• Title/Summary/Keyword: Renal Function

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Excretroy Urography in the Minipig (미니돼지에서 배설성요로조영술의 적용)

  • Jung, Joo-Hyun;Chang, Jin-Hwa;Choi, Min-Cheol
    • Journal of Life Science
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    • v.17 no.9 s.89
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    • pp.1211-1216
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    • 2007
  • Excretory urography was performed on eight healthy minipigs to evaluate radiographic anatomical status and excretive function of the urinary tracts and to get an optimal procedure. The right and left kidneys were located in $T13{\sim}L4$and $T12{\sim}L3.5$, respectively. The left kidneys were located more cra-nially than the right. The everage lengths and widths of kidneys were $8.50{\pm}0.58$ $(mean{\pm}SD)$and $4.30{\pm}0.39$ cm on the ventrodorsal projection and $8.70{\pm}0.76$, and $4.10{\pm}0.40$ cm on the lateral projection, respectively. The lengths of kidneys were twice the width. When the lengths of kidneys were com-pared with lengths of the second lumbar vertebras, the ratios of kidney lengths to L2 lengths were $3.62{\pm}0.30$ on the ventrodorsal projection and $3.63{\pm}1.10$ on the lateral projection. The lengths and 쟝손 of renal pelvis including major calices were $4.01{\pm}0.46$, and 2.20{\pm}0.41$ cm, respectively. The lengths and 쟝손 of minor calices were $0.49{\pm}0.06$, and $0.10{\pm}0.01$ cm. The lengths and widths of the ureters were $12.25{\pm}2.05$, and 2.94{\pm}0.86$ cm. The nephrogram stage was reached in 3{\sim}5$ minutes, and the pyelogram phase in $5{\sim}15$ minutes individually after injection of contrast medium. The result of this study shows similar information and procedure of excretory urography for other laboratory ani-mals and leads to the potential use of this method for minipigs.

Ceftriaxone Associated Biliary Pseudolithiasis (Ceftriaxone 사용후 발생된 Pseudolithiasis)

  • Kim, Jae-Young;Ko, Jae-Sung;Lee, Hwan-Jong;Ko, Young-Ryul;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.100-106
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    • 1998
  • Purpose: Ceftriaxone, a potent parenteral third-generation semisynthetic cephalosporin is widely used for the treatment of a variety of bacterial infections in both children and adult. Review of recent data indicates that ceftriaxone treatment has been associated with the development of reversible biliary pseudolithiasis and that is thought by many to be a benign process. Despite, several reports describe patients with ceftriaxone pseudolithiasis who required cholecystectomy for presumed acute cholecystitis. In this study we evaluated the incidence, risk factors, and prognosis of gallbladder pseudolithiasis after ceftriaxone treatment. Methods: Between march, 1997 and January, 1998, any child admitted to the Children's hospital of National University of Seoul and prescribed ceftriaxone for probable or definite bacterial infection were eligible for the study. 21 of them had ultrasound examination on the 2~12 days later after the start of ceftriaxone treatment, 8 of whom documented gallbladder precipitates or pseudolithiasis during treatment by serial abdominal ultrasound. Repeat abdominal ultrasound was performed 10~80 days later after the end of ceftriaxone treatment. The children with underlying liver disease or decreased renal function were excluded in this study. Results: 1) 21 children had ultrasound examinations of gallbladder during ceftriaxone treatment and 8 (38%) of them acquired pseudolithiasis. 2) The patients who developed gallbladder pseudolithiasis were significantly older ($6.3{\pm}2.9$ yr. vs $2.2{\pm}3.1$ yr.)(p<0.05), and older than 24 months were probably the significant risk associated with this phenomenon (p<0.05). However, no significant differences in sex, type of infection, fasting, and ceftriaxone treatment regimen (dose, duration of therapy). 3) The abnormality found on gallbladder ultrasonography was a strikingly hyperechogenic material with post-acoustic shadowing in 5 patients without post-acoustic shadowing in 3 patients 4) Follow up of gallbladder ultrasound was performed in 6 patients after cessation of ceftriaxone treatment. Sonographic abnormalities completely resolved within 14 days post cessation of therapy in 2 patients; 30 days, 1 patient; 80 days, 3 patients. Conclusions: We suggest that routine abdominal ultrasound should be considered in all children who received high dose ceftriaxone in more than 24 months of age and developed hepatobiliary symptoms during or just after ceftriaxone treatment.

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Study on Optimum Contrast Medium Quantity during Abdominal CT using Dual Energy Technique (복부 CT 검사 시 이중에너지 기법을 통한 적정한 조영제 양에 관한 연구)

  • Kang, Min;Choi, Namgil;Han, Jaebok;Kim, Wook;Jang, Yeongill;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.9-16
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    • 2015
  • The purpose of this study is finding optimum contrast medium quantity during abdominal CT using dual energy technique. The study subjects are 30 patients who had received general single energy abdominal CT and received double energy technique follow-up abdominal CT. dual energy technique abdominal CT images were obtained after setting contrast medium quantities at 30%, 40%, 50%, 60% and 70% of contrast medium quantity at the time of single energy technique. Then the contrast enhancement (Hounsfield Unit; HU) was estimated by setting-up the regions of interest at aorta, inferior vena cava, hepatic portal vein and hepatic parenchymal. The obtained values were compared to the values of the same parts measured during single energy technique abdominal CT. The results of the study were as following. The 60% set up group had HU in aorta : $210.80{\pm}13.609$, IVC : $190.40{\pm}25.215$, hepatic portal vein : $198.40{\pm}21.232$ and hepatic parenchymal : $119.20{\pm}7.98$, The single energy abdomianl CT images had HU in aorta : $205.40{\pm}16.426$, IVC : $188.20{\pm}21.476$, hepatic portal vein : $195.40{\pm}22.744$ and hepatic parenchymal : $121.00{\pm}6.595$. Therefore, it is possible to obtain contrast enhancement by dual energy technique abdominal CT similar to the same by single energy technique abdominal CT by setting-up the quantity of contrast medium at 60% of contrast medium at the time of single energy technique abdominal CT. Based on the result of this study, it is possible to decrease existing quantity of contrast medium by _% and the injection velocity can be also decreased. Accordingly, it is believed that the result of study would be quite useful for patients who have renal function disorder, weak vein or side effect of contrast medium in the past.

Comparison of the Neurologic Outcome according to the Method of Proximal Graft Anastomosis at the Aortic Side during Off-pump Coronary Artery Bypass Grafting: The Heartstring Sealing System versus Conventional Manual Anastomosis (무심폐기 관상동맥 우회술에 있어서 이식편의 대동맥부 근위부 문합 방법에 따른 수술 후 신경학적 합병증 발생의 비교: 하트스트링을 이용한 방법 대 고식적인 수기 문합술)

  • Cho, Won-Chul;Kim, Joon-Bum;Kim, Hee-Jung;Kim, Hwan-Wook;Kim, Yun-Seok;Jung, Jae-Seung;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.441-446
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    • 2009
  • Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

Identification of a SNP in Chicken CaSR Gene and Its Effect on Economic Traits (닭의 CaSR 유전자내 단일 염기 변이 탐색 및 경제 형질간의 연관성 분석)

  • Hong, Y.S.;Oh, J.D.;Lee, J.H.;Kong, H.S.;Choi, C.H.;Lee, S.S.;Jeon, G.J.;Lee, H.K.
    • Korean Journal of Poultry Science
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    • v.34 no.2
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    • pp.151-156
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    • 2007
  • The Function of the calcium sensing receptor (CaSR) is to control calcium levels by altering PTH (parathyroid hormone) secretion and renal calcium resorption. The influence of calcium on the basal and stimulated release of several hormones from chicken pituitary glands has been determined in vitro. The objective of this study was to identify SNP in chicken CaSR gene and to investigate the effect of the SNP on economic traits. The sequencing analysis method was used to identify nucleotide polymorphisms within chicken CaSR gene. This study identified SNP at position 1949 bp(Genebank accession No : XM_416491) in the exon 1. The SNP changed the amino acid to alanine(GCC) from serine(TCC). This SNP showed three genotypes, AA, AS and SS by digestion with the restriction enzyme NcoⅠ using the PCR-RFLP method. The A963S showed significant effect only on the first lay day (P<0.05) in Leghorn population. Leghorn with the genotype AA had significantly faster the first lay day(137.6) than the genotype AS(143.0, P<0.05). Also, the A963S showed significant effect only on the first lay day(P<0.05) and mean of egg weight(P<0.05) in KNC population. KNC with the genotypes AA ans AS had significantly faster the first lay day (151.0 and 152.6, respectively) than the genotype SS(159.4, P<0.05). And the genotypes SS had significantly heavier the mean of egg weight(50.4 kg, P<0.05) than the genotype AA ans AS (47.5 and 47.8 kg, respectively). According to result of this study, an a allele of the A963S was found to have a significant effect on the first lay day. It will be possible to use this SNP marker on selecting chicken to improve the first lay day.

Outcomes of Chronic Peritoneal Dialysis by Various Modalities in Korean Children - A Single Center Study (소아 환자에서 다양한 복막투석 방법간의 결과 비교-단일기관 연구)

  • Lee, Sung-Ha;Baek, Jae-Suk;Lee, Hyun-Kyung;Han, Kyoung-Hee;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.255-263
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    • 2007
  • Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

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Assessment of Hydroureteronephrosis in Children Using Diuretic Radionuclide Ureterography (동위원소 이뇨 요관그람을 이용한 소아 요관폐쇄의 평가)

  • Kim, Jong-Ho;Lee, Dong-Soo;Kwark, Cheol-Eun;Lee, Kyung-Han;Choi, Chang-Woon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Choi, Yong;Choi, Hwang
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.75-84
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    • 1994
  • The need for assessment of ureteric function in the patient with an obviousely dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydrone-phrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during $^{99m}Tc$-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Kt1/2) and ureteral (Ut1/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Kt1/2 (>20 min), no patient with an abnormal ureter underwent therapy at the ureteropelvic junction because the hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

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The Usefulness of Bone Scan in Electric Burns (전기화상에서 골스캔의 유용성)

  • Kim, Tae-Hyung;So, Yong-Seon;Kweon, Ki-Hyeon;Han, Sang-Woong;Kim, Seok-Hwan;Kim, Jong-Soon;Han, Seung-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.130-138
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    • 1996
  • Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

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The Changes of Plasma Atrial Natriuretic Peptide Concentrations During Waking and Sleep in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 각성시와 수면중의 혈중 Atrial Natriuretic Peptide 농도 변화)

  • Moon, Hwa-Sik;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak
    • Sleep Medicine and Psychophysiology
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    • v.2 no.2
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    • pp.156-164
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    • 1995
  • Objectives : Patients with obstructive sleep apnea syndrome(OSAS) often complain of nocturnal enuresis. There are a few reports that OSAS patients have altered renal function, and there are some evidences that the increased release of atrial natriuretic peptide(ANP) may be involved in the pathogenesis of nocturnal urinary symptoms of OSAS patients. In this study, we measured plasma ANP concentrations during waking and sleep in OSAS patients and normal controls to investigate whether there were differences of ANP concentrations between OSAS patients and normal subjects. Methods : 27 patients with OSAS and 10 normal subjects were studied. All subjects underwent a full-night polysomnographic study. Venous blood samples were separately drawn during waking and sleep. Plasma ANP concentrations were measured using radioimmunoassay. Results : In OSAS patients, ANP concentrations during sleep($122.9\;{\pm}\;29.9pg/ml$) were significantly higher than ANP concentrations during waking($60.2\;{\pm}\;5.8pg/ml$)(p < 0.05). However, in normal subjects, there was no significant difference between ANP concentrations during waking($59.2\;{\pm}\;5.7pg/ml$) and sleep($69.6\;{\pm}\;3.0pg/ml$)(p > 0.05). There was no significant difference of ANP concentrations during waking between OSAS patients($60.2\;{\pm}\;5.8pg/ml$) and normal controls($59.2\;{\pm}\;5.7pg/ml$)(p > 0.05), and also there was no significant difference during sleep between OSAS patients($122.9\;{\pm}\;29.9pg/ml$) and normal subjects($69.6\;{\pm}\;3.0pg/ml$)(p > 0.05). Plasma ANP concentrations during sleep showed significant positive correlations with apnea index(r = 0.3846, p < 0.05) and respiratory disturbance index(r = 0.3939, p < 0.05) in OSAS patients. Conclusion : These data suggest that, in OSAS patients, plasma ANP concentrations during sleep are significantly higher than plasma ANP concentrations during waking, and there is a positive correlation between the plasma ANP concentration during sleep and the severity of sleep apnea.

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Effects of Arginine Vasopressin(AVP) Infusion on the Patients with Catecholamine-dependent Septic Shock (카테콜아민계 승압제를 투여중인 패혈성 쇼크 환자에서 아르기닌 바소프레신(AVP)의 효과)

  • Sheen, Seung Soo;Lim, Seung Guan;Jo, Sook Kyoung;Song, Kyoung Eun;Lee, Hyoung No;Oh, Yoon Jung;Park, Kwang Joo;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.506-515
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    • 2003
  • Background : A decreased level of serum arginine vasopressin(AVP) and an increased sensitivity to an exogenous AVP is expected in patients with septic shock who often require a high infusion rate of catecholamines. The goal of the study was to determine whether an exogenous AVP infusion to the patients with septic shock would achieve a significant decrement in infusion rate of catecholamine vasopressors while maintaining hemodynamic stability and adequate urine output. Method : Eight patients with septic shock who require a high infusion rate of norepinephrine had received a trial of 4-hour AVP infusion with simultaneous titration of norepinephrine. Hemodynamic parameters and urine output were monitored during the AVP infusion and the monitoring continued up to 4 hours after the AVP infusion had stopped. Results : Mean arterial pressure showed no significant changes during the study period(p=0.197). Norepinephrine infusion rate significantly decreased with concurrent AVP administration(p=0.001). However, beneficial effects had disappeared after the AVP infusion was stopped. In addition, hourly urine output showed no significant changes throughout the trials(p=0.093). Conclusion : Concurrent AVP infusion achieved the catecholamine vasopressor sparing effect in the septic shock patients, but there was no evidence of the improvement of renal function. Further study may be indicated to determine whether AVP infusion would provide an organ-protective effect to the septic shock patients.