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Study on Glomerular Filtration Rate comparison according to renal depth measurement of kidney donors (신 공여자에서 신장 깊이 측정에 따른 사구체여과율의 비교에 관한 고찰)

  • Lee, Han Wool;Park, Min Soo;Kang, Chun Goo;Cho, Seok Won;Kim, Joo Yeon;Kwon, O Jun;Lim, Han Sang;Kim, Jae Sam;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.48-56
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    • 2014
  • Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

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The Comparison of Glomerular Filteration Rate by Kidney Depth in Dynamic kidney Scan (동적신장검사에서 신장깊이에 따른 사구체여과율 비교)

  • Hwang, Ju-Won;Lim, Young-Hyen;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Mu-Seok;Jung, Ji-Uk;Park, Se-Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.73-77
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    • 2014
  • Purpose Find out about the significance of the GFR values calculated by the kidney depth is measured by comparing the values obtained for kidney depth was measured GFR in the CT image kidney depth and is calculated by Tonnesen law in $^{99m}Tc$-DTPA dynamic kidney scan with each applies. Materials and Methods Among patients with normal value (75~120 mL/min) computed GFR conducted of dynamic renal scan to visit from February 2013 to February 2014 and donor GFR values in patients with normal value. The mean age was 46.9 years with 14 men 13 females. We used abdomen CT image which checked before conducting dynamic Kidney scan for measuring the depth of kidney. We only used CT image that contains renal hilum and measured outermost front of the kidney from the skin surface (a) and the final surface (b) caculated the average depth of [(a + b) / 2] respectively. Using the same ROI in order to limit the change in GFR values by the other additional element was set before and after the depth value was excluded from the GFR falls kidney disease. Results Using Tonnesen law the average value was caculated 5.94 cm from the right kidney 5.90 cm from the left kidney. It was 6.83 cm, 8.71 cm in the left kidney and the right kidney average value of the depth measured on the basis of the CT image. The respective increase in left kidney 0.93 cm and right kidney 2.77 cm calculated on the basis of CT image actually measured values. GFR was calculated as the average depth of the subject calculated by the method Tonnesen $83.3{\pm}9.79mL/min$. $98.6{\pm}14.07mL/min$ GFR was applied to calculate the average depth of the subjects using the CT image, is the difference appears 15.26 mL/min was increased after seting up depth value, P value was less than 0.01 which is significant. Conclusion The difference between GFR before-after setting up depth value cause that the different of depth value. Is a measured depth of the extension value of the calculated estimates Whereas Tonnesen kidney depth method is to use in calculating the value of GFR in a typical dynamic elongation test depth derived using the CT image depth. Is thought to be able to calculate more accurately the GFR value by the distance to the center of kidney more accurately measured in the skin thereby.

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Suitability of Measuring a Kidney Depth with Assessment of Glomerular Filtration Rateusing 99mTc-DTPA in the Ectopic Kidney and Pediatric Patients (99mTc-DTPA를 이용한 사구체여과율 검사에서 이소성 신장과 소아 환자의 신장 깊이 측정방법의 적절성)

  • Choi, Jae Min;Lee, Young Hee;Shim, Dong Oh
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.62-67
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    • 2014
  • A glomerular filtration rate (GFR) study is a test that uses radioactive materials or tracers (radiopharmaceuticals) and a computer to see how well the kidneys are working. Asan Medical Center analyzed and compared data between kidney depth, acquired from kidney donors' CT image and acquired from Gates method's GFR value that are calculated by Tonnesen equation. This study was able to confirm that kidney depth measured from CT image was higher than the Gates Method's GFR value, which was calculated by Tonnessen equation; the direct relationship among pathologic results is confirmed. Particularly, kidney donor whose kidney was at the pelvic area had direct relationship with other clinical results. During the GFR test, it is necessary to confirm the location of kidney has no change with reference of CT image. If kidney depth is manually corrected using CT image when we measures GFR of deformed or horse-shoe kidney, it would be possible to acquire the compatible value which is equivalent to clinical result. There would be a possible issue of appropriateness that whether the applied GFR using CT image's kidney depth has clinical validity. In case of a pediatric patient, the GFR derived from Tonnesen was quiet underestimated while manual method and Gordon stay in normal range. Which results may be correct among them? There have been many reports about kidney depth, to be an accurate index of GFR in children. As one of the study performers, we should contemplate what the best option for pediatric patients would be.

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Oxidative Stress-dependent Structural and Functional Regulation of 2-cysteine Peroxiredoxins In Eukaryotes Including Plant Cells (산화 스트레스에 의존한 식물 및 진핵세포 2-시스테인 퍼록시레독신의 기능 조절)

  • Jang, Ho-Hee;Kim, Sun-Young;Lee, Sang-Yeol
    • Journal of Plant Biotechnology
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    • v.33 no.1
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    • pp.1-9
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    • 2006
  • Peroxiredoxins (Prxs) are ubiquitously distributed and play important functions in diverse cellular signaling systems. The proteins are largely classified into three groups, such as typical 2-Cys Prx, atypical 2-Cys Prx, and 1-Cys Prx, that are distinguished by their catalytic mechanisms and number of Cys residues. From the three classes of Prxs, the typical 2-Cys Prx containing the two-conserved Cys residues at its N-terminus and C-terminus catalyzes $H_2O_2$ with the use of thioredoxin (Trx) as an electron donor. During the catalytic cycle, the N-terminal Cys residue undergoes a peroxide-dependent oxidation to sulfenic acid, which can be further oxidized to sulfinic acid at the presence of high concentrations of $H_2O_2$ and a Trx system containing Trx, Trx reductase, and NADPH. The sulfinic acid form of 2-Cys Prx is reduced by the action of sulfiredoxin which requires ATP as an energy source. Under the strong oxidative or heat shock stress conditions, 2-Cys Prx in eukaryotes rapidly switches its protein structure from low-molecular-weight species to high-molecular-weight protein structures. In accordance with its structural changes, the protein concomitantly triggers functional switching from a peroxidase to a molecular chaperone, which can protect its substrate denaturation from external stress. In addition to its N-terminal active site, the C-terminal domain including 'YF-motif' of 2-Cys Prx plays a critical role in the structural changes. Therefore, the C-terminal truncated 2-Cys Prxs are not able to regulate their protein structures and highly resistant to $H_2O_2$-dependent hyperoxidation, suggesting that the reaction is guided by the peroxidatic Cys residue. Based on the results, it may be concluded that the peroxidatic Cys of 2-Cys Prx acts as an '$H_2O_2$-sensor' in the cells. The oxidative stress-dependent regulation of 2-Cys Prx provides a means of defense systems in cells to adapt stress conditions by activating intracellular defense signaling pathways. Particularly, 2-Cys Prxs in plants are localized in chloroplasts with a dynamic protein structure. The protein undergoes conformational changes again oxidative stress. Depending on a redox-potential of the chloroplasts, the plant 2-Cys Prx forms super-molecular weight protein structures, which attach to the thylakoid membranes in a reversible manner.

Rhizosphere Enhances Removal of Organic Matter and Nitrogen from River Water in Floodplain Filtration (홍수터 여과를 이용한 하천수의 질소와 유기물 제거에 미치는 근권의 효과)

  • Jeong, Byeong-Ryong;Chung, Jong-Bae;Kim, Seung-Hyun;Lee, Young-Deuk;Cho, Hyun-Jong;Baek, Nam-Joo
    • Korean Journal of Soil Science and Fertilizer
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    • v.36 no.1
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    • pp.8-15
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    • 2003
  • If contaminated river water is sprayed over a floodplain, the microbial processes can simultaneously remove organic matter and nitrogen during the infiltration through the sediment profile. The effect of rhizosphere on the removal of organic matter and nitrogen from contaminated river water was investigated using floodplain lysimeters. River water was sprayed at a rate of $68.0L\;m^{-2}\;d^{-1}$ on the top of the lysimeters with or without weed vegetation on the surface, Concentrations of $NO_3$, $NH_4$ and dissolved oxygen (DO), and chemical oxygen demand (COD) and Eh in water were measured as functions of depth for 4 weeks after the system reached a steady state water flow and biological reactions. A significant reductive-condition for denitrification developed in the 30-cm surface profile of lysimeters with weeds. At a depth of 30 cm, COD and $NO_3$-N concentration decreased to 5.2 and $0.9mg\;L^{-1}$ from the respective influent concentrations of 18.2 and $9.8mg\;L^{-1}$. The removal of $NO_3$ in lysimeters with weeds was significantly higher than in those without weeds. Vegetation on the top was assumed to remove $NO_3$ directly by absorption and to create more favorable conditions for denitrification by supply of organic matter and rapid $O_2$ consumption, In the lysimeters without weeds, further removal of $NO_3$ was limited by the lack of an electron donor, i.e. organic matter. These results suggest that the filtration through native floodplains, which include rhizospheres of vegetation on the surface, can be effective for the treatment of contaminated river water.

Successful 20 hours Canine Allograft Preservation with new Solution Containing Triiodothyronine - Development of new lung preservation solution II - (삼요드티로닌을 포함한 폐보존액을 이용한 20시간 폐보존 - 새로운 폐 보존액의 개발 II -)

  • 성숙환;김영태;김주현
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.413-421
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    • 1999
  • Background: Ischemia reperfusion injury is known to contribute to the major causes of the early graft failure in lung transplantation. Triiodothyronine (T3) has been suggested to ameliorate ischemia reperfusion injury from both in vivo and in vitro experiments of various organs. Prospecting its beneficial effect for pulmonary allograft preservation, we made a new solution by adding T3 into the extracellular type dextran solution. Material and Method: Twelve adult mongrel dogs underwent left lung allotransplantation. Six donor dogs were flushed with the new solution(Group 1, n=6), and the remaining six were flushed with Euro-Collins solution to serve as controls(Group 2, n=6). Allografts were stored in each preservation solution for 20 hours at 4$^{\circ}C$. Left single lung transplantations were performed. The right pulmonary artery and the right main bronchus were clamped at 15 minutes after the reperfusion and maintained throughout the experiment to evaluate the transplanted left lung function. Result: Arterial carbon dioxide tension was better in group 1 than in group 2 throughout the experiment period and the difference was statistically significant at 2 hours after reperfusion(28.0${\pm}$3.0 mmHg and 53.1${\pm}$17.4 mmHg, p<0.05). The differences of arterial oxygen partial pressure, peak airway pressure and pulmonary vascular resistance showed no statistical significance. The malondialdehyde(MDA) level, measured from tissue obtained at 120 minutes after reperfusion showed no statistically significant difference. The tissue wet/dry ratio of group 1(649${\pm}$27 %) was significantly lower than that of group 2(686${\pm}$71 %, p<0.05). The microscopic examination revealed varying degrees of injury represented mainly by findings such as perivascular neutrophil infiltration, capillary hemorrhage and interstitial congestion. These findings were less severe in group 1 than those in group 2. Conclusion: The new solution demonstrated superior allograft preservation after 20 hour ischemia compared to Euro-Collins solution in canine single left lung transplantation model, these results suggest that T3 might be a promising agent for pulmonary allograft preservation.

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Superovulation Response and Quality of Embryos Recovered from Cattle after a Single Subcutaneous Injection of FSH Dissolved in Polyethylene Glycol (PEG 융해 FSH 투여방법에 따른 소 과배란 유기 및 수정란이식 효율)

  • 최상용;최수호;박용수;조상래;강태영
    • Journal of Embryo Transfer
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    • v.17 no.1
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    • pp.67-77
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    • 2002
  • This study was carried out to assess the effect of superovulation response and quality of embryos recovered from donor cows after a single subcutaneous injection of FSH dissolved in polyethylene glycol (PEG). Cows were allocated into control and 3 experimental treatment groups. In control, cows were injected intramuscularly 50 mg FSH twice daily for 4 days. Group 1 were injected subcutaneously with a single dose of 400 mg FSH dissolved in 30% PEG solution. Group 2 were injected subcutaneously with a single dose of 200 mg FSH dissolved in 30% PEG solution. Finally in group 3, cows were injected twice 200 mg FSH dissolved in 30% PEG solution by subcutaneous. Superovulation was initiated by injection of FSH between Day 8 and 14 of the estrus cycle (Day 0, the day of estrus), and followed by injection of 25 mg PGF$_2$$\alpha$ at 48 h after first FSH injection. Cows were then artificially inseminated (AI) with semen twice at 48 and 60 h after PGF$_2$$\alpha$ injection. At 7 days after the second AI, embryos collected non-surgically by flushing the uterine horns and were counted and compared morphologically as being transferable and degenerated among different superovulation treatments. Furthermore, progesterone and estradiol -17 $\beta$ in plasma were measured by radioimmunoassay following different treatments at given days All cows of treated groups were observed heat. but control group was showed 77.8%. Superovulation response was observed as 77.8, 87.5, 88.9, and 100% in control, Groups 1, 2 and 3 The mean number of corpus lutea (CL) detected in Group 1 were 19.6, which was, respectively significantly (P<0.05) higher than those of other groups (11.1, 13.4 and 7.6, respectively). However, there did not differ on the mean number of total embryos recovered and of transferable embryos between control and treated groups.

DEVELOPMENT OF BIOCOMPATIBLE DRESSING MATERIAL MADE OF COLLAGEN AND AMNIOTIC MEMBRANE AND WOUND HEALING EXPERIMENT IN RAT (양막과 콜라겐을 이용한 생체 적합 드레싱 소재 개발 및 백서 창상치유 실험)

  • Ahn, Kang-Min;Lee, Ji-Ho;Lee, Ui-Lyong;Lee, Jong-Ho;Lee, Jong-Won;Kim, Sung-Po;Yang, Eun-Kyung;Kim, Ki-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.189-199
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    • 2006
  • Purpose of study: Partial thickness skin graft is the golden standard regimen for full-thickness skin defect caused by burn or trauma. However, in case of extensive burns of more than 50% of total body surface area, the donor site is not sufficient to cover all defects. As a second choice, allograft, xenograft and synthetic materials have been used to treat skin defect. Among them the amniotic membrane(AM) was used as a biological dressing for centuries because of its potential for wound healing. In this study, quantification of EGF in AM and effect of AM-collagen complex on full thickness skin defects was examined. Materials & Methods: The concentration of EGF in fresh, deep frozen and freeze-dried AM was evaluated by ELISA. EGF-R immunostaining was performed in freeze-dried AM. SD rats weighing 250${\sim}$300g was used for wound healing experiment. Three full thickness skin defects(28mm diameter) were made on dorsal surface of SD rat. The control group was covered by Vaselin gauze and AM-collagen complex and $Terudermis^{(R)}$. was grafted in two other defects. Healing area, Cinamon's score were evaluated before biopsy. Grafted sites were retrieved at 3 days, 1 week, 2 weeks and 4 weeks after operation. H & E and Factor VIII immunohistochemical stain was performed to evaluate the microscopic adhesion and structural integrity and microvessel formation. Results: 1. EGF concentration of fresh, deep frozen and freeze-dried AM showed similar level and EGF-R was stained in epithelial layer of freeze-dried AM. 2. At 4 weeks after grafting, the healing area of AM-collagen and Terudermis group was 99.29${\pm}$0.71% and 99.19${\pm}$0.77 of original size. However, that of control group was 24.88${\pm}$2.90. 3. The Cinamon's score of AM-Collagen and $Terudermis^{(R)}$. group at 4 weeks was 15.6${\pm}$1.26 and 14.6${\pm}$3.13 and that of control group was 3.7${\pm}$0.95. Significant difference was observed among control and experimental groups(p<0.05). 4. Histologic examination revealed that AM protected leukocyte infiltration and epithelial migration was nearly completed at 4 weeks. $Terudermis^{(R)}$. group showed mild neutrophil infiltration until 2 weeks and completion of epithelization at 4 weeks. Control group showed massive leukocyte infiltration until 4 weeks. 5. Microvessels were increased sharply at 1 week and control group at 1 and 4 week showed significant differences with $Terudermis^{(R)}$. group of same interval(p<0.05) but no differences were found with AM group(p<0.05). Conclusion: EGF and EGF-R were well preserved in freeze-dried AM. AM attached to collagen acted as excellent biologic dressing which had similar effect with $Terudermis^{(R)}$. AM showed anti-inflammatory action and healing was completed at 4 weeks after full-thickness skin defect.

EVALUATION OF OSTEOGENIC ACTIVITY AND MINERALIZATION OF CULTURED HUMAN PERIOSTEAL-DERIVED CELLS (배양된 인간 골막기원세포의 조골활성 및 골기질 형성의 평가)

  • Park, Bong-Wook;Byun, June-Ho;Lee, Sung-Gyoon;Hah, Young-Sool;Kim, Deok-Ryong;Cho, Yeong-Cheol;Sung, Iel-Yong;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.511-519
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    • 2006
  • Autogenous bone grafts have been considered the gold standard for maxillofacial bony defects. However, this procedure could entail a complicated surgical procedure as well as potential donor site morbidity. Possibly the best solution for bone-defect regeneration is a tissue engineering approach, i.e. the use of a combination of a suitable scaffold with osteogenic cells. A major source of osteogenic cells is the bone marrow. Bone marrow-derived mesenchymal stem cells are multipotent and have the ability to differentiate into osteoblastic, chondrocytic, and adipocytic lineage cells. However, the isolation of cells from bone marrow has someproblems when used in clinical setting. Bone marrow aspiration is sometimes potentially more invasive and painful procedure and carries of a risk of morbidity and infection. A minimally invasive, easily accessible alternative would be cells derived from periosteum. The periosteum also contains multipotent cells that have the potential to differentiate into osteoblasts and chondrocytes. In the present study, we evaluated the osteogenic activity and mineralization of cultured human periosteal-derived cells. Periosteal explants were harvested from mandibule during surgical extraction of lower impacted third molar. The periosteal cells were cultured in the osteogenic inductive medium consisting of DMEM supplemented with 10% fetal calf serum, 50g/ml L-ascorbic acid 2-phosphate, 10 nmol dexamethasone and 10 mM -glycerophosphate for 42 days. Periosteal-derived cells showed positive alkaline phosphatase (ALP) staining during 42 days of culture period. The formation of ALP stain showed its maximal manifestation at day 14 of culture period, then decreased in intensity during the culture period. ALP mRNA expression increased up to day 14 with a decrease thereafter. Osteocalcin mRNA expression appeared at day 7 in culture, after that its expression continuously increased in a time-dependent manner up to the entire duration of culture. Von Kossa-positive mineralization nodules were first present at day 14 in culture followed by an increased number of positive nodules during the entire duration of the culture period. In conclusion, our study showed that cultured human periosteal-derived cells differentiated into active osteoblastic cells that were involved in synthesis of bone matrix and the subsequent mineralization of the matrix. As the periosteal-derived cells, easily harvested from intraoral procedure such as surgical extraction of impacted third molar, has the excellent potential of osteogenic capacity, tissue-engineered bone using periosteal-derived cells could be the best choice in reconstruction of maxillofacial bony defects.

Percutaneous Autologous Marrow and Heterograft Bone Grafting in a Treatment for Simple Bone Cyst (경피적 자가 골수 및 이종골 이식을 이용한 고립성 골낭종의 치료)

  • Lee, Keun-Bae;Rowe, Sung-Man;Yoon, Taek-Rim;Son, Il-Jin;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.24-30
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    • 2003
  • Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

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