Recently, dialysis population with arteriovenous fistula may have some problems about the cannulation due to aged, incompetent vessels. Thus alternative needling method, buttonhole technique has been suggested for the complicated cannulation route. In spite of various benefits, this technique is difficult to apply in Korean hemodialysis unit because it requires much time to form the buttonhole track or tunnel. Meanwhile, Choi et al. reported the superiority of buttonhole technique using the polycarbonate peg, Biohole(TM). Here, we review the buttonhole technique in hemodialysis including new buttonhole technique using the Biohole(TM).
Aged ; Arteriovenous Fistula ; Catheterization ; Dialysis ; Humans ; Polycarboxylate Cement ; Renal Dialysis ; Track and Field

Kidney transplantation is the best treatment for end-stage renal disease patients. However, the relative shortage of organs for transplantation has led to ABO-incompatible kidney transplantation as an accepted method to expand the pool of kidney donors. Recent advances in immunosuppression and antibody removal methods have made ABO-incompatible kidney transplantation more feasible, and have increased the opportunities for patients to receive kidney transplantation, as well as for special patients with ABO-compatible donor. Indeed, the outcome of ABO-incompatible kidney transplantation has shown remarkable developments and is now comparable to that of ABO-compatible kidney transplantation during last decade. However, there are still some uncertain issues to be addressed in ABO-incompatible kidney transplantation. In this article, we reviewed the current status and protocol of ABO-incompatible kidney transplantation and listed the concerns to be addressed in near future.
Antibodies ; Blood Group Incompatibility ; Humans ; Immunosuppression ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Tissue Donors

Spontaneous renal rupture with subcapsular renal hematoma is a rare disease entity. Hereby, we report a 60-year-old female who presented with abrupt right flank pain and was diagnosed as spontaneous renal rupture with subcapsular hematoma related to urinary tract infection and review related literatures.
Female ; Flank Pain ; Hematoma ; Humans ; Kidney ; Middle Aged ; Rare Diseases ; Rupture* ; Rupture, Spontaneous ; Urinary Tract Infections*

Purpose: The purpose of this study was to understand the employment experiences of female Mongolian migrant workers in Korea and identify their meanings. Methods: Data were collected through individual in-depth interviews with eight such women using the phenomenological Colaizzi qualitative research approach. Results: Six categories were drawn from the research: “Facing a dilemma when hitting the wall,” “Foreigners’ lives disrespected,” “Physically filled with wounds,” “Lonely, laborious, and sad,“ “Growing stronger and knowledgeable,” and “Happiness found in the workplace.” Conclusion The results of this study revealed the substantial meaning of the employment experience of female Mongolian migrant workers in Korea. The results of the study could provide basic data for offering such women various kinds of programs to support them psychologically and in their adjustment to their jobs. These programs would enhance their ability to adapt to both working and in Korea.

OBJECTIVES: Metabolic acidosis frequently develops in patients after neobladder reconstruction. However, the incidence of metabolic acidosis in patients with neobladder and the factors associated with the development of metabolic acidosis have not been well elucidated. We aimed to investigate the incidence and the potential predictors for the development of metabolic acidosis after neobladder reconstruction with intestinal segment. METHODS: We included patients who underwent neobladder reconstruction using intestinal segment at Ewha Womans University Mokdong Hospital between January 1, 2005 and December 31, 2014. A subgroup of patients according to the time of metabolic acidosis occurrence was further analyzed in order to characterize predictors for metabolic acidosis. RESULTS: Metabolic acidosis was encountered in 79.4% of patients with neobladder during follow up period. When patients were divided into 2 groups according to anion gap (AG), total CO2 (18.9+/-2.1 mEq/L vs. 20.0+/-1.3 mEq/L, P=0.001) and chloride (106.6+/-4.9 mE/L vs. 109.4+/-3.6 mEq/L, P<0.001) were significant different between groups with AG>12 and AG< or =12. Furthermore, when patients were divided into 3 groups; patients with metabolic acidosis at postoperative day (POD) 1; from POD 2 to 14 days; after 14 days, there was significant difference among those subgroups. CONCLUSION: Our study showed the rate of metabolic acidosis in patients underwent neobladder reconstruction and the difference between patients with metabolic acidosis and those without metabolic acidosis for the first time in Korea. In the future, well designed prospective study will be needed to prevent metabolic acidosis after neobladder reconstruction.
Acid-Base Equilibrium ; Acidosis* ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Prospective Studies

The causes of pyogenic liver abscess has been known as biliary tract disease or intrabadominal infection but the large proportions of the patients has no apparent underlying disorders. Recently colonic mucosal lesions were reported in patients with cryptogenic liver abscess and it has been suggested that colonic mucosal break may play a role in developing liver abscess in otherwise healthy patients. We experienced a patient of severe recurrent liver abscess complicated with endophthalmitis only 3 months after successful treatment of initial cryptogenic liver abscess and a polypoid colon cancer was discovered by chance. It seems prudent to proceed colonoscopic examination in patients with cryptogenic liver abscess especially when it is recurrent.
Biliary Tract Diseases ; Colon ; Colonic Neoplasms ; Endophthalmitis ; Humans ; Klebsiella pneumoniae ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Recurrence

PURPOSE: Chronic kidney disease (CKD) patients tend to have higher serum magnesium values than healthy population due to their positive balance of magnesium in kidney. Recent studies found that magnesium level is positively correlated with endothelial function. Therefore, this study was conducted to define the relationship between magnesium level and endothelial dysfunction in end stage renal disease (ESRD) patients on hemodialysis (HD). MATERIALS AND METHODS: A total of 27 patients were included in this cross-sectional study. Iontophoresis with laser-Doppler flowmetry, flow mediated dilation (FMD), and carotid intima-media thickness were measured. Patients' average serum magnesium levels were measured over previous three months, including the examination month. Pearson's correlation coefficient analysis and multivariate regression model were used to define the association between magnesium and endothelial function. RESULTS: In the univariate analysis, higher magnesium levels were associated with better endothelium-dependent vasodilation (EDV) of the FMD in ESRD patients on HD (r=0.516, p=0.007). When the participants were divided into two groups according to the median magnesium level (3.47 mg/dL), there was a significant difference in EDV of FMD (less than 3.47 mg/dL, 2.8±1.7%; more than 3.47 mg/dL, 5.1±2.0%, p=0.004). In multivariate analysis, magnesium and albumin were identified as independent factors for FMD (β=1.794, p=0.030 for serum magnesium; β=3.642, p=0.012 for albumin). CONCLUSION: This study demonstrated that higher serum magnesium level may be associated with better endothelial function in ESRD patients on HD. In the future, a large, prospective study is needed to elucidate optimal range of serum magnesium levels in ESRD on HD patients.
Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Endothelium ; Humans ; Iontophoresis ; Kidney ; Kidney Failure, Chronic* ; Laser-Doppler Flowmetry ; Magnesium* ; Microcirculation ; Multivariate Analysis ; Prospective Studies ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Vasodilation

PURPOSE: Chronic kidney disease (CKD) patients tend to have higher serum magnesium values than healthy population due to their positive balance of magnesium in kidney. Recent studies found that magnesium level is positively correlated with endothelial function. Therefore, this study was conducted to define the relationship between magnesium level and endothelial dysfunction in end stage renal disease (ESRD) patients on hemodialysis (HD). MATERIALS AND METHODS: A total of 27 patients were included in this cross-sectional study. Iontophoresis with laser-Doppler flowmetry, flow mediated dilation (FMD), and carotid intima-media thickness were measured. Patients' average serum magnesium levels were measured over previous three months, including the examination month. Pearson's correlation coefficient analysis and multivariate regression model were used to define the association between magnesium and endothelial function. RESULTS: In the univariate analysis, higher magnesium levels were associated with better endothelium-dependent vasodilation (EDV) of the FMD in ESRD patients on HD (r=0.516, p=0.007). When the participants were divided into two groups according to the median magnesium level (3.47 mg/dL), there was a significant difference in EDV of FMD (less than 3.47 mg/dL, 2.8±1.7%; more than 3.47 mg/dL, 5.1±2.0%, p=0.004). In multivariate analysis, magnesium and albumin were identified as independent factors for FMD (β=1.794, p=0.030 for serum magnesium; β=3.642, p=0.012 for albumin). CONCLUSION: This study demonstrated that higher serum magnesium level may be associated with better endothelial function in ESRD patients on HD. In the future, a large, prospective study is needed to elucidate optimal range of serum magnesium levels in ESRD on HD patients.
Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Endothelium ; Humans ; Iontophoresis ; Kidney ; Kidney Failure, Chronic* ; Laser-Doppler Flowmetry ; Magnesium* ; Microcirculation ; Multivariate Analysis ; Prospective Studies ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Vasodilation

PURPOSE: This study was aimed to compare hydration status between young and elderly end-stage renal disease (ESRD) patients on hemodialysis (HD) and to analyze factors related to overhydration. METHODS: We measured fluid status before a mid-week HD session in clinically stable 47 patients on maintenance HD using bioimpedance spectroscopy (BIS) device. In addition, weight and blood pressure (BP) were recorded during the treatment. RESULTS: Participants were divided into young (<65 years, n=32) and elderly (> or =65 years, n=15) patients. In elderly patients, pre-HD diastolic BP, intracellular water (ICW), and lean tissue index (LTI) were significantly lower and extracellular water (ECW)/total body water (TBW) was significantly higher than in young patients. However, there were no differences in pre-HD body mass index (BMI), ultrafiltration volume, pre-HD systolic BP, TBW, ECW, and fat tissue index between the two groups. ECW/TBW ratio and LTI were significantly correlated with age. In a multivariate regression analysis, age and pre-HD pulse pressure were significantly associated with ECW/TBW. CONCLUSION: Although BMI and TBW of elderly ESRD patients were similar to those of young patients, ICW and LTI were lower and ECW/TBW was higher in elderly patients than in young patients. Therefore, clinical manifestations related to overhydration may develop more frequently in elderly patients compared with young patients.
Aged ; Blood Pressure ; Body Composition ; Body Mass Index ; Body Water ; Edema ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Spectrum Analysis ; Ultrafiltration ; Water