• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.174-183
• /
• 2010

Purpose : The organisms causing peritonitis and their antibiotic sensitivities vary in different regions and centers, and these data are necessary to establish regional treatment guidelines. The aim of this study was to investigate the changes in incidence and characteristics of the organisms that cause peritonitis in children undergoing peritoneal dialysis (PD) during recent 10 years. Methods : We retrospectively collected and analyzed the data from medical records of 110 children on PD during the period from 2000 to 2010. Results : One hundred and forty episodes of peritonitis have occurred in 57 patients. The overall incidence of peritonitis was 0.43 episodes/patient year, and similar incidence have been maintained since 2003. Sixty percent of the patients experienced peritonitis within 1 year of PD, and all patients commencing PD in infancy experienced peritonitis. Gram positive (G (+)), gram negative (G (-)) organisms and fungi were cultured in 58%, 38%, and 4.1% respectively and cultures were negative in 13.6%. Staphylococcus was the most common G (+) organism, and Pseudomonas and Acinetobacter were 2 most frequent G (-) organisms isolated. Fifty-six percent of the G (+) organisms were sensitive to first generation cephalosporin and 91% of G (-) pathogens were sensitive to ceftazidime. Methicillin-resistance rate was not higher in children less than 2 years of age than in those more than 2 years. Conclusion : An additional breakthrough has to be made to further reduce the incidence of peritonitis. Treatment guideline customized for peritonitis in Korean children on PD need to be established through a nationwide co-work.

• Journal of Digital Convergence
• /
• v.10 no.9
• /
• pp.429-434
• /
• 2012

This study was performed to examine the relationship between dependence of elderly peritoneal dialysis patients and burden on family caregivers. The subjects for this study were 50 elderly patients on Continuous ambulatory peritoneal dialysis(CAPD) who were registered in a hospital in Seoul and 50 their family caregivers. The data were collected from April 4 to August 15, 2011. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of dependence was 139.6 which means their experience of high level dependence. The mean score of burden was 84.2 which means their family caregivers experience of high level burden. Positive correlation was found between dependence of elderly peritoneal dialysis patients and burden on their family caregivers (r=.61, p=.000). It is considered that the study emphasizes for the healthcare providers to recognize dependence as the important nursing issue for elderly CAPD patients. And it is necessary to develop an nursing intervention for decreasing dependence of elderly CAPD patients and burden on their family caregivers.

• Childhood Kidney Diseases
• /
• v.11 no.2
• /
• pp.255-263
• /
• 2007

Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

• Childhood Kidney Diseases
• /
• v.12 no.2
• /
• pp.213-220
• /
• 2008

Purpose : This study aims to verify the effectiveness of initial empirical antibiotic choice recommended by the International Society for Peritoneal Dialysis(ISPD) guide among Korean children. Methods : We have collected data on peritonitis from January 2001 to December 2007 in Samsung Medical Center. Results : Of the 42 patients, 48 episodes of peritonitis had occurred in 21 patients. The rate of peritonitis was one episode over 35.3 patient-months. Mean dialysis duration before peritonitis was 18.06$\pm$15.81 months. Gram-positive organisms accounted for 58.3% of all episodes. Of the gram-positive organisms, the most common pathogen was Staphylococcus aureus(29.2%), the next common pathogens were Coagulase negative staphylococcus(14.6%) and Streptococcus species(6.3%). 35.7% of gram-positive pathogens were resistant to 1st cephalosporin. However, in patients younger than 4 years old, 50% of gram-positive pathogens were resistant to 1st generation cephalosporin. 10 episodes of peritonitis were methicillin-resistant and were treated by vancomycin. Of the gram-negative organisms, E. coli was the most common (8.3%). 64.8% of all pathogens were sensitive to cephalothin or ceftazidime. Conclusion : The empirical therapy with 1st generation cephalosporin and ceftazidime can be also effective to peritoneal dialysis associated peritonitis in Korean children. However, in patients younger than 4 years old, glycopeptide should be considered as the first empirical therapy in Korean children.

• Journal of Veterinary Clinics
• /
• v.26 no.1
• /
• pp.23-28
• /
• 2009

Peritoneal dialysis (PD) is a clinical technique that therapeutically removes toxic solutes from body fluids and normalizes endogenous solutes whose aberrant concentrations disrupt normal physiology. This study retrospectively evaluated clinical outcomes and complications of PD in 20 dogs with renal failure. Blood works (total count of red blood cells (RBC), packed cell volume (PCV), the serum biochemical, and electrolyte values related to renal insufficiency) and complications associated with peritoneal dialysis, and clinical outcomes were recorded before and after PD. Additionally, creatinine reduction ratio (CRR) and urea nitrogen reduction ratio (URR) were calculated for evaluating the efficacy of PD. PD resulted in a significant (p < 0.05) reduction in blood urea nitrogen (BUN) concentration in 19 dogs, while a significant (p < 0.05) reduction in creatinine concentration in 17 dogs. The complications of PD were hypoalbuminemia (12/20, 60%), anemia (10/20, 50%), subcutaneous dialysate leakage (9/20, 45%), bacterial peritonitis (6/20, 30%), dialysate retention (5/20, 25%) and limb edema (4/20, 20%). This study demonstrated that PD was effective in reducing the magnitude of azotemia in dogs with renal failure especially in acute phase, although the complication rate was high but manageable.

• Journal of the Korea Convergence Society
• /
• v.12 no.6
• /
• pp.279-287
• /
• 2021

Purpose: The purpose of this study was to identify the relationships beween depression, self-efficacy and, treatment adherence in peritoneal dialysis patients. Method: Participants were 139 in a hospital located B city Korea. The data were examined using descriptive statistics, t-test, ANOVA, and Pearson's correlation with SPSS 25.0. Results: Self-efficacy had positive correlation with medication(r=.28 p=.001), fluid restriction(r=.23, p=.008), dietary restriction(r=.38, p<.001) in adherence. Depression had a negative correlation with medication(r=-.17 p=.046), dietary restriction(r=-.17, p=.043) Conclusion: Nursing starategies to strengthen the treatment adherence of patients with peritoneal dialysis need to focus on enhacing self-efficacy and alleviating depression.

• Proceedings of the KSCN Conference
• /
• 2004.05a
• /
• pp.417-417
• /
• 2004

지속성복막투석환자의 경우 투석에 의해 단백질 대사물질의 배설은 효과적으로 이루어지나 오랫동안의 만성신부전으로 인한 인의 배설 저하에 따라 골밀도가 대부분 저하되어 있으며 신성골이영양증을 수반하는 경우가 많다. 본 연구에서는 종합병원 신장내과 클리닉에 정기적 checkup을 받고 있는 지속성복막투석환자를 대상으로 골밀도를 측정하였으며 요추(L2-L4)와 대퇴부(femoral neck, trochanter)의 평균 골밀도의 T값이 모두 -1 미만인 군을 골감소증군으로 하였고(N=86) 1군데라도 T값이 -1 이상인 군은 정상군으로(N=32) 분류하여 영양소섭취량, 식행동, 우울정도에 따른 차이를 보고자 하였다.(중략)

• Journal of Chest Surgery
• /
• v.34 no.3
• /
• pp.270-273
• /
• 2001

신동맥 사이 또는 신동맥 상부에 위치하는 대부분의 복부대동맥 축착은 흉복부절개의 접근으로 수술한다. 우리는 경흉막 후복막 접근으로 개복을 하지 않고 단측단측 흉복부대동맥의우회술을 시행한 1례의 수술을 소개하고자 한다. 경흉막 후복막 접근은 흉복부대동맥의 시야가 매우 좋으며 개복을 할 때보다 더 쉽게 흉복부대동맥의 우회술을 할 수 있고 복강내 장기를 노출하지 않는 장점이 있다.

• Pediatric Infection and Vaccine
• /
• v.28 no.3
• /
• pp.168-172
• /
• 2021

Retroperitoneal infections are rarer than intra-abdominal infections in children; however, they can lead to significant morbidity in cases of missed diagnosis. We present a case of retroperitoneal abscess caused by extended-spectrum β-lactamase-producing Escherichia coli in a 10-year-old female adolescent who failed to show clinical improvement following empirical antibiotic therapy.

• The Korean Journal of Medicine
• /
• v.93 no.6
• /
• pp.575-581
• /
• 2018

Retroperitoneal fibrosis (RPF) is a rare disease characterized by marked fibro-inflammatory tissue in the retroperitoneum. Approximately 70% of cases of RPF are idiopathic, while the rest can be secondary to several other causes. The diagnosis is mainly obtained by imaging modalities such as computed tomography (CT). However, histological examination should be considered when the clinical manifestations and imaging studies suggest malignancy. In particular, in malignant diseases with retroperitoneal metastases, abnormal collagen plaques are formed from an exuberant desmoplastic response, which may not be distinguishable from RPF on CT scans. Therefore, even if CT suggests RPF, biopsy is essential to identify malignant disease because it typically results in a fatal prognosis. Here, we report a case of metastatic adenocarcinoma of unknown primary site that developed only in the retroperitoneum and was initially diagnosed as RPF based on CT findings.