• The KIPS Transactions:PartB
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• v.17B no.6
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• pp.437-444
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• 2010

In this paper, we propose a method of analysing the relation between the patient's face color and his(her) kidney disease using image processing technology. This method is based on the ocular inspection which is one of the most famous diagnosis methods used in the oriental medical system. The way of processing and analysing the face image, which is for visualization and objectification of the color difference, is included. The objects are selected from the patients who suffer the kidney disease and use the hemodialyzer. Their facial images and clinical data are collected. From these data, we propose a hypothesis that the color of the patient's face is changed according to the patient's kidney state. At the same time, we present two algorithms of extracting the specific part of face which can identify the state of the patient's kidney and tracing the history of the color's change. This proposed method is evaluated through the practical experiments and their analysis.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.154-159
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• 2004

The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.739-742
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• 2010

Two stents were placed across the right subclavian vein due to stenosis of the right subclavian vein in a 40-year-old patient with chronic renal failure on hemodialysis. During the follow up period, one of stents migrated into the right ventricle inducing tricuspid valve insufficiency. Percutaneous stent removal had failed and the stent was removed by open heart surgery with Tricuspid valve repair with a good result, and then we report the case.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.799-802
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• 2008

Infection occurs very rarely in the sternoclavicular joint compared to other joints in the body. It occurs mainly in IV drug abusers, diabetics, chronic renal failure patients, septic patients and those with central vein catheters. In the early phase, it can be treated simply by antibiotics or incision, and drainage. However, when proper treatment is not begun. early, bone destruction can occur, and only en-bloc resection of the involved bone can cure it. To reduce the risk of recurrence, we advanced a pectoralis major flap into the resected area based on the feeding artery. We report a case of a patient with sternoclavicular osteomyelitis who was successfully treated using en-bloc resection and a pectoral advancement flap.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.749-754
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• 2004

Off-pump coronary artery bypass grafting (Off-Pump CABG) has been proven to have less morbidity and to facilitate early recovery. High-risk surgical patients may have benefitted by avoiding the adverse effects of the cardiopulmonary bypass. We compared the effectiveness of Off-Pump CABG with that of coronary artery bypass using cardiopulmonary bypass (On-Pump CABG) in high-risk patients. Material and Method: 682 patients (424 Off-Pump CABG and 258 On-Pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Patients who were considered high risk were selected High risk is defined as the presence of one or more of nine adverse prognostic factors. Data were collected from 492 patients in Off-Pump CABG and 100 in On-Pump CABG for risk factors, extent of coronary disease, and in-hospital outcomes. Result： Off-Pump CABG group and On-Pump CABG group did not show differences in their preoperative risk factors. We used more arterial grafts in Off-Pump CABG group (p < 0.05). Postoperative results showed that operative mortality (0.5% in Off-Pump CABG versus 2.0% in On-Pump CABG), renal failure (2.6% in Off-Pump CABG versus 7.0% in On-Pump CABG), and perioperative myocardial infarction (1.5% in Off-Pump CABG versus 1.0% in On-Pump CABG) did not differ significantly. However, Off-Pump CABG had shorter mean operation time (p<0.05), lower mean CK-MB level (p <0.05), lower rate of usage of inotropics (p < 0.05), shorter mean ventilation time (p <0.05), lower perioperative stroke (0% versus 2.0%), and shorter length of stay (p < 0.05) than On-Pump CABG. On-Pump CABG had more distal grafts (p<0.05) than Off-Pump CABG. Although Off-Pump CABG and On-Pump CABG did not show statistical differences in mortality and morbidity was more frequent in CABG. Conclusion: Off-Pump CABG reduces morbidity and favors hospital outcomes. Therefore, Off-Pump CABG is safe, reasonable and may be a preferable operative strategy for high-risk patients.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.68-74
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• 2005

Purpose : There is growing use of continuous renal replacement therapy(CRRT) for pediatric patients, but reports about the use and outcome of CRRT in children is rare in Korea. We report our experiences of CRRT in critically ill pediatric patients. Methods : We reviewed the medical records of 23 pediatric patients who underwent CRRT at Asan Medical Center between May 2001 and May 2004. We evaluated underlying diseases, clinical features, treatment courses, CRRT modalities and outcomes. Results : Ages ranged from three days to 16 years with a median of five years. Patients weighed 2.4 to 63.9 kg(median 23.0 kg; 10 patients ${\leq}20kg$). The underlying diseases were malignancy(nine cases), multiple organ dysfunction syndrome(five cases), hyperammonemia(four cases), acute renal failure associated with liver failure(three cases), dilated cardiomyopathy(one case) and congenital nephrotic syndrome(one case). Pediatric Risk of Mortality(PRISM) III score was $17.6{\pm}7.6$ and the mean number of failing organs was $3.0{\pm}1.7$. Duration of CRRT was one to 27 days(median : nine days). Eleven patients(47.8%) survived. Chronic renal failure developed in two cases, intracranial hemorrhage in one case, and chylothorax in one case among the survivors. PRISM III score and the number of vasopressor before the start of CRRT was significantly lower in the survivors($12.7{\pm}4.2$ and $0.9{\pm}1.1$) compared with nonsurvivors($22.1{\pm}7.8$ and $2.4{\pm}1.4$)(P<0.05). Conclusion : CRRT driven in venovenous mode is an effective and safe method of renal support for critically-ill infants and children to control fluid balance and metabolic derangement. Survival is affected by PRISM III score and the number of vasopressors at the initiation of CRRT.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.48-56
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• 2000

Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.8
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• pp.455-467
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• 2020

This study was a systematic review examining the effect of empowerment intervention studies among patients with chronic physical health conditions in Korea. The PICOT-SD (Participants, Intervention, Comparison, Outcomes, Timing of outcome measurement, Setting, Study design) strategy was applied. A total of 19 studies published between January 2000 and April 2020 were selected. Study participants were rheumatoid arthritis patients, hemodialysis patients, stroke patients, diabetes mellitus patients, chronic pulmonary disease patients, hypertensive patients, cancer patients, chronic kidney disease patients, and kidney transplantation patients, etc. A total of 17 studies were found to have presented a conceptual framework. Empowerment skills were participation, dialogue, experience, interaction, support, and problem solving, etc. The most frequently used dependent variables were self-care (n=13), empowerment (n=10), self-efficacy (n=7), and depression (n=5). Self-care, empowerment, and self-efficacy showed significant improvement among patients in at least 60% of the included studies. Based upon this review, there is evidence that empowerment intervention studies are an effective method to improve the health of patients with chronic physical health conditions. This study further suggests the development of an empowerment intervention program to verify the effects of the various variables identified in this study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.265-275
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• 2018

This study is a qualitative investigation that used Colaizzi's (1978) phenomenological method to evaluate the meaning and nature of the experience of dialysis of eight long-term (>30 years) hemodialysis patients with chronic renal failure. Data were collected from February 27, 2017 to May 30, 2017 by in-depth interviews. Respondents were then divided into three categories, 'entirely different life', 'getting back up again' and 'focusing on survival' with nine theme clusters and 22 themes. In general, patients initially experienced an entirely different life and overcame a difficult situation when beginning dialysis, then came to know methods for self-care, shared the experience of dialysis, and focused on survival while receiving dialysis over the long-term. Development of variety of education methods depending on long-term experience of dialysis and nursing care intervention to enable chronic patients to adapt to dialysis and continue their own self-management is necessary.

• The Journal of Internal Korean Medicine
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• v.24 no.4_2
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• pp.1046-1054
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• 2003

Renal Failure is called a disorder of kidney excretion induced by glomerulus filtration rate(GFR) decrease. GFR is measured by Blood Urea Nitrogen(BUN) and Cretinine in blood. This study is about Oriental diagnosis and treatment of Chronic renal failure(CRF) patients. We treated five cases which were diagnosed as CRF by using methods used in oriental medicine, the application of Youkmijihwang-tang(六味地黃湯加減). In most such cases, we concluded that the results turns better as the symptoms like fatigue and digestive disorder decreases and the decrease of BUN and Creatinine in blood as well.