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A Study on Dental Hygienists' Health Management and Their Use of Medical Care Services (치과위생사의 건강관리 및 의료 이용 행태에 관한 조사 연구)

  • Yoon, Mi-Sook;Lee, Kyung-Hee
    • Journal of dental hygiene science
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    • v.4 no.1
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    • pp.13-20
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    • 2004
  • The purpose of this study was to examine how dental hygienists health management and to what extent they used medical care services due to occupational diseases. It's ultimately attempted to improve the health care of dental hygienists and promote their health. After relevant literature and data were reviewed, a survey was conducted for five months from June through October, 2003. The subjects in this study were 160 dental hygienists who worked at dental hospital and clinics across the nation. And the collected data were analyzed. The findings of this study were as follows: (1) Concerning job-related health education experience, 83.1 percent, the greatest rate, had no experience to receive education, and the type of service made a significance difference to that(p<0.05). (2) As to in-house medical examination, 98.6 percent felt the need for medical examination, and 56.3 percent had ever their bodies examined. Their health examination experience was significantly different according to age(p<0.01), marital status(p<0.01), type of service(p<0.01), career(p<0.01) and yearly income(p<0.01). (3) Concerning how much they used hospitals after working as dental hygienists, 85.6 percent, the biggest group, had no experience to be hospitalized, and that was significantly different according to age(p<0.05), type of service(p<0.05), career(p<0.01) and yearly income(p<0.05). 51.9 percent had no experience to receive treatment as outpatients, and their career(p<0.01) made a significant difference to that. (4) As for how to cope with casual diseases, 34.4 percent, the largest group, visited pharmacies, and 32.5 percent, the next largest group, saw the doctors. In regard to herb restorative, 68.1 percent had no experience to take herb restorative, and that experience varied significantly with age(p<0.01), career(p<0.05) and annual income(p<0.01).

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The Role of Radiotherapy in the Treatment of Portal Vein Thrombosis from Advanced Hepatocellular Carcinoma (진행된 간세포암에서의 간문맥 혈전증에 대한 방사선치료 효과)

  • Kim, Jung-Hoon;Choi, Eun-Kyung;Ahn, Seung-Do;Lee, Sang-Wook;Shin, Seong-Soo;Choi, Won-Sik;Lim, Young-Suk;Kim, Kang-Mo;Suh, Dong-Jin;Chung, Young-Wha;Lee, Young-Sang;Won, Hyung-Jin;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.170-176
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    • 2007
  • Purpose: To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). Material and Methods: A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 $Gy_{10}$ (median dose: 61.6 $Gy_{10}$). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months. Results: The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%). Conclusion: Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.

Vitamin B12 Deficiency after a Total Gastrectomy in Patients with Gastric Cancer (위암으로 위 전절제술 후 비타민 Bl2 결핍과 치료)

  • Chae, Hyun-Dong;Park, Ki-Ho
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.6-10
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    • 2006
  • Purpose: The most common metabolic defect appearing following a gastrectomy is anemia. Two types have been identified: One is related to a deficiency in iron and the other is related to an impairment in vitamin B12 metabolism. The purpose of this study is to evaluate the incidence and treatment of vitamin B12 deficiency after a total gastrectomy. Materials and Methods: Serum vitamin B12 concentrations were measured in 128 patients who had undergone a total gastrectomy. The group with a serum concentration under 200 pg/ml was supplemented at one-month intervals with Actinamide and five-six months later, serum concentrations of the vitamin B12 were rechecked. Results: The group with vitamin B12 under 200 pg/ml was 61 (47.6%) of the 128 patients who had undergone a total gastrectomy. In this group, the cumulative incidences of vitamin B12 deficiency were 7.0, 23.4, 33.6, 39.1, 41.4, and 47.7% at 6 months, 1, 2, 3, 4, and 5 or more years, respectively. The treated group with vitamin B12 under 200 pg/ml had 36 (28.17%) of the 128 patients. The 16 of those cases with vitamin B12 levels of $100{\sim}150\;pg/ml$ were supplemented 5.21 times and the vitamine B12 was elevated to above 650 pg/ml. The other 20 cases with an average of vitamin B12 levels of $150{\sim}200pg/ml$ were supplemented an average of 4.75 times, and the vitamin B12 was elevated to above 780 pg/ml. Conclusion: It is necessary to supplement vitamin B12 even 1 year later after a total gastrectomy. The group with vitamin B12 under 200 pg/ml was supplemented $5{\sim}6$ times at one-month intervals with Actinamide $1,000\;{\mu}g$ IM injections and reached normal levels. (J Korean Gastric Cancer Assoc 2006;1:6-10)

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Walking test for assessing lung function and exercise performance in patients with cardiopulmonary disease (심폐질환 환자에서 걷기검사를 이용한 폐기능 및 운동기능의 평가)

  • Jung, Hye Kyung;Chang, Jung Hyun;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.976-986
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    • 1996
  • BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.

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The Protective Effect of Orally Ingested Korean Red Ginseng on the Noise Induced Hearing Loss in Mice (마우스에서 고려 홍삼의 구강내 섭취를 통한 소음성 난청의 예방효과)

  • Ahn, Joong-Ho;Kim, Tae-Soo;Chung, Hana;Lee, Na-Young;Chung, Jong-Woo
    • Journal of Ginseng Research
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    • v.33 no.2
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    • pp.104-110
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    • 2009
  • It is well known that the saponin of Korean red ginseng (KRG) has an anti-oxidant effect and could suppress the accumulation of lipid peroxidation. The aim of the present study was to observe the inhibitory effect of KRG on mice with noise-induced hearing loss, and to determine its optimal dose. BALB/c mice with a normal hearing level and normal Preyer's reflexes were used in the study. The mice in the permanent-threshold-shift (PTS) group were exposed to noise (120-dB SPL, white noise band) in a noise booth for 3 h a day, for three consecutive days. The mice in the experimental group were given heat-processed red-ginseng extract (50 mg/kg, 100 mg/kg, and 200 mg/kg), and those in the control group were given normal saline alone during their noise exposure. The mice in the temporary-threshold-shift (TTS) group were exposed to noise (120 dBSPL, white noise band) in a noise booth for 3 h. The mice in the experimental group were given heat-processed red-ginseng extract (50 mg/kg, 100 mg/kg, and 200 mg/kg), and those in the control group were given normal saline alone before their noise exposure. The hearing levels of the mice were measured through auditory brainstem response (ABR) immediately and I, 3, 5, 7, and 14 days after their noise exposure. Cochleae were removed from the mice 14 days after their noise exposure. lmmunochemical and immunofluorescent staining were performed to observe the expression of 8-oxoG in cochlea. In the PTS group, the hearing function of the mice in all the groups was not recovered after their noise exposure. In the TTS group, however, the hearing function of the mice in all the groups was recovered within 14 days. Reduced hearing impairment and early recovery were observed in the mice that were given 200 mg/kg KRG, and early recovery was observed in the mice that were given 100 mg/kg KRG The immunopositive staining of 8-oxoG was detected in the stria vascularis in the control group but was diminished in the mice that were given 200 mg/kg KRG The ingestion of more than 100 mg/kg KRG demonstrated a protection and recovery effect on the noiseinduced-TTS group. Since KRG has been reported to be a safe compound even up to hundreds of mg/kg, a higher concentration of it may effectively protect and recover TTS.

A Clinical Study on Binaural Hearing Aid (양이 보청효과에 관한 연구)

  • 김기령;김영명;심윤주
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.9.2-9
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    • 1978
  • Monaural and binaural hearing aid performance under quiet and noisy conditions were compared in regard to (1) the degree of hearing impairment, (2) the symmetry of pure tone audiogram, (3) the automatic gain control of the hearing aid. (4) hearing impairement with recruitment and, word discrimination ability. Performance using binaural hearing aids was consistently superior to that using monaural hearing aids. The results were as follows. 1. Speech detection thresholds were enhanced by a mean of 4.25dB when tested with danavox 747 PP stereo type hearing aid and by a mean of 4.12 dB when tested hearing aids connected seperately to the right and left ears. 2. Binaurally tested speech reception thresholds were superior to monaurally tested thresholds by a mean of 3.56dB when tested in quiet and by a mean of 5.56dB when tested in noise. 3. Binaurally tested word discrimination scores were also superior by a mean of 17.09% in quiet and by a mean 19.63% in noise. 4. Both SRT and word discrimination scores were performed best by subjects with moderately-severe impairement. The performance by one mildly impaired subject was the poorest of all performances. The levels of performance order were; moderately-severe loss, severe loss. moderate loss and mild loss. 5. The data obtained using AGC aids when compaired with that of linear amplification show that when AGC aids were worn in both ears. the results were very poor but when one AGC aid was worn in one ear and linear amplification in the other. the results were good. 6. The advantages of binaural hearing aids were obvious even in cases 1) with great diferences in hearing thresholds between right and left ears, 2) when the subject was unable to discriminate words without vision and. 3) when the subject had extreme recruitme t phenomenon.

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NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY (외상성 뇌손상 아동의 신경정신과적 후유증 평가)

  • Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.212-219
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    • 1999
  • Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

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Assessment of Abnormality in Skeletal Muscle Metabolism in Patients with Chronic Lung Desease by $^{31}P$ Magnetic Resonance Spectroscopy ($^{31}P$ 자기 공명분석법을 이용한 만성 폐질환 환자에서의 골격근대사 이상에 관한 연구)

  • Cho, Won-Kyoung;Kim, Dong-Soon;Lim, Tae-Hwan;Lim, Chae-Man;Lee, Sang-De;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.583-591
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    • 1997
  • The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolic changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation, early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. $^{31}P$ MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p < 0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.

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Microsatellite Alterations of Plasma DNA in Non Small Cell Lung Cancer (비소세포폐암 환자의 혈장 DNA를 이용한 Microsatellite 분석)

  • Kim, Kyu-Sik;Kim, Eun-Jung;Kim, Soo-Ock;Oh, In-Jae;Park, Chang-Min;Jeong, Ju-Yeon;Kim, Yu-Il;Lim, Sung-Chul;Park, Jong-Tae;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.352-358
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    • 2005
  • Microsatellites are short tandem repeated nucleotide sequences that are present throughout the human genome. Variations in the repeat number or a loss of heterozygosity around the microsatellites have been termed a microsatellite alteration (MA). A MA reflects the genetic instability caused by an impairment in the DNA mismatch repair system and is suggested to be a novel tumorigenic mechanism. A number of studies have reported that MA in the DNA extracted from the plasma occurs at varying frequencies among patients with a non-small cell lung carcinoma (NSCLC). The genomic DNA from 9 subjects with a non-small cell lung cancer (squamous cell cancer 6, adenocarcinoma 2, non-small cell lung cancer1) and 9 age matched non-cancer control subjects (AMC: tuberculosis 3, other inflammatory lung disease 6) and 12 normal control subjects (NC) were extracted from the peripheral blood leukocytes and plasma. Three microsatellite loci were amplified with the primers targeting the Gene Bank sequence D21S1245, D3S1300, and D3S1234. MA in the form of an allelic loss or a band shift was examined with 6% polyacrylamide gel electrophoresis and silver staining. None (0/12) of the NC subjects less than 40 years of age showed a MA in any of the three markers, while 88.9%(8/9) of the AMC above 40 showed a MA in at least one of the three markers (p<0.05). Sixty percent(6/10) of the control subjects with a smoking history showed a MA in one of the three markers, while 9.1%(1/11) of the control subjects without smoking history showed a MA (p<0.05). However, not only did 66.7%(6/9) of lung cancer patients show a MA in at least one of the three markers but so did 88.9%(8/21) of the AMC patients (p>0.05). In conclusion, a MA in the D21S1245, D3S1300, and D3S1234 loci using DNA extracted from the plasma was detected in 66.7% of lung cancer while no MA was found in the young non-smoking control subjects. However, many of the non-cancer control subjects (aged smokers) also showed a MA, which compromised the specificity of the MA analysis as a screening test. Therefore, a further study with a larger sample size will be needed.

Immediate Effect of Hemodialysis on Pulmonary Function and Bronchodilator Response in Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석이 폐기능 및 기관지확장제에 대한 반응에 미치는 영향)

  • Jeon, Ho Seok;Lee, Yang Deok;Cho, Yongseon;Han, Min Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.77-84
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    • 2004
  • Background : We hypothesized that there was a relationship between body weight change and bronchodilator response (BDR) in patients with chronic renal failure (CRF) on hemodialysis (HD). Several mechanisms such as pulmonary edema due to water retention or increased permeability of alveolar capillary may play a important role in pulmonary function impairment and bronchial hyperresponsiveness in patients with CRF on HD. But, no studies have been published concerning BDR in patients with CRF on HD. This study was aimed to know the immediate effect of hemodialysis on pulmonary function and BDR in patients with CRF on HD. Methods : This study included 30 patients with CRF on HD. We collected data including age, sex, height, pretibial and pedal pitting edema, interdialysis weight gain, postdialysis weight loss, underlying diseases, duration of HD, $FEV_1$, FVC, $FEV_1/FVC$, and BDR before and after HD. Results : Interdialysis weight gain of the patients was $3.4{\pm}1.0kg$, and postdialysis weight loss was $3.2{\pm}0.7kg$. Before HD,$FEV_1$, FVC, and $FEV_1/FVC$ of the patients were $89{\pm}22%$, $86{\pm}19%$ of predicted, and $87{\pm}10%$. After bronchodilator inhalation, these parameters were changed to $95{\pm}22%$, $90{\pm}19%$ of predicted, and $88{\pm}9%$ respectively. BDR was positive in 15 patients. After HD, $FEV_1$, FVC, and $FEV_1/FVC$ of the patients were $100{\pm}23%$, $94{\pm}18%$ of predicted, and $88{\pm}11%$. After bronchodilator inhalation, these parameters were changed to $102{\pm}23%$, $96{\pm}18%$ of predicted, and $89{\pm}8%$ respectively. BDR was positive in 9 patients. Conclusion : First, HD increases $FEV_1$, FVC, and $FEV_1/FVC$ but little affects BDR. Second, there is no correlation between postdialysis weight loss and increases in $FEV_1$, FVC, and $FEV_1/FVC$ after HD. Third, there is also no correlation not only between interdialysis weight gain and BDR before HD but between postdialysis weight loss and BDR after HD.