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The Lived Experience of Dietary Adaptation in Peritoneal Dialysis Patients: A Phenomenological Study (복막투석환자의 식이적응경험: 현상학적 연구)

  • Lee, Hyun-Jung;Kim, Bong-Hee;Kang, Hee-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.11
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    • pp.364-374
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    • 2020
  • This paper describes the experience of the dietary adaptation of patients undergoing peritoneal dialysis due to end-stage renal failure by identifying the meanings and structure of the experience. In the research method, the data from nine patients were collected using individual in-depth interviews and analyzed using Colaizzi's phenomenological method. The experience of the dietary adaptation of participants undergoing peritoneal dialysis was organized into four theme-clusters and 15 themes. These four theme-clusters were characterized as follows: 'the double sufferings of peritoneal dialysis process and dietary adaptation', 'vague and ambiguous diet management', 'the hardship of diet management felt by experiencing diet using one's body', and 'realizing the importance of diet management with peritoneal dialysis, resetting one's goal in life'. This paper describes the dietary adaptation process experienced by peritoneal dialysis patients was a process of adhering to a better life, even though it was the double sufferings of peritoneal dialysis process and dietary adaptation. In conclusion, the findings in this study provide a deep understanding of the lived experience of the dietary adaptation in peritoneal dialysis patients and should help in the development of tailored diet interventions for patients on peritoneal dialysis.

A Comparative Study in the Cognitive Functions of Peritoneal Dialysis, Hemodialysis and Normal Kidney Function Groups (복막투석, 혈액투석 및 정상 신 기능 집단간의 인지기능 비교 연구)

  • Lee, Gi-Sook;Choi, Song-Hee
    • Korean Journal of Adult Nursing
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    • v.13 no.3
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    • pp.451-462
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    • 2001
  • This study was conducted to examine and compare the characteristics in the cognitive functions of peritoneal dialysis, hemodialysis and normal kidney function groups as basic data for effectively educating dialysis patients. The data were collected from May 10 to October 30. 2000, collected from each of 20 patients with peritoneal dialysis, hemodialysis and normal Kidney function and who registered for the dialysis room at a general hospital affiliated to a university in Seoul and sampled by age and educational level through personal interviews with the researchers of this study. As a measuring tool, MMSE developed by Folstein et al.(1975) to measure cognitive function disorder was used, slightly revised for hemodialysis patients. Collected data were processed into frequency, percentage, mean, and standard deviation by the use of SAS. The results of this study are as follows : 1. With a maximum of 30 points for cognitive function, the mean of the peritoneal dialysis patients was $27.06{\pm}2.06$, while that of the hemodialysis patients was $27.25{\pm}2.76$; that of the normal Kidney function patients was $27.85{\pm}2.00$, indicating no significant difference among those three groups. 2. As for the subjects who scored 23 points, the turning point of confirming the cognitive disorder, the percentage was 5% in the case of the peritoneal dialysis, 10% in the case of the hemodialysis and 5% in the case of the normal Kidney function group. 3. Differences between the peritoneal dialysis and hemodialysis patients by gender, occupation, spouse, diabetes, hypertension, the period of dialysis, number of hospitalizations, and the use of erythropoietin were not significant in the scoring of cognitive function. 4. There was no significant correlation between the level of Hb, Hct, albumin, aluminium, PTH, BUN, Cr, dialysis adequacy and the cognitive function. Considering such results, it is clear that there is no significant difference in the cognitive functions of the sampled subjects. Therefore, the nurse in the dialysis room should continually carry out assessment and intervention against elements degrading the effect of patients' education to improve self- care.

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Effect of Subcutaneous Methoxy Polyethylene Glycol-epoetin Beta on Anemia and Nutritional Indices in Peritoneal Dialysis Patients (복막투석 환자에서 Methoxy Polyethylene Glycol-epoetin Beta 피하 투여가 빈혈과 영양지표에 미치는 효과)

  • Kim, Kyung Sook;Lee, Jun Seop;Kim, Hye-Young;Lee, Myung Koo
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.202-210
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    • 2012
  • Methoxy polyethylene glycol-epoetin beta (MPG-EPO), a continuous erythropoietin receptor activator, is a new erythropoiesis-stimulating agent with a long half-life. The purpose of this prospective study is to assess the effects of once-monthly subcutaneous MPG-EPO on hematological responses and nutritional status in peritoneal dialysis patients. Forty four patients undergoing stable peritoneal dialysis were enrolled into the study. Darbepoetin alfa therapy, in peritoneal dialysis patients, was converted to the monthly administration of subcutaneous MPG-EPO for 6 months. The starting dose of MPG-EPO was based on the previous weekly dose of darbepoetin alfa. The dose adjustments were performed to maintain the hemoglobin (Hb) levels in a target range of 10.5-11.0 g/dL. If the Hb levels exceeded 11.0 g/dL, MPG-EPO was temporarily interrupted for 1 month. The mean Hb levels were stable with the values of $9.5{\pm}1.1$ g/dL at baseline, and $10.4{\pm}0.9$ g/dL at the 6th month after conversion. The mean differences in the changes of Hb levels between the baseline and the 6th month were $0.9{\pm}1.4$ g/dL, which was statistically significant. However, the mean differences of iron, transferrin saturation and ferritin concentrations were not significant. It did not show significant differences in the changes of the nutritional parameters. These results suggest that the once-monthly subcutaneous administration of MPG-EPO for 6 months effectively maintains the Hb levels and nutritional status in peritoneal dialysis patients. Taken together, the once-monthly subcutaneous administration of MPG-EPO was practical and might improve the clinical compliance for the management of renal anemia in peritoneal dialysis patients.

Effects of Allergy Related Drugs on Rat Peritioneal Mast Cells in Hyaluronidase Activity and Histamine Release (수종의 알레르기 관련 약물이 흰쥐의 복강내 비만세포에서 Hyaluronidase 및 히스타민 유리에 미치는 영향)

  • Yoo, Shin-Ae;Kim, Ku-Ja;Hah, Jong-Sik
    • The Korean Journal of Physiology
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    • v.22 no.2
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    • pp.259-272
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    • 1988
  • Type I allergic reaction and it's related clinical manifestations are known to occur by the effects of various chemical mediators. These chemical mediators are released from circulating basophils and tissue mast cells, which become 'sensitized' through the binding of antigens and antibodies of the IgE type to their cell surface receptors. Efforts to elucidate the mechanism of the release of these mediators, especially that of histamine, have been persued for years. The mechanism is not yet clarified at the present time. Recent reports of hyaluronidase, an enzyme known to be involved in the tissue inflammatory process, as possible participant in type I allergic reaction, initiated this study. Relationships between the hyaluronidase activity and histamine release from the sensitized rat peritoneal mast cells were investigated. Also anti-allergic agents, tranilast and disodium cromoglycate, along with known histamine releasers, morphine and compound 48/80, were used to observe the inhibitory and stimulatory effects of these substances on the hyaluronidase activity as well as histamine release from the rat mast cells. The results obtained are summarized as follows: 1) Hyaluronidase activity and histamine release from sensitiaed rat peritoneal mast cells started to increase on the 4th day of postsensitization. Hyaluronidase activity reached it's peak value on the 7th day of postsensitization and that of histamine release on the 14th day of postsensitization. 2) Hyaluronidase activity and histamine release from sensitized rat peritoneal mast cells, pre-treated with tranilast revealed significant decrease in comparison with those of non-treated cells. 3) Hyaluronidase activity and histamine release from sensitized rat peritoneal mast cells, pre-treated with tranilast, followed by morphine injection, revealed significant increase in comparison with those of tranilast treated cells. 4) In vitro study of hyaluronidase activity and histamine release from un-sensitized rat peritoneal mast cells, using morphine and compound 48/80 as activators, revealed significant increase compared to those of non-activator used cells. 5) In vitro study of hyaluronidase activity and histamine release from un-sensitized rat peritoneal mast cells, pre-treated with tranilast and disodium cromoglycate, using confound 48/80 and morphine as activators revealed significant decrease in comparison with those of tranilast and disodium cromoglycate treated cells. From above results, participation of enzyme hyaluronidase in the process of histamine release from sensitized rat pertioneal mast cells, could be suggested. It was also quite evident that the clinically used anti-allergic agents, tranilast and disodium cromoglycate, have significant inhibitory function on the hyaluronidase activity and histamine release from sensitized rat peritoneal mast cells, while morphine significantly increased the hyaluronidase activity and histamine release from sensitized rat peritoneal mast cells.

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Differential Diagnosis of Ovarian Mucinous, Serous, and Endometrioid Adenocarcinoma in Peritoneal Washing Cytology (복막세척액 세포검사에서 난소의 점액성, 장액성 및 자궁내막양 선암종의 감별진단)

  • Lee, Shi-Nae;Park, In-Ae
    • The Korean Journal of Cytopathology
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    • v.11 no.2
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    • pp.83-88
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    • 2000
  • This study presents the cytologic features of peritoneal washings, with particular emphasis on the cytologic discrimination among serous, mucinous, and endometrioid adenocarcinoma of the ovary. We selected histologically confirmed 27 cases of peritoneal washing : 8 cases of serous cystadenocarcinomas, 5 cases of mucinous cystadenocarcinomas, and 14 cases of endometrioid adenocarcinomas. The most frequent cytologic pattern of three tumors was clusters. Ball pattern was found in serous cystadenocarcinoma(36%) and acinar pattern in endometrioid adenocarcinoma(36%). Mucinous adenocarcinoma showed mucoid background(100%) and endometrioid adenocarcinoma revealed inflammatory background(43%). The cytoplasmic vacuoles were noted in 80%, 13%, and 43% of mucinous, serous, and endometriold adenocarcinoma, respectively. The endometrioid adenocarcinoma showed prominent nucleoli(64%). In conclusion, the cytologic findings of mucinous cystadenocarcinoma were different from that of serous and endometrioid carcinomas, such as mucoid background, abundant cyytoplasm with vacuolated cytoplasm, and peripherally located cytoplasm. Although endometriold carcinoma showed acinar pattern and prominent nucleoli, the differential diagnosis between serous cystadenocarcinoma and endometrioid adenocarcinoma in peritoneal washing cytology was was always possible.

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Comparison of the Laparoscopic and Open Peritoneal Dialysis Catheter Insertion in Children (소아 환자에서 복강경 복막 투석관 삽입술과 개복 삽입술의 비교)

  • Kim, Hyun-Soo;Jung, Soo-Min;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.125-132
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    • 2011
  • The aim of this study was to compare peritoneal dialysis catheter insertion by the open method to the laparoscopic method. Twenty four laparoscopic and 10 open peritoneal dialysis catheter placements were performed in children between 2001 and 2008. Patient characteristics, operation related data, procedural complications and clinical outcome were compared. Although there were no cases of catheter obstruction, exit site infection or bleeding in the laparoscopic group, compared to the open method, there was no statistically significant difference between the two groups. Catheter removal rate due to complication was high in the open group and catheter survival rate was high in the laparoscopic group. We concluded that laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups with at least equivalent functional results compared to the open method. An advantage of laparoscopic catheter insertion is removal of the great omentum and easy fixation of the catheter to the abdominal wall.

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Preclinical application of 188Re-Tin colloid for treatment of mouse tumor model with peritoneal effusion

  • Jin, Yong Nan;Lee, Yong Jin;Kim, Young Joo;Lee, Yun-Sang;Jeong, Jae Min
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.3 no.2
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    • pp.80-84
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    • 2017
  • Re-188 is an excellent and practical radioisotope produced by W-188/Re-188-generator for therapy. We prepared Re-188-tin colloid for therapy of various diseases and tried to treat peritoneal effusion in animal model. Sarcoma-180 cells were injected into ICR mice to induce peritoneal effusion and the mice were grown for 3 d. Re-188-tin colloids (0.25, 0.5, and 1 mCi/mL per 30 g body weight) were injected into the mice and the mice were grown for 90 d. Planar gamma scintigraphy showed even distribution of Re-188-tin colloid radioactivity. Bax expression was found to be dose dependent to Re-188-tin colloid. Normal saline treated group showed the shortest survival time. Among the treated groups, 0.5 mCi dose group showed the longest survival time. In conclusion, Re-188-tin colloid was prepared successfully and showed the feasibility to use as a peritoneal effusion treatment in mice.

The Development of the Shunt Guiding Kit for the Proper Positioning of the Proximal Shunt Catheter to the Lateral Ventricle in the Ventriculo-Peritoneal Shunt Operation (뇌실-복강간 단락술에서 Proximal Catheter의 정확한 측뇌실내로의 위치를 위한 Shunt Guiding Kit의 개발)

  • Shin, Yong Sam;kim, Se-Hyuk;Zhang, Ho Yeol;Bae, Ju Yong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.981-984
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    • 2001
  • Object : To treat hydrocephalus by ventriculo-peritoneal shunt operation, the correct positioning of the proximal catheter in the ventricle is very important. The purpose of this study was to develop the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle in the ventriculo-peritoneal shunt operation. Materials and Methods: The "shunt guiding kit" is made of tungsten alloy and it consists of one frame, two screws and one guider. Through the guider, the proximal shunt catheter operates by mechanically coupling the posterior burr hole to the anterior target point. Results: We have treated three hydrocephalus patients with use of the "shunt guiding kit", and achieved good location of proximal shunt catheters. Conclusion: We developed the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle, and this would be very useful for preventing ventriculo-peritoneal shunt malfunction and preventing possible brain injury during the procedures.

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Effective Response of the Peritoneum Microenvironment to Peritoneal and Systemic Metastasis from Colorectal Carcinoma

  • Yu, Min;Niu, Zhi-Min;Wei, Yu-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7289-7294
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    • 2013
  • We here document discovery of a new and simple model of tumor seeding involving the mouse peritoneum. Irradiated tumor cells administered by i.p. injection provided effective vaccination against peritoneal carcinomatosis and distal metastasis with colorectal carcinomas. In flow cytometric analysis, CD4+ and CD8+ T lymphocytes, macrophages and myeloid-derived suppressor cells (MDSCs), which are easy to obtain in the peritoneal cavity, were revealed to have significant differences between immunized and non-immunized mice and these contributed to antitumor responses. We also observed that both serum and peritoneal lavage fluid harvested from immunized mice showed the presence of CT26-specific autoantibodies. In addition, increase in level of TGF-${\beta}1$ and IL-10 in serum but a decrease of TGF-${\beta}1$ in peritoneum was found. Taken together, these findings may provide a new vaccine strategy for the prevention of peritoneal and even systemic metastasis of carcinomas through induction of an autoimmune response in the peritoneum.

Inhibitory Effects of Piperine on the Production of Nitric Oxide, Interleukin-10 and Interleukine-12 in Murine Peritoneal Macrophages (복강 대식세포에서 피페린의 일산화질소, 인테루킨-10과 인테루킨-12의 억제 효과)

  • Bae, Gi-Sang;Lee, Ju-Sung;Sung, Kang-Keyng;Park, Sung-Joo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.452-456
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    • 2009
  • The purpose of this study was to investigate the anti-inflammatory effects and cellular mechanism of piperine on murine peritoneal macrophages. To evaluate the effects of piperine, we examined the production of nitric oxide (NO), interleukin (IL)-10 and IL-12. To investigate inhibitory mechanism of piperine, we examined the MAPKs and Ik-Ba in murine peritoneal macrophages, Piperine itself does not have any cytotoxic effect and reduced lipopolysaccharid (LPS), Poly(I:C), CpG-ODN -induced production of NO, IL-10 and IL-12 in peritoneal macrophages. Piperine inhibited the activation of extracelluar signal-regulated kinase (ERK 1/2) and c-Jun NH2-terminal kinase (JNK 1/2) not the activation of p38 and the degradation of inhibitory kappa B a (Ik-Ba) in the LPS-stimulated murine peritoneal macrophages.ln conclusion, Piperine down-regulated LPS-induced production of NO, IL-10 and IL-12, which could provide a clinical basis for anti-inflammatory properties of piperine.