• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.33-36
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• 2016

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

• 성인간호학회지
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• 제12권1호
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• pp.134-146
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• 2000

This study was conducted to investigate the relationship between self-esteem, health promoting behavior and the quality of life of the patients undergoing hemodialysis. The subjects were 86 patients undergoing hemodialysis in H hospital. The data were collected using a questionnaire. Data collection was done from January 11th to June 16th, 1999. The analysis of data was done by use of descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient and Multiple regression using the SPSS/PC+ program. The results are as follows: 1. The mean of the level of self-esteem was 25.02, the level of health promoting behavior, 120.04 and the level of QOL, 128.09. 2. Test for hypothesis: Hypothesis 1. "The higher the level of self-esteem of the patients undergoing hemodialysis, the higher the level of quality of life will be." was supported(r=.296, p<.01). Hypothesis 2. "The higher the level of health promoting behavior, the higher the level of quality of life will be." was supported (r=.628, p<.001). 3. Health promoting behavior explained 39.5percent of QOL($R^2$=.395, F=27.040, p<.001). 4. Monthly income(F=3.85, p<.01) and marital status(F=4.64, p<.05) were significantly related to the quality of life In conclusion, this study showed that self-esteem and health promoting behavior may be important factors that can improve the quality of life of the patients undergoing hemodiaysis. This study identified that nursing plans should include these factors to help physical, psychological and social adaptation of the patients undergoing hemodialysis.

• 대한간호학회지
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• 제26권1호
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• pp.53-72
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• 1996

The Purpose of this study was to identify characteristics of fatigue and the relationship between fatigue and related factors in patients on hemodialysis. This study was a survey study using a cross-sectional design. The subjects for this study were 101 patients on hemodialysis who were registered in the six hemodialysis clinics among a total of eleven clinics in Seoul. The period of data collection was from February 28, 1995 to May 2, 1995. Data were collected through an interview with a structured packet and the physiological data. The tools used in this study were the Visual Analogue Scale-Fatigue developed by Lee et al(1990) and translated by Lee(1991), the fatigue interview schedule developed by this researcher, Zung's self rating depression scale(Zung, 1965), the self-efficacy scale developed by Sherer et al(1982) and the Norbeck Social Support Questionnaire(NSSQ) translated by Oh(1984). The collected data were analyzed using descriptive statistics(mean, standard deviation, frequency, range), Pearson correlation coefficients and Stepwise multiple regression. The results were as follows ; 1. Characteristics of Fatigue of hemodialysis patients : 1) 79 of 101 hemodialysis patients complained fatigue. 2) The mean fatigue score as measured by the VAS-F was 36.2mm. 3) The mean duration of fatigue was 2.9 hours 2. Characteristics of fatigue related factors : 1) The physiologic factor which included Hgb, Hct, BUN, creatinine, potassium and interdialytic weight gain deviated from normal range. 2) The psychological factor which included depression and self-efficacy was about the same level as for patients with other chronic diseases. 3) The environmental factor which included social support had wide variation. 3. The relationship between fatigue and related factors : 1) Interdialytic weight gain in the physiologica factor was the only valuable with fatigue （p＜.05） 2) The relationship between fatigue and the psychological factor of depression showed a positive and strong correlation（p＜.05）. According to the findings of this study, fatigue was highly correlated with the depression. This indicates that nurses should try to assess and control psychological factors when patients complain of fatigue rather than just considering physiological factors. Nursing has to develop effective nursing interventions to reduce fatigue in patients with chronic diseases using the relationship between fatigue and physiological, psychological and environmental factors.

• 대한전기학회논문지:시스템및제어부문D
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• 제51권11호
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• pp.521-527
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• 2002

The Hemodialysis system is the device for the patients who have suffered from end stage renal failure as the kidney which removes the waste products in a human body. The existing hemodialysis is based on a 8-bit micro-controller and it is not a touch-screen type but a manual type. This paper is focused on hemodialysis system based on high control and expension embedded system. The whole system consists of main control unit and sub control unit(dialysis control unit, blood control unit, monitoring control unit, networking unit). The dialysis control unit, blood control unit, monitoring control unit are processed by 3 microcontrollers and network unit is for monitoring a renal failure patient's condition. For the evaluation of the system performance, the saline was pured into blood unit and then water removal rate, conductivity and temperature of hemodialysis liquid were measured 10 times in an each state suing the UF pump in the fluid unit varing the quantity of saline to 1000cc, 2000cc, 3000cc and 4000cc. As a result, the rates of water removal are 98.6% in condition of 000cc saline, 96.9% in 2000cc, 98.9% in 3000cc and 98.3% in 4000cc. The conductivities of hemodialysis liquid are 99.6% in the first to third condition and 99.7% in the forth condition. The temperatures of hemodialysis liquid are 99.8% in the first to third condition and 99.6% in th forth condition.

• Tuberculosis and Respiratory Diseases
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• 제66권6호
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• pp.463-466
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• 2009

S. constellatus는 Streptococcus milleri group을 이루는 균이며 상부호흡기계, 비뇨기계 등에 정상 상재균으로 존재하다 면역저하 상태에서 기회감염을 일으키며 주로 농을 형성하는 것으로 알려져 있다. 저자들은 혈액투석을 받는 환자에게 발생한 S. constellatus에 의한 농흉 1예를 경험하였기에 문헌고찰과 함께 보고한다. 본 증례를 통해 면역이 저하된 환자에게 농흉이 형성된 경우 S. constellatus에 의한 감염을 생각해볼 수 있으며 이와 같은 경우 세균학적 검사 결과에 따른 항생제 치료와 함께 수술적 배농을 고려해야 한다는 것을 경험하였다.

• 대한핵의학회지
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• 제19권2호
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• pp.43-50
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• 1985

With the improvement of hemodialysis, the course of the disease in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (early and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis. 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe due to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

• 대한간호학회지
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• 제29권3호
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• pp.563-575
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• 1999

The purpose of this study was to examine the correlation between self-efficacy and self-care of hemodialysis patients. The subjects consisted of 140 hemodialysis patients who underwent hemodialysis at 2 university hospitals. The data were collected by questionnaires and chart review. The questinnaire used the self-efficacy tool developed by Kim Ju Hyune(1995) and the self-care tool developed by literature review and indepth open openended questions to 10 patients. Also, the questionnaire included physiologic data which collected through review of the patients' charts. The statistical analysis was used the SPSS program for frequency, mean, t-test, ANOVA and Pearson correlation. The results were as follows : 1. The mean score for general self-efficacy of hemodialysis patients was 3.103(1-4point) and there were significant differences according to percieved health. The mean score for specific self-efficacy of hemodialysis patients was 3.113 (1-4point) and there were significant differencies according to percieved health, side effects and complications which related hemodialysis. 2. The mean score for self-care of hemodialysis patients was 3.822(1-5point) and there were significant differencies according to marital status and economic level. 3. The relationship between general self-efficacy and self-care was a positive correlation(P＝.000). The relationship between specific self-efficacy and self-care was a positive correlation(P＝.000). In conclusion, this study revealed the level of self-efficacy and self-care, and the positive correlation between self-efficacy and self-care in hemodialysis patients. Therefore, intervention is needed to promote self-efficacy for self-care of hemodialysis patients. Considering the vulnerable self-care area same as checking blood pressure and weight, fluid restriction, social adjustment, exercise and rest, luther studies should develop self-efficacy promoting programs for self-care of hemodialysis patients.

• 대한의용생체공학회:의공학회지
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• 제29권5호
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• pp.376-383
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• 2008

High-flux dialysis treatment removes various toxins via diffusion as well as convection, which is induced by ultrafiltration and backfiltration. In this study, in vitro (Using the distilled water and the bovine's blood) comparison test was performed to determine whether utilization of a high flux dialyzer paired with different pumps would increase the efficiency of convection. At the same blood flow rates, a pulsatile pump and a roller pump were employed to propel the distilled water and bovine whole blood to a high flux dialyzer. Pressures at the dialyzer inlet and outlet in the blood circuit and in the dialysate circuit were measured, respectively. From these data, we calculated the transmembrane pressure and predicted the ultrafiltration and backfiltration rates developed by both pumps. Using the bovine's blood experiment, ultrafiltration and backfiltration rates were 1.6 times higher with the pulsatile pump than with the roller pump. We conclude that utilization of a pulsatile pump in high flux hemodialysis treatments increases ultrafiltration volume, compared with a roller pump under conditions of the same blood flow rate.

• 동의생리병리학회지
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• 제24권4호
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• pp.707-715
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• 2010

In this study, meridian massage is developed and applied on post menopausal Women with Hemodialysis to identify the effects of Menopausal Symptoms, Mood, Estradiol($E_2$), and Pain. The study was a nonequivalent control group pre-post test Quasi-experimental design. There were 17 people in the experimental group and 17 people in the control group. Meridian massage was performed for 4 weeks, 3 times a week for 20 minutes each sessions. The data were collected at pretest and posttest. SPSS win. 11.5 program was used. Fisher's exact test and Mann Whitney U-test were used to analyze the Pre-treatment homogeneity. Wilcoxon Sign Rank test was used to find out the effectiveness within each groups. Mann Whitney U-test was used in comparing between the two groups. After meridian massage, there were significant differences in menopausal symptoms in experimental group(z=-2.583, p=.010) and pain between groups(U=86.00, p=.040). $E_2$ was not effective in both groups. The mood was effective in both groups, since the mood had influenced by interviewer's collecting data. Meridian massage was effective in alleviating menopausal symptoms and pain of post menopausal women with Hemodialysis, but it is desirable to perform meridian massage to the patients for enough time.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1167-1172
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• 1991

Since March 1988 we have performed 133 arteriovenous fistulae for hemodialysis in 121 patients with chronic renal failure. Of the 133 cases of arteriovenous fistulae, follow-up evaluation was possible for 80 cases which performed in 69 patients. The relation between blood flow and patency rate and duration of arteriovenous fistula was examined. The overall 6 - 12 - 18 -, and 24 - month patency rates of arteriovenous fistulae were 82%, 64%a, 62%, and 57%, respectively. The maximum blood flow was 150 ~ 350ml /min[mean 217.1$\pm$44.27]. The patency duration was evaluated in patients divided into three groups owing to maximum blood flow through the fistulae. The range of maximum blood flow was 150 ~ 200ml /min for group A, 200 ~ 250ml /min for group B, and above 250ml /min for group C. The mean duration of the patency was 10.7$\pm$7.60 months in group A, 14.9$\pm$9.82 months in group B, and 21.6$\pm$11.16 months in group C[p<0 05]. With increased maximum blood flow, the duration of the patency was longer in group A than group B and C [r=0.39, p<0. 05]. The maintenance blood flow was 100 ~ 250ml /min[mean 179.2$\pm$37.26 ml/min]. When the maintenance blood flow was above 200ml /min, long-term patency rate was higher than the group below 200ml /min[r=0.48, p<0.01]. In the same range of blood flow, patency duration of the patients with using their own blood vessels were longer than the patients with using vascular graft for A-V fistula. We concluded that the patency of the arteriovenous fistulae was closely correlated with the blood flow through the fistulae.