• Investigative Magnetic Resonance Imaging
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• 제17권3호
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• pp.181-191
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• 2013

목적: 급성 신부전 쥐 모델에서 상자성 철 산화물 (superparamagnetic iron oxide(SPIO)로 표지한 인간탯줄혈관내피 세포를 자기공명영상으로 추적할 수 있는지 그 유용성을 평가하고자 하였다. 대상과 방법: 인간탯줄혈관내피 세포를 SPIO와 poly-L-lysine (PLL) 혼합물로 표지 하였다. SPIO 농도에 따라서 이완율, 세포 생존율, 표지 안정성을 SPIO 농도의 변화에 따라 평가하였다. 인간탯줄혈관내피 세포를 급성 신부전 쥐 모델에서 꼬리정맥을 통하여 주사하였다. MR을 이용한 추적 검사는 $T2^*$ 경사에코 MR 영상을 이용하였다. 1, 3, 5, 7일째 추적한 MR 영상 소견을 조직 소견과 서로 견주어 보았다. 결과: SPIO-PLL 혼합물을 표지 한 후 Prussian blue 염색에서 평균 $98.4{\pm}2.4%$ 세포가 양성반응을 보였다. 3일과 5일 후 측정한 이완율은 1일에 비해 큰 차이가 없었다. 인간탯줄혈관내피 세포를 SPIO로 표지 한 후 안정성이 유지됨을 알 수 있었다. 추적 MR 영상에서 급성신부전을 유도한 왼쪽 신장 외곽 신 수질에서 신호강도 소실을 보였으나 오른쪽은 정상이었다. 3, 5, 7일 후 촬영한 영상에서 왼쪽 신 수질에서 보인 신호강도 소실이 점차 사라졌으나 오른쪽 신장에서는 여전히 특별한 변화를 보이지 않았다. 조직학 검사에서도 MR 영상의 신호강도 소실이 Prussian blue 염색을 보인 부분과 일치하였다. 면역화학적 분석에서 신 수질에서 보인 세포들이 인간탯줄혈관내피 세포임을 확인하였다. 결론: MR 영상은 급성 신부전 치료의 한 방법인 세포 치료의 경우 세포 추적 검사에 유용하게 사용될 수 있음을 확인하였다.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.389-392
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• 2015

Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.249-256
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• 2006

Diarrhea-associated hemolytic uremic syndrome(D+ HUS) is induced by enterohemorrhagic Escherichia coli(EHEC) and is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. The disease is usually transmitted by meat and water contaminated by excreta of domestic animals. We report a son and his mother with diarrhea-associated hemolytic uremic syndrome that spread within the family.

• Clinical and Experimental Pediatrics
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• 제54권8호
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• pp.322-328
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• 2011

Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

• Childhood Kidney Diseases
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• 제6권2호
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• pp.251-258
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• 2002

저자들은 다장기 부전과 패혈증에 의한 ?상태의 급성 신부전 환아 세 명에서 펌프를 이용한 CVVH를 이용하여 효과적으로 한외여과액을 유지할 수 있었던 경험을 문헌 고찰과 함께 보고하는 바이다.

• 대한한의학회지
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• 제15권2호
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• pp.132-142
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• 1994

Paraquat has been widely used as a herbicide in Korea since 1970. Human ingestion results in transient impairment of liver and kidney function and a characteristically respiratory failure with a high mortality rate. Clinical investigation and Oriental Medical Treatment were done on 3 cases of paraquat poisoning admitted to the department of 1st Internal Medicine. Kyung San University Oriental Medical Hospital from August 1991 to December 1992. and following results were obtained. The symptoms of paraquat poisoning can be regarded as Sim hua chi song(心火熾盛), Kan hua sang yom(肝火上炎). um hu hua wang(陰虛火旺), Kan tam sup yol(肝膽濕熱), Yang myong yol tok(陽明熱毒) in Oriental Medicine. and the principle of treatment for paraquat poisoning can be applicable to Chong yol Ii sop(淸熱利濕), Chong yol hae tok(淸熱解毒). Sa ha hae tok(瀉下解毒). Ja um kang hua(滋陰降火) and so on. Three cases were treated by HuangYonHaeTokTang(黃蓮解毒湯) and KamDuTang(甘豆湯): all of them have survived without complications. According to the result above, it suggests that determination of treatment based on the differentiation of symptoms and signs(Pyon jung si chi ;辨證施治) of Oriental Medicine may prove to be helpful in saving lives of patients with paraquat poisoning.

• Childhood Kidney Diseases
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• 제25권2호
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• pp.112-116
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• 2021

Hyperammonemia is mainly caused by diseases related to liver failure. However, there are also non-hepatic causes of hyperammonemia, such as urinary tract infection (UTI) due to urease-producing organisms. Urease production by these bacteria induces a hydrolysis of urinary urea into ammonia that can cross the urothelial cell membrane and diffuse into blood vessels, leading to hyperammonemia. Delayed diagnosis and treatment of hyperammonemia can lead to lethal encephalopathy that can cause brain damage and life-threatening conditions. In the presence of obstructive uropathy, UTI by urease-producing bacteria can lead to more severe hyperammonemia due to enhanced resorption of ammonia into the systemic circulation. In this report, we present a case of acute severe hyperammonemic encephalopathy leading to brain death due to accumulation of ammonia in blood caused by Morganella morganii UTI in a 10-year-old girl with cloacal anomaly, causing obstructive uropathy even after multiple corrections.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.42-46
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• 2014

가와사끼병은 전신성 혈관염을 일으키는 질환중의 하나로 여러 장기들을 침범할 수 있다. 신장증세로는 농뇨, 혈뇨, 단백뇨, 간질성 신염, 급성 신부전증, 용혈성 요독 증후군, 신반흔 등이 있다. 가와사끼병의 신장침범에 대한 병리기전은 아직 알려져 있지 않지만, 자가면역질환으로 인한 것으로 사려된다. 가와사끼병이 요로감염 이 후에 발병한다는 몇몇 보고들이 있었다. 하지만, 이미 보고된 논문들에 포함된 많은 요로감염 환자들은 신장방광 초음파, DMSA 스캔이나 배뇨중 요도방광조영술 등을 모두 받은 경우는 없었다. 이에 저자들은 급성 신우신염이 재발한 후 불완전 가와사끼병이 발생한 고도의 방광요관역류가 있는 8개월 남아를 보고하는 바이다. 급성 신우신염은 가와사끼병의 초기 증세일 수 있다. 그런 경우, 환아가 가와사끼병으로 확진되더라도 요로감염 진료지침에 따라 요로기형에 대한 이미지 검사를 시행할 필요가 있다고 생각한다.

• 한국자원식물학회지
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• 제26권5호
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• pp.652-657
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• 2013

국내 유통되는 한약재를 이용한 신장질환의 예방 및 치료제 개발을 위한 기초 자료를 제시하고자 경동시장에서 구입한 63종의 한약재 추출물을 이용하여 항산화 활성 및 사구체혈관간 세포의 증식억제능 탐색 활성을 확인하였다. 그 결과 강진향, 고련피, 대풍자, 목향이 RMC 세포의 증식을 50% 이상 억제하는 것으로 나타났고, ORAC와 DPPH assay를 통한 항산화 활성을 확인한 결과 백단향, 백렴이 가장 우수한 ORAC 활성 효능을 보였으며, DPPH 라디칼 소거활성에서는 계혈등, 귀전우, 대풍자, 반대해, 백단향, 백렴이 우수한 효능을 나타냈다. 이 중 대풍자 추출물과 목향 추출물은 항산화 활성과 사구체혈관간세포 증식억제능 모두 뛰어난 효능을 나타냈으나, 목향이 함유하고 있는 aristolochic acid는 임상적으로 신장에 독성을 일으켜 신장질환 치료제에서 제외되는 한약재로 알려져 있다. 따라서, 가장 뛰어난 효능을 보인 대풍자 추출물은 신장질환 치료 및 예방을 위한 한약재 후보물질로서 분획별 항산화 활성과 유효성분 규명의 연구가 요구된다.

• 한국임상약학회지
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• 제32권3호
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• pp.251-259
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• 2022

Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.