• Journal of Chest Surgery
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• v.24 no.4
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• pp.397-403
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• 1991

From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.201-224
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• 2023

Objectives: The purpose of this study was to evaluate the effect of Gwibi-tang (GBT) on renal anemia. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate changes in anemia levels before and after oral administration of GBT in patients with renal anemia. Relevant literature published up to May 25, 2023, was searched in 10 academic electronic databases. Results: Data from 489 patients from 7 RCTs were obtained and analyzed. All participants were receiving erythropoietin-stimulating agent treatment, and most of them were under hemodialysis. Additional administration of GBT to the participants significantly increased the hemoglobin concentration (10.55 g/L, 95% CI 6.99 to 14.11) compared to the control group. Hematocrit, red blood cell count, serum ferritin concentration, transferrin saturation, and the total effective rate for anemia was also significantly higher in the GBT-treated group than in the control group. Conclusions: This study suggests that GBT may be considered to be a promising option for the effective management of patients with renal anemia under conventional treatment. However, the limitations of this study, including the quantitative and qualitative weakness of the RCTs, the lack of safety-related evidence, and the absence of long-term follow-up data, should be taken into account when interpreting the results of this study.

• Clinical and Experimental Vaccine Research
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• v.12 no.3
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• pp.249-259
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• 2023

Purpose: Since patients on hemodialysis (HD) are known to be vulnerable to coronavirus disease 2019 (COVID-19), many studies were conducted regarding the effectiveness of the COVID-19 vaccine in HD patients in Western countries. Here, we assessed antibody response of HD patients for 6 months post-vaccination to identify the duration and effectiveness of the COVID-19 vaccine in the Asian population. Materials and Methods: We compared antibody response of the COVID-19 vaccine in HD patients with healthy volunteers. Patient and control groups had two doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) was measured before vaccination, 2 weeks after the first dose, 2 and 4 weeks, 3 and 6 months after the second dose. Neutralizing antibody was measured before vaccination and at 2 weeks, 3 and 6 months after second dose. Since the third dose was started in the middle of the study, we analyzed the effect of the third dose as well. Results: Although antibody production was weaker than the control group (n=22), the patient group (n=39) showed an increase in IgG and neutralizing antibody after two doses. And, 21/39 patients and 14/22 participants had a third dose (BNT162b2 or mRNA-1273 in the patient group, mRNA-1273 in the control group), and it did not affect antibody response in both group. Trend analysis showed IgG and neutralizing antibody did not decrease over time. Age, sex, and HD vintage did not affect antibody production in HD patients. Patients with higher body mass index displayed better seroresponse, while those on immunosuppressants showed poor seroresponse. Conclusion: Two doses of vaccination led to significant antibody response in HD patients, and the antibody did not wane until 6 months.

• Kidney Research and Clinical Practice
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• v.36 no.2
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• pp.200-204
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• 2017

Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.

• BMB Reports
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• v.56 no.8
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• pp.426-438
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• 2023

Muscle wasting in end-stage renal disease (ESRD) is an escalating issue due to the increasing global prevalence of ESRD and its significant clinical impact, including a close association with elevated mortality risk. The phenomenon of muscle wasting in ESRD, which exceeds the rate of muscle loss observed in the normal aging process, arises from multifactorial processes. This review paper aims to provide a comprehensive understanding of muscle wasting in ESRD, covering its epidemiology, underlying molecular mechanisms, and current and emerging therapeutic interventions. It delves into the assessment techniques for muscle mass and function, before exploring the intricate metabolic and molecular pathways that lead to muscle atrophy in ESRD patients. We further discuss various strategies to mitigate muscle wasting, including nutritional, pharmacological, exercise, and physical modalities intervention. This review seeks to provide a solid foundation for future research in this area, fostering a deeper understanding of muscle wasting in ESRD, and paving the way for the development of novel strategies to improve patient outcomes.

• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.481-483
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• 2017

Sphingomonas paucimobilis (S. paucimobilis) is a gram negative bacillus. It has existed in soil, drinking water and plants. It has been isolated from distilled water tanks, respirators, and hemodialysis devices at the hospital setting. Patients with chronic disorders or immune suppression may be susceptible to infections with it. This microorganism has also been reported to infect healthy persons. Both nosocomial and community-acquired infections have been reported. So far, a variety of infections have been reported, including sepsis, septic pulmonary embolism, septic arthritis, peritonitis, and endophthalmitis. Only 2 cases of meningitis have been reported so far in the literature. So far, no previous reports of culture proliferation have been reported in patients with external ventricular drains, as was the case in our patient. Therefore, our case is the first to have S. paucimobilis proliferation in cerebrospinal fluid culture during intensive care unit stay for an external ventricular drain.

• Journal of Hospice and Palliative Care
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• v.23 no.1
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• pp.27-38
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• 2020

Purpose: The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers. Methods: An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffe test, and multiple regression with dummy variables. Results: The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked subdimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking "why?", receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking "why?". The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group. Conclusion: The results of this study may serve as evidence that spiritual care for non-cancer patients' family caregivers should be considered as an important part of hospice and palliative care.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.440-444
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• 2015

The purpose of this case report was to present the treatment of continuous renal replacement therapy (CRRT) in dogs with end-stage CKD with uncontrolled uremia. Hemodialysis were carried out 6 patients who failed to improve clinical status with conventional management for CKD. Four dogs with urea reduction ratio (URR) range of 57-72% and 1 dog with URR of 37.3% showed good outcome with decreasing tendency of pre-dialysis Therefore, we suggest that CRRT could be recommended for use in CKD dogs with uncontrolled azotemia or uremia and should be monitor carefully throughout the CRRT.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.366-371
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• 2019

Hemarthrosis occurring after arthroscopic surgery for lesions of the shoulder joint is a very rare complication that can develop due to an injury to the blood vessels when an anterior portal is formed. This is a complication that rarely develops in patients who are taking antithrombotic drugs or who do not have associated diseases, such as thrombocytopenia. We report a case of hemarthrosis that occurred after performing arthroscopic surgery to repair a rotator cuff tear in a patient with a stenosis in an arteriovenous fistula for hemodialysis in the ipsilateral upper arm.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.