• The Science & Technology
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• v.32 no.7 s.362
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• pp.71-75
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• 1999

몇해 전만 해도 대부분의 과학자들은 신장이나 심장과 같은 인간의 조직은 장기제공자로부터 직접 이식을 받거나 또는 플라스틱, 금속 그리고 컴퓨터칩으로 만든 완전 인공부붚므오만 대체할 수 있다고 믿고 있었다. 또 많은 사람들은 생세포와 인공폴리머의 혼성물인 바이오인공장기는 결코 제작할 수 없으며 이식용 인간장기의 부족을 충당할 수 있는 유일한 길은 동물의 장기를 사용하는 것 뿐이라고 생각했다. 그러나 앞으로는 조직공학이라는 새로운 생명과학기술의 진보로 간질환 환자가 자기의 간세포와 플라스틱섬유로 만든 '네오(신)장기' 이식으로 병을 치유할 수 있고 인슐린에 의존하던 당뇨병환자가 대체용 췌장 덕에 인슐린주사를 자주 맞을 필요가 없게 되며 신장병환자는 누구든지 자기의 세포로 키운 새로운 신장을 이식할 수 있게 되어 신장투석기의 모습이 세상에서 사라지게 되는 시대를 기대할 수 있게 되었다. 또 우리 몸을 형성하는 육체의 '부품'을 사고 팔 수 있는 시대가 뜻밖에도 빨리 다가올지 모른다고 생각하고 있는 과학자들도 있다.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.854-857
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• 2006

The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

• Childhood Kidney Diseases
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• v.18 no.2
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• pp.64-70
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• 2014

Purpose: The aims of this study were to assess the clinical and laboratory profiles of chronic kidney disease-mineral bone disorder (CKD-MBD) and to assess the effects of treatment of active vitamin D analogs on severe hyperparathyroidism (SHPT) in pediatric patients on chronic peritoneal dialysis. Methods: This is a retrospective study included 53 patients who had been undergoing dialysis for more than 1 year, between January 2003 and December 2012. Results: Even after treatment with phosphate binders and active vitamin D analogs, the $mean{\pm}standard$ deviation of the percentage of time during peritoneal dialysis that the patients' serum concentrations of phosphorus, corrected total calcium, and parathyroid hormone (PTH) fell within the Kidney Disease Outcomes Quality Initiative recommended ranges was $25.06{\pm}17.47%$, $53.30{\pm}23.03%$, and $11.52{\pm}9.51%$, respectively. Clinical symptoms or radiological signs of CKD-MBD were observed in 10 patients (18.9%). There were significant differences in percentage of time that the serum intact PTH concentration was outside of the recommended range between patients with and without symptoms or signs of CKD-MBD (below recommended range, $11.74{\pm}7.37%$ vs. $40.77{\pm}25.39%$, P <0.001; above the recommended range, $63.79{\pm}27.86%$ vs. $37.09{\pm}27.76%$, P =0.022). Of the 25 patients with SHPT, high-dose alfacalcidol treatment was required in 13 patients that controlled SHPT in 7 of these patients, without marked complications. Conclusion: Despite our efforts to manage CKD-MBD, patients' met the recommended ranges from relevant guidelines at a low frequency. The treatment of high-dose active vitamin D analogs was required in about half of the patients with SHPT and effective in about half of them.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.213-220
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• 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 the Korean Data and Information Science Society
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• v.26 no.3
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• pp.707-714
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• 2015

The SF-36 is the most common instrument to check the quality of life for dialysis patients with chronic renal failure. However, there were too much burden for them to answer 36 items of it. So we purposed to develop the RFQoL-K reduced type of the SF-36. Participants who had newly registered for dialysis were enrolled in 29 medical centers during 45months from 2009. We developed the RFQoL-K through 355 people who applied the SF-36 at 3 and 12 months after registration and then checked it's internal validity. External validity about it was checked via 411 people who answered only one time survey after registration. In conclusion, the RFQoL-K had total 14 items which was consisted of 8 items on physical factors and 6 items on mental factors from the SF-36. The RFQoL-K summary scores explained 91-93% of the SF-36 summary scores. The RFQoL-K was well reflected SF-36 because the correlation and the internal consistency between two tools were very high 0.96 to 0.98 and 0.96 to 0.98 respectively.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.267-270
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• 2009

Neuroleptic malignant syndrome (NMS) is a rare, but a potentially life threatening condition associated with the use of antipsychotics. The most frequent signs and symptoms of NMS include fever, muscle rigidity, autonomic dysfunction such as tachycardia, tachypnea, and labile blood pressure. Acute complications of NMS include disseminated intravascular coagulation, sepsis, seizure, myocardial infarction, acute renal failure due to rhabdomyolysis and death. We report a rare case of acute renal failure due to rhabdomyolysis associated with neuroleptic malignant syndrome.

• 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 Veterinary Clinics
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• v.26 no.2
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• pp.170-175
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• 2009

A 7-year-old, intact male Pomeranian(weighing 2.2 kg), was presented with clinical signs of prolonged anorexia, polydypsia/polyuria, severe azotemia, proteinuria and heart murmur. Diagnostic studies found chronic kidney disease, severe hypertension and hypertrophic cardiomyopathy. The dog was treated with 2-day peritoneal dialysis, blood transfusion, anti-hypertensive therapy with amlodipine and conservative therapies direct to chronic renal failure. This is a rare case of hypertensive cardiomyopathy complicated with chronic kidney disease in dogs.

• Journal of Korean Physical Therapy Science
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• v.17 no.3_4
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• pp.1-9
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• 2010

Purpose: The objectives of this study were to investigate the current status of the pain in and the dysfunction related to the musculoskeletal system experienced by patients with end-stage renal failure receiving hemodialysis. Methods: A questionnaire survey was given to 107 patients undergoing hemodialysis in M Hospital. The survey was conducted by using a brief pain inventory(BPI) to investigate the body parts in pain, degree of pain, difficulty in daily life, correlation with hemodialysis and the degree of satisfaction with their own health. Results: The investigation of the patients undergoing hemodialysis showed that 89(83.2%) of the 107 patients experienced pain in their musculoskeletal system. Their pain's incidence was highest in the knees(46.1%) and 68.5% of the patients reported that the most severe pain they had experienced within the past 24 hours was at a level between "moderate" and "severe." The limitation of daily life by pain is high most as 47.7% in the accomplishment of works. Conclusion: Most hemodialysis patients experience musculoskeletal related pain that affects their daily life. Hemodialysis patient management programs should include an assessment and management of such pain.