• Title/Summary/Keyword: 신장조직검사

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Utility of $^{99m}Tc$-MAG3 Perfusion Indices in the Evaluation of Renal Transplant Function During Early Post-transplantation Period (이식 초기 이식신 기능 평가에서 $^{99m}Tc$-MAG3 신관류 지표의 유용성)

  • Kim, Sung-Hoon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.497-507
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    • 2000
  • Purpose: We have examined the utility of $^{99m}Tc$-MAG3 perfusion indices for assessing renal graft function in early post-transplantation period. Materials and Methods: Our study included 80 renal transplant recipients (48 men and 32 women, mean age: 40.3 years). Diagnosis was based on biopsy, laboratory data and clinical course. Renal scintigraphy (RS) was obtained using 100 MBq of $^{99m}Tc$-MAG3 from 11 days to 23 days of kidney transplantation. We measured 5 indices in whole-kidney (WK) and cortical (C) renograms; Hilson's perfusion index (PI), transplant perfusion index (TP) and transplant function index (TF) as perfusion parameter, and the time to peak activity (Tmax) and the ratio of renal counts at 20 min to that at 3 min (K20/3) as functional parameter. Results: The diagnoses at the day of RS were normal graft (NG) in 44, acute rejection (AR) in 14, acute tubular necrosis (ATN) in 10, and Cyclosporine A nephrotoxicity (CsA) in 12. TP and TF were significantly decreased in AR, ATN and CsA, compared to those in NG. K20/3 of AR and ATN wore significantly greater than that of NG. WK-Tmax of AR was significantly longer than that of NG. K20/3 of AR and C-K20/3 of ATN were significantly prolonged relative to those of CsA. There were no statistically significant perfusion indices among complication groups. Conclusion: TP and TF reflecting microperfusion and initial tubular extraction are reliable in assessing graft function. However, it is required to correlate perfusion indices with functional indices and clinical course in differentiating from one another among complication groups.

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A Case of Microscopic Polyangiitis with Pulmonary Hemorrhage and Rapidly Progressive Glomerulonephritis (폐출혈과 급속 진행성 사구체신염을 동반한 현미경적 다발성 동맥염 (Microscopic Polyangiitis) 1례)

  • Kwon Hae Sik;Lee Young-Mock;Kim Ji Hong;Kim Pyung-Kil;Kang Hae Youn;Hong Soon Won;Jeong Hyeon Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.213-218
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    • 2001
  • Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN l17 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 213-18)

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Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood $Henoch-Sch\"{o}nlein$ Purpura Nephritis (소아 $Henoch-Sch\"{o}nlein$ 자반병 신염의 임상양상 및 병리소견과 임상경과)

  • Huh Yun-Jung;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.30-37
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. Methods : The clinical features, initial laboratory and pathologic findings, and clinical out-come were evaluated in 60 children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. Results : The ratio of male to female patients was 1.2:1. The interval between the onset of $Henoch-Sch\"{o}nlein$ purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome In 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. Conclusion : Renal manifestation and pathologic findings correlated with the clinical out-come. It is necessary to evaluate the correlation between pathologic findings and treatment.

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A Case of Wilms Tumor with Thrombi which Invaded the Right Ventricule (종양색전이 우심실까지 침범한 Wilms 종양 1례)

  • Uhm, Ji Hyun;Won, Sung Chul;Lyu, Chuhl Joo;Yang, Chang Hyun;Kim, Byung Soo;Hwang, Eui Ho;Park, Young Hwan;Seo, Chang Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.390-394
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    • 2002
  • Wilms tumor is the second most common malignant retroperitoneal tumor. Inferior vena cava and right atrial involvement is found in about 4-10% and 0.5-3% of cases, respectively. But, right ventricular involvement has not been reported. We experienced a case of Wilms tumor with right ventricular invasion in a 2 year-old male who presented intermittent hematuria and abdominal pain. Computed tomogram and echocardiogram showed a homogeneous mass extended to right ventricle via inferior vena cava. He received pre-operative chemotherapy followed by operation, radiation therapy including heart, and post-operative chemotherapy.

Characteristics of Wheat Flour Dough and Noodles with Amylopectin Content and Hydrocolloids (아밀로펙틴 함량 변화와 하이드로콜로이드 첨가에 의한 밀가루 반죽 및 국수의 특성)

  • Cho, Young-Hwa;Shim, Jae-Yong;Lee, Hyeon-Gyu
    • Korean Journal of Food Science and Technology
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    • v.39 no.2
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    • pp.138-145
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    • 2007
  • The effects of amylopectin and hydrocolloid (locust bean gum and guar gum) content on wheat flour dough and noodle properties were investigated. As the amount of amylopectin increased, the water absorption rate (farinograph), the tension (tension test), the gel stability (freeze-thawing treatment), and the springiness and the cohesiveness (TPA) increased, but the pasting temperature (RVA), the lightness and yellowness (color measurement), and the hardness (TPA) tended to decrease. In sensory evaluations, the scores for cohesiveness, springiness, and acceptability of cooked noodle increased as the proportion of amylopectin increased. The proper combination of amylose/amylopectin ratio and hydrocolloids improved the freeze-thaw stability and the sensory acceptability of wheat flour dough and noodle.

Therapeutic response of cyclosporine and outcome in steroid resistant nephrotic syndrome (스테로이드 저항성 신증후군에서 cyclosporine 치료 반응 및 결과)

  • Choi, Hyung Soon;Lee, Joo Hoon;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.293-298
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    • 2008
  • Purpose : The aim of our study was to evaluate the therapeutic response to cyclosporine, time to remission and side effects in steroid resistant nephrotic syndrome (SRNS). Methods : This study included 22 children with idiopathic SRNS who were treated with cyclosporine between June 1989 and August 2006. Medical records were reviewed retrospectively. Results : The mean age of patients at diagnosis was $5.2{\pm}3.3\;years$. The male to female ratio was 1.2:1. Pre-treatment renal biopsies showed minimal change (MCD) in 12 (54.5%), focal segmental glomerulosclerosis (FSGS) in 8 (36.4%), membranous nephropathy (MGN) in one (4.5%) and mesangioproliferative glomerulonephritis in one (4.5%). 15 (68.2%) patients responded to cyclosporine, of whom 11 (91.6%) patients were MCD, 3 (37.5%) patients FSGS, and 1 patient MGN (MCD vs FSGS, P<0.05). The time to remission in patients who responded to cyclosporine was $31.5{\pm}15.2\;days$. Four of the 15 cyclosporine responders maintained complete remission even after cessation of the medication Seven still received cyclosporine, 2 were intermittently treated with steroids after discontinuation of cyclosporine, and two were treated with cyclosporine and steroids. The mean duration of cyclosporine therapy was $546.5{\pm}346.2$, $1,392.9{\pm}439.7$, $439.5{\pm}84.1$, and $433.5{\pm}74.2$ days, respectively. We performed post-treatment biopsies in 8 patients and partial interstitial fibrosis and tubular atrophy were found in two. Conclusion : The thrapeutic response of cyclosporine is good in steroid resistant nephrotic syndrome, especially in minimal change. But, there is a problem of long term cyclosporine dependency.

Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria (단백뇨를 동반한 IgA 신병증 및 HSP 신염을 가진 소아에서 메틸프레드니솔론 충격요법과 경구 스테로이드 요법의 비교)

  • Ahn, Ji Young;Moon, Jung Eun;Hwang, Young Ju;Choi, Bong Seok;Ko, Cheol Woo;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

The Effect of Recombinant Human Epidermal Growth Factor on Cisplatin and Radiotherapy Induced Oral Mucositis in Mice (마우스에서 Cisplatin과 방사선조사로 유발된 구내염에 대한 재조합 표피성장인자의 효과)

  • Na, Jae-Boem;Kim, Hye-Jung;Chai, Gyu-Young;Lee, Sang-Wook;Lee, Kang-Kyoo;Chang, Ki-Churl;Choi, Byung-Ock;Jang, Hong-Seok;Jeong, Bea-Keon;Kang, Ki-Mun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.242-248
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    • 2007
  • Purpose: To study the effect of recombinant human epidermal growth factor (rhEGF) on oral mucositis induced by cisplatin and radiotherapy in a mouse model. Materials and Methods: Twenty-four ICR mice were divided into three groups-the normal control group, the no rhEGF group (treatment with cisplatin and radiation) and the rhEGF group (treatment with cisplatin, radiation and rhEGF). A model of mucositis induced by cisplatin and radiotherapy was established by injecting mice with cisplatin (10 mg/kg) on day 1 and with radiation exposure (5 Gy/day) to the head and neck on days $1{\sim}5$. rhEGF was administered subcutaneously on days -1 to 0 (1 mg/kg/day) and on days 3 to 5 (1 mg/kg/day). Evaluation included body weight, oral intake, and histology. Results: For the comparison of the change of body weight between the rhEGF group and the no rhEGF group, a statistically significant difference was observed in the rhEGF group for the 5 days after day 3 of. the experiment. The rhEGF group and no rhEGF group had reduced food intake until day 5 of the experiment, and then the mice demonstrated increased food intake after day 13 of the of experiment. When the histological examination was conducted on day 7 after treatment with cisplatin and radiation, the rhEGF group showed a focal cellular reaction in the epidermal layer of the mucosa, while the no rhEGF group did not show inflammation of the oral mucosa. Conclusion: These findings suggest that rhEGF has a potential to reduce the oral mucositis burden in mice after treatment with cisplatin and radiation. The optimal dose, number and timing of the administration of rhEGF require further investigation.

Azathioprine Therapy in $Henoch-Sch\"{o}nlein$ Purpura Nephritis Accompanied by Nephrotic syndrome (신증후군을 동반한 HSP 신염에서 Azathioprine의 치료 효과)

  • Son Jin-Tae;Kim Ji-Hong;Kim Pyung-Kil;Chung Hyeun-Joo
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.41-49
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    • 1998
  • Treatment of $Henoch-Sch\"{o}nlein$ purpura nephritis(HSPN) accomanied by nephrotic syndrome is still controversal, even though both corticosteroids and immunosuppressants have been used for therapy. Azathioprine(AZA) is a chemical analog of the physiologic purines-adenine, guanine, and hyoxanthine and an antagonist to purine metabolism which may inhibit RNA and DNA synthesis and is mainly used for immunosuppressive agent. We studied the effects of AZA in HSPN accompanied by nephrotic syndrome and evaluating the clinical status and histopathologic changes by sequential biopsies following the treatment. Fifteen patients with nehprotic syndrome either initially or during the course of HSPN confirmed by renal biopsies were treated with AZA(2 mg/kg/day) and prednisolone (0.5-1 mg/kg/day qod) for 8months. Folow up renal biopsy was done after treatment in 11 patients. The clinical status of the patients on admission were C(12 cases) and B(3 cases). Improvement of clinical status were showed in 12 cases, but 3 cases were not improved and 1 case was aggrevated after AZA treatment. Complete remission of proteinuria were in 8 cases(53.3%), partial remission were in 4 cases(26.7%) and persistence of proteinuria and hematuria were in 3 cases(20.0%). The loss of hematuria were in 10 cases(66.7%). Histopathologically and immunopathologically, 4 cases were improved. This study suggests that, although control studies are needed, AZA could be used in the treatment of HSPN accompanied by nephrotic syndrome.

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Rapid Detection of Infectious Bursal Disease Virus (IBDV) in Chickens by an Immunochromatographic Assay Kit

  • Choi, Kang-Seuk;Oh, Jin-Sik;Jeon, Woo-Jin;Na, Keon-Sok;Lee, Eun-Kyoung;Lee, Youn-Jeong;Sung, Hwan-Woo;Ha, Gun-Woo;Kwon, Jun-Hun
    • Korean Journal of Poultry Science
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    • v.37 no.2
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    • pp.167-172
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    • 2010
  • An immunochromatograhy (IC) based infectious bursal disease virus (IBDV) detection kit, which employed two anti-IBDV VP2 monoclonal antibodies, was evaluated for rapid diagnosis of infectious bursal disease virus (IBD). The detection limit of the IC kit for IBDV was $10^{3.1}$ to $10^{3.9}$ $EID_{50}$/mL, indicating that the IC kit detected IBDV sensitively as same as double antigen capture ELISA but less than a RT-PCR assay. The IC kit did not detect other viral pathogens such as Newcastle disease virus, infectious bronchitis, avian influenza virus, and infectious larynotracheitis virus. When applied to tissue samples of experimental chickens died 3 or 4 days post infection after very virulent IBDV (strain Kr/D62) infection, the IC kit detected IBDV in all samples of the bursa of Fabricius, spleen, kidney, cecal tonsil and in 87.5%, 37.5% and 0% of liver, thymus and proventriculus samples. In particular, BF tissue samples showed stronger signal bands than other tissues. Positive signal was observed. All except for one thymus sample of samples having negative results by the IC kit showed the same result with DAS-ELISA but RT-PCR assay detected IBDV in some of IC kit negative samples of thymus and proventriculus. When swab samples from the bursa of Fabricius of dead chickens (n=231) on field farms were tested, the sensitivity and specificity of the IC assay relative to RT-PCR was 100% (109/109) and 97.5% (119/122), respectively and kappa value between both assay was 0.97. The kit can provide a useful aid for rapid detection of IBDV in chickens under field circumstances.