• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.604-619
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• 1992

This study was designed to investigate the problems facecl by adolescents who have nephrotic syndrome and who have struggled with their disease over a long time. Information obtained from this study can be utilized as basic data in planning nursing care for these adolescents. The subjects in this study were 13 adolescents who were being treated in the pediatric OPD of one general hospital in Seoul. The treatment period ranged from 2 to 15 years. The tool for this study was constructed after asking patients with nephrotic syndrome about their problems using anunstructured questionalire. Problem items which were observed during nursing cared in the pediatric unit. were also inclucled. Ten problem items were constructed on the basis of Moonlcy's problem check list and two additional items related to diet and physical activity were added to the list. The results of this study can be summerized as follows : adolescents with Nephrotic Syndrome. 1) have a vague knowledge about their illness and have distorted concepts. 2) feel social isolation within their peer group because of their changed appearance, limited physical activity and special diet regimen. 3) have problesm in heterosexual relationship because of short height in boys and changes in body propotions in girls. 4) think that their personality has changed due to illness. In most cases(8) changes were in a negative direct ion but in two cases they were positive. 5) have problems with scholastic achievement due to physical weakness and school absence. 6) who are in late adolescentce are more realistic and plan for their future taking into consideration their prognosis much more so than do patients who are in early adolescence. 7) have problems in their peer relationships. 8) have limitation their enjoy ment of leisure time. 9) have some conflict with their siblings. 10) think religion is significant and it has and influence on their life.

• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.205-211
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• 2016

Idiopathic nephrotic syndrome (INS) in children is characterized by massive proteinuria and hypoalbuminemia. Minimal change nephrotic syndrome (MCNS) is the most common form of INS in children. The pathogenesis of MCNS still remains unclear, however, several hypotheses have been recently proposed. For several decades, MCNS has been considered a T-cell disorder, which causes the impairment of the glomerular filtration barrier with the release of different circulating factors. Increased levels of several cytokines are also suggested. Recently, a "two-hit" theory was proposed that included the induction of CD80 (B7-1) and regulatory T-cell (Treg) dysfunction, with or without impaired autoregulatory functions of the podocyte. In contrast to the well-established involvement of T cells, the role of B cells has not been clearly identified. However, B-cell biology has recently gained more attention, because rituximab (a monoclonal antibody directed against CD20-bearing cells) demonstrated a very good therapeutic response in the treatment of childhood and adult MCNS. Here, we discuss recent insights into the pathogenesis of MCNS in children.

• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.84-96
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• 1999

This study was conducted to identity the degree of burden and social support perceived by mothers of nephrotic syndrome patients. Also, relations between burden and social support were investigated to provide basis data for their family health and nursing intervention. The study subjects were mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Jun. 1, 1998 to Jun. 30, 1998. Burden measurement Instrument for this study was designed by the researcher and its basis in one developed by Montgomery et al.(1985) and the reliability was .78. Also. P.R.Q. Part I, II by Brandt and Weinert(1981) was used as social support measurement instrument and the reliability .71. The data analysis was done by SPSS, t-test, ANOVA Pearson correlation. The result were as follows. 1. Burden felt by mothers shows an average value of 60.82 (Maximum 86, Standard deviation 1.244). 2. Of the mother characteristics, the score of burden was high in case of no religion and low income. Of the patient characteristics, the score burden ranked as high MCNS, doing oral therapy, injection therapy at the same time and negative perceived patients condition. 3. The mean score of support was 77.54(Maximum 96, Standard deviation 1.096). 4. The main supporters were husband (the highest), brother, sister, health speciality and the subject expressed the highest satisfaction toward supporters in chronic disease. 5. Of the patient characteristics, the higher age group and the elder group showed high support. Also, positive perceived patient's condition, high support. 6. The relationship between burden and social support is not significant. In conclusion to the above study, the researcher suggests. 1. The Qualitative research to investigate influential factors on burden of family of nephrotic syndrome patients is needed.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.52-57
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• 2006

Kimura's disease is a rare chronic inflammatory disease of unknown etiology which appears primarily in young Asian males as non-tender subcutaneous swellings in the head and neck region. Histologic characteristics are the presence of lymphoid follicles, vascular proliferation and infiltration of eosinophils. Peripheral eosinophilia and elevated serum IgE are frequently combined. Systemic steroid therapy with surgical excision is the mainstay of treatment, though recurrence after surgery or discontinued steroid treatment is common. It has been known that about 16% of the cases are associated with renal diseases, particularly nephrotic syndrome. We present an 8-year-old boy with a past history of steroid-responsive, infrequently relapsing nephrotic syndrome who developed right buccal swelling and peripheral eosinophilia during the remission state. He has been managed with surgical resection, steroid and cyclosporine due to multiple recurrences.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.117-124
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• 2001

Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.171-175
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• 2015

Nephrotic syndrome (NS) is a common chronic disease in children; in 90 percent of cases, the condition is primary (idiopathic). Toxic nephropathy can be induced by herbal medicines, and is mainly manifested as tubulointerstitial nephritis and rarely, as glomerulopathy. Here in, we describe two cases of steroid-sensitive NS, which developed after the patients received herbal medicines. A 5-year-old boy and an 8-year-old girl were separately admitted within a short time period with acute onset of generalized edema, proteinuria, hypoalbuminemia, and hypercholesterolemia. Each patient had previously taken herbal medicine, which had been prescribed by different oriental medical clinics for different conditions. The patients were diagnosed with herbal medicine-induced NS and were treated empirically by a standard steroid therapy, with subsequent resolution of their NS. One patient relapsed, but her NS again responded to steroid therapy. We described two unusual cases of prototypical pediatric, steroid-sensitive NS, which was presumed to be minimal-change disease that developed after the administration of herbal medicines. We also reviewed the literature.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.210-212
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• 2001

Retinal detachment is a rare disease in children but cases of serous retinal detachment due to use of systemic corticosteroids have been reported in and out country Rhematogenous retinal detachment has developed in a child with oral and steroid pulse therapy due to nephrotic syndrome. He was treated with laser and buckling in right and left eye respectively. Currently he is under observation through the out patient department. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 210-12)

• Childhood Kidney Diseases
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• v.20 no.2
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• pp.97-100
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• 2016

Toxic epidermal necrolysis (TEN) is a rare, acute, serious, and potentially fatal skin disease, in which cell death causes the epidermis to separate from the dermis. It is thought to be a hypersensitivity complex that affects the skin and mucous membranes, and is caused by certain medications, infections, genetic factors, underlying immunologic disease, or more rarely, cancers. We report two cases of TEN associated with deflazacort (DFZ), a derivative of prednisolone, used in the first episode of nephrotic syndrome (NS). The skin eruption appeared on the $4^{th}$ and $5^{th}$ weeks after DFZ administration, while NS was in remission. The widespread lesions were managed by intensive supportive treatment, discontinuation of DFZ, and oral administration of cyclosporine. Both patients showed a rapid improvement in symptoms of TEN without any complications or relapse of NS.

• Journal of Korean Academy of Nursing
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• v.34 no.3
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• pp.534-540
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• 2004

Purpose: The purposes of this study were to describe the relationship between depression and resilience and to identify variables associated with depression among children with nephrotic syndrome. Method: Data was collected from 45 children who were registered at one hospital in Seoul. The criteria for sample selection were 10 to 15 year-old children who were diagnosed at least 6 month prior. The instruments included a self-reported questionnaire on resilience by Kim, CDI by Beck, and MBRI by Kwak. Descriptive, Pearson correlation and multiple regression analyses were done. Result: The mean score of depression was 11.44 (range:0-54) and resilience was 97.47 (range:32-128). There were significant positive relationships between depression and age (r=0.302, p<.005) and academic achievement (r=-0.318, p<.005). In addition, negative relationships between depression and maternal attitude (r=-0.412, p<.001) and resilience (r=-0.649, p<.001) occurred. The results of multiple regression analysis showed that maternal behavior (${\beta}$=-0.421, p<.005) and resilience (${\beta}$=-0.639, p<.001) were related to depression. Conclusion: Children with higher resilience and with an affectionate mother were less depressed. Thus, it is important to identify strengths of children and help them to increase resilience and implement parenting and counseling programs for parents' of these children. Similar studies with children with other chronic illnesses are needed.

• Journal of Nutrition and Health
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• v.33 no.2
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• pp.141-146
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• 2000

This study was conducted to investigate the effects of vitamin E supplementation renal lipid peroxidation in high fat diet and adriamycin (ADR) induced experimental nephrotic syndrome model rats. Treated rats were injected intraperitoneally with ADR (2mg/kgBW/wk) once a week for four weeks. control rats were injected with saline solution instead of ADR. The rats in each group were fed experimental diets of three levels of vitamin E for 10 weeks: Normal (501U/kg diet), high (5,000IU/kg diet), excess (7,500IU/kg diet). The high fat diet and ADR treatment was performed to induce the decrease of kidney functions. Serum total cholesterol was significantly decreased by the excess supplementation. But there was no effect of vitamin E supplementation on serum total lipid and triglyceride. Thiobarbituric acid reacting substances(TBARS) was significantly decreased at high and excess supplementation. Glutathione reductase (GR), glutathione peroxidase ({TEX}$GP_{x}${/TEX}) and catalase activities (CAT) were measured as antioxidative enzymes. The renalglutathione reductase (GR) and catalase activities (CAT) were inclined to elevate by vitamin E supplementation. Thus the vitamin E supplementation was found to have an antioxicant effect. These results suggested that vitamin E supplementation could alleviate the changes in renal lipid peroxidation.