• Title/Summary/Keyword: 말기환자

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Long-term Management of Copper-associated Hepatic Cirrhosis with D-penicillamine, SAMe, and DBB in a Dog (개에서 발생한 구리 축적성 간경화에 D-penicillamine, SAMe, DBB로 병용 치료하여 장기간 생존한 1례)

  • Seo, Kyoung-Won;Lee, Young-Heun;Bhang, Dong-Ha;Ahn, Jin-Ok;Coh, Ye-Rin;Hwang, Cheol-Young;Kim, Dea-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.249-253
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    • 2011
  • A 4-year-old intact female American Cocker Spaniel presented with lack of appetite, shivering, and abdominal distension. It was initially diagnosed with chronic hepatitis with cirrhosis, by serum chemistry, radiography, ultrasonography, and histopathologic examination following liver biopsy. Abundant copper granules were detected in most hepatocytes with rhodanine stain, with hepatic copper concentration at 1460 ppm (reference range: <400 ppm). Based on these findings, copper-associated hepatitis with cirrhosis was diagnosed and successfully managed with long-term D-penicillamine, s-adenosylmethionine, biphenyl-dimethyl-dicarboxylate and supportive care. The spaniel died 35 months after diagnosis.

A Case of Conjunctival and Corneal Calcification in a Child on Peritoneal Dialysis (소아 복막 투석 환자에서의 결막과 각막의 석회 침착 1례)

  • Lee, Yeoun-Joo;Lim, Gin-A;Lee, Joo-Hoo;Prak, Young-Seo;Kim, Myoung-Joon
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.239-244
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    • 2008
  • Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification(CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high Ca$\times$P value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.

AUTOTANSPLANTATION OF IMPACTED MAXILLARY CANINES: CASE REPORTS (자가 이식을 이용한 매복 견치의 치험례: 증례보고)

  • Ko, Yoon-Sik;Kim, Ji-Yeon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.435-440
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    • 2011
  • Maxillary canine impaction is a common eruption problem in children. Impaction frequently involves further complications such as root resorption of adjacent teeth, cyst formation and migration of the neighboring teeth, etc. Various treatment modalities include extraction of preceding deciduous canine, orthodontic traction, and surgical extraction followed by immediate replantation of the extracted tooth at the proper position(autotransplantation). Autotransplantation is considered as the treatment of choice when surgical exposure and subsequent orthodontic traction are difficult or impossible due to unfavorable impacted position. The prognosis of autotransplantation is affected by the degree of apex formation, surgical procedures performed, timing of root canal treatment, and length of stabilization period. In these two cases presented, the patients with unerupted maxillary canine were treated with autotransplantation. One case was thought that guidance of eruption by orthodontic traction was difficult because of its unfavorable impacted position. In the other case, parents didn't agree to treat by orthodontic traction, therefore autotransplantation was done. In both cases, autotransplantation was carried out following root canal treatment and orthodontic treatment, and both cases have demonstrated to be successful to this day.

Therapeutic efficacy of the photoactivated sickle cells as novel drug delivery vehicle (약물전달 시스템 개발을 위한 여기된 광감응제의 응용)

  • Choe, Se-woon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2015.10a
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    • pp.958-960
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    • 2015
  • Sickle cells possess a unique combination of traits that may enable their use as models for novel synthetic tumor targeting controlled release drug carriers with the ability to treat disseminated tumors in advanced metastatic disease. In this study, we assess the ability of light-activated release sickle cells to enhance tumor delivery of the fluorescent dye calcein by delayed photolysis controlled release compared to free systemic administration of calcein. Sickle cells from mouse models of the disease were shown to preferentially accumulate in tumors compared to adjacent tissue, in 4T1 tumors in mice on a time scale about 12 hours. Sickle cells photosensitized with protoporphyrin IX achieved delayed release of 50% of contents 8-16 hours after photoactivation, which was deemed useful for in vivo delivery of cargo to tumors given the tumor accumulation time of the sickle cells. Sickle cells may be useful as a model for new synthetic drug carrier particles with delayed photolysis controlled release properties.

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Inferior Vena Cava Stenosis Following Orthotopic Liver Transplantation: Differentiating Points from False Positives (뇌사자 간이식 후 발생한 하대정맥 협착: 위양성과의 감별점)

  • Yeonsoo Choi;Jin Hyeok Kim;Ung Bae Jeon;Joo Yeon Jang;Tae Un Kim;Hwaseong Ryu
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.713-718
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    • 2023
  • Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

A study on the correlation of sexual function, depression, and sleep quality in hemodialysis male patients (혈액투석 남성 환자의 성기능, 우울, 수면의 질의 상관관계 연구)

  • Han, Ol;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.645-655
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    • 2020
  • This is a descriptive study investigating the relationships between sexual function, depression, and sleep quality in male hemodialysis patients. The participants of this study consisted of 134 outpatients who were diagnosed with end stage chronic kidney disease and who had undergone hemodialysis. The data were collected from June 10, 2019, to October 30, 2019. The collected data were then analyzed using descriptive statistics, the mean from independent sample t-tests, one-way analysis of variance (ANOVA), the Scheffe test, and Pearson's correlation coefficient using SPSS version 21.0. The lower the overall satisfaction, the lower the sexual function and the higher the degree of depression (r=.-19, p=.028). The greater the depression, the lower the quality of sleep (r=.60, p<.001). This study shows it is necessary to develop a program including symptom management to reduce depression in male hemodialysis patients. When developing nursing interventions to improve sexual function and quality of sleep, it will be necessary to develop a program that includes people who help the subjects.

Pattern Clustering of Symmetric Regional Cerebral Edema on Brain MRI in Patients with Hepatic Encephalopathy (간성뇌증 환자의 뇌 자기공명영상에서 대칭적인 지역 뇌부종 양상의 군집화)

  • Chun Geun Lim;Hui Joong Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.381-393
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    • 2024
  • Purpose Metabolic abnormalities in hepatic encephalopathy (HE) cause brain edema or demyelinating disease, resulting in symmetric regional cerebral edema (SRCE) on MRI. This study aimed to investigate the usefulness of the clustering analysis of SRCE in predicting the development of brain failure. Materials and Methods MR findings and clinical data of 98 consecutive patients with HE were retrospectively analyzed. The correlation between the 12 regions of SRCE was calculated using the phi (φ) coefficient, and the pattern was classified using hierarchical clustering using the φ2 distance measure and Ward's method. The classified patterns of SRCE were correlated with clinical parameters such as the model for end-stage liver disease (MELD) score and HE grade. Results Significant associations were found between 22 pairs of regions of interest, including the red nucleus and corpus callosum (φ = 0.81, p < 0.001), crus cerebri and red nucleus (φ = 0.72, p < 0.001), and red nucleus and dentate nucleus (φ = 0.66, p < 0.001). After hierarchical clustering, 24 cases were classified into Group I, 35 into Group II, and 39 into Group III. Group III had a higher MELD score (p = 0.04) and HE grade (p = 0.002) than Group I. Conclusion Our study demonstrates that the SRCE patterns can be useful in predicting hepatic preservation and the occurrence of cerebral failure in HE.

Mutational Analysis of Mitochondria DNA in Children with IgA Nephropathy (소아 IgA 신병증 환자에서 미토콘드리아 DNA 돌연변이 분석)

  • Eom, Tae Min;Jang, Chang-Han;Kim, Hyoung Kyu;Kim, Nari;Chung, Yun Seo;Han, Jin;Chung, Woo Yeong
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.73-79
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    • 2012
  • Purpose: The association of mitochondrial DNA (mtDNA) mutations, deletions and copy number with progressive changes in patients with some glomerular disease and end-stage renal disease have been reported. In this study, we performed mtDNA mutation analysis in children with IgA nephropathy to investigate its role in progressive clinical course. Methods: Seven children with IgA nephropathy were involved in this study. MtDNA isolated from platelet was amplified by PCR and sequenced entirely. Results: The mean age at renal biopsy was $11.5{\pm}2.2$ year and the mean age at latest evaluation was $17.9{\pm}3.2$ year. The mean follow-up period were $7.8{\pm}3.1$ years. Patients was divided into 2 groups according to the amount of proteinuria at presenting manifestation. Group 2 patients were nephrotic syndrome. Renal function reveals within normal range in all patients. In group 2 patients, the mean serum albumin level was significantly lower than those of group 1 ($3.7{\pm}0.6g/dL$ vs. $4.7{\pm}0.2g/dL$, P=0.0241) and the mean total cholesterol level was significantly higher than those of group 1 ($222.7{\pm}35.7mg/dL$ vs. $148.3{\pm}29.1mg/dL$, P=0.0283). In Group 2 patients, total amount of protein of 24 hour collected urine also significantly higher than those of group 1 ($1,466.0{\pm}742.5mg$ vs. $122.5{\pm}48.1mg$, P=0.0135). Pr/Cr ratio in random urine sample was also higher in group 2 than those of group 1 but the statistical significance was not noted ($1.8{\pm}1.6$ vs. $0.2{\pm}0.2$, P=0.0961). Deletion of mtDNA nt 8272-8281 were observed in two patients, one patient in each groups, respectively. This is noncoding lesion. No patients demonstrated the mtDNA mutations. Conclusions: We have identified a deletion of mtDNA nt 8272-8281 in two children with IgA nephropathy. Further studies are needed to clarify the role of mitochondrial function in the progressive change of IgA nephropathy.

Palliative Effect of Radiation Therapy in Management of Symptomatic Osseous Metastases (골 전이암에서 고식적 방사선치료의 효과)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.102-109
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    • 1992
  • Bone metastases represent an important and frequent clinical problem in patients with advanced cancers. Especially, painful bone metastases are common features in these patients. Radiotherapy is an effective tool for palliative aim of painful metastatic osseous lesions. Various treatment results have been previously reported. The present retrospective study was aimed to evaluate the efficacy of palliative irradiation on pain relief, with the goal of selecting appropriate irradiation dose schedule. Radiotherapy consisted of 5times a week with a various fractional dose between 180 and 400cGy. The response of pain relief and the survival time after completion of radiotherapy are related to total dose and most of the patients have shown a similar response by the end of radiotherapy. The higher dose and the more aggressive multimodality treatment, the better pain control and the longer survival time.

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