• 제목/요약/키워드: Chronic kidney disease

검색결과 379건 처리시간 0.036초

개의 만성 신부전에서 대황 추출물의 치료학적 효과의 평가 (Evaluation of Therapeutic Effect of the Extract from Rhubarb (Rheum officinalis) in Dogs with Chronic Renal Failure)

  • 김예원;현창백
    • 한국임상수의학회지
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    • 제29권6호
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    • pp.435-440
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    • 2012
  • 이번 연구는 만성신부전이 있는 개에서 대황 추출물($Rubenal^{(R)}$)의 치료적 효과와 부작용을 평가하기 위해서 실시되었다. 보호자가 있는 만성신부전 IRIS II-III 단계의 개 40마리가 이번 연구에서 사용되었다. 개들에게 동일한 모양의 대황 추출물과 위약을 투여한 후 0, 30, 90, 180일 동안 관찰, 평가하였다: BSC, 임상적 평가(식욕, 다음/다뇨, QOL), 혈액 검사(WBC, RBC, PCV), 혈청화학검사(ALT/AST, ALP, Creatinine /BUN, Total protein, albumin), 전해질검사(Na, K, Cl, Ca, iCa, P), 혈압, 요검사(UPC, 요비중) 그리고 IRIS 단계를 평가하였다. 이번 연구에서 개들에게 대황 추출물을 적용하였을 때 부작용 없이 잘 받아들이는 것을 확인하였다. 또한, 통계학적으로 임상적 평가(수의사와 보호자의 QOL)와 혈청 BUN, creatinine 수치, 혈청 인 농도, 단백뇨의 양, 그리고 만성신부전의 IRIS 점수가 루비날치료 6개월 후에 유의성 있게 개선되었다. 이러한 발견은 대황의 추출물은 만성신부적의 임상증상(i.e., azotemia, hypertension, proteinuria, hyperphosphoremia)과 삶의 질(i.e., body condition score, appetite and PD/PU)을 향상시키고, 개에서 만성신부전의 진행을 늦출 수 있다는 것을 보여준다. 그러므로 대황 추출물은 준임상적, 그리고 임상적으로 신장 질환을 치료하고 있는 개에게 좋은 보조제가 될 수 있다. 하지만 본 연구는 작은 규모의 파일럿 연구이므로 이중 맹검법의 대규모 실험을 통해 보다 정확한 실험결과의 재현이 요구된다.

요중(尿中) B형(型) 간염항원(肝炎抗原) 발현(發現)의 의의(意義)에 관(關)한 연구(硏究) (The Study on the Prevalence and Significance of Urinary HBsAg. Detection)

  • 한진석;표희정;신영태;박정식;김성권;최강원;이정상;이문호
    • 대한핵의학회지
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    • 제15권1호
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    • pp.27-32
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    • 1981
  • HBsAg. was identified in the urine of the patients positive for serum HBsAg. by Tripatzis in 1970. In 1977, Hourani et al reported the incidence of HBsAg. in urine was about 52% in the patients positive for serum HBsAg. with hemodialysis treatment due to chronic renal failure. A series of studies on the HBsAg. in urine has revealed the urine of the patients positive for serum HBsAg. to be important source of infection. But there's much room to debate on the relationship of HBsAg. in urine with infectivity and the exact mechanism of urinary emergence of HBsAg. The authors detected HBsAg. in serum and urine by employing sandwitch solid-phase rad ioimmunoassay, and performed urinalysis, liver function test and renal function evaluation. Percutanous liver and/or kidney biopsis were done. Among 38 renal disease patients, 9 cases (23.4%) were shown to be positive for serum HBsAg. and 5 cases (55.5%) among above 9 patients positive for urine HBsAg.. 56 cases (67.4%) of 83 liver disease patients revealed positive for serum HBsAg. but only 11 cases (13.2%) among the 56 cases positive fo urine HBsAg. All 10 renal and liver disease patients revealed positive serum HBsAg., and among the 9 cases (90%) positive for urine HBsAg.. In the 25 patients positive for urine HBsAg. all of 5 renal patients and 9 renal and liver patients had hematuria or/and proteinuria above 2 positive for albumin. But in the 11 liver patients 6 cases (55.1%) were normal findings. And there's no significant difference in cpm of urine HBsAg. between the patient positive for serum HBsAg. and negative, and in cpm of serum HBsAg. between liver and renal disease patients. But there's statistical significance in cm of urine HBsAg. between renal and liver diseases.

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내과(內科) 영역(領域)의 요통(腰痛)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Bibliographical study on Lumbago in Oriental Internal Medicine)

  • 윤철호;정지천
    • 대한한방내과학회지
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    • 제15권2호
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    • pp.318-346
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    • 1994
  • A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

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${\ll}$교주부인양방(校注婦人良方)${\gg}$에 수재된 의무기록 의안(醫案)에 관한 연구 (A Study about medical records in ${\ulcorner}$Gyojubuin-yangbang${\lrcorner}$)

  • 오창영;김나영;박영수;김병회;조호근;김중오;김동일
    • 대한한방부인과학회지
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    • 제19권2호
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    • pp.226-239
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    • 2006
  • Background : Medical records are documents in files which consist of all diagnostic studies and medical treatments patients had received while they were hospitalized or treated as outpatients. A doctor or medical team can use medical records as a data for diagnosis, treatment, and education. In traditional eastern asian medicine, medical reports have different forms and contents. The most important thing in medical reports of traditional eastern asian medicine was how to express practitioner's medical ideas. So it has a weak point, for example, it has poor information about patient and clinical process, which make some trouble to understand it. Methods and Results : We studied medical records in Gyojubuin-yangbang, a commentary book of Chen-zi-ming's Obstetrics and Gynecology textbook done by Xue-ji in Ming dynasty, China. This book consists of 10 parts; treatment of menstruation disorders and leukorrhea, general gynecology, treatment of infertility, education for fetus, diagnosis of fetus and gravida, treatment of general and obstetrical disease in gravida, care for delivery, postpartum care and treatment, and treatment of mass and inflammation. It has 546 medical records about women's disease that commonly believed as Xue-ji's case reports. They are all review articles and made during about 23 years from A.D 1523 to 1546. Most patients of Xue-ji's case reports were common people, this fact is different from that of case reports in Chen-zi-ming's Obstetrics and Gynecology textbook. Conclusion : Xue-ji was a very famous Ob&Gy doctor who was from Suzhou Jingsu province in China. He was born in A.D 1468, died in A.D 1588. He emphasize emotional factors in pathology and to tonify spleen and kidney. We think Xue-ji's medical records are good references for us to treat psychosomatic Ob&Gy disease and chronic women's disease.

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Pseudonormal or Restrictive Filling Pattern of Left Ventricle Predicts Poor Prognosis in Patients with Ischemic Heart Disease Presenting as Acute Heart Failure

  • Lee, Jae-Geun;Beom, Jong Wook;Choi, Joon Hyouk;Kim, Song-Yi;Kim, Ki-Seok;Joo, Seung-Jae
    • Journal of Cardiovascular Imaging
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    • 제26권4호
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    • pp.217-225
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    • 2018
  • BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.

단일신을 가진 소아의 임상적 특징과 동반기형 (Clinical Characteristics and Associated Anomalies in Children with Solitary Kidney)

  • 김주휘;이세은;정윤혜;한경희;이현경;강희경;하일수;정해일;최용
    • Childhood Kidney Diseases
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    • 제14권1호
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    • pp.42-50
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    • 2010
  • 목 적 : 단일신을 가진 소아의 임상적 특징과 동반기형 및 장기적 신기능 등에 대해 알아보고자 하였다. 방 법 : 1989년 12월부터 2009년 12월까지 20년간 서울대학교 어린이병원에서 진단된 38예의 단일신 환자를 대상으로 후향적 조사를 하였으며, 단일신은 영상검사를 통해 진단된 일측성 신장 무형성으로 정의하였고, 일측성 이형성 신의 퇴행으로 발생한 단일신은 제외하였다. 결 과 : 진단 연령의 중앙값은 6.5개월(출생직후-13세)이었고, 남자가 12명(31.6%), 여자가 26명(68.4%) 이었다. 19예(50.0%)에서는 좌측 신장이 없었고 19예에서는 우측 신장이 없었다. 산전 초음파에서 진단된 경우가 14예(36.8%), 신장 혹은 요로계 질환에 대한 검사 도중 13예(34.2%), 우연히 발견된 경우가 10예(26.3%)이었다. 동반 기형으로는 방광요관 역류 11예(28.9%)를 포함한 신장기형이 17예(44.7%), 기타 비뇨생식기계의 기형이 16예(42.1%) 그리고 다 기관 증후군 혹은 염색체 이상이 9예(23.7%)에서 진단되었다. 혈청 크레아티닌의 중간값은 0.6 mg/dL이었으며 만성 신부전이 2예(5.3%)에서 확인되었다. 결 론 : 단일신은 신장의 선천성 기형 중 상대적으로 흔한 질환이며, 일반적으로 증상이 없다. 그러나 일부에서는 단일신은 다른 기관의 이상과 연관이 되어있거나 관련된 증상이 발생한다. 단일신을 가진 소아의 연관 기형의 조기 발견과 추적 관찰이 장기적인 신 손상의 위험을 감소시키기 위해 필요하다.

일개 농촌지역 저소득층 당뇨병환자의 관리 상태 (Management of Diabetic Mellitus in Low-income Rural Patients)

  • 김혜연;윤우준;신민호;권순석;안혜란;최성우;이영훈;조동혁;이정애
    • Journal of Preventive Medicine and Public Health
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    • 제42권5호
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

혈액투석 환자의 단백질 섭취량에 따른 혈중 albumin과 hs-CRP 농도의 비교 연구 (Comparative study of serum levels of albumin and hs-CRPin hemodialysis patients according to protein intake levels)

  • 이예지;이연주;오일환;이창화;이상선
    • Journal of Nutrition and Health
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    • 제46권6호
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    • pp.521-530
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    • 2013
  • Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ${\geq}$ 1.0g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.

수분 섭취량 측정법에 관한 연구 (A Study on Fluid Intake Measurements)

  • 이창관;김유경;서명화;이경미;이주은
    • 성인간호학회지
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    • 제25권5호
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    • pp.567-573
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    • 2013
  • Purpose: The purpose of this study was to compared two methods for measuring fluid intake and to assess the most effective method. Methods: Data from 44 hospitalized patients with chronic kidney disease was analyzed. Two methods were used. The liquid method is to measure the daily intake of water in the form of pure water or some other beverage and IV fluid, the liquid-solid method is to measure the daily intake of water which enters by the oral route and IV fluid. Results: The daily intake of fluid was 1483.10mL and 2245.99mL respectively. The fluid output was 1883.72 mL. The Intra-Class Correlation (ICC) between the liquid method and the liquid-solid method and fluid output was 0.64 and 0.69, respectively. The correlation between differences of fluid in two methods and body weight change was r=.47 (p<.001) and r=.56 (p<.001), respectively. Conclusion: The results of this study suggest that there are no difference between the two measuring methods as to reflecting the most close value to fluid output. And the difference between intake and output by two methods is correlated with body weight change. Therefore, it can be suggested that the either method could be useful as patients' fluid intake measurement.

Ki-67/MIB-1 as a Prognostic Marker in Cervical Cancer - a Systematic Review with Meta-Analysis

  • Piri, Reza;Ghaffari, Alireza;Gholami, Nasrin;Azami-Aghdash, Saber;PourAli-Akbar, Yasmin;Saleh, Parviz;Naghavi-Behzad, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권16호
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    • pp.6997-7002
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    • 2015
  • Background: In cervical cancer patients it has been reported that there in a significant Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value is still not well understood. Materials and Methods: In the present meta-analysis the prognostic value of Ki-67/MIB-1 with regard to overall survival (OS) and disease-free survival (DFS) in cervical cancer was investigated. The databases of PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, Science Direct and Wiley Online Library were used to identify appropriate literature. Results: In order to explore the relationship between Ki-67/MIB-1 and cervical cancer, we have included 13 studies covering 894 patients in the current meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63 (95%confidence interval (CI) 1.09-2.45; P<0.05). The pooled HR for DFS was 1.26 (95%CI 0.58-2.73; P>0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95%CI 2.65-5.09) in Asians. Conclusions: According to this meta-analysis, Ki-67/MIB-1 has prognostic value for OS in patients suffering from cervical cancer. For better evaluation of the prognostic role of Ki-67/MIB-1 on DFS, studies with larger numbers of patients are needed to validate present findings in the future.