RESUMEN
BACKGROUND: Dialysis-induced hypotension is a very common but difficult complication to manage. Amezinium methylsulfate is a newly developed sympatho-mimetic agent which has been reported as effective in postural hypotension. We studied the preventive effect of amezinium methylsulfate on dialysis-induced hypotension in chronic hemodialysis patients. METHODS: Twenty-five hemodialysis(HD) patients who were maintaining on hemodialysis longer than 3 months and had frequent episodes of dialysis hypotension were enrolled in this study. After 4 weeks of observation period, patients received one tablet of ameziniurn 30 minutes prior to every hemodialysis session for 4 weeks. We com mean arterial pressure(MAP), number of hypotensive episodes and number of nursing interventions(defined as position change, bolus injection of saline or 50% dextrose in water, need to decrease transmembrane pressure or discon- tinuation of dialysis) between observation and medication period in each patient. RESULTS: The number of nursing interventions (mean, 2.5+/-0.9 interventions vs. 1.4+/-0.9 interventions, p<0.05) and hypotensive episodes(mean, 1.7+/-0.7 episodes per session vs. 0.9+/-0.7 episodes per session; p<0.05) decreased significantly in the medication period and the nadir MAP(57+/-13mmHg vs 70+/-15mmHg; p<0.05), mid-HD MAP(65+/-15mmHg vs. 79+/-15mmHg; p<0.05) and post-HD MAP(66+/-14mmHg vs 78+/-16 mmHg ; p<0.05) are higher in the medication period compared with observation period. CONCLUSION: These results show that amezinium methylsulfate is useful to prevent dialysis-induced hypotension in chronic hemodialysis patients.
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Humanos , Diálisis , Glucosa , Hipotensión , Hipotensión Ortostática , Enfermería , Diálisis Renal , AguaRESUMEN
The status of renal replacement therapy in Korea as follows ; 1) The response rate to questionaire was 57.9% of the 226 hemodialysis centers in Korea and data file was sent in the 62.4% of responder. 2) The number of dialysis center was 226 and the number of hemodialysis machine was 3,507 and annual increasing rate were 8,7%, 14.0%, respectively. 3) The total number of ESRD patients was 20,244 and prevalance and incidence of ESRD were 431.9 and 101.1 patients per million population(ppm). 4) The proportion of renal replacement therapy was hemodialysis(HD) 53.3%, peritoneal dialysis(PD) 17.196, renal transplants(KT) 29.5%. 5) The proportion of long-term and elderly patients was markedly increased comparing 1985 (long term dialysis 20% vs. 2%, over 60 year old patients 26.2% vs. 13.8%. 6) The primary cause of renal disease was diabetic nephropathy 34.09o, chronic glomerulone-phritis 20.8%, hypertensive nephropathy 15.7%. 7) The mean BMI(body mass index,' kg/M)in over 18 year old patients was 20.7+/-2.7 kg/M in the HD and 22.23.0 kg/M in the PD. 71.9M of HD patients and 73.2% of PD were in the normal range (18.5-24.9). 8) The fistula survival rate was 6 month 93.4%, 1 yr 91.7%, 3 yr 87.6%, 5 yr 84.7%. 9) The cause of death were cardiac disease 31.8%, miscellaneous 23.5%, vascular disease 17.2%, infection 14.2%, liver disease 1.2%, social cause 5.9%.
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Adolescente , Anciano , Humanos , Persona de Mediana Edad , Procesamiento Automatizado de Datos , Causas de Muerte , Nefropatías Diabéticas , Diálisis , Fístula , Cardiopatías , Incidencia , Fallo Renal Crónico , Corea (Geográfico) , Hepatopatías , Valores de Referencia , Diálisis Renal , Terapia de Reemplazo Renal , Tasa de Supervivencia , Enfermedades VascularesRESUMEN
Primary hyperparathyroidism is characterized by hypercalcemia and increased intact parathyroid hormone, and associated with reduced bone density and bony change. We experienced the case of a 18-year-old man presenting as fracture of brown tumor. And then ectopic superior mediastinal parathyroid adenoma was detected by preoperative localization studies (Tc-99m sestamibi scan, neck CT). The patient presented with fracture of the right 5th proximal phalanx which was brown tumor, and was diagnosed as having primary hyperparathyroidism due to elevated serum calcium level (12.1 mg/dl) and intact parathyroid hormone levels (1631.8 pg/ml). Ultrasonography, Tl-201/Tc-99m subtraction scan, Tc-99m sestamibi scan, computed tomography was performed, and then revealed an enlarged parathyroid gland in the superior mediastinum. Tumor was removed via a transcervical approach. Pathologically, the tumor was confirmed to be a parathyroid adenoma. After his operation, his calcium level rapidly returned to within normal ranges, and increased bone density and some remineralization of brown tumor has occurred after eight months.
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Adolescente , Humanos , Densidad Ósea , Calcio , Hipercalcemia , Hiperparatiroidismo Primario , Mediastino , Cuello , Glándulas Paratiroides , Hormona Paratiroidea , Neoplasias de las Paratiroides , Valores de Referencia , UltrasonografíaRESUMEN
Amyloidosis is a rare complication of nonhodgikin's lymphoma. In review of the literature, almost all amyloidosis in lymphoma are the AL type and they are resulted frorn monoclonal light chains synthesized by the lymphoma cells. But we want to describe the AA type in patient with small lymphocytic lymphoma. A 60-year-old male patient admitted due to generalized edema and asthenia. He complained anorexia and dizziness at standing. Initial laboratory test revealed nephrotic range proteinuria and hypoalbuminemia. Combined pituitary stimulation test confirmed a decreased pituitary function and the adrenal function was also regarded hypofunctioning status in view of decreased cortisol response. Serum protein electrophoresis revealed monoclonal peak in gamma globulin area. This protein was composed by IgG and Lambda. We found the monotonous cellular infiltration in bone marrow specimen. These cells were lamMa positive in immunohistochemical stain- ing and only CD 20 positive in immunophenotype study. We made a diagnosis of small lymphocytic lymphoma with bone marrow involvement. Kidney biopsy revealed amyloidosis and the electrornicroscopy showed definite randomly arranged amyloid fibril, but immunohistochemical staining was positive with AA amyloid, unexpectedly. We suggest that all amyloidosis in lymphoma patient should be explored the origin of the amyloid fibrile, that is AA type or AL type.
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Humanos , Masculino , Persona de Mediana Edad , Amiloide , Amiloidosis , Anorexia , Astenia , Biopsia , Médula Ósea , Diagnóstico , Mareo , Edema , Electroforesis , gammaglobulinas , Hidrocortisona , Hipoalbuminemia , Inmunoglobulina G , Riñón , Leucemia Linfocítica Crónica de Células B , Linfoma , Síndrome Nefrótico , ProteinuriaRESUMEN
No abstract available.
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Varicela , Herpes Simple , Herpesvirus Humano 3 , Simplexvirus , TrasplanteRESUMEN
No abstract available.