Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

Atrial flutter is and infrequent, but potentially unstable tachyarrythmia that occurs in pediatric ages. Transesophageal atrial pacing was used for treatment of 10 episodes of atrial flutter in 7 patients. At the time of atrial flutter conversion, patients were 6 days to 14 years old. 6 patients had associated with congenital heart disease. The atrial cycle length of atrial flutter ranged from 140 to 280 msec with variable atrioventricular conduction. Transesophageal atrial pacing was performed using a bipolar 4 F transesophageal electrode catheter. Atrial flutter conversion was accomplished with stimulation bursts using about 5 seconds of stimuli, 10 msec in duration at 20 to 27 mA. Pacing cycle length was 45 to 110 msec less than the atrial cycle length of tachycardia in 6 episodes. But in a neonate, underdrive pacing converted atrial flutter to sinus rhythm. Conversion attempts were unsuccessful on 2 occasions. Transesophageal atrial pacing is a safe and effective, minimally invasive technique for treatment of atrial flutter in infants and children.
Adolescent ; Atrial Flutter* ; Catheters ; Child* ; Electrodes ; Heart Defects, Congenital ; Humans ; Infant* ; Infant, Newborn ; Tachycardia

No abstract available.

PURPOSE: This study was to search the optimal slice thickness of computed tomography (CT) in an intensity modulated radiation therapy plan through changing the slice thickness and comparing the change of the calculated absorbed dose with measured absorbed dose. MATERIALS AND METHODS: An intensity modulated radiation therapy plan for a head and neck cancer patient was done, first of all. Then CT with various ranges of slice thickness (0.125~1.0 cm) for a head and neck anthropomorphic phantom was done and the images were reconstructed. The plan parameters obtained from the plan of the head and neck cancer patient was applied into the reconstructed images of the phantom and then absorbed doses were calculated. Films were inserted into the phantom, and irradiated with 6 MV X-ray with the same beam data obtained from the head and neck cancer patient. Films were then scanned and isodoses were measured with the use of film measurement software and were compared with the calculated isodeses. RESULTS: As the slice thickness of CT decreased, the volume of the phantom and the maximum absorbed dose increased. As the slice thickness of CT changed from 0.125 to 1.0 cm, the maximum absorbed dose changed ~5%. The difference between the measured and calculated volume of the phantom was small (3.7~3.8%) when the slice thickness of CT was 0.25 cm or less. The difference between the measured and calculated dose was small (0.35~1.40%) when the slice thickness of CT was 0.25 cm or less. CONCLUSION: Because the difference between the measured and calculated dose in a head and neck phantom was small and the difference between the measured and calculated volume was small when the slice thickness of CT was 0.25 cm or less, we suggest that the slice thickness of CT should be 0.25 cm or less for an optimal intensity modulated radiation therapy plan.
Head ; Head and Neck Neoplasms ; Humans ; Neck

Although some employees working for Seoul Metropolitan Subway Cooperation are working at the noisy workplaces, they has been excluded from Special Periodic Health Examination Program. And some workers complained of hearing loss or tinnitus. So, this study was carried out to investigate the prevalence rate of Noise Induced Hearing Loss of employees(10,792) working for Seoul Metropolitan Subway Cooperation. The number of subjects were total 10,792 with 10,355 men and 437 women. A questionnaire survey, otological examination, Rinne test, pure tone audiometric tests were performed and through the first and second screening audiometric examination, 605 workers were selected after excluding employees with past otologic problems, recent exposure to high level noise, and under medications. and the results were as follow; 1. Among 10,792 workers, 4 workers(0.037%) diagnosed as NIHL and 601 workers(5.56%) as early NIHL. As workers grew older, the prevalence rate of NIHL and early NIHL became more rising. 2. The prevalence rate of NIHL and early NIHL was different between work site. After age adjustment, The prevalence rate of NIHL and early NIHL was 23.74% in Train repairmen{80dB(A)}, 3.1% in Station staffs{below 70dB(A)}, 2.53% in Train crew{below 70dB(A)}, 2.1% in Office workers. 3. The perception rate of necessities of ear plug in NIHL and early NIHL was below 55% and wearing rate of ear plug in NIHL and early NIHL was 1.1% In conclusion, some employees who was under working environment in Seoul Metropolitan Subway Cooperation should be monitored to prevent hearing impairment and would be needed health education.
Ear ; Female ; Health Education ; Hearing Loss* ; Hearing* ; Humans ; Male ; Mass Screening ; Noise* ; Prevalence ; Railroads* ; Seoul* ; Tinnitus ; Workplace ; Surveys and Questionnaires

There were 20 patients (22 kidneys) with staghorn calculi evaluated clinically (Clinical presentation, Complications, Management) and kidneys were studied on pathologic basis. Only 15 percent of the patients could be defined as having a silent stone calculus. Clinical complication occurred in 50 percent of the patients. On 7 kidneys submitted for a pathoanatomic study (nephrectomy) hydropy0nephrosis was found in 28.6 percent, end stage pyelonephritic kidney in 28.6 percent, end stage hydronephOsis 14.2 percent, severe pyelonephritis 28.6 percent. The kidney was considered to be relatively undamaged in 22.7 percent, of the cases. Complete removal of the calculus and appropriate medical adjunctive therapy should be done early in the course of the disease in an attempt to prevent complications and renal deterioration. The results of treatment are discussed and compared to those obtained in a group of patients who initially were managed conservatively.
Calculi* ; Humans ; Kidney* ; Pyelonephritis

No abstract available.
Humerus*

No abstract available.
Sciatic Nerve*

Purpose: To evaluate the pre- and post-operative refractive powers of patients undergoing sutured and sutureless scleral fixation (the latter: the Yamane technique). Methods: Patients who had undergone sutured or sutureless scleral fixation to treat intraocular lens (IOL) dislocation or phacodonesis at Dong-A University Hospital from January 2017 to December 2021 were retrospectively investigated. The preoperatively predicted spherical equivalents (derived using the radii of corneal curvature) were measured via optical coherence topography and the axial lengths were determined using an IOL master ® (Zeiss, Carl Zeiss Meditec, Jena, Germany) device and A-scan biometry (AL-100; Tomey, Nagoya, Japan) ultrasound. The spherical equivalent was measured 1 month after surgery employing an automatic refractive keratometer. The extent of agreement between the predicted and actual spherical equivalents were compared between the sutured and sutureless scleral fixation groups. Results: The sutured scleral fixation group included 20 eyes and the sutureless group 12 eyes. The preoperatively predicted spherical equivalent of the sutured group was -0.158 ± 0.577 diopters (D) on A-scan (Tomey) ultrasound and -0.143 ± 0.617 D employing the IOL master ® (Carl Zeiss Meditec); both correlated poorly with the postoperatively measured spherical equivalent of -0.400 ± 0.923 D (p = 0.903, 0.563). However, the predicted spherical equivalent of the group undergoing sutureless fixation was -0.340 ± 0.368 D on A-scan ultrasound and -0.183 ± 0.251 D using the IOL master ® (Carl Zeiss Meditec); both correlated significantly with the postoperatively measured spherical equivalent of -0.313 ± 1.129 D (p = 0.038, 0.005). Conclusions The preoperatively predicted refractive power correlated significantly with the postoperative refractive power after sutureless but not sutured scleral fixation. Sutureless fixation was safe and the postoperative refractive power was comparable to that of sutured fixation.

Protein-energy malnutrition is frequently observed in CAPD patients and is closely correlated with morbidity and mortality. We investigated the effects of AS on nutritional parameters in malnourished CAPD patients. Eleven CAPD patients who were proved to be malnourished by biochemical and anthropometric measurements, not admitted for 2 months recently, received intramuscularly 200mg of Nandrolone Decanoate, monthly. After AS was administered for more than 12 weeks, the nutritional parameters were checked. The mean age of patients was 53.5+/-9.8(SD) years, the sex ratio was 4:7. The mean duration of CAPD was 34.5+/-23.2 months. Three patients were diabetics. The mean duration of AS administered was 22.0+/-3.6 weeks. Eight of eleven patients improved their subjective symptoms such as appetite and muscle strength. There were significant increases in hemoglobin(7.0+/-0.9 vs. 7.8+/-1.1g/dl), hematocrit(20.3+/-2.8 vs. 23.0+/-2.8%), insulin-like growth factor I(165.9+/-71.6 vs. 207.1+/-69.5ng/ml), prealbumin(30.1+/-11.0 vs. 39.3+/-9.1mg/dl), transferrin(205.4+/-48.8 vs. 239.6+/-47.7mg/dl) and nPCR(0.75+/-0.15 vs. 0.84+/-0.15g/kg/day)(P<0.05). There were no changes in albumin, total lymphocyte, cholesterol, weeklky Kt/Vurea, weekly creatinine clearance and urea nitrogen appearance. On anthropometric measurements, midarm muscle circumference(21.8+/-3.2 vs. 22.7+/-3.5cm, P<0.05) and % lean body mass(57.6+/-12.7 vs. 60.5+/-11.4%, P<0.05) were increased, but triceps skinfold thickness, and body mass index were not changed. Edema was observed in 8 patients and acne was noted in a patient. Severe edema and ultrafiltration failure were observed in 2 patients. The mean time that edema developed was 17.6 4.6 weeks. In conclusion, AS seems to be useful in correcting malnutrition with their protein anabolic effect in malnourished CAPD patients.
Acne Vulgaris ; Anabolic Agents ; Appetite ; Body Mass Index ; Cholesterol ; Creatinine ; Edema ; Humans ; Lymphocytes ; Malnutrition ; Mortality ; Muscle Strength ; Nandrolone ; Nitrogen ; Peritoneal Dialysis, Continuous Ambulatory ; Protein-Energy Malnutrition ; Sex Ratio ; Skinfold Thickness ; Ultrafiltration ; Urea