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1.
Biomolecules & Therapeutics ; : 274-283, 2022.
Artigo em Inglês | WPRIM | ID: wpr-925616

RESUMO

KRAS activating mutations, which are present in more than 90% of pancreatic cancers, drive tumor dependency on the RAS/ mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT signaling pathways. Therefore, combined targeting of RAS/MAPK and PI3K/AKT signaling pathways may be required for optimal therapeutic effect in pancreatic cancer.However, the therapeutic efficacy of combined MAPK and PI3K/AKT signaling target inhibitors is unsatisfactory in pancreatic cancer treatment, because it is often accompanied by MAPK pathway reactivation by PI3K/AKT inhibitor. Therefore, we developed an inRas37 antibody, which directly targets the intra-cellularly activated GTP-bound form of oncogenic RAS mutation and investigated its synergistic effect in the presence of the PI3K inhibitor BEZ-235 in pancreatic cancer. In this study, inRas37 remarkably increased the drug response of BEZ-235 to pancreatic cancer cells by inhibiting MAPK reactivation. Moreover, the co-treatment synergistically inhibited cell proliferation, migration, and invasion and exhibited synergistic anticancer activity by inhibiting the MAPK and PI3K pathways. The combined administration of inRas37and BEZ-235 significantly inhibited tumor growth in mouse models. Our results demonstrated that inRas37 synergistically increased the antitumor activity of BEZ-235 by inhibiting MAPK reactivation, suggesting that inRas37 and BEZ-235 co-treatment could be a potential treatment approach for pancreatic cancer patients with KRAS mutations.

2.
Biomolecules & Therapeutics ; : 527-536, 2020.
Artigo | WPRIM | ID: wpr-830962

RESUMO

Liver fibrosis constitutes a significant health problem worldwide due to its rapidly increasing prevalence and the absence of specific and effective treatments. Growing evidence suggests that apoptosis-signal regulating kinase 1 (ASK1) is activated in oxidative stress, which causes hepatic inflammation and apoptosis, leading to liver fibrogenesis through a mitogen-activated protein kinase (MAPK) downstream signals. In this study, we investigated whether selonsertib, a selective inhibitor of ASK1, shows therapeutic efficacy for liver fibrosis, and elucidated its mechanism of action in vivo and in vitro. As a result, selonsertib strongly suppressed the growth and proliferation of hepatic stellate cells (HSCs) and induced apoptosis by increasing Annexin V and TUNEL-positive cells. We also observed that selonsertib inhibited the ASK1/MAPK pathway, including p38 and c-Jun N-terminal kinase (JNK) in HSCs. Interestingly, dimethylnitrosamine (DMN)-induced liver fibrosis was significantly alleviated by selonsertib treatment in rats. Furthermore, selonsertib reduced collagen deposition and the expression of extracellular components such as α-smooth muscle actin (α-SMA), fibronectin, and collagen type I in vitro and in vivo. Taken together, selonsertib suppressed fibrotic response such as HSC proliferation and extracellular matrix components by blocking the ASK1/MAPK pathway. Therefore, we suggest that selonsertib may be an effective therapeutic drug for ameliorating liver fibrosis.

3.
Biomolecules & Therapeutics ; : 172-183, 2020.
Artigo | WPRIM | ID: wpr-830939

RESUMO

Phosphoinositide 3-kinase (PI3K) is considered as a promising therapeutic target for rheumatoid arthritis (RA) because of its involvement in inflammatory processes. However, limited studies have reported the involvement of PI3KC2γ in RA, and the underlying mechanism remains largely unknown. Therefore, we investigated the role of PI3KC2γ as a novel therapeutic target for RA and the effect of its selective inhibitor, PBT-6. In this study, we observed that PI3KC2γ was markedly increased in the synovial fluid and tissue as well as the PBMCs of patients with RA. PBT-6, a novel PI3KC2γ inhibitor, decreased the cell growth of TNF-mediated synovial fibroblasts and LPS-mediated macrophages. Furthermore, PBT-6 inhibited the PI3KC2γ expression and PI3K/AKT signaling pathway in both synovial fibroblasts and macrophages. In addition, PBT-6 suppressed macrophage migration via CCL2 and osteoclastogenesis. In CIA mice, it significantly inhibited the progression and development of RA by decreasing arthritis scores and paw swelling. Three-dimensional micro-computed tomography confirmed that PBT-6 enhanced the joint structures in CIA mice. Taken together, our findings suggest that PI3KC2γ is a therapeutic target for RA, and PBT-6 could be developed as a novel PI3KC2γ inhibitor to target inflammatory diseases including RA.

4.
Journal of Korean Biological Nursing Science ; : 259-265, 2019.
Artigo em Coreano | WPRIM | ID: wpr-786045

RESUMO

PURPOSE: The purpose of this paper was to investigate clinical nurses' knowledge and educational needs about dizziness. One of the most frequent complaints among adult persons visiting the hospital is experiencing dizziness. Clinical nurses in the hospital play a crucial role in managing such patients.METHODS: Our paper is a cross-sectional survey using structured instruments to evaluate clinical nurses' knowledge and educational needs about dizziness. This study was conducted January through February 2018. Subjects were 246 clinical nurses in an outpatient, intensive care, internal medicine unit and emergency department at university hospital. Data were analyzed using SPSS statistics 21.RESULTS: The average ofdizziness knowledge score was 57.66±23.75 (range 0-100) and educational need was 3.55±.47(range 0-5). There were significant differences in dizziness knowledge according to age (p < .001), working unit (p < .001), career duration (p < .001), change experience of unit (p < .001), dizziness patient care experience and participation in dizziness education (p < .001). There was positive correlation between knowledge of dizziness and the need for dizziness education (r=.26 p < .001).CONCLUSION: Results of this paper indicate that a dizziness education program is urgently needed for clinical nurses. Such a program should be seriously considered based on our results.


Assuntos
Adulto , Humanos , Cuidados Críticos , Estudos Transversais , Tontura , Educação , Serviço Hospitalar de Emergência , Medicina Interna , Pacientes Ambulatoriais , Assistência ao Paciente
5.
Journal of Agricultural Medicine & Community Health ; : 234-249, 2018.
Artigo em Coreano | WPRIM | ID: wpr-719891

RESUMO

This study was performed to identify the impact of awareness and educational experiences on cardiopulmonary resuscitation in the ability to execute of cardiopulmonary resuscitation among Korean adults. This study used original data of 2014 Community Health Data Survey. 228,712 participants in this survey were resident in South Korea who is aged 19 or older on July 2014. Participants in this survey were sampled an average of 900 residents(target error ± 3 percent) per community health center of Korea. Data were analyzed by using R 3.1.3 employing chi-squared test, fisher's exact analysis, and logistic regression analysis. Ability to execute CPR was significantly higher in males(3.34 time), higher the education level (1.61 times), the white color occupation (1.14 times), the higher the income level (1.07 times), the higher the education level (0.91 times), non-hypertensive patients (1.12 times), non-diabetic patients (1.16 times), non-dyslipidemic patients (0.86 times), non-stroke patients (0.30 times), CPR education experience group (3.25 times), CPR experience group with manikin-based training (4.30 times), higher subjective health status (1.08 times, 1.16 times) respectively. This study identified that awareness, educational experience, and mannequin-based learning experience of CPR impacted on the ability to execute CPR. Responding to education-related factors could contribute to reducing the rate of out-of-hospital acute cardiac arrest by improving the ability to execute CPR of the general public.


Assuntos
Adulto , Humanos , Reanimação Cardiopulmonar , Centros Comunitários de Saúde , Autoavaliação Diagnóstica , Educação , Parada Cardíaca , Coreia (Geográfico) , Aprendizagem , Modelos Logísticos , Ocupações
6.
Kidney Research and Clinical Practice ; : 43-46, 2013.
Artigo em Inglês | WPRIM | ID: wpr-142104

RESUMO

Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (ATN) associated with gross hematuria is very rare in cirrhosis-related IgAN, although acute renal failure is a frequently reported complication in advanced cirrhosis. Herein, we report an unusual case of ATN requiring renal replacement therapy, associated with gross hematuria in a patient with nonalcoholic, hepatitis B virus-associated cirrhosis. Results of a histopathological analysis revealed obstruction of the lumen of renal tubules by red blood cell casts, a marked tubular necrosis, and IgA deposition in the mesangium. The patient's renal function and gross hematuria were clearly improved after lamivudine treatment.


Assuntos
Humanos , Injúria Renal Aguda , Eritrócitos , Fibrose , Glomerulonefrite por IGA , Hematúria , Hepatite B , Imunoglobulina A , Imunoglobulinas , Lamivudina , Necrose , Insuficiência Renal , Terapia de Substituição Renal
7.
Kidney Research and Clinical Practice ; : 43-46, 2013.
Artigo em Inglês | WPRIM | ID: wpr-142101

RESUMO

Immunoglobulin A (IgA) nephropathy associated with cirrhosis is the most common form of secondary IgA nephropathy (IgAN). Cirrhosis-related IgAN is usually clinically silent with a rare occurrence of gross hematuria, unlike in cases of idiopathic IgAN. Especially, acute tubular necrosis (ATN) associated with gross hematuria is very rare in cirrhosis-related IgAN, although acute renal failure is a frequently reported complication in advanced cirrhosis. Herein, we report an unusual case of ATN requiring renal replacement therapy, associated with gross hematuria in a patient with nonalcoholic, hepatitis B virus-associated cirrhosis. Results of a histopathological analysis revealed obstruction of the lumen of renal tubules by red blood cell casts, a marked tubular necrosis, and IgA deposition in the mesangium. The patient's renal function and gross hematuria were clearly improved after lamivudine treatment.


Assuntos
Humanos , Injúria Renal Aguda , Eritrócitos , Fibrose , Glomerulonefrite por IGA , Hematúria , Hepatite B , Imunoglobulina A , Imunoglobulinas , Lamivudina , Necrose , Insuficiência Renal , Terapia de Substituição Renal
8.
Korean Journal of Nephrology ; : 537-541, 2011.
Artigo em Coreano | WPRIM | ID: wpr-64072

RESUMO

Cefepime-induced nonconvulsive status epilepticus (NCSE) in end-stage renal disease (ESRD) patients receiving hemodialysis has only rarely been reported. Here we report a case of cefepime-induced NCSE presenting as coma in a patient with ESRD on hemodialysis. A 73-year-old man, who had been receiving maintenance hemodialysis, developed aphasia and coma during cefepime therapy for epidural abscess. Emergent eletroencephalography (EEG) revealed evidence of NCSE. The abnormal EEG findings were resolved and comatose mentality was completely recovered after cessation of cefepime and administration of anticonvulsive drugs. Cefepime-induced NCSE should be considered if neurological symptoms including comatose mentality develops during cefepime therapy in a patient with renal failure.


Assuntos
Idoso , Humanos , Anticonvulsivantes , Afasia , Cefalosporinas , Coma , Eletroencefalografia , Abscesso Epidural , Falência Renal Crônica , Diálise Renal , Insuficiência Renal , Estado Epiléptico
9.
Tuberculosis and Respiratory Diseases ; : 30-36, 2011.
Artigo em Coreano | WPRIM | ID: wpr-89640

RESUMO

BACKGROUND: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. METHODS: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. RESULTS: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. CONCLUSION: This study demonstrates that VRI can be safely applied to patients with pneumonia.


Assuntos
Humanos , Centros Médicos Acadêmicos , Instituições de Assistência Ambulatorial , Temperatura Corporal , Proteína C-Reativa , Causas de Morte , Doenças Transmissíveis , Testes Hematológicos , Contagem de Leucócitos , Pneumonia , Atenção Primária à Saúde , Respiração , Tórax , Vibração
10.
Journal of Rheumatic Diseases ; : 324-326, 2011.
Artigo em Coreano | WPRIM | ID: wpr-22742

RESUMO

Dermatomyositis (DM) is rare systemic inflammatory disease with typical skin manifestations and muscular involvement. Various skin lesions can accompany this disease, such as Gottron's sign, Heliotrope rash, mechanic's hands, V sign and shawl sign. Scleredema is a very rare skin manifestation in DM. We report a case of DM in a 63-year-old woman, who had scleredema on her thighs. A diagnosis of DM was established by clinical manifestation, elevated muscle enzyme levels, electromyogram measures, and muscle biopsy findings. She was successfully treated with the immunosuppressants methotrexate, cyclosporine, and steroids (low dose).


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Biópsia , Ciclosporina , Dermatomiosite , Exantema , Mãos , Imunossupressores , Metotrexato , Músculos , Escleredema do Adulto , Pele , Manifestações Cutâneas , Esteroides , Coxa da Perna
11.
Journal of Korean Academy of Fundamental Nursing ; : 264-271, 2009.
Artigo em Coreano | WPRIM | ID: wpr-654091

RESUMO

PURPOSE: This study was done to identify the relationship of life satisfaction, family support, physical health and demographic characteristics to perceived health, and to identify factors affecting perceived health of elderly participating in programs in welfare centers for senior citizens. METHOD: The research design for this study was a descriptive survey design using a convenience sampling. Data collection was done using self-questionnaire with 211 elders from 2 welfare centers for senior citizens located in Seoul. ANOVA, t-test, Pearson correlation coefficients and hierachical multiple regression with the SPSS Win 12.0 Program were used to analyze the data. RESULTS: The mean score for degree of perceived health was 3.27+/-0.91. Perceived health had a significant positive correlation with life satisfaction (r= .362, p< .001), family support (r= .403, p< .001), physical health (r= .424, p< .001). The explained variance for perceived health was 37.9%. Among the variables, physical health (beta= .175, p= .014), life satisfaction (beta= .208, p= .002), and family support (beta= .277, p< .001) significantly predicted the degree of perceived health. CONCLUSION: Findings of this study provide a comprehensive understanding of perceived health and related factors for elders in Korea. However, further study with a larger random sample from various living environment is necessary.


Assuntos
Idoso , Humanos , Inquéritos e Questionários , Coreia (Geográfico) , Projetos de Pesquisa
12.
Korean Journal of Nephrology ; : 525-530, 2009.
Artigo em Coreano | WPRIM | ID: wpr-158399

RESUMO

Encapsulating peritoneal sclerosis (EPS) is an uncommon but fatal complication of peritoneal dialysis (PD). Recently, there were some reports of advanced EPS cases that were successfully treated by enterolysis although an intestinal perforation or leakage from intestinal anastomosis were associated with a high mortality. We experienced a case of EPS in a 53-year-old man on PD for 3.5 years without a previous history of episode of peritonitis who presented with hemoperitoneum during treatment of peritonitis. EPS was diagnosed radiologically according to typical CT findings; The series of CT scans revealed how to develop in sequence from a very subtle findings to full-blown findings of EPS. Enterolysis was performed because the patient did not respond to conservative management such as cessation of PD with transfer to hemodialysis, nutritional support and steroid therapy. In spite of intestinal perforation during surgery, he was successfully treated with enterolysis. Therefore, we report this case with review of the literature.


Assuntos
Humanos , Pessoa de Meia-Idade , Hemoperitônio , Perfuração Intestinal , Apoio Nutricional , Diálise Peritoneal , Fibrose Peritoneal , Peritonite , Diálise Renal , Esclerose
13.
Korean Journal of Cytopathology ; : 119-125, 2007.
Artigo em Coreano | WPRIM | ID: wpr-726280

RESUMO

Urine cytology is an important screening tool for urinary tract neoplasms. Liquid-based preparation methods, such as ThinPrep(R), have been introduced for non-gynecological samples. We aimed to assess the diagnostic accuracy of liquid-based preparations in urine cytology by comparing the results of the conventional Cytospin preparation method for the same samples. A total of 236 cases subject to urine cytology were enrolled in this study from January 2005 to December 2005. All cases were subjected to cystoscopy and if a malignancy was suspected, a biopsy was performed. Urine cytology slides were made using the ThinPrep(R) preparation method and the conventional Cytospin and/or direct smear method from the individual samples. The results of urine cytology were compared with the final cystoscopic or histological diagnoses. We analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of both cytology preparation methods. A total of 236 slides made using the liquid based method were satisfactory for slide quality, whereas 5 slides (2.1%) prepared by conventional methods were unsatisfactory because of air-drying, a thick smear, or a bloody or inflammatory background. The ThinPrep(R) method showed 53.1% sensitivity, 92.6% specificity, a 92.6% positive predictive value, a 94.1% negative predictive value and 85.6% accuracy, while the conventional method showed 51% sensitivity, 98.4% specificity, a 92.6% positive predictive value, a 98.4% negative predictive value and 88.6% accuracy. Although the diagnostic values were equivalent between the use of the two methods, the quality of the cytology slides and the time consumed during the microscopic examination for a diagnosis were superior for the ThinPrep(R) method than for the conventional method. In conclusion, our limited studies have shown that the use of the liquid based preparation method is beneficial to improve the quality of slides and reduce the duration for a microscopic examination, but did not show better sensitivity, accuracy and predictive values.


Assuntos
Biópsia , Cistoscopia , Diagnóstico , Programas de Rastreamento , Sensibilidade e Especificidade , Neoplasias Urológicas
14.
Journal of the Korean Surgical Society ; : 229-235, 2003.
Artigo em Coreano | WPRIM | ID: wpr-125355

RESUMO

PURPOSE: The aim of this study was to evaluate the safety of the nonoperative management of traumatic liver injuries. METHODS: The medical records of 67 patients, with traumatic liver injury, between January 1998 and December 2001, were reviewed retrospectively, with respect to the cause of injury, combined injury, hemodynamic stability, amount of transfusion, liver injury grade, length of hospital stay and complications. RESULTS: Of the 67 patients, 30 were treated operatively (Group A), and 37 nonoperatively (Group B). The initial systolic blood pressure in Group A was significantly lower than that in Group B (81.33+/-23.00 vs 108.10+/-20.66 mmHg, P<0.001). The amount of transfusion for hemodynamic stability were 2.83 and 0.89 units (P<0.01), and the mean total transfusion requirement and injury grade were 10.30 and 1.29 units (P<0.001). 3.63+/-0.99 and 2.48+/-1.12 (P<0.001) for Groups A and B. The duration of intensive care unit stay in Group A was significantly shorter than that of Group B (6.70+/-6.12 vs. 3.13+/-4.00 days, P<0.01), but there was no difference in total length of hospital stay. The complication rates in Groups A and B were 63.3 and 21.8%, respectively (P<0.01), and the most common complications were respiratory problems, such as pleural effusion, pneumonia, atelectasis and pulmonary edema. Five patients in Group A died, 2 from hypovolemic shock, and one each from disseminated intravascular coagulation, multiple organ failure, and respiratory failure, but no patients in Group B died. CONCLUSION: Nonoperative management is safe for hemodynamically stable patients with traumatic liver injury, regardless of the injury severity, but close observation and frequent physical examinations must be adhered to.


Assuntos
Humanos , Pressão Sanguínea , Coagulação Intravascular Disseminada , Hemodinâmica , Unidades de Terapia Intensiva , Tempo de Internação , Fígado , Prontuários Médicos , Insuficiência de Múltiplos Órgãos , Exame Físico , Derrame Pleural , Pneumonia , Atelectasia Pulmonar , Edema Pulmonar , Insuficiência Respiratória , Estudos Retrospectivos , Choque
15.
Korean Journal of Nephrology ; : 101-105, 2000.
Artigo em Coreano | WPRIM | ID: wpr-56203

RESUMO

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.


Assuntos
Humanos , Diálise , Glucose , Hipotensão , Hipotensão Ortostática , Enfermagem , Diálise Renal , Água
16.
Korean Journal of Nephrology ; : 468-473, 2000.
Artigo em Coreano | WPRIM | ID: wpr-52616

RESUMO

Hemodialysis is a safe and effective treatment for uremic patients but hemodynamic changes during hemodialysis is suggested to be the possible cause of encephalopathy. However, few studies have evaluated the cerebral circulation of and the effects of hemodialysis. Therefore, this study was performed to evaluate the cerebral blood flow by transcranial doppler. The study populations were 12 male patients who ranged in age from 28 to 58 years(mean:57) and were receiving maintenance hernodialysis for 3.8 years(0.5-11.5 years). Mean blood flow velocity(MFV), pulsatility index(PI) and resistance index(RI) were measured in carotid artery(CA), middle cerebral artery(MCA), anterior cerebral artery(ACA) and posterior cerebral artery(PCA) before, during and after hemodialysis. Simultaneously, we also checked variables(body weight, blood pressure, arterial blood gases, hematocrits, and other biochemical parameters) which might affect cerebral blood flow. MFV during(70.5+/-20.3 vs. 60.0+/-211cm/sec) and after(vs. 60.6+/-13.7cm/sec, p<0.01) hemodialysis in CA showed significant reduction as compared to the that of before hemodialysis, but other vessels(MCA, ACA and PCA) showed no significant changes. There were no significant changes in PI and RI before, during and after hemodialysis. Body weight, PaCO(2), blood urea nitrogen and hematocrit changed significantly during and after hemodialysis as compared to those of before hemodialysis, but correlation between changes of MFV and these variables was not observed. Hemodialysis and its associated physiologic changes are not associated with cerebral blood flow, and this result suggests the well-preservation of autoregulation of cerebral blood flow during and after hemodialysis.


Assuntos
Humanos , Masculino , Pressão Arterial , Velocidade do Fluxo Sanguíneo , Nitrogênio da Ureia Sanguínea , Peso Corporal , Gases , Hematócrito , Hemodinâmica , Homeostase , Diálise Renal
17.
Korean Journal of Nephrology ; : 158-162, 2000.
Artigo em Coreano | WPRIM | ID: wpr-70067

RESUMO

Subclavian catheters were used in the treatment of chronic renal failure patients waiting for the maturation of AV fistula. But, it sometimes causes fatal complications. Of these, massive bleeding into pleural cavity after subclavian vein cannulation is a rather rare but causes very serious complication. Most of patients with hemothorax are successfully treated with conservative treatment(i.e. pleural drainage, maintaining the circulatory volume, treatment of possible coagulopathy) but it sometimes needs surgery. We recently experienced a case of ARDS complicated by hemothorax which was successfully treated with thracooscopic drainage. We reviewed the pathogenesis of ARDS by hemothorax and suggested the guidlines for the treatment of massive hemothorax using video-assisted thoracoscopic surgery.


Assuntos
Humanos , Cateterismo , Catéteres , Drenagem , Fístula , Hemorragia , Hemotórax , Falência Renal Crônica , Cavidade Pleural , Veia Subclávia , Cirurgia Torácica Vídeoassistida
18.
The Korean Journal of Internal Medicine ; : 51-55, 2000.
Artigo em Inglês | WPRIM | ID: wpr-25837

RESUMO

OBJECTIVES: ACKD has been described mainly in patients treated with hemodialysis(HD), and there are only a few reports about the prevalence of ACKD in continuous ambulatory peritoneal dialysis (CAPD) patients. Therefore, we compared the prevalence of ACKD in patients receiving HD and CAPD, and evaluated the possible factors which may affect the development of ACKD. METHODS: Forty nine HD and 49 CAPD patients who had received dialysis therapy for at least 12 months were enrolled in this cross-sectional study. Patients who had a past history of polycystic kidney disease and had acquired cystic kidney disease on predialysis sonographic exam were excluded. Detection of ACKD was made by ultrasonography and ACKD was defined as 3 or more cysts in each kidney. RESULTS: The prevalence of ACKD was about 31+ACU- (30/98) and there was no significant difference between HD and CAPD patients(27+ACU- vs. 34+ACU-, p +AD4- 0.05). The prevalence of ACKD was not associated with age, sex, primary renal disease, the levels of hemoglobin, BUN, and serum creatinine. However, the duration of dialysis was significantly related to the development of ACKD (presence of ACKD, 74.4 42.4 months vs. absence of ACKD, 37.8 24.1 months, p +ADw- 0.05). CONCLUSION: The prevalence of ACKD is not different according to the mode of dialysis, and the major determinant of acquired cyst formation is duration of dialysis.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Adolescente , Distribuição por Idade , Distribuição de Qui-Quadrado , Estudo Comparativo , Estudos Transversais , Falência Renal Crônica/terapia , Testes de Função Renal , Doenças Renais Císticas , Doenças Renais Císticas , Pessoa de Meia-Idade , Diálise Peritoneal Ambulatorial Contínua/métodos , Diálise Peritoneal Ambulatorial Contínua , Prevalência , Diálise Renal/métodos , Diálise Renal , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Estatísticas não Paramétricas
19.
Korean Journal of Medicine ; : 40-46, 2000.
Artigo em Coreano | WPRIM | ID: wpr-30267

RESUMO

BACKGROUND: Although percutaneous transluminal angioplasty (PTA) is effective on the treatment of chronic venous stenosis during hemodialysis, its effect on poor maturation of native arteriovenous fistula (AVF) before cannulation is not well known. We evaluated the effect of PTA on the treatment of poor maturation of native AVF before cannulation in hemodialysis patients. METHODS: Venography was performed in 17 patients with poor maturation of native AVF before cannulation. If the stenosis was a 70% or greater decrease in lumen diameter, PTA was performed. RERULTS: The incidence of diabetes mellitus was 70.6% (n=12). Of those patients studied, total occlusion was observed in 3 cases, discrete stenosis in 12 cases, no stenosis with multiple accessory veins in 2 cases. Of the 15 patients with stenosis or total occlusion, 9 had such lesions in the proximal vein and 4 at the AV anastomosis and 2 in the artery. Of thirteen of 15 patients with these lesions who underwent PTA, 12 patients initially had successful dilatation and the follow up patency rate at 6.0+/-5.8 months was 61.5%. Two of the patients with restenosis underwent re-PTA with successful dilatation. CONCLUSION: PTA seems to be effective on the treatment of poor maturation of native AVF before cannulation.


Assuntos
Humanos , Angioplastia , Artérias , Fístula Arteriovenosa , Cateterismo , Constrição Patológica , Diabetes Mellitus , Dilatação , Seguimentos , Incidência , Flebografia , Diálise Renal , Veias
20.
Korean Journal of Nephrology ; : 552-557, 2000.
Artigo em Coreano | WPRIM | ID: wpr-172294

RESUMO

Hepatic cysts are the most common extrarenal manifestations of adult polycystic kidney disease, but the hepatic cyst infection in a patient with polycystic kidney disease is rare. The infection may remain localized or may be followed by acute cholangitis or septicemia. The best management for infected hepatic cyst is drainage in combination with antibiotic therapy. We experienced a case of infected hepatic cyst in a patient with polycystic kidney disease in a 46-year-old man receiving hemodialysis. He presented with fever and abdominal pain and was found to have an infected liver cyst. Treatment with antibiotics and percutaneous drainage of the cyst resulted in clinical improvement. Thus, we report a case of infected hepatic cyst in a patient with polycystic kidney disease with review of the literature.


Assuntos
Adulto , Humanos , Pessoa de Meia-Idade , Dor Abdominal , Antibacterianos , Colangite , Drenagem , Febre , Fígado , Doenças Renais Policísticas , Rim Policístico Autossômico Dominante , Diálise Renal , Sepse
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