• 임상간호연구
• /
• 제23권3호
• /
• pp.398-406
• /
• 2017

Purpose: The purpose of this study was to evaluate food carving among hemodialysis patients and to identify factors affecting the food carving. Methods: A descriptive correlational study was conducted. Data were collected from 129 patients receiving hemodialysis between March 15 and April 15, 2017. Measurement instruments included the general food craving questionnaire trait, the center for epidemiological studies-depression scale, and stress response inventory-modified form. The statistical analysis included t-test, analysis of variance, pearson correlation analysis, and stepwise multiple regression analysis. Results: Mean food craving score was $53.00{\pm}12.36$. Food craving was higher in patients younger than 40 years (F=4.36 p=.006) and having occupation (t=2.18 p=.031). Patients receiving hemodialysis demonstrated higher levels of depression ($21.37{\pm}9.62$) and stress ($39.68{\pm}15.95$). Factors influencing food craving were depression (${\beta}=.52$, p<.001), stress (${\beta}=.65$, p<.001), and age 50~59 years old (${\beta}=-.28$, p=.001) and 60~69 years old (${\beta}=-.19$, p=.026), which accounted for 25.6% of total variance. Conclusion: Food craving among hemodialysis patients was influenced by patients' depression, stress and age. Assessment and management of depression and stress needs to be incorporated as a nursing strategy for dietary management for hemodialysis patients.

• 핵의학기술
• /
• 제23권2호
• /
• pp.25-28
• /
• 2019

GFR 검사는 신장의 기능을 평가하는 지표이다. 정확한 진단을 위해서 GFR 값은 상당히 중요하다. 체내검사와 체외검사 GFR 값을 비교하였고, 모든 GFR 값 기준은 체외검사로 하였다. 성인 환자 30명을 대상으로 하였다. 정상적인 위치에 신장이 있는 환자 27명과 특이한 위치에 신장이 있는 환자 3명(1. 선천적 신장 기형 환자, 2. 신장 이식 환자, 3. 마제형 신장 환자)을 대상으로 하였다. 검사 장비로는 GE Healthcare Infinia Hawkeye SPECT를 사용하였다. 체내검사 방법은 검사 30분전 물 $500m{\ell}$를 드시게 하였고, 환자 table과 detector 1, 2의 거리를 32 cm으로 하였고, $^{99m}Tc-DTPA$ 555 MBq으로 전체 주사기 계수(full syringe counts)를 측정한 후 신장 동적검사를 하였다(flow-1분, clearance-20분). 그리고 빈 주사기 계수(empty syringe counts)를 측정하였고, 3가지 방법(1. tonnensen 2. taylor 3. manual)으로 신장의 깊이를 측정하여 GFR 값을 구하였다. 모든 GFR 값은 gates method로 구하였다. 체외검사는 채혈을 통해서 GFR 값을 구하였다. 정상적인 위치에 있는 환자들의 경우는 체내검사와 체외검사의 GFR 값은 유의미한 차이가 없었다 (p> 0.05). 하지만 특이한 위치에 신장이 있는 환자의 경우는 수동(manual)방법으로 신장의 깊이를 측정하여 구한 GFR 값이 체외검사 GFR 값과 상당히 비슷하게 나왔고, 편차는 다음과 같다(1.선천적 신장 기형 환자: 6.4%, 2. 신장 이식 환자: 22.0%, 3번째 마제상 신장 환자: 2.0%). 그러므로 정상적인 위치에 신장이 있는 성인 환자들에 대해서는 어떤 방법으로 신장의 깊이를 이용하여 구하여도 체외검사 GFR 값과 유의미한 차이는 없었고, 특이한 위치에 신장이 있는 환자들에 대해서는 수동방법으로 신장의 깊이를 측정하여 GFR 값을 구하는 것이 가장 효과적이라고 사료된다.

• 대한핵의학회지
• /
• 제23권1호
• /
• pp.55-61
• /
• 1989

While cisplatin has been widely used in the treatment of a variety of cancers, nephrotoxicity is one of the major problems which frequently limit clinical usefulness of cisplatin. This study has been conducted to investigate nephrotoxicity of cisplatin in terms of changes in glomerular filtration rate (GFR) and effective renal plasma flow (EFPF) measured by the simultaneous use of $^{99m}Tc-DTPA$ and $^{131}I-OIH$, before and after administration of cisplatin, in 12 patients with lung cancer and four patients with esophageal cancer. Cisplatin was administrated at total doses of $75\sim100mg/m^2$ with two hour hydration and diuresis method. GFR determined by the use of $^{99m}Tc-DTPA$ had a good correlation with 24-hour creatinine clearance rate (r=0.77, p<0.001). GFR and filtration fraction decreased immediately after administration of cisplatin, however, they showed a tendency to be in completely recovered four weeks after administration. ERPF was not changed immediately after and four weeks after administration of cisplatin. GFR before and immediately after administration of cisplatin were analyzed with regard to age, sex, performance status, previous adminstration of cisplatin and method of administration. None of these factors had any influence on the rate of decrease in GFR except method of administration. Administration of cisplatin as a single dose lowered GFR more compared with that as divided doses. In this study, we have also demonstrated that the simultaneous use of $^{99m}Tc-DTPA$ and $^{131}I-OIH$ was a useful tool for the measurement of GFR and ERPF respectively.

• 한국임상약학회지
• /
• 제24권1호
• /
• pp.9-14
• /
• 2014

Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

• 한국콘텐츠학회논문지
• /
• 제10권5호
• /
• pp.343-350
• /
• 2010

체외충격파쇄석술(Extracorporeal shock wave lithotripsy ; ESWL) 시 환자가 받는 방사선 피폭선량을 측정하기 위하여 신장 및 요관 결석으로 진단을 받은 총 55명(남:36명, 여:19명)을 대상으로 방사선피폭선량을 측정하였다. 측정 방법은 투시 관전압 80kVp, 관전류 5mA로 고정하여 인체 모형의 Rando Phantom과 형광유리 선량계를 사용하였으며, 주요 장기인 양측 신장, 방광, 간에 5분과 10분씩 각각 2회 흡수선량을 측정하여 유효선량으로 환산하였다. 환자 당 평균 시행 횟수는 1.8회(1~4)이었고, 평균 투시시간은 533초(248~2516)로 나타났다. 우측 신장결석 치료 시 우측 신장의 평균값은 2.458mSv, 좌측 신장은 0.152mSv, 간은 1.404mSv, 방광은 0.019mSv로 측정 되었고, 좌측 신장결석 치료 시 좌측 신장의 평균값은 2.496mSv, 우측 신장은 0.252mSv, 간은 0.178mSv, 방광은 0.017mSv이었으며, 하부요관 결석치료 시 방광에서의 평균값은 3.742mSv, 우측 신장은 0.009mSv, 좌측 신장은 0.01mSv로 유효선량이 측정 되었다.

• Investigative Magnetic Resonance Imaging
• /
• 제22권1호
• /
• pp.65-70
• /
• 2018

The objective of this study was to describe a radiofrequency (RF) coil design for in vivo sodium magnetic resonance imaging (MRI) for use in small animals. Accumulating evidence has indicated the importance and potential of sodium imaging with improved magnet strength (> 7T), faster gradient, better hardware, multi-nucleus imaging methods, and optimal coil design for patient and animal studies. Thus, we developed a saddle-shaped sodium volume coil with a diameter/length of 30/30 mm. To evaluate the efficiency of this coil, bench-level measurement was performed. Unloaded Q value, loaded Q value, and ratio of these two values were estimated to be 352.8, 211.18, and 1.67, respectively. Thereafter, in vivo acquisition of sodium images was performed using normal mice (12 weeks old; n = 5) with a two-dimensional gradient echo sequence and minimized echo time to increase spatial resolution of images. Sodium signal-to-noise ratio in mouse kidneys (renal cortex, medulla, and pelvis) was measured. We successfully acquired sodium MR images of the mouse kidney with high spatial resolution (approximately 0.625 mm) through a combination of sodium-proton coils.

• 한국산업보건학회지
• /
• 제24권2호
• /
• pp.169-181
• /
• 2014

Objectives: The purpose of this study was to obtain information regarding classification and health hazards that may result from a 13-week inhalation exposure to 2-methylpentane by Sprague-Dawley rats. Materials: The testing method was conducted in accordance with OECD guidelines for the testing of chemicals No. 413. The rats were divided into four groups(ten male and ten female rats in each group) and exposed to 0 ppm, 290 ppm, 1,160 ppm, 4,640 ppm 2-Methylpentane in each exposure chamber for six hours per day, five days per week, for 13 weeks. Results: No death or particular clinical presentation including weight change and change of feed rate was observed. The relationships between dose, gender and response were also not significantly changed in urinalysis, hematologic examination, or biochemical examination of blood(except for total cholesterol being up, total protein being up, and chloride ion being down in males), and blood coagulation time. For the relative weight measurement of organs, in the male group the weight change of both kidney and liver were increased in proportion to dose. In histopathological examination, nephropathy in the kidney(cystic change of renal tubules, regenerative tubule, inflammatory cell infiltration and necrosis in the interstitial tissue) was increased in a dose-dependent manner in the male group(290 ppm, 1,160 ppm, 4,640 ppm). However, other organs were not affected by the test substance. Conclusions: 2-methylpentane was estimated as a chemical causing nephropathy in the male group. NOAEL(No Observable Adverse Effect Level) in the female group is more than 4,640 ppm, while inthe male group it is less than 290 ppm.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.407-410
• /
• 2015

Background: Acute kidney injury is an important issue in chemotherapy receiving patients an neutrophil gelatinase-associated lipocalin has been proposed as a novel marker. We here aimed to assess the role of urinary levels for assessment after platin exposure. Materials and Methods: Patients who had treated with cisplatin or carboplatin or oxaliplatin containg regimens were included in this study. Baseline and postchemotherapy serum urea, creatinine, urine neutrophil gelatinase-associated lipocalin and urine creatinine levels were determined. To avoid the effects of hydration during chemotherapy infusion the urinary neutrophil gelatinase-associated lipocalin/urine creatinine ratio was used to determine acute kidney injury. Results: Of a total of 42 patients receiving platin compounds,14 (33.3%) received cisplatin containing regimens, 14 (33.3%) received carboplatin and 14 (33.3%) oxaliplatin. The median age was 60 (37-76) years. Nineteen of the patients (45.2%) had lung cancer, 12 (28.6%) colorectal cancer and 11 (26.2%) others. The median pre and post chemotherapy urine neutrophil gelatinase-associated lipocalin/urine creatinin ratio was 15.6 ng/mg and 35.8 ng/mg (p=0.041) in the cisplatin group, 32.5 ng/mg and 86.3 ng/mg (p=0.004) in the carboplatin group and 40.9 ng/mg and 62.3 ng/mg (p=0.243) in the oxaliplatin group. Conclusions: Nephrotoxicity is a serious side effect of chemotherapeutic agentslike cisplatin and carbopaltin, but only to a lower extent oxaliplatin. All platin compounds must be used carefully and urine neutrophil gelatinase-associated lipocalin measurement seems to be promising in detecting acute kidney injury earlier than with creatinine.

• Childhood Kidney Diseases
• /
• 제17권1호
• /
• pp.1-5
• /
• 2013

사구체에 면역글로불린은 음성이면서 C3 만 침착되는 경우, 다른 원인이 없는 경우 C3GN을 의심하여야 한다. 광학현미경으로는 세포의 증식이 있는 경우와 없는 경우가 있지만, 전자현미경으로는 EDD가 내피세포 밑으로 혹은 메산지움 등에 침착함을 확인하여야 한다. 대체보체경로의 조절이상이 원인임으로 혈청 C3 치를 비롯하여 CFH, CFI, CFB 등을 측정하여야 하며, C3 nephritic factor, anti-factor H 자가항체 등을 조사하는 것이 필요하다. 보체 조절이상을 일으키는 유전자 돌연변이를 조사해 보아야 한다. 예후는 안정적이지만, 치료는 대증적이다. 이론적으로 보체의 활성화를 저지하는 약으로 가능할 것으로 생각되며, C5 항체인 eculizumab으로 치유된 보고도 있다.

• 대한두경부종양학회지
• /
• 제14권2호
• /
• pp.206-213
• /
• 1998

Primary hyperparathyroidism is still uncommomn disease in Korea. However the frequency of this disease has been slowly increased with routine measurement of serum calcium and increasing awareness of hyperparathyroidism in recent years. The diagnosis is established by a persistent elevation of serum calcium and parathyroid hormone and by clinical evaluation. This is a report of eleven patients with primary hyperparathyroidism treated with surgical operation during a period from 1983 to 1997 at Department of Hospital. Authors analyzed the cases to evaluate clinical characteristics and outcome of surgical treatment retrospectively. The result was as follows. 1) In sex distribution, female patients were eight and three were male, the age distribution ranged from 18 to 67 years. 2) The presenting clinical manifestations were renal and urinary stone in eight, bone pain or fracture in six, muscle weakness in four, neurologic symptoms in four, neck mass in three, hypertension in two, and G-I symptoms in one. 3) All patients showed hypercalcemia and elevated serum parathyroid hormone level. 4) Preoperative localization study was performed with computerized tomography, ultrasonography, MRI, arteriography and thyroid scaning. 5) The tumor locations were left lower in eight, left upper in one, right lower in one, and right upper location was one case. 6) Histopathologic findings disclosed adenoma in all cases. 7) All patients were treated by surgical excision and postoperatively transient hypocalcemia occurred in six patients, but no other complication was developed.