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*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Epilepsy* ; Humans ; Seizures*

No abstract available.
Sciatic Nerve*

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

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation

We report herein a case of epidermolysis bullosa (Weber-Cockaynetype) in a 22-year-old male soldier. He had tense egg sized bulla on the both feet for about 10 years. The lesions were exacerbated during hot weather but were mild. After entering military service, lesions became severe by mecanical trauma such as prolonged walking or marching. Histopathological findings showed subepidermal bulla and a few inflammatory infiltration in the dermis.
Dermis ; Epidermolysis Bullosa* ; Foot ; Humans ; Male ; Military Personnel ; Ovum ; Transcutaneous Electric Nerve Stimulation ; Walking ; Weather ; Young Adult

BACKGROUND: Oral allergy syndrome(OAS) is composed of it,ching sense and edema in oral cavity, lips, throat, pharynx, and larynx following eating some fresh fruits or vegetables. It has been known that most of patients with OAS are allergic to pollens. Common epitopes were found among pollens, fruits and vegetables. Although OAS is a common farm of food allergy in adults, this is the first epidemiologic study of OAS in Korea. MATERIAL AND METHOD: One hundred and fifty one patients who showed positive skin reaction to pollens were telephone-interviewed. Investigation of the prevalence and clinical manifestations of OAS was possible in 81 patients. RESULT: The prevalence of OAS among these patients was 34.6% (28/81). OAS was found in 24(48%) out of 50 patients sensitized to tree pollens, whereas 4(13%) of 31 grass or weed pollen-sensitized paients had OAS. Most common causative food was apple and all of 17 apple- OAS patients were sensitized to tree pollens. Peach was the second common food and 14 of 15 peach-OAS patients were sensitized to tree pollens. Besides oral symptoms, rhinitis, asthma, diarrhea, nausea, vomiting or generalized urticaria were accompanied in half of the OAS patients (14/28). Some patients showed OAS to some unique Korean foods such as dropwort, taro and Aster. CONCLUSION: OAS was very common in pollen-sensitized patients. Larger epidemiologic studies are needed to find unique Korean foods and their antigensm causing OAS.
Adult ; Asthma ; Colocasia ; Diarrhea ; Eating ; Edema ; Epidemiologic Studies ; Epitopes ; Filipendula ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity* ; Korea ; Larynx ; Lip ; Mouth ; Nausea ; Pharynx ; Poaceae ; Pollen* ; Prevalence ; Prunus persica ; Rhinitis ; Skin ; Urticaria ; Vegetables ; Vomiting

No abstract available.
Humans

BACKGROUND: Preventive measures need to be implemented to lower the incidence of osteoporotic fractures. Osteoporotic fractures increase morbidity and mortality as well as impose a socioeconomic burden; however, current research is limited to the administration rates of osteoporosis drugs for Korean postmenopausal females. METHODS: This study represents a nationwide, observational, and cross-sectional survey that investigates the administration rates of osteoporosis drugs based upon a bone mineral density (BMD) test performed on Korean postmenopausal patients who visited outpatient orthopedic clinics. BMD test results were examined in postmenopausal female patients (50 to 80 years of age); subsequently, the patients were classified into an osteoporosis group, osteopenia group, and normal group. The administration rates of osteoporosis drugs and bisphosphonates were then analyzed. The osteoporosis group was subdivided into a T-score less than -3.0 group and a T-score between -3.0 and -2.5 group that were separately analyzed. RESULTS: Based on the lumbar spine BMD, the rate of administration of osteoporosis drugs in the osteoporosis group was 42.1%, which was significantly higher compared to the osteopenia group or normal group. A significantly low bone mineral density was observed in patients who were administered bisphosphonates. Based on the lumbar spine BMD, the administration rate of osteoporosis drugs in the group with a T-score between -3.0 and -2.5 (34.2%) was significantly lower than the group with a T-score less that -3.0 (46.2%). The bisphosphonate administration rate was also significantly low; however, the administration rate for osteoporosis drugs was significantly lower than that of the osteopenia group. CONCLUSIONS: Only about 40% of Korean postmenopausal female patients with osteoporosis were administered osteoporosis drugs. The administration rate in patients with a T-score between -3.0 and -2.5 was particularly low and active treatment to prevent osteoporotic fractures is required in this group.
Aged ; Aged, 80 and over ; Bone Density Conservation Agents/*therapeutic use ; Cross-Sectional Studies ; Drug Prescriptions/*statistics & numerical data ; Female ; Humans ; Insurance Benefits/*methods ; Middle Aged ; Osteoporosis/*drug therapy/epidemiology ; Republic of Korea

Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.
Administration, Oral ; Adult ; Antidotes/therapeutic use ; Aphrodisiacs/adverse effects* ; Case Report ; Cyanosis/drug therapy ; Cyanosis/chemically induced ; Cyanosis/blood ; Dapsone/adverse effects* ; Human ; Male ; Methemoglobinemia/drug therapy ; Methemoglobinemia/chemically induced* ; Methylene Blue/therapeutic use