• Journal of Veterinary Clinics
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• v.24 no.4
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• pp.522-528
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• 2007

A 3-year-old male Maltese dog(weighing 2.5 kg) was referred with an excessive movement of mandible and depression. Comprehensive diagnostic investigation revealed an end-stage of renal disease with secondary hyperparathyroidism. The renal allograft was performed after the condition of dog was stabilized by hemodialysis and medical treatment. After transplantation, the renal function of this dog was returned to normal. thereafter, the dog died suddenly without apparent clinical signs. The subsequent pathological studies revealed the actual etiology of death was not clearly identified However acute pancreatitis caused by abrupt introduction of food after prolonged luting might be involved in the etiology. This case study showed the necessity of pancreatic function test in postoperative management after renal transplantation.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.236-241
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• 2012

Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.182-192
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• 2017

Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.256-261
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• 2008

Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle causing myoglobin and other intracellular proteins and electrolytes to leak into the circulation. There are various causes of acute rhabdomyolysis in childhood, such as direct trauma to muscle, muscle necrosis from ischemia, inflammation in muscle, or exposure to drugs and toxins. The most-important complication of this disorder is acute renal failure (ARF). However, the contributing factors to the development of ARF in children with rhabdomyolysis remain obscure. We report two cases of rhabdomyolysis after excessive exercise.

• Environmental Analysis Health and Toxicology
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• v.12 no.3_4
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• pp.55-59
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• 1997

Furfural, an organic solvent, is widely used as synthetic component material in producing chemical products. However, furfural has been reported that it shows strong toxicities to human being showing intense stimulus to skin, eyes, mucous membrane and nerve system. It is also known to cause anemia, liver cirrhosis, kidney failure and genetic toxicity in the human being working in the exposed area. LD$_{50}$ of furfural for peritoneal injected mouse has been known around 20mg/kg, but the acute toxicity on aquatic organisms such as fish, daphnid or algae are not well known, compared to those on rodents. In this experiment, we studied on the fish toxicity of furfural using Japanese Medaka (Orvzias latipes) and Common Carp (Cvprinus carpio). We also observed histological changes in the fish organs. The LC$_{50}$ were 12. Smg/L in Japanese Medaka and 21.8 mg/L in Common Carp, respectively. When Common Carps were exposed to 120mg/L of furfural concentration for 30 minutes, blood congestion in gills and lysis of secondary lamella were shown. Though the muscle of caudal fin was not completely eroded, its epidermic cells were shown to be necrotic in various parts. Tissue atrophy and cell necrosis were also shown in the liver of Common Carps exposed to furfural. From these results, furfural seems to cause histological damages on liver, an internal organ as well as on external organs such as gills and fins eventhough the fish were exposed for a short-term.

• Biomedical Science Letters
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• v.7 no.4
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• pp.211-216
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• 2001

This studs was carried out to evaluate KBrO$_3$-induced acute toxicity by clinical pathological parameters in rats. Fourty rats were divided into 4 groups including normal group and three KBrO$_3$-treated groups with doses of 200, 300, and 400 mg/kg, p. o., respectively. Creatinine and BUN were increased remarkably by KBrO$_3$ at 400 mg/kg, respectively (p<0.05, p<0.01). Phosphorus content increased two times the control at 400 mg/kg (p<0.05). Osmolarity was increased, whereas $CO_2$ content showed decrease at 400 mg/kg, respectively (p<0.01, p<0.05). Histopathological findings also showed dose-dependent renal failure. On the other hand, AST was increased three times the control at 400 mg/kg (p<0.01). WBC was increased by KBrO$_3$ depending on the dosage. Platelet was decreased at 200 mg/kg, whereas it was increased at 400 mg/kg (p<0.05). The results above suggest that clinical pathological parameters could be used as indices for the evaluation of KBrO$_3$-induced acute toxic reponse occuring in not only kidney but other organs including liver, when the dosage is as high as 400 mg/kg.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.227-231
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• 1999

Hemolytic uremic syndrome is a clinical syndrome with various etiology and pathogenesis. And pneumococcal neuraminidase has been known to play a pathogenetic role in some cases with this syndrome. We experienced two children with hemolytic uremic syndrome complicated by pneumococcal infection. One was 21-month-old girl with pneumococcal pneumonia, and the other was 7-month-old girl with pneumococcal meningitis and sepsis. Both of them showed typical clinical manifestations of hemolytic uremic syndrome with prolonged anuria during the course of pneumococcal infection. The renal functions of both cases did not recovered after resolution of acute hemolytic episode and chronic renal failure developed.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.82-85
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• 2003

The hemolytic uremic syndrome(HUS), a heterogenous group of disorders characterized by micorangiopathic hemolytic anemia, thrombocytopenia, and azotemia, is the most frequent cause of acute renal failure in children. The association of the HUS with E. coli O157 : H7 has been well-described, but the other intestinal infection have been relatively less reported to date. We report a 18-month-old boy presenting with typical clinical characteristics of HUS associated with amoebic dysentery with a brief review of literatures.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.48-51
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• 2016

Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.

• Natural Product Sciences
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• v.20 no.4
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• pp.251-257
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• 2014

Chungsimyeonja-tang (CSYJT) is an herbal decoction that consists with 12 herbal medicines. CSYJT has been shown to have anti-stress, anti-allergic and anti-oxidant effects. The aim of this study was to determine flavonoid contents in CSYJT and evaluate its protective effect against cisplatin induced nephrotoxicity using both in vitro (porcine renal epithelial cell; PK15 cell) and in vivo (Sprague Dawley rat) experiments. In the present study, thee mean contents of baicalin, wogonoside and baicalein in CSYJT were 14.65, 5.27 and 0.02 mg/g, respectively. The CSYJT extract treatment attenuated the following alteration in porcine renal epithelial (PK15) cell: the increase in reactive oxygen species (ROS), the glutathione depletion and the increase in p53 expression induced by cisplatin treatment. In the in vivo study, rats were orally treated with CSYJT extract once a day for 28 days. Five days before the last treatment, cisplatin (5 mg/kg) was intraperitoneally injected to induce acute renal failure. Increased blood urea nitrogen (BUN) and creatinine (CRE) levels after cisplatin treatment were ameliorated by pretreatment of CSYJT extract. In addition, lipid peroxidation was decreased and antioxidant enzyme (glutathione) was recovered in CSYJT pretreated kidney tissue. In histopathological examination, CSYJT pretreated group showed ameliorated pathological alteration after cisplatin injection with decreased apoptosis. Taken together, pretreatment of CSYJT could ameliorate cisplatin-induced nephrotoxicity.