• 제목/요약/키워드: nephrotic syndrome

검색결과 231건 처리시간 0.021초

만성 교약성 심낭염의 외과적 치료 (Surgical Treatment of Constrictive Pericarditis)

  • 유회성
    • Journal of Chest Surgery
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    • 제8권2호
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    • pp.101-108
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    • 1975
  • Since 1959 the authors experienced 43 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seonl. Of 43 cases, detailed patients' records could be obtainable in 36 cases, and most of our studies. were made on the basis of these 36 available cases. About 84 per cent of the cases were male with several pediatric cases, and duration of symptoms ranged between 2 months and 10 years. The diagnosis of this condition is not difficult, however, about half of our cases were previously treated under the impression rf various other conditions such as liver cirrhosis or nephrotic syndrome at other hospitals and clinics. Many of our cases showed hepatic functional disturbances and about 89 per cent of the cases showed reversed A/G ratio, and we are sure that some of them had so-called protein losing enteropathy. Three of 36 cases showed normal electrocardiogram, and most peculiar electrocardiographic findings were ST or T changes and low amplitude of QRS complexes. Seven cases showed auricular fibrillation and five had first degree A-V block. Mean preoperative peripheral venous pressure at the antecubital fossa and arm-to-tongue circulation time were 273 mm $H_2O$and 20.2 seconds, respectively, and they were markedly reduced postoperatively to 152 mm $H_2O$ and 13 seconds, respectively. Several different approaches were made with various extents of pericardial decortication according to patients' condition and probably surgeon's preference. In 12 cases we met cardiovascular injuries during decortication and one of them died of massive bleeding through the torn right atrium, and we experienced excellent postoperative result in a grave case operated on just a small pericardial window. Eleven of 35 cases were tuberculous pericarditis and others were non-specific pericarditis histopathologically, and 6 of total 43 cases operated on passed away by various ways with the mortality rate of 13.9 per cent.

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우측 쇄골 및 늑골골절과 동반된 폐경식 1례 (Pulmonary Infarction Associated with Fracture of Right Clavicle and Multiple Ribs)

  • 김수성;이종임
    • Journal of Chest Surgery
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    • 제30권9호
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    • pp.941-944
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    • 1997
  • 폐경색은 임상적으로나 방사선학적으로 폐암, 폐출혈, 울혈성 무기폐, 단순괴사와 감별이 힘든 질환으로 흉부외상과 관련되어 보고된 예는 없다. 환자는 45세 남자로 약 3주전 흉부외상에 의한 우측의 다발성 늑골골절과 쇄골골절로 치료를 받아오 다가 증상이 점점 악화되어 본원에 전원된 후 우상엽 절제술을 받았으며, 조직검사 결과 폐경 색으로 진 단되었다. 전원 당시 흉부의 컴퓨터 단층활영상 우상엽에 거대한 종괴음영이 있었고, 양측 폐야에 5개 정도의 작 은 결절상 음영이 있었으나 폐 생검에서 암세포는 발견되지 않았고, 우상엽 절제술 당시 대부분의 작은 결절들은 자연 소실되어 있었다 절제된 우상엽에서 육안적으로 인지되는 혈전은 보이지 않았고, 조직검사상 주로 폐동맥의 분지인 0.6 ∼2.0 mm 정도의 근형 동맥들이 혈전에 의해 폐쇄되어 있었으며 일부는 더 진행하여 기질화를 보이거나 혈류의 재소통이 이루어진 곳도 관찰되었다.

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진무탕이 배양 인체 메산지움 세포증식과 기질 침착에 미치는 영향 (The Effects of Jinmu-tang on Mesangial Cell Proliferation, Fibronectin Synthesis and Expression of ICAM-1, $\beta$ 1-Integrin, MHC-Class II)

  • 안영민;안세영;두호경;이태원;박재경
    • 대한한의학회지
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    • 제21권3호
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    • pp.40-50
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    • 2000
  • Objectives : The progression of renal disease can be identified as a glomerulosclerosis by histological examination, and the basic mechanism of glomerulosclerosis is mesangial cell proliferation and mesangial matrix accumulation. ICAM-1, ${\beta}1-integrin$ and MHC-class II are known to attribute to the progression of glomerulosclerosis. They mediate cell-cell or cell-matrix interactions and are expressed in response to injury and inflammation. Up to now, there have been few satisfactory regimens to treat glomerular diseases except minimal change nephrotic syndrome, which can be improved by steroid therapy. Studies were performed in order to investigate whether Jinmu-tang has suppressive effects on some factors associated with the progression of glomerular disease, mesangial cell proliferation, fibronectin synthesis, ICAM-1, ${\beta}1-integrin$ and MHC-class II expression. Methods : Studies were performed with the method of surface enzyme immunoassays or flow cytometry after addition of peripheral blood mononuclear cells(PBMC) supernatants treated with Jinmu-tang, using the cultured human mesangial cells. Results : 1. The suppressive effect of Jinmu-tang on mesangial cell proliferation was higher than that of hydrocortisone. 2. Jinmu-tang has some suppressive effects on fibronectin synthesis, ICAM-1, expression, ${\beta}1-integrin$ expression and MHC-class II expression of mesangial cells, but was lower than hydrocortisone. Conclusions : Jinmu-tang generally shows some immunosuppressive effects. We carefully suggest that the above prescription may be applied to prevent the progression of renal disease or can be used as an adjuvant of or a substitute for steroid therapy.

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고지방 식이로 유발된 고지혈증 동물 모델에서 사물활혈탕(四物活血湯)의 효과 연구 (Study of the Effects of Samulhwalhyeol-tang in Hyperlipidemic Animal Model Induced with a High-Fat Diet)

  • 강성순;신용진;조재준;전상윤
    • 대한한방내과학회지
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    • 제35권2호
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    • pp.119-132
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    • 2014
  • Objectives : This study was undertaken to investigate the effects of Samulhwalhyeol-tang (SM) in a hyperlipidemic animal model induced by a high-fat diet using diverse biological methods. Methods : This study was to determine whether fractionated EtOH extracts of SM inhibit reactive oxygen species (ROS) and nitric oxide (NO) in RAW 264.7 cells. Hyperlipidemia was induced by a high-fat diet fed for 6 weeks. Total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, glucose, liver function, cholesterol gene revelation control efficiency, and histologic change of liver were measured after oral administration of SM. Results : 1. Compared to the control group, ROS production (%) and NO production (%) were decreased significantly by SM. 2. Total cholesterol, LDL cholesterol, triglyceride were decreased significantly by SM. 3. HDL cholesterol was increased significantly by SM. 4. Rats' body weight and glucose were decreased significantly by SM. 5. AST, ALP were decreased significantly by SM. 6. In histopathologic examination, fatty liver and fiver fibrosis were inhibited, almost eliminated as round of fat was observed in the liver. Conclusions : SM would appear that effective in the prevention and treatment of atherosclerosis, ischemic heart disease, other cardiovascular diseases, fatty liver and nephrotic syndrome caused by hyperlipidemia.

가미수화분청음(加味水火分淸飮)과 가미수화분청음가녹용(加味水火分淸飮加鹿茸)이 Puromycin Aminonucleoside로 유발(誘發)된 백서(白鼠)의 신증(腎症)에 미치는 영향(影響) (A Study on the effects of Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu on rats with nephrosis induced by Puromycin Aminonucleoside)

  • 백정한;강석봉
    • 대한예방한의학회지
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    • 제4권2호
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    • pp.294-312
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    • 2000
  • The effects of Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu on rats with nephrosis induced by a single tail-intravenous injection of PAN(puromycin amjnonucleoside), 2.5mg/100g of body weight was evaluated in the present study. The effects of Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu on PAN nephrosis was evaluated by measuring the concentrations of albumin, total protein, total lipid, cholesterol, triglyceride in the serum and the amount of protein in the urin. The results are summarized as follows; 1 In The Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu group as compared to The Control group, The concentrations of albumin and total protein in the serum were significantly increased. 2. In The Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu group as compared to The Control group, The concentrations of total lipid, cholesterol and triglyceride in the serum were significantly decreased 3. In The Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu group as compared to The Control group, The amount of urine protein during 24 hours were significantly decreased . 4. In The Gamisoohwabunchungum plus Cervi Pantotrichum Cornu group as compared to The Gamisoohwabunchungum group, The concentrations of total protein in the serum were significantly increased. 5. In The Gamisoohwabunchungum plus Cervi Pantotrichum Cornu group as compared to The Gamisoohwabunchungum group, The concentrations of cholesterol and triglyceride in the serum were significantly decreased To conclude, it can be inferred that Gamisoohwabunchungum and Gamisoohwabunchungum plus Cervi Pantotrichum Cornu have the effects of improving proteinuria, hypoproteinemia, hyperlipidemia in nephrotic syndrome.

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혈관여포양 임파선 증식증 -1예 보고- (Angiofollicular Lymph Node Hyperplasia (= Castleman's Disease) -Report of A Case -)

  • 길학준;오윤경;윤세철;신경섭;박용휘
    • Radiation Oncology Journal
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    • 제5권1호
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    • pp.37-41
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    • 1987
  • 혈관여포양 임 파선증식 증 (angiofollicular lymph node hyperplasia)은 원인 미상의 드문 양성 질환으로서 대부분 흉곽내에 발생한다. 진단은 임상증상, 이학적 경사 그리고 X-선 촬영을 비롯한 각종 영상술에 의하며 여러 다른 질환과 감별진단이 어렵다. 대개 수술적 적출에 의한 조직학적 검색으로 확진이 된다. 조직학적으로는 두 가지로 분류되며 하나는 초자양혈관형으로서 여포내에 혈관이 증식되고 초자양화(hyalinization)가 일어나는 것이 특징이다. $90\%$가 이에 속하고 다른 하나는 형질세포형으로서 $10\%$를 차지한다. 후자는 여포간 조직내에 형질세포가 미만성으로 증식되고 신증후군, 발열, 빈혈, 적혈구침강속도 증가, 고감마글로블린혈증, 저알부민혈증 등의 변화가 있는 점이 전자와 다른 점이다. 치료는 주로 수술적 제거술에 의하며 수술로서 절제되지 못하는 것은 방사선 치료에 의하게 된다. 저자들은 경도의 흉부불쾌감과 경부 임파절 종대를 보인 61세 남자에서 전상종격동 종괴를 수술적 부분제거 후 외부 방사선 치료를 실시하여 완치된 1예를 경험하였기에 보고하는 바이다.

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복수가 동반되지 않은 간경변증 환자에서 발생한 우측성 흉막액 저류 1예 (A Case of Right Pleural Effusion in Liver Cirrhosis without Ascites)

  • 윤진;김응진;김순혜;고광곤;김문재;정원재;조철호;신용운;박찬섭
    • Tuberculosis and Respiratory Diseases
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    • 제39권3호
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    • pp.261-265
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    • 1992
  • Pleural effusion due to hepatic cirrhosis and ascites is well known. But rarely a pleural effusion may develop in a cirrhotic patient in the absence of detectable ascites. The differential diagnosis of a right-sided transudative pleural effusion in a patient with chronic liver disease with or without ascites includes congestive heart failure and nephrotic syndrome. These diseases are usually ruled out with standard clinical tests. Patients with hepatic hydrothorax should be treated with fluid restriction, diuretics and the correction of hypoalbuminemia. Patients with severe symptoms due to refractory hepatic hydrothorax might benefit from pleural sclerosis and surgical closure of diaphragmatic defect. We experienced a case of right-sided pleural effusion in liver cirrhosis without ascites.

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금은화(金銀花)가 Cationic Bovine Serum Albumin 투여로 유발된 Membranous Nephropathy Mouse Model에 미치는 영향 (Effects of the Lonicerae Flos Extract on the Membranous Nephropathy Induced by Cationic Bovine Serum Albumin in Mice)

  • 이주호;조충식;김철중
    • 동의생리병리학회지
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    • 제23권5호
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    • pp.1063-1072
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    • 2009
  • Membranous nephropathy(MN) is the most common cause of adult nephrotic syndrome worldwide. But treatment of MN is not defined. This study was to evaluate the effects of Lonicerae Flos Extract(LFE) on the MN induced by cBSA in mice. Mice were divided into 4 groups. The first group named for 'Normal' was injected with a saline solution. The second group named 'Control' treated with cBSA(10 mg/kg i.p) only. The third group named 'LFE-250', treated with cBSA(10 mg/kg i.p) and LFE(250 mg/kg, p.o). The fourth group named 'LFE-500'treated with cBSA(10 mg/kg i.p) and LFE(500 mg/kg, p.o). After cBSA and LFE treatment for 4 weeks, we measured change of body weight, 24hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN, creatinine, TNF-$\alpha$, IL-6, IL-$1{\beta}$, IL-10, IFN-$\gamma$, IgA, IgM and IgG levels. The morphologic changes of renal glomeruli were also observed with a light microscope. The levels of 24 hrs proteinuria, total cholesterol, IgG , IgM, IgA, IL-6 were significantly decreased in both LFE groups. The level of triglyceride, IL-$1{\beta}$ was significantly decreased in LFE-500 group. The level of Albumin was significantly increased in LFE-250 group. The level of TNF-$\alpha$, IFN-$\gamma$ were significantly decreased in LFE-250 group. The mRNA expression of IL-$1{\beta}$ in splenocytes was consideraly decreased in LFE-500 group. In histological findings of kidney tissue, thickening of GBM decreased in both LFE groups. This study shows that the LFE might be effective for treatment of MN. More clinical data and studies are to be done for efficient application.

만성질환아를 가진 어머니의 비통감과 이에 대응하는 정도에 관한 연구 (A study on the grief and coping pattern of mothers who have a chronically ill child)

  • 한정석;오가실
    • 대한간호
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    • 제29권4호
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    • pp.73-88
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    • 1990
  • This study was done in order to identify symptoms of grief and patterns of coping in mothers of chronically ill children. Nurses, as health professionals, must understand helpful coping methods for mothers who have chronically ill children. Based on this knowledge, nurses can develop appropriate nursing intervention strategies, and so help the mothers to develop effective ways of coping and give support to mothers with chronically ill children in process of coping with this grief. The research questions guiding this research were: 1. what type of grief does the mother have at the time of child's diagnosis and at present\ulcorner 2. what are the problems confronting the mother 3. what are the coping patterns of the mother\ulcorner 4. is there a difference according to child's diagnosis in the mother's grief and coping pattern\ulcorner The subject for this study were obtained by taking a convenience sample of 120 mothers with a chronically ill child. Interviews took place in four medical school hospitals and one medical center in Seoul from March 19th to May 16th 1990. The tools used in this study were Mcfarlan's(1983), Grief contents, Folkman & Lazarus(1983), Ways of Coping and Hymovich's (1983) the Chronicity Impact and Coping Instrument. The findings were as follows; 1. Grief items had a maximum score of three points. The highest item scrores at the time of diagnosis, were in order, heart broken, talkative, and could not do anything, at the present, 'talkative', 'heart broken' and 'busy myself with other things'. 2. The problems confronting the mothers were 'worry about ill child's future', 'her responsibilities in taking care of the ill child.' 3. Most of the mothers used similar ways of coping, that is 'problem focused coping', 'detachment', 'wishful thinking', 'seeking social support" and 'focusing on the positive and hardly any of them used 'tension reduction'. 4. There was a sinificant difference in coping methods according to the childs diagnosis, leukemia, cancer hemophillia and nephrotic syndrome. The most frequently used coping method was detachment, especially for the mother of the child with. 5. At the time of diagnosis there was a positive correlation between the level of grief and the coping method of detachment and seeking social support.

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어성초(魚腥草)가 Cationic Bovine Serum Albumin 투여로 유발된 Membranous Nephropathy Mouse Model에 미치는 영향 (Effects of the Houttuyniae Herba Extract on the Membranous Nephropathy induced by Cationic Bovine Serum Albumin in Mice)

  • 정대호;조충식;김철중
    • 대한한의학회지
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    • 제30권4호
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    • pp.93-107
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    • 2009
  • Objective: Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults. However, there is not a satisfactory treatment for MN. This study aimed to evaluate the effect of Houttuyniae Herba Extract (HHE) on MN induced by cationic bovine serum albumin (cBSA). Methods: Mice were divided into 4 groups. The first group, Normal, was injected with saline. The second group, Control, was treated with cBSA (10mg/kg i.p) only. The third group, HHE-250, was treated with cBSA (10mg/kg i.p) and HHE (250mg/kg, p.o). The fourth group, HHE-500, was treated with cBSA (10mg/kg i.p) and HHE (500mg/kg, p.o). After treatment for 4 weeks, we measured change of body weight, 24 hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN, creatinine, IgA, IgM, IgG, TNF-${\alpha}$, IL-1${\beta}$ levels and the mRNA expression of IFN-${\gamma}$, IL-6, and IL-10. The morphologic changes of renal glomeruli were also observed with a light microscope and an electron microscope. Results: The levels of 24 hrs proteinuria and serum triglyceride, BUN, IgG, TNF-${\alpha}$, IL-1${\beta}$ significantly decreased in both HHE groups, while the level of serum albumin significantly increased in both HHE groups. The mRNA expression of IFN-${\gamma}$ and IL-6 in splenocytes considerably increased in both HHE groups. The mRNA expression of IL-10 in splenocytes considerably decreased in both HHE groups. In histological findings of kidney tissue, thickening of GBM decreased in both HHE groups. Conclusions: This study shows that HHE might be effective for treatment of acute stage MN. More clinical data and studies are to be done for efficient application.

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