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Outcomes of Arteriovenous Fistula for Hemodialysis in Pediatric and Adolescent Patients
김서민,민승기,안상현,민상일,하종원 대한혈관외과학회 2016 Vascular Specialist International Vol.32 No.3
Purpose: This retrospective review aimed to report the outcomes of arteriovenousfistula (AVF) and to evaluate the suitability of AVF as a permanent vascular accessin pediatric populations. Materials and Methods: Data were collected for all patients aged 0 to 19 yearswho underwent AVF creation for hemodialysis between January 2000 and June 2014. Results: Fifty-two AVFs were created in 47 patients. Mean age was 15.7±3.2 yearsand mean body weight was 46.7±15.4 kg. Of the 52 AVFs, 43 were radiocephalicAVFs, 7 were brachiocephalic AVFs and 2 were basilic vein transpositions. Witha mean follow-up of 49.7±39.2 months, primary patency was 60.5%, 51.4%,and 47.7% at 1, 3, and 5 years, respectively and secondary patency was 82.7%,79.2% and 79.2% at 1, 3, and 5 years, respectively. Age, body weight, AVF type,the presence of a central venous catheter, use of anticoagulation therapy, andhistory of vascular access failure were not significantly associated with patencyrates. There were 9 cases (17.3%) of primary failure; low body weight was anindependent predictor. Excluding cases of primary failure, the mean duration ofmaturation was 10.0±3.7 weeks. During follow-up, 20 patients (42.6%) underwentkidney transplantation, with a median interval to transplantation of 36 months. Conclusion: AVF creation in children and adolescents is associated with acceptablelong-term durability, primary failure rate and maturation time. Considering thewaiting time and limited kidney graft survival, placement of AVFs should beconsidered primarily even in patients expected to receive transplantation.
투석접근로에 의한 도류증후군에서의 새로운 치료법인 동맥유입부 근위화 수술
김서민,하종원,민상일,박태진,안상현,민승기,김상준 대한혈관외과학회 2011 Vascular Specialist International Vol.27 No.2
Hemodialysis access-related arterial steal syndrome can result in serious complications, such as tissue loss and amputation. Several methods have been used to treat arterial steal syndrome, but controversy persists regarding the optimal technique. Here we present a case of arterial steal syndrome successfully treated with proximalization of arterial inflow (PAI). A 63-year-old man with a brachial-cephalic arteriovenous fistula (AVF) was admitted with complaints of coldness and pain in the left hand and fingers. Duplex sonography and angiography revealed arterial steal and occlusion of the distal radial artery. He was underwent PAI which included transsection of the AVF just distal to the previous anastomosis and attachment of the arterialized vein to a more proximal portion of the brachial artery with a 4-mm expanded polytetrafluoroethylene graft. Digital arterial flow was restored, and his symptoms subsequently were relieved. The AVF was well-functioning without any ischemic symptoms after 3-month follow-up.
수술장에서 시행한 하지 동맥 폐색성 질환의 혈관 내 수술 초기경험
김서민,정중기,정인목 대한혈관외과학회 2011 Vascular Specialist International Vol.27 No.4
Purpose: Endovascular surgery (EVS) has been rapidly increasing within the last two decades, changing the pattern of treatments for arterial disease. The purpose of this study was to report our initial experiences of EVS for lower extremity arterial occlusive diseases in the operation room performed solely by a vascular surgeon. Methods: Between January 2009 and June 2010, 13 EVS were performed for lower extremity arterial occlusive diseases with a mobile C-arm. Three patients underwent simultaneous bypass surgery with balloon angioplasty. Clinical characteristics, treatments, and outcomes were retrospectively reviewed. Results: Primary patency rates at 1 and 12 months following balloon angioplasty were 92.3% (12/13) and 88.9% (8/9), respectively. Only one patient had a thrombotic occlusion, resulting in an above-knee amputation. No procedure-related deaths occurred. Conclusion: We showed an initial acceptable result of EVS for lower extremity arterial occlusive diseases in the operation room. However, the data analyzed was of a small group with a short term follow-up period. More experiences, judicious planning, and efforts to optimize endovascular techniques to resolve complications are needed to be a true vascular and endovascular surgeon.
디자인 워크숍 및 설문을 통한 CPTED 사업의 효과 연구 - 성별에 따른 대학생의 인식 비교를 중심으로 -
서민진(Seo, Min-Jin),김고원(Kim, Go-Won),오하늘(Oh, Ha-Neul),박승연(Park, Seung-Yeon),강석진(Kang, Seok-Jin) 대한건축학회 2023 대한건축학회논문집 Vol.39 No.10
This study analyzed gender-based differences in crime perception and awareness through surveys (anxiety perception perspective) and Crime Prevention Through Environmental Design (CPTED) workshops (spatial perspective). By deriving CPTED items reflecting these differences and analyzing the effectiveness of CPTED workshops, we aimed to identify variations in crime anxiety and perception based on gender. The results of the analysis revealed perceptual-cognitive disparities based on gender within the same environment (context). The satisfaction with crime prevention effects derived from the CPTED items was found to be remarkably high. Particularly noteworthy is the high level of satisfaction with alternative solutions, as emphasized in local solutions. This underscores the effectiveness of spatially-oriented CPTED workshops in contributing to CPTED initiatives.
자살시도 환자 대상 응급실 기반 사례관리서비스에서 추적관찰 중단과 연관이 있는 요인
서민범,김 건,이혜원,이운정,우선희,김상윤,김대희 대한응급의학회 2024 대한응급의학회지 Vol.35 No.1
Objective: Emergency department-based interventions are known to be effective at reducing the risk of repeat suicide attempts among patients admitted to emergency departments after attempting suicide. However, the factors that influence loss to follow-up after emergency department-based interventions are not well known. Methods: This study investigated suicide attempt patients who registered with an emergency department-based intervention and received counseling at least once from January 2019 to December 2020. Patients were allocated to a followup group or a loss-to-follow-up group depending on whether emergency department-based interventions had been performed more than three times. Clinical factors and socioeconomic status were considered independent variables. Logistic regression analysis was performed to identify factors that influenced loss to emergency department-based interventions. Results: Of 339 patients enrolled, 210 (61.9%) were lost to follow-up. Time taken to initiation of intervention after discharge (adjusted odds ratio [aOR]=2.42; 95% confidence interval [CI], 1.38-4.30) and suicide attempt associated with physical illness (aOR=0.31; 95% CI, 0.14-0.68) independently influenced loss to emergency department-based interventions. Conclusion: Initiation of intervention after discharge significantly influenced emergency department-based intervention follow-up loss of suicide attempt patients. The study suggests initiation of intervention prior to discharge might reduce the risk of repeat suicide attempts.
수용액상 비스페놀A의 선택적 검출을 위해 분자각인 기법을 접목한 마그네타이트 코어-쉘 제조
김다솜,서민아,이병환 한국공업화학회 2018 한국공업화학회 연구논문 초록집 Vol.2018 No.0
산업이 발달함에 따라 미량오염물질로 인한 환경오염의 심각성과 유해성에 이목이 집중되고 있다. 최근에는 오염물질들을 쉽고 저렴한 가격으로 검출하는 기술이 연구되고 있다. 본 연구에서는 수용액상 비스페놀A의 선택적 검출을 위해 코어-쉘 구조에 분자각인 고분자를 접목시켰다. 자성을 가지게 하기 위해 코어는 Fe<sub>3</sub>O<sub>4</sub>를 사용하였고, 대상물질인 비스페놀A의 검출을 위해 쉘은 분자각인 고분자를 접목시킨 실리카를 사용하였다. 분자각인 고분자를 접목시킨 코어-쉘은 비스페놀A를 만나면 형광이 줄어들어 색 센서의 역할을 할 수 있다. 코어-쉘의 형태를 확인하기 위해 TEM을 이용하였고, 코어의 자성을 측정하기 위해 자화율 측정 장치를 사용하였다. 코어-쉘이 비스페놀A와 결합한 것을 확인하기 위해 spectrofluorometer를 이용하였다. 분자각인 고분자를 접목시킨 마그네타이트 코어-쉘은 비스페놀A를 검출하고 난 후 코어-쉘에 각인 된 비스페놀A를 제거함으로써 재사용의 효과도 기대할 수 있다.