• 제목/요약/키워드: Renal disease

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Alagille 증후군을 가진 환자의 구강내 특징에 대한 증례보고 (ORAL CHARACTERISTIC OF ALAGILLE SYNDROME - A CASE REPORT)

  • 김태완;김영진
    • 대한장애인치과학회지
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    • 제3권1호
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    • pp.17-21
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    • 2007
  • Allagille 증후군은 담즙분비의 감소로 인한 간의 손상, 황달, 황색종, 소양증 등의 다양한 문제들을 가진다. 구강영역의 문제점으로는 출혈 및 감염, 치아의 변색을 들 수 있다. 또한 증례의 환아와 같이 간이식을 할 경우 지속적인 면역억제제의 사용으로 인한 감염의 위험성은 평생 동안 계속되게 된다. 따라서, Alagille 증후군 환자에 있어서는 다음과 같은 사항들이 치과치료에서 필요하다고 생각된다. 의과 및 치과병력을 정확히 파악하고, 내원마다 전 치아들에 대한 평가를 철저히 실시하며, 발견되는 우식은 더 이상 진행이 되지않도록 즉시 치료해야 한다. 예방적 항생제를 투여하더라도 감염과 출혈을 예방하기위해 치료 시 최소한의 외상이 가해지도록 하며, 치료 후에도 감염의 소지가 있을 수 있는 치아는 제거하는 편이 유리하다. 성장이 끝난 후에는 심미적 기능적인 문제를 해결하기 위해 전 치열에 대한 재건이 필요하며 환자 스스로 구강위생에 신경을 쓸 수 있도록 예방 교육에 힘써야 할 것으로 생각한다.

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혈액투석 환자의 치료에 대한 믿음, 질병 통제감과 우울, 건강 관련 삶의 질과의 관계 (Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis)

  • 차지은;이명선
    • 성인간호학회지
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    • 제26권6호
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    • pp.693-702
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    • 2014
  • Purpose: The purpose of this study was to examine the relationships between treatment belief, personal control, depressive mood, and health-related quality of life in patients with hemodialysis based on self-regulation theory. Methods: Data were collected from 220 patients at 27 local hemodialysis clinics in Seoul during 2013 and 2014. The Revised Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale, and Medical Outcomes Study Short Form-12 were used to measure outcome variables. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression using the 'enter' method. Results: Treatment belief and personal control scored 3.58 and 3.54 out of 5 points respectively, on average. Treatment belief and personal control of kidney disease were negatively correlated with depressive mood and positively correlated with health-related quality of life. According to the regression analysis, treatment belief, monthly income, and personal control were discovered to account for 21.8% of the variance in depressive mood, where as depressive mood, monthly income, treatment belief, and age were found out to account for 40.6% of the variance in health-related quality of life. Conclusion: Our study demonstrated significant positive relationships between treatment belief and illness outcome in hemodialysis patients. Interventions aimed to provide the necessary information and trust to maximize the effectiveness of treatment need be developed to improve patients outcomes.

폐혈전증과 갑상선기능항진증이 동반된 타카야수 폐동맥염 1예 (A Case of Isolated Pulmonary Takayasu's Arteritis Combined with Pulmonary Thromboembolism and Hyperthyroidism)

  • 엄재선;권정현;김태우;지정선;김진우;김승준;이숙영;김영균;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제57권2호
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    • pp.188-192
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    • 2004
  • 폐동맥만을 침범한 타카야수 동맥염은 매우 드물고 폐혈전증과 동반되어 갑상선기능항진증으로 증상이 악화된 경우를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

사백산(瀉白散)과 사백산가사려륵(瀉白散加訶藜勒)이 호흡기계(呼吸器系)에 미치는 영향(影響) (Effect of Sabaeksan and Sabaeksangakaryereuk on the Respiratory System in Experimental Animals)

  • 이순호;한상환
    • 대한한방내과학회지
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    • 제16권1호
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    • pp.104-129
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    • 1995
  • Sabaeksan and Sabaeksangagaryureuk, a traditional prescription, has been used in Korea for many centuries as a treatment for chronic respiratory disease. The purpose of the present study was to determine the effect of Sabaeksan and Sabaeksangagaryureuk on acetylcholine-induced tracheal smooth muscle contraction in guinea pigs and norepinephrine-induced vascular smooth muscle contraction in pigs. Guinea pig (500g, female) were killed by CO2 exposure and a segment (8-10mm) of the thoracic trachea from each guinea pig and renal artery from each pig were cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 0.5g loading tension. The dose of acetylcholine (Ach) and norepinephrine (NE) which evoked 50% of maximal response ($ED_{50}$) was obtained from cumulative dose response curves for acetylcholine (10-7-10-4M) and norepinephrine (10-7-10-4M). Contractions of tracheal smooth muscle evoked by Ach ($ED_{50}$) were inhibited significantly by Sabaeksan and Sabaeksangagaryureuk. Propranolol (10-7M) slightly but significantly attenuated the inhibitory effects of Sabaeksan and Sabaeksangagaryureuk. Indomethacin and methylene blue (10-7M) did not significantly alter the inhibitory effect of Sabaeksan and Sabaeksanga-garyureuk. Contractions of vascular smooth muscle evoked by NE (NE50) were inhibited significantly by Sabaeksan and Sabaeksangagaryureuk. Propranolol (10-7M) slightly but significantly attenuated the inhibitory effects of Sabaeksan and Sabaeksangagaryureuk. Indomethacin and methylene blue (10-7M) did not significantly alter the inhibitory effect of Sabaeksan and Sabaeksangagaryureuk. These results indicate that Sabaeksan and Sabaeksangagaryureuk can relax acetylcholine-induced contraction of guinea pig tracheal smooth muscle, and norepinephrine-induced contraction of pig vascular smooth muscle that this inhibition involves, in part, the relation of adrenergic receptor.

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비타민 D 저항성 구루병 환아의 치험례 (VITAMIN D-RESISTANT RICKETS : A CASE REPORT)

  • 김소정;박재홍;김광철;최성철
    • 대한장애인치과학회지
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    • 제6권1호
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    • pp.10-14
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    • 2010
  • 본 증례에서는 비타민 D 저항성 구루병으로 진단받았으며, 가족력이 있었고, 작은 키, 휜 다리 등의 전신적인 증상을 보이는 환아의 구강 증상과 치료를 보고하였다. 특징적으로 구강 내에 심한 우식이 없는 치아에 다발성 치은 농양이 관찰되었고, 방사선학적으로 유치와 영구치에서 상아법랑경계까지 길게 뻗은 치수각, 얇은 상아질 및 확장된 치수 강이 관찰되었다. 이러한 비타민 D 저항성 구루병 환아에게는 치수 절제술 및 기성 금관 수복뿐만 아니라 더욱 더 적극적인 예방치료와 주기적인 검사가 필요할 것으로 사료된다.

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림프구 자극 시험으로 확진된 금제에 의한 과민성폐렴 1예 (A Case of Gold Induced Hypersensitivity Pneumonitis Diagnosed by Lymphocyte Stimulation Test with Gold)

  • 염호기;한성훈;김형곤;이혜경;전우기;이윤우;김동순
    • Tuberculosis and Respiratory Diseases
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    • 제41권5호
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    • pp.546-551
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    • 1994
  • 금치료는 류마티스 관절염에서 고식적인 치료에 반응하지 않는 경우 유용하게 사용되고 있고, 드물게 금제에 의한 과민성 폐렴을 유발하는 것으로 알려져 있다. 저자등은 6년간 혈청반응검사 양성 류마티스 관절염을 앓아 왔던 26세 여자환자에서 Gold sodium thiomalate 300 mg을 사용후 발생원 과민성 폐렴 1예를 림프구 자극 시험으로 확인하여 문헌고찰과 함께 보고한다.

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Streptococcus Constellatus에 의한 농흉 1예 (A Case of Empyema Caused by Streptococcus Constellatus)

  • 류용석;이재형;이병훈;김상훈;양동진;류상렬;유연화;정미연;채정돈
    • Tuberculosis and Respiratory Diseases
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    • 제66권6호
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    • pp.463-466
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    • 2009
  • S. constellatus는 Streptococcus milleri group을 이루는 균이며 상부호흡기계, 비뇨기계 등에 정상 상재균으로 존재하다 면역저하 상태에서 기회감염을 일으키며 주로 농을 형성하는 것으로 알려져 있다. 저자들은 혈액투석을 받는 환자에게 발생한 S. constellatus에 의한 농흉 1예를 경험하였기에 문헌고찰과 함께 보고한다. 본 증례를 통해 면역이 저하된 환자에게 농흉이 형성된 경우 S. constellatus에 의한 감염을 생각해볼 수 있으며 이와 같은 경우 세균학적 검사 결과에 따른 항생제 치료와 함께 수술적 배농을 고려해야 한다는 것을 경험하였다.

혈액투석환자의 자가간호행위 (Self Care Behavior of Hemodialysis Patients)

  • 조미경;최명애
    • 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.

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Recombinant Human Erythropoietin Therapy for a Jehovah's Witness Child With Severe Anemia due to Hemolytic-Uremic Syndrome

  • Woo, Da Eun;Lee, Jae Min;Kim, Yu Kyung;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • 제59권2호
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    • pp.100-103
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    • 2016
  • Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

A case of McKusick-Kaufman syndrome

  • Son, Se-Hyung;Kim, Yoon-Joo;Kim, Eun-Sun;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • 제54권5호
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    • pp.219-223
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    • 2011
  • McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.