No abstract available.
Kidney Failure, Chronic*

No abstract available.
Glomerulonephritis* ; Humans ; T-Lymphocytes*

No abstract available.
Adult* ; Cyclosporine* ; Humans ; Nephrosis, Lipoid*

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus. The prevalence of neuropathic pain is estimated to occur in about 30-50% of all diabetic patients. Clinical symptoms vary depending on the nerves affected, and may include both positive and negative symptoms. Many patients with DPN experience pain or discomfort, anxiety, depression, and limitations in activity, which can significantly impact their physical, emotional, and social well-being. Early diagnosis is essential for the successful management of DPN. Routine management consists of glucose and risk factor control, and symptomatic relief, along with therapies designed to target the underlying disease pathology. Pharmacological treatment of DPN includes tricyclic compounds, serotonin noradrenalin reuptake inhibitors, the antioxidant alpha-lipoic acid, anticonvulsants, opiates, membrane stabilizers, topical capsaicin, and other drugs. Management of DPN must be tailored to each individual, and depends on a variety of factors, including disease severity and response to treatment.
Anticonvulsants ; Anxiety ; Capsaicin ; Depression ; Diabetes Mellitus ; Diabetic Neuropathies ; Early Diagnosis ; Glucose ; Humans ; Membranes ; Neuralgia ; Pathology ; Peripheral Nervous System Diseases* ; Prevalence ; Risk Factors ; Serotonin ; Thioctic Acid

The first Medical Terminology was published by the Korean Medical Association in 1977 in Korea. Since then 4 more editions of Medical Terminology have been published. The final one, the 5th edition was published in 2009. Among these, in the 3rd edition, almost all of the medical terms were words in Chinese characters. In contrast, the 4th edition had been completely changed. Almost all of the terms were Hangul (Korean language) terms. The 5th edition accepted both terms in Chinese characters and Hangul terms. Owing to this major shift in medical terminology, users of medical terms have been greatly inconvenienced. At present, the Medical Terminology Committee of the Korean Medical Association are carrying out the work of selecting the representative term for each medical term. Medical terms should be easily understandable because medical terms are used by lay people as well as medical doctors. For easy and efficient communication between the doctor and the patient, it is not important whether the term is in Chinese characters or Hangul terms. The work of selecting representative terms should be carried out in rational way. Close communication and cooperation between the Medical Terminology Committee of the Korean Medical Association and each academic medical society in the Republic of Korea is necessary for consistency in establishing medical terminology. A system for collection and translation of medical terms newly coined and imported from abroad should be developed.
Asian Continental Ancestry Group ; Humans ; Korea ; Lifting ; Numismatics ; Republic of Korea ; Societies, Medical

Chronic renal failure (CRF) is a functional diagnosis characterized by a progressive and generally irreversible decline in glomerular filtration rate (GFR). It is caused by a number of diseases, most commonly diabetes, glomerulonephritis, hypertension and the genetic diseases. The renal function of CRF patients declines by unrelenting progressive loss of nephron that persists long after the inciting event. CRF is not a curable disease. The aim of the treatment of CRF is to halt or delay the progression of renal failure and amelioration of symptoms, not to cure of the disease. Systemic hypertension, glomerular hypertension, proteinuria and protein-rich diet contribute to the progression of renal failure. Restriction of dietary protein intake help to preserve residual renal function. Among the antihypertensives, angiotensin converting enzyme inhibitor (ACEI) is the drug of choice for blood pressure control in CRF patients, because this class of drug reduces intraglomerular pressure. There is a growing awareness of a need not only to identify CRF patients at an earlier stage in the disease process, but also to initiate treatment strategies earlier to delay progression of CRF and to define the optimal time required to prepare CRF patients for renal replacement therapy. Early referral to the nephrologist is important for timely intervention. The consequences of late referral include increased morbidity and mortality. There is also an impact on patient's quality of life and missed opportunities for pre-emptive transplantation. Late referral also limits therapeutic options, and these limitations exert adverse effects on long-term outcomes once patients are on dialysis.
Antihypertensive Agents ; Blood Pressure ; Diagnosis ; Dialysis ; Diet ; Diet Therapy ; Dietary Proteins ; Drug Therapy ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Mortality ; Nephrons ; Peptidyl-Dipeptidase A ; Proteinuria ; Quality of Life ; Referral and Consultation ; Renal Insufficiency ; Renal Replacement Therapy

No abstract available.
Humans

Cytomegalovirus(CMV) infection occurs more frequently in renal transplant recipients than in the normal population. But the incidence and severity of CMV infection and antibody positivity are different between countries. We studied the incidence of CMV infection with a long term follow up in renal transplant recipients who were IgG CMV positive and whose donors were also IgG CMV positive preoperatively. We studied the difference and usefulness of various detection methods including IgM CMV antibody by ELISA, shell vial culture, and quantitative dual polymerase chain reaction(PCR). We also studied possible factors that may affect CMV infection and the function of the grafted kidney in CMV infected patients. This study included 36 patients, 20 males and 16 females, who received renal transplantation at Hanyang University Hospital between July, 1994 and March, 1995. IgG and IgM CMV antibodies were detected and shell vial cultures were performed in recipient candidates and donor candidates preoperatively. Postoperatively, we checked IgM CMV and performed shell vial cultures in renal transplant recipients every month after the operation and when CMV infections were suspected. We also performed dual PCR with endpoint titration to quantify the amount of CMV DNA. The total incidence of CMV infection was 30.6% (11 patients among 36 patients). Three patients had CMV disease, and only one patient was severe enough to need gancyclovir therapy. The average onset of infection was 12.9 weeks after the operation(earliest 5weeks-latest 33weeks). In all patients with CMV disease, CMV positivity appeared by all three detection methods. But detection time and duration of positivity were different. The amount of CMV DNA in patients with active CMV disease was higher than those of asymptomatic patients and one patient following antiviral therapy. Age, sex, donor type, HLA matching and rejection did not affect CMV infection. Incidence of CMV infection was higher in patients who were transfused within 3 weeks before the operation(6/8 vs 5/28, p=0.048). Changes of creatinine level from initial outpatient department(OPD) visit to last OPD visit which were corrected by OPD follow up time showed no significant difference between CMV infected and non-infected patients In conclusion, the incidence of CMV infection and disease was relatively low, and the degree of disease severity was mild. In our renal transplant recipients, CMV infection may not be a serious problem. Quantitative dual PCR using end-point titration is a good method to detect CMV infections and monitor the clinical course. Because it is easy to use, detect disease earlier and can quantify the amount of CMV DNA. Among various factors, transfusion affected CMV infection significantly in our patients. In an average of 231 days of OPD follow up time, CMV infected patients showed no impairment of grafted kidney function, but a more long term follow up is needed.
Antibodies ; Creatinine ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Ganciclovir ; Humans ; Immunoglobulin G* ; Immunoglobulin M ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Outpatients ; Polymerase Chain Reaction ; Tissue Donors ; Transplantation* ; Transplants

Glucocorticoids are usually given according to a standard dosing protocol regardless of individual difference. We evaluated the pharmacokinetic characteristics of methylprednisolone and the degree of interpatient variation in stable Korean renal transplant recipients during the period of 15-21 days after transplantation. This study included 23 renal transplant recipients, 13 males and 10 females, who received kidneys from living donors with stable graft function and without episode of acute rejection. On the study day at 8 A.M., 16.3mg of ethylprednisolone sodium succinate (i.v.) was administered to each patient instead of usual dose (20mg) of prednisolone (p.o.) after sampling of 7cc of baseline blood and additional blood samples were drawn after starting infusion. Plasma was separated and analyzed for methylprednisolone level using high performance liquid chromatography (HPLC) assay, and parameters for pharmacokinetics were calculated. There was significant interpatient variation in the pharmacokinetics of methylprednisolone in our patients group. There was no significant difference in the pharmacokinetic parameters between patients with and without side effects of steroid. Korean renal transplant recipients had higher volume of distribution than black renal transplant recipients; lower clearance than white renal transplant recipients; longer t1/2 than both black and white renal transplant recipients. Even if the number of patients included in this study was too small to reach conclusion, the differences in the pharmacokinetics of glucocorticoids do not seem to be a significant risk factor for side effects of steroid after transplantation. It may be necessary to individualize the dose of a glucocorticoid to achieve an optimal effect and also we need to establish a new steroid regimen protocol for Korean renal transplant recipients.
Chromatography, Liquid ; Female ; Glucocorticoids ; Humans ; Individuality ; Kidney ; Kidney Transplantation ; Living Donors ; Male ; Methylprednisolone* ; Pharmacokinetics ; Plasma ; Prednisolone ; Risk Factors ; Sodium ; Succinic Acid ; Transplantation* ; Transplants