• Title/Summary/Keyword: disease damage

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Ischemic Time Associated with Activation of Rejection-Related Immune Responses (허혈 시간과 거부반응 관련 면역반응)

  • Nam, Hyun-Suk;Choi, Jin-Yeung;Kim, Yoon-Tai;Kang, Kyung-Sun;Kwon, Hyuk-Moo;Hong, Chong-Hae;Kim, Doo;Han, Tae-Wook;Moon, Tae-Young;Kim, Jee-Hee;Cho, Byung-Ryul;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.138-143
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    • 2009
  • Ischemia/reperfusion injury(I/RI) is the major cause of acute renal failure and delayed graft function(DGF) unavoidable in renal transplantation. Enormous studies on ischemia damage playing a role in activating graft rejection factors, such as T cells or macrophages, are being reported. Present study was performed to determine whether ischemia time would play an important role in activating rejection-related factors or not in rat models of I/RI. Male Sprague-Dawley rats were submitted to 30, 45, and 60 minutes of warm renal ischemia with nephrectomy or control animals underwent sham operation(unilateral nephrectomy). Renal function and survival rates were evaluated on day 0, 1, 2, 3, 5 and 7. Immunofluorescence staining of dendritic cells(DCs), natural killer(NK) cells, macrophages, B cells, CD4+ and CD8+ T cells were measured on day 1 and 7 after renal I/RI. Survival rates dropped below 50% after day 3 in 45 minutes ischemia. Histologic analysis of ischemic kidneys revealed a significant loss of tubular architecture and infiltration of inflammatory cells. DCs, NK cells, macrophages, CD4+ and CD8+ T cells were infiltrated from a day after I/RI depending on ischemia time. Antigen presenting cells(DCs, NK cells or macrophages) and even T cells were infiltrated 24 hours post-I/RI, which is at the time of acute tubular necrosis. During the regeneration phase, not only these cells increased but B cells also appeared in more than 45 minutes ischemia. The numbers of the innate and the adaptive immune cells increased depending on ischemia as well as reperfusion time. These changes of infiltrating cells resulting from each I/RI model show that ischemic time plays a role in activating rejection related immune factors and have consequences on progression of renal disease in transplanted and native kidneys.

Assessment of Renal Function in Silicobis with Urinary N-acetyl-$\beta$-D-glucosaminidase Activity (규폐증환자의 신기능 평가를 위한 요중 N-acetyl-$\beta$-D-glucosaminidase활성치 측정의 의의)

  • Lee, Hoo-Rak;Kim, Don-Kyoun;Lee, Su-Il;Cho, Byung-Mann;Kim, Wha-Jo
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.49-64
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    • 1993
  • To provide the basic data for assessment of renal dysfunction related to silicosis, urinary N-acetyl-$\beta$-D-giucobarninidase(NAG) activity known as a sensitive markers for early renal damage were measured in 58 silicosis patients, and control subjects of 40 pulmonary tuberculosis Patients and 51 official workers. The results were summarized as fellows. 1. The values of blood urea nitrogen and serum creatinine in all subjects were within reference limits. But the mean value of urinary NAG activity($7.25{\pm}7.31U/g\;creatinine$) was beyond reference value and more sensitive test than others. 2. The mean value of urinary NAG activity in silicosis group was $11.98{\pm}9.05U/g\;creatinine$ and significantly higher than in tuberculosis and healthy group(p<0.01), but the mean values of NAG activity in tuberculosis and healthy group were not different(p>0.05). 3. The value of NAG activity in tuberculosis had a tendency to be increased according to severity of disease, but that was not significant(p>0.05). The value of NAG activity was increased significantly by use of nephrotoxic antituberculosis drugs(p<0.05). 4. The value of NAG activity in silicosis had a tendecy to be increased according to the size of nodule, use of nephrotoxic antituberculosis drugs and shortness of onset duration, but the increase was not significant(p>0.05). 5. After excluding the users of nephrotoxic antituberculosis drugs, the mean values of NAG activity in healthy control and in tuberculosis control were same as 3.63 U/g creatinine and 3.60 U/g creatinine, respectively. But the mean value of NAG activity in silicosis group was remarkably increased as 10.90 U/g creatinine(p<0.01). As above results, even though there are no abnormal finding in screening renal function test, silicosis can be related with renal dysfunction. And it will be very useful to apply urinary NAG activity in health management of workers exposed to dust.

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Effect of Iron Excess-induced Oxidative Stress on Platelet Aggregation (과잉 철로 유도된 산화적 스트레스가 혈소판 활성화에 미치는 작용)

  • Seo, Geun-Young;Park, Hyo-Jin;Jang, Sung-Geun;Park, Young-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.8
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    • pp.979-984
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    • 2006
  • Although iron is essential for many physiological processes, excess iron can lead to tissue damage by promoting the generation of reactive oxygen species (ROS). There is increasing evidence that ROS might play an important role in the pathogenesis of cardiovascular disease. However, the effects of iron excess on platelet function and the thrombotic response to vascular injury are not well understood. We examined the effects of iron excess-induced oxidative stress and the antioxidants on platelet aggregation. Oxidative stress was accessed by either free iron $(Fe^{+2})$ or hydrogen peroxide $(H_2O_2)$, as well as their combination on washed rabbit platelets (WPs) in vitro. When WPs were stimulated with either $Fe^{+2}$ alone or a subthreshold concentration of collagen, which gave an aggregatory curve with a little effect, and a dose dependent increase in platelet aggregation was observed by increasing concentrations of $Fe^{+2}$ with $H_2O_2$. This aggregation was associated with the iron-catalyzed formation of hydroxyl radicals from $H_2O_2$, and were inhibited by NAD/NADP (proton acceptor), catalase $(H_2O_2\;scavenger)$, tiron (iron chelator), mannitol (hydroxyl radical scavenger), and indomethacin (cyclooxygenase inhibitor), but not by NADH/NADPH (proton donor), superoxide mutase, and aspirin. However, NADH/NADPH, an essential cofactor for the antioxidant capacity by the supply of reducing potentials, showed the effect of an enhanced radical formation, suggesting a role for NADH/NADPH-dependent oxidase. These results suggest that iron $(Fe^{+2})$ can directly interact with washed rabbit platelets and this aggregation be mediated by OH formation as in the Fenton reaction, inhibited by radical scavengers.

A study of pain perception related to IV therapy in hospitalized preschool children and their mothers (정맥주사와 채혈시 학령전기 아동과 어머니가 인지하는 동통)

  • 임지영
    • Journal of Korean Academy of Nursing
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    • v.22 no.1
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    • pp.49-67
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    • 1992
  • Most hospitalized children will experience physical pain as well as psychological distress. Preschool children's pain perception related to painful procedures can increase due to elevated anxiety and fear because they do not have understanding logical of their disease and hospitalization. In particular, they are distressed about needle - related procedures which are feared because they are seen to be a cause of bodily damage. This descriptive study attempted to identify pain perception levels in preschool children and their mothers. A self-reporting measurement and behavioral observation were used to collect the data. A total of 25 hospitalized preschool children and their mothers were investigated and data were collected about 60 painful procedures. Data collection was carried out by the researcher and two trained investigators from November first to December tenth. Three insruments were used to collect the data : Faces Pain Rating Scale(FPRS) developed by Beyer was used to measure the degree of preschool children's pain perception about painful procedures. The Visual Analogue Scale(VAS) devised by Huskisson was used to assess the degree of mothers' pain perception about their children's painful procedures. A Pain Behavioral Checklist based on the Procedure Behavior Check List by LeBaron and Zelter and modified by the researcher was used to observe behaviors of preschool children, their mothers, and nurses when the painful procedures took place. The data were analyzed by an SPSS program, and were tested using real numbers, percentages, Pearson correlation coefficient, t-test, and ANOVA. The results of this study are as follows : 1. Of all the painful procedures, the mean score for the FPRS for the preschool children's pain perception was 4.02 points, and the mean score for the VAS of mothers' pain perception was 10.92 points. 2. A Positive correlation which was statistically significant was found between the pain perception of preschool children and their mothers (r=.53, p<.01). that is, the higher the children's pain perception was, the higher their mothers' pain perception was. 3. The characteristics of the painful procedures related with children's pain perception as follows : The type of painful procedure was found to be statistically significant (F=23.44, p<.01), Among the three procedures Ⅳ starting was found to be perceived as the most painful procedures to the children. The greater the number of times that the procedure had been done, the higher the pain perception was (F=4.44, p<.01), and the longer the duration of the procedure, the higher the pain perception wa(r=.30, p<.05). Pain perception in the treatment room was higher than in the children's room(t=6.30, <.01), pain perception in the mother's presence was the higher than when the mother was not present (t=2.91, p<.01). 4. The characteristics of the painful procedures related with the mothers' pain perception as follows : The type of painful procedure was found to be statistically significant(F=6.01, p<.01). Among the three procedures Ⅳ sampling was found to be perceived as the most painful procedures to the mothers. The greater the number of times that the procedure had been done, the higher the pain perception was (F=5.95, p<.01), and the longer the duration of the procedure, the higher the pain perception was (r=.31, p<.05). Pain perception in the treatment room was higher than in the children's room (t=3.51, p<.01), but pain perception in the mother's presence showed statistically significant no difference. 5. Of all of the 19 children's behaviors during the painful procedures, the most frequent behaviors observed Were as follows in order of frequency “crying”, “screamirig”, “facial grimacing”, “physical resistance”, Of all of the nine methers' behaviors, the most frequent by observed in “console children”, “hold children”, “applaud children”, Of all of the 11 nurses' behaviors during the painful procedures, the mast frequent in order were “smiling”, “physical restraint”, “console children”, “praise children”. 6. A positive correlation between children's and mothers' pain perception and children's behaviors was found to be statistically significant (r=.65, p<.01, r=67, p<.01). Also the relationship between children's and mothers' pain percertion, and mothers' behavior was found to be statistically significant (r=.57, p<. 01, 4=.60, p<.01). The relationship between children's pain perception and nurses' behaviors was also found to be statistically significant (r=.46, p<.01), but there was difference between mothers' pain perception and nurses' behaviors.

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Effects of Green Tea Extract on Acute Ethanol-induced Hepatotoxicity in Rats (녹차추출물이 에탄올 투여에 의한 초기 간 손상에 미치는 영향)

  • Jin, Dong-Chun;Jeong, Seung-Wook;Park, Pyoung-Sim
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.3
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    • pp.343-349
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    • 2010
  • The liver is the major target of ethanol toxicity and oxidative stress plays a role in development of alcoholic liver disease. This study was performed to investigate the effects of green tea extracts (GTE) on acute ethanol-induced hepatotoxicity in rats. Experimental animals were divided into 4 groups, control, GTE, ethanol, and GTE+ethanol treatment, with 5 rats in each group. Ethanol (6 g/kg body weight (BW)) and GTE (200 mg/kg BW) were treated by gavage. At 1 hour, 3 hours and 20 days (6 g/kg BW every 2 days for total 10 doses) after ethanol and/or GTE treatments, animals were killed; hepatic tumor necrosis factor-alpha (TNF-$\alpha$) and glutathione level, serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), hepatic antioxidant enzymes (SOD, CAT, GPx) activities and hepatic thiobarbituric acid reactive substances (TBARS) were measured. At 1 hour and 3 hours, hepatic TNF-$\alpha$ levels were increased significantly in ethanol group and ethanol+GTE group but that levels was significantly lower in ethanol+GTE group compared with ethanol group. Hepatic glutathione level was decreased by ethanol treatment but GTE prevented the ethanol-induced glutathione decrement. The levels of liver marker enzymes (AST, ALT), liver antioxidant enzymes (SOD, CAT, GPx) and lipid peroxidation marker (TBARS) were not changed in rats of 1 and 3 hours after ethanol treatment. After 20 days, GTE decreased the changes of liver marker enzymes (AST, ALT) activities and TBARS level by ethanol. This study shows that GTE beneficially modulates TNF-$\alpha$ and glutathione levels in liver of ethanol administered rats. The GTE supplementation could be beneficial to liver by decreasing early changes of biomarkers of liver damage caused by ethanol.

Effect of the Climatic Condition on the Growth Characteristic of Domestic Corn Hybrids in Alpine Region (고랭지에서 기후조건이 국내육성 옥수수 품종의 생육특성에 미치는 영향)

  • Kim, Meing-Jooung;Lee, Seung-Ho;Chang, Sun-Sik;Kim, Tae-Il;Choi, Sun-Ho;Cho, Won-Mo;Hong, Seong-Gu;Lee, Sang-Rak;Kim, Myeong-Hwa
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.31 no.4
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    • pp.371-382
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    • 2011
  • The aim of the present study was to investigate the relationship between climates, growth characteristic and yield of silage corn at Hanwoo Experiment Station, National Institute of Animal Science, Daegwallyeong in Gangwon Province located at altitude of 760 m, from 2009 to 2010. The mean minimum temperature was $12.29^{\circ}C$ from seeding to harvest in 2009, $14.30^{\circ}C$ in 2010, the mean maximum temperature was $21.66^{\circ}C$, $23.48^{\circ}C$, respectively. The mean temperature was $16.85^{\circ}C$ in 2009 and $18.55^{\circ}C$ in 2010, respectively. Duration of sunshine was 711.3 hours in 2009 and 663.8 hours in 2010, and precipitation was 893.8 mm in 2009 and 752.1 mm in 2010, respectively. In 2009, for all Kwangpyeongok, Gangdaok, Cheonganok, Cheongsaok, Pyeonganok, the early growth was good with 1.2, while in 2010 the growth for Pyeonganok was good with 1.3 comparing to others, which showed worse growth than in the previous year with 2.4~3.0. There was significant difference in the ear height between 2009 and 2010, showing mean value of 85.8 cm and 105 cm for all the species in 2009 and in 2010, respectively (p<0.001). In 2010, stem diameter for all the species were larger, and there was significant difference in mean value of the diameter between 2009 and 2010 (p<0.001). There was significant difference in the plant height and ear height between 2009 and 2010, showing 200 cm and 258 cm in 2009 and 2010, respectively (p<0.001). There was significant difference in the average days to silk, showing 103.8 days in 2009, 90 days in 2010, respectively (p<0.001). There was no lodging or disease-insect damage in all hybrid silage corn in both 2009 and 2010. The mean ear rates were 23.4% in 2009, but almost doubled, 52.1%, in 2010. There was significant difference in fresh yield between the two years, showing 54,611 kg/ha in 2009 and 78,733 kg/ha in 2010, respectively (p<0.001). Dry matter yields were higher in 2010 than in 2009. TDN yields of Gangdaok and Cheonganok were higher in 2009, whereas that of Cheongsaok and Pyeonganok were higher in 2010. Crude protein contents were higher in 2010 than in 2009 for all the species.

The City Rhinoreaction Research of the Corn Feed for the Heavy Metal Removal of the Pig Ordure Sludge Using the Citric Acid and Stability Evaluation (구연산을 이용한 돈분슬러지의 중금속 제거 및 안정성평가를 위한 사료용 옥수수의 시비반응 연구)

  • Oh, Tae-Seok;Kim, Chang-Ho;Choi, Bong-Su
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.31 no.4
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    • pp.395-408
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    • 2011
  • The study which it sees exclusions the copper and the zinc which contain in pig sludge, It study pig sludge resources fertilizer production which are rational, pig sludge resources fertilizers after seeding, silage corn it investigates growth characteristics and forage value, the result which investigates pig sludge resources fertilizers effectiveness with afterwards is same. With fertilizer ingredients in pig sludge chemical qualities, the content of the nitrogen and the phosphoric acid comes 4.4% to be 6.29%, pH 7.02 and content of the copper and the zinc which is a heavy metal which contains in pig sludge with 805 mg/kg and 1,704 mg/kg, it is a restrictive standard of the fertilizer, 300 mg/kg and 900 mg/kg it sees to be high, it manufactures citric acid 1 hydrate with the organic acid solution, heavy metals of pig sludge where it is a mixture ratio of the organic acid solution, it divides to 25%, 50%, 75% and 100% 4 kind levels, the result which measures the heavy metal exclusion ratio of the copper and the zinc, the mixture ratio of the organic acid solution to be many exclusion ratio of the copper and the zinc is showing a just interrelation, from organic acid solution 100% level content of pig sludge remains copper and zinc 330.03 mg/kg and 41.28 mg/kg, it shows the exclusion ratio of copper 59% zinc 97%. 'Cheonganok' growth characteristics with citric acid 1 hydrate, Treatment 2 and control growth characteristics etc, it exclusion the copper and the zinc it doesn't appear on significant difference statistically but, treatment 3 after only pig sludge in resources disposal where it seeding, growth characteristics of leaf area etc. is badness, it compares in control and treatment 2 the growth characteristics badness, it is appearing, it is caused by with disease and insects occurrence of $Ostrinia$ $furnacalis$ and brown spot, the damage was many. From forage value, Treatment 2 where it exclusion the heavy metal with the citric acid 1 hydrate with control it compares and there are not significant difference from crude protein and ADF and NDF contents etc., seeding only Pig Sludge in resources disposal treatment 3, it is caused by with $Ostrinia$ $furnacalis$ etc., trunk and aging of the leaf to be high ADF content is low. but from crude protein, the nitrogen ingredient which pig sludge has and interrelation it seemed and high numerical value were confirmed.

Antioxidant Activity of Rubus crataegifolius Bge. Fruit Extracts (Rubus crataegifolius Bge. 열매 추출물의 항산화 활성)

  • Moon, Kyoung-Mi;Kim, Ji-Eun;Kim, Hae-Young;Lee, Jae-Seol;Son, Gi-Ae;Nam, Soo-Wan;Kim, Byung-Woo;Lee, Jong-Hwan
    • Journal of Life Science
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    • v.21 no.9
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    • pp.1214-1218
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    • 2011
  • We investigated the fruits of Rubus crataegifolius Bge, a plant which has been traditionally used in Korea in phytotherapy, to describe antioxidant materials from plant sources. R. crataegifolius fruits were extracted with methanol and further fractionated into n-hexane, diethyl ether, and ethyl acetate. The antioxidant activity of each fraction and the residue was assessed using a 1,1-diphenyl-2-picrylhydrazyl (DPPH), $H_2O_2$ radical scavenging method, and their cytotoxicity on human primary kerationcyte (HK) was determined by an MTS assay. The R. crataegifolius fruit methanol extract showed strong antioxidant activity (75.04%, 50%) compared with vitamin C (79.9%, 54.1%) by the DPPH, and $H_2O_2$ method, respectively. The measured activity from the subsequent extracts of the methanol extract were 20.3% for n-hexane fraction (HF), 68.8% for diethyl ether fraction (DF), 67.1% for ethyl acetate fraction (EF), and 67.1% for the residue fraction (RE) by DPPH and 2.2% for HF, 1.6% for DF, 10% for EF, and 50% for the RE by $H_2O_2$ assay. An oxidative stress model of HK was established under a suitable concentration (1 mM). The cell viability of the RE treated group increased and the percentage of apoptotic cells decreased at concentrations of 0.005-0.02% RE compared with the $H_2O_2$ treated group. Fruit extracts of the medicinal plant R. crataegifolius showed potent antioxidant activity and the ability to relieve cell damage from $H_2O_2$ induced injury to HK.

A Study on the Blood-Letting Therapy in Elementary Questions (("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究))

  • Lee, Jun-Geun
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.1
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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Factors associated with Renal Scarring in Children with a First Episode of Febrile Urinary Tract Infection (소아의 첫 발열성 요로감염에서 신 반흔에 영향을 미치는 인자)

  • Jung Suk-Won;Jung Kyeong-Hun;Kim Myung-Hyun;Hong Young-Jin;Son, Byong-Kwan;Lee Ji-Eun
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.56-63
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    • 2005
  • Purpose : Development of renal scarring is associated with delayed diagnosis and treatment of urinary tract infection(UTI). This study was performed to clarify how soon treatment should be started to Inhibit renal scarring after onset of UTI and the factors associated with renal scarring in children with a first episode of febrile UTI. Methods : We retrospectively reviewed 163 patients with a first episode of febrile UTI under the age of 2 years from April 2000 to Ap,il 2004. All patients had a DMSA renal scan and voiding cystourethrogram done in the diagnostic period, 6 months after which a follow-up renal scan was done. After patients wet-e divided into 2 groups according to the duration of fever prior to start of treatment, the duration of fever after start of treatment, and total duration of fever, initial and follow-up DMSA scan findings were analyzed among the different groups. We compared the factors associated with renal scars between the groups with and without renal scars. Results : The initial DMSA renal scan identified abnormal finding in 23% of the patients who were treated $\leq$24 hr from the onset of disease and in 43% of those with fever more than 24 hr. Renal scars developed in 33% of patients who were treated $\leq$24 hr and 38% of those with fever >24 hr prior to treatment. Renal scars developed in 34% of patients with remission of fever $\leq$48 hr after treatment and ill 50% of those with fever >48 hr after treatment. The risk for renal scars was significantly higher in children who had total duration of feyer >72 hr(67%) than in those with shorter duration(19%). In children with renal scars, VUR was most highly associated with an increased risk of renal scar formation. Conclusion : Although children with a first episode of febrile UTI are treated within 24 hr after onset of the fever, renal damage cannot be prevented completely and it is mainly associated with VUR. (J Korean Soc Pediatr Nephrol 2005;9:56-63)

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