• 제목/요약/키워드: kidney surgery

검색결과 353건 처리시간 0.027초

신장이식 환자의 인플루엔자 예방접종 실태와 이행 영향 요인 (Current Immunization Status and Factors Affecting the Influenza Vaccination in Kidney Transplant Patients)

  • 조한경;정재심;문성미;김미나
    • Journal of Korean Biological Nursing Science
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    • 제18권2호
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    • pp.118-125
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    • 2016
  • Purpose: The present study examines the current influenza immunization rate among kidney transplant patients in an effort to identify the factors influencing their decisions pertaining to the immunization. Methods :Participants in the study included 150 adults over the age of 64 years who visited a General Surgery Department in Korea on April 2015, who had had a kidney transplant at least two years prior to the visit. We compared the characteristics of transplant patients who were immunized against those of the patients who had not been immunized. Results: The average age of the participants was $48.5{\pm}9.6years$, consisting of 87 males (58.0%) and 63 females (42.0%). The average post-surgery period was $91.0{\pm}59.0months$. Between September and December 2014, the immunization rate among these participants was 61.3%. Factors which influenced the participant's decision to get immunized in 2014 and drove up the immunization rate were: previous immunization in 2013 (OR=24.57, CI= 8.79-68.70, p<.001), marital status (OR=3.33, CI 1.05-10.56, p=.041), and awareness (OR=1.58, CI=0.99-2.52, p=.056). Conslusion: The current study found that the previous year's immunization record, marital status, and awareness increased the rate of immunization among the participants.

양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고- (Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • 제30권6호
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    • pp.625-630
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    • 1997
  • 56세 남자 환자가 신경과에 내원하였는데, 그는 최근에 심해지는 우측 세번째에서 다섯번째 수지의 반복 적인 저린 통증과 파악력의 약화를 주소로 하였다. 이와 함께 보행시 하지 동통을 호소하였다. 경동맥 조영술상 우내경동맥이 완전히 막혀 있었고 좌우총경동맥과 외경동맥, 좌내 경동맥은 심각한 협착이 있었다. 함께 시행한 대동맥 조영술상 신동맥이하는 완전한 폐색을 보였고 양측 대퇴 동맥은 지연 조영 을 보였다. 두개의 동맥 병변에 대해 단계별로 수술 계획을 세웠다. 양측 경동맥 병변은 경동맥 내막절제술을 시행 하였다. 이 때 좌측은·경동맥 션트를 사용하였다. 복부대동맥 병변은 2주후에 시행되었으며 복강동맥하방의 대동맥을 결찰하고 허혈시 신장을 보존하기위 해 신보존액을 주입하였다. 역 Y 회로 이식술과 신보존을 시행하여 린분간의 허혈동안에도 성공적으로 시술되었으며 별다른 문제없이 술 후 보름만에 퇴원하였다.

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Tissue-resident natural killer cells exacerbate tubulointerstitial fibrosis by activating transglutaminase 2 and syndecan-4 in a model of aristolochic acid-induced nephropathy

  • Wee, Yu Mee;Go, Heounjeong;Choi, Monica Young;Jung, Hey Rim;Cho, Yong Mee;Kim, Young Hoon;Han, Duck Jong;Shin, Sung
    • BMB Reports
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    • 제52권9호
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    • pp.554-559
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    • 2019
  • Despite reports suggesting that tissue-resident natural killer (trNK) cells cause ischemic kidney injury, their contribution to the development of tubulointerstitial fibrosis has not been determined. This study hypothesized that the depletion of trNK cells may ameliorate renal fibrosis by affecting transglutaminase 2/syndecan-4 interactions. Aristolochic acid nephropathy (AAN) was induced in C57BL/6 mice as an experimental model of kidney fibrosis. The mice were treated with anti-asialo GM1 (ASGM1) or anti-NK1.1 antibodies to deplete NK cells. Although both ASGM1 and NK1.1 antibodies suppressed renal $NKp46^+DX5^+$ NK cells, renal $NKp46^+DX5^-$ cells were resistant to suppression by ASGM1 or NK1.1 antibodies during the development of tubulointerstitial fibrosis in the AAN-induced mouse model. Western blot analysis showed that both antibodies increased the expression of fibronectin, transglutaminase 2, and syndecan-4. These findings indicate that trNK cells played an exacerbating role in tubulointerstitial fibrosis by activating transglutaminase 2 and syndecan-4 in the AAN-induced mouse model.

신장이식 환자의 수술 후 경과기간에 따른 미충족요구 분석 (Analysis of Unmet needs by Elapsed Time in Kidney Transplantation Patients)

  • 노세희;박정숙
    • 한국융합학회논문지
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    • 제11권12호
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    • pp.457-467
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    • 2020
  • 본 연구는 지속적인 자가간호가 필요한 신장이식 수술환자의 경과 기간에 따른 미충족 요구를 파악하여, 시기에 맞는 통합적인 간호중재 프로그램 개발에 필요한 기초자료를 제공하고자 시도되었다. 연구대상은 신장이식 수술 후 1년까지 입원 및 외래환자 84명으로 구성되었다. 자료수집 기간은 2020년 2월 17일부터 5월 31일까지로, Comprehensive Needs Assessment Tool in Cancer(CNAT)를 신장이식 환자에 맞게 수정·보완, 전문가 타당도 검증을 거쳐 사용하였다. 자료분석은 Chi-square, 독립 t-test, one-way ANOVA, ANCOVA, 사후검정은 Scheffé로 하였다. 연구결과 신장이식 수술 환자의 미충족 요구는 171점 만점 중 총점 평균 68.28(±38.88)점, 하부영역 8개 중 정보 및 교육이 17.92(±8.36)점으로 가장 높았다. 경과 기간에 따른 미충족 요구는 3-6개월에 비해 6개월-1년까지가 유의하게 높았다(F=7.57, p=.001). 이를 토대로 신이식 후 회복이 되어 관심이 줄어들 수 있는 6개월-1년 사이 환자의 미충족 요구는 증가하였으므로 적절한 정보와 도움을 융합하여 제공하는 간호중재 프로그램이 필요하다.

제생신기환이 허혈-재관류로 유발된 급성 신부전 마우스에 미치는 효과 (Effect of Jesaeng-sinkihwan on Renal Dysfunction in Ischemia/Reperfusion-Induced Acute Renal Failure Mouse)

  • 한병혁;이현경;장세훈;태애림;윤정주;김혜윰;이윤정;이호섭;강대길
    • 대한한의학방제학회지
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    • 제29권1호
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    • pp.33-44
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    • 2021
  • Renal ischemia-reperfusion injury(IRI), an important cause of acute renal failure (ARF), cause increased renal tubular injury. Jesaeng-sinkihwan (JSH) was recorded in a traditional Chines medical book named "Bangyakhappyeon (方藥合編)". JSH has been used for treatment of diabetes and glomerulonephritis with patients. Here we investigate the effects of Jesaeng-sinkihwan (JSH) in a mouse model of ischemic acute kidney injury. The animals model were divided into four groups at the age of 8 weeks; sham group: C57BL6 male mice (n=9), I/R group: C57BL6 male mice with I/R surgery (n=9), JSH Low group: C57BL6 male mice with surgery + JSH 100 mg/kg/day (n=9) and JSH High group: C57BL6 male mice with surgery + JSH 300 mg/kg/day (n=9). Ischemia was induced by clamping the both renal arteries during 25 min, and reperfusion was followed. Mouse were orally given with JSH (100 and 300 mg/kg/day during 3 days after surgery. Treatment with JSH significantly ameliorates creatinine clearance(Ccr), Creatinine (Cr) and blood urea nitrogen(BUN) in obtained plasma. . Treatment with JSH reduced kidney inflammation markers such as Neutrophil Gelatinase Associated Lipocalin (NGAL) and kidney injury molecule-1 (KIM-1). JSH also reduced the periodic acid schiff (PAS) staining intensity and picro sirius red staining intensity in kidney of I/R group. These findings suggest that JSH ameliorates tubular injury including renal dysfunction in I/R induced ARF mouse.

Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery

  • Lee, Yoo Jin;Park, Bong Soo;Park, Sihyung;Park, Jin Han;Kim, Il Hwan;Ko, Junghae;Kim, Yang Wook
    • Journal of Yeungnam Medical Science
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    • 제38권2호
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    • pp.136-141
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    • 2021
  • Background: Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery. Methods: This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016. Results: AKI occurred in 13 (3.7%) of the 351 patients. The patients' preoperative estimated glomerular filtration rate (eGFR) was 66.66 ±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02-0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61-0.89; p=0.002). Conclusion: Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

편측성 요관폐색으로 유발된 신장 질환 백서 모델에서 오령산, 금궤신기환, 좌귀음의 보호효과 (The ProtectiveEffect of Oryeongsan, Geumgwe-sinkihwan, and Jwagwieum on Renal Injury in Rats with Unilateral Ureteral Obstruction)

  • 한병혁;유제국;장윤재;김혜윰;윤정주;조남근;이호섭;강대길
    • 대한한의학방제학회지
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    • 제31권3호
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    • pp.133-144
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    • 2023
  • Ureteral obstruction can be causes of renal dysfunction and renal injury at late period of kidney pathology. The purpose of this study was to determine the protective effects of Oryeongsan (ORS), Geumgwe-sinkihwan (GSH), and Jwagwieum (JGE) in rats with unilateral ureteral obstruction (UUO). The animal models were divided into five groups randomly at the age of 5 weeks; Control group: SD male rats (n=10), UUO group: SD male rats with UUO surgery (n=10), ORS group: SD male rats with UUO surgery + ORS 200 mg/kg/day (n=10), GSH group: SD male rats with UUO surgery + GSH 200 mg/kg/day (n=10), JGE group: SD male rats with UUO surgery + JGE 200 mg/kg/day (n=10). Treatment with ORS, GSH, and JGE significantly ameliorate creatinine clearance(Ccr). The present results also showed that ORS, GSH, and JGE improved the morphological aspects of renal tissues. These prescriptions also reduced the expression levels of cytokines such as TNF-α, IL-1β, and IL-6. In Kidney, UUO increased the expression levels of inflamasome markers such as NLRP3, ASC, and Caspase-1. However, ORS, GSH, and JGE suppressed these levele. Treatment with these prescriptions reduced kidney inflammation markers such as Neutrophil Gelatinase Associated Lipocalin (NGAL) and kidney injury molecule -1 (KIM-1). Therefore, these findings suggest that ORS, GSH, and JGE has a protective effect on renal injury by alleviating renal inflammation and improving renal function in rats with UUO.

일측폐장절제가 잔류폐, 간 및 신장의 대상성 증식과 혈청전기영동상에 미치는 영향 (Effect of Unilatromral Pneumonectomy on the Compensatory Growth of the Residual Lung, Liver, and Kidney, ana Serum Electrophoresis Pattern)

  • 이영만;이석강;주영은
    • The Korean Journal of Physiology
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    • 제17권2호
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    • pp.177-182
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    • 1983
  • In order to clarify the effect of the unilateral pneumonectomy on the compensatory growth of the residual lung, liver and kidney, and serum electrophoresis pattern, right lung pneumonectomy was performed on rabbits under general anesthesia with pentobarbital sodium. On the fifth day after the surgery, the weight of the residual lung, liver and bilateral kidneys was measured and organ weight-body weight ratio was calculated. And in an attempt to know whether the cells in the liver and the kidney were proliferated by unilateral pneumonectomy, DNA content was determined. The quantity(g/100 ml) of serum protein was determined also and serum electrophoresis was performed on cellulose acetate membrane. The results obtained are summarized as following. The weight of the residual lung and lung weight-body weight ratio was significantly increased respectively. The weight of the liver and organ weight-body weight ratio were not changed but the DNA content of the liver and kidney tissue increased significantly, illustrating that unilateral pneumonectomy caused cellular hyperplasia in the liver and in the kidney as well as in the residual lung. The quantity(g/100 ml) of serum protein was significantly increased and in the analysis of the electrophoregram, there was significant difference between the normal and pneumonectomy group. Taken together, these results indicate that unilateral pneumonectomy caused the compensatory hyperplasia of the liver, the kidney and the residual lung as well as the change of electro-phoretic pattern. And it also suggests that a humoral factor, which proliferates the cells in the residual lung, the liver and the kidney, existed in the pneumonectomized rabbits.

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Outcome of 980 nm diode laser vaporization for benign prostatic hyperplasia: A prospective study

  • Mithani, M. Hammad;El Khalid, Salman;Khan, Shariq Anis;Sharif, Imran;Awan, Adnan Siddiq;Mithani, Shoaib;Majeed, Irfan
    • Investigative and Clinical Urology
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    • 제59권6호
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    • pp.392-398
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    • 2018
  • Purpose: To evaluate the initial experience and outcome of photo-selective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) in Pakistan with the use of a 980 nm diode laser. Materials and Methods: A prospective study was performed from November 2016 to December 2017. A total of 100 patients diagnosed with bladder outlet obstruction secondary to BPH who planned for PVP were enrolled in the study. PVP was carried out with a diode laser at 980 nm (Biolitec Diode 180W laser) in a continuous wave with a 600 nm (twister) fiber. Baseline characteristics and perioperative data were compared. Postoperative outcomes were evaluated by International Prostate Symptom Score (IPSS), post void residual (PVR) and maximum urinary flow rate (Qmax) at 3 and 6 months after surgery. Results: The mean age was $65.82{\pm}10.42$, mean prostate size was $67.35{\pm}16.42$, operative time was $55.85{\pm}18.01$ and total energy was $198.68{\pm}49.12kJ$. At 3 months and 6 months, significant improvements were noted (p<0.001) in IPSS $7.04{\pm}1.69$ (-18.92), Qmax $19.22{\pm}4.75mL/s$ (+13.09) and and PVR $18.89{\pm}5.39mL$ (-112.80). Most frequent problems were burning micturition (35%) and terminal dysuria (29%). No significant difference in postoperative hemoglobin was seen in patients who were on anti-platelet drugs. Conclusions: PVP with a diode laser is a safe and effective procedure for the treatment of BPH and is also safe in patients who are on anti-platelet agents.

Analysis of Abdominal Trauma Patients Using National Emergency Department Information System

  • Song, In-Gyu;Lee, Jin Suk;Jung, Sung Won;Park, Jong-Min;Yoon, Han Deok;Rhee, Jung Tak;Kim, Sun Worl;Lim, Borami;Kim, So Ra;Jung, Il-Young
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.116-123
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    • 2016
  • Purpose: To develop an inclusive and sustainable trauma system as the assessment of burden of injuries is very much important. The purpose of this study was to evaluate the estimates and characteristics of abdominal traumatic injuries. Methods: The data were extracted from the National Emergency Department Information System. Based on Korean Standard Classification for Disease 6th version, which is the Korean version of International Classification of Disease 10th revision, abdominal injuries were identified and abdominal surgeries were evaluated with electronic data interchange codes. Demographic factors, numbers of surgeries and clinical outcomes were also investigated. Results: From 2011 to 2014, about 24,696 patients with abdominal trauma were admitted to the hospitals annually in South Korea. The number of patients who were admitted to regional and local emergency medical centers was 8,622 (34.91%) and 15,564(63.02%), respectively. Based on National Emergency Department Information System, liver was identified as the most commonly injured abdominal solid organ (39.50%, 9,754/24,696, followed by spleen (17.57%, 4,338/24,696) and kidney (12.94%, 3,195/24,696). Conclusion: This study shows that the demand for abdominal trauma care is considerable in South Korea and most of the patients with abdominal trauma were admitted to regional or local emergency centers. The results of this study can be used as good source of information for staffs to ensure proper delivery of abdominal trauma care in trauma centers nationally.