• 대한영양사협회학술지
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• 제24권2호
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• pp.117-140
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• 2018

The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

• Journal of Veterinary Science
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• 제22권1호
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• pp.14.1-14.11
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• 2021

Background: Quantitation of urine protein is important in dogs with chronic kidney disease. Various analyzers are used to measure urine protein-to-creatinine ratios (UPCR). Objectives: This study aimed to compare the UPCR obtained by three types of analyzers (automated wet chemistry analyzer, in-house dry chemistry analyzer, and dipstick reading device) and investigate whether the differences could affect clinical decision process. Methods: Urine samples were collected from 115 dogs. UPCR values were obtained using three analyzers. Bland-Altman and Passing Bablok tests were used to analyze agreement between the UPCR values. Urine samples were classified as normal or proteinuria based on the UPCR values obtained by each analyzer and concordance in the classification evaluated with Cohen's kappa coefficient. Results: Passing and Bablok regression showed that there were proportional as well as constant difference between UPCR values obtained by a dipstick reading device and those obtained by the other analyzers. The concordance in the classification of proteinuria was very high (κ = 0.82) between the automated wet chemistry analyzer and in-house dry chemistry analyzer, while the dipstick reading device showed moderate concordance with the automated wet chemistry analyzer (κ = 0.52) and in-house dry chemistry analyzer (κ = 0.53). Conclusions: Although the urine dipstick test is simple and a widely used point-of-care test, our results indicate that UPCR values obtained by the dipstick test are not appropriate for clinical use. Inter-instrumental variability may affect clinical decision process based on UPCR values and should be emphasized in veterinary practice.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• 가정간호학회지
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• 제30권1호
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• pp.48-58
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• 2023

Purpose: The purpose of this study was to construct a nomogram for predicting difficulty in peripheral intravenous cannulation (DPIVC) for adult inpatients. Methods: This study conducted a secondary analysis of data from the intravenous cannulation cohort by intravenous specialist nurses at a tertiary hospital in Seoul. Overall, 504 patients were included; of these, 166 (32.9%) patients with failed cannulation in the first intravenous cannulation attempt were included in the case group, while the remaining 338 patients were included in the control group. The nomogram was built with the identified risk factors using a multiple logistic regression analysis. The model performance was analyzed using the Hosmer-Lemeshow test, area under the curve (AUC), and calibration plot. Results: Five factors, including vein diameter, vein visibility, chronic kidney disease, diabetes, and chemotherapy, were risk factors of DPIVC. The nomogram showed good discrimination with an AUC of 0.81 (95% confidence interval: 0.80-0.82) by the sample data and 0.79 (95% confidence interval: 0.74-0.84) by bootstrapping validation. The Hosmer-Lemeshow goodness-of-fit test showed a p-value of 0.694, and the calibration curve of the nomogram showed high coherence between the predicted and actual probabilities of DPIVC. Conclusion: This nomogram can be used in clinical practice by nurses to predict DPIVC probability. Future studies are required, including those on factors possibly affecting intravenous cannulation.

• 임상간호연구
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• 제29권1호
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• pp.135-145
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• 2023

Purpose: This was a descriptive study investigating the effect of symptom experience and self-care agency on quality of life among patients with stage 5 chronic kidney disease undergoing regular hemodialysis. Methods: The participants were recruited from one general hospital and two private hospitals located in J city. 154 participated and completed structured questionnaires from June 30 to July 18, 2022. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: The mean symptom experience score was 0.91±0.67 (out of 5), self-care agency was 4.19±0.71 (out of 6), and quality of life was 3.02±0.49 (out of 5). A negative correlation was found between quality of life and physical symptom experience (r=-.39, p<.001) and emotional symptom experience (r=-.39, p<.001). A positive correlation was found between quality of life and self-care agency (r=.66, p<.001). The regression analysis showed self-care agency (β=.48, p<.001), emotional symptom experience (β=-.27, p=.001), and monthly family income (β=.19, p=.002) significantly influenced quality of life, and explained 54.0% of the quality of life. Conclusion: These results suggest to improve the quality of life among patients on hemodialysis, it is necessary to assess and intervene with emotional symptom experiences and develop effective programs with specific strategies to enhance self-care agency.

• Childhood Kidney Diseases
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• 제13권1호
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• pp.63-74
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• 2009

목 적 : 경제 발전과 생활양식의 변화는 보건환경에 많은 영향을 끼쳤고, 이로 인해 소아청소년기의 비뇨생식기질환의 질병양상에도 영향을 주었을 것으로 생각된다. 소아청소년의 비뇨생식기질환의 양상의 변화를 파악하기 위해서 한국의 소아 입원환자에 대한 단면적 연구(cross-sectional survey date)를 이용해 역학적 분석을 하였다. 방 법 : 전국 소아청소년과 85개 수련병원을 대상으로 2004년부터 2006년까지 신 요로 질환으로 퇴원한 환자의 자료를 수집하였다. 수집자료의 지표는 ICD-10 의 진단체계를 사용한 최종진단명, 나이, 성별, 입원기간 등을 고려하여 비뇨생식기 질환의 퇴원 환자 현황을 분석하였다. 의료비와 소득손실을 나타내는 지표로 질병부담을 선택하였고, 이는 입원건수와 평균 재원일수를 곱하여 산정하였다. 결 과 : 총 826,896명의 퇴원 환자 중 비뇨생식기 질환으로 퇴원한 환자는 33,876명으로 전체의 4.1%로 1970년대와 비교할 때 감소하는 경향을 나타내었다. 남녀 성비는 1.8:1이었고, 가장 많은 연령대는 생후 4주부터 1세까지의 영아기로 전체 소아 신질환의 32.3%를 차지하였는데. 이후 유아기, 청소년기, 학동기, 신생아기 순이었다. 가장 많은 질환은 요로감염으로 전체 비뇨생식기질환중 42%로 가장 많았고, 음낭수종이 13.2%, 신증후군이 5.1%의 순이었다. 결 론: 소아 비뇨생식기질환은 전체 입원환자에서 차지하는 비중이 높지는 않지만 요로감염의 경우 영유아기에 높은 빈도수를 차지하는 중요질환이며, 본 연구에서는 확인이 되지는 않았지만 요로감염이 신 반흔을 초래하게 되면 말기신부전증으로 이어지기 때문에 중요한 건강문제라고 볼 수 있다. 본 연구는 ICD-10에 의한 전국적인 자료 분석이기 때문에 효율적인 보건 정책의 수립에 있어 중요한 기초자료가 될 수 있지만, 더 실용적이고 정확한 소아청소년 비뇨생식기질환의 질병추이 관찰을 위해서는 입원 진단기준을 포함한 자료수집체계의 수정보완과 지속적인 조사연구가 필요하다.

• 대한수의학회지
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• 제52권3호
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• pp.183-191
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• 2012

The maintenance of peripheral immune tolerance and prevention of chronic inflammation and autoimmune disease require $CD4^{+}CD25^{+}$ T cells (regulatory T cells). The transcription factor Foxp3 is essential for the development of functional, regulatory T cells, which plays a prominent role in self-tolerance. Retroviral vectors can confer high level of gene transfer and transgene expression in a variety of cell types. Here we observed that following retroviral vector-mediated gene transfer of Foxp3, transductional Foxp3 expression was increased in the liver, lung, brain, heart, muscle, spinal cord, kidney and spleen. One day after vector administration, high levels of transgene and gene expression were observed in liver and lung. At 2 days after injection, transductional Foxp3 expression level was increased in brain, heart, muscle and spinal cord, but kidney and spleen exhibited a consistent low level. This finding was inconsistent with the increase in both $CD4^{+}CD25^{+}$ T cell and $CD4^{+}Foxp3^{+}$ T cell frequencies observed in peripheral immune cells by fluorescence-activated cell-sorting (FACS) analysis. Retroviral vector-mediated gene transfer of Foxp3 did not lead to increased numbers of $CD4^{+}CD25^{+}$ T cell and $CD4^{+}Foxp3^{+}$ T cell. These results demonstrate the level and duration of transductional Foxp3 gene expression in various tissues. A better understanding of Foxp3 regulation can be useful in dissecting the cause of regulatory T cells dysfunction in several autoimmune diseases and raise the possibility of enhancing suppressive functions of regulatory T cells for therapeutic purposes.

• 대한한의학회지
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• 제20권3호
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• pp.45-53
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• 1999

Since Radix Stemonae was recorded hypothennal and a little toxic in the 'Myngyubelrok (名醫別錄)', it has been recorded as having the same nature in many herbal books. However, the security of Radix Stemonae when used to treat respiratory disease over a long term has not been studied until now. Therefore, the objective of this study is to determine the effects of Radix Stemonae on the main organs if Radix Stemonae is administrated over a long term. In order to investigate the histological changes of the liver and kidneys of rats after oral administration of Radix Stemonae extract, the experimental rats were subdivided into control, 1, 3, 5, 7, 21, 28 and 35 days after administration groups, and 10 rats per group were used in this study. The control group was sufficiently supplied with water and solid forage. The other groups were administrated the reagent at 5mg/kg once a day by oral injection. Several times each day, the experimental groups were carefully observed for any changes of general condition, toxic symptoms, activity, appearance and the number of dead rats. The experimental groups were weighed and narcotized. For the histological observation, the tissues of liver and kidneys of the experimental groups were collected, stained by hematoxylin-eosin stain, and evaluated by observing the changes of gross appearance and by observing microscopic findings. 1. This drug, during the experimental term, did not induce any toxicological effect in mortality, abnormal symptoms or changes of body weight except for the 1 day after administration groups whose body weights were decreased, compared to the control group. 2. No gross changes of the liver and kidneys were observed in this study. 3. No histological changes of the liver were detected in 1 day after administration groups. However, dilation of the central vein was observed in 3, 5 and 7 days after administration groups and chronic passive congestion of the liver was demonstrated in the 21 days after administration groups. In the 28 and 35 days after administration groups, a centrolobular disposition of fatty tissue (adipose cell) was observed. 4. No histological changes of the kidneys were observed in this study. It is evaluated that if Radix Stemonae is administrated for a long term, it induces toxicity in the liver. So, to examine the toxicity of Radix Stemonae on the liver and kidney, it is necessary that the studies of biochemistry and electron microscopic findings about Radix Stemonae be systematically performed.

• 한국임상약학회지
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• 제21권4호
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• 한국융합학회논문지
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• 제10권5호
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• pp.385-395
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• 2019

본 연구는 혈액투석환자의 사회적지지와 회복탄력성이 환자역할행위 이행에 미치는 영향을 파악하고, 혈액투석 환자의 환자역할행위 이행 증진을 위한 간호중재 프로그램의 기초자료를 제공하고자 시도되었다. 연구방법은 D광역시에 위치한 일개 종합병원에서 정기적으로 혈액투석 치료를 받고 있는 만성콩팥병 환자 131명의 설문지를 최종 분석하였다. 연구의 분석결과 혈액투석환자의 사회적지지는 $3.93{\pm}0.84$점, 회복탄력성은 $2.67{\pm}0.80$점이었고, 환자역할행위 이행은 $3.99{\pm}0.80$점으로 나타났다. 사회적지지가 높을수록 회복탄력성과 환자역할행위 이행이 증가하며 회복탄력성이 높을수록 환자역할행위 이행이 증가하는 것으로 나타났다. 대상자의 환자역할행위 이행에 영향을 미치는 요인으로 투석횟수, 사회적지지, 회복탄력성이 있었고 모형의 설명력은 44.0%이었다. 환자역할행위 이행을 증진시키기 위해서는 회복탄력성을 활용하고 사회적지지를 지속적으로 유지하는 간호중재 프로그램을 연구, 개발이 필요할 것으로 생각된다.