• Title/Summary/Keyword: Chronic kidney diseases

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Kidneys with bad ends (신장 기능과 틸로미어)

  • Suh, Dong-Chul
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.11-22
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    • 2008
  • Telomeres consist of tandem guanine-thymine(G-T) repeats in most eukaryotic chromosomes. Human telomeres are predominantly linear, double stranded DNA as they ended in 30-200 nucleotides(bases,b) 3'-overhangs. In DNA replication, removal of the terminal RNA primer from the lagging strand results in a 3'-overhang of uncopied DNA. This is because of bidirectional DNA replication and specificity of unidirectional DNA polymerase. After the replication, parental and daughter DNA strands have unequal lengths due to a combination of the end-replication problem and end-processing events. The gradual chromosome shortening is observed in most somatic cells and eventually leads to cellular senescence. Telomere shortening could be a molecular clock that signals the replicative senescence. The shortening of telomeric ends of human chromosomes, leading to sudden growth arrest, triggers DNA instability as biological switches. In addition, telomere dysfunction may cause chronic allograft nephropathy or kidney cancers. The renal cell carcinoma(RCC) in women may be less aggressive and have less genomic instability than in man. Younger patients with telomere dysfunction are at a higher risk for RCC than older patients. Thus, telomeres maintain the integrity of the genome and are involved in cellular aging and cancer. By studying the telomeric DNA, we may characterize the genetic determinants in diseases and discover the tools in molecular medicine.

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Diabetic Nephropathy - a Review of Risk Factors, Progression, Mechanism, and Dietary Management

  • Natesan, Vijayakumar;Kim, Sung-Jin
    • Biomolecules & Therapeutics
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    • v.29 no.4
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    • pp.365-372
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    • 2021
  • Type 2 diabetes mellitus (T2DM) leads to many health problems like diabetic nephropathy (DN). One of the key factors for chronic kidney disease and end-stage renal disease (ESRD) is T2DM. Extensive work is being done to delineate the pathogenesis of DN and to extend possible remedies. This review is intended to understand the nature of DN risk factors, progression, effects of glycemic levels, and stages of DN. We also explored the novel diagnostic and therapeutic approaches for DN such as gene therapy and stem cell treatments.

Kleefstra syndrome combined with vesicoureteral reflux and rectourethral fistulae: a case report and literature review

  • Chae Won Lee;Min Ji Park;Eun Joo Lee;Sangyoon Lee;Jinyoung Park;Jun Nyung Lee;So Mi Lee;Shin Young Jeong;Min Hyun Cho
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.111-115
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    • 2022
  • Kleefstra syndrome is a rare genetic disease characterized by mental retardation, hypotonia, and a characteristic facial appearance. Furthermore, in some cases, Kleefstra syndrome is associated with various anorectal and genitourinary complications, including imperforated anus, vesicoureteral reflux, hydronephrosis, and chronic kidney disease. Herein, we present a case of Kleefstra syndrome with recurrent urinary tractinfections associated with vesicoureteral reflux and rectourethral fistula, which was treated by a multidisciplinary approach.

A Hybrid Multi-Level Feature Selection Framework for prediction of Chronic Disease

  • G.S. Raghavendra;Shanthi Mahesh;M.V.P. Chandrasekhara Rao
    • International Journal of Computer Science & Network Security
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    • v.23 no.12
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    • pp.101-106
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    • 2023
  • Chronic illnesses are among the most common serious problems affecting human health. Early diagnosis of chronic diseases can assist to avoid or mitigate their consequences, potentially decreasing mortality rates. Using machine learning algorithms to identify risk factors is an exciting strategy. The issue with existing feature selection approaches is that each method provides a distinct set of properties that affect model correctness, and present methods cannot perform well on huge multidimensional datasets. We would like to introduce a novel model that contains a feature selection approach that selects optimal characteristics from big multidimensional data sets to provide reliable predictions of chronic illnesses without sacrificing data uniqueness.[1] To ensure the success of our proposed model, we employed balanced classes by employing hybrid balanced class sampling methods on the original dataset, as well as methods for data pre-processing and data transformation, to provide credible data for the training model. We ran and assessed our model on datasets with binary and multivalued classifications. We have used multiple datasets (Parkinson, arrythmia, breast cancer, kidney, diabetes). Suitable features are selected by using the Hybrid feature model consists of Lassocv, decision tree, random forest, gradient boosting,Adaboost, stochastic gradient descent and done voting of attributes which are common output from these methods.Accuracy of original dataset before applying framework is recorded and evaluated against reduced data set of attributes accuracy. The results are shown separately to provide comparisons. Based on the result analysis, we can conclude that our proposed model produced the highest accuracy on multi valued class datasets than on binary class attributes.[1]

Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan ($^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰)

  • Bae Hyun-Chul;Kim Hyun-Young;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.31-37
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    • 1997
  • The DMSA scan is a useful radiologic study in diagnosis of morphologic and functional diseases of kidney. We evaluated the distribution of sex and age, clinical manifestations, diagnosis, combined diseases, treatment and prognosis of the 61 patients with non-functioning kidney(no isotope uptake or uptake below 5% in DMSA scan) who admitted in our hospital from 1980 to 1995. The proportion of patients under 1 year old age was 46%. Sex ratio was 1.4:1 with male predominance. Most diagnosis of non-functioning kidneys were congenital such as multicystic dysplastic kidney, hydronephrosis due to ureteropelvic junction obstruction, renal agenesis and renal hypoplasia. In order of frequency thirty one percent of them were previously detected on antenatal ultrasonogram. Treatment consisted of operation in 47.5%, mostly nephrectomy and 32.8% of patients were followed up at OPD base without definite treatment. The most common combined diseases was hydronephrosis, in 4patients who had both kidneys inveloved progressed to chronic renal failure, but the prognosis in most cases were good. It is important to evaluate renal diseases in perinatal periods, and we believe that highly sensitive diagnostic study contribute to early treatment plan and thus to good prognosis.

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A Literature Study of Senile Constipation (노인(老人) 변비(便秘)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Jeong, Chang-Hwan;Shin, Hyeon-Chul;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.16 no.1
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    • pp.40-61
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    • 1995
  • This study was performed to investigate concept, systoms, causes of disease, pathogenic mechanisms, therapies and precriptions about senile constipation through the successive medical literature, recent chinese medical literature and chinese medical joumals. Senile constipation seems to be applicable to dryness syndrom and constipation of insufficiency type, have something to do with kidney(the most), lung, spleen and large intestine. The most principal cause of disease is yin-fluid, the rest deficiency of qi, insufficiency of yang, stagnation of qi and retention of fever etc. There are enriching the blood and moistening dryness in principal therapy, the rest are invigorating qi and loosing the bowel, warming and invigorating the spleen and kidney, regulating the flow of qi and promoting the stagnancy of qi and expelling the pathogenic heat etc. In prescriptions there are Yunjangtang, Jengaektang, Hwanggitang, Jechunjeon, Yukmatang and Majainhwan as the causes of disease, meanwhile are Yungjang-tang, Jechunjeon and Majainhwan in the vulgaris prescriptions. And in medical herbs there are nourishing yin medicines as Rhizoma rehmanniac, Radix ophiopogonis and Radix scrophulariae etc., invigorating qi medicines as Radix astragali, Radix codonopsitis and Radix polygoni multiflori etc, invigorating yang medicines as Caulis cistanchis and Semen psoraleae etc., promoting qi circulating medicines as Radix saussurea, Lignum aquilariae and Radix linderae etc., and reducing fever and therapeutic method to keep the adverse qi flowing downward medicines as Semen cannabis, Rhizoma rhei, Fructus immaturus ponciri, and Cortex magnoliae etc.. Meantime Rhizoma rehmanniae, Radix ophiopogonis, Caulis cistanchis, Radix angelicae gigantis, Semen cannabis, Semen biotae, Semen pruni japonicae and Semen persicae in principal herb-medicines. In clinical reports the process of disease was between 10 to 20 years, the evacuation cycle between 4 to 7 days, generally possessed chronic diseases as hypertension, diabetes, arteriosclerosis and cerebro- vascular disorders etc. and the efficiency rate was more than 90%. The senile constipation is occured in succession or promoted by chronic diseases as obesity, hypertension, diabetes, arteriosclerosis. hrperlipemia, cerebro- vascular disorders etc., so diet-regulating, adequate exercise, proper evacuation-habit and psychologic rest etc. are important more than medicine-treatments.

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Hwanggeum-tang Water Extracts Suppress TGF-β1 Induced EMT in Podocyte (황금탕의 족돌기세포에서의 EMT 억제 효능)

  • Shin, Sang Woo;Jeong, Han-Sol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.2
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    • pp.61-66
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    • 2020
  • Epithelial-mesenchymal transition (EMT) is the process by which epithelial cells lose their characters and acquire the properties of mesenchymal cells. EMT has been reported to exert an essential role in embryonic development. Recently, EMT has emerged as a pivotal mechanism in the metastasis of cancer and the fibrosis of chronic diseases. In particular, EMT is drawing attention as a mechanism of renal fibrosis in chronic kidney diseases such as diabetic nephropathy. In this study, we developed an EMT model by treating TGF-β1 on the podocytes, which play a key role in the renal glomerular filtration. This study explored the effects of Hwanggeum-tang (HGT) recorded in Dongeuibogam as being able to be used for the treatment of Sogal whose concept had been applied to Diabetes Mellitus (DM), on the TGF-β1-induced podocyte EMT. HGT suppressed the expression of vimentin and α-SMA, the EMT marker, in the human podocytes stimulated by TGF-β1. However, HGT increased the expression of ZO-1 and nephrin. Interestingly, HGT selectively inhibited the mTOR pathway rather than the classical Smad pathway. HGT also activated the AMPK signaling. HGT's inhibitory effect on the podocyte EMT through regulation of the mTOR pathway was achieved through the activation of AMPK, which was confirmed by comparison with cells treated with compound C (CC), an inhibitor of AMPK signaling. In conclusion, HGT can be applied to the renal fibrosis by preventing TGF-β1-induced EMT of podocytes through AMPK activation and mTOR inhibition.

Reasons and Risk Factors for Readmission Following Hospitalization for Community-acquired Pneumonia in South Korea

  • Jang, Jong Geol;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.147-156
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    • 2020
  • Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

A Case of Hinman Syndrome Complicated by Chronic Renal Failure (만성 신부전을 초래한 Hinman 증후군 1례)

  • Lee Gyeong-Hoon;Lee Eun-Sil;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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Extracorporeal Shock Wave Therapy: Its Acoustical Aspects

  • Choi, Min-Joo;Cho, Sung-Chan;Paeng, Dong-Guk;Lee, Kang-Il
    • The Journal of the Acoustical Society of Korea
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    • v.29 no.3E
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    • pp.119-130
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    • 2010
  • Extracorporeal shock wave therapy (ESWT) is simply evolved from extracorporeal shock wave lithotripsy known as a revolutionary non-invasive technique for treating kidney stone diseases. Since ESWT was approved for treating plantar fasciitis by FDA in 2000, it has been rapidly accepted into various clinical practices. Its indication includes chronic tendinitis and pseudoarthrosis, and has been widened to various applications other than orthopeadics. Little has been reported on their acoustic properties, yet, even if a number of clinical ESWT systems are readily available. This article reviews the acoustical aspects of ESWT and discusses critical issues towards acoustic exposure optimization and shock wave dosimetry.