• 제목/요약/키워드: Kidney, US

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간 초음파영상에서 컴퓨터보조진단을 이용한 미만성 간질환의 영상분석 (Image Analysis of Diffuse Liver Disease using Computer-Adided Diagnosis in the Liver US Image)

  • 이진수;김창수
    • 한국방사선학회논문지
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    • 제9권4호
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    • pp.227-234
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    • 2015
  • 본 연구는 간 초음파영상에서 통계적 속성 기반의 밝기 히스토그램에 기초한 픽셀 질감분석 파라미터(평균밝기, 왜곡도, 균일도, 엔트로피)와 간과 콩팥실질의 밝기 차를 이용한 영상분석을 통해 미만성 간질환의 컴퓨터보조진단 적용 가능성을 알아보고자 하였다. 실험은 간 초음파영상(정상, 지방간, 간경화)에서 관심영역($50{\times}50$픽셀)을 설정하고 4가지의 픽셀 질감분석 파라미터와 간과 콩팥의 실질 밝기의 차를 이용하여 질환인식률을 평가하였다. 그 결과 평균밝기, 균일도, 엔트로피의 질환인식률은 100%, 왜곡도 96%로 높게 나타났으며, 간과 콩팥의 실질 밝기 차는 정상 $-1.129{\pm}12.410$, 지방간 $33.182{\pm}11.826$으로 뚜렷한 차이를 나타내었으나, 간경화의 경우 $-1.668{\pm}10.081$로 정상과는 다소 작은 차이를 나타내었다. 이러한 결과를 바탕으로 높은 질환인식률을 보인 픽셀 질감분석 파라미터와 실질 밝기 차를 이용한 컴퓨터보조진단은 미만성 간질환의 감별에 유용한 도구로써 임상적인 활용 가능성이 있으며, 판독 오류를 최소화하고 정확한 진단과 치료방향 제시에 도움이 될 것으로 기대된다.

정신기능소재로서의 뇌에 대한 한의학적 해석근거 연구 (A Study on Interpretative Basis of Brain as a Place of Mental Function in Oriental Medicine)

  • 김용훈;김인락;지규용
    • 동의생리병리학회지
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    • 제16권5호
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    • pp.881-887
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    • 2002
  • This treatise is written in order to solve the important contradiction between the two theories; in oriental medicine psychological function is responsible for heart, but in western one it is responsible for brain. So we take the methods of studying in the aspects of morphological characteristics(MC) and visceral manifestation theory(VMT, 藏象論) and others about two organs-heart and brain. Brain(頭腦) is preferred to understand as a structure which is manifesting mental activity of heart. So the brain can be named with external heart(外心) corresponding to the relation of kidney(外 and external kidney. Saying conversely, the nutritional foundation of the mental function is the blood of heart, but the enlightening and insightful features of mentality make it's own residence move to the organ in the uppermost and positive site, that is head. And the close relationships on mental functions between heart and brain were discussed in various aspects, like investigation on east and west etymological literature, or Jiu gong and Taoist theory as well as Me and VMT, These understandings can make us know about the pathology of brain by itself. It has deep relations with heart fire and heart blood and kidney essence, and gastrointestinal function and liver with lung additionally. In another point, it makes the highly complicated psychological functions to be explained free from body relatively, and so can do a role in the complement of the strict 5 viscera theory.

Evaluation and Management of Antenatal Hydronephrosis

  • Hong, Young Kwon;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • 제19권1호
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    • pp.8-13
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    • 2015
  • Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

2세 미만 소아의 첫 발열성 요로 감염에서 연령군에 따른 발병양상 및 영상의학적 검사 결과의 비교 (Comparison of the Clinical and Radiologic Characteristics between Different Age Groups with First Febrile UTI Under 2 Years of Age)

  • 고희정;김태형;조혁;김지홍
    • Childhood Kidney Diseases
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    • 제11권2호
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    • pp.229-238
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    • 2007
  • 목 적 : 2세 미만의 요로감염 환아는 방광요관 역류의 빈도와 역류성 신염의 유병률이 높아 VCUG를 시행하여 신요로계의 기형여부를 조사하는 것을 권장하고 있으나 검사의 부작용 및 합병증으로 모든 환자에서 시행하기에 어려움이 있다. 이에 2세미만의 요로감염 환아를 6개월을 기준으로 구분하여 임상양상과, 급성 신실질 손상의 빈도, 방광요관역류 유병률을 조사하여 연령군별 특성을 파악하고, 방광요관역류의 동반 가능성을 예측할 수 있는 임상적, 영상의학적 지표를 찾고자 하였다. 방 법 : 첫 발열성 요로감염으로 진단된 211명의 환아를 연령에 따라 1개월 이상 6개월 미만의 영아군과 6개월 이상 2세 미만의 유아군으로 구별하여 발병 당시의 임상양상, 진단검사의학적 결과, 영상의학적 결과를 후향적으로 조사하였다. 결 과 :총 212명의 환아 중 영아군은 121명(57%), 유아군은 91명(43%)이었으며, 영아군에서 남아의 요로감염 빈도가 의미 있게 높았고 원인균주로 E.coli의 비율이 의미 있게 높았다. DMSA 신스캔상 급성 신실질 손상은 영아군에서 50%, 유아군에서는 33%로, 영아군에서 급성 신실질손상의 빈도가 의미 있게 높았다. 방광요관역류는 VCUG를 시행한 84명 중 24명(29%)에서 발견되었고, 첫 발열성 요로감염을 보였던 전체 대상 환아의 11%(211명 중 11명)에서 발견되었으며, 두 연령군 간의 의미 있는 빈도의 차이를 보이지 않았다. DMSA 신스캔상 신실질손상이 있었던 환아에서의 방광요관역류의 빈도는 40%로 손상이 없었던 환아의 빈도 15% 보다 의미 있게 높았으며, 특히 영아군에서 DMSA상 신실질 손상유무에 따른 방광요관역류 존재 가능성이 의미 있게 높았다. 경증의 방광요관역류 환자 중 55%, 중증의 방광요관역류 환아 중 100%에서 DMSA 신스캔상 신실질손상이 관찰되어, 중증의 방광요관역류에서 신실질손상 빈도가 의미 있게 높았다.

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급성신손상으로 인해 발생한 dabigatran 독성 (Dabigatran Toxicity Secondary to Acute Kidney Injury)

  • 문형호;이승은;오동준;조희범;권기환;김윤진;김경수;신성준
    • 대한임상독성학회지
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    • 제12권2호
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    • pp.92-96
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    • 2014
  • Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

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신세포암에서 $^{18}F-FDG-PET/CT$ ($^{18}F-FDG-PET/CT$ in Renal Cell Carcinoma)

  • 전태주
    • Nuclear Medicine and Molecular Imaging
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    • 제42권sup1호
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    • pp.126-129
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    • 2008
  • Renal cell carcinoma is the most common histological type of renal malignancy, predominant in men and the primary treatment modality of this tumor is surgery. The role of diagnostic imaging in the management of this tumor is the evaluation of extent of disease as well as the detection and characterization of renal mass. US has long been a routine screening tool for kidney but tomographic imaging modalities such as CT and MRI begin to be also commonly used these days. On the other hand, the sensitivity of $^{18}F-FDG-PET$ in detection of renal mass is relatively low because of inherent limitation caused by FDG excretion pathway despite avid uptake of FDG to tumor cell per se. Many studies revealed FDG PET scan could play an important role in detection of metastatic lesions although the sensitivity for the detection of primary lesion is not so high. Furthermore, development of PET/CT scanner will make it possible to expand the indication of FDG PET scan in this malignancy.

『의학입문(醫學入門)』 명문(命門) 형상(形狀)의 유래와 의의 (Origin and Meanings of Shape of Vital Gate(命門) in Yixuerunmen(醫學入門))

  • 조학준
    • 대한한의학원전학회지
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    • 제28권4호
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    • pp.79-97
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    • 2015
  • Objectives : To research origin of the shape of vital gate(命門) in Yixuerunmen makes us understand more exactly what the author, Li Chan(李梴) thought vital gate shaped. Methods : It's shape described in his book was compared with pictures portraying it in Hua Tuo Xuan Men Nei Zhao Tu(華陀玄門內照圖), one of references of his book. Results : He reasonably modified its passing track, while explaining it according to the paintings in Hua Tuo Xuan Men Nei Zhao Tu. Vital gate, as he thought, was not an real organ like the other five viscera, but a cord or a tube similar to blood vessels. He believed its cord had long connections from pericardium to terminal of urethra, which went through pericardium upward, right kidney downward, right around terminal rectum down-frontward, and urethra in parallel outward. Conclusions : He had consistent understandings for vital gate to penetrate several different viewpoints, as based on pictures in Hua Tuo Xuan Men Nei Zhao Tu.

Renal scar formation after urinary tract infection in children

  • Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • 제55권10호
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    • pp.367-370
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    • 2012
  • Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects reflux-associated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

소변 농축 기전과 요소운반체 (Urine Concentrating Mechanism and Urea Transporters)

  • 김동언
    • Childhood Kidney Diseases
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    • 제9권1호
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    • pp.1-7
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    • 2005
  • The production of concentrated urine is achieved by countercurrent multiplication in the renal medulla. The single effect of the outer medulla is the active NaCl reabsorption in the thick ascending limb, while the single effect of the inner medulla is the passive efflux of NaCl through the thin ascending limb. The passive mechanism in the inner medulla requires a high interstitial urea concentration which is maintained by intrarenal recycling of urea. During the past decade, many transport proteins involved in the urine concentrating mechanism have been cloned, which has enabled us to understand the countercurrent multiplication mechanism on a molecular basis. This review will summarize the locations and functions of the renal medullary transport proteins, and the recent insights that have been acquired into the long term regulation of urea transporters.

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The Trend in the Development of Oncolytic Virus Therapy

  • Kwon, Sun-Il
    • 대한의생명과학회지
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    • 제25권3호
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    • pp.201-210
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    • 2019
  • The oncolytic viruses selectively infect and destroy cancer cells, not harming normal cells. The cancer cell materials released by oncolysis, like tumor antigens, stimulate host antitumor immune responses, which is a long-lasting antitumor immunity removing cancer cells in remote parts of the body by a systemic response. Oncolytic viruses armed with transgenes such as cytokines or other immune stimulating factors enhance the immune responses. The first oncolytic virus approved by US-FDA is $Imlygic^{(R)}$ targeting for melanoma. The oncolytic virus is considered as a revolutionary immunotherapy for tumors together with immune checkpoint inhibitors. A variety of oncolytic viruses are under research in the treatment of kidney cancer, liver cancer, breast cancer, and many others solid tumors. Clinical trials have shown promising results in different types of cancers. Here, we present a brief introduction of various aspects of oncolytic virus, and a review of the current status of oncolytic virus therapy development.