• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.37-42
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• 2018

Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy. Eculizumab is a newly developed biologic that blocks the terminal complement pathway and has been successfully used in the treatment of aHUS. Currently, several guidelines for aHUS, including the Korean guideline, recommend eculizumab as the first-line therapy in children with aHUS. Moreover, life-long eculizumab therapy is generally recommended. Further studies on discontinuation of eculizumab are needed.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.58-62
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• 2022

Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury without any association with preceding diarrhea. Dysregulation of the complement system is the most common cause of aHUS, and monoclonal humanized anti-C5 antibodies are now recommended as the first-line treatment for aHUS. However, if the complement pathway is not the cause of aHUS, C5 inhibitors are ineffective. In this study, we report the second reported case of aHUS caused by DGKE mutations in Republic of Korea. The patient was an 11-month-old infant who presented with prodromal diarrhea similar to typical HUS, self-remitted with conservative management unlike complement-mediated aHUS but recurred with fever. While infantile aHUS often implies genetic dysregulation of the complement system, other rare genetic causes, such as DGKE mutation, need to be considered before deciding long-term treatment with C5 inhibitors.

• Journal of Trauma and Injury
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• 제26권1호
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• pp.34-37
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• 2013

Although a majority of patients with splenic rupture present acutely, up to 15% present with a delayed rupture days to weeks following a substantial abdominal injury. The mortality for patients presenting with acute splenic rupture is approximately 1% whereas that associated with delayed rupture approaches 15%. Although many cases of delayed splenic rupture have been reported, the majority of those reports present delayed splenic rupture associated with an underlying systemic disorder such as liver or kidney disease, or another hematologic disorder. We found a delayed splenic rupture case that documented the normal spleens of young healthy soldiers after trivial abdominal trauma, and we have had successful treatment experience with delayed rupture of a normal spleen after trivial trauma. Therefore, we want to review the literature and discuss the phenomenon of delayed rupture of the spleen following trivial trauma.

• Childhood Kidney Diseases
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• 제20권2호
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• pp.74-78
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• 2016

Purpose: Early diagnosis and treatment of urinary tract infection have been emphasized to prevent renal scarring. If untreated, acute pyelonephritis could cause renal injury, which leads to renal scarring, hypertension, proteinuria, and chronic renal failure. The purpose of this study was to assess risk factors of renal scarring after treatment of acute pyelonephritis (APN). Methods: The medical records of 59 patients admitted at Daegu Fatima Hospital because of APN between March 2008 and April 2015 whose renal cortical defects were confirmed by using initial technetium-99m dimercaptosuccinic acid (DMSA) scans were reviewed retrospectively. We divided 59 patients into 2 groups according to the presence of renal scar and assessed risk factors of renal scar, including sex, age at diagnosis, feeding method, hydronephrosis, bacterial species, vesicoureteral reflux, and vesicoureteral reflux grade. Results: Of 59 patients (41%), 24 showed renal scar on follow-up DMSA scan. No significant differences in sex, hydronephrosis, bacterial species, and fever duration were found between the renal-scarred and non-scarred groups. As for age at diagnosis, age of >12 months had 5.8 times higher incidence rate of renal scarring. Vesicoureteral reflux (VUR) affected renal scar formation. VUR grade III or IV had 14.7 times greater influence on renal scar formation than VUR grade I or II. Conclusion: Our data suggest that the presence of VUR and its grade and age at diagnosis are risk factors of renal scar on follow-up DMSA scan after APN.

• 대한수의학회지
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• 제63권2호
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• pp.15.1-15.5
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• 2023

The hepatitis A virus (HAV) induces severe acute liver injury and is adapted to human and monkey cell lines but not other cells. In this study, the HAV was inoculated into porcine kidney (PK-15) cells to determine its infectivity in porcine cells. The growth pattern of the HAV in PK-15 cells was compared with its growth pattern in fetal rhesus kidney (FRhK-4) cells. The growth of HAV was less efficient in PK-15 cells. In conclusion, HAV replication was verified in PK-15 cells for the first time. Further investigations will be needed to identify the HAV-restrictive mechanisms in PK-15 cells.

• Childhood Kidney Diseases
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• 제3권2호
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• pp.109-116
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• 1999

목적 : Insuln-like growth factor(IGF)-I및 -II는 성장인자로 일군의 IGF-binding protein(IGFBP)에 의하여 그 작용이 조절된다. IGF-I은 백서 신장에서 발견되고 대사효과와 성장효과를 갖고 있다. 이번 연구는 백서에서 신장발육과 허혈성 신손상 후 재생과정 동안에 IGFBP의 발현이 변화하는지를 보고자 한다. 방법 : 태생 15주부터 성숙 할때까지 백서 신장에서 IGFBP 발현의 변화를 알아보기 위해 Northern blotting을 시행하였고, 급성신부전 백서의 신장에서 IGF-IGBP axis의 변화를 보기 위해 Northern blotting과 Immunohisto-chemistry를 이용하였다. 결과 : IGFBP-1과 -3는 태생기에는 거의 발현되지 않다가 출생 후 7일째부터 성숙이 끝날 때까지 점진적으로 증가하였다. 반면에 IGFBP-2와 -5는 태생기에 많이 발현되고, IGFBP-2는 출생 후 7일째까지 IGFBP-5는 30일째까지 높은 농도를 유지하다가 급격히 감소하였다. 한편 IGFBP-4는 태생기에 중등도로 발현되는데 출생 후 증가하기 시작하여 7일째 가장 많이 발현되다가 급격히 감소하였다. 신손상 후 IGFBP의 변화를 보면 IGFBP-1과 -4는 재생기간 동안 3-5배 증가되다가 정상으로 회복된 반면 IGFBP-3와 IGFBP Related Protein-1(IGFBPrP-1) 은 신손상 1일째에는 약간 감소하다가 그후 증가하여 정상보다 약간 높은 수준을 유지하였다. 결론 : 백서 신장에서 신장구조나 기능의 발달, 분화 및 재생에 대한 IGF의 작용을 조절할 수 있는 IGFBP 발현에 현저한 변화가 있었다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.164-167
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• 2011

Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

• Childhood Kidney Diseases
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• 제9권2호
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• pp.251-254
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• 2005

저자들은 핍뇨를 주소로 내원한 12세 남아에서 임상 소견 및 검사 소견 상 전신적 강직성 경련으로 유발뇐 횡문근융해증에 의해 초래된 급성신부전으로 진단하고 충분한 수액공급 소변의 알칼리화, 이뇨제 투여와 함께 항경련제의 사용으로 경련을 조절함으로써 급성신부전이 호전된 1례를 경험하였기에 보고하는 바이다.

• 동의생리병리학회지
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• 제20권1호
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• pp.98-102
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• 2006

The present stuby was carried out to determine if Radix Glycyrrhizae extract exerts beneficial effect against the ischemia-induced acute renal failure in rabbits. Radix Glycyrrhizae was known to reinforce the function of the spleen and replenish Qi, remove heat and counteract toxicity, dispel phlegm and relieve cough, alleviate spasmodic pain, and to moderate drug actions. It's indications are weakness of the spleen and the stomach marked by lassitude and weakness; cardiac palpitation and shortness of breath; cough with much phlegm; spasmodic pain in the epigastrium, abdomen and limbs; carbuncles and sores. It is often used for reducing the toxic or drastic actions of other drugs. Rabbits were treated with Radix Glycyrrhizae extract via i.v., followed by renal ischemia/reperfusion. Fractional excretion of glucose and phosphate, lipid peroxidation and light microscopy were done to evaluate the beneficial effect of Radix Glycyrrhizae extract on ischemia/reperfusion induced acute renal failure. Renal ischemia/reperfusion caused increase of fractional excretion of glucose and phosphate increased in ischemia-induced animals, which was partially prevented by Radix Glycyrrhizae extract treatment. Ischemia/reperfusion increased lipid peroxidation, which was prevented by Radix Glycyrrhizae extract administration. And the beneficial effect of Radix Glycyrrhizae extract on ischemia/reperfusion induced kidney injury was shown through the light micrographic observation. These results indicate that lipid peroxidation plays a critical role in ischemia-induced acute renal failure. Radix Glycyrrhizae extract exerts the protective effect against acute renal failure induced by renal ischemia/reperfusion.

• Journal of Chest Surgery
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• 제45권4호
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• pp.236-241
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• 2012

Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.