• 제목/요약/키워드: 腎臟(kidney)

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Pathogenetic Overlapping of Renovascular Hypertension Developed in a Child with Takayasu Arteritis: 'One-clip, One and Half-kidney Model'

  • Lee, Su Jeong;Baek, Hee Sun;Jang, Hea Min;Kim, Hyung-Kee;Huh, Seung;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • 제20권1호
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    • pp.33-36
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    • 2016
  • There are two pathogenic models of renovascular hypertension (RVH) originating from renal artery stenosis. We noted a case of a boy who had severe hypertension with atrophic left kidney, hypertrophic right kidney, a segmental stricture of the abdominal aorta, and total occlusion of the right renal artery. Due to the atrophic change of the contralateral, unclipped left kidney, this patient presented with various clinical manifestations related to both models of pathogenesis of RVH occurring at the same time. We conclude that this patient presented with the middle stage of the two RVH pathogenetic models, so called the 'one-clip, one and half-kidney model.'

다양한 배후 방사능 설정에 따른 Cates 법 사구체 여과율의 차이: I-125-Iothalamate 측정법과의 비교 (GFRs Measured by Gates' Method According to 5 Background Sites: Comparison with GFR Measured by I-125-Iothalamate Method)

  • 정현석;정용안;김성훈;김정호;이성용;손형선;백준현;정수교
    • 대한핵의학회지
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    • 제38권4호
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    • pp.306-310
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    • 2004
  • 목적 : 감마 카메라를 이용하여 사구체 여과율을 측정할 때 설정하는 배후 방사능 관심 영역의 위치에 따라 사구체 여과율이 어떻게 달라지는 지를 알아보고자 하였다. 대상 및 방법: 성인 63명(남:여=39:24, 평균나이:37.9세)을 대상으로 하였다. 감마 카메라를 이용한 사구체 여과율 측정은 Tc-99m-DPTA와 Gates 방법을 이용하였다. 배후 방사능 관심 영역은 5개 부위로 설정하였고, 이들은 각각 신장 하방, 신장 주위, 신장 상방, 신장 측방, 양측 신장 사이였다. 또한 같은 사람에서 I-125-iothalamate를 주사하고 4시간까지 1시간 간격으로 혈액과 소변을 채취하여 사구체 여과율을 측정하였다. 두 검사 사이의 간격은 3주 이내인 경우만을 대상으로 하였다. 먼저 감마 카메라법과 I-125-iothalamate 측정법으로 얻은 사구체 여과율의 상관 관계를 상관 분석을 이용하여 비교 분석하였다. 그리고 신장 깊이가 7cm 이상인 경우를 1군으로, 7cm 미만인 경우를 2군으로 나누어 각 군에서 얻어진 Gates 방법을 이용한 측정치와 I-125-iothalamate법을 이용한 측정치들을 비교 분석하였다. 결과: 배후 방사능 관심 영역을 신장 상방과 양측 신장 사이에 설정하고 측정한 사구체 여과율이 I-125-iothalamate 사구체 여과율과 가장 좋은 상관 관계를 보였다(r=0.462:0.454, p=0.0001, 0.0002). 신장 깊이가 7cm 미만인 군에서는 5개 부위에 배후 방사능을 설정하고 Gates 방법을 이용하여 측정한 사구체 여과율이 모두 I-125-iothalamate을 이용하여 측정한 사구체 여과율과 통계적으로 유의한 상관 관계를 보였으나(p<0.01), 신장 깊이가 7cm이상인 1군에서는 5개 부위에 배후 방사능을 설정하고 Gates 방법을 이용하여 측정한 사구체 여과율이 모두 I-125-iothalamate을 이용하여 측정한 사구체 여과율과 통계적으로 유의한 상관 관계를 보이지 않았다. 결론: Gates 방법을 이용한 사구체 여과율 측정에서 배후 방사능 관심 영역은 신장의 상방과 양측 신장사이, 즉 혈액 풀 방사능이 많이 분포하는 부위에 설정하는 것이 I-125-iothalamate을 이용한 사구체 여과율과 가장 높은 상관 관계를 보였고, 신장 깊이가 깊지 않은 2군에서 두 사구체 여과율은 더 높은 상관 관계를 보였다.

신장이식환자를 위한 능력증강교육프로그램 효과 (The Effects of an Empowerment Education Program for Kidney Transplantation Patients)

  • 김성희;유혜숙
    • 대한간호학회지
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    • 제47권4호
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    • pp.445-455
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    • 2017
  • Purpose: This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance. Methods: The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes. Results: Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher. Conclusion: Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.

자기효능증진 운동프로그램이 신장이식 환자의 체중, 체지방율, 운동시간 및 심폐기능에 미치는 효과 (The Effects of the Self Efficacy Promotion and Exercise Program on the weight, body fat rate, exercise time and cardiopulmonary function of kidney transplant recipients)

  • 안재현;김남초
    • 성인간호학회지
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    • 제12권3호
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    • pp.452-462
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    • 2000
  • The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Program to prevent of obesity and cardiovascular diseases for the kidney transplant recipients. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study ws carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids therapy and did not take any physical exercise regularly. The subjects received the self efficacy promotion and exercise program for 12 weeks which contained self efficacy promotion education and exercise program. The weight, body fat rate, exercise time and cardiopulmonary function were evaluated before the experiment and after the experiment. The results were as follows: 1. After the experiment, the weight was significantly decreased than that of before the experiment(p=.0001). 2. After the experiment, the body fat rate was significantly decreased than that of before the experiment(p=.0010). 3. After the experiment, the exercise time was significantly increased than that of before the experiment(p=.0002). 4. After the experiment, the absolute VO2 was significantly increased than that of before the experiment(p=.0008). 5. After the experiment, the relative VO2 was significantly increased than that of before the experiment(p=.0002). This study showed that the self efficacy promotion and exercise program was effective. So it would be expected that this self efficacy promotion and exercise program could be applied as an effective independent nursing intervention widely in prevention of obesity and cardiovascular diseases for kidney transplant recipients.

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신장이식 환자의 근력, 근지구력, 유연성 및 일상생활활동의 변화 (The Change of Muscle Strength, Muscle Endurance, Flexibility and Activities of Daily Living of the Kidney Transplant Recipients)

  • 안재현;하희선;홍정자
    • 성인간호학회지
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    • 제13권1호
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    • pp.5-14
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    • 2001
  • The purpose of this study was to explore the change of muscle strength, muscle endurance, flexibility and activities of daily living to develop a rehabilitational program. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study was carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids and did not take any physical exercise regularly. The muscle strength, muscle endurance, flexibility and activities of daily living were evaluated at 1st week and after 12 weeks. The data were analyzed with numbers, percentiles, mean, standard deviation and t-test. The results were as follows: 1. After 12 weeks, the grip strength was significantly decreased than 1st week (p=.0002). 2. After 12 weeks, the back lift strength was significantly decreased than 1st week (p=.0002). 3. After 12 weeks, the muscle endurance was increased than 1st week, but it was not significant(p=.5487). 4. After 12 weeks, the flexibility was significantly decreased than 1st week (p=.0002). 5. After 12 weeks, the activities of daily living was significantly decreased than 1st week (p=.0006). Like the above result, the kidney transplant receipients' muscle strength, flexibility and activities of daily living were reduced. In order to solve this problem, the writer has found that program development to prevent the defects should be extremely required. Since now on the number of patients should expand. After the kidney transplantation, the periods of 4, 8, 12 and 16 weeks are extended. The writer proposes to examine the different phase of change in each periods.

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신장이식 환자와 가족의 퇴원후 교육요구 (A Study on the Educational Needs of Patients with Kidney Transplants and their Family Members after Discharge from Hospital)

  • 안재현;김남초
    • 대한간호학회지
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    • 제29권6호
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    • pp.1324-1335
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    • 1999
  • The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. The results are as follows; 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.

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총 계수 분석법과 평균 계수 분석법에 따른 신장 기능의 차이 분석 (The analysis of difference in the relative renal function based on total counts method and average counts method)

  • 정우영;조시만;박승온;심동오
    • 대한방사선협회지
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    • 제29권1호
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    • pp.44-49
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    • 2003
  • 감마카메라를 이용하여 영상화할 수 있는 $^{99m}Tc-DMSA$ 신장 검사는 비침습적으로 신장의 기능과 형태를 동시에 평가할 수 있고, 신장 기능의 이상은 형태학적인 변화 보다 먼저 나타나기 때문에 다른 검사보다 $^{99m}Tc-DMSA$ 신장 검사를 이용하면 병변을 조기에 진단할 수 있는 장점이 있다. 신장의 상대적 기능 평가시에 깊이 보정, 총 계수 또는 평균 계수의 사용, BKG 보정, SPECT 검사의

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8주 유산소 트레이닝이 중년의 제 2형 당뇨(T2DM)환자의 혈청지질 및 신장기능에 미치는 영향 (The Effect of 8 Weeks of Aerobic Exercise on Serum Lipids and Kidney Function in Middle-Aged T2DM Patients)

  • 김철우;곽이섭;김군도;김영일
    • 생명과학회지
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    • 제22권5호
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    • pp.582-586
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    • 2012
  • 본 연구의 목적은 8주 유산소 트레이닝이 제 2형 당뇨(T2DM)환자의 콜레스테롤과 신장기능에 미치는 영향을 규명하기 위함이다. 피험자는 총 4명(남 3, 여 1)이며 8주 유산소 걷기 트레이닝의 운동강도는 최대심박수($HR_{max}$)의 60~75%, 주당 3~5 회, 20~45 분간 실시되었으며 다음과 같은 결과를 얻었다. 신체적 특성 중 체지방률과 공복시 혈당은 8주 유산소 걷기 트레이닝 후 유의하게($p$ <0.05) 감소함을 나타냈고, 혈중지질인 총 콜레스테롤(TC)과 중성지방(TG)도 유의한 감소를 나타냈다. 그러나 신장기능[BUN, uric acids, creatinine]은 유의한 변화를 나타내지 못했다. 결과적으로 8주 유산소 트레이닝은 제 2형 당뇨(T2DM)와 당뇨병성 신증 환자의 1예에서 체지방률과 공복시혈당, 지질을 감소시키는데 영향을 미쳤지만 신장기능 증진에는 어떠한 영향도 미치지 못했다.

생쥐 신장, 간, 비장 내 시간에 따른 수은 농도 변화와 수은 화합물의 위치 (Changes in the Concentration and Localization of Accumulated Mercury in Kidney, Liver, and Spleen of Mice over Time)

  • 김유선;김영은;조현욱
    • 생명과학회지
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    • 제29권8호
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    • pp.879-887
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    • 2019
  • 본 연구에서는 생쥐 신장, 간, 비장 내 축적된 수은의 위치와 아울러서 시간에 따른 수은 농도 변화를 조사하였다. 수은 투여 종료 후 10일, 150일, 300일에 생쥐를 희생하여 수은 농도변화를 분석하였다. 10일에 희생시킨 생쥐 신장의 경우, 근위세뇨관 상피세포의 핵 위쪽 세포질에 수은이 다량으로 분포하였으나, 사구체에는 분포하지 않았다. 간의 경우, 수은이 주로 간문맥 주위에 있는 간세포와 굴모세혈관에 있는 Kupffer 세포에 분포하였다. 10일에 희생시킨 비장의 경우, 백색 수질과 적색 수질에 수은이 흩어져 분포하였다. 수은의 농도 변화에 있어서, 150일과 300일에 희생시킨 신장의 피질과 수질에 축적되어 있던 수은이 낮은 농도로 나타났다. 역시 간세포에 축적되어 있던 수은도 150일과 300일의 경우, 낮은 농도로 나타났다. 비장의 경우, 백수와 적수 조직에 있던 수은 농도가 감소되었다. 이런 결과를 통해 세포나 조직에 축적되어 있던 수은의 위치가 확인되었으며, 또한 이 결과는 기관에 축적되어 있던 수은 농도가 시간이 지남에 따라 자연스럽게 감소된다는 사실을 확인해 주고 있다.

개에서 발생한 신장원성 혈관육종의 면역조직화학적 진단 (Immunohistochemical Diagnosis of Primary Renal Hemangiosarcoma in a Dog)

  • 정수교;양형석;김재훈
    • 한국임상수의학회지
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    • 제30권4호
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    • pp.296-300
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    • 2013
  • 7년령의 중성화된 수컷 Yorkshire Terrier가 복강에 종괴가 촉진되어 이를 주증으로 내원하였다. 방사선 검사 상 복강의 등쪽면에 신장 종괴와 작은 복강 종괴가 관찰되었다. 수술적으로 적출된 우측 신장에서는, 육안적으로 붉은 갈색조를 띄는 종괴와 낭상 구조가 함께 관찰되었다. 병리조직검사 상에서 다각형 또는 타원형의 내피세포를 가진 다수의 불규칙한 모양의 신생혈관이 관찰되었으며, 이 혈관들과 종양세포들은 주변조직으로의 강한 침습성을 보였다. 복강의 또 다른 작은 종괴에서는 신장 종괴와 동일한 병리조직학적 소견을 관찰할 수 있었다. 면역조직화학염색을 실시한 결과 종양세포들은 vimentin, CD31 및 von Willbrand factor에 대해 양성 반응을 보였으나, cytokeratin에 대해서는 음성 반응을 보였다. 육안적인 특징, 병리조직학적 소견 및 면역조직화학적 검사를 바탕으로 본 증례는 신장원성 혈관육종으로 진단하였다.