• Journal of Chest Surgery
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• 제53권3호
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• pp.121-126
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• 2020

Background: The aim of this study was to analyze the clinical outcomes of autogenous brachiocephalic arteriovenous fistulas and to investigate the factors associated with 1-year patency after initiation of hemodialysis. Methods: We retrospectively reviewed the medical records of 41 patients who underwent surgery to create an autogenous brachiocephalic arteriovenous fistula between January 2015 and December 2017, received hemodialysis at the same hospital for longer than 1 year, and were monitored for their vascular access status. Intraoperative flow was measured using transit-time ultrasonography. Results: The 1-year primary and secondary patency rates were 61% (n=25) and 87.8% (n=36), respectively. The functional group (subjects who required no intervention to maintain patency within the first year after hemodialysis initiation) displayed a significantly higher median intraoperative flow rate (450 mL/min) than the non-functional group (subjects who required intervention at least once regardless of 1-year patency) (275 mL/min) (p=0.038). Based on a receiver operating characteristic curve analysis, all patients were additionally subdivided into a high-flow group (>240 mL/min) and a low-flow group (≤240 mL/min). The high-flow group included a significantly greater number of functional brachiocephalic arteriovenous fistulas than the low-flow group (74.2% vs. 20%, respectively; p=0.007). Conclusion: Transit-time flow, as measured with intraoperative transit-time ultrasonography, was associated with patency without the need for intervention at 1 year after initiation of hemodialysis.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1167-1172
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• 1991

Since March 1988 we have performed 133 arteriovenous fistulae for hemodialysis in 121 patients with chronic renal failure. Of the 133 cases of arteriovenous fistulae, follow-up evaluation was possible for 80 cases which performed in 69 patients. The relation between blood flow and patency rate and duration of arteriovenous fistula was examined. The overall 6 - 12 - 18 -, and 24 - month patency rates of arteriovenous fistulae were 82%, 64%a, 62%, and 57%, respectively. The maximum blood flow was 150 ~ 350ml /min[mean 217.1$\pm$44.27]. The patency duration was evaluated in patients divided into three groups owing to maximum blood flow through the fistulae. The range of maximum blood flow was 150 ~ 200ml /min for group A, 200 ~ 250ml /min for group B, and above 250ml /min for group C. The mean duration of the patency was 10.7$\pm$7.60 months in group A, 14.9$\pm$9.82 months in group B, and 21.6$\pm$11.16 months in group C[p<0 05]. With increased maximum blood flow, the duration of the patency was longer in group A than group B and C [r=0.39, p<0. 05]. The maintenance blood flow was 100 ~ 250ml /min[mean 179.2$\pm$37.26 ml/min]. When the maintenance blood flow was above 200ml /min, long-term patency rate was higher than the group below 200ml /min[r=0.48, p<0.01]. In the same range of blood flow, patency duration of the patients with using their own blood vessels were longer than the patients with using vascular graft for A-V fistula. We concluded that the patency of the arteriovenous fistulae was closely correlated with the blood flow through the fistulae.

• 대한핵의학회지
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• 제29권4호
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• pp.460-464
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• 1995

임상적으로 부갑상선 항진증이 의심되는 8명의 환자들을 대상으로 하여 수술 전에 정확한 병변의 위치를 확인하고자 $^{201}T1/^{99m}Tc$ 감영 스캔을 시행하였다. 6예에서 부갑상선 선종이 진단되었고 이들 전부가 수술 소견과 동일한 위치에서 양성소견을 보였으며, 수술 후 병리조직학적으로 확진 되었다. 나머지 2예는 만성 신부전, MEN type I 과 동반된 미만성 부갑상선 과형성증이었다. 결론적으로 $^{201}T1/^{99m}Tc$ 감영 스캔은 부갑상선 항진증의 진단에 유리하며, 특히 수술 전, 부갑상선 선종의 위치 확인에 유용하다.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.241-246
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• 2010

Purpose: Laparoscopy-assisted gastrectomy (LAG) has become a technically feasible and safe procedure for early gastric cancer treatment. LAG is being increasingly performed in many centers; however, there have been few reports regarding LAG at low-volume centers. The aim of this study was to report our early experience with LAG in patients with gastric cancer at a low-volume center. Materials and Methods: The clinicopathologic data and surgical outcomes of 39 patients who underwent LAG for gastric cancer between April 2007 and March 2010 were retrospectively reviewed. Results: The mean age was 68.3 years. Thirty-one patients had medical co-morbidities. The mean patient ASA score was 2.0. Among the 39 patients, 4 patients underwent total gastrectomy and 35 patients underwent distal gastrectomy. The mean blood loss was 145.4 ml and the mean operative time was 259.4 minutes. The mean time-to-first flatus, first oral intake, and the postoperative hospital stay was 2.8, 3.1, and 9.3 days, respectively. The 30-day mortality rate was 0%. Postoperative complications developed in 9 patients, as follows: anastomotic leakage, 1; wound infection, 1; gastric stasis, 2; postoperative ileus, 1; pneumonia, 1; cerebral infarction, 1; chronic renal failure, 1; and postoperative psychosis, 1. Conclusions: LAG is technically feasible and can be performed safely at a low-volume center, but an experienced surgical team and careful patient selection are necessary. Furthermore, for early mastery of the learning curve for LAG, surgeons need education and training in addition to an accumulation of cases.

• 재활간호학회지
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• 제8권2호
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• pp.119-128
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• 2005

Purpose: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. Method: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. Results: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey(34.3%), quasi experimental study(20.9%), correlation study(19.4%). Nursing intervention of experimental study was exercise(39.0%), education(17.1%). Place of data collection was hospital (58.2%), position of researcher was professor(67.2%), method of data collection was questionnaire(50.7%). Conclusion: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.

• 대한영양사협회학술지
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• 제24권2호
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• pp.117-140
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• 2018

The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

• Biomolecules & Therapeutics
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• 제6권2호
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• pp.171-181
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• 1998

DA-3585, a biosynthetic recombinant human erythropoietin has been developed as a treatment for anemia associated with chronic renal failure in Dong-A pharmaceutical Co. Ltd. This study was carried out to assess its acute and subacute toxicities in rabbits. DA-3585 was intravenously administered to rabbits at dose levels of 6250, 12500 or 25000 lU/kg for single dose toxicity study and at dose levels of 100, 500 or 2500 lU/kg/day for 4-week repeated dose toxicity study. In the acute toxicity study, dose up to 25000 lU/kg had no adverse effect on the behavior or body weight gain. Pathological examinations revealed no abnormal gross lesions related to DA-3585. In the subacute toxicity study, all animals survived until termination of treatment. DA-3585 had no influence on clinical signs, food and water intake or on body weight changes. Hematological examination showed increases in the number of RBC, hemoglobin contents and hematocrit values with a dose dependent manner in the animals treated with DA-3585. Histopathological examination revealed erythroid hyperplasia in the bone marrow and extramedullary hematopoiesis in the liver. The changes detected in the hematological and histopathological examination presumably represent exaggerated pharmacological effects of erythropoietin. The NOAEL (no-observed-adverse-effect-level) of DA-3585 was estimated to be 100 lU/kg/ day under this study condition.

• 수면정신생리
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• 제14권2호
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• pp.99-106
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• 2007

목 적：혈액투석을 받고 있는 만성신부전 환자들에서 하지불안증후군(restless legs syndrome, RLS)의 발생빈도와 삶의 질과의 관계에 대한 연관성을 평가하는 것을 목적으로 하였다. 방 법：고대안암병원 인공신장실에서 만성신부전증으로 혈액투석 중인 83명의 환자들을 대상으로 직접 면담과 설문지를 통해 International Restless Legs Syndrome Study Group(IRLSSG) 진단기준에 합당한 지를 검사하였고 International Restless Legs Scale(IRLS), Athens insomnia scale(AIS), Epworth sleepiness scale(ESS), Medical Outcome Study Short Form-36(SF-36)을 설문지를 통해 측정하였다. 또한 각 환자들의 정신적 상태와 우울증에 대한 선별을 위해 Clinical Global Impression(CGI)와 Hamilton Depression Rating Scale(HDRS)을 시행하였다. 결 과：31명(37.3%)이 IRLSSG 진단기준에 합당한 RLS 환자로 판명이 되었고 RLS 증상을 가지는 환자들은 51.8%에 이르렀다. RLS로 판정된 경우에는 높은 AIS, ESS, HDRS, CGI 점수와 통계적으로 유의한 관련성이 있었다. 또한 RLS 환자로 판정된 경우 낮은 SF-36 총점, 신체적 정신적 요소 점수를 보였고 특히 세부항목으로는 낮은 신체적 역할 제한, 전반적인 건강상태, 신체적 역할제한, 정신적 역할제한, 정신건강 점수와 통계적으로 유의한 관련성이 있었다. 결 론：혈액투석을 하는 만성신부전 환자에서 높은 RLS 유병률을 보이고 있다. RLS를 동반한 경우는 동반하지 않은 경우보다 전반적인 삶의 질의 저하를 보였고 세부적으로는 역할의 제한, 전반적인 건강 및 정신건강 상태 항목에서의 저하가 뚜렷하게 나타났다.

• 대한유전성대사질환학회지
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• 제17권3호
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• pp.92-95
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• 2017

Fabry 병은 성염색체 연관 유전성 리소좀 대사 질환으로 ${\alpha}$-galactosidase A 를 코딩하는 GLA 유전자의 변이로 인한 ${\alpha}$-galactosidase A 효소의 결핍에 의해 발생한다. 이 질환은 globotriaosylceramide (GL-3) 및 관련된 글리코스핑고리피드(glycophospholipids)가 신장 사구체, 심근, 후근 신경절 및 자율 신경계, 혈관 내피 세포 및 평활근 등에 축적되어 사지 말단 동통, 신부전, 심부전 등의 다양한 임상양상을 보이게 된다. 대증적 요법으로만 치료하던 Fabry 병은 효소대체요법의 발전으로 신부전을 포함하여, 심각한 합병증의 예방 및 호전과 함께 질환의 예후를 향상시키고 있다. 또한 사지 말단 동통은 Fabry 병 환자들의 삶의 질을 특히 떨어뜨리며, 적절한 효소대체요법에 효과가 있는 것으로 알려져 있다. 저자들은 40대 후반에 Fabry 병을 진단받고 효소대체요법을 시작하여 사지 말단 동통이 호전된 중국인 남자 환자에 대해 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.82-93
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• 1994

1992년 12월부터 1993년 7월까지 8개월동안 영남대학교 의과대학 부속병원 내과에서 치료중인 혈액투석환자 64명을 대상으로 erythropoietin 치료 유무와 간기능 검사 이상 유무에 따라 군을 나누어 각 군간의 혈색소, 적혈구 용적, 적혈구 지수, 망상 적혈구수, 혈청철, TIBC, ferritin, transferrin saturation을 비교하여, 이들 값과 수혈양의 관계를 조사한 성적은 다음과 같다. 대상환자의 MCH는 $28.8{\pm}2.0pg$, MCV $92.4{\pm}4.7fl$로 정색소성 정구성 빈혈의 소견을 나타냈다. Ferritin치는 남자 $657.4{\pm}292.0ng/ml$, 여자 $511.5{\pm}370.7ng/ml$, serum iron치는 남자 $145.5{\pm}63.7{\mu}g/dl$, 여자 $125.6{\pm}57.1{\mu}g/dl$, transferin saturation은 $61.6{\pm}28.4%$로 ferritin, serum iron, transferrin saturation 모두 정상인보다 높았으며 EPO 치료 유무에 따른 환자비교에서, EPO치료를 받는 환자(20례)의 혈색소, 적혈구 용적은 비 EPO치료군 보다 유의하게 높았고, 1달간 평균 수혈량은 비 EPO치료군에서 유의하게 높았다(p<0.05). 간기능 이상이 있는 군(10례)과 간기능이 정상인 군 (54례)간의 비교에서, 혈청 철 및 transferrin saturation은 간기능 이상이 있는 군에서 유의하게 높았다(p<0.05). 수혈횟수는 ferritin(r=0.4675), transferrin saturation(r=0.3823), iron(r=3386)과 유의한 상관관계를 보였다. 결론적으로 빈혈의 교정을 수혈에 의존하는 환자는 철분 과부하, 즉 hemosiderosis, hemochromatosis 등의 위험이 있으며, erythropoietin치료는 철분 과부하를 포함한 수혈과 관련된 여러 가지 위험성을 감소시킬 것으로 생각된다.