• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.202-210
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• 2012

Methoxy polyethylene glycol-epoetin beta (MPG-EPO), a continuous erythropoietin receptor activator, is a new erythropoiesis-stimulating agent with a long half-life. The purpose of this prospective study is to assess the effects of once-monthly subcutaneous MPG-EPO on hematological responses and nutritional status in peritoneal dialysis patients. Forty four patients undergoing stable peritoneal dialysis were enrolled into the study. Darbepoetin alfa therapy, in peritoneal dialysis patients, was converted to the monthly administration of subcutaneous MPG-EPO for 6 months. The starting dose of MPG-EPO was based on the previous weekly dose of darbepoetin alfa. The dose adjustments were performed to maintain the hemoglobin (Hb) levels in a target range of 10.5-11.0 g/dL. If the Hb levels exceeded 11.0 g/dL, MPG-EPO was temporarily interrupted for 1 month. The mean Hb levels were stable with the values of $9.5{\pm}1.1$ g/dL at baseline, and $10.4{\pm}0.9$ g/dL at the 6th month after conversion. The mean differences in the changes of Hb levels between the baseline and the 6th month were $0.9{\pm}1.4$ g/dL, which was statistically significant. However, the mean differences of iron, transferrin saturation and ferritin concentrations were not significant. It did not show significant differences in the changes of the nutritional parameters. These results suggest that the once-monthly subcutaneous administration of MPG-EPO for 6 months effectively maintains the Hb levels and nutritional status in peritoneal dialysis patients. Taken together, the once-monthly subcutaneous administration of MPG-EPO was practical and might improve the clinical compliance for the management of renal anemia in peritoneal dialysis patients.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.160-164
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• 2008

A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.

• Journal of Yeungnam Medical Science
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• v.29 no.2
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• pp.121-124
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• 2012

Valaciclovir is metabolized to acyclovir after ingestion and thereafter exerts its antiviral activity. Because of its superior pharmacokinetic profile, it has quickly replaced acyclovir in the treatment of herpesvirus infection. Neurotoxicity caused by valaciclovir has been reported, however, among patients with pre-existing impaired renal function. This paper reports a case of neurotoxicity of valaciclovir in a patient with end-stage renal disease who was undergoing continuous ambulatory peritoneal dialysis (CAPD). A 67-year-old female on CAPD took 500 mg of valaciclovir twice for herpes zoster. After she took her second dose orally, she developed confusion and disorientation, along with involuntary movements. Her mental confusion progressed to a coma. Discontinuation of valaciclovir showed no rapid improvement. There- fore, hemodialysis was started. After two sessions of hemodialysis, the patient became alert; and after four sessions of hemodialysis, her neurological abnormalities were completely reversed. In conclusion, valaciclovir can induce life-threatening neurotoxicity, especially in CAPD patients, even with appropriate dose reduction, which can be effectively managed by hemodialysis.

• Korean Journal of Veterinary Pathology
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• v.7 no.1
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• pp.59-62
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• 2003

A two-year-old pointer dog showed a liver failure for long duration. By radiographic examination, barium or gas filled intestine was detected in the pericardium. Although liver function was bad, surgery was tried to repair hernia due to the poor prognosis. Intestine, omentum, and liver with gall bladder were dislocated in the pericadial sac by peritoneopericardial diaphragmatic hernia (PPDH). Intestine was easily removed from pericardial sac but omentum and liver were not because of strong adhesion to the pericardial sac. Postmortem examination was performed because the patient was died after surgery. Grossly, herniated liver whose right medial lobe was strongly adhered to the pericardial sac was severely congested with fibrin adhesion on the surface. Hypoplastic abnormally up-located heart had a fissure in the outside of lower right venticulum bordered apex and depressed large vessels including vena cava and aortic arch into the base of heart. It was suggested that formation of a fissure and depression of vessels might be due to the pressure of herniated organs. In the veterinary literature as far as we knew, PPDH associated with liver failure due to adhesion of liver to the pericardial sac has not been reported.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.332-335
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• 2010

Solitary fibrous tumor is an uncommon submesothelial mesenchymal neoplasm that primarily arises from the pleura. Most solitary fibrous tumors have a benign course, and the single most important predictor of the clinical outcome is the ability to excise the entire lesion. We experienced a case of CSF leakage through a subarachnoid-pleural fistula after resection of a malignant solitary fibrous tumor and the involved rib. We detected CSF leakage via performing CT myelography and we treated this case with hemilaminectomy and dura repair.

• Korean Journal of Clinical Pharmacy
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• v.24 no.3
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• pp.206-212
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• 2014

Objectives: This was to evaluate the current usage of three erythropoietin stimulating agents (ESA) and their efficacy for management of anemia in peritoneal dialysis (PD) patients with chronic kidney disease. Methods: It was a retrospective comparative study through review of electronic medical records of chronic kidney disease patients undergoing PD at a tertiary teaching hospital from January 1998 to June 2013. Results: Average administration frequency was 1.66 times/week in EPO group, 0.75 times/week in DA group, and 0.19 times/week in MPG-EPO group. At the first 4 weeks, there were significant differences in mean hemoglobin levels between EPO and DA groups ($9.25{\pm}1.28g/dL$, $10.02{\pm}0.95g/dL$ each, p = 0.018) and also in hemoglobin response rates (10.0%, 45.2% each, p = 0.008), but since after 4 week, there had been no significant differences. There also showed no significant differences in achievement of hemoglobin target between the two groups. When converted to MPG-EPO in EPO/DA groups, there showed a slight increase in hemoglobin levels of both groups. MPG-EPO was the highest compared with two other drugs by the average cost based on the average weekly dose. Conclusion: EPO, DA, and MPG-EPO showed similar effects in treatment of anemia of PD patients based on hemoglobin target range (11.0~12.0 g/dL) which NFK-K/DOQI guidelines suggest. Though the average cost of MPG-EPO was higher than the other two drugs, the number of PD patients using MPG-EPO has increased and it is thought that long half-life and low administration frequency of MPG-EPO have improved the compliance of PD patients who have to self-administrate.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.706-716
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• 2000

The purpose of this study was to provide fundamental data for nursing intervention by assessing self-esteem and quality of life(QL) in patients on hemodialysis and peritoneal dialysis. The subjects of this study were 60 patients on hemodialysis at H university medical center in Seoul and 56 patients on peritoneal dialysis at B company. The analysis was done by using t-test, ANOVA, Scheffe and Stepwise multiple regression. The results were as follows: 1. The average self-esteem score was significantly higher in patients on hemodialysis (27.98) than in patients on peritoneal dialysis (25.64). And there were no statistically significant differences between patients on hemodialysis(128.45) and patients on peritoneal dialysis(122.83) in the scores on QL. Among four factors of QL, hemodiaysis patients showed higher score than peritoneal dialysis patients in all factors. But, only family had statiscally significant differences. Also family showed the highest score in both groups, but psychomental showed the lowest score. 2. In patients on hemodialysis, self-esteem was significantly different by occupation(t=3.122, p=.003) and in patients on peritoneal dialysis by age(F=4.450, p=.007), education level(F=7.458, p=.001) and occupation (t=2.491, p=.017). Also in patients on hemodialysis, QL was significantly different by occupation(t=2.223, p=.033) and in patients on peritoneal dialysis by education level(F=4.007, p=.024), and occupation (t=2.806, p=.007). 3. Self-esteem accounted for 36.3% of variance in QL and monthly income accounted for an additional 6.1% of QL in hemodialysis patients by means of stepwise multiple regression analysis. In peritoneal patients, self-esteem accounted for 65.1% and monthly income accounted for an additional 2.7% in QL.

• Journal of Korean Traditional Oncology
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• v.20 no.2
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• pp.37-49
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• 2015

Objectives : Retroperitoneal liposarcoma (RPS) is a rare solid tumor and has a high recurrence rate after surgery. New complementary and alternative medicine is required to manage symptoms of RPS and side effects of surgery, chemotherapy and radiation therapy. The purpose of this case report is to report two cases of reduction of side effects of surgery and radiation therapy in RPS treated with Wheel Balanced Therapy (WBT) which is a traditional Korean medicine treatment program for patients with cancer. Methods : Two patients with RPS were treated with WBT. Each of patients received personalized WBT schedule including acupuncture. The changes in clinical and laboratory findings were evaluated. Results : The symptoms of patients were improved after about 2 weeks hospitalization. Conclusions : This case report suggests that WBT has a potential to treat side effects of surgery and radiation therapy in patients with RPS. Further rigorous studies are necessary to investigate the therapeutic effects of WBT on RPS.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.87-92
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• 2012

A six months old, male Shih Tzu dog was referred to the Veterinary Medical Teaching Hospital at Kangwon National University, for lethargy, respiratory embarrassment. Survey radiography revealed enlarged cardiac silhouette due to displacement of gas-filled intestine in the pericardium. Although there were no specific clinical signs, this case was diagnosed as peritoneopericardial diaphragmatic hernia (PPDH) based on the results of positive contrast radiography and thoracic ultrasonograpic findings. In addition, the thickened gall bladder wall observed in ultrasonography, increase of alkaline phosphatase and neutrophils indicated cholecystitis. Two hepatic lobes and gall bladder were severely necrotized and adhere to the diaphragm. Direct reduction of the herniated organs might cause hepatic hemorrhage and bile juice leakage which may induce very poor prognosis. To solve the problems, the adhered organs were dissected with part of diaphragm, and lobectomy with cholecystectomy was performed for prevention of some possible complications including peritonitis. This is case report describing resection of part of diaphragm adhered to herniated organ reduce the risk of possible hepatic hemorrhage during surgical correction of PPDH followed bycholecystectomy and lobectomy.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1251-1253
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• 1997

Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.