• Childhood Kidney Diseases
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• v.10 no.2
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• pp.174-181
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• 2006

Purpose : To analyse the results of the renal biopsies and the clinical diagnoses of patients who had undergone percutaneous kidney biopsies in the department of pediatrics at Kyunghee University Hospital for 22 years from 1984 to 2005. Methods : We retrospectively reviewed the medical records of 1559 patients and analyzed the chief complaints that led to a renal biopsy, age, sex, histopathologic findings and diagnosis. Routine kidney biopsies were performed by automated gun biopsy guided by real time ultrasonography. The diagnoses were made based on the specimen's light microscopy, immunofluorescence microscopy and electron microscopy findings and clinical symptoms and signs. Results : The mean age of the patients was 10 years with the male to female ratio being 1.3:1. The chief complaints that led to a renal biopsy included hematuria only(753 cases, 48.3%), proteinuria only(125 cases, 8.0%) and hematuria combined with proteinuria(537 cases, 34.4%). The most frequent histopathological finding was primary glomerular disease(75.4%) which included IgA nephropathy(30.1%) and mesangial proliferative glomerulonephritis(27.6 %). Systemic disease comprised 11.4% which included Henoch-$Sch\ddot{o}nlein$ nephritis(10.5%) and lupus nephritis(0.8%). Alport syndrome was found in 1.1% of cases which was attributed to hereditary causes. 628 children(40.3%) visited the clinic due to abnormal school urine screening abnormalities and among these, 237 children had mesangial proliferative glomerulonephritis and 234 children who had IgA nephropathy were managed thereafter. Conclusion : IgA nephropathy and mesangial proliferative glomerulonephritis were the two major forms of primary glomerulonephritis found in Korean children who had kidney biopsies from 1984 to 2005.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• Journal of Haehwa Medicine
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• v.13 no.1
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• pp.107-128
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• 2004

This thesis is focused to get treatment on climacteric syndrome through literary study. The results are followed as below. 1. The climacteric syndrome is beginning with lowering of secretion of female hormone. It's not understood as abnormal disease but as normal phenomenon. 2. The causes of climacteric syndrome are defined as deficiency of the Kidney, stagnation of Liver, disharmony between Heart and Kidney, insufficiency of both the Heart and the Spleen, blood stagnation. 3. The causes of climacteric bleeding are continuous with overstrain, injury of the five emotions, blood heat, deteriorating blood. 4. The treatment of climacteric syndrome are mainly nutrition of Kidney and Liver, that of Kidney heat, descending Yang of Liver, nutrition of blood of heart, having a comunication with Kidney and Heart, nutrition of Spleen and Stomarch. 5. For the prescriptions on climacteric syndrome, the treatments such as Jaguium(左歸飮), Wooguium(右歸飮), Soyosan(逍遙散加減), Jibakjihwangtang(知柏地黃湯加減), Esuntang(二仙湯), Ejihwan(二至丸加味), Sihogayonggolmoryutang(柴胡加龍骨牡蠣湯加減) are used. And the acupuncture points such as Conception Channel, the Spleen Channel, the Urinary Bladder Channel, the Kidney Channel which are related to the lower belly of woman.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.822-834
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• 2007

This study searched the philosophical and medical thought of mutual understanding and human body. Mutual understanding is a fundamental problem in all branches of oriental studies. In other words, mutual understanding becomes the existential foundation of heaven-earth-human(三才). So human beings, heaven and the earth can't exist if there is no mutual understanding. It comes out the problem of self-consciousness in philosophy, and qi movement pattern like upward, downward, inward and outward movement in traditional korean medicine. Human beings have mutual understandings with heaven and the earth from a macroscopic standpoint, on the other side the human body from a microscopic standpoint. Qi movement is the mutual understanding and response of qi in human body, so with which the physiological functions and pathologic changes of viscera and bowels comes out. Therefore we want to present how to complete qi movement between viscera-bowels and organs to examine mutual understandings in human body closely. The results was summarized as follows; First, upbearing the clear yang and down bearing the turbid yin of spleen-stomach is main pivot of upward and downward of qi movement, and it is true form of mutual understandings between viscera and bowels, so upward, downward, inward and outward movement of whole viscera and bowels can be controlled by spleen-stomach. Second, by restraining relationships between downward heart fire and upward kidney water, heart fire and kidney water have close communications physiologically and pathologically as upper-lower, yin-yang and water-fire. Third, by restraining relationships between upbearing and effusion of liver and purification and down-sending of lung, liver and lung are outer circles of upward and downward movement, so they have antagonistic functions. Firth, by the relationships between upbearing the clear and down bearing the turbid of spleen-stomach and free coursing of liver, free coursing of liver-gallbladder is the essential requirement that it certify transportation and transformation of spleen-earth, so the disease of liver-gallbladder induce spleen-stomach disease pattern to affect its function of transportation and transformation. Fifth, by spleen and kidney, spleen yang is based on kidney yang, so the weakness of kidney yang can affect the function of transportation and transformation of spleen-stomach as it can't warm spleen earth. Sixth, by homogeny of liver-kidney, essence and blood of liver-kidney and ministerial fire of liver-kidney have mutal generation and limitation physiologically and they mutually are affected in pathologically.

• The Journal of the Korea Contents Association
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• v.14 no.7
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• pp.367-375
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• 2014

This study aimed to develop a valid and reliable self-management instrument for pre-dialysis patients with chronic kidney disease (CKD). A total of 143 patients with CKD recruited from a medical center completed the questionnaire. The dimension and items of self-management were composed by literature review. The items of self-management was evaluated using exploratory factor analysis and measures of reliability. Five factors were extracted and labelled adherence to treatment regimen and partnership, diet adherence, problem solving, health behavior, and pursuit of psycho-social health. The five factors accounted for 51.1% of total variance. Each factors showed acceptable internal reliability with Cronbach's alpha from 0.64-0.79. The developed self-management instrument can be useful in self control of their disease for patients with CKD, and both evaluating patients' self-management and developing intervention program for health care professionals.

• Journal of Haehwa Medicine
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• v.20 no.1
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• pp.11-23
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• 2011

Systemic Lupus Erythematosus(SLE) is an autoimmune disease invading the skin, joint, kidney, intestinal membrane, neurosystem and other organs. SLE is an autoimmune disease characterized by immune dysregulation resulting in the production of antinuclear antibodies(ANA), generation of circulating immune complexes, and activation of the complement system. In Korean medicine, lupus can be classified as acute arthritis, reddish butterfly erythema, asthenic disease, edema and so on. The cause and procedure of the diseases are flourishing noxious heat, excessive fire due to deficiency of yin, blood stasis due to stagnation of qi, internal movement of the liver-wind, congenital deficiency, exhausted vital-qi, which are treated by clearing away heat and cooling the blood, nourshing yin and extinguishing fire, treating flatulence and activating blood circulation, nourishing the blood to expel wind, invigorating the liver and kidney, invigorating qi and replenishing the blood. To experimentally examine the influence of Insam-Buja-Tang (Ginseng & Aconiti Extract, IBT) on the outbreak and development of lupus, lupus induce MRL/MpJ-Faslpr lupus-prone mice model was used. As IBT was orally administrated to a lupus model mouse, various tests such as the weight, urine protein, renal function, Lymph cell test of the spleen, Cytokine expression, histopathological analysis of kideny were performed to see the influence on the kidney and whether it work effectively on the immune function. The main purpose of this study is to evaluate the effect of IBT on MRL/MpJ-Faslpr lupus-prone mice model. The effect of IBT on MRL/MpJ-Faslpr lupus-prone mice that can have autoimmune disease similar to SLE in human was evaluated after IBT per oral in the present study.

• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.248-256
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• 2018

Objectives: Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population. Methods: A total of 9695 participants aged ${\geq}40years$ were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied. The participants, of whom 2133 were men and 3444 were women, were grouped into 5 categories according to their quintile of SUA levels. An estimated glomerular filtration rate of < $60mL/min/1.73m^2$ at the time of follow-up was considered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounders were assessed using Cox proportional hazard models. Results: Among the 5577 participants, 9.4 and 11.0% of men and women developed CKD. The hazard ratio (HR) of CKD was higher in the highest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.60; 95% confidence interval [CI], 1.02 to 2.51) and women (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.83; 95% CI, 1.15 to 2.90). The effect of SUA was consistent in younger, obese, and hypertensive men. Conclusions: Both high and low SUA levels were risk factors for CKD development in rural Korean men, while only high levels were a risk factor in their women counterparts.

• Journal of Korean Neurosurgical Society
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• v.54 no.4
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• pp.296-301
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• 2013

Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.157-160
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• 2018

Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.189-196
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• 2003

Purpose : Ureteral duplication is a common urologic anomaly and early diagnosis may prevent irreversible renal damage. We thus aimed to evaluate the benefits of prenatal sonography in early detection. Methods : We retrospectively studied 55 children with duplicated systems who were admitted to Severance Hospital, Yonsei University, Seoul, Korea from January 1998 to July 2003. Results : The mean age at diagnosis was 2.3 years old. 89% of the children had complete duplicated ureter. 47% of the children visited the hospital with an initial complaint of abnormal prenatal sonographic findings. Among these patients, 70.8% had DMSA defects. The mean differential renal function(DRF) in the DMSA scan was 48.2% in the group diagnosed prenatally. In the postnatally-diagnosed group, DMSA defects were found in 67.7% patients and the mean DRF was 45.5%. Conclusion : In comparison with the past studies, the mean age at diagnosis is becoming younger, and the proportion of abnormal prenatal sonography as an initial complaint larger. Other clinical manifestations were similar. The difference of the renal damage between the prenatally diagnosed group and the postnatally diagnosed group was not statistically significant. A multi-center study may help to prove the importance of prenatal sonography in early diagnosis and treatment of ureteral duplication. (J Korean Soc Pediatr Nephrol 2003;7:189-196)