• Title/Summary/Keyword: 말기 질환

Search Result 128, Processing Time 0.028 seconds

Chronic Renal Failure in Children: A Nationwide Survey in Korea (소아 만성 신부전증의 전국적인 조사연구)

  • Kim, KyoSun;Jeon, Jeong-Sik;Lee, Ik-Jun;Go, Dae-Gyun;Lee, Gyeong-Il;Yun, Hui-Sang;Gu, Ja-Hun;Go, Cheol-U;Jo, Byeong-Su;Kim, Jun-Sik;Son, Chang-Seong;Yu, Gi-Hwan;An, Yeong-Ho
    • Childhood Kidney Diseases
    • /
    • v.4 no.2
    • /
    • pp.92-101
    • /
    • 2000
  • Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

  • PDF

Single Lung Transplantation in the Patient with End-stage Lymphangioleiomyomatosis -Report of 1 case- (말기 폐림프관 평활근종증 환자에서의 단측 폐이식술)

  • 양희철;최용수;김진국;심영목;김관민
    • Journal of Chest Surgery
    • /
    • v.37 no.12
    • /
    • pp.1015-1018
    • /
    • 2004
  • Lymphangioleiomyomatosis (LAM) is a rare disease in women in childbearing age leading to progressive respiratory failure. LAM is characterized by an abnormal harmartomatous proliferation of smooth muscle cells surrounding the blood vessels, lymphatics and airways in the lung. This proliferation leads to airway obstruction, cystic alveolar change and lymphatic obstruction. Patients present with dyspnea, pneumothorax, cough, chest pain, hemoptysis, and chylous effusion. Although lung transplantation is the only therapeutic modality in end-stage LAM with respiratory failure, there has not been any report of successful treatment in Korea. We report one case of successful left single lung transplantation in a 40 year old woman suffering from end-stage LAM.

다양한 특징 파라미터와 선형변별분석을 이용한 후두암의 선별검사

  • 이원범;왕수건;권순복;전경명;전계록;김수미;김형순;양병곤;조철우
    • Proceedings of the KSLP Conference
    • /
    • 2003.11a
    • /
    • pp.149-149
    • /
    • 2003
  • 후두질환 감별용 음성 분석방법인 multi-dimensional voice program (MDVP)으로 분석이 불가능할 정도로 주기성이 크게 훼손된 후두암 말기의 음성 에 대하여 효과적인 감별을 하기 위하여, 몇 가지 켑스트럼(cepstrum) 파라미터를 비롯하여, 주기성 및 그 동요 정도, 영교차율(zero-crossing rate, ZCR), 스텍트럼 중심 (spectral centroid, SC) 등 다양한 특징 파라미터를 이용한 감별 실험을 수행하였다. 후두암 감별 실험을 위해 부산대학교 병원 이비인후과에서 수집한 정상 남자 음성 데이터 50개, 양성 후두질환 남자 음성 데이터 50개 및 남성 후두암 환자 음성 데이터 105개를 사용하였다. 음성 데이터는 단모음 /아/ 발성만을 사용하였고, 정상인과 양성후두질환 환자, 그리고 MDVP 분석이 가능한 후두암 환자 음성 데이터 중 2/3는 학습에, 나머지 113은 감별실험에 사용하였다. 후두암 감별을 위한 분류기로는 Gaussian Mixture Model(GMM) 분류기를 사용하였으며, 이때 모델의 복잡도를 표현하는 mixture 수는 1에서 10까지 가변시키면서 가장 좋은 성능을 나타내는 값으로 결정하였다. 또한 모든 실험에서 켑스트럼 분석의 차수는 동일하게 12차로 고정시켰다. (중략)

  • PDF

Hospice and Palliative Care in End Stage Liver Disease (말기 간질환 환자에서의 호스피스 완화의료)

  • Kim, Moon Young
    • Journal of Hospice and Palliative Care
    • /
    • v.20 no.3
    • /
    • pp.167-172
    • /
    • 2017
  • End-stage liver disease (ESLD) is a terminal condition of cirrhosis which cannot be treated without liver transplantation. Thus, it is natural for patients to consider hospice/palliative care (HPC). Since the recent legislation of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life (Act No. 14013) in Korea, the practicality of this law has become an issue. The criteria for HPC should be defined with consideration to how the severity of each ESLD complication may vary by individual patients. Generally, patients qualify if they have an intractable condition despite aggressive treatment such as the hepatorenal syndrome, hepatic encephalopathy or variceal hemorrhage. However, the option of liver transplantation should be sufficiently discussed with patients and their families before making a decision on HPC. The evaluation of which ESLD patients should receive HPC should be based on a long-term doctor-patient relationship and sufficient objective data. Therefore, a multidisciplinary approach and mutual consultation among cirrhosis specialists and doctors with other expertise are essential to offer optimal and balanced treatments between liver-specific treatment and HPC. Discussed in this review are adequate criteria for HPC and special considerations for ESLD at the point of HPC.

Clinical Aspects of Pulmonary Radioactivity Observed in Radiocolloid Liver Scintigraphy (간 스캔에서 관찰되는 폐 방사능에 관한 임상적 고찰)

  • So, Young;Lee, Kang-Wook;Lee, Heon-Young;Lee, Won-Woo
    • The Korean Journal of Nuclear Medicine
    • /
    • v.36 no.3
    • /
    • pp.185-194
    • /
    • 2002
  • Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

특집 : 올바른 신장합병증 관리를 위해 - 신장합병증의 치료 I - 혈액투석과 복막투석으로 치료

  • Kim, Min-Ok
    • The Monthly Diabetes
    • /
    • s.261
    • /
    • pp.22-23
    • /
    • 2011
  • 당뇨병은 전 세계적으로 급격하게 증가하면서 심각한 대혈관 및 미세 혈관 합병증들의 원인이 되고 있으며 대다수 선진국에서 당뇨병은 만성 신질환 및 말기 신부전의 가장 중요한 원인으로 알려져 있다. 당뇨병성 신증은 단백뇨를 특징으로 하며 30% 정도의 환자에서는 혈뇨도 관찰된다. 그래서 당뇨병성 신증의 발병 검진은 미세알부민뇨 검사로 하는 것이 가장 이상적이며 제 1형 당뇨병환자는 일반적으로 당뇨병 발병 5년 이후에 하며 위험인자가 있는 환자는 더 조기에 한다. 제 2형 당뇨병환자는 당뇨병 진단 시점부터 매년 하는 것을 원칙으로 한다.

  • PDF

특집 : 올바른 신장합병증 관리를 위해 - 전문의 인터뷰 "신장 나쁘면 미리 준비해야 합니다" - 중앙대학교병원 신장내과 유석희 교수

  • Kim, Min-Gyeong
    • The Monthly Diabetes
    • /
    • s.261
    • /
    • pp.18-21
    • /
    • 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.

  • PDF

Contvalateral Single Lung Re-transplantation in the Patient with Lymphangioleiomyomatosis due to Graft Failure (폐림프관 평활근종증 환자에서 이식편 기능부전에 의한 반대쪽 단측폐 재이식수술)

  • Joung Eun-Kyu;Hwang Jung-Joo;Kim Jae-Ho;Youn Young-Nam;Lee Doo-Yun;Paik Hyo-Chae
    • Journal of Chest Surgery
    • /
    • v.39 no.4 s.261
    • /
    • pp.323-327
    • /
    • 2006
  • Lymphangioleiomyomatosis (LAM) is a rare disease in women of childbearing ages that eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic modality in end-stage LAM. While single-lung transplantation is the preferred operation, the graft failure or recurrence of LAM was reported. We performed a single lung transplantation on a 36-year-old woman suffering from respiratory failure due to lymphangioleiomyomatosis. After a 1-year follow up, the patient was readmitted because of graft failure with collapsed transplanted lung. The lung volume reduction surgery (LVRS), tracheostomy and ventilator care were performed. However, neither the medical nor surgical treatment had any effect. Subsequently, we performed a contralateral single lung re-transplantation and had a good postoperative results.

The Influence of Vocal Cords and Intensity by Hemodialysis in End Stage Renal Disease (말기 신부전 환자에서 혈액투석 치료가 성대 및 강도의 변화에 미치는 영향)

  • Kim, Bong-Hyun;Cho, Dong-Uk;Kang, Eung-Taek
    • The Journal of Korean Institute of Communications and Information Sciences
    • /
    • v.35 no.7B
    • /
    • pp.1066-1072
    • /
    • 2010
  • Kidney diseases rates in modern Korean society, which is entering an aging society, are growing. These diseases diagnosed at early stage can be cured with the drug or dietary treatment. If, however, at worsening stage, kidney dialysis or transplant is needed. In this context, we analyzed the relationship between kidney and voice by measuring and analyzing the changing rate of the vocal chord and intensity according to hemodialysis. For this, we collected voice samples before and after hemodialysis, and compared and analyzed them through application of vocal analytical element. Namely, based on oriental medical diagnosis theory that voice is quieted down when kidney is abnormal, we collected voice samples before and after hemodialysis, and applied trembling and intensity analysis of vocal chord.

Experience in Acceptance of Hospice by Patients with Terminal Cancer : A Phenomenological Research (말기암 환자의 호스피스 수용 경험: 현상학적 연구)

  • Kwak, Su Young;Lee, Byoung Sook
    • Journal of Korean Academy of Nursing
    • /
    • v.43 no.6
    • /
    • pp.781-790
    • /
    • 2013
  • Purpose: The purpose of this study was to further understanding of the experience in acceptance of hospice by patients with terminal cancer and to explore the structure of this experience. Methods: A phenomenological methodology was used for the study. Participants were nine patients who were admitted to the hospice unit of a university hospital. In-depth interviews were done for data collection and the data were analyzed using Colaizzi's method. Results: Four categories, eight theme clusters and 18 themes were identified for the experience in acceptance of hospice by patients with terminal cancer. The three categories were 'Hope for a comfortable death', 'Overcoming barrier of prejudice about hospice', 'Incessant craving for life', 'The last consideration for self and family' Conclusion: While accepting the hospice care, participants experienced inner conflict between giving up medical treatments that prolong life and choosing a comfortable death, and also experienced an incessant craving for life. By accepting hospice care, they showed a human dignity that entails careful concerns for both self and family members.