• 한국미생물·생명공학회지
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• 제47권2호
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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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• 제29권2호
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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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• 제21권3호
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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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• 제32권3호
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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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• 제35권5호
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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.

• 대한임상독성학회지
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• 제7권1호
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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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• 제23권2호
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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.

• 대한기계학회논문집B
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• 제39권12호
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• pp.921-925
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• 2015

매년마다 신장질환으로 고통 받는 사람들이 증가하는 추세이다. 가장 흔한 치료법 중 하나는 혈액 투석인데, 이 방법은 많은 시간이 걸리고, 비용이 많이 드는 방법이다. 이러한 이유 때문에, 인공신장 연구의 중요성이 대두되고 있다. 혈액에서 크레아티닌을 여과하는 것은 신장의 주요 기능 중 하나이다. 우리는 이 기능에 초점을 맞춘 새로운 2 채널 마이크로 플루이딕 칩을 고안하였다. 두 개의 PDMS 층을 결합하기 위하여, 아크릴을 가공한 하우징 시스템이 개발하였으며, 이 방법은 여과막을 쉽게 바꿀 수 있다는 이점이 있다. 우리는 알루미늄 양극 산화물(AAO)을 여과막으로 사용하였다. 여과된 용액은 자페반응(Jaffe reation)을 이용하여, 크레아티닌 농도별 흡광도 차이를 분석하였다. 크레아티닌의 양에 대한 표준식을 만들어, 측정한 데이터를 보간하여 여과된 용액의 농도를 확인하였다. 실험을 통하여 유량 및 크레아티닌 농도에 따른 여과율을 얻을 수 있었다.

• 폴리머
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• 제36권3호
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• pp.326-331
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• 2012

본 연구에서는 혈액투석 시 필요한 혈관접근통로로 활용되는 expanded poly(tetrafluoro ethylene)(ePTFE) 인공혈관을 표면 개질하였다. 생분해성 합성고분자인 poly(D,L-lactide-$co$-glycolide)(PLGA)와 함께 항암제로서 뿐만아니라 항증식제제로서 널리 쓰이고 있는 파클리탁셀을 인공혈관 표면에 코팅함으로써 PLGA가 생분해됨에 따라 파클리탁셀을 서방할 수 있도록 고안하였다. 인공혈관의 다공구조 특성을 유지하면서 인공혈관 표면에 1.96 mg/$cm^2$의 PLGA가 코팅되었음을 ATR-FTIR을 통해 확인하였다. 또한 0.263 mg/$cm^2$의 파클리탁셀이 인공혈관에 코팅되었음을 HPLC로 확인하였다. PLGA를 코팅함으로써 인공혈관의 모듈러스는 감소하였으나 인장강도는 향상되었다. 약물방출 실험 결과 PLGA의 생분해거동에 동반하여 코팅된 파클리탁셀의 약 35%가 28일 동안 지속적으로 방출되었다. 이러한 지속적인 파클리탁셀의 방출은 장기간에 걸쳐 신내막 과형성증을 억제하여 혈관의 개존율을 향상시킬 것으로 기대된다.

• Journal of Yeungnam Medical Science
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• 제8권2호
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• pp.128-137
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• 1991

신생아나 영아의 급성신부전증의 치료를 위하여서 복막투석이 매우 유효한 방법으로 알려져 있지만 혈역학적으로 불안정한 상태에서 저용량, 고농도의 투석액으로 자주 교환하는 방법이 통상적인 투석방법과 마찬가지로 효율적인지를 알아보기 위하여 본 연구를 시도하였다. 대상환아는 신생아와 영유아에서 혈역학적으로 불안정하리라 추정되는 7례의 급성신부전증 환아를 대상으로 저용량($14.2{\pm}4.2ml/kg$), 고농도(4.25% dextrose)의 투석액을 30-45분의 짧은 간격으로 교환하는 복막투석을 실시하여 통상적인 방법을 사용한 4례의 환아와 비교하였다. 환아의 연령은 $1.9{\pm}1.3$개월이었고, 체중은 $4.6{\pm}1.6kg$이었으며 신부전증을 일으킨 원인은 패혈증과 이에 동반한 쇽 5례와 심장수술 후 과다혈량 상태가 생긴 2례였다. 도관은 경피적으로 pigtail 도관이나 Tenckhoff 도관을 삽입하였다. 유효한외과여과율은 $0.27{\pm}0.09ml/min$로서 통상적인 방법에 의한 $0.29{\pm}0.09ml/min$와 유의한 차이가 없었다. 또한 투석 24시간 후 혈중 BUN은 $95.6{\pm}37.5mg/dl$에서 $ 75.7{\pm}25.9mg/dl$로 감소하였고, 혈중 pH는 $7.122{\pm}0.048$에서 $7.326{\pm}0.063$으로 증가하였다. 투석중의 부작용으로는 2례의 고혈당증, 2례의 도관 주위 누출, 1례의 경한 저나트륨혈증과 1례의 복막염이 발생하였으나 비교적 용이하게 교정이 가능하였다. 이들 환아중 2례의 환아가 선행질환의 악화로 사망하였다.