• Journal of Chest Surgery
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• 제55권6호
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• pp.435-441
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• 2022

Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.189-196
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• 2009

목적 : 신증후군에서 사구체 단백 투과성이 증가하는 것은 전신적인 순환 인자와 관련되어 있는 것으로 여겨진다. 전신적인 순환 인자의 사구체 외 기관에서의 영향과 관련하여, 본 연구에서는 복막 투석 중인 steroid resistant nephrotic syndrome (SRNS) 환자에서의 복막투석을 통한 단백 소실 정도를 파악하고자 하였다. 방법 : 2001년부터 2009년까지 복막 투석 중인 신증후군 환자 12명(SRNS)과 대조군 14명을 대상으로 후향적 환자-대조군 연구를 시행하였다. 성별, 투석 시작 시 연령, 체중, 신장, 투석 방법, 투석양, 투석 시작 시 검사 소견(혈액 요소 질소, 혈청 크레아티닌, 혈청 단백, 혈청 알부민, 24시간 투석액 부피, 24시간 투석액 단백, Kt/V)과 1년 뒤 투석 시 검사 소견(24시간 투석액 단백)을 조사하였다. 단백질 섭취 정도를 평가하기 위해 nPNA (normalized protein equvalent of total nitrogen appearance)를 측정하였다. 결과 : SRNS군과 대조군은 nPNA를 비롯한 다른 지표에 의미 있는 차이를 보이지 않았으나, SRNS군에서 혈청 알부민이 $3.7{\pm}0.3$ g/dL로 대조군($4.0{\pm}0.4$ g/dL, P=0.021)보다 낮았다. 복막액을 통한 단백 소실량은 SRNS군에서 대조군보다 통계학적으로 의미 있게 높았으며($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007), 혈장 단백에 대한 복막의 투과성은 SRNS군에서 대조군보다 2배 가량 높았다($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). SRNS군과 대조군 모두 초기와 1년 뒤 복막 단백 소실량이 증가하였으나 대조군에서 더 큰 차이를 보였으며 복막 단백 소실량의 시간 경과에 따른 변화는 두 군(SRNS군 vs. 대조군)간에 의미있게 차이가 있었다(P=0.023). 결론 : 신증후군을 앓고 있는 소아 환자에서 복막 투석을 시행할 때는 이들의 영양상태, 성장 및 발달에 평가가 보다 적극적으로 이루어져야 하고, 복막을 통한 단백 소실을 모니터링하여 이를 보충하려는 노력 또한 필요하리라 생각된다.

• Childhood Kidney Diseases
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• 제3권1호
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• pp.35-41
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• 1999

목 적 : 사람의 미세변화 신증후군과 유사한 신증을 일으키는 것으로 알려진 puromycin aminonucleoside (PAN)의 1회 투여로 발생하는 신세포의 변화는 여러 기전이 작용하는 것으로 알려져 있으며, 최근에는 oxygen free radical이 사구체 손상의 중요한 한 가지 원인이라고 한다. 백서에 PAN을 투여하여 신증을 발생시킨 후, $\alpha$-tocopherol을 투여하였을 때 PAN신증에 미치는 영향에 대해 연구하고자 한다. 방 법 : 건강한 수컷 Sprague-Dawley 흰 쥐를 3군으로 나누어, 1군은 생리 식염수를 1회 투여한 대조군(N=6), II군은 PAN 1회 단독 투여군 (N=8), III군은 PAN투여 후 $\alpha$-tocopherol을 투여한 군 (N=7)으로 하였다. PAN 투여 직전과 투여 후 5일, 11일, 18일에 24시간 뇨의 protein, creatinine을 측정하였고, 18일째에는 혈청 protein, albumin, cholesterol도 함께 측정하였다. 또한 Oxygen free radical에 의한 신장 조직 손상을 평가하기 위해 신장 피질 미세균질액의 lipid peroxide와 reduced glutathione을 측정하였다. 결 과 : PAN투여 5일 후 24시간 뇨 protein/creatinine비는 II군과 III군에서 대조군에 비해 유의하게 증가하였다(P<0.01), 그러나 18일째에는 $\alpha$-tocopherol를 투여한 III군이 PAN을 단독 투여한 II군에 비해 유의하게 단백뇨가 적었다 (P<0.05). 신장 피질의 lipid peroxide과 reduced glutathione은 III군에 비해 II군에서 유의하게 증가하였다(P<0.05). 18일째의 신조직의 형태학적 변화는 PAN단독으로 투여한 II군에서는 사구체 상피세포의 족돌기가 심하게 융합되어 있으나, $\alpha$-tocopherol을 투여한 III군에서는 족돌기가 잘 보존되고 있었다. 결 론 : PAN투여로 초래된 백서 신증에서 $\alpha$-tocopherol의 투여는 lipid peroxidation의 진행을 차단하여 족돌기의 손상을 회복시키며 단백뇨의 배설도 감소시키는 것으로 사료된다.

• Toxicological Research
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• 제18권1호
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• pp.47-57
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• 2002

The subacute oral toxicity of 1-(4-methylpiperazinyl)-3-phenylisoquinoline (CWJ- a-5) was investigated in Sprague-Dawley (SD) rats. Five groups of 5 males and 5 females were orally administered at doses of 0, 37.5, 75, 150 and 200 mg/kg with CWJ-a-5 for 2 weeks. In clinical signs, Salivation was observed in the 75, 150 and 500 mg/kg male and female groups. Loss of fur was observed in the 500 mg/kg male and female group. Body weight were significantly decreased in the 150 and 500 mg/kg male groups and in the 500 mg/kg female group. Food consumption was significantly decreased in the 300 mg/kg male group. In serum biochemistry, total cholesterol and phospholipid were significantly increased in 500 mg/kg male and female group. Aspartate aminotransferase was significantly increased in the 500 mg/kg female group. In histopathological examination, vacuolar degeneration of renal tubules in the kidney, vacuolar degeneration of hepatocytes in the liver vacuolar degeneration of myocytes in the heart, vacuolar degeneration of histiocytes in the spleen and thymus, atrophy of seminiferous tubule and degeneration of germinal epithelium in the testis, vacuolar degeneration of corpus luteum, granulosa cell and theca cell in the ovary were observed in the 150 and 500 mg/kg male and female groups. Based on these results, the no observed adverse effect level (NOAEL) with CWJ-a-5 was considered to be 75 mg/kg and the absolute toxic dose was considered to be 150 mg/kg in this study

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2475-2478
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• 2016

Background: Laparoscopic partial nephrectomy is one of the major surgical techniques for small renal masses. However, it is difficult to manage cutting and suturing procedures within acceptable time periods. To overcome this difficulty, we applied a three-dimensional (3D) video system with laparoscopic partial nephrectomy, and evaluated its utility. Materials and Methods: We retrospectively enrolled 31 patients who underwent laparoscopic partial nephrectomy between November 2009 and June 2014. A conventional two-dimensional (2D) video system was used in 20 patients, and a 3D video system in 11. Patient characteristics and video system type (2D or 3D) were recorded, and correlations with perioperative outcomes were analyzed. Results: Mean age of the patients was $55.8{\pm}12.4$, mean body mass index was $25.7{\pm}3.9kg/m^2$, mean tumor size was $2.0{\pm}0.8cm$, mean R.E.N.A.L nephrometry score was $6.9{\pm}1.9$, and clinical stage was T1a in all patients. There were no significant differences in operative time (p=0.348), pneumoperitoneum time (p=0.322), cutting time (p=0.493), estimated blood loss (p=0.335), and Clavien grade of >II complication rate (p=0.719) between the two groups. However, warm ischemic time was significantly shorter in the 3D group than the 2D group (16.1 min vs. 21.2min, p=0.021), which resulted from short suturing time (9.1 min vs. 15.2 min, p=0.008). No open conversion occurred in either group. Conclusions: A 3D video system allows the shortening of warm ischemic time in laparoscopic partial nephrectomy and thus may be useful in improving the procedure.

• 한국한의학연구원논문집
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• 제16권2호
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• pp.143-157
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• 2010

Objectives : The objective of this study was to access the effect of Artemisiae capillaris herba Extracts on the organogenetic reproductive toxicity of New Zealand White rabbits when administered by oral gavage. Methods : Gestational New Zealand White rabbits were dosed from 6 days of gestation to 18 days of gestation. It was conducted in accordance with the recommendations of the KFDA Guideline for Detection of Toxicity to Reproduction for Medicinal Products. In addition, serum AST, ALT, LDH and ALP levels were detected with their necropsy and histopathological observation Results: No significant changes of body weights, gains and food consumption were demonstrated in all dosed groups compared to those of vehicle control group except for 2,000mg/kg-dosing group, which showed significantly increase of body weight compared to that of vehicle control group. Normal gross findings were demonstrated in all tested groups. No significant changes of number of corpora lutea, implantation, implantation rate, number of fetal death, loss rate of post-implantation, number of live youngs at C-section, survival rate of post-implantation, number of male live youngs at C-section, number of female live youngs, sex ratio of live young, external anomalies of live youngs and body weight of live youngs were demonstrated in all dosed groups compared to those of vehicle control group. Although some visceral variations such as thymic reminant in the neck, dilation of renal pelvis, dilated ureter and malpositioned left common carotid artery, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. Some malformations and variation were demonstrated with retardations. However, no significant changes were demonstrated in all dosed groups compared to that of vehicle control group. In addition, similar ossification numbers were detected in sternebrae, metacarpals, metatarsals, phalanges, cervical vertebrae, and sacral and caudal vertebrae. No Artemisiae capillaris herba Extracts treatment-related changes of serum AST, ALT, LDH and ALP levels were demonstrated in all dosed levels in this study. Conclusions : We could conclude that oral administration of Artemisiae capillaris herba Extracts hasn't an influence on the organogenetic reproductive toxicity.

• 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.

• Clinical and Experimental Pediatrics
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• 제54권2호
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• pp.90-93
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• 2011

Pseudohypoaldosteronism type 1 (PHA1) is a rare form of mineralocorticoid resistance characterized in newborns by salt wasting with dehydration, hyperkalemia and failure to thrive. This disease is heterogeneous in etiology and includes autosomal dominant PHA1 owing to mutations of the NR3C2 gene encoding the mineralocorticoid receptor, autosomal recessive PHA1 due to mutations of the epithelial sodium channel (ENaC) gene, and secondary PHA1 associated with urinary tract diseases. Amongst these diseases, autosomal dominant PHA1 shows has manifestations restricted to renal tubules including a mild salt loss during infancy and that shows a gradual improvement with advancing age. Here, we report a neonatal case of PHA1 with a NR3C2 gene mutation (a heterozygous c.2146_2147insG in exon 5), in which the patient showed failure to thrive, hyponatremia, hyperkalemia, and elevated plasma renin and aldosterone levels. This is the first case of pseudohypoaldosteronism type 1 confirmed by genetic analysis in Korea.

• 한국임상수의학회지
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• 제18권2호
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• pp.116-123
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• 2001

This study was undertaken to find out the effect of Korean safflower seed powder on histopathological changes of cadmium toxicity in mice. Fifty BALB/c mice were divided into a control group(A) and four experimental groups(B, C, D, E) : group A received tap water and basal diet, group B received tap water and diet supplemented with 3% Korean safflower seed powder alone, group C received basal diet and 300 $\mu\textrm{g}$/g of cadmium, group D and E received basal diet supplemented with 3% and 10% Korean safflower seed powder and 300$\mu\textrm{g}$/g of cadmium respectively. Cadmium dissolved in tap water was used, and the Korean safflower seed powder were mixed with feed. All mice were dissected on the 56th day. Histopathological changes in liver, kidney, lung, cortical osseous tissue of femoral shaft, bone trabecular of femur, and epiphyseal cartilage plate of femur were observed. Group B showed no significant changes compared with the control group. But group C showed the unclearness of specific cells in liver, the loss of architecture and focal necrosis of hepatocyte, the glomerular swelling, degeneration and necrosis of convoluted tubules, desquamation and vacuolization of the greater part of the renal tubular epithelium, the marked congestion and thickness of the wall of alveolus in lung, slightly thinning of the cortical osseous tissue in femoral shaft, reduction of cancellous bone volume and marked narrowness of bone trabecular, marked thinning of epiphyseal cartilage plate and irregular arrangement of columnar structure of cartilage cells. On the other hand, Korean safflower seed powder-treated group showed a little convalescent changes and maintained their normal architectures in liner, kidney, lung, cortical osseous tissue of femoral shaft, bone trabecular of femur and epiphyseal cartilage plate of femur.

• 대한소아치과학회지
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• 제32권1호
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• pp.152-157
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• 2005

Hypophosphatemia rickets는 비타민 D의 치료량에 내성을 갖기 때문에 Vitamin D-resistant rickets(VDRR)라고도 명명되며, 이는 요세관으로부터 무기질 인산의 재흡수가 감소됨으로써 혈청 칼슘농도는 정상이나 인산농도가 낮고 alkaline phosphatase가 약간 증가되기 때문에 쉽게 진단되는 구루병의 한 형태이다. 이러한 Hypophosphatemia rickets의 임상적인 소견으로 양다리가 휘는 것. 작은 키, 척추측만. 손목과 발목부위의 팽대가 나타나며 구강내 소견으로는 자발적인 치성농양의 높은 발생률, 맹출 지연, 근단공의 폐쇄지연, 얇고 저형성된 법랑질, 명확히 인지하기 힘든 치조백선, 확대된 치수강, 법랑상아경계까지 연장된 치수각 등이 있다. 본 증례는 유치의 상실과 그에 따른 치료를 위해 본원 소아과에서 의뢰된 비타민 D저항성 구루병 환아의 임상소견과 그 치과적 치료에 대해 보고하는 바이다.