• Neonatal Medicine
• /
• 제17권2호
• /
• pp.161-167
• /
• 2010

Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF) is defined as the sudden impairment of kidney function (estimated from the glomerular filtration rate [GFR]) that results in the lack of excretion of waste products. More than 30 definitions of AKI exist in the literature, most of which are based on serum creatinine. Lack of a uniform and multidimensional AKI definition has led to failure to recognize significant renal injury, delays in treatment, and inability to generalize single-study results. The RIFLE criteria were developed to standardize the diagnosis of ARF and in the process the term AKI has been proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy. Large prospective studies are needed to test definitions and to better understand risk factors, incidence, independent outcomes, and mechanisms that lead to poor short- and long-term outcomes. Early biomarkers of AKI need to be explored in critically ill neonates.

• Journal of Chest Surgery
• /
• 제25권3호
• /
• pp.232-239
• /
• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• 대한수의학회지
• /
• 제53권3호
• /
• pp.169-174
• /
• 2013

We demonstrated that a mineral aqueous solution (MAS) administered to mice functionally and histologically protected against cisplatin-induced acute renal failure (ARF) and $CCl_4$-induced acute liver failure (ALF). In ARF model, 0.4 and 0.2% MAS decreased mortality and the serum concentrations of blood urea nitrogen (BUN) and creatine in mice. Additionally, 0.4 and 0.2% MAS reduced contraction of distal convoluted tubules and suppressed expression of the proinflammatory cytokines interlukein-6 (IL-6) and tumor necrosis factor (TNF-${\alpha}$) in the kidney. In ALF model, 0.4 and 0.2% MAS decreased serum concentrations of alanine aminotransferase and aspartate aminotransferase in mice. Additionally, 0.4 and 0.2% MAS reduced necrotic areas and suppressed expression of IL-6 and TNF-${\alpha}$ in the liver. These results indicate that a MAS might have protective effects against ARF and ALF.

• Journal of Chest Surgery
• /
• 제39권11호
• /
• pp.854-857
• /
• 2006

환자는 8세 여자 환자로 확장성 심근병증을 진단 받은 환자이다. 환자는 심부전으로 인하여 양심실 순환보조를 15일간 시행하였다. 15일 중 후반기 7일은 급성 신부전증이 발생하여 지속적 정맥-정맥간 혈액투석을 시행하였다. 이후 뇌사상태의 A형 혈액형을 가진 심장 공여자에게서 심장을 이식받아 심장이식술을 시행하였다. 면역 억제제는 급성 신부전증을 고려하여 사용하였다. 신부전 상해는 2주간 지속되었고, 심장 이식술 후 약 14일 후 배뇨가 시작되었다. 환자는 수술 후 12일째에 시행한 우심실 조직검사에서 특별한 거부반응의 증거가 없었으며, 면역요법 후 수술 후 52일째에 특별한 문제 없이 퇴원하였다. 환자는 술 후 약 14개월간 조직검사에서 면역 거부반응 없이 외래 경과관찰 중이다.

• 한국농공학회지
• /
• 제30권2호
• /
• pp.31-43
• /
• 1988

The Purpose of this study is to develop the rainfall-delayed response model (RDR Model) which influences the baseflow proportion of rivers as a result of the antecedent precipitation of the previous several months. The assesment of accurate baseflows in the rivers is one of the most important elements for the planning of seasonal water supply for agriculture, water resources development, hydrological studies for the availability of water and design criteria for various irrigation facilities. The Palukan river gauging site which is located in the Pulukan catchment on Bali Island, Indonesia was selected to develop this model. The basic data which has been used comprises the available historic flow records at 19 hydrologic gauging stations and 77 rainfall stations on Bali Island in the study. The methology adopted for the derivation of the RDR model was the water balance equation which is commonly used for any natural catcbment ie.P=R+(catchment losses) -R+(ET+DP+DSM+DGW). The catchment losses consist of evapotranspiration, deep percolation. change in soil moisture, and change in groundwater storage. The catchment areal rainfall has been generated by applying the combination method of Thiessen polygon and Isohyetal lines in the studies. The results obtained from the studies may be summarized as follows ; 1. The rainfall-runoff relationship derived from the water balance equation is as shown below, assuming a relationship of the form Y=AX+B. Finally these two equations for the annual runoff were derived ; ARO$_1$=0.855 ARF-821, ARF>=l,400mm ARO$_2$=0.290ARF- 33, ARF<1,400mm 2. It was found that the correction of observed precipitation by a combination of Thiessen polygons and Isohyetal lines gave good correlation. 3. Analysis of historic flow data and rainfall, shows that surface runoff and base flow are 52 % and 48% (equivalent to 59.4 mm) of the annual runoff, respectively. 4. Among the eight trial RDR models run, Model C provided the correlation with historic flow data. The number of months over which baseflow is distributed and the relative proportions of rainfall contributing in each month, were estimated by performing several trial runs using data for the Pulukan catchment These resulted in a value for N of 4 months with contributing proportions of 0.45, 0.50, 0.03 and 0.02. Thus the baseflow in any month is given by : P$_1$(n) =0.45 P(n) +0.50 P(n-I ) +0.03 P(n-$_2$) +0.02 P(n-$_3$) 5. The RDR model test gave estimated flows within +3.4 % and -1.0 % of the observed flows. 6. In the case of 3 consecutive no rain months, it was verified that 2.8 % of the dependable annual flow will be carried over the following year and 5.8 % of the potential annual baseflow will be transfered to the next year as a result of the rainfall-delayed response. The results of evaluating the pefformance of the RDR Model was generally satisfactory.

• 약학회지
• /
• 제49권6호
• /
• pp.511-517
• /
• 2005

Low sensitivity to anticancer drugs such as 5-fluorouracil (5-FU) has been associated with decreased expression of genes involved in cell proliferation, apoptosis and metastasis. Recently, it has been shown that the expression levels of some of these genes are reduced by transcription inhibition due to epigenetic silencing on CpG islands. Therefore, epigenetic therapy has been proposed, where epigenetic silencing is repressed with DNA methyltransferase (DNMT) inhibitors and histone deacetylase (HDAC) inhibitors alone or in combination with other chemotherapeutic agents. The aim of our study was to evaluate the combination effect of 5-FU and its association with the status of epigenetic silencing using methylation-specific PCR of $p14^{ARF}$ when given with S-aza-2'-deoxycytidine (5-aza-dC), a DNMT inhibitor and depsipeptide, an HDAC inhibitor in DLD-1 human colorectal cancer cells. The combination of 5-aza-dC with depsipeptide showed a synergism and induced unmethylation of $p14^{ARF}$. However, triplet combination of 5-aza-dc/depsipeptide and 5-FU resulted in antagonistic effects and abrogated unmethylation of $p14^{ARF}$. These results suggest that unfavorable interaction of 5-aza-dC/depsipeptide with 5-FU in DLD-1 cells may be related with the failure in repression of epigenetic silencing, which warrants further investigation.

• 한국수자원학회논문집
• /
• 제35권2호
• /
• pp.173-186
• /
• 2002

설계홍수량 산정에는 강우-유출 모형이 주로 사용되고 있으며 이 모형의 가장 중요한 인자는 확률강우량과 단위도이다. 따라서, 확률강우량을 합리적이고 정확하게 산정하는 것은 가장 중요한 과정이다. 국내의 경우, 확률강우량은 유역면적이 일정 기준을 초과할 경우에는 면적확률강우량을 사용하여야 하나 지점평균확률강우량을 주로 사용하고 있다. 이에 따라 확률강우량은 상당히 높게 사용하는 반면 단위도는 상대적으로 낮게 사용하고 있어서 개선 이 필요한 실정이다. 본 연구에서는 기존에 일반적으로 사용되고 있는 1일, 2일 강우량을 24시간, 48시간 강우량으로 변환하기 위한 계수를 제시하였으며, 유역의 동시간 강우자료를 이용하여 임의시간 면적강우량 자료계열을 작성하였다. 또한 자료계열의 빈도해석을 통하여 기존의 지점평균확률강우량과 면적확률강우량을 산출한 후 면적에 따른 지점평균확률강우량의 면적확률강우량으로의 감소율인 면적감소계수론 산정하였다. 본 연구에서 제시하는 면적감소계수는 지점평균강우량에서 면적확률강우량을 손쉽게 환산할 수 있는 방안이 된다.

• Tuberculosis and Respiratory Diseases
• /
• 제81권4호
• /
• pp.319-329
• /
• 2018

Background: Bronchoalveolar lavage (BAL) is a necessary procedure for diagnosis of various lung diseases. High-flow nasal cannula (HFNC) oxygen delivery was recently introduced. This study aimed to investigate the safety and effectiveness of HFNC oxygen supply during BAL procedure in patients with acute respiratory failure (ARF). Methods: Patients who underwent BAL while using HFNC at a partial pressure of oxygen in arterial blood/fraction of inspired oxygen ($PaO_2/FiO_2$; PF) ratio of 300 or below among patients who had been admitted from March 2013 to May 2017 were retrospectively investigated. Results: Thirty-three BAL procedures were confirmed. Their baseline PF ratio was $166.1{\pm}46.7$. $FiO_2$ values before, during, and after BAL were $0.45{\pm}0.12$, $0.74{\pm}0.19$, and $0.57{\pm}0.14$, respectively. Flow (L/min) values before, during, and after BAL were $26.5{\pm}20.3$, $49.0{\pm}7.2$, and $40.8{\pm}14.2$, respectively. Both $FiO_2$ and flow during and after the procedure were significantly different from those before the procedure (both p<0.001). Oxygen saturation levels before, during, and after BAL measured by pulse oximeter were $94.8{\pm}2.9$, $94.6{\pm}3.5$, and $95.2{\pm}2.8%$, respectively. There were no significant differences in oxygen saturation among the three groups. Complications of BAL procedure included transient hypoxemia, hypotension, and fever. However, there was no endotracheal intubation within 24 hours. Baseline PF ratio in "without HFNC" group was significantly higher than that in "with HFNC" group. There were no differences in complications between the two groups. Conclusion: The use of HFNC during BAL procedure in ARF patients was effective and safe. However, there were no significant differences in oxygen saturation level and complications comparing "without HFNC" group in mild ARF. More studies are needed for moderate to severe ARF patients.

• 대한한방내과학회지
• /
• 제30권4호
• /
• pp.832-844
• /
• 2009

Objectives : This study was to observe the nephroprotective effects of the traditional prescription, Taeksa-san(TSS). TSS has generally been used for treating various renal diseases, including renal failure. Methods : Three different dosages of TSS extract were orally administered once a day for 28 days, At the 23rd day after TSS extract treatment, cisplatin was also treated. Then, 5 days after cisplatin treatment, all the rats (6 groups of 8 rats each) were sacrificed. Changes in the body weight, kidney weight, serum BUN and creatinine levels were observed with changes on the kidney MDA and GSH contents. The results were compared with captopril 100mg/kg, of which the effects on cisplatin-induced acute renal failures are already confirmed. Results : Dramatic decrease of body weight, increase of kidney weight, increase of serum BUN and creatinine levels were detected in the cisplatin control as compared with the intact control. In addition, marked increase of kidney MDA contents and decrease of kidney GSH contents were also detected in the cisplatin control as compared with the intact control. This means that cisplatin-induced ARF is induced by oxidative stress and related lipid peroxidation in the present study. However, these ARFs and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment with all three different dosages of TSS extracts. Conclusion : This study suggests that TSS extracts show favorable effects on cisplatin-induced rat ARF.

• 대한한방내과학회지
• /
• 제31권3호
• /
• pp.620-630
• /
• 2010

Purpose : The object of this study was to observe the nephroprotective effects of Manjeonmoktong-san(MJMTS), which has traditionally been used as Korean medicine for treating various renal diseases, on cisplatin-induced rat acute renal failure. Methods : At first, three different dosages of MJMTS extract were orally administered once a day for 28 days. On the 23rd day after MJMTS extract treatment, cisplatin was treated. Then, 5 days after cisplatin treatment, all the rats (6 groups of 8 rats each) were checked in the present study. The changes to the body weight, kidney weight, serum BUN and creatinine levels were observed with changes on the kidney MDA and GSH contents. The results were compared with captopril 100mg/kg in which the effects on cisplatin-induced acute renal failures were already confirmed. Results : It showed dramatical decrease on the body weight, increase of serum BUN and creatinine levels were detected in cisplatin control as compared with intact control. In addition marked increase of kidney MDA contests and decrease of kidney GSH contents were also detected in cisplatin control as compared with intact control. it means that cisplatin induced ARF are induced by oxiidative stress and related lipid peroxidation in the present study. However, these ARFs and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment of all three different dosages of MJMTS extracts. Conclusion : This study suggests that MJMTS extracts have favorable effects on the cisplatin-induced rat ARF.