• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.398-406
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• 2018

Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

• 대한임상독성학회지
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• 제15권1호
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• pp.11-16
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• 2017

Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{\pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${\geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

• 대한한방내과학회지
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• 제37권2호
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• pp.202-211
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• 2016

Objective: This clinical study reports on a case of generalized edema with hypoalbuminemia and pleural effusion improved by combined traditional Korean and Western medical treatments in a patient with chronic myeloid leukemia medicated with dasatinib.Method: Combined traditional Korean and Western medical treatment was carried out, including herbal medicine, acupuncture, moxibustion, and albumin injection. We examined the serum albumin, measured the circumference of both thighs and ankles to estimate the volume of the edema, and evaluated the pleural effusion symptoms.Results: The serum albumin increased, and generalized edema and pleural effusion improved significantly after the administration of Bojungchiseub-tang-gami.Conclusion: These results showed that complications of generalized edema and pleural effusion associated with dasatinib medication have the potential to be improved via combined traditional Korean and Western medical treatments.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.253-258
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• 2005

Generalized edema and hypoalbuminemia are relatively common presenting manifestations in many clinical situations. The differential diagnosis of hypoalbuminemia include: Kwashiorkor, synthetic dysfunction of the liver, and excessive protein loss as in nephrotic syndrome. In systemic lupus erythematosus (SLE), hypoalbuminemia and generalized edema are most commonly due to protein loss associated with lupus nephritis; gastrointestinal involvement is uncommon, and therefore protein loss through the gastrointestinal tract is quite rare. We report a case of a protein losing enteropathy (PLE) associated with SLE. The patient was referred to our hospital for generalized edema, arthralgia and facial rash. After clinical evaluation, the patient met the criteria for the SLE diagnosis; hypoalbuminemia with general edema was consistent with a protein losing enteropathy. After two weeks of therapy with parenteral high dose glucocorticoid, the patients was improved in laboratory findings as well as clinical symptoms.

• 대한한의학회지
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• 제22권3호
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• pp.179-188
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• 2001

Diarrhea is the frequent passage of loose, watery stool (frequency: ${\geq}4/day$, weight: ${\geq}250g/day$) Most antibiotics can cause inflammatory change of the colon or Pseudomembranous colitis (PMC). Typical presentations of PMC are watery diarrhea, abdominal pain, fever, leukocytosis ($12,000~20,000/\textrm{mm}^3$), hypoalbuminemia, hypovolemia and recent or concurrent use of antibiotics. Diagnostic methods of PMC are stool assay, sigmoid scopy, abdominal CT, abdominal US, etc. The age-related susceptibility noted with PMC is impressive but unexplained. Two stroke patients had diarrhea, abdominal pain, fever hypoalbuminemia and a history of recent or concurrent use of antibiotics. By use of Shirhyung- Tang, we could improve clinical symptoms (diarrhea, abdominal pain, fever hypoalbuminemia, etc.) and so report clinical course of two stroke patients with antibiotics-associated PMC.

• 약학회지
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• 제55권4호
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• pp.352-360
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• 2011

Standard combination chemotherapy including isoniazid, rifampin, pyrazinamide, and ethambutol is very effective against tuberculosis. But, these medicines can cause hepatotoxicity which is the main reason for treatment interruption or change in drug regimen. In order to identify risk factors associated with hepatotoxcity in Koreans and assess elevated baseline LFTs' contributions to hepatotoxicity, a retrospective case control study was performed. The medical records of 277 patients who diagnosed with tuberculosis at a community hospital from January 1st, 2007 to June 30th, 2010 were reviewed. Patients were categorized into 3 groups (non toxic group, patients without increase in LFT levels; mild to moderate hepatotoxic group and severe hepatotoxic group). And the correlation between risk factors and hepatotoxicity was analyzed by using SPSS program. The overall incidence of hepatotoxicity was 18% and 8.7% of patients developed severe toxicity. Patients in the severe toxic group had the longest treatment period among the three groups. In 75% of severe toxic group, hepatotoxicity occurred within 18.3 days after starting medication. Hypoalbuminemia (serum albumin <3 g/dl) was a significant risk factor for development of severe toxicity. Elevated baseline transaminase (except ALT), total bilirubin, and preexisting hepatitis were also risk factors which were more than twice as likely to increase risk of severe hepatotoxicity (p>0.05). In conclusion, hypoalbuminemia (serum albumin level <3 g/dl) was a significant risk factor for anti-tuberculosis druginduced severe toxicity. Therefore, before starting antituberculosis chemotherapy, serum albumin level should be assessed at baseline. In high-risk patients (hypoalbuminemia, elevated LFTs) for hepatotoxicty, liver function should be closely monitored up to at least 21 days after taking medication.

• Clinical and Experimental Pediatrics
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• 제48권5호
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• pp.523-526
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• 2005

목 적 : 흉수가 있는 환아에서 저알부민혈증의 중등도에 따른 임상 경과의 차이점을 알아보고자 하였다. 방 법 : 1999년 8월부터 2004년 8월까지 부산대학교병원에 입원 당시 흉수가 있었던 환아 96명 중 감염이 원인 질환인 환아 79명을 혈청 알부민 수치에 따라 두 군으로 나누었다(1군 : ${\leq}2.5g/dL$, 2군 : >2.5 g/dL). 각 환자의 연령, 성별, 혈청 알부민 수치를 포함한 기본 혈액 검사, 흉부 방사선 촬영 결과와 각 군에서 환아의 치료 방법 및 예후를 의무 기록을 바탕으로 후향적으로 조사하였다. 결 과 : 79명 중 남아 48명, 여아 31명이었고, 평균 나이는 3.9세 이었다. 각 군에서 기본 혈액 검사는 차이가 없었고, 원인이 되었던 질환은 폐렴 58례, 농흉 12례, 폐 결핵 8례, 심낭염과 폐렴이 동반된 환아는 1례이었다. 각 군별로 입원 기간은 1군이 더 긴 것으로 나왔고, 항생제나 항결핵제 사용만으로 회복된 환아는 1군에서 4례, 2군에서 26례로 각 군별 환자 비율에 유의한 차이를 나타냈다(P=0.004). 항생제 사용하면서 흉관 삽입을 한 경우는 1군에서 14례, 2군에서 26례로 각 군별 환자 비율에 차이가 없었다. 그리고 인공 호흡기 치료가 필요하였던 경우가 1군에서 8례, 2군에서 1례로 분포되어 있었고, 통계학적으로 유의한 차이를 보였다(P=0.000). 결 론 : Starling 법칙에 따라 모세혈관의 정수압의 상승과 삼투압의 감소가 흉수를 일으킨다고 알려져 있지만 뚜렷한 체액의 저류 없이 저알부민혈증을 가진 경우도 드물게 흉수를 일으킬 수 있다. 그리고 혈청 알부민 수치가 낮을수록 인공 호흡기 치료를 하거나 사망하는 경우와 같은 치명적인 결과를 초래할 가능성이 높다.

• 대한한방내과학회지
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• 제22권1호
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• pp.103-108
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• 2001

Nephrotic syndrome(NS) is characterized albuminuria, hypoalbuminemia, hyperlipidemia and edema. The thromboembolic complications of NS are reasonably common and have a broad range of clinical manifestations. The treatment of NS is empirical and symptomatic because the etiology and pathogenesis are unknown. We report treatment of patient who has been afflicted with NS for 20 years. He complained edema, dyspnea, Rt. hemiparesis, aphasia. We treated him with converting enzyme inhibitor, steroid, three kinds of herb-medicine for 45 days. The patient improved in clinical symptoms and routine chemistry, urine analysis test.

• Parasites, Hosts and Diseases
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• 제26권3호
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• pp.221-226
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• 1988

면역기능이 저하된 한국인 73세 남자가 요통을 주소로 입원하였다. 환자는 prednisolone 을 장기간 투여하였다고 하며 입원시 전신성 pitting edema와 기침, 객담, 구토, 설사를 하였고 빈 사상태였다. 백혈구는 증가하였으나 초산구중가증은 없었으며 저 단백혈증, hypoalbuminemia, 패혈증, 빈혈이 있었다. 뇨는 한색이었다. 대변검사에서 rhabditiform 유충이 관찰되었으며 대변 배양 검사로 분선충의 filariform유충이 확인되어 분선충에 의한 hyperinfection으로 진단되었다. 치료목적으로 입원 제3일부터 albendazole을 4일간 투여하였다. 입원 제7일에 객담검사에서 filariform유충이 관찰되었으며 설사변에서 분선충의 기생세대 자충 619마리를 수집하였다. 그러나 환자는 희망없이 빈사상태로 퇴원하였으며 얼마 후 자택에서 사망하였다.

• Nutrition Research and Practice
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• 제11권1호
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• pp.57-63
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• 2017

BACKGROUND/OBJECTIVES: The level of serum albumin is an index of nourishment care and management. However, the distribution and correlates of serum albumin levels among individuals with motor disorders have not been reported until now. Therefore, we examined the distribution and correlates of serum albumin levels among individuals with motor disorders. SUBJECTS/METHODS: A cross-sectional study on 249 individuals with motor disabilities (144 men, mean age: 51.4 years; 105 women, mean age: 51.4 years) was conducted at five institutions in Ibaraki Prefecture, Japan in 2008. The results were compared with data from the National Health and Nutrition Survey. RESULTS: The mean serum albumin levels were $4.0{\pm}0.4g/dL$ for men and $3.8{\pm}0.5g/dL$ for women. Overall, 17 (11.8%) men and 25 (23.8%) women had hypoalbuminemia (serum albumin level ${\leq}3.5g/dL$); these proportions were greater than those among healthy Japanese adults (${\leq}1%$). Low serum albumin level was related with female sex, older age, low calf circumference, low relative daily energy intake, low hemoglobin (Hb), low blood platelet count, low high-density lipoprotein cholesterol (HDL-C), low $HbA_{1c}$, and high C-reactive protein (CRP) levels. The strongest correlates, based on standardized betas, were Hb (0.321), CRP (-0.279), and HDL-C (0.279) levels. CONCLUSIONS: These results indicate that the prevalence of hypoalbuminemia is higher in individuals with motor disabilities than in healthy individuals and that inflammation is a strong negative correlate of serum albumin levels. Therefore, inflammation should be examined for the assessment of hypoalbuminemia among institutionalized individuals with motor disabilities.