• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.421-426
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• 2015

Purpose: The vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates. Methods: We retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively. Results: The mean CLvcm (${\pm}$standard deviation) was $74.52{\pm}31.17L/hr$, the volume of distribution of vancomycin was $0.67{\pm}0.14L$, and vancomycin half-life was $9.16{\pm}17.42hours$. The SCr was $0.46{\pm}0.25mg/dL$ and serum Cys-C was $1.43{\pm}0.34mg/L$. The peak and trough concentrations of vancomycin were $24.65{\pm}14.84$ and $8.10{\pm}5.35mcg/mL$, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were $70.2{\pm}9.45$ and $63.6{\pm}30.18mL/min$, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001). Conclusion: The use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.243-243
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• 1994

Although active systemic anaphylaxis and passive cutaneous anaphylaxis have been empolyed to study anaphylactic hypersensitivity, it is difficult and time-consuming to induce these reactions in experimental animals. In recent, Jun et al have found a simple method to induced anaphylactic hypersensitivity such as anaphylactic shock(AS) and cutaneous reaction(CR) using compound48/80. Cortex mori (Morus alba L.), the root bark of mulberry tree has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine. The purpose of this study was to determine whether the methanol extract of Cortex mori could inhibit the compound 48/80-induced AS and CR. To induce AS, various doses of compound 48/80 (5, 7.5, 10, 15$\mu\textrm{g}$/gm B.W.) were injected intraperitoneally (i.p.) into ICR mice. The animals were pretreated by three injection(i.p.) of Cortex mori before compound 48/80 administration. Peripheral blood was collected from the right ventricle to estimate the level of serum histamine at 15 minutes after the injctin(i.p.) of various concentration of compound48/80. Mortility rate, mean death time and mesenteric mast cell degranulation rate were evaluated over a 72 hour period. To estimate the effect of Cortex mori on compound 48/80-induced cutaneous reaction, various doses of compound 48/80 with or without Cortex mori were injected intradermally(i.d.) into the shaved flank of Sprague-Dawley rats, and the blue cutaneous patchs induced by Evans'blue injection at the compound 48/80 alone and Cortex mori plus compound 48/80 injection sites were observed. As a Parameter of these reactions, the levels of histamine in the supernatant, calcium uptake and intracellular CAMP of RPMC were measured. supernatant, 1)compound 48/80-induced mortility rate, mean death time, mesenteric mast cell degranulation rate, and serum histamine level in ICR mice were significantly inhibited by pretreatment of Cortex mori, 2) cutaneous reaction inducd by compound48/80 was well developed in Sprague-Dawley rat, but Cortex mori inhibited the compound 48/80-induced blue patch formation remarkably, 3) the compound 48/80-induced degranulation, histamine release and calcium uptake of RPMC pretreated with Cortex mori were significantly inhibited, compared to those of control without Cortex mori pretreatment, and 4)the level of cAMP of RPMC was reduced bythe increased concentration of compound 48/80, pretreatment of Cortex mori not only inhibited the compound 48/80-induced reduction of CAMP but also significantly increased the level of cAMP naturally, from the above results, it is suggested that Cortex mori has an some substances with an ability to inhibits the compound 48/80-induced AS,CR, and mast cell activation.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.347-359
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• 2024

Background/Aims: Renal relapse has known to be a poor prognostic factor in patients with lupus nephritis (LN), but there were few studies that identified the risk factors of renal relapse in real world. We conducted this study based on 35-years of experience at a single center to find out predictors of renal relapse in Korean patients with LN after achieving complete response (CR). Methods: We retrospectively analyzed the clinical, laboratory, pathologic and therapeutic parameters in 296 patients of LN who reached CR. The cumulative risk and the independent risk factors for renal relapse were examined by Kaplan-Meier methods and Cox proportional hazards regression analyses, respectively. Results: The median follow-up period from CR was 123 months. Renal relapse had occurred in 157 patients. Renal relapse occurred in 38.2%, 57.6% and 67.9% of patients within 5-, 10-, and 20-year, respectively. The age at diagnosis of SLE and LN were significantly younger, and the proportions of severe proteinuria and serum hypoalbuminemia were higher in patients with renal relapse. Interestingly, the proportion of receiving cytotoxic maintenance treatment was higher in patients with renal relapse. In Cox proportional hazards regression analyses, only young-age onset of LN (by 10 years, HR = 0.779, p = 0.007) was identified to independent predictor of renal relapse. Conclusions: Young-age onset of LN was only independent predictor and the patients with severe proteinuria and serum hypoalbuminemia also tended to relapse more, despite of sufficient maintenance treatment. Studies on more effective maintenance treatment regimens and duration are needed to reduce renal relapse.

• Food Quality and Culture
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• v.2 no.2
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• pp.89-96
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• 2008

In order to determine whether green tea tannin ameliorates abnormal arginine metabolism as the result of excessive arginine, we have assessed the effects of the administration of green tea tannin mixture in rats treated 30 days with 2% arginine. In the arginine-treated group, the level of guanidino compounds such as arginine (Arg), guanidinoacetic acid (GAA), creatinine (Cr), methylguanidine (MG) and guanidinosuccinic acid (GSA), nitric oxide, urea, protein and glucose increased significantly in the serum, urine and kidney, whereas the oxygen species-scavenging enzymes of kidney were reduced as compared with the non-arginine-treated group. By way of contrast, the administration of green tea tannin reduced blood urea nitrogen and serum creatinine, and reduced the urinary excretion of guanidinoacetic acid, creatinine, and $NO_2^-+NO_3^-$. The increased levels of urinary urea, protein and glucose in the arginine-treated group were also lowered by the administration of green tea tannin. In these groups, the activities of superoxide dismutase and catalase in the kidney were increased, thereby suggesting the involvement of radicals in the normalizing of kidney function. These results show that the abnormal renal function induced by the adminstration of excessive arginine in rats may be restored by treatment with green tea tannin.

• Korean Journal of Clinical Pharmacy
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• v.8 no.1
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• pp.23-28
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• 1998

The pharmacokinetics of atenolol (25 mg/kg, i.v.) in the folate-induced renal failure rabbits was studied. Renal failure was induced by the i.v. injection of folate (50, 100, and 200 mg/kg). At folate dose of 100 and 200 mg/kg, the serum creatinine concentration (Scr) and blood urea nitrogen (BUN) increased significantly compared with control rabbits. Plasma concentrations and AUC of atenolol increased significantly at folate dose of 100 and 200 mg/kg. The elimination rate constant $(K_{el})$ and total body clearance $(CL_t)$ of atenolol decreased significantly, and half-life ($t_{1/2}$) and mean residence time (MRT) of atenolol increased significantly at folate dose of 100 and 200 mg/kg. The serum creatinine concentration $(S_{cr})$ correlated well (p<0.05) with half-life $(t_{1/2})$ and elimination rate constant $(K_{el})$ of atenolol, as well as BUN with AUC and total body clearance $(CL_t)$ of atenolol.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.240-248
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• 2014

Background: Open heart surgery using cardiopulmonary bypass (CPB) is considered one of the most frequent surgical procedures in which acute kidney injury (AKI) is a frequent and serious complication. The aim of the present study was to evaluate the efficiency of neutrophil gelatinase-associated lipocalin (NGAL) as an early AKI biomarker after CPB in cardiac surgery (CS). Methods: Thirty-seven adult patients undergoing CS with CPB were included in this retrospective study. They had normal preoperative renal function, as assessed by the creatinine (Cr) level, NGAL level, and estimated glomerular filtration rate. Serial evaluation of serum NGAL and Cr levels was performed before, immediately after, and 24 hours after the operation. Patients were divided into two groups: those who showed normal immediate postoperative serum NGAL levels (group A, n=30) and those who showed elevated immediate postoperative serum NGAL levels (group B, n=7). Statistical analysis was performed using Statistical Package for the Social Sciences version 18. Results: Of the 37 patients, 6 (6/37, 16.2%) were diagnosed with AKI. One patient belonged to group A (1/30, 3.3%), and 5 patients belonged to group B (5/7, 71.4%). Two patients in group B (2/7, 28.5%) required further renal replacement therapy. Death occurred in only 1 patient (1/37, 2.7%), who belonged to group B. Conclusion: The results of this study suggest that postoperative plasma NGAL levels can be used as an early biomarker for the detection of AKI following CS using CPB. Further studies with a larger sample size are needed to confirm our results.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.329-331
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• 2006

Alkaptonuria is a rare metabolic disease in which homogentisic acid cannot be metabolized due to a lack of the enzyme homogentisic acid oxidase. The disease often manifests itself in childhood by darkening of the urine upon standing. The disease leads to such serious consequences as ochronosis of cartilage and connective tissues with arthritis. It is expected that treatment with ascorbic acid and a dietary restriction of protein may decrease the late and serious consequences by diminishing the serum concentration of the metabolite benzoquinone acetic acid. A thirteen month-old girl was recently diagnosed with alkaptonuria by urine organic acid analysis. She excreted pinkish urine on a diaper and as time went by the urine color changed to a light brown. In laboratory findings, urine examination and culture results were normal. But urine organic acid analysis detected abnormal findings a prominent and massive elevation of homogentisic acid. The other physical findings were normal. This is the first case diagnosed in Korea.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.3
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• pp.350-357
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• 2024

Backgrounds/Aims: This trial evaluated whether anti-inflammatory agents hydrocortisone (H) and indomethacin (I) could reduce major complications after pancreatoduodenectomy (PD). Methods: Between June 2018 and June 2020, 105 patients undergoing PD with > 40% of acini on the intraoperative frozen section were randomized into three groups (35 patients per group): 1) intravenous H 100 mg 8 hourly, 2) rectal I suppository 100 mg 12 hourly, and 3) placebo (P) from postoperative day (POD) 0-2. Participants, investigators, and outcome assessors were blinded. The primary outcome was major complications (Clavien-Dindo grades 3-5). Secondary outcomes were overall complications (Clavien-Dindo grades 1-5), Clinically relevant postoperative pancreatic fistula (CR-POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), surgical site infections (SSI), length of stay, POD-3 serum amylase, readmission rate, and mortality. Results: Major complications were comparable (8.6%, 5.7%, and 8.6% in groups H, I, and P, respectively). However, overall complications were significantly lower in group H than in group P (45.7% vs. 80.0%, p = 0.006). CR-POPF (14.3% vs. 25.7%, p = 0.371), PPH (8.6% vs. 14.3%, p = 0.710), DGE (8.6% vs. 22.9%, p = 0.188), and SSI (14.3% vs. 25.7%, p = 0.371) were comparable between groups H and P. Major complications and overall complications in group I were 5.7% and 60.0%, respectively, which were comparable to those in groups P and H. CR-POPF rates in groups H, I, and P were 14.3%, 17.1%, and 25.7%, respectively, which was comparable. Conclusions: H and I did not decrease major complications in PD.

• Asian-Australasian Journal of Animal Sciences
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• v.22 no.12
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• pp.1640-1647
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• 2009

Two field studies were conducted to determine the efficacy of difructose anhydride III (DFA III) as a supplement in colostrum replacer (CR) for improving the general health status (judged on the basis of incidence of enteritis, bronchitis, and pneumonia) of group-housed suckling Japanese Black calves. In a preliminary study, CR supplemented with DFA III (6 g) was orally administered within 24 h of calving to eight individually reared calves fed colostrum (DFA III group) (Exp. 1). Subsequently, CR supplemented with DFA III (6 g) was orally administered twice within 2 and 12 h of calving to four calves (DFA III group) that were not fed colostrum (Exp. 2). In both experiments, the health status of the calves was assessed during the preweaning period. In Exp. 2, hematological and blood-chemistry parameters were analyzed 24 h after the second administration of CR and at 1 wk and 1 month after calving. The results were compared between the DFA III and control groups (without DFA III supplementation; Exp. 1: n = 10, Exp. 2: n = 4). In Exp. 1, the number of calves requiring medications for the treatment of enteritis, bronchitis, and pneumonia during the preweaning period was significantly (p<0.05) lower in the DFA III group than in the control group. In Exp. 2, supplementation of DFA III did not influence the gain in body weight of calves during the pre-weaning period. Calves in the DFA III group tended to require medications for a shorter duration than those in the control group (DFA III: 10.3 d/calf, control: 21.3 d/calf; p = 0.07). Significant differences (p<0.05) in the level of mean corpuscular hemoglobin, total protein, total cholesterol, and immunoglobulin (Ig)G were observed between the DFA III and control groups. These differences probably reflect the health and nutritional status of the calves. Additionally, the serum iron and lactoferrin concentrations at 24 h and 1 wk after calving, respectively, differed significantly between the 2 groups. These concentrations might reflect the incidence of infections after calving. The present study revealed that the administration of DFA III as a CR supplement may prevent diseases in group-housed calves during the pre-weaning period.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.213-218
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• 2001

Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN l17 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 213-18)