• Journal of Chest Surgery
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• v.35 no.4
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• pp.267-273
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• 2002

Background: We performed a phase IV clinical trial to examine the usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in patients with acute aortic dissection. material and Method: Systolic/diastolic blood pressure, and heart rate were monitored before and after the intravenous administration of nicardipine in 31 patients with aortic diseases. The period of nicardipine administration in each patient was from 3 to 14 days. Efficacy was evaluated by determining the average amount of blood pressure reduction on the 3rd day of drug administration. The dosage of another antihypertensive agent was slowly tapered down, and ultimately replaced by the test drug. Result: 28 patients were diagnosed as acute aortic dissection, 2 patients as rupture of the aortic arch aneurysm, and 1 patient as traumatic aortic rupture. Mean age was 53.9 $\pm$ 14.9(29~89) years, and 21 patients(67.7%) were male. 14 patients(32.3%) had complications associated with underlying aortic disease: aortic insufficiency in 7, hemopericardium in 6, acute renal failure in 1, paraplegia in 1, lower extremity ischemia in 1, and hemothorax in 1. The time needed to reach the target blood pressure was within 15 minutes in 16, from 15 to 30 minutes in 10, from 30 to 45 minutes in 3 and from 45 to 60 minutes in 2, and their baseline average systolic, diastolic, and mean arterial blood pressures(mmHg) were 147$\pm$23, 82.3$\pm$ 18.6, and 104 $\pm$ 18, respectively. Average systolic, diastolic, and mean arterial blood pressures(mmHg) on the third day of nicardipine infusion were 119$\pm$ 12, 69$\pm$9, and 86$\pm$8, and they all showed statistically significant decrease(p<0.05). The average systolic, diastolic, and mean arterial blood pressure(mmHg) after the discontinuation of the nicardipine infusion were 119 $\pm$ 15, 71 $\pm$ 14, and 86$\pm$ 13, respectively. No significant difference was observed between the average pressures measured on the third day and those measured after the discontinuation of the nicardipine infusion, and no definite side effects were observed during the study period. Conclusion: Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.221-229
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• 1998

Purpose : The symptom of urinary tract infection in children is non-specific and systemic compared to that of adults. So the diagnosis of UTI in children can be delayed. If UTI in children is not appropriately managed, it may he resulted in renal failure, hypertension, growth failure in adolescence because there are already documented renal scar or urinary tract abnormality in infection period. Especially upper UTI that involve renal parenchyme may be result in fatal complication. The purpose of this study is analyzing the relationship between acute reactive marker and $^{99m}TC$-DMSA renal scan in upper urinary tract infection. Methods : This study included 56 children admitted at Dankook University Hospital Pediatric Department in Jan. 1995~May. 1998. We analyzed quantatively the results of acute reactive marker(CRP, ESR, WBC), pyuria, fever and compared to those of sonographically find ing and $^{99m}TC$-DMSA renal scan. Comparison between groups were performed by the chi-square (x2) test and a p value of less than 0.05 was considered statistically significant. Results : 1) The number of boys less than 1 year of age was larger than that of girls. But the number of boys more than 1 year of age was reversed. 2) The higher me level of reactive marker (CRP, WBC), the more the probability of upper UTI. 3) The higher fever, the more the probability of upper UTI. 4) The more pyuria, the more probability of upper UTI. 5) The more higher the grade of vesicoureteral reflux, the more probability of upper UTI. 6) $^{99m}TC$-DMSA renal scan is more sensitive and more specific diagnostic tool than renal sonogram. Conclusion : The appearance of an abnormal $^{99m}TC$-DMSA renal scan is correlated with acute reactive marker (CRP, ESR, WBC), fever, pyuria. $^{99m}TC$-DMSA renal scan can be a good valuable predictor tool in upper UTI. So we can start early treatment and decrease the incidence of complication of upper urinary tract by above indicators before knowing the result of urine culture. And we can follow up the patients in more good relationships with their parents by telling them the duration of treatment and follow-up plan.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.48-56
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• 2000

Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.

• Neonatal Medicine
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• v.17 no.2
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• pp.254-261
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• 2010

Little is known about neonatal mitochondrial disease, though mitochondrial metabolic disorders may often present in the neonatal period because of the high energy requirement of neonate. In newborn period, common presentations are not specific and the disease course may be rapid and fatal. In this study, we report three cases of neonatal mitochondrial disease. The first case was strongly suspected because of sudden seizure and mental change with severe lactic acidosis, and multiorgan failure. Plasma lactate/pyruvate (L/P) ratio was increased to 55.6 with marked lactic aciduria and increased plasma alanin up to 2,237 nmol/mL. In the second patient, a peritoneal dialysis was performed for acute adrenal and renal failure, but metabolic acidosis persisted. Plasma L/P ratio was increased to 23.9, and MRC I (mitochondrial respiratory chain defect) was diagnosed through the enzymatic analysis of the muscles. The third case showed repetitive episode of lactic acidosis during the first two months of life, hypotonia, failure to thrive and feeding difficulties. We found markedly increased cerebrospinal fluid L/P ratio up to 57 though plasma L/P ratio(19.4) was borderline with increased plasma lactate. The lactate peak was prominent in brain magnetic resonance spectroscopy (MRS). MRC II was confirmed through muscle biopsy. Plasma lactate level and lactate peak of brain MRS were normalized after conservative treatment.

• Journal of Acupuncture Research
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• v.17 no.1
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• pp.107-117
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• 2000

This study was undertaken to determine if Juglandis Semen Aquacupuncture(Ja) has a protective effect against glycerol-induced acute renal failure in rats. Rats were dehydrated for 24hr and then injected with $5m{\ell}/kg$ of 50% glycerol, one-half of dose in each hindlimb muscle. In experiments for Ja effect, rats received $0.1m{\ell}$ of Ja extraction in both sides of corresponding $Sh{\grave{e}}ns{\bar{u}}$($BL_{23}$) of human body and non-acupuncture points(the root of tail) for 3 days after injection of glycerol. The experimental group were divided into the Normal group, the Control group, the Ja to $Sh{\grave{e}}ns{\bar{u}}$($BL_{23}$) group(Ja-AS), the Ja to non-acupuncture points group(Ja-AN). There were significant decrease of Urine vollume, total protein and phosphate level in Ja-AS as compared with the control group. There were not any significant change of Urine creatinine in Ja-AS as compared with the control group. There were significant decrease of Unine glucose in Ja-AS, Ja-AN as compared with the control group. This suggests that Ja-AS could be used in prevention and treatment of acute renal failure. However, the precise mechanisms of Ja protection remain to be determined.

• Journal of Sasang Constitutional Medicine
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• v.17 no.3
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• pp.103-112
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• 2005

1. Objective : The present author have examined the comparative effects of Hyeongbangjihwang-tang and Sibimikwanjung-tang in glycerol-induced acute renal failure, a model for myoglobinuric acute renal failure. 2. Methods : Above two prescriptions were applied to rat ad libitum and serum level of creatinine, glucose and blood urea nitrogen(BUN) were measured. And serum level of $Na^+$, $K^+$ and $Cl^-$, too. 50%(vol/vol) glycerol at a dose of 10 ml/kg of rat body weight intramuscularly and 1% concentration of prescriptions were applied to rats for 7 days ad libitum. 3. Results : Serum level of creatinine and $K^+$ significantly increased by glycerol injection, and these showed pre-renal and renal cause of acute renal failure. Hyeongbangjihwang-tang administered group showed decreasing tendency on serum level of creatinine when compared with control groups, but not significant. Sibimikwanjung-tang administered group showed significant increase of serum level of BUN when compared with control groups. 4. Conclusions : Above two prescriptions showed no significant changes on glycerol induced acute renal failure, but Hyeongbangjihwang-tang and Sibimikwanjung-tang showed a little different manner of response.

• The Journal of Internal Korean Medicine
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• v.32 no.2
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• pp.278-287
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• 2011

Objectives : The object of this study was to observe the nephroprotective effects of Sojongchobisunki-tang (SCST), which has traditionally been used as Korean medicine for treating various renal diseases, on cisplatin-induced rat acute renal failure. Methods : Three different dosages of SCST were orally administered once a day for 23 days before cisplatin treatment (5 mg/kg, single intraperitoneally administered) and 5 days after cisplatin treatment (once a day for 28 days). 6 groups, of 8 rats per group were used in the present study after 7 days of acclimatization. Changes of the body weight, kidney weight, serum BUN and creatinine levels were observed, as well as changes of the kidney MDA and GSH contents. The results were compared with captopril 100 mg/kg of which the effects on cisplatin-induced acute renal failures are already confirmed. Results : Acute renal failure induced by cisplatin were induced by oxidative stress and related lipid peroxidation in the present study. However, these acute renal failures and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment at all three different dosages of SCST extracts. Conclusions : This study suggests that SCST extracts showed favorable effects on the cisplatin-induced rat ARF.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.821-831
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• 2009

Purpose : This study was to observe the nephroprotective effects of the traditional prescription, Daebuncheong-eum (DBCE). DBCE has generally been used for treating various renal diseases, including renal failure. Methods : Three different dosages of DBCE extract were orally administered once a day for 28 days. At the 23rd day after DBCE extract treatment, cisplatin was also treated. Then, 5 days after cisplatin treatment, all rats (6 groups of 8 rats each) were sacrificed. Changes on the body weight, kidney weight, serum BUN and creatinine levels were observed, along with changes to the kidney MDA and GSH contents. The results were compared with captopril 100mg/kg, from which the effects on cisplatin-induced acute renal failures have already been confirmed. Results : Cisplatin induced ARF are induced by oxidative stress and related lipid peroxidation in the present study. However, these ARFs and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment of all three different dosages of DBCE extracts. Conclusion : This study suggests that DBCE extracts show favorable effects on cisplatin-induced rat ARF.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.49-60
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• 2002

Objective : The aim of this experiment is to investigate the effect of acupuncture and moxibustion at SP6(Sanyinjiao) and BL28(Pangguanshu) on uranyl acetate-induced acute renal failure in rats. Methods : To induce experimental acute renal failure, uranyl acetate was intraperitoneally injected to rats by 5mg/kg. 3 days later acupuncture and moxibustion treatment was done at SP6(Sanyinjiao) and BL28(Pangguanshu) bilaterally of the rats. And then 4 days later, we measured rats' body weight, kidney weight, serum BUN, creatinine and serum eletrolyte levels(Na, K and Cl). Results : In the moxibustion group, hypertrophy index of kidney and serum BUN level were decreased marginally significantly, and serum creatinine, K levels were decreased significantly. But in the acupuncture group, there was no significance at this experiment. Conclusions : SP6(Sanyinjiao) and BL28(Pangguanshu) moxibustion can decrease serum BUN, creatinine, and serum eletrolyte levels on uranyl acetate-induced acute renal failure in rats. And the study will be done continuously about non-effect in the acupuncture group at this experiment.