• Microbiology and Biotechnology Letters
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• v.47 no.2
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• pp.173-182
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• 2019

The use of double lumen catheters as a means of hemodialysis access is commonly accompanied with the use of gentamicin as an antibiotic lock. Other antibiotics and anticoagulants are often added to increase the efficacy of gentamicin in order to reduce catheter-related infection and to prevent biofilm formation. This review aimed to evaluate the following: 1) the use of gentamicin in eliminating catheter-related infection and reducing biofilm formation in hemodialysis catheters, 2) the efficacy of additional antibiotics in combination with gentamicin, and 3) the effect of additional anticoagulants to complement the efficacy of gentamicin as the main prophylactic antibiotic lock. We sorted through data from 242 PubMed and ScienceDirect studies, which were then short-listed to 33 studies. Next, they were grouped, extracted, and analyzed qualitatively to fulfil the objectives of this review. Consequently, the use of a gentamicin-lock solution was shown to reduce the incidence of bacteremia; however, it was not strong enough to inhibit the growth of infectious microbes and formation of biofilms. Several bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Klebsiella pneumoniae, have been reported as infectious agents. Combination with other antibiotics also provided no effect in reducing bacterial growth and biofilm formation in catheters. Furthermore, the additional anticoagulants (trisodium citrate and EDTA) were reported to be effective in enhancing the efficacy of gentamicin in avoiding catheter-related infection, bacterial growth, and biofilm formation; thus, the use of gentamicin can be rationalized.

• Bulletin of the Korean Chemical Society
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• v.29 no.2
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• pp.422-426
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• 2008

Hemodialysis graft coated with paclitaxel prevents stenosis; however, large initial burst release of paclitaxel causes many negative effects such as drug toxicity and inefficient drug loss. Therefore we developed and tested a novel coating method, double dipping, to provide controlled and sustained release of paclitaxel locally. Expanded polytetrafluoroethylene (ePTFE) grafts were dipped twice into a solution of several different paclitaxel concentrations. In vitro release tests of the double dipping method showed that early burst release could be somewhat retarded and followed by sustained release for a long time. We observed the effect of paclitaxel coating by double dipping in porcine model of arterio-venous (AV) grafts between the common carotid artery and the external jugular vein. 12 weeks after constructing AV grafts, cross sections of the graft venous anastomosis were obtained and analyzed. Paclitaxel coated ePTFE grafts by double dipping were observed to prevent neointimal hyperplasia and therefore reduced stenosis of the arteriovenous hemodialysis grafts, especially at the graft venous anastomosis sites. Our results demonstrate that second dipping of ePTFE graft, which was already coated once with paclitaxel, washes off the drug on a surface of the graft and affects the ratio of paclitaxel on the surface to that of the inner space, possibly by diffusion: thus the early burst of drug can be somewhat reduced.

• Journal of Korean Biological Nursing Science
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• v.21 no.3
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• pp.169-177
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• 2019

Purpose: The purpose of this paper was to identify blood pressure, interdialytic weight gain, thirst and intradialytic discomfort in subjects after applying individual low-sodium dialysis fluid (1,2,3 mEq/L) to hemodialysis patients for 12 weeks. Methods: This study was a non-equivalent pre-post design. For 12 weeks, dialysate concentration was maintained at 1 mEq/L or 2 mEq/L or 3 mEq/L based on average sodium concentration of each individual, and the difference was compared after applying individually. Results: Change in blood pressure significantly decreased in the group where in pre-hemodialysis systolic pressure decreased the gradient of sodium concentration in serum sodium and dialysis solution by 2mEq/L. Interdialytic weight gain, and thirst showed significant decrease in all three groups. But in all three groups, intradialytic discomfort among dialysis showed no significant changes. Conclusion: Although application of low sodium dialysis fluid showed no change in intradialytic discomfort, lowered blood pressure, thirst, and interdialytic weight gain, which could be used for individual showing increased interdialytic weight gain and increased blood pressure. There is need for continued study on this.

• Bulletin of the Korean Chemical Society
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• v.32 no.3
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• pp.805-808
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• 2011

We have determined the urea concentration in an aqueous solution using Raman spectroscopy by incorporating a Teflon tube as an effective intensity correction standard as well as sample container. A non-overlapping Teflon band was used as the reference peak to correct Raman intensity variations that occasionally resulted from changes in laser power. To increase the sensitivity, we positioned a copper reflector inside the Teflon tube to maximize the collection of Raman scattering. The obtained accuracy using Raman spectroscopy was 0.53 mM, close to the range of accuracy of previous NIR studies (0.15-0.52 mM).

• Bulletin of the Korean Chemical Society
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• v.35 no.5
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• pp.1333-1336
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• 2014

Expanded polytetrafluoroethylene (ePTFE) grafts have been used as vascular access for many patients suffering from end stage renal disease. However, the vascular graft can cause significant clinical problems such as stenosis or thrombosis. For this reason, many studies have been performed to make drug eluting graft, but initial burst is major problem in almost drug eluting systems. Therefore we used biodegradable polymer to reduce initial burst and make sustained drug delivery. The ePTFE grafts were dipped into a paclitaxel-dissolved solution and then PLGA-dissolved solution was passed through the lumen of ePTFE. We analyzed whether the dose of paclitaxel is enough and the loading amount of PLGA on ePTFE graft increases according to the coating solution's concentration. Scanning electron microscope (SEM) images of various concentration of PLGA showed that the porous surface of graft was more packed with PLGA by tetrahydrofuran solution dissolved PLGA. In addition, in vitro release profiles of Ptx-PLGA graft demonstrated that early burst was gradually decreased as increasing the concentration of PLGA. These results suggest that PLGA coating of Ptx loaded graft can retard drug release, it is useful tool to control drug release of medical devices.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.1
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• pp.38-40
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• 2009

Formalin is a water-soluble, colorless, pungent, irritating and highly reactive gas. A 40% solution of formaldehyde in water, also known as formalin, is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid. Ingestion can lead to immediate deleterious effects on almost all systems of the body including gastrointestinal tract, central nervous system, cardiovsacular system and hepato-renal system, causing gastrointestinal hemorrhage, cardiovsacular collapse, unconsciousness or convulsions, severe metabolic acidosis and acute respiratory distress syndrome. We treated a 39-year-old woman who ingested 300 ml formalin in a suicidal attempt. Despite hemodialysis, death occurred after 23 h.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.67-76
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• 2019

Kidney disease is a major global health issue. Hemodialysis and kidney transplantation have been used in the clinic to treat renal failure. However, the dialysis is not an effective long-term option, as it is unable to replace complete renal functions. Kidney transplantation is the only permanent treatment for end-stage renal disease (ESRD), but a shortage of implantable kidney tissues limits the therapeutic availability. As such, there is a dire need to come up with a solution that provides renal functions as an alternative to the current standards. Recent advances in cell-based therapy have offered new therapeutic options for the treatment of damaged kidney tissues. Particularly, cell secretome therapy utilizing bioactive compounds released from therapeutic cells holds significant beneficial effects on the kidneys. This review will describe the reno-therapeutic effects of secretome components derived from various types of cells and discuss the development of efficient delivery methods to improve the therapeutic outcomes.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.12
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• pp.921-925
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• 2015

The number of people suffering from renal disease increases every year. One of the most common treatments (clinical care options) for renal diseases is hemodialysis. However it takes a long time and has a high cost. Therefore, the importance of artificial kidney research has risen. Filtering creatinine from blood is one of the prime renal functions. Thus, we designed a novel two channel microfluidic chip focused on that function. In order to bond the individual polydimethylsiloxane layers, we have developed a housing system using acrylic plastic frame. This method has significant advantages in changing filter membranes. We use anodic aluminum oxide for the filter membrane. We analyzed the difference in the absorbance values for various creatinine concentrations using the Jaffe reaction. For the purpose of acquiring a standard equation to quantify the creatinine concentration, we interpolated the measured data and confirmed the concentration of the filtered solution. Through this experiment, we determined how the filtration efficiency depended on the flow rate and creatinine concentration.

• Polymer(Korea)
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• v.36 no.3
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• pp.326-331
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• 2012

In this study, expanded poly(tetrafluoro ethylene) (ePTFE) graft was modified to be used as a hemodialysis vascular access. Biodegradable poly(D,L-lactide-$co$-glycolide) (PLGA) was coated onto the inner surface of ePTFE graft with paclitaxel, which is often used as an anti-cancer agent and for reducing neointimal hyperplasia. Surface characterization before and after PLGA coating was carried out by SEM and ATR-FTIR. Porous sturcture of ePTFE was maintained after coating of PLGA solution. The amounts of coated PLGA and paclitaxel determined by ATR-FTIR and HPLC were 1.96 and 0.263 mg/$cm^2$, respectively. Young's modulus was decreased and tensile strength was increased by PLGA coating. Released paclitaxel as a function of incubation time was monitored by HPLC. Approximately 35% of coated paclitaxel was released steadily for 4 weeks with the biodegradation of PLGA. From these results, it is expected that the effect of paclitaxel on reducing neointimal hyperplasia and stenosis is maintained for a long time.

• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.128-137
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• 1991

Peritoneal dialysis has been widely considered to be the dialytic treatment of choice for acute renal failure in infants and young children, because the technique is simple, safe and easily adapted for these patients. Also peritoneal dialysis in infants might have more effective ultrafiltration and clearance than in adults. In certain circumstances associated with hemodynamic instability, ordinary volume peritoneal dialysis(30-50 ml/kg body weight per exchange) or hemodialysis may not be suitable unfortunately. But frequent cycled, low volume, high concentration peritoneal dialysis may be more available to manage the hemodynamically untable acute renal failure of newborns and infants. Seven infants underwent peritoneal dialysis for hemodynamically unstable acute renal failure with low exchange volume($14.2{\pm}4.2ml/kg$), short exchange time(30 to 45 minutes) and hypertonic glucose solution(4.25% dextrose). Age was $1.9{\pm}1.3$ months and body weight was $4.6{\pm}1.6kg $. Etiology of acute renal failure was secondary to sepsis with or without shock(5 cases) and postcardiac operation(2 cases). Catheter was inserted percutaneously with pigtail catheter or Tenkhoff catheter by Seldinger method. Dialysate was commercially obtained Peritosol which contained sodium, chloride, potassium, magnesium, lactate and calcium. Net ultrafiltration(ml/min) showed no difference between low volume dialysis and control($0.27{\pm}0.09$ versus $0.29{\pm}0.09$) Blood BUN decreased from $95.7{\pm}37.5$ to $75.7{\pm}25.9mg/dl$ and blood pH increased from $7.122{\pm}0.048$ to $7.326{\pm}0.063$ after 24 hours of peritoneal dialysis. We experienced hyperglycemia which were controlled by insulin(2 episodes), leakage at the exit site(2), mild hyponatremia(1) and Escherichia coli peritonitis(1). Two children of low volume dialysis died despite the treatment. In our experience, low volume and high concentration peritoneal dialysis with frequent exchange may have sufficient ultrafiltration and clearance without significant complications in the certain risked acute renal failure of infants.