• Title/Summary/Keyword: Renal diseases

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Changes in Nutritional Status of General Medical Patients During Hospitalization (내과 환자의 입원후 영양상태 변화 연구)

  • 양영희;최스미;김은경
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.49-60
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    • 1997
  • The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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A Case of Adenocarinoma of the Lung Associated with Multi-oragn Infarctions (다발성 장기 경색을 동반한 폐선암 1례)

  • Park, Chang-Whan;Lee, Chung-Hoon;Whang, Jun-Wha;Jang, Il-Gwon;Park, Hyeong-Kwan;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1177-1183
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    • 1997
  • The relationship between neoplastic disease and thromboembolic disorders has been recognized since 1865, when Armand Trousseau first reported a high incidence of venous thrombosis in a series of patients with gastric carcinoma. The overall incidence of thromboembolic disease in patients with cancer has been reported to vary 1% to 15%. In a prospective study, Ambrus and associates reported that thrombosis and/or bleeding was the second most common cause of death in haspitalized cancer patients. We report a case who presented as a thromboembolic disease and subsequently confirmed to have an underlying lung malignancy. This 45 years old male patient visited our hospital with abdominal pain and distention of 3 days duration. Abdominal CT scan revealed multiple splenic and renal infarctions. On 20th haspital day, drowsy mental status was developed and hemorrhagic cerebral infarction was noted in brain CT scan. Chest CT scan revealed a 4cm sized spiculated mass on left lung apex and multiple paratracheal lymph adenopathy. With surgical biopsy of left supraclavicular lymph nodes, this patient was confirmed to have adenocarcinoma.

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A Case of Hemolytic Uremic Syndrome in a Lung Cancer Patient Treated with Gemcitabine (Gemcitabine을 사용한 폐암환자에서 발생한 용혈성 요독증후군 1예)

  • Park, Youn-Jung;Yang, Keun-Suk;Jung, Hong-Soon;Nam, Hee-Chul;Jung, Seung-Hye;Kim, Boo-Gyoung;Kim, Ka-Young;Kim, Jung-Ho;Kim, Young-Ok;Yun, Yu-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.207-211
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    • 2012
  • Hemolytic uremic syndrome (HUS) is a rare disorder characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS arises from a wide spectrum of conditions, and chemotherapeutic agents have been reported to be associated with HUS, including Mitomycin, Cisplatin, Bleomycin, and Gemcitabine. A 76-year-old man treated with Gemcitabine due to non-small cell lung cancer developed clinical and laboratory findings compatible with HUS. Gemcitabine was ceased and hemodialysis and plasma exchange were utilized and he recovered. A high level of suspicion for HUS is necessary when cancer patients are treated with Gemcitabine, and prompt recognition and treatment are also essential.

Assessment of the Dietary Consultation and Patient Education Practices in the Hospital Dietetics (한국 병원 영양실의 환자 영양 교육 실행 현황에 관한 실태조사)

  • Ohk, Hae-Woon
    • Journal of Nutrition and Health
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    • v.13 no.1
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    • pp.9-14
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    • 1980
  • A total of 35 hospitals throughout Korea were surveyed for the assessment of the educational function of dietitians. The current situation and the depth of practices were diagnosed in such areas as: 1. The continuing education for the hospital dietitians 2. The characteristics of patient consultation performed by the hospital dietitians 3. Systems and methods of patient instruction practiced by the dietitians, and 4. Prospectives in establishing the nutrition education center for the in-and out-patients. The major findings are: 1. Approximately half of the hospital dietitians feel positive about the practicality of their college education for the job. Extremely small number of them are on any kind of continuing education program 2) The monthly average of only 20 patients at one hospital receive diet consultation or nutrition education service from dietitians. The 50% of the consultation cases is taken up by the patients with diabetes and various circulartory diseases followed by the tube feedings, liver and renal diseases with less frequencies 3) Not even a single hospital has an office for the diet consultation and nutrition education for the in-or out-patients. Very few hospital dietetics have educational aids and/or any feedback system to evaluate the effect of the consultation. Charting is not practiced by most dietitians leaving no record of their contributions to the patient care. 4) Although the necessity of the nutrition education center in the hospital is strong1y recognized among dietitians the progress has been blocked by such obstacles as the poor system in the hospital administration in general, short in funds, lack of preparation in the dietetics and the lack of recognition both by the hospital administration and by the dietitian themselves.

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A case of pseudohypoaldosteronism type 1 with a mutation in the mineralocorticoid receptor gene

  • Lee, Se-Eun;Jung, Yun-Hye;Han, Kyoung-Hee;Lee, Hyun-Kyung;Kang, Hee-Gyung;Ha, Il-Soo;Choi, Yong;Cheong, Hae-Il
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.90-93
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    • 2011
  • Pseudohypoaldosteronism type 1 (PHA1) is a rare form of mineralocorticoid resistance characterized in newborns by salt wasting with dehydration, hyperkalemia and failure to thrive. This disease is heterogeneous in etiology and includes autosomal dominant PHA1 owing to mutations of the NR3C2 gene encoding the mineralocorticoid receptor, autosomal recessive PHA1 due to mutations of the epithelial sodium channel (ENaC) gene, and secondary PHA1 associated with urinary tract diseases. Amongst these diseases, autosomal dominant PHA1 shows has manifestations restricted to renal tubules including a mild salt loss during infancy and that shows a gradual improvement with advancing age. Here, we report a neonatal case of PHA1 with a NR3C2 gene mutation (a heterozygous c.2146_2147insG in exon 5), in which the patient showed failure to thrive, hyponatremia, hyperkalemia, and elevated plasma renin and aldosterone levels. This is the first case of pseudohypoaldosteronism type 1 confirmed by genetic analysis in Korea.

Charlson comorbidity index as a predictor of periodontal disease in elderly participants

  • Lee, Jae-Hong;Choi, Jung-Kyu;Jeong, Seong-Nyum;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.2
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    • pp.92-102
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    • 2018
  • Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

A Case of Severe Bleomycin-Induced Pneumonitis at Non-Hodgkin's Lymphoma (비호즈킨 림프종 환자에서 저용량의 Bleomycin에 의해 발생한 급성 중증 폐독성 1예)

  • Han, Dong-Ha;Min, Young-Joo;Yoon, Je-Hyun;Park, Jong-Ho;Ahn, Jong-Joon;Lee, Ki-Man;Park, Jae-Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.260-264
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    • 2002
  • Bleomycin-induced pulmonary toxicity usually occurs in the elderly patients (greater than 70 years old), patients with a cumulative dose above 400 units, previous chest radiotherapy, oxygen therapy, and renal failure. However, there are some reports of severe pneumonitis that developed after administering low bleomycin doses(less than 100 units). In severe bleomycin-induced pneumonitis in non-Hodgkin's lymphoma patients, the response to corticosteroid is poor and the mortality rate is very high, approximately 83%. Therefore, clinicians should have a low threshold for investigating and treating bleomycin-induced pneumonitis. Here, we report a case of severe bleomycin-induced pneumonitis as a complication of a non-Hodgkin's lymphoma treatment.

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

  • Uhm, Jae Sun;Kwon, Jung Hyun;Kim, Tae Woo;Ji, Jeong Seon;Kim, Jin Woo;Kim, Seung Joon;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.188-192
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    • 2004
  • Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.

An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae

  • Jang, Juah;Kim, Cheol-Hong;Yoo, Jun Jae;Kim, Mi Kang;Lee, Jae Eun;Lim, Ah Leum;Choi, Jeong-Hee;Hyun, In Gyu;Shim, Jung Weon;Shin, Ho-Seung;Han, Joungho;Seok, Soon Ja
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.6
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    • pp.264-268
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    • 2013
  • A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.

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

  • Yum, Ho-Kee;Han, Seong-Hoon;Kim, Hyung-Gon;Lee, Hye-Kyung;Jeon, Woo-Ki;Lee, Yun-Woo;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.546-551
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    • 1994
  • Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not known. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.

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