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Percutaneous Catheterization of the Internal Jugular Vein for Hemodialysis
(Chung Ho Yeum),(Soo Wan Kim),(Myong Yun Nah),(Seong Kwon Ma),(Jung Hee Ko),(Nam Ho Kim),(Ki Chul Choi) 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.4
N/A Objectives: The present study was aimed at evaluating the clinical experiences in the internal jugular venous catheterization for hemodialysis. Methods: We retrospectively analyzed the data on internal jugular venous catheterization at Chonnam National University Hospital from May 2000 to Results: There were 132 uremic patients with a total of 150 attempts of internal jugular cannulation. Overall success rate was 90.9% with average puncture trials of 2.3±2.1. 124 (82.7%) of the catheterization attempts were made on the right side and 26 (17.3%) were made on the left. The catheters were left in place from 2 to 87 days with an average of 19.5±15.3 days per catheter. The dialysis sessions per catheter were from 2 to 58 with an average of 11.3±6.8. The mean blood flow during hemodialysis immediately after catheterization was 213.4±42.2ml/min. Thirty two (21.3%) patients had early complications. These included carotid artery puncture (11.3%), local bleeding (4.7%), local pain (3.3%), neck hematoma (0.7%) and malposition of the catheter (1.3%). Seventeen(11.3%) patients had late complications. These included fever or infection (11.3%), inadequate blood flow rate (3.3%) and inadvertent with drawal (2.0%). There was no catheter-related mortality. Conclusions: Our experiences revealed that the internal jugular vein catheterization is relatively safe and efficient for temporary vascular access for hemodialysis.
박종욱(Jong Wook Park),백윤웅(Yun Woong Paek),염충호(Chung Ho Yeum),나명윤(Myong Yun Nah),김수완(Soo Wan Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.1
N/A Background: Although being associated with an elevated plasma atrial natriuretic peptide(ANP), its precise role in the postobstructive diuresis has not been fully under- stood. Evidence has been provided suggesting that the locally-synthesized ANP in the kidney contributes to the regulation of urinary sodium excretion. The present study was aimed to investigate whether an altered regulation of local ANP system is involved in the postobstructive diuresis. Methods: Male Sprague-Dawley rats were used. Both proximal ureters were ligated for 48 hours, after which the kidneys were taken without releasing the ligature, being designated as bilateral ureteral obstruction(BUO) group; or the ligature was released and 4 or 24 hr later, urinary data were collected, being designated as BUR-4 or BUR-24, respectively. Sham operated rats were used as control. Plasma ANP levels were determined by radioimmunoassay. The expression of ANP and natriuretic peptide receptor(NPR)-A mRNAs was determined by reverse transcription-polymerase chain reaction(RT-PCR). To further examine whether the altered renal ANP system, if any, was associated with an altered biological effects of guanylyl cyclase, ANP- stimulated cGMP accumulation was determined in membrane preparations of the glomeruli and papillae by radioimmunoassay. Results: The plasma ANP level was increased in BUO group compared with that in the control(260.5±32.5 vs. 133.3±23.5pg/mL, p<0.05), decreased in BUR-4 group(3.6±0.5 vs. 143.5±42.8pg/mL, p<0.01), while not significantly different in BUR-24 group. In BUR- 4. the urinary flow rate increased compared with that in the control(1598±370 vs. 215<34 DμL/hr, p<0.01), along with increases of FENa(11.5±64.1 vs. 0.25±0.02%, p<0.05) and UNaV (153.7±23.7 vs. 36.5±9.3 μEq/hr, p<0.01). In BUR-24, the urinary parameters were normalized. Renal tissue expression of ANP mRNA was increased in BUO as well as in BUR-4, while not changed in BUR-24. NPR-A mRNA expression was decreased in the kidney of BUO. The ANP-stimulated accumulation of cGMP in the isolated glomeruli and papillae in BUO was significantly reduced. The guanylyl cyclase activities were partly recovered in BUR-4 and completely in BUR-24. Conclusion : An enhanced local activity of ANP in the kidney may be causally related to the postobstructive diuresis.