• Childhood Kidney Diseases
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• v.9 no.2
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• pp.231-236
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• 2005

Juvenile rheumatoid arthritis(JRA) is the most common major connective tissue disease in children. Renal involvement in JRA is rare. Among the renal lesions that have been reported in JRA, amyloidosis and drug-induced nephropathy are the most common. Crescentic glomerulonephritis in JRA has rarely been reported. We report a case of ANCA-associated pauci-immune crescentic glomerulonephritis in JRA. The patient was a 15-year old boy with a 3-year history of JRA. He presented with gross hematuria, proteinuria, positive p-ANCA and elevation of BUN and creatinine. Pathologic findings revealed focal necrotizing and crescentic glomerulonephritis. There were no significant immunoglobulin or complement deposits. His renal function recovered after intravenous methylprednisolone pulse therapy and oral steroid use. In Korea, this is the first reported case of pauci-immune crescentic glomerulonephritis in JRA. (J Korean Soc Pediatr Nephrol 2005;9:231-236)

• Journal of the Korean Society of Food Science and Nutrition
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• v.20 no.4
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• pp.337-345
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• 1991

This study was designed to investigate the effects of dietary protein ana calcium levels on hematological properties and renal functions of the Pb-administered rats. Male Sprague-Dawley rats were assigned to a 3$\times$3$\times$2 factorial design with 3 levels of protein (40％, 16％, 6％), 3 levels of Ca (1.2％, 0.6％, 0.12％) and 2 feeding Periods (3 and 7 Weeks). The Control group was included separately, The rats were exposed to the drinking water containing 2, 000ppm of lead. Hematocrit, hemoglobin content and RBC count were lower in the Pb-added groups than in the control group and were reduced with decreasing dietary protein and Ca levels. Urinary-aminolevulinic acid was higher in the Pb-added groups than in the control group and increased with decreasing dietary Ca level. However, urinary glucose was higher in the Pb-added groups than in the control group and enhanced with decreasing dietary protein and Ca levels. Creatinine celarance was not affected by the Pb administration when the rats fed the diet containing sufficient protein and Ca.

• Journal of Ocean Engineering and Technology
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• v.31 no.2
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• pp.130-140
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• 2017

Typically, a submerged breakwater is one of the good scene-friendly coastal structures used to reduce wave energy and coastal erosion. However, sometimes, a submerged breakwater also has a negative aspect in that a strong rip current occurring around an open inlet due to a difference in mean water levels on the front and rear sides of the structure leads to scouring. Such scouring has a bad effect on its stability. In order to eliminate this kind of demerit, this study investigated four new types of submerged breakwaters with drainage channels. First, hydraulic experiments were performed the typical and new structures. Then, the wave height and mean water level distributions around the structures were examined using the experimental results. Finally, it was revealed that the new type of submerged breakwater could efficiently reduce the mean water level on its rear side. In particular, in the case of new-type submerged breakwater 2, an average reduction efficiency of 71.2% for the difference between the mean water levels at the front and rear sides was shown in comparison with the typical one.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.34-47
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• 2023

Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects meta-analysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results : The systematic review included 11 RCTs (n = 591, average age 60.2-76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.33-39
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• 2006

Purpose: To determine appropriate sampling frequency and time of multiple blood sampling dual exponential method with $^{99m}Tc$-DTPA for calculating glomerular filtration rate (GFR). Materials & Methods: Thirty four patients were included in this study. Three mCi of $^{99m}Tc$-DTPA was intravenously injected and blood sampling at 9 different times, 5ml each, were done. Using the radioactivity of serum, measured by gamma counter, the GFR was calculated using dual exponential method and corrected with the body surface area. Using spontaneously chosen 2 data points of serum radioactivity, 15 collections of 2-sample GFR were calculated. And 10 collections of 3-sample GFR and 12 collections of 4-sample GFR were also calculated. Using the 9-sample GFR as a reference value, degree of agreement was analyzed with Kendall's $\tau$ correlation coefficients, mean difference and standard deviation. Results: Although some of the 2-sample GFR showed high correlation coefficient, over or underestimation had evolved as the renal function change. The 10-120-240 min 3-sample GFR showed a high correlation coefficient (${\tau}=0.93$), minimal difference ($Mean{\pm}SD=-1.784{\pm}3.972$), and no over or underestimation as the renal function changed. The 4-sample GFR showed no better accuracy than the 3-sample GFR. Conclusions: In the wide spectrum of renal function, the 10-120-240 min 3-sample GFC could be the best choice for estimating the patients' renal function.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.176-185
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• 2004

Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.61-66
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• 2009

Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age $51.3{\pm}16.9$) with various renal function were examined. we compared the GFR using $^{99m}Tc$-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and $^{99m}Tc$-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with $3.0{\pm}3.1\;mg/dL$, In patients with normal renal function (Scr<1.5 mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5$^{99m}Tc$-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, $^{99m}Tc$-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.687-694
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• 2003

Purpose : Regeneration and repair after ischemic renal injury appears to be modulated by circulating or locally produced growth factors. This study examined the changes of serum insulin like growth factor(IGF-I) and renal expression of IGF-I and II, vascular endothelial growth factor(VEGF), transforming growth $factor-{\beta}$($TGF-{\beta}$), and connective tissue growth factor(CTGF) during the active regeneration period after acute ischemic injury. Methods : Sera and kidney tissue samples(whole kidney, cortex, outer medullae and inner medullae) were obtained before and after one, three, five and seven days of 40 minutes bilateral renal pedicle clamping. Acute renal failure was assessed by measuring the concentration of serum creatinine. Serum IGF-I level was measured by radioimmunoassay. The mRNA expression in kidney was measured by RT-PCR. The distribution of IGF-I and CTGF was detected by immunohistochemistry. Resuts : Serum IGF-I concentration after one day following acute ischemic renal injury was significantly decreased compared to preischemic value. The mRNA levels of IGF-I, IGF-II, $TGF-{\beta}1$ and VEGF in whole kidney were temporally decreased on day one of ischemic injury. IGF-I and IGF-II expressions in outer medullae were significantly decreased on day one after ischemic injury. $TGF-{\beta}1$, CTGF and VEGF expressions were markedly decreased in medullae after one day of ischemic injury compared to other kidney sections. IGF-I was markedly decreased in cortical tubules on day one of uremic rat. CTGF was markedly increased on tubule within three days of ischemic injury. Conclusion : These findings suggest that IGFs, $TGF-{\beta}1$ and CTGF may involve in the pathogenesis or the recovery from acute ischemic renal injury.

• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.92-105
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• 2014

Objectives : Cisplatin is a widely used cancer therapy drug. However, nephrotoxicity resulting in increased oxidative stress is a major side effect of cisplatin chemotherapy, thereby limiting its chemotherapeutic use. Lycium chinense Miller (LCM) has been used as a traditional herbal medicine in various febrile and inflammatory diseases such as night sweat, cough, nosebleed, bronchitis, pulmonary tuberculosis, etc. In this study we investigated the protective and antioxidative potential of LCM against cisplatin-induced nephrotoxicity in rats. Methods : Twenty-four 8-week-old male Wistar rats were divided into four groups: normal untreated; cisplatin treatment only; LCM 10 mg/kg plus cisplatin treatment; and LCM 30 mg/kg plus cisplatin treatment. Twenty-four hours after the last cisplatin injection, all the rats were sacrificed, and serological changes were evaluated. The levels of NF-${\kappa}B$ activity and NOX-4, $p47^{phox}$, $p22^{phox}$, COX-2, iNOS, SOD, catalase expressions were analyzed in Western blot analysis. Results : Cisplatin injection caused an increase in the BUN level, which is a reliable indicator of renal toxicity. The levels of BUN, renal ROS, and renal TBARS were significantly reduced in the LCM groups compared with the cisplatin-only groups. The levels of $p47^{phox}$ and $p22^{phox}$, which are NADPH oxidase subunits, were increased in the cisplatin-only groups, whereas they were decreased in the LCM groups. The levels of renal NF-${\kappa}B$ activity and COX-2, iNOS expressions were increased significantly in the cisplatin-only groups compared with the normal groups, whereas they were decreased in the LCM groups. Compared with the cisplatin-only groups, renal GSH and GSH/GSSG increased in the LCM groups. Also, the administration of LCM increased levels of SOD and catalase as compared with the cisplatin-only groups. Conclusions : These results suggest that LCM protects cisplatin-induced nephrotoxicity via a mechanism that may involves the inhibition of oxidative stress by the activation of antioxidants.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.369-375
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• 2007

Purpose : There have been numerous researches on urine ${\beta}_2$-microglobulin (${\beta}_2$-M) concerned with primary nephrotic syndrome and other glomerular diseases, but not much has been done in relation to pediatric age groups. Thus, our hospital decided to study the relations between the analysis of the test results we have conducted on pediatric patients and renal functions. Methods : Retrospective data analysis was done to 102 patients of ages 0 to 4 with renal diseases with symptoms such as hematuria, edema, and proteinuria who were admitted to Chung-Ang Yongsan Hospital and who participated in 24-hour urine and urine ${\beta}_2$-M excretion test between January of 2003 and January of 2006. Each disease was differentiated as independent variables, and the statistical difference of the results of urine ${\beta}_2$-M excretion of several groups of renal diseases was analyzed with student T-test by using test results as dependent variables. Results : Levels of urine ${\beta}_2$-M excretion of the 102 patients were as follows : 52 had primary nephrotic syndrome [MCNS (n=45, $72{\pm}45{\mu}g/g$ creatinine, ${\mu}g/g-Cr$), MPGN (n=3, $154{\pm}415{\mu}g/g-Cr$), FSGS (n=4, $188{\pm}46{\mu}g/-Cr$], six had APSGN ($93{\pm}404{\mu}g/g-Cr$), seven had IgA nephropathy ($3,414{\pm}106{\mu}g/g-Cr$), 9 had APN ($742{\pm}160{\mu}g/g-Cr$), 16 had cystitis ($179{\pm}168{\mu}g/g-Cr$), and 12 had HSP nephritis ($109{\pm}898{\mu}g/g-Cr$). IgA nephropathy (P<0.05) and APN (P<0.05) were significantly higher than in other renal diseases. Among primary nephrotic syndrome, FSGS with higher results of ${\beta}_2$-microglobulin test had longer treatment period (P<0.01) when compared to the lower groups, but no significant differences in Ccr, BUN, or Cr were observed. Conclusion : IgA nephropathy and APN groups showed significantly higher level of ${\beta}_2$-M excretion value than other groups. Although ${\beta}_2$-microglobulin value is not appropriate as an indicator of general renal function and pathology, it seems to be sufficient in the differential diagnosis of the UTI and in the prediction of the treat-ment period of nephrotic syndrome patients.