Background: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. Material and Method: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0$\pm$1.2). Result: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). Conclusion: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.
Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.
Lee Sun-Mi;Mun Youn-Ok;Cho Woo-Hyun;Lee Hoo-Yeon;Kang Hye-Young
Health Policy and Management
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v.16
no.2
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pp.96-116
/
2006
To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.
Journal of the Korea Academia-Industrial cooperation Society
/
v.21
no.7
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pp.645-655
/
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.
Purpose : Acute poststreptococcal glomerulonephritis(APSGN) is a common form of glomerulonephritis in children. Most patients recover completely after the acute phase but a few patients have acute complications or progress to chronic renal disease. In recent years, the frequency of APSGN has been was decreasing but is still common in children. So we studied the clinical characteristics of APSGN from 1994 to 2003 and compared it with past studies. Methods : We studied 105 patients who were diagnosed with APSGN in the Department of Pediatrics, Asan Medical Center between January 1994 and December 2003, with a retrospective chart review. Results : The mean age was $8.5{\pm}2.6$ years. The male to female ratio was 2 : 1. Average annual incidence was $10.5{\pm}4.9$ most patients(60.0 percent) occurred from October to January. Edema was seen in 82 cases(78.1 percent), gross hematuria in 70 cases(66.7 percent), hypertension in 50 cases (47.6 percent) and oliguria in 22 cases(20.9 percent). Microscopic hematuria was seen in 105 cases (100 percent), positive ASO in 99 cases(94.2 percent), proteinuria in 67 cases(63.8 percent) and azotemia in 38 cases(36.2 percent). Serum complement 3(C3) level decreased in 96 cases and returned to normal within eight weeks in 70 patients(75.3 percent). Kidney biopsy was carried out in 22 cases. Most acute symptoms subsided within 2 weeks of onset. Conclusion : We concluded that there was no significant difference between clinical features of recent and past APSGN in children, and short term prognoses were excellent.
The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate, 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows : G1(N=15) : Not-administrated furosemide(control group) G2(N=15) : Administrated furosemide(Experimental group). All patients were premedicated with Hydroxyzine(1mg/kg, IM) and were performed continous epidural anesthesia with 2% lidocaine(1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20mg furosemide was administrated to experimental group. The blood samples for the values of $Na^+$, $K^+$, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these data, serum osmolality and effective osmolality were calculated. The results were as follows : 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.7
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pp.688-698
/
2017
This study was conducted to identify the conceptual definitions and attributes of fatigue in hemodialysis patients based on the Hybrid Model of concept development. The Hybrid Model was used to investigate the main attributes and indicators of the concept by applying three stages. After a literature review, data were collected through observation and interviews including qualitative research in the field work stage. The participants included 10 patients in hemodialysis center of two hospitals in Gwang-ju, Korea. The attributes of fatigue concept in the hemodialysis patients were divided into four dimensions, physical activity, affective mood, social role, and cognitive reflection. The definition of fatigue by hemodialysis patients was defined as 'subjective feeling usually experienced in four dimensions during the process to recognize and adjust energy deficiency and limited functions caused by uremia and repeated hemodialysis for chronic renal failure'. Considering the dimensions and attributes derived from this study, it may be possible to develop an effective intervention program for fatigue in hemodialysis patients.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.1
/
pp.688-698
/
2018
The government has recognized the importance of smart city indicators and prepared the legal grounds for the certification of smart cities in the recently revised "Act on Smart City Development and Industrial Promotion." This study derived smart city indicators adequate for the domestic conditions and compatible with the overseas trends by examining and complementing the indicators through an AHP analysis based on consultations and interviews (surveys) with experts and local government officials, who are actually carrying out related projects. In addition, the adequacy and reliability of the indicators were confirmed by verifying and certifying the Korean local governments' smart city plans through demand surveys on a trial basis. This study is meaningful in that it systematically studies the smart city indicators that have gained in importance and reviews their application. The findings of this study can be used as a basis for implementing a smart cities certification system in the future. Recently, the Special Committee on Smart Cities was established under the Committee for the Fourth Industrial Revolution. This committee is composed of civilian members and is working with the Ministry of Land, Infrastructure, and Transport, the Ministry of Science and ICT, etc., to promote the creation of smart cities. It is expected that smart city indicators that include the levels of both domestic and overseas smart cities will boost the active spread of such cities in Korea.
Park, Hye Ja;Jang, Eun Jung;Kim, Mi Kyung;Jo, Nam Mi
Korean Journal of Adult Nursing
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v.12
no.1
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pp.88-98
/
2000
Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain & thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I (p=0.04). 2. Incidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during hemodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group I($3.1{\pm}0.8$) than Group I($2.8{\pm}0.8$) and III ($2.9{\pm}0.9$) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, $0.05{\pm}0.12$, $0.41{\pm}0.24$and $0.22{\pm}0.29$ respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.
The purpose of this research is to study the excellence and originality of the Joseon artillery(Jungwan-gu) through an effective restoration. Jungwan-gu that was used during the Japanese Invasion of Korea in 1592 was able to maintain its maritime dominance based on cutting-edge technology of its time. Joeson artillery(Jungwan-gu) was used in major naval/land battles during the Japanese Invasion of Korea in 1592 and is an important cultural heritage that provides a glimpse into Joeson people's will to defend the nation from foreign invasion. For further historical verification such as operational method of Jungwan-gu, extensive research in various fields including size, proportions, structure, materials, and casting method were required. Accordingly, for a more effective research on Jungwan-gu, cutting-edge technologies such as 3D scanning and 3D printing were utilized. Firstly, 3D scanning, modeling, and printing technology were applied to identify the morphological characteristics of Jungwan-gu. Through this, we were able to reach our research objective of identifying the size, internal structure, and proportionality of Jungwan-gu. In addition, by studying the form, operation, casting methods, and other characteristics, the restoration of Jungwan-gu provided us with an important opportunity to verify the dominance and originality of the Joeson era's science and technology during the Japanese Invasion of 1592. This reaserch subject participated in the "4th 3D printing BIZCON Contest" and won the Minister Prize of Science and Technology Information and Communication.
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