• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.169-172
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• 2012

A 12-year-old castrated male Shih-tzu dog presented with vomiting, anorexia, and weight loss. The patient's medical history and hematological, radiographic, ultrasonographic, and endoscopic findings were used for diagnosis. The patient's medical history showed that he was being treated for chronic kidney disease since a few weeks. The serum biochemical analysis showed moderate azotemia. However, abdominal radiographic and ultrasonographic findings showed the presence of a mass in the pylorus area of the stomach. On gastrointestinal endoscopic examination, the proliferative mass was found in the pyloric antrum. The histopathological results of the endoscopic biopsy specimen indicated that it was strongly suspected a gastric adenoma; therefore, we surgically excised the pyloric outflow region via a Y-U pyloroplasty. The histopathological examination of the surgically excised specimen also indicated that the mass was a gastric adenoma. After surgical treatment, the patient's condition improved gradually, and the clinical symptoms diminished in approximately 3 weeks after surgery. The patient's condition was well controlled until recently, i.e., 18 months after surgery. This case report describes the clinical findings, imaging characteristics, endoscopic findings, and histopathological features of a gastric adenoma in the pyloric outflow tract of a dog.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.145-154
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• 2019

This study examined the relationship between the estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) with ferritin in Korean adults. This study included 4,948 adults aged ${\geq}20years$ from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) data. A covariance test adjusted for covariates was performed for the ferritin levels in relation to the decreased eGFR (eGFR<$60ml/min/1.73m^2$) and elevated uACR ($uACR{\geq}30mg/g$). Several key findings were made in the present study. First, after adjusting for the related variables, the ferritin level was higher in the decreased eGFR group [$103.04{\pm}6.59mL/min/1.73m^2$; 95% confidence interval (CI), 90.12~115.96] than in the normal eGFR group ($84.87{\pm}1.16mL/min/1.73m^2$; 95% CI, 82.59~87.14; P=0.007). Second, after adjusting for the related variables, the ferritin level ($M{\pm}SE$) was similar in the normal uACR group ($85.70{\pm}1.20mg/g$; 95% CI, 83.35~88.05) and elevated uACR group ($82.72{\pm}4.09mg/g$; 95% CI, 74.71~90.73) (P=0.487). Chronic kidney disease was positively associated with the ferritin level in Korean adults but albuminuria was not.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.106-116
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• 2021

Background: We evaluated the mid-term outcomes and angiographic patency of redo coronary artery bypass grafting (CABG). Methods: Of 2,851 patients who underwent isolated CABG at Seoul National University Hospital from 2000 to 2017, 88 underwent redo CABG. Patients' mean age at redo CABG was 66.0±8.0 years. The mean interval between the first-time and redo CABG was 113.0±62.4 months. The mean follow-up duration was 86 months. Early and mid-term clinical outcomes were evaluated. Angiographic patency rates were evaluated early (1-2 days), 1 year, and 5 years after surgery. Comparative analyses between on-pump and off-pump CABG were also performed. Results: The culprits for reoperation were previous grafts (65.6%), native coronary vessels (17.8%), and both (16.7%). Off-pump CABG was performed in 75 cases (85.2%), and the mean number of distal anastomoses was 1.8±0.8. The saphenous vein (39.7%) was used most frequently, followed by the right internal thoracic artery (28.4%), right gastroepiploic artery (21.3%), left internal thoracic artery (7.8%), and radial artery (2.8%). Operative mortality was 1.1%. The overall survival, cumulative incidence of cardiac death, and cumulative incidence of major adverse cardiac events were 71.3%,12.0%, and 23.3% at 5 years after surgery, respectively. The overall angiographic patency rates were 95.7%, 90.1%, and 92.2% on early, 1-year, and 5-year angiograms, respectively. The angiographic patency rates of saphenous vein grafts were 93.1%, 85.6%, and 91.3% on early, 1-year, and 5-year angiograms, respectively. No significant differences in clinical outcomes or angiographic patency rates were observed between the on-pump (n=13) versus off-pump (n=75) groups. Multivariable analysis revealed that age (hazard ratio [HR], 1.07; p=0.005) and chronic kidney disease (HR, 3.85; p=0.001) were risk factors for all-cause mortality. Conclusion: Redo CABG could mostly be performed using the off-pump technique and did not show increased operative mortality and morbidities.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.32-40
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• 2021

This study examined the association between hypertension (HTN), estimated glomerular filtration rate (eGFR), and urine microalbumin/creatinine ratio (ACR) in Korean adults. Data for 8,922 adults (3,941 men and 4,981 women) aged ≥20 years from the Sixth Korean National Health and Nutrition Examination Survey VI (2013~2014) were analyzed. In men, after adjusting for the related variables, the odds ratios (ORs) of HTN [systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or use of HTN medications] were significantly higher in the decreased eGFR group [eGFR <60 mL/min/1.73 ㎡, 1.98 (95% CI, 1.21~3.24)], elevated ACR group [ACR ≥30 mg/g, 2.03 (95% CI, 1.54~2.69)], and decreased eGFR plus elevated ACR group [eGFR <60 mL/min/1.73 ㎡ and ACR ≥30 mg/g, 6.03 (95% CI, 2.82~12.92)] than in the normal group (eGFR ≥60 mL/min/1.73 ㎡ and ACR <30 mg/g). In women, after adjusting for the related variables, the ORs of HTN were significantly higher in the decreased eGFR group (2.29, 95% CI, 1.27~4.13), elevated ACR group (2.22, 95% CI, 1.68~2.94), and decreased eGFR plus elevated ACR group (10.77, 95% CI, 3.89~29.82) than the normal group. In conclusion, HTN was associated with a decreased eGFR and elevated ACR in Korean men and women. In addition, the prevalence of HTN increased greatly when a decreased eGFR and elevated ACR occurred simultaneously.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.3
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• pp.167-173
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• 2023

This study assesses the urine microalbumin to urine creatinine ratio (uACR) with uric acid and the association with the high-density lipoprotein cholesterol (UA/HDL-C) ratio in Korean adults. Data from the 2019 Korean National Health and Nutrition Examination Survey was procured and included 5,845 adults aged 20 years or older. Several key findings were obtained in the present study. After adjusting for the related variables (age, gender, hypertension, obesity, type 2 diabetes mellitus, and chronic kidney disease), the uACR was found to be positively associated with the quartiles of the UA/HDL-C ratio (P=0.002). Moreover, after adjusting for related variables, the odds ratio (OR) of albuminuria (uACR≥30.0 mg/g) was not significant in quartile 2 (Q2) (OR, 1.015; 95% confidence interval [CI], 0.757~1.361) and Q3 (OR, 1.090; 95% CI, 0.811~1.465) but was significantly higher in Q4 (OR, 1.416; 95% CI, 1.044~1.921) as compared to Q1 of the UA/HDL-C ratio. We conclude that since the UA/HDL-C ratio is positively associated with albuminuria in Korean adults, an increased UA/HDL-C ratio could be applied as a useful measure to assess albuminuria in Korean adults.

• Korean Journal of Clinical Laboratory Science
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• v.56 no.2
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• pp.125-134
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• 2024

The present study was conducted to explore relationships between anemia and estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) in Korean adults with or without metabolic syndrome (MetS). The data of 4,943 adults aged ≥20 years who participated in KNHNES V-3 (2012) were analyzed. In the non-MetS group, the odds ratio (OR) for anemia of those with a decreased eGFR {eGFR<60 mL/min/1.73 m², 3.85 (95% confidence interval [CI], 2.03~7.30)} was significant as was the OR of those with decreased eGFR plus elevated uACR (eGFR<60 mL/min/1.73 m² and uACR≥30 mg/g, 5.81 [95% CI, 2.60~13.02]). In the MetS group, ORs for anemia for those with an elevated uACR (2.18 [95% CI, 1.11~4.27]), a decreased eGFR (3.74 [95% CI, 1.11~12.55]), or a decreased eGFR plus an elevated uACR (16.79 [95% CI, 5.93~47.57]) were significant. In conclusion, in non-MetS, anemia was associated with a low eGFR, whereas in MetS, anemia was associated with a low eGFR and an elevated uACR. In addition, the OR for anemia was greatly increased when eGFR was diminished and uACR was elevated regardless of MetS and MetS status.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.588-597
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• 2020

Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetization transfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction (UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). The obstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations, ¹⁸F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis was measured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at 1.2 ppm (MTR_asym(1.2ppm)) derived from CEST and maximum standard uptake value (SUV_max) and between magnetization transfer ratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of contralateral kidneys (p < 0.05). On day 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of sham-operated kidneys (p < 0.05). The MTR_asym(1.2ppm) of UUO renal medulla was fairly negatively correlated with SUV_max (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p < 0.001). Conclusion: CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosis in UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.95-103
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• 1998

Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.4-12
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• 1997

Purpose: To evaluate the prevalence and clinical manifestations of various glomerulonephritis (GN) in children, a clinicopathological anlysis of 310 biopsied cases were performed. Method: We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 310 cases diagnosed as glomerulonephritis by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results: 1) Male to female ratio was 1.54:1 and the range of age was from 13 months to 15 years 10 months. 2) Among these, 217 (70.0%) patients were belong to primary GN and 93 (30.0%) patients were belong to secondary GN. As a whole, the most common pathologic diagnosis was minimal change lesion (MC, 32.6%), which was followed by IgA nephropathy (IgAN, 15.8%), $Henoch-Sch\"{o}nlein$ purpura nephritis (HSPN, 13.5%), Poststreptococcal glomerulonephritis (PSAGN, 8.1%). 3) Clinical manifestations of patients were asymptomatic urinary abnormality (43.2%), nephrotic syndrome (41.0%), acute glomerulonephritis (14.2%), chronic glomerulonephritis (1.0%), rapidly progressive glomerulonephritis (0.6%). 4) In primary GN, the most common pathologic diagnosis was MC (46.5%), IgAN (22.6%), thin glomerular basement membrane (GBM) disease (7.8%), membranoproliferative glomerulonephritis (MPGN, 5.5%), mesangial proliferative glomerulonephritis (MesPGN,4.6%), focal segmental glomerulosclerosis (FSGS, 4.6%), membranous nephropathy (MN, 0.9%), sclerosing glomerulonephritis (SCGN, 0.9%), crescentic glomerulonephritis (CreGN, 0.5%) and non-specific glomerulonephritis (NonspGN, 6.0%). 5) Major causes of secondary GN were HSPN (45.2%), PSAGN (26.9%), hepatitis B associated glomerulonephritis (HBGN, 17.2%), lupus nephritis (LN, 6.5%), Alport syndrome (2.2%), hemolytic uremic syndrome (1.0%), fibrillary glomerulonephritis (1.0%) in descending order. Conclusions: There are some differences of the results of clinicopathological stuidies of glomerulonephritis in children because of its different indications of renal biopsy, pathologic classification of renal disease and methods of analysis among investigators. In order to establish more reliable data of incidence and classification of childhood glomerulonephritis in Korea, multicenter cooperative study were necessary.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.153-160
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• 1999

Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children. Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas. Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{\pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V. Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.