• Title/Summary/Keyword: Renal loss

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Study on pathology of Alzheimer's disease, trends and future strategy for research (치매의 병리(病理), 연구동향(硏究動向)과 향후(向後) 연구전략(硏究戰略)에 대(對)한 고찰(考察))

  • Oh, Young-Sun;Kim, Sung-Hoon
    • Journal of Haehwa Medicine
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    • v.8 no.1
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    • pp.793-825
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    • 1999
  • For the development of drugs for alzheimer,s disease, the study was done to review the oriental pathology, clinical data, recent trends for research and strategy for future study. The results were as follows: 1. The medical term Chi-dsi implying alzheimer,s disease was referred for the first time in a medical book, Hwatasheneubijeon written by Hwa-Ta and its differentiation and treatment were studied more in Ming or Ching dynasties. Chi-dai can be differentated as weak(虛) syndrome and Shi(實) syndrome. This can be caused by deficiencies of renal Yin, renal Yang, cardiac Yin and hepatic blood, while that by deficiencies of pathological fluid(痰飮) and clotted blood(瘀血). 2. Dementia can be roughly classified as alzheimer's disease and multi-infarct disease. Its causes were known to be cholinergic transmitter, C-peptide, amyloid-${\beta}$, apolipoprotein, APP(amyloid precursor protein), TGF, MMP-9 and free radical. 3. In Korea experimental studies were chiefly done for the elimataion of C-peptide, amyloid-${\beta}$, apolipoprotein, APP for alzheimer's disease, for the development of drug inhibiting degerative change following CVA and loss of memory and also administrative measure was done by support of government. 4. Drugs of dimentia developed so far were Chi-Dai dan, extracts from aloe, mushroom, green tea, Ganoderma and also folic acid, vitamin C, DHEA and silk amino acid were reported to be effective in dimenta. 5. Future strategic research had better be done on dementia-inducing factors such as acetylcholine, C-peptide, amyloid-${\beta}$, apolipoprotein, APP, TGF, MMP-9 and free radical, development of animal model for dimentia, clinical study, epidemiology, nursing and administrative studies and also consortium for dimentia research should be formed so that repeated investment be avoided.

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Effects of Cadmium Chloride on Fine Structures of Renal Glomerulus and Epithelial Cells of Proximal Convoluted Tubules in Albino Rats (Cadmium Chloride가 흰쥐신사구체 및 근위요세관 상피세포의 미세구조에 미치는 영향)

  • Kwak, Jin-Ku;Lee, Koon-Za;Chung, Ho-Sam;Lee, Kyu-Sik
    • Applied Microscopy
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    • v.21 no.2
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    • pp.76-95
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    • 1991
  • A single injection of cadmium chloride (3.75 mg/kg) was made into the peritoneal cavities of albino rats. The cortices of kidney were obtained from the experimental animals at 3 hr., 6 hr., 12 hr., 24 hr. and 36 hr. after administration of cadmium chloride, respectively. The specimens of each experimental animal were prefixed in 2% glutaraldehyde-4% paraformaldehyde solution for $2{\sim}4$ hours, and these specimens were post-fixed in 1% osmic acid. After fixation, the specimens were dehydrated with alcohol and acetate and embedded in Epon 812. Ultrathin sections, $600{\sim}800{\AA}$ thickness were made and stained with uranyl acetate and lead citrate. And all the preparations were observed with Hitachi-600 transmission electron microscope. The results obtained were as follows: 1. The main changes in ultrastructures of the glomeruli observed at 3 hr. after cadmium chloride administration include loss of filtration slit and fenestrae of capillary endothelium that was resulted from thickings of the basal lamina and fusion of pedicels of the podocytes. At 12 hr. after cadmium chloride administration the Bowman's capsules were mostly filled with abnormally thickened and fused pedicels. After 24 hr. however, the only recognized change was loss of fenestrae of the capillary endothelium. And the ultrastructure of the glomeruli were almost normal in 36 hr. after cadmium chloride treatment. 2. At 3 hr. after treatment with cadmium chloride, in the renal tubular cells the vesicles and vacuoles increased in number at the apical portion, of the tubular epithelial cells, the basal infoldings were reduced and the basal lamina was thickened. After 12 hr., a number of phagosomes appeared at the apical portion and the cisternae of rough endoplasmic reticulum were swollen. At 24 hr. after cadmium chloride administration irregularly shaped mitochondria were observed in the apical area, and mitochondria with swollen cristae were found at the basal portion. And after 36 hr. The ultrastructures of the epithelial cells appeared almost normal except for a moderate increase in the number of vesicles and vacuoles. Consequently it is suggested that in albino rats, cadmium chloride induces acute reversible degenerative changes in the glomeruli as well as in the epithelial cells of the proximal convoluted tubules.

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The Comparative Effects of Yugmijihwangtang in Donguibogam and Experiment Research Results -Focusing on the Korean Medicine and Traditional Chinese Medicine- (육미지황탕 효능의 동의보감과 실험연구결과의 비교고찰 -한의학과 중의학을 중심으로-)

  • Han, Yoochang;Kim, Myung Dong;Lee, Sundong
    • Herbal Formula Science
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    • v.25 no.2
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    • pp.223-251
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    • 2017
  • Objectives : A lot of experiment results of Yugmijihwangtang(YM) are reported in various kinds of journals. Many of them report on the new effects that are not recorded in the traditional medical texts. So it is necessary to take it into consideration that newly reported effects could be of help to clinical practice, because this process of comparison of Donguibogam and scientific experiment results will have basis to lead into the evidence based medicine. Methods : We compared the effects of in Donguibogam and the experiment results of YM. Results : The effects of YM in Donguibogam are to replenish essence and marrow, and to treat red wen, fatigue, treat hypouresis, urinary sediment, urinary urgency, hematuria, hydrocephalus, speech and movement retardation, yin-deficiency, diabetes mellitus, nonalcoholic fatty liver, melanoma, disability to see near and far sight, tinnitus, hearing loss, alopecia, angiogenesis, cough, cough at night, trachyphonia, and, infantile convulsion. The experiment results of YM since 2000 in both Korea and China are to inhibit atopic dermatitis, renal interstitial fibrosis, anti-oxidant, emphysema, stress, glomerulosclerosis, diabetic nephropathy, chronic glomerulonephritis, hemorrhage, plantar sweating, dermal aging, kidney aging, bone loss, breast cancer, pathological myocardial cell, primary liver cancer, thrombosis, osteoporosis, intrauterine growth retardation, chronic renal failure, IgA nepropathy, slow cerebral development, and hippocampal tissue lesions on the one hand, and to help bone formation, renin-angiotensin- aldosterone system, cerebral recovery, cognitive function and expression, osteoblast proliferation and differentiation, learning and memory, cold-tolerance and oxygen deficit-tolerance and anti-fatigue, endometrial formation, humoral and cell-mediated immunity, immune regulation effect, Hypothalamus-Pituitary-Ovary Axis, and spermatogenesis, on the other hand. Conclusion : When we compared the effects of YM with the experiment results of YM, there existed a considerable gap between them. So, from now on, it is expected that a great effort and consideration are needed to solve these gaps from an academic and clinical point of view.

Comparison of the Effectiveness of University of Wisconsin and Histidine-Tryptophan Ketoglutarate Solution on Renal Cold Preservation in the Miniature Pig (미니돼지에서 University of Wisconsin 용액과 Histidine-Tryptophan Ketoglutarate 용액의 신장 저온보존효과 비교)

  • Nam, Hyun-Suk;Yoon, Byung-Il;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.445-449
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    • 2009
  • For human organ transplantations, histidine-tryptophan-ketoglutarate solution (HTKS) and University of Wisconsin solution (UWS) have been shown to engender similar outcomes as gold standard cold preservation solutions ($4^{\circ}C$). To select the effective preservation solution for cold storage of kidney xenografts in miniature pig, which could be a potential source animal of bio-organs, this study compared early histopathological outcomes of cold preservation injury using HTKS and UWS. Twelve miniature pigs weighing 25.6 to 34.7 kg were divided into two groups (n = 6 per group), UWS group and HTKS group. The kidneys in each group were harvested, cold flushed, and preserved for 0, 24, 48, and 72 hrs at $4^{\circ}C$ with UWS or HTKS, respectively. Histolopathological examinations were assessed on kidney biopsy specimens, taken after each cold storage. The degree of renal injury was scored using 5 different criteria (pyknotic nuclei, disruption of cytoplasm, detachment of epithelium, loss of microvilli, tubular necrosis and loss of glomerular tufts) of the cellular components of the tissue. The degree of kidney damage was increased with prolonged cold ischemia time. UWS and HTKS have at least similar efficacy in kidney preservation within 24 hrs cold preservation time. However, in HTKS group cold-induced injury started to be observed more than in UWS group after 48 hrs of cold storage. In conclusion, UWS and HTKS were equally effective for cold preservation of miniature pig kidney in early preservation times; however, UWS may be more effective at longer preservation times as compared to HTKS.

Clinical Significance of Preoperative Embolization for Non-Hypervascular Metastatic Spine Tumors

  • Yoo, Sung-Lim;Kim, Young-Hoon;Park, Hyung-Youl;Kim, Sang-Il;Ha, Kee-Yong;Min, Hyung-Ki;Seo, Jun-Yeong;Oh, In-Soo;Chang, Dong-Gune;Ahn, Joo-Hyun;Kim, Yong-Woo
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.106-113
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    • 2019
  • Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

Interactions between Collagen IV and Collagen-Binding Integrins in Renal Cell Repair after Sublethal Injury

  • Nony, Paul A,;Schnellmann, Rick G.
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2002.11a
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    • pp.80-88
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    • 2002
  • Recent studies demonstrate that collagen IV selectively pro-motes the repair of physiological processes in sublethally injured renal proximal tubular ceils (RPTC). We sought to further define the mechanisms of cell repair by measuring the effects of toxicant injury and stimulation of repair by L-ascorbic acid-2-phosphate (AscP), exogenous collagen IV, or function-stimulating integrin antibodies on the expression and subcellular localization of collagen-binding integrins (CBI) in RPTC. Expression of CBI subunits ${\alpha}_1$, ${\alpha}_2$, and ${\beta}_1$ in RPTC was not altered on day 1 after sublethal injury by S-(1,2-dichlorovinyl)-L-cysteine (DCVC). On day 6, expression of ${\alpha}_1$ and ${\beta}_1$ subunits remained unchanged, whereas a 2.2-fold increase in ${\alpha}_2$ expression was evident in injured RPTC. CBI localization in control RPTC was limited exclusively to the basal membrane. On day 1 after injury, RPTC exhibited a marked inhibition of active $Na^+$ transport and a loss of cell polarity characterized by a decrease in basal CBI localization and the appearance of CBI on the apical membrane. On day 6 after injury, RPTC still exhibited marked inhibition of active $Na^+$ transport and localization of CBI to the apical membrane. However, DCVC-injured RPTC cultured in pharmacological concentrations of AscP (500 ${\mu}$M)or exogenous collagen IV (50 ${\mu}$g/ml) exhibited an increase inactive $Na^+$ transport, relocalization of CBI to the basal membrane, and the disappearance of CBI from the apical membrane on day 6. Function-stimulating antibodies to CBI ${\beta}_1$ did not promote basal relocalization of CBI despite stimulating the repair of $Na^+$/$K^+$-ATPase activity on day 6 after injury. These data demonstrate that DCVC disrupts integrin localization and that physiological repair stimulated by AscP or collagen IV is associated with the basal relocalization of CBI in DCVC-injured RPTC. These data also suggest that CBI-mediated repair of physiological functions may occur independently of integrin relocalization.

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Nephropathy in Chronic Lead Poisoning (만성 연중독자에서 발생한 신장해)

  • Kim, Byoung-Gwon;Kim, Sung-Ryul;Hong, Young-Seoub;Rha, Seo-Hee;Kim, Jung-Man;Jung, Kap-Yull;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.43-50
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    • 1996
  • We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.

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Estimating the Cost Savings Due to the Effect of Kremezin in Delaying the Initiation of Dialysis Treatments among Patients with Chronic Renal Failure (크레메진의 투석도입 지연효과에 따른 진행성 신부전증환자의 비용감소분 추계)

  • Cho, Woo-Hyun;Lee, Sun-Mi;Kim, Hyung-Jong;Lee, Ho-Yong;Woo, Tae-Wook;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.2
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    • pp.149-158
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    • 2006
  • Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.

Predictors of Mortality after Surgery for Empyema Thoracis in Chronic Kidney Disease Patients

  • Pulle, Mohan Venkatesh;Puri, Harsh Vardhan;Asaf, Belal Bin;Bishnoi, Sukhram;Malik, Manish;Kumar, Arvind
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.392-399
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    • 2020
  • Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

Chromosome 3p Deletions in Korean Head and Neck Carcinomas (한국인 두경부암 환자에서 제3번 염색체 단완의 결손)

  • Son Mi-Na;Yoo Young-A;Cho Zeung-Keun;Choi Kun;Choi Jong-Wook;Kim Yeul-Hong;Kim Jun-Suk
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.20-26
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    • 1998
  • Objectives: Deletion in the short arm of chromosome 3 is common in many human cancers, including sporadic and hereditary renal carcinomas, small cell lung carcinomas, non-small cell lung carcinomas, and carcinomas of the ovary, breast, and cervix. A high frequency of chromosomal aberrations in head and neck cancers involving chromosome 3p has also been reported. These findings suggest that multiple tumor suppressor genes may be present on the short arm of chromosome 3. Materials and Methods: To investigate the possibility of chromosome 3p deletions in the Korean head and neck cancer patients, we applied a polymerase chain reaction(PCR)-based Restriction Fragment Length Polymorphism analysis to the DNA samples of matched normal mucosa and head and neck squamous cell carcinomas from 19 patients. Results: In the 19 normal samples heterozygosity at the polymorphic loci varied: 6 at the D3F15S2 locus(on telomeric 3p21), 2 at the D3S32 locus(on centromeric 3p21), and 4 at the THRB locus(on centromeric 3p24). In 12 matched carcinoma specimens, LOH(loss of heterozygosity) was observed at D3F15S2 in 1 of 6(17%), D3S32 in 1 of 2(50%), and at THRB in 2 of 4 cases(50%). Conclusion: The frequency of chromosome 3p deletion in the Korean head and neck carcinomas appear as other country did.

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