• 한국임상수의학회지
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• 제34권5호
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• pp.313-317
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• 2017

Symmetric dimethylarginine (SDMA) is a new renal biomarker for kidney function. It is almost exclusively eliminated by renal filtration. The purpose of this retrospective study was to evaluate the changes in serum ceatinine (CREA), blood urea nitrogen (BUN) and SDMA concentrations in dogs with chronic mitral valve insufficiency (CMVI), according to the severity of CMVI. The evaluation of the severity of CMVI was performed according to the American College of Veterinary Internal Medicine (ACVIM) classification of heart failure. The dogs were classified into two groups: group 1 (ACVIM B; n = 11) and group 2 (ACVIM C; n = 15). In dogs with advanced CMVI, the serum SDMA concentrations were significantly increased above the normal reference range and were independent of body weight (BW), systolic blood pressure (SBP), or sex. No dog in either group had higher serum CREA concentrations than the upper limit. The serum SDMA concentration may be a better renal marker than serum CREA concentrations for the early diagnoses of renal dysfunction in dogs with CMVI.

• 한국동물생명공학회지
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• 제36권2호
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• pp.116-120
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• 2021

Three different cats who had chronic kidney disease (CKD) were treated for more than one month with fluid therapy in an animal clinic. Although this long-term treatment and hospitalization, there was no clinical improvement in clinical signs as well as serum biochemical indexes including blood urea nitrogen (BUN), creatinine (CREA), and phosphate (PHOS). All cases were then injected three times with allogeneic stem cells through an intravenous route for treatment on Day 0, 7, and 14 or 30. On the same day, clinical observation and blood tests for serum biochemistry were conducted together. Upon administrating stem cells to the CKD cats, clinical conditions and the indexes of BUN and CREA were clinically improved within normal ranges. Additionally, one of the cats who had the renal cysts presented clinical improvement with showing decreased cysts size than before.

• 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.

• 한국임상수의학회지
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• 제25권4호
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• pp.236-240
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• 2008

부갑상샘 호르몬 (PTH)은 칼슘과 무기인의 수송을 조절한다. 속발성 부갑상샘 기능항진증은 대개 만성신부전에서 발생하고, 이는 개와 고양이에 있어서 CRF의 일반적인 합병증이다. 신부전을 갖는 21마리의 개가 본 연구에 사용되었다. 공시동물로부터 채혈한 혈액 중 칼슘 (Ca),무기인 (iP), PTH의 농도를 측정하여 칼슘과 무기인의 비율에 따라 두 군으로 분류하였다 (Ca / iP $\leq$ I; 그룹 1, Ca/ip $\geq$ 1.5; 그룹 II). 성과 연령 사이에 부갑상샘 호르몬 수준은 유의성 있는 차이가 없었다. 두 군 사이에 부갑상샘 호르몬 수준과 Ca/P의 비율에는 유의성 (p<0.0001)있는 차이가 나타났다. 결론적으로, 칼슘과 무기인의 비율은 신부전을 갖는 개에서 부갑상샘 호르몬 수준을 예측하기 위한 지표로 이용될 수 있을 것으로 생각된다.

• 대한임상독성학회지
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• 제3권1호
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• pp.63-66
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• 2005

Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. It is known to be toxic to the nervous system, hematopoietic system, and causes acid-base and electrolyte disorders. Acute respiratory failure with hypokalemia and rhabdomyolysis with acute renal failure should be considered as potential events in protracted glue sniffing. We reported the case of 26-year-old woman was admitted to the emergency department with the development of respiratory failure and altered mentality due to hypokalemia after chronic glue sniffing. She was weaned from the ventilator 3 days later after potassium and sodium bicarbonate replacement and was discharged without respiratory symptoms and other complications.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.296-301
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• 2013

Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

• 한국임상수의학회지
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• 제28권1호
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• pp.52-56
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• 2011

Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

• Tuberculosis and Respiratory Diseases
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• 제47권6호
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• pp.824-835
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• 1999

연구배경: 만성신부전 환자들은 수면과 관련된 호흡장애가 흔히 동반되는데 특히 수면 무호흡은 이들 환자의 심혈관계 기능부전을 더욱 악화시켜 장기 사망률에 영향을 미칠 것으로 생각된다. 혈액투석 유지요법은 만성신부전에 의한 대사장애를 교정하기 위하여 시행되는 가장 보편적인 내과적 치료법이지만, 이 방법이 수면 무호흡을 포함한 수면장애를 개선시킬 수 있는지 여부는 명확하지 않다. 저자들은 혈액투석 유지요법이 수면의 질과 수면과 관련된 호흡장애, 특히 수면 무호흡에 미치는 영향에 대해 관찰하고자 하였다. 방 법: 혈액투석 유지요법을 받고 있는 만성신부전 환자 47명을 대상으로 수면설문지검사를 시행하여 수면장애와 관련된 임상증상을 조사하였고, 이들 중 15명을 대상으로 혈액투석 전과 후에 수면다원검사, 혈중 신기능검사 및 전해질검사, 동맥혈가스분석을 시행하여 비교하였다. 결 과: 수면설문지검사를 시행한 47명중 40명(85.1%)이 수면-각성 주기의 장애와 관련된 임상증상을 호소하였으며. 55.3%가 코골음이 있다고 답변하였고, 27.7%의 환자는 수면 중 타인에 의해 무호흡이 관찰된 적이 있다고 답변하였다. 급속안구운동수면 시간이 혈액투석 전에 비하여 혈액투석 후에 증가하였다(p<0.05). 비급속안구운동수면 시간이 전체 수면시간에서 차지하는 백분율은 혈액투석 후에 감소하였고(p<0.05), 1단계 및 2단계 비급속안구운동수면이 전체 수면시간에서 차지히는 백분율은 혈액투석 후에 짧아지는 경향을 보였으나(p=0.051), 3단계 및 4단계 비급속안구운동수면은 혈액 투석 전후에 차이가 없었다. 수면 무호흡의 유형은 혈액투석 전과 후 모두에서 폐쇄성이 중추성에 비하여 우세하였으며, 혈액투석후의 무호흡지수 및 무호흡-저호흡지수는 혈액투석 전에 비하여 유의한 차이가 없었다. 혈액투석 후에 혈액뇨질소(BUN), 혈중 creatinine, potassium 및 phosphorus 농도는 유의하게 감소하였으나(p<0.05), 혈중 sodium 및 chloride 농도는 변화가 없었으며, 혈액투석 전과 후의 이들 검사 결과와 수면구조를 포함한 수면다원검사 각 지표와는 상호관련성이 없었다. 동맥혈가스분석에서 pH는 혈액투석 전에 비하여 혈액투석 후에 감소하였으나(p<0.05). $PaO_2$, $PaCO_2$ 및 $HCO_3^-$는 변화가 없었고, 혈액투석 전과후의 동맥혈가스분석 결과와 수면구조를 포함한 수면다원검사 각 지표와는 상호 관련성이 없었다. 결 론: 만성신부전은 수면장애를 유발할 수 있는 중요한 전신질환이다. 혈액투석 유지요법은 만성신부전 환자에서 시행되는 가장 보편적인 치료법이지만 수면구조 및 수면 무호흡을 효과적으로 개선시키지 못하였다. 따라서 만성신부전 환자를 치료함에 있어서는 혈액투석에 의한 대사장애의 적절한 교정과 더불어 수면장애의 치료에 대한 적극적인 고려가 필요하다고 생각한다.

• 대한치과마취과학회지
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• 제3권2호
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• pp.98-102
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• 2003

Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

• 대한간호학회지
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• 제25권3호
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• pp.549-561
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• 1995

This study was designed to identify the relation-ship of perceived social support on self-esteem and hopelessness in patients with chronic renal failure who are hemodialysis. The subjects of this study were the 50 patients who were registered in the hemodialysis department of the two hospitals. The data were collected using a questionnaire and The period of the data collection was from August 9 to 16, 1993. The instruments for this study were the perceived social support scale designed by Park Ji-Won, the self -esteem scale designed by Rosenberg and the hopelessness scale designed by Beck et al. The data were analyzed using frequencies, percentages, t-test, ANOVA, and .Pearson correlation coefficient. The results are summarized as follows ; 1. The degree of support according to the type of perceived social support ranged down in the fol-lowing order from high to low the mean emotion-al support 21.12, the mean informational support 19.58, the mean appraisal support 17.00, the mean material support 15.22, the man self-esteem was 32.00 and the mean hopelessness was 60.48. 2. Test for hypothesis ; Hypothesis 1, "The higher the level of perceived social support in patients on hemodialysis, the higher their level of self-esteem will be. " was not supported(r=.05, p=0.74). Hypothesis 2, "The higher the level of perceived social support in patients on hemodialysis, the lower their level of hopelessness will be. " was supported(r=-0.53, p=0.00). 3. The relations between general characteristics and the level of perceived social support, self-esteem, and hopelessness ; (1) The 'Gender'(P=0.04), 'Occupation'(P=0.04), 'Education'(P=0.00), 'Married state'(P=0.00) 'Duration of Hemodialysis'(P=0.00) and 'In-come'(P=0.00) of the subjects were related to perceived social support and showed a statistically significant difference. (2) No general characteristics of the subjects were related self-esteem in a statistically significant way. (3) The 'Education'(P=0.00) , 'Income'(P=0.00) of the subjects were related to hopelessness and showed a statistically significant difference. Thus, it is concluded that social support must be included in nursing interventions for patients with chronic renal failure on hemodialysis.