• The Korean Journal of Nuclear Medicine
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• v.38 no.4
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• pp.306-310
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• 2004

Purpose: The aim was to assess how the background site affects the Gates' glomerular filtration rate(GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-lothalamate method. Material and methods: The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean=37.9 yrs). The fellowing five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney(subrenal), 2) around each kidney(circumferential), 3) upper side of each kidney(suprarenal), 4) lateral side of each kidney(lateral), 5) between the two kidneys(inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal $depth{\geq}7cm$ and group 2 with renal depth<7cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. Results: The GFRs by Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal $depth{\geq}7cm$. Conclusion: GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were plated over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.73-79
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• 2012

Purpose: The association of mitochondrial DNA (mtDNA) mutations, deletions and copy number with progressive changes in patients with some glomerular disease and end-stage renal disease have been reported. In this study, we performed mtDNA mutation analysis in children with IgA nephropathy to investigate its role in progressive clinical course. Methods: Seven children with IgA nephropathy were involved in this study. MtDNA isolated from platelet was amplified by PCR and sequenced entirely. Results: The mean age at renal biopsy was $11.5{\pm}2.2$ year and the mean age at latest evaluation was $17.9{\pm}3.2$ year. The mean follow-up period were $7.8{\pm}3.1$ years. Patients was divided into 2 groups according to the amount of proteinuria at presenting manifestation. Group 2 patients were nephrotic syndrome. Renal function reveals within normal range in all patients. In group 2 patients, the mean serum albumin level was significantly lower than those of group 1 ($3.7{\pm}0.6g/dL$ vs. $4.7{\pm}0.2g/dL$, P=0.0241) and the mean total cholesterol level was significantly higher than those of group 1 ($222.7{\pm}35.7mg/dL$ vs. $148.3{\pm}29.1mg/dL$, P=0.0283). In Group 2 patients, total amount of protein of 24 hour collected urine also significantly higher than those of group 1 ($1,466.0{\pm}742.5mg$ vs. $122.5{\pm}48.1mg$, P=0.0135). Pr/Cr ratio in random urine sample was also higher in group 2 than those of group 1 but the statistical significance was not noted ($1.8{\pm}1.6$ vs. $0.2{\pm}0.2$, P=0.0961). Deletion of mtDNA nt 8272-8281 were observed in two patients, one patient in each groups, respectively. This is noncoding lesion. No patients demonstrated the mtDNA mutations. Conclusions: We have identified a deletion of mtDNA nt 8272-8281 in two children with IgA nephropathy. Further studies are needed to clarify the role of mitochondrial function in the progressive change of IgA nephropathy.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.210-217
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• 2010

Purpose : Diabetes mellitus (DM) is known as one of the common causes of secondary enuresis in children. However, enuresis in diabetic children is overlooked only as a symptom of polyuria due to hyperglycemia. We evaluated the prevalence of nocturnal enuresis in children with diabetes mellitus in this paper. Methods : Among children with diabetes in three hospitals in Daegu area, 117 agreed to 'Tele research by means of a questionnaire'. Results : Diabetic patients were divided into two groups: Nocturnal enuresis and nonnocturnal enuresis group. thirty-two of 117 (27.0%) patients were in enuresis group, with more daytime urination than non-nocturnal enuresis group ($4.2{\pm}1.6/3.6{\pm}1.2$ times, P=0.016). HbA1c at diagnosis was $12.0{\pm}2.3%/12.0{\pm}2.5%$, and at follow-up $9.3{\pm}2.3%/8.3{\pm}2.3%$ (P =0.042). Insulin was administered at $1.1{\pm}0.5/1.1{\pm}0.4$ units/kg/day. Ten children of enuresis (31.2%) group were monosymptomatic (MNE) and 22 (68.8%) children were non-monosymptomatic enuresis (non-MNE). Fourteen (43.8%) of enuresis group had persistent symptoms, with 5 MNE and 9 non-MNE each. HbA1c at diagnosis was $11.1{\pm}2.5$, $12.4{\pm}2.1$, higher in non-MNE (P=0.144). Average arousal during sleep was step $3.3{\pm}1.2$, $2.5{\pm}1.0$, higher in improved enuresis group (P=0.059). Conclusion : Nocturnal enuresis among DM patients is underestimated. However, considering psychological and social effects of enuresis in children, extensive and long-term studies are needed in the future to clarify relationship between prevalence and DM control.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.353-361
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• 1998

Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.64-68
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• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.398-404
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• 1999

Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of $^{99m}Tc$-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of $^{99m}Tc$-DMSA in predicting early diabetic nephropathy Materials and Methods: $^{99m}Tc$-DMSA scan was performed and a total renal uptake of $^{99m}Tc$-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of $^{99m}Tc$-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of $^{99m}Tc$-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of $^{99m}Tc$-DMSA of Group II ($40.8{\pm}11.0%$) was significantly lower than that of Group I ($54.4{\pm}6.3%$, p<0.001). The uptake of Group III ($27.7{\pm}12.0%$) was significantly lower than those of both Group I and Group II (p<0.001). $^{99m}Tc$-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.102, p<0.001). Conclusion: $^{99m}Tc$-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, $^{99m}Tc$-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.3
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• pp.78-86
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• 2018

Purpose: We aimed to delineate clinical spectrum and short-term effects after enzyme replacement therapy (ERT) for 5 mucopolysaccharidosis type II (MPS II). Methods: Five patients were diagnosed with MPS II by clinical findings, enzyme activity, and genetic testing. Idursulfase was administered by intravenous infusion at a dose of 0.5 mg/kg every week. Observational chart analysis of patients, who underwent systematic investigations more than 12 months after initiation of ERT was done retrospectively. Results: Three patients were classified as having the attenuated type, and 2 patients were classified as having the severe type. The median age at the diagnosis was 9.6 years (range 3.4-26 years). Four different mutations in 5 Korean patients (4 families) with MPS II were identified, among which two were novel mutations (1 small insertion mutation: p.Thr409Hisfs*22, and 1 missense mutation: p.Gly134Glu). Two severe type sibling patients with the same mutation had different clinical manifestation. Urinary glycosaminoglycan excretion decreased within the twelve months of ERT (P=0.043). Liver and spleen volumes showed reductions that were maintained in all patients (P=0.043 and P=0.043, respectively). Improvements were also noted in left ventricular mass index (P=0.042), shoulder flexion (P=0.043), shoulder abduction (P=0.039), knee flexion (P=0.043), elbow flexion (P=0.042), and respiratory distress index (P=0.041). Conclusion: This study demonstrates that Korean patients with MPS II are clinically heterogeneous and indicates that idursulfase is relatively effective in several clinical parameters including heart size and respiratory distress index without infusion-related reactions in patients with MPS II.

• Journal of agricultural medicine and community health
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• v.47 no.3
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• pp.181-188
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• 2022

Objectives: The prevalence of diabetes mellitus was approximately 16% in populations of over age 30 years, and deaths from diabetes mellitus became the sixth most prevalent cause of death by disease. To assess the relationship between HbA1c and heavy metal level in blood and urine, targeted residents were evaluated in a vast steel industrial complex. Methods: We selected 414 subjects for analysis after applying the following exclusion criterion: 18 persons with diabetes mellitus. They took part in a questionnaire survey and underwent blood and urinary assessments. HbA1c and lead (Pb) level were measured in blood and, cadmium (Cd), inorganic arsenic (iAs) and mercury (Hg) were evaluated in urine. Two subgroups were divided by HbA1c 6.5%. Each subgroup was divided by 10th, 20th, 30th, 40th, 50th, 60th, 70th, 80th and 90th percentile levels of biological exposure index of the heavy metals for logistic regression. Results: Odd ratios have a tendency to increase as they go from the 90th to the 10th percentile of cadmium. However, lead, arsenic and mercury did not have significant relationships with HbA1c. In correction of age, region, gender and smoking history, a higher distribution in the subgroup with cadmium above 0.8318 ㎍/g creatinine (30th percentile) was demonstrated in the subgroup with HbA1c levels above the 6.5%, with an odds ratio of 5.26 (95% C.I. ; 1.44~19.17). Conclusion: This study found a significant correlation between urinary levels of cadmium and HbA1c in correction of several factors. It is meaningful that this outcome may be used as a basis for a study to establish the acceptable limit of urinary cadmium in Korea.