• 한국임상약학회지
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• 제23권2호
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• pp.142-150
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• 2013

Background: Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease, affecting most of those who are receiving dialysis. Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower PTH levels in dialysis patients. Objective: This study aimed to assess efficacy, safety and appropriateness of use of cinacalcet in dialysis patients. Method: This retrospective study was performed on total 24 cases with identified intact parathyroid hormone (iPTH), serum calcium and phosphorus levels before and 4 weeks after cinacalcet initiation at a teaching hospital from July 1st, 2011 to October 31st, 2012. Results: Cinacalcet decreased iPTH by 19% from baseline after 4weeks treatment and it was statistically significant (p<0.001). Cinacalcet also significantly decreased iPTH levels regardless of dialysis modality (hemodialysis group versus peritoneal dialysis group) and severity of SHPT (iPTH 300-800 pg/ml group versus iPTH >800 pg/ml group). Serum calcium, phosphorus and Ca x P levels were decreased without statistical significance. Gastrointestinal events, headache and hypocalcemia were the most common side effects. Monitoring for iPTH and serum calcium was not performed appropriately. 43.7% patients initiated cinacalcet therapy at serum calcium level< 9.0 mg/dl. Conclusion: In conclusion, cinacalcet lowers parathyroid hormone levels with no serious side effects. However, it is required to avoid cinacalcet treatment in patients with low serum calcium levels and monitor iPTH and serum calcium levels during cinacalcet administration.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.375-382
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• 1986

We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomittent illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC(disseminated intravascular coagulopathy), paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialvsate, Imperinol $solution^R$, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotol swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdiminal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomittant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.

• Bulletin of the Korean Chemical Society
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• 제23권11호
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• pp.1579-1584
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• 2002

Since surfactant or emulsifiers remained on the nanoparticle surface significantly affect the physicochemical properties, the biodegradation rate, the biodistribution, and the biocompatibility of nanoparticles, surfactant-free nanoparticles should be good candidate. surfactant-free PLGA nanoparticles were successfully prepared by both the dialysis method and the solvent diffusion method. The PLGA nanoparticles prepared using the solvent diffusion method has a smaller particle size than the dialysis method. The solvent diffusion method was better for a higher loading efficiency than the dialysis method but the nanoparticle yield was lower. Testosterone (TST) release from the PLGA nanoparticles was dependent on the particle size rather than the drug contents. Testosterone release from the PLGA nanoparticles prepared by the solvent diffusion method using acetone was faster than those prepared by the dialysis method. TST release from the PLGA nanoparticles prepared by the solvent diffusion method using acetone and the dialysis method using dimethylformamide (DMF) was completed for 4 days while the PLGA nanoparticles prepared by the dialysis method using acetone showed approximately 80% TST release after 4 days. Since the PLGA nanoparticle degradation ratio was below 20% within 5 days at all samples while TST release completed within 4 days, TST release was dependent on the diffusion mechanism rather than degradation.

• Childhood Kidney Diseases
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• 제11권1호
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• pp.41-50
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• 2007

목적 : 영유아 만성 신부전 환자의 투석은 어른에 비해 여러 가지 면에서 어려움이 있다. 본 연구에서는 2세 미만 영유아에서 만성투석을 시행한 10례에 대한 경험을 고찰하여 보다 나은 투석 치료의 방향을 제시하고자 하였다. 방법 : 1999년 3월부터 2007년 2월까지 삼성서울병원에서 3개월 이상 만성 투석을 시행한 2세 미만의 만성 신부전 환아 10례의 의무기록을 후향적으로 조사하였다. 결과 : 대상 환아의 만성 신부전의 원 질환은 이형성신이 5례로 가장 많았다. 10명의 환아 중 남아는 6명, 여아는 4명이었다. 투석 시작 시 연령의 중간값은 3개월(22일-20개월)이었고 투석 시작 시 체중은 3.75 kg(2.2-10.3 kg)이었다. 투석시작 시 혈청 크레아티닌은 4.3 mg/dL(1.4-11.4 mg/dL)이었다. 투석기간은 29.5개월(3-62개월)이었다. 10명의 환아 중 2명은 혈액투석만 시행하였고, 4명은 복막투석만 시행하였다. 4명은 혈액투석과 복막투석을 모두 시행했다. 10명 중 9명은 적혈구 생성인자(Erythropoietin)를 투여 받았으며 고혈압 조절을 위해 항고혈압제를 복용하였다. 최근 추적관찰에서 1례는 신장 이식을 받았고, 2례는 패혈증으로 사망했으며, 5례는 복막투석 중이고, 2례는 추적관찰 되지 않았다. 투석의 합병증으로 감염이 가장 흔했고, 혈액투석 시 도관 확보 및 유지가 중요했다. 투석 시작 시와 비교해 투석 5개월 후 체중과 신장의 mean SDS 는 악화 되었으나 투석 1년 후에는 호전되었고 복막투석이 혈액투석보다 성장 면에서 유리한 경향을 보였다. 결론 : 2세 미만 영유아에서 만성 투석을 하는 경우 감염을 예방하고 도관을 잘 유지해야 한다. 적절한 영양공급을 통해 성장을 보완하고 보존적 치료를 병행하면 영유아에서 비교적 안전하게 투석치료를 할 수 있고 향후 신 이식이 가능하도록 생존율을 높이고 삶을 질을 호전시킬 수 있을 것으로 기대된다.

• 대한화학회지
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• 제16권5호
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• pp.304-313
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• 1972

溶解된 粒子의 이온量 또는 分子量을 決定하는 方法으로서의 透膜法에는 裝置의 未備點과 實驗方法의 改良되어야 할 點이 아직 남아 있으므로 우선 이들을 改善하여 補完하였다. 透析簡에 膜을 密着시킬수 있도록 鐵製링을 開發하였다. 透析液과 外部液의 水準을 0.02mm의 精度로 一致調節하고 維持시킴으로써 渗透 및 濾過效果를 最小限度로 抑制시켰다. 두 液의 攪拌速度를 任意의 定速度로 變更하여 그 攪拌量을 一定하게 維持할 수 있도록 하였으며, 그 溫度를 透析其間中 ${\pm}0.01^{\circ}C$의 精度로 一致維持시킬수 있도록 하였다. 透析期間中 透析液의 부피變化를 -1.62 ~ +0.92%範圍로 좁혔으며, 渗透 및 濾過效果와 膜孔의 크기와의 關係를 追究하여 最適透析時間을 究明하였다.

• 성인간호학회지
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• 제12권4호
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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.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권2호
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• 동의생리병리학회지
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• 제18권3호
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• pp.874-879
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• 2004

Alakaline phosphatase (ALP)- or horseradish peroxidase (HRP)-antibody conjugate was used frequently on the immunological detection methods such as enzyme-linked immunosobent assay (ELISA), immunobolt, immunohistochemistry. The classical enzyme-antibody coupling method by one-step (direction) injection of glutaraldehyde bring into being disadvantage such as low sensitivity of antigen detection because of homopolymers. This study was modified with the dialysis glutaraldehyde method to provide simple coupling through E-amino residues present in most protein. The dialysis glutaraldehyde coupling effects were better than the classical one-step glutaraldehyde injection in antigen detection of ELISA and immunobolt. Optimal dose of the dialysis glutaraldehyde solution was 0.10-0.25 %. This results suggest that the dialysis glutaraldehyde coupling method can readily applied to antigen detection of in vitro and in vivo.

• Clinical and Experimental Pediatrics
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• 제50권10호
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• pp.938-947
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• 2007

Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

• 대한전해질대사연구회지
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• 제16권2호
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• pp.27-29
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• 2018

Peritoneal dialysis (PD)-related peritonitis is a major cause of injury and technique failure in patients undergoing PD. Aeromonas hydrophila is ubiquitous in the environment, and is a Gram-negative rod associated with infections in fish and amphibians in most cases; however, it can also cause opportunistic infections in immunocompromised patients. We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device. Although Set Plus is disposable, the patient reused the product by cleansing with tap water. He was successfully treated with intraperitoneally-administered ceftazidime and has been well without recurrence for more than 2 years.