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우리나라 무증상 성인에서의 신장기능 및 성인병의 발현빈도
진동찬(Dong Chan Jin),윤영석(Young Suk Yoon),신영신(Young Shin Shin),송호철(Ho Cheol Song),박철휘(Cheol Whee Park),안석주(Seog Ju Ahn),김석영(Suk Young Kim),최의진(Euy Jin Choi),장윤식(Yoon Sik Chang),방병기(Byung Kee Bang) 대한내과학회 1996 대한내과학회지 Vol.51 No.5
N/A Objectives: This report is the results of mass study on renal functions and prevalence of adult diseases in asympotmatic Korean. Methods: The subjects were 50,000 persons (male 31,633, female 18,367) who were enrolled a regular health check up program, June 1990 to Dec 1994, at Catholic Medical Center, Korea. Results: The mean serum creatinine were 1.073±0.19㎎/dl in male and 0.824±0.13㎎/dl in female. Abnormal creatinine (over mean plus 2 standard deviation) prevalence rate were 0.37% in male (1.6㎎/dl and aver) and 0.65% in female (1.2㎎/dl and over). The prevalence of urine occult blood (one positive) were 3.6% in male, 13.4% in female. The proteinuria were 3.3%, 2.1%, respectively. The differences between age group of serum creatinine were little, but that of blood pressure, cholesterol, body mass index were significant, especially before and after menopause in woman. The prevalence of hypertension were 27.1% in male and 24.2% in female. Hyperlipidemia and obesity (BMI over 25㎏/㎡) were 9.5, 9.3% in male and 28.9, 25.0% in female, respectively. Conclusion: These data were may represent overall Korean normal value and could be useful as reference value in Korea.
김동숙 ( Dong Sook Kim ),정진희 ( Jin Hee Jung ),진동찬 ( Dong Chan Jin ),김미경 ( Mi Kyoung Kim ),이규덕 ( Kyoo Duck Lee ),김선민 ( Seon Min Kim ),이병란 ( Byoung Lan Lee ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
Purpose: This study was a pilot study to develop structure, clinical performance and outcome measurement and criteria for increasing number of dialysis facilities and patients to provide quality of care. Methods: The six components of developing quality indicators for hemodialysis were as follows: 1) Organizing expert panel members. 2) Selecting the area: to reflect stakeholders` opinion, structured interviews were done. And literature reviews were performed to investigate guidelines and quality measurements of foreign countries. 3) Selecting clinical performance indicators: From experts` opinions and literature review. 4) Developing candidate indicators. 5) Performing demonstration survey: Systemic sampling was performed and 43 facilities were participated in self-answered medical record survey. 6) Based on preliminary evaluation model, final indicators were selected from expert panel reviews. Results: Eleven measures of structure, thirteen performance measures of process and nine monitoring measures of outcome were developed based on literature review and clinical practice guideline. As for criterion-related validity, those of process and outcome were most high and in case of face validity, those of structure and process were most high. The most valid quality indicators were the rate of internal medicine specialist, dialysis frequency per doctor, whether or not keeping emergency equipment, examination of water quality, hemodialysis adequacy (Kt/V), monitoring arterial venous graft for stenosis maintenance of iron storage, and administration of supplemental iron. Conclusion: By developing quality indicators of hemodialysis and performing demonstration evaluation, quality of care for hemodialysis patients is expected to be improved, so as to promote hemodialysis patients` health and improve on quality of life.
천공성 급성 담낭염에 의한 복막염으로 복강경적 담낭절제 수술 후 다시 복막투석으로 복귀한 증례 1예
민진수 ( Jin Soo Min ),장세나 ( Se Na Jang ),김형욱 ( Hyung Wook Kim ),신영신 ( Shin Young Shin ),원용성 ( Yong Sung Won ),진동찬 ( Dong Chan Jin ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
We experienced a 59 year-old female diabetic CAPD patient with severe peritonitis due to perforated acute cholecystitis. Because of heart failure due to old myocardial infarction and cerebral infarction she had been treated with CAPD for 5 years in bed-ridden state. Initial presentation was dark brown colored peritoneal dialysate effluent (changed greenish bile color later) and septic shock. We diagnosed perforated acute cholecystitis by computerized tomography three days after improvement of sepsis. She was received laparoscopic cholecystectomy and continuous venovenous hemodiafiltration for two weeks and returned to peritoneal dialysis without complication. Secondary CAPD peritonitis with cholecystitis or bowel disease should be carefully considered in patients with specific dialysate color, which could be cured with laparoscopic surgery, and then patients can be returned to CAPD again without complication.