• 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.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1996.11a
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• pp.85-89
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• 1996

성장저해는 만성신부전 (chronic renal failure, CRF) 소아환자나 실험동물에게서 나타나는 합병증의 하나로, 그 발생기전이 잘 알려져 있지 않다. 성장저해를 일으키는 원인으로 비내분비적 요인 (metabolic acidosis, renal osteodystrophy, anemia)과 내분비적 요인의 복합적 결과로 생각하나, 비내분비적 요인들은 약물투여로 그 증세를 완화시켜도 성장저해에 대한 궁극적 치료효과는 나타나지 않는다. 따라서 성장 호르몬 (Growth Hormone, GH)이 관여하는 내분비적 요인의 변화에 그 병리기전이 있을 것으로 연구되어 왔다. GH는 직접적 성장 효과와 Insulin-like growth factor-1(IGF-I)을 간으로부터 유리시켜 나타나는 간접적 성장효과를 가지고 있다. 그런데 CRF환자의 GH 및 IGF-I 의 혈중 농도는 정상이거나, 흑은 오히려 증가상태에 있음에도 볼구하고 성장저해가 일어나는 것으로 보아, 환자의 말단기관 (end-organ)에 원인을 알 수 없는 저항성 (resistance)이 있다고 규정되어진다.

• Journal of Veterinary Clinics
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• v.37 no.6
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• pp.360-362
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• 2020

A 12-year-old intact female Pomeranian dog was presented with vulvar discharge, lethargy, polyuria, and polydipsia. A complete blood count revealed leukocytosis and anemia. The serum biochemical analyses showed elevated serum alkaline phosphatase activity and blood urea nitrogen. Survey abdominal radiography revealed an enlarged left kidney. Abdominal ultrasonography identified multiple rounded hypoechoic subcapsular lesions in the left kidney. The bilateral uterine horn was enlarged, and contained echogenic fluid. Percutaneous ultrasonographic-guided aspiration of the renal subcapsular lesions was performed on the left kidney. Cytological examination revealed bacterial cocci, degenerated neutrophils, and suppurative inflammation. Bacterial culture produced growth of Escherchia coli. Left nephrectomy and ovariohysterectomy were performed. Dilated uterine fluid was also evaluated for bacterial culture, and showed growth of E. coli. Urine was examined by bacterial culture, and showed negative results. The treatment consisted of antibiotic therapy according to the antibiotic sensitivity test. Based on these findings, the diagnosis was renal subcapsular abscess associated with pyometra. This study suggests that pyometra should be considered as the cause of renal abscess.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.114-119
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• 1998

We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intervals. On initial scan, uplake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.1-16
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• 1969

The double tracer study on erythrokinetics was carried out experimentally with radioactive iron ($^{59}Fe$) and chromium ($^{51}Cr$) in rabbits. The 0.1% canthalidin solution and 1% pot. perchlomate solution was given subcutaneously to 20 rabbits respectively. 3 and 6 days after injection, the blood chemistry, urine examination, ferrokinetics and apparent half survival time of RBC were ($^{51}Cr\;T\frac{1}{2}$)determined. Following were the results: 1) Red blood cell hematocrit and hemoglobin values were moderately reduced and B.U.N. and serum creatinine values were slight]y inercased in the canthalidin group, while B.U.N. and serum creatinine values were within normal limits in the pot. perchlomate group. Reticulocyte values were slight]y increased in the canthalidin group, while was normal range in the pot. perchlomate group. 2) Blood chemistry finding was not significant statistically in both experimental groups, but serum iron value was moderately reduced in both group. 3) Plasma volume was unchanged in both group, but red cell volume and whole blood volume were slightly reduced in both groups. 4) Results of ferrokinetics were as follows: i) The plasma iron disappearance rate was delayed in both groups. Plasma iron turnover rate, red cell iron utilization and red cell iron turnover rate were decreased in both groups, and then red cell iron turnover rate was more decreased than plasma iron turnover rate in both groups. Circulating red cell iron was slight]y increased in canthalidin group and red cell iron concentration was within normal range in both groups. ii) P.I.T.R.-R.C.I.T. value was moderately increased in the canthalidin group and slightly increased in the pot. perchlomate group. Reticulocyte index, red cell iron turnover index, plasma iron turnover index and effective erythropoiesis index were whole]y reduced in both groups. iii) The red cell life span was slightly shortened in the canthalidin group while was within normal range in pot. perchlomate group. The pathologic finding of renal biopsy of the canthalidin group shows a selective damage in glomerulus, while shows almost normal range or slight damage in tubules. And that of the pot. perchlomate group shows a selective damage in tubules with slight damage of glomerulus.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.192-196
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• 2003

Angiodysplasia is the most common vascular abnormality of the gastrointestinal tract and probably the most frequent cause of recurrent lower intestinal bleeding in otherwise healthy elderly patients. Also, it is an important cause of hemorrhage in chronic renal failure observed in up to 19~32% of patients. Bleeding due to gastric angiodysplasia is treated by various endoscopic approaches, including argon and Nd : YAG laser photocoagulation, monopolar or bipolar electrocoagulation, heater probe, injection sclerotherapy, band ligation or hemoclipping. A 15-year-old boy, who had undergone hemodialysis for chronic renal failure for about 10 years, was admitted due to melena and progressive anemia. A gastroduodenoscopy revealed a cherry red and fern-like lesion with oozing on the posterior wall at junction of gastric body and fundus. Endoscopic hemoclipping therapy was performed. However, melena recurred four days later. Argon plasma coagulation and hemoclipping therapy were performed again. Since then, no recurrence of bleeding has been observed.

• Korean Journal of Veterinary Research
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• v.48 no.2
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• pp.215-218
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• 2008

A 2-year-old, female, Maltese dog (3.2 kg of body weight) was referred to the Veterinary Medical Teaching Hospital, Chungnam National University with vomiting, anorexia and depression. Twelve hours prior to the onset of clinical signs, the dog ingested some grape skins (about 60 g). Physical examination at the time of presentation showed peripheral edema and mucous pallor. Blood and blood chemical analysis revealed anemia and moderate azotemia with elevated blood urea nitrogen (107.2 mg/dl), creatinine (6.3 mg/dl) and hyperphosphatemia (11.3 mg/dl). Echogenicity of renal cortex were observred by ultrasonography. The dog was diagnosed as acute renal failure occurred by grape skin toxicosis. The dog was treated with supportive care such as fluid therapy, diuretics (furosemide) and phosphorus binder (almagate). A normal condition of blood and blood chemical findings and clinical signs was observed at five days after treatment, and prognosis is good to date.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.1
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• pp.12-18
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• 2011

The purpose of this study was to evaluate the significance of higher than normal mean corpuscular volume (MCV) and lower than normal mean corpuscular hemoglobin concentration (MCHC) in 20 patients. The hemoglobin (Hb), red blood cell indices (MCV, MCH, MCHC,), red cell distribution width (RDW), serum ferritin, serum iron (Fe) and total iron binding capacity (TIBC) were measured and the transferrin saturation were calculated. 18 (90.0%) cases were categorized as chronic diseases. Chronic renal failure, malignancy, and bleeding were all related to the cases. The mean values of hemoglobin was $9.5{\pm}2.14g/dL$; the MCV was $29.0{\pm}2.8fL$; the MCH was $30.9{\pm}1.0pg$; the MCHC was $31.2{\pm}0.5%$; the RDW was $17.0{\pm}3.6%$; serum Fe was $39{\pm}21{\mu}g/dL$; the TIBC was $219.7{\pm}108.8{\mu}g/dL$; transferrin saturation was $19.2{\pm}9.9%$ and ferritin was $445.5{\pm}499.6{\mu}g/L$ in the patients. The WHO criteria for hemoglobin of patients confirms anemia in 18 of the 20 (90.0%) cases. Anemia of chronic disease was shown in 11 (73.3%) cases; acute gastric ulcer with hemorrhage in 1 (6.7%) case; iron deficiency anemia in 1 (6.7%) case; 2 patients (13.3%) were of normal cases. There were changes in the baseline Hb level results of the 19 (95.0%) cases while no change was shown in 1 case. As a result, diseases associated with anemia and bleeding where the MCV is higher than the normal range and MCHC is lower than normal range are considered relevant findings.

• Childhood Kidney Diseases
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• v.21 no.2
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• pp.61-68
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• 2017

Purpose: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.