• 제목/요약/키워드: Polycystic

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How to delay the progression of chronic kidney disease: focusing on medications

  • Jeesu Min
    • Childhood Kidney Diseases
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    • 제28권2호
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    • pp.51-58
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    • 2024
  • Patients with chronic kidney disease (CKD) bear a significant financial burden and face numerous complications and higher mortality rates. The progression of CKD is associated with glomerular injury caused by glomerular hyperfiltration and oxidative stress. Factors such as uncontrolled hypertension, elevated urine protein levels, anemia, and underlying glomerular disease, contribute to CKD progression. In addition to conservative treatment, several medications are available to combat the progression of CKD to end-stage kidney disease. Renin-angiotensin-aldosterone system blockers could slow the progression of CKD by reducing glomerular hyperfiltration, lowering blood pressure, and decreasing inflammation. Mineralocorticoid receptor antagonists inhibit the mineralocorticoid receptor signaling pathway, thereby attenuating inflammation and fibrosis. Sodium-glucose cotransporter 2 inhibitors exhibit protective effects on the kidneys and against cardiovascular events. Tolvaptan, a selective vasopressin V2-receptor antagonist, decelerates the rate of increase in total kidney volume and deterioration of kidney function in patients with rapidly progressive autosomal dominant polycystic kidney disease. The protective effects of AST-120 remain controversial. Due to a lack of evidence regarding the efficacy and safety of these medications in children, it is imperative to weigh the benefits and adverse effects carefully. Further research is essential to establish the efficacy and safety profiles in pediatric populations.

완관절(腕關節) 결정종(結節腫)에 대한 배담(排痰)·양자침구치료(揚刺鍼灸治療)의 임상적(臨床的) 관찰(觀察) (Clinical Study on Wrist Ganglion by Newly Transformed Centro-Square Acupuncture·Moxibustion)

  • 김기현
    • Journal of Acupuncture Research
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    • 제17권4호
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    • pp.113-119
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    • 2000
  • Objectives : Wrist ganglion is one of the most common diseases on the wrist joint. So far acupuncture, medication, drainage and local anesthetic excision therapy have been used for this disease, but the development of more effective treatment method is being expected because of frequent recurrence and side effect. Considered that most ganglion is polycystic, on the basis of classic centro-square acupuncture, newly transformed centro-square acupuncture was applied to this report. Methods : All the patients with wrist ganglion was divided into two groups. Newly transformed centro-square acupuncture was app(ied to one group composed of 11 patients and classic centro-square acupuncture to the other group with 19 patients. Classic centro-square acupuncture is made up of slanting and straight insertion. the former is a method that tips of 4 needles are inserted from the outersurface of wrist ganglion oriented to the center of the ganglion, the latter is that tip of one needle is inserted on the center of the ganglion straightly. In the newly transformed centro-square acupuncture, straight insertion of dry needle was taken place of by syringe needle in order to drain phlegm. In this report, classic and newly transformed centro-square acupuncture were used somewhat differently from original ones. Moxibustion was applied after removing all the needles. In newly transformed centro-square acupuncture, moxibustion was also applied after drainage of phlegm and slanting insertion. Results : 1. Wrist ganglion was frequently developed around the acupoint of Tae-Yeon(Tai Yuan, LU9) and Yang-Ji(Yang Chi, TE4) and the difference between occurrence of development on the left and right hand had no significancy. 2. The mean number of treatment for recovery : The newly transformed centro-square acupuncture had fewer treatment than classic one. 3. The newly transformed centro-square acupuncture was more effective than classic one. 4. As a result of following up 6 to 72 months after wrist ganglion had been eliminated, there was no recurrence. Conclusion : In the treatment of wrist ganglion, newly transformed centro-square acupuncture can be regarded as more useful method in the clinical practice, because it has comparatiely shorter duration of treatment and is more effective.

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미성숙 난자로부터 체외 성숙한 포배기 배아의 Re-vitrification 후 성공적 임신 1례 (Successful Birth after Transfer of Re-frozen Blastocysts Developed from Immature Oocytes Retrieved from a Woman with Polycystic Ovarian Syndrome)

  • 윤혜진;윤산현;이소영;김해균;이원돈;임진호
    • Clinical and Experimental Reproductive Medicine
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    • 제32권1호
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    • pp.65-70
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    • 2005
  • 본 연구는 이식 후 남은 잉여의 포배기 배아를 두 번의 냉동과 융해 과정을 반복적으로 실시한 후 이식한 결과에 관한 보고이다. 사람 포배기 배아의 동결보존에서 높은 생존율과 성공적인 임신율이 보고되고 있으나 미성숙 난자로부터 발달한 포배기 배아에 두 번의 초급속 냉동 방법을 실시한 후 이식한 보고는 되어 있지 않다. 이에 본 연구에서는 다낭성 난소 증후군 환자에게서 얻은 미성숙 난자로부터 발달한 포배기 배아를 artificial shrinkage 후 초급속 냉동함으로써 생존율을 높이는 방법을 이용하여 재냉동 이식하였을 때 임신에 성공한 증례를 보고하고자 한다. 29세의 환자로부터 채취한 55개의 미성숙 난자들(germinal vesicle stage oocytes)을 체외배양 하여 성숙한 37개의 난자들로부터 30개의 수정란을 얻을 수 있었다. 12개의 배아가 포배기 배아까지 발달하였으며 이 중 3개의 양질의 포배기 배아를 선별하여 이식하였고, 이식을 한 후에 남은 9개의 포배기 배아들은 artificial shrinkage의 과정을 마친 후에 초급속 냉동 방법을 이용하여 동결보존 하였다. 그 중, 4개의 포배기 배아들을 융해한 후 이식을 하지 않고 다시 재냉동을 하여 보관하였고 이 후 재냉동 되었던 4개의 포배기 배아들을 다시 융해 하여 이식을 한 결과 임신이 되어 건강한 남아를 분만하였다. 이로써 미성숙 난자로부터 얻은 포배기 배아가 두 번의 냉동과 융해의 과정을 통해 크게 손상을 입지 않고 생존할 수 있다는 것을 알 수 있었다. 그러므로 융해이식 후 남은 잉여의 포배기 배아를 다시 냉동 보관하여 다음 주기에 이용함으로써 축적된 임신율을 증가시킬 수 있을 것으로 사료된다.

한방여성의학 영역에서 진단 도구로 적외선 체열 검사(Digital Infrared Thermal Imaging, DITI)를 활용한 국내 연구 동향 분석 (A Review of the Domestic Study Trends on Obstetrics & Gynecological Diseases by Using Digital Infrared Thermal Imaging as a Diagnosis Instrument)

  • 임지영;황덕상;이진무;이창훈;장준복
    • 대한한방부인과학회지
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    • 제33권3호
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    • pp.80-94
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    • 2020
  • Objectives: The purpose of this review is to analyze the domestic study trends of clinical use of Digital Infrared Thermal Imaging (DITI) as a diagnosis instrument on obstetrics and gynecological diseases in Korean literature. Methods: We searched for clinical studies using DITI in the journal of Korean obstetrics & gynecology, National Digital Science Library, Research Information Sharing Service, Korean Medical Database up to May 2020. After searching studies, we selected studies and analyzed according to disease. Results: 18 clinical studies were published in two kinds of academic journals. There were 4 studies about dysmenorrhea and menopausal symptoms, 2 studies about postpartum disease and hypercryalgesia, 1 study about amenorrhea, premenstrual syndrome, leukorrhea, infertility, polycystic ovary syndrome and hot flush. Conception vessel was frequently used for DITI measurement, followed by stomach meridian. The temperatures of abdomen (CV4, CV12), face (HN3), upper and lower limb (PC8, LU4, LR3, ST32) were commonly measured. Conclusions: This study shows that DITI could be one of effective diagnosis instrument for obstetrics and gynecological diseases. More well-designed clinical studies using DITI will be needed.

신세뇨관 확장증, Caroli 증후군 및 총 담관낭을 동반한 선천성 간 섬유증 1례 (A Case of Congenital Hepatic Fibrosis Accompanied by Renal Tubular Ectasia, Caroli Syndrome and Choledochal Cyst)

  • 최봉석;배상남;임영탁;박재홍;이창훈;이준우
    • Clinical and Experimental Pediatrics
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    • 제45권7호
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    • pp.923-927
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    • 2002
  • 우연히 발견된 간비장 종대를 주소로 내원한 3세 여아에서 신낭종을 동반한 선천성 간섬유화증을 진단한 예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

$^{99m}Tc-DMSA$ 신티그램을 이용한 신질환 형태 분류 (Morphological classification of Renal Disease Using $^{99m}Tc-DMSA$ Scintigram)

  • 문태용
    • 대한핵의학회지
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    • 제25권2호
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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.

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Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • 제58권1호
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

양허증(陽虛證)의 임상적 질환 범위에 대한 고찰 (Study on Clinical Diseases of Yang Deficiency Pattern)

  • 박미선;김영목
    • 동의생리병리학회지
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    • 제27권2호
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    • pp.153-166
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    • 2013
  • Yang deficiency pattern is a representative syndrome differentiation. This article is a study on to which categories of modern diseases yang deficiency is assigned by reference to modern clinical papers and the meaning of yang deficiency interpreted with a perspective of Korean Medicine and a modern perspective. Yang deficiency, yang qi deficiency, lack of yang qi and yang qi debilitation are the words found in "Nei Ching" and yang qi can be interpreted as something to warm, drive and arouse. Zhangzhongjing considered recovery or loss of Yang as the key to life in "Shanghanlun". Danxi proposed "Yang being liable to hyperactivity, Yin being insufficient" and emphasized pathological ministerial fire of Yang exuberance rather than physiological ministerial fire of Yang deficiency. Zhangjingyue proposed "Yang not being in excess, Yin being often deficient" and understood growth and decline of yin qi are all led by yang qi and put emphasis on true yin in addition to yang qi. Diseases of yang deficiency pattern are related with decline of metabolic level, hypofunction of internal secretion, disorder of immune function, disorder of automatic nerve system, sympathetic nerve inhibition, metabolic disorder of microelements, increase of cGMP, change of microcirculation, low speed of blood stream, kidney malfunction. Diseases related with kidney are sterility, polycystic ovary syndrome, spinal stenosis, edema, renal failure, IgA nephropathy, erectile dysfunction, nephritis, prostatitis, benign prostatic hyperplasia, decrease of adrenal cortical hormone by nephrotic syndrome, myelodysplastic syndrome. Disease related with heart are heart failure, arrhythmia, cardiomyopathy, atherosclerosis heart disease, hypertension, hyperlipidemia, pulmonary heart disease. Diseases related with spleen are irritable bowel syndrome, ulcerative colitis. Diseases related with liver are hypothyroidism, liver cirrhosis ascites, hepatitis B, chronic hepatitis, hepatic diabetes. Diseases related with lung are allergic rhinitis, cough variant asthma, bronchial asthma, pulmonary emphysema. And diabetes mellitus, metabolic syndrome, aplastic anemia, headache, encephalatrophy, Alzheimer's disease are also related with yang deficiency.

장기간 한약복용이 부인과 환자의 간 및 신장기능에 미치는 영향: panel연구 - 복용 전과 후 3, 6개월 비교를 중심으로 - (Effects of Long-Term Intake of Korean Medicine on Gynecology Patients' Livers and Kidneys; Panel Study - Focus on Before Intake, After 3, 6 Months -)

  • 양준모;성동민;김유진;이선동
    • 대한한의학회지
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    • 제41권1호
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    • pp.84-92
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    • 2020
  • Objectives: To observe the effects on liver and kidney of gynecology patients' during long term Korean Medicine. Methods: This research was conducted as a panel study on 29 female gynecology patients at Korean medicine clinic and compares their conditions before, 3 months after, and 6 months after Intake of Korean medicine. This analysis was conducted to frequency(%), repeated measure ANOVA and significantly statistics was p<0.05, confidence interval. Results: The most common conditions among the subjects were polycystic ovary syndrome, endometriosis, adenomyosis, and uterine myoma. Except in a few instances, liver functions (AST, ALT, γ-GTP) were within the normal range before and after the intake of Korean medicine. Further, while there was a slight change in liver functions when three months and six months after the intake, but there was no statistical significance (p>0.05). As for the kidney functions (BUN, Creatinine, BUN/Creatinine), they were within the normal range before and after the intake of Korean medicine. Further, while there was a slight change in kidney functions three months and six months after the intake, there was no statistical significance(p>0.05) either. Conclusions: Based on these results, it can be concluded that Korean medicine does not have a negative impact on the gynecology patients' liver and kidney.

A Preliminary Study on Effects of Different Dietary Selenium (Se) Levels on Growth Performance and Toxicity in Juvenile Black Seabream, Acathopagrus schlegeli (Bleeker)

  • Lee, Seunghyung;Lee, Jun-Ho;Bai, Sungchul C.
    • Asian-Australasian Journal of Animal Sciences
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    • 제21권12호
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    • pp.1794-1799
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    • 2008
  • This preliminary feeding trial was conducted to study the effects of different dietary selenium (Se) levels on growth performance and toxicity in juvenile black seabream, Acanthopagrus schlegeli (Bleeker). Fish averaging $7.0{\pm}0.1g$ ($mean{\pm}SD$) were fed one of the five semi-purified diets containing 0.21, 0.30, 0.52, 1.29 and 12.3 mg sodium selenite ($Na_2SeO_3$)/kg diet (Se 0.21, Se 0.30, Se 0.52, Se 1.29 or Se 12.3) for 15 weeks. After the feeding trial, weight gain (WG), feed efficiency (FE), specific growth rate (SGR) and protein efficiency ratio (PER) of fish fed Se 0.21, Se 0.30, Se 0.52 and Se 1.29 diets were not significantly different, however fish fed Se 12.3 diet showed significantly lower WG, FE, SGR and PER than those of fish fed the other diets (p<0.05). Fish fed Se 0.21, Se 0.30, Se 0.52, Se 1.29 and Se 12.3 diets showed no significant differences in hematocrit (PCV), hemoglobin (Hb) and red blood cells (RBC), however fish fed Se 12.3 diet showed lower values of PCV, Hb and RBC than those of fish fed the other diets. Histopathological lesions such as tubular necrosis and polycystic dilation of tubules in the kidney tissues were observed in fish fed Se 12.3 diet. Se was accumulated in a dose-dependent manner in the liver, kidney, muscle and gill tissues. Based on the results of this preliminary feeding trial, a dietary Se level of 0.21 mg $Na_2SeO_3/kg$ diet could be optimal for proper growth performances, and a dietary Se level of 12.3 mg $Na_2SeO_3/kg$ diet may ultimately be toxic to juvenile black seabream, Acanthopagrus schlegeli.