• Title/Summary/Keyword: GFR

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Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality

  • Cho, Won-Chul;Yoo, Dong-Gon;Kim, Joon-Bum;Lee, Jae-Won;Choo, Suk-Jung;Jung, Sung-Ho;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.131-136
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    • 2011
  • Background: We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods: Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was $59.8{\pm}3.3$ months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results: There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion: The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.

Regulation of Mitogen Activated Protein Kinase Activity by Solubilized Matrigel in the Preimplantation Mouse Embryos (생쥐 착상 전 배아에서 용해된 Matrigel에 의한 Mitogen Activated Protein Kinase 활성의 조절)

  • 강병문;정병목;계명찬
    • Development and Reproduction
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    • v.6 no.1
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    • pp.1-6
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    • 2002
  • To elucidate the mechanism underlying the embryotropic effect of extracellular matrix(ECM) on the preimplantation development of mammalian embryos, the involvement of mitogen-activated protein kinase(MAPK) downstream the integrin signaling was examined in mouse blastocysts. Blastocysts were cultured in the presence of growth factor-reduced(GFR) Matrigel(0.5%, v/v). MAPK activity was measured by in vitro phosphorylation of myelin basic protein by the Erk1/2 antibody immunoprecipitates of embryonic extract following the Matrigei treatment. MAPK activity of the early blastocysts rapidly increased within 10 min fo1lowing the Matrigel treatment. When the embryos were cultured for 12 h in the presence of Matrigel, the MAPK activity was significantly higher than that ot the control embryos. PD098059, a MAPK kinase(MEK) inhibitor, attenuated the effect of Matrigel on the change in MAPK activity. Taken together, it suggested that the embryotropic effect of ECM proteins might be mediated by the activation of MAPK cascade.

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Beneficial Effect of Glycyrrhizae Radix Extract on Ischemia-Induced Acute Renal Failure in Rabbits (토끼의 허혈성 신부전 대한 감초(甘草) 추출물의 억제 효과)

  • Kim, Gyung-Ho;Kim, Min-Ho;Yun, Yeo-Chung;Kim, Young-Gyun;Cho, Su-In
    • The Korea Journal of Herbology
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    • v.20 no.3
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    • pp.43-49
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    • 2005
  • Objectives : The present study was carried out to determine if Glycyrrhizae Radix extract exerts beneficial effect against the ischemia-induced acute renal failure in rabbits. Glycyrrhizae Radix 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. Methods : Antioxidative effect of 3% concentration of Glycyrrhizae Radix extract was measured. Rabbits were treated with Glycyrrhizae Radix extract via i.v., followed by renal ischemia/reperfusion, and the changes of urine volume, serum creatinine levels, glomerular filtration rate(GFR), fractional Na+ excretion$(FE\;Na^+)\;and\;K^+\;excretion(FE\;K^+)$ in ischemia/reperfusion induced acute renal failure were measured. Results : Renal ischemia/reperfusion caused increase of serum creatinine level, which was accompanied by a reduction in glomerular filtration rate(GFR). The fractional excretion of $Na^+\;and\;K^+$ increased in ischemia-induced animals, which was partially prevented by Glycyrrhizae Radix extract treatment. Conclusions : These results indicate that lipid peroxidation plays a critical role in ischemia-induced acute renal failure. Glycyrrhizae Radix extract exerts the protective effect against acute renal failure induced by renal ischemia/reperfusion, and its effect may be attributed to an antioxidant action.

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A Study on Development of the Korea Agricultural Population Forecasting Model and long-term Prediction (농가인구예측 모형 개발 및 중장기 전망)

  • Han, Suk-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.3797-3806
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    • 2015
  • A population decline in rural area is correlated with the number of household, with agricultural workers, as a result, affects the farming income. Agricultural population is a foundation of agriculture structure. Agricultural population decline influences agricultural policies to be implemented for the future and there is concern about slowdown in productivity. The purpose of this study is to build the ability to use the model and conduct applied analyses of various kinds and to make rational agricultural policies by forecasting and analyzing agricultural population change. Unlike previous studies, which have some assumptions about the giving-up farming rate (GFR) of the key points on the agricultural population model or, After estimating only one equation with respect to the total population, and then distribute by sex and age. This study was conducted to investigate the reactions are different from the farmhouse, gender, age by estimating giving-up farming rate (GFR) equations each gender & age. Through this research, we can find that Farm Population changes of the simulation can be performed for a variety of agricultural policy in conjunction with existing agricultural simulation models as well.

Relationship of Prostate-Specific Antigen Level With Obesity Indices in Korean Middle-Aged Population

  • Min, Seung Ki;Choi, Kwibok;Kim, Byoung Hoon;Cho, In-Chang
    • The Korean Journal of Urological Oncology
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    • v.16 no.3
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    • pp.103-109
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    • 2018
  • Purpose: We evaluated the relationship of prostate-specific antigen (PSA) and obesity indices (weight, body mass index [BMI] and waist circumference [WC]) in Korean middle-aged men. Materials and Methods: From February to September 2013, 1,900 police men under 60 years old who participated in a prostate health screening program were included this cross-sectional study. All subjects underwent clinical examinations including weight, height, BMI, WC, fasting blood sugar, lipid profiles, estimated glomerular filtration rate (GFR), and PSA. Total prostate volume (TPV) was assessed clinically. Spearman correlation and multiple linear regression tests were performed to evaluate the obesity indices and PSA relationships. Results: The mean age was $52.0{\pm}4.7years$, and the mean PSA was $0.97{\pm}0.99ng/mL$. The PSA showed a significant positive correlation with the age (r=0.108, p<0.01), TPV (r=0.349, p<0.01), height (r=-0.052, p<0.05), weight (r=0.186, p<0.05), low-density lipoprotein cholesterol (r=0.056, p<0.05), and GFR (r=-0.096, p<0.01). All obesity indices including weight, BMI, and WC showed negative correlations with PSA (beta=-0.013, p<0.001; beta=-0.039, p<0.001; and beta=-0.010, p=0.005; respectively) in age and TPV-adjusted model. Conclusions: Common obesity indices (weight, BMI, and WC) were associated with lower PSA in Korean middle-aged population. Thus, an individual's degree of obesity should be considered when PSA is checked in the first prostate cancer screening of life.

Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction

  • Yoon, Ji Hyung;Park, Sejun;Park, Sungchan;Moon, Kyung Hyun;Cheon, Sang Hyeon;Kwon, Taekmin
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.376-382
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    • 2018
  • Purpose: The authors performed this study to investigate the risk factors for predicting stent failure and to evaluate its impact on prognosis. Materials and Methods: Between January 2002 and March 2017, we retrospectively reviewed 117 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The patients were classified according to their pre-stenting chronic kidney disease (CKD) stage. The factors affecting stent failure were analyzed using a logistic regression model. Overall survival (OS) was estimated, and the prognostic significance of each variable was estimated using Cox proportional-hazards regression modeling. Results: Before stenting, 91 patients were CKD stages 1-3 and 26 patients were CKD stages 4-5. These two groups differed significantly only in pre-stenting estimated glomerular filtration rate (eGFR), bilateral obstruction, and pre-stenting pyuria. Among the 117 patients, stent failure occurred in 30 patients (25.6%), and there were no differences between the groups. Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 79 deaths in total, including 56 in the CKD stages 1-3 group and 23 in the CKD stages 4-5 group. In the multivariate analysis predicting patient OS, pre-stenting eGFR and post-stenting disease progression were significant factors. Conclusions: Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.

A Study of Predicting the Severity Following Glufosinate Ammonium Containing Herbicide Poisoning Experienced in Single Emergency Medical Institution (단일 응급의료기관에서 경험한 글루포시네이트 암모니움 포함 제초제 중독 후 중증도 예측에 관한 연구)

  • Lee, Doo Sung;Choi, Kyoung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.7-13
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    • 2019
  • Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

Importance of Target Blood Pressure Management in Diabetic Kidney Disease (당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성)

  • Kim, Hee Sung
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.461-470
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    • 2019
  • In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.

Acute Kidney Injury after Dose-Titration of Liraglutide in an Obese Patient (비만 환자에서 리라글루티드 증량 과정에서 발생한 급성 신손상)

  • Lee, Hee Jin;Park, Hye Soon
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.78-82
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    • 2022
  • Liraglutide (SaxendaR) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m2, and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m2. This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.

Association between hyperuricemia and metabolic syndrome (고요산혈증과 대사증후군과의 연관성)

  • Park, Yun-jin
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.5
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    • pp.674-682
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    • 2022
  • This study aims to examine the relationship between hyperuricemia and metabolic syndrome, which is a risk to health, and to analyze the effect of hyperuricemia on the body. The analysis data were downloaded and used for the 8th 2nd (2020) data of the National Health and Nutrition Survey, and in this study, 2,320 men and 2,893 women were finally analyzed. For the analysis of the data, Chi-square test and t-test were used for the difference values according to collected general characteristics and hyperuricemia, and the risk of eGFR rise was analyzed by regression analysis, and Pearson correlation was used to confirm the correlation with each variable. Through this study, it was found that hyperuricemia is significantly related to metabolic syndrome, and through this, preemptive management is needed to prevent metabolic syndrome from worsening into vascular diseases including kidney diseases. Therefore, it is proposed to develop a health program suitable for the patient's age through this study.