• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.693-699
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• 2005

Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.656-666
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• 2020

This study was a descriptive research study for hemodialysis patients to survey the effects of social support and health literacy on treatment adherence. The subjects of this study were 140 hemodialysis patients aged over 40 years who had been receiving treatment for more 1 year in artificial kidney rooms at two general hospitals in Y city. The data were collected from November 1, 2019 to December 31, 2019 and were analyzed using descriptive statistics, t-tests, one-way ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regression with the SPSS/WIN 26.0 statistical program. The results of this study show that social support (family, friends, medical staff) and health literacy (functional, communication, critical) were positively correlated with treatment adherence. The variables affecting treatment adherence in hemodialysis patients were identified by social support and health literacy with 69.6% explanatory power. To improve the treatment adherence of hemodialysis patients, it is necessary to develop education programs to improve health literacy based on social support.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.669-674
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• 2005

Nephrogenic diabetes insipidus (NDI) is a disorder in which the secretion of antidiuretic hormone is normal, but the response of the renal collecting tubules to vasopressin is impaired. Compared with acquired NDI (a-NDI), which is secondary to chronic bilateral incomplete urinary tract obstruction with hydronephrosis, congenital NDI (c-NDI) is a very rare heritable disorder that usually follows the X- linked recessive pattern. Clinical symptoms of c-NDI can be non specific, and often the disease ultimately results in failure to thrive, or mental retardation. Recently, the diagnosis can be confirmed by direct sequencing analysis of the peripheral blood specimens. The long-term results of treatment for c-NDI are not satisfactory. Reports on the follow up of c-NDI cases are rare and there is no report on the cases treated with combinations of three drugs. We report herein a case of severe c-NDI in an 8 year-old-boy with a severely dysconfigurated urinary tract system. The patient and his mother showed a frameshift mutation on the AVPR2 gene on chromosome Xq28:.847_851delTGCTG (p.C283fsX90). The patient showed normal growth and development by treatment with combinations of hydrochlorothiazide ($65mg/m^2$), amiloride (0.3 mg/kg/d) and indomethacin ($100mg/m^2$), yet after five years he needed adjuvant cystostomy to relieve him from the residual symptoms of urgency with polyuria.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.688-698
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• 2017

This study was conducted to identify the conceptual definitions and attributes of fatigue in hemodialysis patients based on the Hybrid Model of concept development. The Hybrid Model was used to investigate the main attributes and indicators of the concept by applying three stages. After a literature review, data were collected through observation and interviews including qualitative research in the field work stage. The participants included 10 patients in hemodialysis center of two hospitals in Gwang-ju, Korea. The attributes of fatigue concept in the hemodialysis patients were divided into four dimensions, physical activity, affective mood, social role, and cognitive reflection. The definition of fatigue by hemodialysis patients was defined as 'subjective feeling usually experienced in four dimensions during the process to recognize and adjust energy deficiency and limited functions caused by uremia and repeated hemodialysis for chronic renal failure'. Considering the dimensions and attributes derived from this study, it may be possible to develop an effective intervention program for fatigue in hemodialysis patients.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.3
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• pp.50-59
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• 2018

Objectives : The aim of this review is to investigate studies on skin adverse reactions and to demonstrate subjects related to the adverse effects in dermatology. Methods : Electric searches were performed with KISS(Korean studies Information Search System) and the key words were combination of 'skin' and 'adverse effect'. 87 literatures investigated in this review were issued from 1900 to 2016. Results : Among the 87 papers, dermatologic adverse reactions were reported in 83 papers in medicine, accounting for 95.4%. Of the adverse effects seen on the skin, 84 discoloration such as erythema, pigmentation and hemotelangiosis were the most common, accounting for 21%. Among the medical adverse reactions not seen on the skin, 21 infection were the most common, accounting for 25%. Among the subjective adverse reactions, of which 32 pruritus were the most common, accounting for 43%. Among the 87 papers, there were 3 cases with underlying diabetes and 3 cases with underlying hypertension, followed by 2 cases with chronic renal failure, HBV, atopic dermatitis and respectively 1 case with alcoholism, depression addiction, multiple myeloma, arthritis and psoriasis. The most frequent period until adverse reactions appeared was within 2 weeks, accounting for 13 papers. And 4 were the most frequent adverse reactions lasting less than 1 month, and 4 were more than 3 months and less than 6 months. There were 48 cases where adverse reactions were caused by nonmedical practioner's treatment. The adverse reactions by the pharmacist were the highest at 11 cases (23%). There were 17 cases of adverse reactions due to medical treatment, among which dermatologists and nondermatologists accounted for the majority of 5 cases, 29%. The most common cause of adverse reactions was the application of external medicine (41 cases), followed by 36 cases of foreign body implantation, eyebrow tattooing, ear piercing, etc. Conclusions : In this report, we demonstrated patterns of adverse reactions in the medical field of dermatology caused by non-medical personnel than medical personnel. We suggest that more effort should be followed by medical personnel to establish clear awareness of skin disease and by patients to be aware of the risks of the illegal medical treatment by non-medical personnel.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.332-340
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• 2011

Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.123-129
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• 1997

Purpose : The Childhood Steroid Resistant Nephrotic Syndrome (SRNS) has a poor prognosis and there has been no effective therapy against SRNS of children. In 1990, Mendoza have reported that methylprednisolone pulse therapy was effective against SRNS of children. But in 1992, Waldo have reported that methylprednisolone pulse therapy was not as effective as in the report of Mendoza. So, retrospectively, we have studied 20 korean children with SRNS to evaluate the effect of methylprednisolone pulse therapy, Methods : Mothylprednisolone pulse therapy were given to 20 korean children with SRNS who admitted to Seoul National University Hospital from 1990 to 1995 and follow up was done Results : 1) During methylprednisolone pulse therapy, remission of nephrotic syndrome was induced in 45% of patients. 2) during follow up after the end of methylprednisolone pulse therapy, remission of nephrotic syndrome was maintained in 45% of patients. 3) 25% of patients has progressed to chronic renal failure. Conclusion : We think that the methylprednisolone pulse therapy is a effective therapy against SRNS of children with the 45%, remission rate of of SRNS in Korean Children

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.329-338
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• 2005

The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. To evaluate of digital nerve conduction velocity of median nerve for obtain clinically useful reference value and compare difference in each fingers. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected conduction velocity and amplitude of digital nerves in median nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, ANOVA was used to compare each fingers and independent t-test was used to compare between Rt and Lt side also compare between different in genders. Conduction velocity of the right thumb was 49.77m/sec, index finger was 56.80m/sec, middle finger was 56.15m/sec and ring finger was 53.38m/sec. The left thumb was 50.48m/sec, index finger was 56.76m/sec, middle finger was 55.99m/sec and ring finger was 53.23m/sec. Amplitude of the right thumb was $64.30{\mu}V$, index finger was $73.95{\mu}V$, middle finger was $77.97{\mu}V$ and ring finger was $43.92{\mu}V$. The left thumb was $74.21{\mu}V$, index finger was $85.72{\mu}V$, middle finger was $88.06{\mu}V$ and ring finger was $47.28{\mu}V$. There were significantly difference between thumb, index, middle and ring fingers(p<.01) but there were no statistically difference between conduction velocity and amplitude of index and middle fingers(p>.01). The conduction velocity of index finger are faster than other fingers and amplitude of middle finger are greater than other fingers. The present results revealed that electodiagnosis can easily perform in index and middle finger for digital nerve of median nerve study.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.158-162
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• 2009

Background: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. Methods: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. Results: Using the drip infusion method, we identify the epidural space in all the patients as ＋/＋＋ grade. The catheter insertion method was also successful in identifying those epidural spaces over a ${\pm}$ grade. The pseudo LOR was over ${\pm}$ grade in 47 patients. Conclusions: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.62-70
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• 2005

The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of median and ulnar motor nerve was poorly reported in Korea. To evaluate of median and ulnar motor nerve terminal latency, amplitude of CMAP(compound muscle action potential), conduction velocity and F-wave latency for obtain clinically useful reference value. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected terminal latency, amplitude of CMAP, conduction velocity and F-wave latency of median and ulnar motor nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, independent t-test was used to compare between Rt and Lt side also compare between different in genders. The results are summarized as follows: 1. Median motor nerve terminal latency was right 3.00ms, left 2.99ms and there was no significantly differences between right and left side and genders. 2. Median motor nerve amplitude of CMAP was right 17.26mV, left 1750mV and there was no significantly differences between right and left side and genders. 3. Median motor nerve conduction velocity was right 57.89m/sec, left 58.03m/sec and there was no significantly differences between right and left side and genders. 4. Median motor nerve F-wave latency was right 25.74ms, left 25.59ms and there was significantly differences between genders. 5. Ulnar motor nerve terminal latency was right 2.38ms, left 2.45ms and there was significantly differences between right and left side. 6. Ulnar motor nerve amplitude of CMAP was right 15.99mV, left 16.02mV and there was no significantly differences between right and left side and genders. 7. Ulnar motor nerve conduction velocity was right 60.35m/sec, left 59.73m/sec and there was no significantly differences between right and left side and genders. 8. Ulnar motor nerve F-wave latency was right 25.53ms, left 25.57ms and there was significantly differences between genders.