• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.237-244
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• 1991

$^{99m}Tc-DMSA$ renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of $^{99m}Tc-DMSA$ renal scan as the groups of symmetric and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of normal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119.4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent $^{99m}Tc-DMSA$ and IVP concommitantly. Among 85 cases of PD in $^{99m}Tc-DMSA$ renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with symmetric small size in $^{99m}Tc-DMSA$ renal stan.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.427-434
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• 2016

Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

• Journal of Korean Neurosurgical Society
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• v.43 no.5
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• pp.237-238
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• 2008

Myoclonus is a rare side effect of gabapentin (GBP) and has been reported in patients with preexisting myoclonus, mental retardation, chronic static encephalopathy, diffuse brain damage, impaired renal function, or end stage renal disease. We report a case of myoclonus in a patient with normal renal function and no previous disorders. A 69-year-old female underwent diskectomy and foraminotomy at the left L4-L5 level. Post-operatively, she complained of paresthesia in her left leg, which was thought to be due to root manipulation during surgery. To relieve the paresthesia, she was given tramadol, an oral opioid agonist, and GBP. One week after GBP was increased to 900 mg per day, myoclonus developed, which severely impaired her normal activity. Her symptoms resolved 2 days after discontinuation of GBP. The coadministration of tramadol and GBP may mutually enhance the myoclonic potential of each drug. The causal relationship between GBP and myoclonus was suggested by cessation of myoclonus after GBP discontinuation despite continued therapy with tramadol.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.385.2-385.2
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• 2002

Cornus officinalis has been used as protective drug for liver and kidney function. In order to evaluate the effect on renal function of Corni Fructus. We measured urine volume, chemical parameters(urea nitrogen. creatinine, uric acid). electrolytes($Na^{+}$, $K^{+}$, $Cl^{-}$) in serum and urine. Furosemide showed significant urine volume. serum and urine parameters, but Corni Fructus showed normal level parameters by dose increasing in rats.

• Journal of Veterinary Clinics
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• v.34 no.3
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• pp.208-212
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• 2017

This study was performed to retrospectively pursue any correlation between renal cortex thickness (RCT), outer medulla thickness (OMT) on ultrasonography (US) and chronic kidney disease (CKD) with International Renal Interest Society (IRIS) stage. Medical records and US findings of the dogs diagnosed CKD were reviewed for comparing to those of the clinically healthy dogs from March. 2015 through June. 2016. To evaluate the correlation about normal and CKD patients, RCT and the OMT were measured on US images. RCT and OMT were adjusted by dividing body surface area for standardization (RCTS, OMTS). Also the ratio of RCT/OMT were calculated and these indices were evaluated to investigate any tendency between 5 groups (normal and 4 IRIS stages) using Jonckheere-Terpstra trend test (J-T test). The RCTS showed a declining tendency (p < 0.02) and the OMTS showed an inclining tendency from normal through each IRIS stage (p < 0.01). The RCT/OMT showed also declining tendency (p < 0.01). Although the gold standard for renal function including GFR is lack, it is thought that differentiation between normal and CKD patients could be possible on US measurement of renal cortex and outer medulla thickness, which could be an alternative index for kidney function in diagnostic imaging.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.871-886
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• 2008

Objective : Gypsum fibrosum has been traditionally used in treatment of febrile diseases and recently been shown to have anti-inflammatory effect. Chronic renal failure has a serious clinical symptoms including proteinuria, azotemia, anemia, and hyperlipidemia and has characteristic histopathological changes, glomerular hypertrophy, infiltration of inflammatory cells, and crescentic sclerosis, We investigated the effects of gypsum fibrosum on renal functional and histopathological disorder in chronic renal failure rat model induced 5/6 nephrectomy. Methods : Using Sprague-Dawley rats, CRF was induced by 5/6 nephrectomy. The rats were divided into 3 groups, normal, conrol, and gypsum administered orally with gypsum fibrosum 500mg/kg/day. Body weight, 24 hr proteinuria, hematologic analysis, and histological morphologic changes were followed up after 8 weeks. The glomerular macrophage/monocyte infiltration, $TGF-{\beta}_1$, type IV collagen, and angiotensin II type1 receptor($AT_1$) were evaluated by immunohistochemistry. Resuls : In the CRF control group, functional parameters and histopathologic changes clearly indicated the development of CRF. 24 hr proteinuria significantly increased in the CRF control group over the normal group, and serum creatinine level was lower in the gypsum group than in the control group, LDL-cholesterol was significantly lower in the gypsum group than in the control group. Morphological investigations showed a variety of characteristic features of CRF, glomerular hypertrophy, increasing cellular density of glomerulus, deposition of extra-cellular matrix, fibrotic change, and glomerular sclerosis in the control group, but in the gypsum group, these features diminished significantly. In observation of renal type IV collagen and $AT_1$ expression, positive area significantly increased in the control group over the normal group, and it significantly decreased in the gypsum group compared to the control group. Conclusions : Our findings suggest that gypsum fibrosum inhibits $AT_1$ and type IV collagen expression in renal tissues and attenuates progression of glomerulosclerosis and interstitial fibrosis in chronic renal failure rats, which lead to amelioration of renal function. From these results, we suggest that gypsum fibrosum may have renoprotective effects and could be a useful remedy agent for treating chronic renal failure.

• Biomedical Science Letters
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• v.15 no.2
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• pp.119-126
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• 2009

This study investigated the effect of Corni Fructus(Cornus officinalis Sieb. et Zucc.) extract on hyperglycemia and renal function in streptozotocin-induced diabetic rats. Male Sprague-Dawley rats were divided into three groups including normal control(NC), diabetic control(DC), and diabetic treatment with Corni Fructus(DCF). Over a 4-week experimental period, Corni Fructus aqueous extract was administered orally at 500 mg/kg BW/day. The final fasting serum glucose, serum urea nitrogen, triglyceride, urinary total protein level, and relative weight of the left kidney in the DCF group were significantly lower than the DC group. Serum insulin level in the DCF group was higher than the DC group by 23%. The renal xanthine oxidase and superoxide dismutase activities in the DCF group were significantly lower than the DC group. The renal catalase activity in the DCF group was significantly higher than the DC group. In conclusion, these results indicated that Corni Fructus can reduce glucose level and prevent or retard the development of diabetic complication via its antioxidative effect and protecting against diabetic renal damage in streptozotocin-induced diabetic rats.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.141-144
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• 2020

Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning. Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

• Journal of Veterinary Science
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• v.21 no.4
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• pp.58.1-58.11
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• 2020

Background: Quantitative evaluation of renal cortical echogenicity (RCE) has been tried and developed in human and veterinary medicine. Objectives: The objective of this study was to propose a method for evaluating RCE quantitatively and intuitively, and to determine associations between ultrasonographic renal structural distinction and estimated glomerular filtration rate (eGFR) in canine chronic kidney disease (CKD). Methods: Data were collected on 63 dogs, including 27 with normal kidney function and 36 CKD patients. Symmetric dimethylarginine and creatinine concentrations were measured for calculating eGFR. RCE was evaluated as 3 grades on ultrasonography images according to the distinction between the renal cortex and outer medulla. The RCE grade of each kidney was measured. Results: There was a significant difference in eGFR between the group normal and CKD (p < 0.001). As mean of RCE grades (the mean values of each right and left kidney's RCE grade) increases, the proportion of group CKD among the patients in each grade increases (p < 0.001). Also, severity of RCE (classified as "high" if any right or left kidney evaluated as RCE grade 3, "low" otherwise) and eGFR is good indicator for predicting group CKD (p < 0.001). Conclusions: The degree of distinction between the renal cortex and the outer medulla is closely related to renal function including eGFR and the RCE grade defined in this study can be used as a method of objectively evaluating RCE.

• Childhood Kidney Diseases
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• v.23 no.1
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• pp.53-57
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• 2019

Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.