• Journal of Korean Biological Nursing Science
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• 제9권2호
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• pp.105-117
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• 2007

Purpose: The purpose of this study was two folds: first, to identify the level of self care behavior of the hemodialysis patients and second, to find the correlation between the self care behavior and the physiologic indices. Method: The subjects were 52 hemodialysis patients, male and female, who have regularly received hemodialysis dialysis at the Dialysis Room in a leading teaching hospital, Seoul. The patients responded to the self care behavior questionnaires including their socio-demographic characteristics. The respondents have regularly recorded the self care log book. The physiologic indices, clinical characteristics related to the disease and hemodialysis were collected by the chart review. Result: The mean score of the self care behavior was 3.46. The mean score of the self care behavior on categories demonstrated as follows: medication 4.29, fistula management 4.13, management of physical problem 3.71, diet 3.28, exercise and rest 3.22, blood pressure and body weight management 2.97 and social adjustment 2.05 in order. Thirty patients managed discomfort of their fistula. Eleven patients took exercise for 0.5-1 hr/week. Thirty patients measured their body weight daily and thirty two measured their blood pressure daily. The score of self care behavior was significantly correlated with the mean weight gains between the dialysis sessions(r=-.312, p=.05). The mean weight gains between dialysis sessions was found to be high as the level of serum phosphorus and potassium increased(r=-.316, p=.05, r=-.465, p=.01). Conclusion: The result suggests that nursing intervention to the hemodialysis patients to improve self care behavior should be encouraged and further developed.

• 대한의생명과학회지
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• 제23권3호
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• pp.185-193
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• 2017

Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.

• 성인간호학회지
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• 제27권5호
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• pp.505-514
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• 2015

Purpose: The purpose of this study was to examine their levels of knowledge of the kidney, self-efficacy, and kidney function in pre-dialysis patients with chronic renal insufficiency. Methods: A total of 142 pre-dialysis patients with chronic renal insufficiency were recruited from a nephrology clinic of a hospital in Korea. Participants' knowledge of the kidney, self-efficacy, and kidney function were measured, and the correlations between these factors were computed. Results: The levels of knowledge of the kidney were moderate, with a mean score of $12.30{\pm}5.35$. Knowledge level was significantly correlated with age, education level, occupation, income, physical symptoms, and information resources (p<.05). The mean score for self-efficacy was $6.06{\pm}2.00$. Self-efficacy was significantly associated with patients' age, education level, occupation, income, cigarette use, and information resources (p<.05). The mean score for kidney function was $35.66{\pm}18.68mL/min/1.73m^2$. Kidney function was significantly correlated with use of medications and drinking behavior (p<.05). Knowledge of the kidney was significantly correlated with self-efficacy (r=.31, p<.001), but not with kidney function. There was a significant correlation between self-efficacy and kidney function (r=.30, p<.001). Multiple regression analysis revealed that self-efficacy and drinking behavior accounted for 11% of the variance in kidney function of pre-dialysis patients with chronic renal insufficiency. Conclusion: Nursing interventions are necessary to increase self-efficacy among pre-dialysis patients with chronic renal insufficiency in order to maintain their kidney function.

• Journal of Chest Surgery
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• 제48권3호
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• pp.193-198
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• 2015

Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

• Macromolecular Research
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• 제16권8호
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• pp.717-724
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• 2008

In this study, we prepared all-trans retinoic acid (ATRA)-encapsulated, surfactant-free, PLGA nanoparticles. The nanoparticles were formed by nanoprecipitation process, after which the solvent was removed by solvent evaporation or dialysis method. When a nanoparticle was prepared by the nanoprecipitation - solvent evaporation method, the nanoparticles were bigger than the nanoparticles of the nanoprecipitation - dialysis method, despite the higher although loading efficiency. Nanoparticles from the nanoprecipitation - dialysis method were smaller than 200 nm in diameter, while the loading efficiency was not significantly changed. Especially, nanoparticles prepared from DMAc, 1,4-dioxane, and DMF had a diameter of less than 100 nm. In the transmission electron microscopy (TEM) observations, all of the nanoparticles showed spherical shapes. The loading efficiency of ATRA was higher than 90% (w/w) at all formulations with exception of THF. The drug content was increased with increasing drug-feeding amount while the loading efficiency was decreased. In the drug release study, an initial burst was observed for $2{\sim}6$ days according to the variations of the formulation, after which the drug was continuously released over one month. Nanoparticles from the nanoprecipitation - dialysis method showed faster drug release than those from the nanoprecipitation - solvent evaporation method. The decreased drug release kinetics was observed at lower drug contents. In the tumor cell cytotoxicity test, ATRA-encapsulated, surfactant-free, PLGA nanoparticles exhibited similar cytotoxicity with that of ATRA itself.

• 임상간호연구
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• 제15권3호
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• pp.5-16
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• 2009

Purpose: This study was done to provide effective nursing interventions using an individualized educational program designed to contribute to the knowledge, compliance and physiologic parameters (serum potassium, phosphorus and interdialytic weight gain) of non-compliant hemodialysis patients. Methods: There were 22 participants in the experimental group and 19 in the control group. Nurses with rapport with patients provided education to non-compliant hemodialysis patients for 20 minutes three times a week for six weeks. This education program consisted of individual consulting, telephones conversations regarding hemodialysis, and requests for patient support from patients' families and colleagues. Results: Hypothesis 1; "Knowledge about hemodialysis in the experimental group will be higher than the control. group" was not supported. Hypothesis 2; "Compliance will be higher in the experimental group than in the control group", and Hypothesis 3; "Physiologic parameters of experimental group will improve" were supported as serum potassium and interdialytic weight gain decreased, but results were not consistent for phosphorous. Conclusion: This program for non-compliant patients increased compliance and improved physiologic parameters. Therefore, this educational program should be effective as a nursing intervention.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.109-116
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• 1997

목적 : 말기 신부전 환자에서 심혈관계 질환은 유병율 및 사망율의 중요한 원인중 하나이다. 이들 환자에서 흔히 동반되는 고지질단백 혈증은 심혈관계 질환의 위험인자로 작용하며, 특히 lipoprotein(a)[Lp(a)]는 관상동맥 질환과 혈전증의 위험 인자로 알려져 있다. 소아에서도 만성 신부전시 고지질 혈증이 보고되어 있다. 저자들은 투석 치료중인 만성 신부전 소아를 대상으로 혈중 지질, 지질단백 및 Lp(a)의 농도 변화를 분석하였다. 방법 : 서울대학교 어린이병원 소아과에서 유지 혈액 투석을 받고 있는 환아 10명과 지속성 외래 복막 투석을 받고 있는 환아 14명을 대상으로 정맥 혈청중 지질, 지질단백 및 Lp(a)농도를 측정하여 건강 대조군과 비교하였으며, Lp(a)의 혈중 농도에 따른 다른 지질단백의 혈중 농도를 비교하였다. 혈액투석(hemodialysis, HD)환아군의 평균 연령이 $162{\pm}59$ 개월, 남녀비는 7:3 이었으며 복막투석(peritoneal dialysis, PD)환아군의 평균 연령은 $123{\pm}69$개월, 남녀비는 6:8 이었다. 결과 : 1) 연령, 성별, 비만지수, 투석기간은 HD군과 PD군 간의 차이가 없었으나 혈중 단백과 알부민치는 PD군에서 유의하게 낮았다. 2) HD군과 PD군 모두에서 혈중 콜레스테롤, 중성지방, 저비중 지질단백 콜레스테롤(low density lipoprotein-cholesterol, LDL-콜레스테롤)과 고비중 지질단백 콜레스테롤(high density lipoprotein-cholesterol, HDL-콜레스테롤)의 비는 대조군에 비해 증가되어 있었으며, HDL-콜레스테롤과 콜레스테롤의 비는 대조군에 비해 유의하게 낮았다. 3) 혈중 아포단백 B치는 대조군에 비해 상승되어 있었지만 아포단백 Al과 아포단백 B의 비는 차이가 없었고, 혈중 Lp(a)치는 PD군에서만 대조군보다 상승되어 있었다. 4) 혈중 Lp(a)치가 30 mg/dl 미만인 환아는 13명, 30 mg/dl 이상인 환아는 11명으로 이들 간에 연령, 비만지수, 투석방법, 투석기간은 차이가 없었으나 혈중 알부민은 Lp(a)가 상승된 환아들에서 감소되어 있었다. 5) 혈중 Lp(a)농도와 다른 지질 단백과의 비교에서 아포 단백 B만이 유의한 차이를 보였다. 결론 : 투석 치료중인 만성 신부전 소아에서 혈중 지질단백 이상이 관찰되었으며 특히 PD군에서는 혈중 Lp(a)치가 증가되어 있었다. 따라서 만성 신부전 소아에서 관상 동맥 질환의 위험도가 높을 것으로 사료되며 이에 대한 장기적이고 지속적인 관찰이 필요하다.

• Membrane and Water Treatment
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• 제1권1호
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• pp.39-47
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• 2010

Using a conventional two-compartment cell with stirrers the separation of an aqueous solution of HCl-$NiCl_2$ by an anion-exchange membrane Neosepta-AFN was investigated. The dialysis process was characterized by the permeability coefficient of the membrane towards to $Cl^-$ ions. This quantity was determined by the numerical integration of equations, which describe the time dependence of the total concentration of $Cl^-$ ions in compartment initially filled with stripping agent (water), combined with an optimizing procedure. The analysis of the experimental results showed that this permeability coefficient is a satisfactory characteristic for the process studied. It can be graphically correlated with the initial acid and initial salt concentrations in the compartment initially filled with acid+salt mixture.

• Journal of Chest Surgery
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• 제28권11호
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• pp.973-976
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• 1995

The assessment method of human body composion by bioelectrical impedance is very simple, safe, rapid and noninvasive. Based on prediction formulas for total body water from bioelectrical impedance, the observed weight loss should be associated with an increase in impedance. However in edematous patients for dialysis, the calculated total body water loss as calculated from impedance were overestimated and significantly higher than the weight loss after dialysis. So determination of impedance were made in 50 edematous patients before, during and after dialysis. Mean weight loss, which was assumed to be only loss of water was 1719$\pm$ 866 gr and mean impedance change was 71.0 $\pm$ 23.0 Ohm under 50kHz. Body weight loss was highly correlated [r>0.81 with the increase in body impedance under variable frequencies[1, 10, 20, 30, 40, 50 kHz . But there were no differences between frequences. In conclusion, clinical application of bioelectrical impedance method is useful for individual edematous patients with new correlation equation[Y=230+26.8X, X;Impedance change, Y;Calculated total body water loss .

• Toxicological Research
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• 제26권3호
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• pp.233-236
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• 2010

The analytical in vivo chromium ion was searched for using a voltammetric hollow-fiber dialysis sensor via square wave stripping voltammetry (SW), cyclic voltammetry (CV), and chronoamperometry. Under optimum parameters, the analytical results indicated linear working ranges of 50~400 mg/l CV and $10{\sim}80\;{\mu}g/l$ SW within a 30-sec accumulation time. The analytical detection limit (S/N) was $6.0\;{\mu}g/l$. The developed method can be applied to in vivo tissues and in ex vivo toxicity assay, as well as to other materials that require chromium analysis.