at 4, 12 and 16 weeks after renal ablation. Results : LP and NP developed progressive hypertension. Eight weeks after surgery, LPE and NPE controlled hypertension. LP, LPE, and NPE had significantly less proteinuria than NP at 16 weeks (P<0.05). Kidney weight in LP were markedly less enlarged than NP (P<0.05). There was no difference in kidney weight between LPE and NPE. At 12 and 16 weeks the mesangial matrix expansion score was significantly less in LP, LPE, and NPE compared to NP (P<0.05). At 12 and 16 weeks mean glomerular volume was significantly less in LP compared to NP (P<0.05). At 12 and 16 weeks mean glomerular volume in LPE was significantly less compared to NPE. Conclusion : Dietary protein restriction afforded considerable protection from renal injury in the rat remnant kidney model. During the enalapril treatment, there was no additional protective effect of dietary protein restriction against the development of renal lesions.

• Journal of the Korean Arthroscopy Society
• /
• v.16 no.2
• /
• pp.167-174
• /
• 2012

Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.

• Journal of Chest Surgery
• /
• v.35 no.10
• /
• pp.705-711
• /
• 2002

The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

• The Korean Journal of Nuclear Medicine
• /
• v.29 no.4
• /
• pp.460-464
• /
• 1995

[ $^{201}T1/^{99m}Tc$ ] pertechnetate subtraction scintigraphy of the parathyroid gland was performed in a study of 8 patients with clinical and biochemical evidence of hyperparathyroidism for diagnosis and Localization of the lesion prior to sugery. 6 cases of parathyroid adenomas were accurately localized and 2 cases of diffuse hyperplasia associated with chronic renal failure(CRF) and multiple endocrine neoplasia (MEN) type I. $^{201}T1/^{99m}Tc$ pertechnetate scan was useful for patients with hyperparathyroidism, especially in definite localization preoperatively.

• Childhood Kidney Diseases
• /
• v.8 no.2
• /
• pp.176-185
• /
• 2004

Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.1
• /
• pp.55-60
• /
• 2002

Central pontine myelinolysis(CPM) and Extrapontine myelinolysis(EPM) are uncommon neurologic disorders associated with osmotic inequality between the extracellular fluid compartment and intracellular fluid compartment in the brain. Myelinolysis can occur in hyponatremia and after rapid correction of hyponatremia. It may be caused by various metabolic disturbances such as chronic alcoholism, malnourishment, cancer, chronic renal failure and organ transplantation. The authors reported a 43-year-old male patient who have received a kidney transplantation because of chronic renal failure due to diabetic nephropathy. The patient manifested psychotic symptoms such as delusion, loosened association, hallucination, inappropriate affect and aggressiveness as a sequele of CPM and EPM. He also showed neurocognitive impairment such as disorientation, memory impairment, decresed intelligence and aphasia. These manifestations are rare in CPM and EPM. We discuss the clinical features, diagnosis, course and management of the patient which may be clinically significant in the neuropsychiatric aspect especially at the consultation-liaison field.

• Journal of the East Asian Society of Dietary Life
• /
• v.13 no.5
• /
• pp.408-424
• /
• 2003

The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 6S.6% of hypertension patients with diastolic blood pressure over 90mmHg, 80% with systolic blood pressure over 140mmHg, 20% of hypercholesterolemia patients (serum cholesterol over 230mg/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200mg/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism. The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7mg/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4mg/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.lg of salt which were more than the recommended amount 2∼4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.

• Journal of Chest Surgery
• /
• v.38 no.10 s.255
• /
• pp.680-684
• /
• 2005

Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

• Childhood Kidney Diseases
• /
• v.12 no.1
• /
• pp.70-77
• /
• 2008

Purpose: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars. Methods: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature $\geq37.5^{\circ}C$, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR). Results: 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2) Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05). Conclusion: Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.