The effect of oxytocin on antidiuresis and urinary excretion of aquaporin 2 in human

학위논문(박사)--서울대학교 대학원 :의학과 내과학전공,2000.Docto

만성 신부전에 의한 대사성 산증에서 혈청 음이온차의 양상과 요 적응기전

학위논문(석사)--서울대학교 대학원 :의학과 내과학전공,1995.Maste

Definition and Evaluation of Acute Kidney Injury: Clinical Practice Guidelines

급성 신손상은 환자의 이환율과 사망률을 증가시키고 회복한 이후에도 장기적인 심혈관계 질환, 만성 신장병, 사망의 위험도가 증가하는 임상적으로 중요한 질환이다. 2002년이후 RIFLE 진단 기준과 AKIN 진단 기준이 발표되고 2012년 KGIGO 임상 진료 지침이 발표되어 진단 기준 및 단계에기초한 진료 지침을 제시하였기에 저자들은 KGIGO 임상 진료 지침을 중심으로 급성 신손상의 진단 및 위험군 환자의관리와 평가에 대해 기술하였다. ersiblerenal dysfunction. Although this potentially devastating disease is associated with increased mortality, early detection andtimely intervention may improve clinical outcomes. In this regard, a standardized definition and classification of AKI, reflectingprognosis on the basis of evidence, may allow early recognition and stage-based management of the disease. Nevertheless, there hasbeen considerable variability and inconsistency in the definition and classification of AKI, resulting in failure to bridge the gap betweenresearch and clinical practice. The definition of AKI has evolved, with the introduction of the Risk, Injury, Failure, Loss,and End-stage renal disease (RIFLE), and AKI Network (AKIN) criteria. The recent Kidney Disease Improving GlobalOutcomes (KDIGO) guidelines proposed a uniform definition of AKI, essentially merging the RIFLE and AKIN criteria. This reviewwill focus on the definition and classification of AKI, as proposed by KDIGO in 2012, and their use in clinical practice forclinicians.N

The impact of the features and CSF by phase of ERP systems for public companies on the implementations

학위논문(석사) - 한국과학기술원 : 경영정보전공, 2008.2, [ vi, 100 p. ]1994년 이래로, 한국의 많은 기업들은 경영관리를 위해 ERP시스템을 도입하여 운영하고 있다. 특히, 2006년 현재 1,000명이상 대기업의 78.6%가 ERP시스템을 도입하여 운영 중에 있다. 그리고, 사기업을 대상으로 ERP시스템의 성공요인과 시스템 특징에 관한 많은 연구가 이루어지고 있으나, 공공기관을 대상으로한 연구는 거의 찾아 볼 수가 없다. 이러한 점을 바탕으로 본 연구에서는 공공기관을 대상으로 연구를 진행하여 공공기관 ERP시스템 특징 및 구축단계별 주요성공요인이 도입성과에 미치는 영향을 찾아보고자 한다. 본 연구는 공공기관 중에 ERP를 활용하여 운영 중에 있는 기관을 대상으로 설문지를 작성하였다. 설문지의 경우, 공공기관도 기관의 특성에 따라 ERP 시스템 도입 형태가 다를 것으로 가정하여 이를 최대한 반영한 설문지를 만들었으며, 추가적으로 공공기관의 ERP 시스템의 특징을 알아보기 위하여 일반적인 사항을 설문지에 포함하여 설문을 실시하였다. 본 연구결과에 따라 공공기관의 성공요인과 시스템 특징을 파악할 수 있다. 이를 통해 우리나라 공공기관의 ERP 구축 성과에 대한 영향 요인들을 분석하여 공공기관의 경영혁신 및 전산자원의 활용에 대한 보다 효과적인 방안을 제시하고자 합니다.한국과학기술원 : 경영정보전공

How Long Should We Monitor the Patient for Bleeding after Percutaneous Renal Biopsy?

Purpose: Percutaneous renal biopsy (PRB) may become complicated by serious bleeding. Overnight observation after renal biopsy is a standard safety strategy. Although it was recently reported that outpatient observation is safe, appropriate observation time after the renal biopsy is still in debate. We evaluated prospectively the incidence, onset time and risk factors of hemorrhagic complications to determine the optimal duration of observation after PRB. Methods: We enrolled 100 patients who underwent renal biopsy from October 2009 to April 2010 using the standard strategy. The biopsy was performed by two experienced nephrologists using 16-gauge spring-loaded biopsy gun under real-time ultrasound guidance. Serial color Doppler ultrasound was done immediately, 8 hours, 24 hours and 1 week after the PRB. Results: The 32 patients experienced hemorrhagic complications (32.0%, 10 with gross hematuria, 26 with hematoma, and 4 with both), and 1 major complication occurred 3 days after PRB. Baseline serum creatinine of the patient with the major complication was 6.0 mg/dL. Serum creatinine and BMI were higher in complication group (p<0.05). Number of needle passes, blood pressure, and degree of edema and proteinuria were not related to the complication. In multivariate analysis, serum creatinine was the only significant risk factor of complication (p=0.007). Hemorrhagic complications developed in 9 patients (28.1%) between 8 and 24 hours after PRB, all of which were minor. Conclusion: The 8 hours observation time after renal biopsy may be deemed appropriate for stable patients with normal creatinine.Y

Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea

Background: Socioeconomic status is an important factor affecting the accessibility and prognosis of kidney transplantation. We aimed to investigate changes in kidney transplant recipients socioeconomic status in South Korea and whether such changes were associated with patient prognosis. Methods: T his retrospective nationwide o bservational c ohort s tudy i n S outh Korea included kidney transplant recipients between 2007 and 2016. South Korea provides a single-insurer health insurance service, and information on the socioeconomic status of the recipients is identifiable through the claims database. First, a generalized linear mixed model was used to investigate changes in recipients socioeconomic status as an outcome. Second, the risk of graft failure was analyzed using Cox regression as another outcome to investigate whether changes in socioeconomic status were associated with patient prognosis. Results: Among the 15,215 kidney transplant recipients included in the study, economic levels (defined based on insurance fee percentiles) and employment rates declined within the first 2 years after transplantation. Beyond 2 years, the employment rate increased significantly, while no significant changes were observed in economic status. Patients whose economic status did not improve 3 years after kidney transplantation showed a higher risk of death than those whose status improved. When compared to those who remained employed after kidney transplantation, unemployment was associated with a significantly higher risk of death-censored graft failure. Conclusions: The socioeconomic status of kidney transplant recipients changed dynamically after kidney transplantation, and these changes were associated with patient prognosis.N

Association between postoperative hyponatremia and renal prognosis in major urologic surgery

Recent evidence for the clinical significance of postoperative hyponatremia after urologic surgeries remains scarce. We examined the incidence, risk factors, and outcomes of electrolyte imbalance in urologic surgery. Patients with newly developed hyponatremia, defined as a sodium level lower than 135 mEq/L within 7 days after surgery, were included in our study group. The primary outcome was progression to end-stage renal disease (ESRD). Secondary outcome was composition of progression to ESRD and creatinine doubling/eGFR halving from baseline. A survival analysis with a multivariable Cox proportional hazard model was performed. We included 9,206 cases of bladder, prostate, ureter, and kidney surgery. Incidence of new-onset postoperative hyponatremia was 15.4% (1,414/9,206). Postoperative hyponatremia mostly developed in patients with high-risk perioperative characteristics. The development of postoperative hyponatremia was independently associated with progression to ESRD (adjusted HR 1.343, 95% CI 1.082-1.680, P = 0.007). The secondary outcome was also related to the electrolyte imbalance in prostate (adjusted HR 1.729, 95% CI 1.145-2.612, P = 0.009) and kidney (adjusted HR 1.339, 95% CI 1.099-1.632, P = 0.004) surgery. Postoperative hyponatremia in urologic surgery was a common electrolyte imbalance in patients with high-risk perioperative status, and associated with worse renal prognosis.OAIID:RECH_ACHV_DSTSH_NO:T201724737RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A080131CITE_RATE:5.168DEPT_NM:의학과EMAIL:[email protected]_YN:YY