• Childhood Kidney Diseases
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• 제18권2호
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• pp.106-110
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• 2014

선천성 흉강내 신장은 이소성 신장의 가장 드문 형태로 알려져 있다. 흔히 증상이 없어 우연히 흉부 방사선 촬영을 통해 발견 되며, 주로 성인 시기와 산전 진단에서 진단 받는 경우가 많은 것으로 알려져 있다. 선천성 흉강내 신장은 다른 동반기형이 없는 무증상의 경우 수술적 치료가 필요하지 않으며, 횡격막 탈장이 동반된 경우 출생 후 수일 이내에 교정 수술이 필요 하다. 이에 저자들은 분만력, 과거력상 특이 소견이 없었던 15개월 남아로 간헐적인 심한 보챔을 주소로 내원하였고 흉부 방사선 촬영에서 종격동 종괴를 보여 시행한 초음파와 스캔에서 신장 위치의 이상을 확인하였고, MRI를 통해 횡격막 탈장을 확인한 예를 경험하였기에 보고하는 바이다.

• Childhood Kidney Diseases
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• 제5권2호
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• pp.164-175
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• 2001

목 적 ; Alport 증후군은 1927년 Alport에 의해 처음 보고된 유전성 신질환으로 전신적으로 기저막에 영향을 미쳐 계속적으로 진행하는 신질환과 감각신경성 난청, 눈의 이상, 전자현미경상 특징적 소견, 그리고 대부분의 경우 가족력 동반을 특징으로 한다. 저자들은 Alport 증후군 환아의 임상적 특징을 중심으로 관찰하여 이 질환의 예후에 관련된 위험요인을 알아보고자 후향적 조사를 시행하였다. 대상 및 방법 : 1980년 1월부터 1999년 12월까지 20년동안 소아과에서 시행한 신장조직검사에서 Alport 증후군으로 진단 후 추적관찰이 가능하였던 환아 24명을 대상으로 하였다. 처음 내원 당시와 현재의 신장기능을 비교하여 현재까지 정상의 신장기능을 유지하고 있는 군(Group I)과 만성신부전으로 진행한 군(Group II)으로 나누어 Group I과 Group II간의 여러 가지 임상양상을 비교하였으며 통계학적 방법으로는 비모수검정법을 이용하였다. 결 과 : 24명의 환아 중 남녀의 비는 3:1이였고 신증상 발현시의 연령은 평균 $5.2{\pm}3.6세$였으며 내원 당시 나이는 평균 $7.8{\pm}4.4세$였다. 처음 내원 당시의 주증상은 육안적 혈뇨가 15예($62\%$)로 가장 많았고, 진단 당시의 환아들의 임상양상으로는 가족력이 있는 경우가 17예($70\%$), 육안적 혈뇨는 18예($75\%$), 단백뇨가 있었던 경우가 14예($58\%$), 부종은 14예($58\%$), 고혈압은 6예($25\%$)에서 관찰되었다. 전체 24명의 환아 중 만성신부전으로 진행된 경우는 11예($46\%$)였고, 이 중 말기신부전으로 진행되어 신장이식 후 관찰 중인 경우가 7예($29\%$) 있었다. 청각이상소견을 보인 경우는 12예($50\%$)였으며, 안과적 정밀검사상 이상소견을 보인 경우는 5예($21\%$)였다. 신증상 발현이후 계속해서 신장기능이 유지되고 있는 집단을 Group I(n=13), 만성신부전으로 진행한 집단을 Group II(n=11)라고 할 때, 이 두 집단 사이의 진단당시의 임상양상의 차이를 보면 고혈압, 단백뇨 및 부종의 빈도가 Group I에서 통계적으로 유의하게 증가되어 있으며, 임상병리검사 소견에서는 혈중 총단백량, 알부민, creatinine 청소율이 Group I에서 통계적으로 유의하게 감소되어 있고, BUN, creatinine은 통계적으로 유의하게 증가되었다. 결 론 : Alport 증후군 환아에서 임상적으로 유의미한 예후와 관련된 위험요인으로는 진단시의 고혈압, 부종, 단백뇨 유무 여부와 혈중 총단백량, 알부민, BUN, creatinine, 사구체 여과율이 중요하며, 이런 가능한 위험요인의 분석과 관찰이 Alport 증후군 환아의 치료와 예후 인지에 많은 도움이 되리라 사료된다.

• 대한이식학회지
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• 제28권3호
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• pp.144-153
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• 2014

Background: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. Methods: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). Results: The donors were predominantly female (62.5%) and the average age was 48.9±11.8 years, and the average period after nephrectomy was 9.7±5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3±13.9. Higher than average scores (116.3±19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). Conclusions: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7497-7500
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• 2013

Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

• 대한한방부인과학회지
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• 제24권3호
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• pp.127-145
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• 2011

Purpose: The purpose of this study is to analyze the effect of oriental-western medicine integrative care after gynecology surgery by DSOM((Diagnosis System of Oriental Medicine) and improvement of major symptoms. Methods: 66 patients belonged to the experimental group and 47 patients belonged to the control group out of 113 patients taken gynecology surgery. We studied general characteristics and difference on DSOM results between the two groups. And we had patients answer questionnaires about major symptoms such as abdominal discomfort, headache, fatigue, urinary discomfort, constipation, lumbago, edema, tingling, digestive disorder, cough, pruritus, arthralgia, cold feeling by VAS (Visual Analogue Scale) in order to analyze improvement and difference between two groups. Results: Experimental group had significantly high score on deficiency of blood, blood stasis, dryness, spleen, kidney, phlegm and high frequency on deficiency of blood, dampness, kidney, phlegm pathogenesis in DSOM. It had significantly high intensity in symptoms of abdominal discomfort, headache, fatigue, urinary discomfort, constipation, lumbago at the first time, and headache at 1 month after western hospital discharge out of symptoms associated with surgery. And it had significantly high improvement in symptoms of abdominal discomfort, headache, urinary discomfort, constipation at oriental-western integrative hospital discharge, and headache, fatigue, urinary discomfort, constipation, lumbago at 1 month after western hospital discharge out of symptoms associated with surgery. Conclusion: We recognized that oriental-western medicine integrative care after gynecology surgery has significant effect.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.505-512
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• 2014

Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients.

• Journal of Chest Surgery
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• 제55권3호
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• pp.189-196
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• 2022

Background: This study investigated the predictive value of the frailty index calculated using laboratory data and vital signs (FI-L) in patients who underwent coronary artery bypass grafting (CABG). Methods: This study included 508 patients (age 67.3±9.7 years, male 78.0%) who underwent CABG between 2018 and 2021. The FI-L, which estimates patients' frailty based on laboratory data and vital signs, was calculated as the ratio of variables outside the normal range for 32 preoperative parameters. The primary endpoints were operative and medium-term all-cause mortality. The secondary endpoints were early postoperative complications and major adverse cardiac and cerebrovascular events (MACCEs). Results: The mean FI-L was 20.9%±10.9%. The early mortality rate was 1.6% (n=8). Postoperative complications were atrial fibrillation (n=148, 29.1%), respiratory complications (n=38, 7.5%), and acute kidney injury (n=15, 3.0%). The 1- and 3-year survival rates were 96.0% and 88.7%, and the 1- and 3-year cumulative incidence rates of MACCEs were 4.87% and 8.98%. In multivariable analyses, the FI-L showed statistically significant associations with medium-term all-cause mortality (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.010-1.076), MACCEs (subdistribution HR, 1.054; 95% CI, 1.030-1.078), atrial fibrillation (odds ratio [OR], 1.02; 95% CI, 1.002-1.039), acute kidney injury (OR, 1.06; 95% CI, 1.014-1.108), and re-operation for bleeding (OR, 1.09; 95% CI, 1.032-1.152). The minimal p-value approach showed that 32% was the best cutoff for the FI-L as a predictor of all-cause mortality post-CABG. Conclusion: The FI-L was a significant prognostic factor related to all-cause mortality and postoperative complications in patients who underwent CABG.

• Journal of Chest Surgery
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• 제22권2호
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• pp.202-211
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• 1989

We experienced a series of animal experimental studies of the total artificial heart in 1988. So called, "Korean Heart* was used in this study, which is developed and fabricated in the Department of Biomedical Engineering, College of Med., S.N.U.. "Korean Heart" is a Rolling-Cylinder Motor-Driven type which is a newly developed electromechanical heart over the shortcomes of the previous artificial hearts, especially pneumatic type. The advantages of the "Korean Heart" are total implantability, quiet and smooth movement, small size fittable in oriental people, etc. The animal experiments were performed two times, as an assist device in sheep and total artificial heart implant experiment in calf weighing 100 kg. After total implantation, the artificial heart was well functioned in movement and hemodynamic control. So that, the calf was recovered excellently, which was able to stand up by herself and take an oral intake. Total survival time was 100 hours and the cause of death was a sudden pumping failure [electrical connection problem]. Several postoperative laboratory results almost within normal limits and no hemolysis, but in autopsy, the multiple thromboembolic findings were seen at the lung and kidney.n at the lung and kidney.

• 동서간호학연구지
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• 제18권1호
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• pp.9-17
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• 2012

Purpose: The purpose of this study was to identify the effects of an individual educational program on self-care knowledge and self-care behavior in kidney transplantation patients. Methods: The kidney transplantation patients were recruited from a transplantation center, at a university hospital located in Korea. Data were collected from June 1, 2010 to January 31, 2011. The research design was a nonequivalent one group pre-post test. Forty-two subjects were participated two times individually in an educational program given by the researcher. Results: After the intervention, the participants showed a significant increase in self-care knowledge(t=-4.10, p=.000) and self-care behavior (t=-6.07, p=.000) than before the intervention. Conclusion: This results suggest that the program developed in this study can be considered an effective nursing intervention for health promotion, prevention of complication and self-care behavior in kidney transplantation patients.

• Journal of Chest Surgery
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• 제46권5호
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• pp.373-376
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• 2013

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.