- The relationship between disability and clinical outcomes in maintenance dialysis patients
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Seok Hui Kang, Jun Young Do, Jun Chul Kim
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Yeungnam Univ J Med. 2021;38(2):127-135. Published online October 15, 2020
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DOI: https://doi.org/10.12701/yujm.2020.00346
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- Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.
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- Characterizing Interventions Used to Promote Life Participation in Adults on Peritoneal Dialysis Therapy: A Scoping Review
Alexia Kateb, Kaleigh McCarthy, Janine Farragher Canadian Journal of Kidney Health and Disease.2024;[Epub] CrossRef - The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis
Nilofar Pasyar, Mostafa Jowkar, Masoume Rambod BMC Nephrology.2023;[Epub] CrossRef - Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population
Seung Min Chung, Jun Sung Moon, Min Cheol Chang Frontiers in Medicine.2021;[Epub] CrossRef
- Improvement of catheter-related outcomes after application of tunneled cuffed hemodialysis catheter insertion without fluoroscopy
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Seok Hui Kang, Jun Young Do
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Yeungnam Univ J Med. 2020;37(3):186-193. Published online March 17, 2020
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DOI: https://doi.org/10.12701/yujm.2019.00465
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5,880
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- Background
Non-tunneled catheters (NTCs) are used for hemodialysis (HD) in many centers in which fluoroscopy is not easily accessed despite high complication rates and conditions requiring long-term HD. Therefore, here we aimed to evaluate the superiority of catheter-related outcomes after the application of tunneled cuffed catheter (TCC) without fluoroscopy versus unconditioned NTC insertion.
Methods We divided the participants into two phases: those receiving NTCs between March 2010 and February 2011 (phase I), and those receiving TCCs or NTCs between March 2011 and February 2012 (phase II). Catheter survival, nurse satisfaction, and reasons for catheter removal were analyzed.
Results Two hundred and sixty patients in phase I and 300 patients in phase II were enrolled in this study. The success rate of TCC insertion was 99.2%. The catheter survival rate in phase I was 65.5% at 1 month, while that in phase II was 74.9% at 1 month (p=0.023). We compared catheter survival between TCCs and NTCs for all periods regardless of phase. The TCC survival rate was higher than the NTC survival rate (p<0.001). Catheter-associated problems led to catheter removal in 97 patients (26.6%) in phase I and 68 patients (18.5%) in phase II (p=0.009). Among 14 HD nurses, all reported being satisfied with manipulation during pre-/post-HD, manupulation during HD, and overall. Eleven HD nurses (78.6%) reported being satisfied with the workload.
Conclusion Compared with unconditional NTC insertion for HD, TCC insertion without fluoroscopy improved the overall catheter survival and nurse satisfaction rates.
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Citations
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- Validating the anatomical landmark technique for bedside tunneled central venous catheter placement in the medical intensive care unit
Hanny Sawaf, James Lane, Roman Shingarev, Matthew Siuba, Alvin G Kwon, Tarik Hanane, Tushar J Vachharajani The Journal of Vascular Access.2024;[Epub] CrossRef
- Complete atrioventricular block during tunneled cuffed hemodialysis catheter insertion in a patient with pre-existing left bundle branch block.
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Eun Woo Choi, Ji Yoon Jung, Jun Huck Su, Sae Huyn Park, Kyu Hyang Cho, Kyung Woo Yoon, Jong Won Park, Jun Young Do, Seok Hui Kang
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Yeungnam Univ J Med. 2015;32(2):152-154. Published online December 31, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.2.152
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- Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.
- Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient.
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Yo Han Jeong, Jun Young Do, Mun Ju Hwang, Min Jung Kim, Min Geun Gu, Byung Sam Park, Jung Eun Choi, Tae Woo Kim
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Yeungnam Univ J Med. 2014;31(1):25-27. Published online June 30, 2014
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DOI: https://doi.org/10.12701/yujm.2014.31.1.25
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1,998
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- Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.
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- Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience
H.-W. Kou, C.-N. Yeh, C.-Y. Tsai, J.-T. Hsu, S.-Y. Wang, C.-W. Lee, M.-C. Yu, T.-L. Hwang Hernia.2021; 25(5): 1317. CrossRef
- Rhabdomyolysis Induced Acute Kidney Injury in a Patient with Leptospirosis.
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Yoon Jung Choi, Jeung Min Park, Yo Han Jung, Jong Ho Nam, Hyun Hee Chung, Tae Woo Kim, Kyu Hyang Cho, Jun Young Do, Kyeung Woo Yun, Jong Won Park
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Yeungnam Univ J Med. 2011;28(1):54-59. Published online June 30, 2011
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DOI: https://doi.org/10.12701/yujm.2011.28.1.54
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- Leptospirosis is a spirochetal infectious disease caused by Leptospira interrogans, and may vary in degree from an asymptomatic infection to a severe and fatal illness. The kidney is one of the principal target organs of Leptospira. Renal disorders caused by Leptospira infection vary from an abnormality in urinalysis to acute kidney injury (AKI). Incidence of AKI in severe leptospirosis varies from 40% to 60%. AKI reflects the severity of leptospirosis and is generally accompanied by cholestatic jaundice. The pathophysiology of AKI in leptospirosis consists of hypovolemia, direct tubular toxicity, and rhabdomyolysis. Most patients with acute leptospirosis experience severe myalgias, and show laboratory evidence of mild rhabdomyolysis. However, occurrence of severe rhabdomyolysis is rare. We report here on a patient with leoptospirosis, who had severe rhabdomyolysis and acute kidney injury without jaundice.
- A Case of Exit-Site Infection and Abscess by Mycobacterium Abscessus in a CAPD Patient.
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Sun Young Jung, Ji Hoon Na, Kyu Hyang Cho, Jong Won Park, Jun Young Do, Kyeung Woo Yun, In Wook Song, Jeong Hwan Cho, Chang Woo Son
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Yeungnam Univ J Med. 2009;26(2):137-143. Published online December 31, 2009
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DOI: https://doi.org/10.12701/yujm.2009.26.2.137
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1,899
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- Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.
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Citations
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- A Case Report ofMycobacterium abscessusPeritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis
Seon Joo Kang, Heungsoo Kim, Kyoung Un Park, Young Ae Lim, Wee Gyo Lee Annals of Clinical Microbiology.2013; 16(2): 101. CrossRef - A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due toStenotrophomonas maltophiliaUsing Antibiotic Combination
Hee Sung Ko, Ah Ran Choi, Tae Hoon Kim, Chan Hee Kyung, Jang Ho Cho, Yong Hoon Kim, Jung Eun Lee Yeungnam University Journal of Medicine.2013; 30(2): 109. CrossRef
- A Case of Pneumatosis Intestinalis in Peritoneal Dialysis Peritonitis.
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Sun Young Jung, Ji Hun Na, Yun Jung Choi, Sung Ae Koh, Ku Hyang Choi, Jong Won Park, Jun Young Do, Kyeng Woo Yun
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Yeungnam Univ J Med. 2009;26(1):49-55. Published online June 30, 2009
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DOI: https://doi.org/10.12701/yujm.2009.26.1.49
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- Peritonitis is a serious problem in patients undergoing peritoneal dialysis. Rarely pneumatosis intestinalis can occur as a complication of this infectious process. Pneumatosis intestinalis is a potential life threatening condition with a challenging management. The mortality of peritoneal dialysis patients with pneumatosis intestinalis secondary to mesenteric ischemia is almost 100%. We describe a rare case of pneumatosis intestinalis in a peritoneal dialysis patient who developed Staphylococcus aureus peritonitis which was initially treated with appropriate antibiotics. Since initial response to therapy was not achieved, an abdominal computerized tomography was done which revealed a pneumatosis intestinalis. A laparotomy was performed and small bowel necrosis was seen. A segmental resection with ileostomy, jejunostomy was done. Though surgical treatment was performed, the patient died in 2 weeks after admission. Pneumocystitis intestinalis in peritoneal dialysis peritonitis is a uncommon complication which requires prompt evaluation to rule out mesenteric ischemia as it carries a high mortality and its management will be surgical.
- A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure.
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Seok Min Kim, Kyung Ae Chang, Sun Young Jung, Chan Soh Park, Jong Won Park, Jun Young Do, Yong Jin Kim, Kyung Woo Yoon
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Yeungnam Univ J Med. 2008;25(1):58-63. Published online June 30, 2008
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DOI: https://doi.org/10.12701/yujm.2008.25.1.58
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- Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.
- Epithelial to Mesenchymal Transition in CAPD Patients.
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Jun Young Do
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Yeungnam Univ J Med. 2006;23(1):10-18. Published online June 30, 2006
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DOI: https://doi.org/10.12701/yujm.2006.23.1.10
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- Epithelial to mesenchymal transition (EMT) is an important etiologic factor for the development of peritoneal fibrosis in CAPD patients. Mesothelial cells are main source of trans-differentiated fibroblasts under stress from the bioincompatible peritoneal dialysate. In our study there was no difference in dialysate TGF-beta and VEGF between the low and high GDP groups during an initial 12 months. However, after adjusting with D-CA125, the low GDPs group showed a significantly lower D-TGF-beta/D-CA125 and D-VEGF/CA125 during the initial 12 months. Among the adjusted peritoneal growth factors for CA125, VEGF/CA125 and TGF-b/CA125 were factors significantly associated with greater EMT in this study. Adjustment of the peritoneal growth factor for effluent CA125 (surrogate for mass of HPMCs) revealed significant association with EMT suggesting that the fibroblastoid transition from HPMCs could be affected by the amount of intraperitoneal growth factors (TGF-b, VEGF) per unit mass of HPMCs. There was significant improvement in both cell score and D-CA125 at the sixth and 12th months after switching from a high GDPs solution to a low GDPs solution. Use of icodextrin solution in patients who had average peritoneal transport showed not only better systemic effects such as decreased glucose absorption via dialysate but also preservation of the peritoneum, including less EMT and high mesothelial bulk mass. In conclusion, Therapy with low GDP solution including icodextrin may positively impact preservation of the peritoneal membrane integrity and prevention of peritoneal fibrosis with time on PD.
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Citations
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- Transtorming Growth Factor β1 Induces Epithelial-to-Mesenchymal Transition of A549 Cells
Ju Hee Kim, Young Sook Jang, Kwang-Seok Eom, Young Il Hwang, Hae Raen Kang, Seung Hun Jang, Cheol Hong Kim, Young Bum Park, Myung Goo Lee, In Gyu Hyun, Ki-Suck Jung, Dong-Gyu Kim Journal of Korean Medical Science.2007; 22(5): 898. CrossRef
- The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis.
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Hang Jae Jung, Sung Hwa Bae, Jun Bum Park, Kyoo Hyang Jo, Young Jin Kim, Jun Young Do, Kyung Woo Yoon
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Yeungnam Univ J Med. 1999;16(2):333-341. Published online December 31, 1999
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DOI: https://doi.org/10.12701/yujm.1999.16.2.333
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- BACKGROUND
AND METHODS: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). RESULTS: The results were as follows: 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantlydecreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.005). 3) After changing the modality from hemodialysis to peritoneal dialysis. MAP(mmHg, from 107.1+/-4.5 to 98.6+/-8.8, p<0.05), antihypertensive drug requirements(from 5.6+/-2.6, to 2.0+/-2.5, p<0.01) and erythropoietin dosages(Uint/week, from 4600+/-2660 to 2000+/-1630, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V. weekly creatinine clearance) was not revealed. CONCLUSION: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.
- A case of Rifampin-induced Acute Renal Failure.
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Dong Hwa Lee, Te Gue Park, Je Sung Lee, Heui Sik Kim, Kyoung Hyun Kim, Young Jun Ha, Sung Bok Jung, Jun Young Do, Kyung Woo Yoon
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Yeungnam Univ J Med. 1998;15(1):173-181. Published online June 30, 1998
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DOI: https://doi.org/10.12701/yujm.1998.15.1.173
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- Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.
- Long-term Effect of Desferrioxamine to rHuEPO Regident Anemia in Hemodialysis Patients.
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Sang Woo Lim, Hang Jae Jung, Sung Wha Bae, Jun Young Do, Kyung Woo Yoon
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Yeungnam Univ J Med. 1997;14(2):399-414. Published online December 31, 1997
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DOI: https://doi.org/10.12701/yujm.1997.14.2.399
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- There are several factors concerning to anemia in chronic renal failure patients. But when rHuEPO is used, most of these factors can be overcome, and the levels of hemoglobin are increased, However, about 10% of the renal failure patients represent rHuEPO-resistant anemia eventhough high dosage of rHuEPO. For these cases, desferrioxamine can be applied to correct rHuEPO resistnacy, and many mechanism og DFO are arguing. So we are going to know whether DFO can applied to correct anemia of the such patients, how long its effect can continued. The seven patients as experimental group(DFO+EPO) who represent refractoriness to rHuEPO and the other seven patients as control group(EPO) were included. Experimental group has lower than 9 g/dL of hemoglobin levels despite high rHuEPO dosage (more than 4000U/Wk) and showed normochromic anemia. There were no definitive causes of anemia such as hemorrhage or iron deficiency. Control group patients has similar characteristics in age, mean dialysis duration but showed adequate response to rHuEPO. DFO was administered to experimental group for 8 weeks along with rHuEPO(the rHuEPO individual mean dosage had been determined by mean dosage of the previous 6 months. Total mean dosage; 123.5 U/Kg/Wk). After 8 weeks of DFO administration, the hemoglobin and rHuEPO dosage levels were checked for 15 consecutive months. It should be noted that the patients determined their own rHuEPO dosage levels according to hemoglobin levels and economic status. In control group, rHuEPO was administered by the same method used in experimental group without DFO through the same period. Fifteen months of ovservation period after DFO trial were divided as Time I(7 months after DFO trial) and Times II(8 months after Time I). The results are as follows: Before DFO trial, mean hemoglobin level of experimental group was 7.8 g/dL, which is similar level(p>0.05) to control group(mean Hb; 8.2 g/dL). But in experimental group, significantly(p<0.05) higher dosages of rHuEPO(mean; 123.5 U/Kg/Wk) than control group (mean;41.6 U/Kg/Wk) had been used. It means resistancy to rHuEPO of experimental group. But after DFO trial, the hemoglobin levels of the experimental group were increased significantly(p<0.05), and these effect were continued to II.(Time I; mean 8.6g/dL, Time II; mean 8.6g/dL) The effects of DFO to hemoglobin were continued for 15 months after DFO trial with simiral degree through Time I, Time II. Also, rHuEPO dosage used in the experimental group were decreased to simiral levels of the control group after DFO trial and these effect were also continued for 15 months(Time I; mean 48.1 U/Kg/Wk. Time II; mean 51.8 U/Kg/Wk). In the same period, hemoglobin levels and rHuEPO dosages used in the control group were not changed significantly. Notibly, hemoglobin increment and rHuEPO usage decrement in experimental group were showed maxilly in the 1st month after DFO trial. That is, after the use of DFO, erythropoiesis was enhanced with a reduced rHuEPO dosage. So we think rHuEPO reisistancy can be overcome by DFO therapy. In conclusion, the DFO can improve the anemia caused by chronic renal failure at least over 1 year, and hence, can reduce the dosage of rHuEPO for anemia correction. Additional studies in order to determined the mechanism of DFO on erythropoiesis and careful attention to potential side effects DFO will be needed.
- A Study on the Serologic Parameters in Petients with Anemia of Chronic Renal Failure-According to Erythropoietin Treatment
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Jong Sik Lim, Ho Jung Kang, Won Jong Park, Jun Young Do, Kyeung Woo Yun
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Yeungnam Univ J Med. 1994;11(1):82-93. Published online June 30, 1994
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DOI: https://doi.org/10.12701/yujm.1994.11.1.82
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- Clinical study was carried out on the 64 hemodialysis patients (HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obtained. In hematologic parameters, MCH was 28.8±2.0 pg, and MCV was 92.4±4.7 fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0 ng/ml in men and 511.5±370 g in women. Mean values of serum iron were 145.5±63.7 µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum ferritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoietin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoietin treatment group (p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test (LFT0 hemodialysis group than normal LFT group (p<0.05). Transfusion amounts revealed positive correlation with ferritin (r=0.4675), transferrin saturation (r=0.3823) and iron (r=0.3386) (p<0.05). In conclusion, erythropoietin treatment can reduce requirement of blood transfusion and transfusion related side effects such as iron overload, hemosiderosis and hemochromatosis.
- Factors influencing arterial CO² tension in cats during high frequency oscillation ventilation.
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Jun Young Do, Jae Yick Lee, Kwan Ho Lee, Yeung Jo Kim, Jae Chun Chung, Hyun Woo Lee, Suck Kang Lee
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Yeungnam Univ J Med. 1989;6(2):47-55. Published online December 31, 1989
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DOI: https://doi.org/10.12701/yujm.1989.6.2.47
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- High frequency ventilation (HFV) is a new ventilatory technique that uses very small tidal volume (less than the anatomic dead space) and high frequency, and classified 4 distinct types according to frequency and mode of gas delivery. The mechanism of gas transport of high frequency oscillation ventilation (HFOV) is somewhat different to other types of HFV. To evaluate the determinants of PaCO² in HFOV, a study was done with a HFOV on 9 cats, and the results are: 1) PaCO² was not correlated with frequency at the constant stroke volume (6 voltage) and bias flow (6 L/minutes). 2)PaCO² was correlated with stroke volume but not with bias flow under the constant frequency (15 Hz/min) and bias flow (3 to 6 L/min). From above results, the main determinant of PaCO² on artificial ventilation with HFOV was stroke volume, but further study between flow, the site of delivery to the airway and humidification of bias flow and CO² elimination is required in future research.
- Uptake of 99mTc - DISDA in Primary Hepatocellular Carcinoma and Metastatic Nodule in the Lung.
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Jun Young Do, Heon Ju Lee, Soo Bong Choi, Hyun Woo Lee
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Yeungnam Univ J Med. 1988;5(2):171-174. Published online December 31, 1988
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DOI: https://doi.org/10.12701/yujm.1988.5.2.171
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- Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.
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