http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
한대석,김형직 대한신장학회 1987 Kidney Research and Clinical Practice Vol.6 No.2
Establishment of a secure, properly functioning peritoneal access device is a critical element in the success of any C.A.P.D. program. Implantation of the catherter can be performed surgically under general or regional anesthesia with direct visualization or medically with the help of special trocar at the bedside. Wherever it is done, strict sterile precautions are mondatory. Presence of possibly complicating factors such as scars from previous surgery, hernia, organo-megalies, bowel distension or ileus should be carefully evaluated by the performing physician prior to implantation. In these situation, heightened precautions are indicated if catheter placement is performed medically without direct visualization. Priorto catheter placement, proper preparat'n of the patients is advised. The bladder must be empty and the abdominal wall must be free of infection. The value of prophylactic antibiotic coverage is not established, but is being used commonly. The site of catheter placement can be either midline through linea alba or lateral through recuts abdominis muscle. Lateral placement is claimed to have lesser dialysate leakage compared to midline insertion. In any approach, prior instillation of adequate amount of dialysate into peritoneal cavity is essential for pushing of parietal epithelium against abdominall wall and suspension of intestine in a fluid medium to facilitate good catheter positioning. When double-cuff catheter is used, the exact location of the skin exit site must be determined lest subcutaneous catheter kinking or erosion of the cuff occur. The external cuff is kept 3 cm deep to the skin exit site to reduce the possibility of extrusion. To minimize the potential for the catheter displacement, the exit site should be placed superior to the fascial insertion site so as the subcutaneous tunnel will tend to direct the catheter into the pelvis.
각종 신질환에서 혈청 B형 간염 표면 항원(HBsAg) 의 발현 빈도
한대석,최인준,이호영,정석호,신성태,우은균 대한신장학회 1984 Kidney Research and Clinical Practice Vol.3 No.2
Overall incidence of positive serum hepatitis-B antigen in Korean adult population is exceptio- nally higb with a positive rate of about 12%. In view of development of certain types of glome- rular diseases, especially membranous glomerulo- pathy in children associated with chronic hepa- titis-B infection presumably mediated by immune complex deposition, we studied the incidence rate of positive serum HBsAg and anti-HBs in 304 adult patients with various glomerular diseases and chronic renal failure evaluated at the Seve- rance Hospital, Yonsei University Medical Center during the period beginning from Jan. 1979 till Dec. 1983. As a control group, 2,634 subjects with no clinical and laboratory evidences of renal diseases were studied. 1) Serum hepatitis-B surface antigen was posi- tive in 52 patients out of 304 renal patients(17. 1 %)while the positive rate for normal control population was 12.3%. This difference was sta- tistically signifieant(p(0. 01). 2) Incidence rate for positive serum anti-HBs in patient and control group was not significantly different; 34.8,o (94/269) and 40.4%(639/1583) respectively. 3) As a group, patients with tiopsy proven nephrotic syndrome from various primary glome- rular diseases showed the highest positive incide- nce rate of HBsAg(24. 1%) compared to the patients with chronic renal failure(8. 9%) or chronic glomerulonephritis(18.6%). The positive inclidence rate in nephrotic patients was sign- ificantly higher than that of control group(p$lt;0.01). 4) Biopsy proven patients with membranous nephropathy(MN) and membranoproliferative glo- merulonephropathy(MPGN) showed significantly higher positive incidence rate for serum HBsAg compared to the normal control group(p$lt;0. 025, p$lt;0. 005). In patients with MN and MPGN, 35. 3 %(6/17) and 42. 6,o(12/28) was positive at the time of renal biopsy. Patients with minimal change lesion and focal sclerosis showed positive incidence rate of 18. 8% and 0% which were not significantly different from normal group. 5) Incidences of positive serum anti-HBs in the patients with various glomerular diseases and chronic renal failure were not different significa- ntly from the control group except a lower rate (23%), observed in the patients with minimal change lesion nephrotic syndrome(p$lt;0. 005). Our data are discussed within the concept that chronic carrier state of hepatitis-B surface antigen can lead to the development of certain types of glomerular diseases in adults, particularly memb- ranous nephropathy and membranoproliferative glomerulonephropathy. Further studies are nece- ssary to prove this important manifestations of hepatitis-B viral infection.