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이시래,최창필 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2
Over the years results with all types of treatment have progressively improved, which allows for encourgement and optimism. CAPD is increasingly used not only because of econornic advantages but also the improved clinical and metabolic results. An excellent control of blood glucose level is made possible by using the intraperitoneal route three to four times a day for administration of insulin. Since the insulin delivered intraperitoneally in absorbed from the peritoneal cavity via the hepatic portal system which is the site of entry for pancreatic insulin, it seem likely that this would be a $quot;physiologic$quot; delivery route. Because of certain similarties between physiological insulin secretion and intra- peritoneal insulin administration, it is expected that the intraperitoneal administration of insulin during CAPD will give excellent diabetic control and achieve more desirable long term results in diabetic end stage renal disease. We reviewed some authors articles for the administration of insulin in diabetics during CAPD and shared our experiences in this article. During the last 4 years, we have treated 17 diabetics with CAPD. Good control of blood sugar was achieved by intraperitoneal administration of insulin. Average period required to control blood sugar was 13 days. After our patients blood sugar was stablized, their daily average insulin requirement was 46 units, ranged from 8 to 162 units.
이시래 대한신장학회 1985 Kidney Research and Clinical Practice Vol.4 No.1
A steady imrovement of results in the treatment of diabetic patients with end-stage renal disease has been observed with all methods, hemodialysis, CAPD and renal transplantation, used during last 10 years. Everyone agrees that exclusion of diabetics from renal function replacement therapy is no longer acceptable when treatment facilities are available. In many industrialized countries, numbers of diabetic patients with end-stage renal disease on dialysis has heea progressively increasing. CAPD is an appealing dialysis procedure ia diabetics. Many authors agree that diabetics with end-stage renal disease can handle the technique very well and the rate of peritonitis can be not higher to what is observed in a non diabetics. An excellent contro) of blood glucose levels is made possible by using the intraperitoneal route three to four times a day for administration of insulin. Also in many patients hypertension highly prevalent in these patients is under good control without using antihypertensive agents agents and stabilization or even improvement of the visual status can be observed occasionally. Finally the greatest benefit is the possibility of being dialyzed at home. In this article, general guide of treatment of diabetics, control of blood sugar by intraperitoneal insulin administration, and review of articles for CAPD in diabetics with end-stage renal disease including our results were briefly summariaed.
지속성 외래 복막투석환자에서 전산화 단층 촬영을 이용한 서혜부 탈장 진단 2예
이시래,이종명,정유성,윤철수,윤명순,허동,김중경,장익득,배현호,허길 대한신장학회 1995 Kidney Research and Clinical Practice Vol.14 No.2
The incidence of abdominal and inguinal hernia varies from 10 to 2% among continuous ambulatory peritoneal dialysis(CAPD) patients. We experienced two cases of marked scrotal and external genital swelling caused by indirect inguinal hernia in CAPD patients. Hy using computerized tomography(CT) scanning after intraperitoneal instillation of contrast dye via Tenckhoff catheter, we could identify precisely the two-dimensional location of anatomical defects such as the existence of a patent processus vaginalis or tearing in a hernia sac. These lesions were successfully repaired without recurrence during the 2 years follow-up period.