• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.57-60
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• 2013

Ingestion of grapes or raisins has been reported to the occurrence of acute renal failure (ARF) in dogs, although the mechanism remains undetermined. The prognosis often depends on the severity or clinical course of the disease at the time of presentation and is poor if the dog becomes anuric phase. To explore the characteristics and outcome of ARF caused by grape or raisin poisoning, sequentially collected data, from 2005 to 2008, of the Veterinary Medical Teaching Hospital at the Kangwon National University for clinical evaluation were retrospectively analyzed. Of the 11 clinically affected dogs, 4 cases made a full recovery, 3 died and 4 were euthanized. All but one case (raisin ingestion) had a history of grape exposure, but the exact quantity of fruit ingested was not known. The female dogs accounted for 72.7% (8 cases). Overall, the mean age was 5.3 years (range 0.2-11.3 years), and the mean body weight was 4.1 kg (range 1.4-13 kg). The average duration of hospital stay was 7.1 days (range 2-22 days). Vomiting and anorexia was reported in all dogs. Diarrhea (4 cases), oliguria (5 cases), and anuria (4 cases) with or without isosthenuria were also reported. Five dogs of 11 had mild to moderate anemia, with a decrease in packed cell volume and hemoglobin. All dogs had elevations in serum phosphorous, creatinine, and blood urea nitrogen values, but calcium values were variable; 2 dogs with hypocalcemia, 2 dogs with hypercalcemia, and the remaining 7 cases within reference interval. Dogs (n = 8) with measured on blood gas parameters had metabolic acidosis. In addition, higher serum enzyme activities were observed; amylase in 8 (72.7%) dogs, alkaline phosphatase in 7 (63.6%) dogs, and alanine aminotransferase in 5 (45.5%) dogs. Non-survived dogs revealed lower counts of platelet and lymphocyte subpopulation, as compared to the survived dogs.

• Childhood Kidney Diseases
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• v.15 no.1
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• pp.49-57
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• 2011

Purpose: The aim of this study is to investigate the change in incidence and clinical characteristics of acute poststreptococcal glomerulonephritis (APSGN) through a single center's experience. Methods: We retrospectively analyzed the medical records of 53 children who were diagnosed with glomerular nephritis at National Health Insurance Corporation Ilsan Hospital between March 2000 and December 2009. Twenty-six of 53 patients falled to meet the dragnostic criteria of APSGN and were excluded. Chief complaints, physical examinations, urinalysis, urine culture, laboratory results, chest x-ray, and clinical manifestations were all retrieved from the remaining 27 patients. Results: The incidence of APSGN by age was highest in children between six to seven years of age, with similar distributions in both genders, and seasonal incidence was higher from November to February when compared to other months, which was similar to the previously reported studies. However, the annual number of APSGN patients did not show a significant decrease from 2000 to 2009. The incidences of edema and hypertension were 59.3% and 48.1% respectively, suggesting lower incidences than those from previous studies. Six patients (22.2%) experienced hematuria for more than 6 months. Hypertensive encephalopathy, one of APSGN critical complications occurred in one patient but resolved with conservative treatment. Conclusion: Our study shows that APSGN still occur as a common renal disease but the disease severity seems to decrease with milder clinical manifestations and less complications compared to past studies.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.351-355
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• 2007

Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.203-206
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• 2012

Treatment for heart failure is directed to reduce atrial volume overload by diuretic agents, to lessen ventricular pressure overload by vasodilatory agents and to increase myocardial performance through inotropic agents. Of those cardiac therapeutics, diuretic agents are the most important to control heart failure in dogs, although long-term use often causes detrimental side-effects such as acute renal failure and electrolyte abnormalities. Thus, this study was designed to find a new diuretic agent from medicinal herbs which has better diuretic effect and less unfavorable complications in dogs. In a preliminary study performed with 5 normal healthy dogs, the extract from Akebia quinata Decaisne showed mild to moderate diuretic effect (0.3-0.5 potency of furosemide 2 mg/kg) and minimal changes in serum chemistry and electrolyte. Although the study population was not large enough and study period was not sufficient enough, this study found a good alternative diuretic agent which can replace or reduce the use of furosemide in dogs with heart failure.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.335-342
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• 2003

Background: The aortic arch replacement in an acute aortic dissection is technically demanding procedure that has a lot of postoperative morbidity and high mortality The authors have applied several techniques of aortic arch replacement to overcome the risks of the procedure. Therefore we analysed the results of these techniques. Material and Method: From March of 1996 to July of 2002, we performed 31 cases of the aortic arch replacement in the Stanford type A acute aortic dissection. There were 12 male and 19 female patient's with 59.6$\pm$9.4 years of mean age. Among them 18 cases were treated with the hemiarch replacement and 13 cases with the total arch replacement. We approached the aortic arch through median sternotomy in all but 3 cases of Clamshell incision and applied the deep hypothermic circulatory arrest with retrograde cerebral perfusion. The associated procedures were 2 Bentall's procedures, an axillobifemoral bypass, a femorofemoral bypass and a carotid artery bypass. Result: The postoperative morbidities were 8 acute renal failures, 3 CNS complications, 2 low cardiac output syndromes, 2 malpefusion syndromes, and 2 deep wound infections. There were 4 cases of early hospital mortality which were from an acute renal failure a postoperative bleeding, a low cardiac output syndrome, and a reperfusion syndrome. There were 3 cases of late hospital mortality which were from an acute renal failure, and 2 multiorgan failures. So the total mortality rate was 22.5%. There were 4 cases of late mortality after the discharge, which were form 2 cases of distal anastomotic rupture and 2 cases of intracranial hemorrhage. Conclusion: The hemiarch replacement has relatively shorter operative time and lower hospital mortality but higher late mortality than the total arch replacement. The total arch replacement needs more technically demanding procedure.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.606-613
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• 2005

Purpose : Acute poststreptococcal glomerulonephritis(APSGN) is a common form of glomerulonephritis in children. Most patients recover completely after the acute phase but a few patients have acute complications or progress to chronic renal disease. In recent years, the frequency of APSGN has been was decreasing but is still common in children. So we studied the clinical characteristics of APSGN from 1994 to 2003 and compared it with past studies. Methods : We studied 105 patients who were diagnosed with APSGN in the Department of Pediatrics, Asan Medical Center between January 1994 and December 2003, with a retrospective chart review. Results : The mean age was $8.5{\pm}2.6$ years. The male to female ratio was 2 : 1. Average annual incidence was $10.5{\pm}4.9$ most patients(60.0 percent) occurred from October to January. Edema was seen in 82 cases(78.1 percent), gross hematuria in 70 cases(66.7 percent), hypertension in 50 cases (47.6 percent) and oliguria in 22 cases(20.9 percent). Microscopic hematuria was seen in 105 cases (100 percent), positive ASO in 99 cases(94.2 percent), proteinuria in 67 cases(63.8 percent) and azotemia in 38 cases(36.2 percent). Serum complement 3(C3) level decreased in 96 cases and returned to normal within eight weeks in 70 patients(75.3 percent). Kidney biopsy was carried out in 22 cases. Most acute symptoms subsided within 2 weeks of onset. Conclusion : We concluded that there was no significant difference between clinical features of recent and past APSGN in children, and short term prognoses were excellent.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.512-516
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• 2007

A mechanical circulatory support system is a life-saving option for treating acute severe respiratory failure or cardiac failure. There are currently a few types of assist devices and the Twin-Pulse Life Support (T-PLS) system is a kind of pulsatile pump. We report here on three patients with severe life threatening cardiopulmonary dysfunction who had the T-PLS system used as an assist device. The indications for applying the T-PLS system were continuing respiratory or cardiac failure in spite of maximal ventilatory and inotropic support. There were two patients with acute respiratory failure due to infection and one patient with cardiac failure due to acute myocarditis. One respiratory failure patient and one cardiac failure patient survived after applying the T-PLS system for 3 days and 5 days, respectively. The T-PLS system is useful as an assist device and it should be considered before multi-organ failure occurs.

• Childhood Kidney Diseases
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• v.1 no.2
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• pp.170-175
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• 1997

Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.163-174
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• 2012

Objective: The primary objective this study was to evaluate the effect of Paljeong-san (PJS) pharmacopuncture treatment on against the glycerol-induced acute renal failure in rats. Methods: Glycerol injection decreased GFR (glomerular filtration rate) and increased urine volume, serum creatinine, BUN level, urine albumine secretion and fractional excretion of Na+, K+. PJS was selected in the basis of invigorating kidney which can eliminate pathogens. Rats were treated with PJS pharmacopuncture on Shin-shu (BL23) and Chon-chu (ST25) point for 3 days, followed by 50% concentration of glycerol injection ($5m{\ell}/kg$ body weight). Results: After the 3 days treatment period, Paljeong-san (PJS) pharmacopuncture treatment improved renal function. In addition, Glycerol injection increased lipid peroxidation, and decreased Na-K-ATPase in renal cortex and which were prevented by PJS treatment. Conclusion: This study suggests that Paljeong-san (PJS) pharmacopuncture treatment show favorable effect on glycerol-induced acute renal failure in rats.

• Journal of Acupuncture Research
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• v.21 no.2
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• pp.155-166
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• 2004

Objective : The present study was carried out to determine if Semen Plantaginis Herbal-Acupuncture exerts beneficial effect against the cisplatin-induced acute renal failure in rabbits. Method : Semen Plantaginis was selected in the basis of invigorating kidney-QI which can eliminate pathogens. The oxidative stability determined by the Rancimat technique showed higher antioxidative index when compared with control. Rabbits were treated with Semen Plantaginis Herbal-Acupuncture on Shin-shu point for 3 days, followed by cisplatin injection(5mg/kg body weight). Results : Cisplatin injection caused an increase in serum creatinine level, which was accompanied by a reduction in GFR. The fractional excretion of $Na^{+}$, $K^{+}$, glucose and phosphate increased in cisplatin-induced animals, which was partially prevented by Semen Plantaginis Herbal-Acupuncture treatment. Cisplatin injection increased lipid peroxidation, which was not prevented by Semen Plantaginis Herbal-Acupuncture. Conclusions : These results indicate that lipid peroxidation plays a critical role in cisplatin-induced acute renal failure. Semen Plantaginis Herbal-Acupuncture exerts the protective effect against acute renal failure induced by cisplatin, and its effect may be attribued to an antioxidant action.