• Korean Journal of Veterinary Research
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• v.48 no.2
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• pp.215-218
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• 2008

A 2-year-old, female, Maltese dog (3.2 kg of body weight) was referred to the Veterinary Medical Teaching Hospital, Chungnam National University with vomiting, anorexia and depression. Twelve hours prior to the onset of clinical signs, the dog ingested some grape skins (about 60 g). Physical examination at the time of presentation showed peripheral edema and mucous pallor. Blood and blood chemical analysis revealed anemia and moderate azotemia with elevated blood urea nitrogen (107.2 mg/dl), creatinine (6.3 mg/dl) and hyperphosphatemia (11.3 mg/dl). Echogenicity of renal cortex were observred by ultrasonography. The dog was diagnosed as acute renal failure occurred by grape skin toxicosis. The dog was treated with supportive care such as fluid therapy, diuretics (furosemide) and phosphorus binder (almagate). A normal condition of blood and blood chemical findings and clinical signs was observed at five days after treatment, and prognosis is good to date.

• Journal of Veterinary Clinics
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• v.21 no.1
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• pp.66-71
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• 2004

2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

• Clinical and Experimental Pediatrics
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• v.57 no.5
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• pp.240-244
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• 2014

Pseudohypoparathyroidism type Ia (PHP Ia) is a disorder characterized by multiform hormonal resistance including parathyroid hormone (PTH) resistance and Albright hereditary osteodystrophy (AHO). It is caused by heterozygous inactivating mutations within the Gs alpha-encoding GNAS exons. A 9-year-old boy presented with clinical and laboratory abnormalities including hypocalcemia, hyperphosphatemia, PTH resistance, multihormone resistance and AHO (round face, short stature, obesity, brachydactyly and osteoma cutis) which were typical of PHP Ia. He had a history of repeated convulsive episodes that started from the age of 2 months. A cranial computed tomography scan showed bilateral calcifications in the basal ganglia and his intelligence quotient testing indicated mild mental retardation. Family history revealed that the patient's maternal relatives, including his grandmother and 2 of his mother's siblings, had features suggestive of AHO. Sequencing of the GNAS gene of the patient identified a heterozygous nonsense mutation within exon 11 (c.637 C>T). The C>T transversion results in an amino acid substitution from Gln to stop codon at codon 213 ($p.Gln213^*$). To our knowledge, this is a novel mutation in GNAS.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.216-219
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• 2014

An 1-year-old, female, mixed-breed dog weighing 17 kg was referred for abrupt collapse. She had remarkable hypocalcemia and hyperphosphatemia, and survey radiographs revealed a severe gas-filled intestine. Treatment with serial injections of calcium gluconate was initiated promptly and most of the gastrointestinal distension disappeared after 4 h. However, the clinical signs were not resolved completely. The serum intact parathyroid hormone concentration was not elevated in the context of hypocalcemia, which suggested primary hypoparathyroidism. The clinical signs and laboratory abnormalities in the patient were resolved completely 3 days after administration of calcium gluconate and calcitriol. This case describes the unique presentation of severe gastrointestinal distension in a dog diagnosed with primary hypoparathyroidism.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.359-366
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• 2001

Studies were carried out to explore the influence of dietary protein level on bone metabolism in uninephrectomized rat (experimental renal failure model) when dietary Ca and P contents were equal. Male rats were uninephrectomized or sham operated and fed 8%, 15% and 40% casein diets for 24 weeks. Ca and P contents of the all diet were 0.4% and 0.6% respectively. The results are summarized as follows. We did not found any significant difference in PTH and Ca level of the serum, Ca intake and Ca excretion among the experimental groups. There was significant positive correlation between the PTH and phosphate level. There was significant inverse correlation between serum Ca and creatinine level. The effect of the dietary protein level and renal mass loss on density and Ca contents of the bone were small and different according to the kinds of the bone. Low protein diet was associated with a significant enhancement of scapular density. Femur and vertebra density, however, were not influenced by dietary protein level and uninephrectomy. Light microscopic examination showed several calcified foci in the kidney in all experimental groups. Low protein diets have been used for a long time in the conservative management of chronic renal failure as they have a beneficial effect in preventing the appearance of symptoms. This study elucidated that part of beneficial effects of the low protein diet related to the suppression of the hyperphosphatemia. And these results, even though uninephrectomized rats fed high protein diet, the secondary hyperparathyroidism is supressed by the regulation of the P level. Therefore this study emphasized the need to pay more attention to the regulation of dietary P level as well as dietary protein content in chronic renal failure. (Korean J Nutrition 34(4): 359∼366, 2001)

• Journal of the East Asian Society of Dietary Life
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• v.13 no.5
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• pp.408-424
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• 2003

The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 6S.6% of hypertension patients with diastolic blood pressure over 90mmHg, 80% with systolic blood pressure over 140mmHg, 20% of hypercholesterolemia patients (serum cholesterol over 230mg/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200mg/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism. The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7mg/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4mg/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.lg of salt which were more than the recommended amount 2∼4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.97-106
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• 2016

Background: Sevelamer is associated with reduced complications of chronic kidney disease-mineral bone disorder (CKD-MBD) resulted from hyperphosphatemia, which may contribute mortality, in CKD patients with dialysis. So far clinical outcomes of sevelamer on mortality and risk of cardiovascular mortality related to CKD-MBD are debating. Purpose of this study was to evaluate the effectiveness of sevelamer HCl on mortality of secondary hyperparathyroidism (SHPT), risk of cardiovascular mortality and, frequency of osteopathy in end stage renal disease (ESRD) patients with dialysis. Methods: We retrospectively reviewed the electronic medical records of 536 patients with ESRD, who were admitted for moderate to severe SHPT, for 36 months. 75 patients who met inclusion criteria were evaluated for the efficacy of sevelamer (mean serum iPTH = 487.5 pg/mL). Results: Sevelamer intervention was not associated with increased three-year survival time compared with non-sevelamers group [average survival month: 30.4 months in sevelamer group, 26.8 months in non-sevelamer group, p = 0.463]. Sevelamer intervention was not associated with significant mortality benefit and cardiovascular mortality benefit as compared to non-sevelamer group [sevelamer group: non-sevelamer group, all-cause mortality (iPTH > 600 pg/mL): 14.3% (1/34): 20% (1/41) p = 0.962, OR = 0.935, 95% CI, 0.058-14.98, heart disease mortality: 6.67% (2/30): 0% (0/32) p = 0.138]. Sevelamer was not associated with significantly lower cumulative incidence of osteopathy compared to non-sevelamer group (sevelamer group: non-sevelamer group, 5.9% (2/34):9.8% (4/41); p = 0.538; OR = 0.578; 95% CI, 0.099-3.367). Conclusion: Sevelamer was not associated with decreased all-cause mortality and risk of cardiovascular mortality compared to non-sevelamer group in ESRD patients with SHPT.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.156-158
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• 2012

Purpose: Although lipoma is known as one of the most common soft tissue tumors, calcification in lipoma is very rare in its occurrence. This calcified lipoma has been reported by some as a result of regression of lipoma, but its genesis is not clearly known yet with various opinions being discussed regarding its possible metabolic relation to hypercalcemia or hyperphosphatemia to be considered as a regression phase of lipoma. The authors would like to present this unusual case of calcified lipoma. Methods: A 50-year-old male patient visited our hospital with complaint of an enlarging mass on his right forehead which has been acknowledged for 5 years' period. On physical examination, a mass was observed on his forehead as palpable, non-tender, mobile and firm in its consistency. Ultra sonogram examination revealed a well-demarcated mass (1.92 cm) with central echoic zone at deep layer of forehead. Mass excision and biopsy were performed subsequently. Results: According to the pathological report, the diagnosis confirmed the lipoma consisting of grown-up adipocyte and calcification. Neither growing lipoma nor relapse was observed for postoperative three years' follow-up of the patient. Conclusion: Now that the calcified lipoma was successfully removed and cured by a simple mass excision, authors hereby report the case of calcified lipoma on forehead.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.186-189
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• 2006

A 7-month-old female Cocker spaniel dog was examined for chronic anemia. Based on information provided by local clinician the patient had had a 'flu-like' illness three weeks before submission of the sample, had a fever of $40.9^{\circ}C$, and had mild hepatomegaly. This dog had also history of weight loss, vomiting, anorexia, dehydration, lethargy, ascites, polyuria and polydipsia. A blood smear showed non-regenerative anemia. Thoracic radiograph showed irregular shadowing in the left mid-zone. Serum biochemical results showed a hypercalcemia, azotemia, hypercholesterolemia, hyperphosphatemia, hypoalbuminemia, and metabolic acidosis. Results of urinalysis showed proteinuria, slightly acidic with isosthenuria. Histopathologic examination of tissue sections revealed amyloid deposits in multiple sites including kidneys, liver and spleen.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.655-658
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• 2009

An 11-year-old, female, Maltese dog was presented with abdominal distension and intermittent slight lameness on left hindlimb. Palpable abdominal pain and purulent vaginal discharge were observed on physical examination. Severe leukopenia with toxic change, and azotemia, hyperphosphatemia, and hyponatremia were identified on blood profile. On radiographs and abdominal sonograms, remarkable soft tissue mass containing echogenic material deviating intestines craniodorsally compatible with pyometra. On stifle radiographs, 4-5 fragmented sesamoid bone (fabella) was identified on both stifle joint with medial patella luxation. Immediate ovariohysterectomy was performed and the patient was recovered well with normal blood work. No specific treatment was attempted to the left hindlimb showing minimal and intermittent lameness. No remarkable abnormal gait was reported for 3-month follow-up period. The fragmented lateral fabella is considered congenital multipartite of lateral fabella not related to the lameness.