• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.3
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• pp.87-94
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• 2018

We present the case of long-term observation of a patient with chronic kidney disease (CKD) caused by advanced focal segmental glomerulosclerosis (FSGS) resulting from underlying congenital chloride diarrhea (CLD). A 20-year-old woman was admitted for prolonged proteinuria despite conservative treatment for CLD. She was diagnosed with CLD and started taking KCl salt supplementation from the time of birth. Mild proteinuria was first found at 12 years of age, which progressed to moderate proteinuria at 16 years of age. At 16 years of age, CKD stage 2 with FSGS was diagnosed based on the initial assessment of the glomerular filtration rate (GFR) and kidney histology. On admission, we re-assessed her renal function, histology and genetic analysis. GFR had deteriorated to CKD stage 4 and renal histology revealed an advanced FSGS combined with tubulointerstitial fibrosis. A homozygous mutation in the SLC26A3 gene (c.2063-1G>T) was found by diagnostic exome sequencing and may have been inherited from both parents. CLD patients can be more vulnerable to renal injury, which may also cause progression of renal failure. Therefore, even if there is an early diagnosis and adequate salt supplementation, close monitoring of renal function and tailored treatment should be emphasized for renal protection and favorable CLD prognosis.

• The Journal of Korean Medicine
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• v.30 no.2
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• pp.63-78
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• 2009

Objective: The purpose of experimental study was to prove the effects of Boyangmakseong-bang (BYMSB) treatment on cBSA-induced in a MN mouse model. Methods: We divided mice into 4 groups. The Normal group had no treatment. We used cBSA and induced MN mouse model to the other 3 groups. The Control group was treated with cBSA (9mg/kg i.p) only. The second group, named 'BY-250', was treated with cBSA (9mg/kg i.p) and BYMSB extract (250mg/kg, p.o). The third group, named 'BY-500', was treated with cBSA (9mg/kg i.p) and BYMSB extract (500mg/kg, p.o). After cBSA and BYMSB extract treatment for 4 weeks, the increase in percentage of body weight, proteinuria, serum albumin, total cholesterol, creatinine and BUN of all groups were measured. The CD3+, CD19+, CD4+, CD8+ cell levels of spleen of all groups were analyzed. IgA, IgG, IgM, IL-$1{\beta}$, TNF-${\alpha}$, IL-6 and IFN-${\gamma}$ levels of all groups were gauged. H&E staining, immunofluorescence staining and electron microscopy of kidney were observed. Results: BYMSB showed significant decrease in the 24hrs proteinuria, serum total cholesterol, serum IgG levels and BUN levels, and showed significant increase in the serum albumin levels compared with the control group. BYMSB showed increase in the increasing percentage of body weight and IFN-${\gamma}$ levels compared with the control. BYMSB showed decrease in the CD3+ T cells, CD4+ Th cells, IL-$1{\beta}$, TNF-${\alpha}$ and IL-6 levels, but did not show significant change compared with the control. BYMSB showed considerable decrease in the thickening of the GBM on H&E staining, deposition of IgG on immunofluorescence staining and deposition of electron-density on electron microscopy of kidney compared with the control. Conclusions: According to the above results, it is suggested that BYMSB decreases the symptoms of MN induced by cBSA in a mouse model. Therefore BYMSB seems to be applicable to MN in clinical practice.

• Clinical and Experimental Pediatrics
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• v.61 no.10
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• pp.327-331
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• 2018

Purpose: The incidence of inflammatory bowel disease (IBD) is rapidly increasing, and several reports have described the renal complications of IBD. We sought to evaluate the clinical manifestations of renal complications in children with IBD in order to enable early detection and prompt treatment of the complications. Methods: We retrospectively reviewed the medical records of 456 children and adolescents aged <20 years who had been diagnosed with IBD since 2000. We analyzed patient age, sex, medication use, IBD disease activity, and clinical manifestations of renal symptoms. Results: Our study comprising 456 children with IBD included 299 boys (65.6%) and 157 girls (34.4%). The study included 346 children with Crohn disease and 110 children with ulcerative colitis. The incidence of kidney-related symptoms was 14.7%, which was significantly higher than that in normal children. We observed 26 children (38.8%) with isolated hematuria, 30 children (44.8%) with isolated proteinuria, and 11 children (16.4%) with hematuria and concomitant proteinuria. A renal biopsy was performed in 7 children. Histopathological examination revealed immunoglobulin A nephropathy in 5 children (71.4%). All children presented with mild disease and well-controlled disease activity of IBD. Conclusion: Children with IBD are more likely to show kidney-related symptoms than healthy children and adolescents are. Therefore, regular screening of urine and evaluation of renal function in such children are necessary for early detection of renal complications.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.213-218
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• 2001

Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN l17 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 213-18)

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.188-195
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• 2001

Type II membranoproliferative glomerulonephritis (Dense deposit disease) is an acquired primary glomerular disease characterized by electron microscopic evidence of a continuous dense membrane deposition replacing the lamina densa. It is a subtype of idiopathic membra- noproliferative glomerulonephritis, and was described as a separate entity by Berger and Galle in 1963. It frequently occurs in older chilren and young adults and the clinical course is variable, but is generally progressive. The presenting feature is nephrotic syndrome in many patients, and proteinuria and hematuria are also seen frequently. The purpose of this paper is to present a case of DDD (Dense deposit disease) from a 10 year old boy who was diagnosed as a acute poststreptococcal glomurulonephritis with protenuria, hematuria, and facial edema by renal biopsy 4 years ago. (J, Korean Soc Pediatr Nephrol 2001 ; 5 : 188-95)

• The Journal of Korean Medicine
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• v.29 no.4
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• pp.68-82
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• 2008

Objective: The purpose of our study was to show the effects of Hwalhyulmaksung-bang (Huoxiemoxing-fang, HHMSB) treatment on cBSA-induced in MN Mouse Model. Methods: We divided the 20 mice into 4 groups. One group, named NR, was not treated. The second group, named CT, was treated with cBSA (7mg/kg i.p) only. The third group, named HH-250, was treated with cBSA (7mg/kg i.p) and HHMSB extract (250mg/kg, p.o). The fourth group, named HH-500, was treated with cBSA (7mg/kg i.p) and HHMSB extract (500mg/kg, p.o). 4 weeks after cBSA, proteinuria, serum albumin, total cholesterol, serum creatinine, BUN, total cell number of spleen and kidney of all groups were measured. CD3e+/CD19+ and CD4+/CD8 cells ratio of peripheral blood, kidney and spleen of all groups were analyzed. $IL-1{\beta}$ and TNF-$\alpha$, IL-6, IgG, IgM, and IFN-$\gamma$ levels of all groups were gauged. Histological analysis of kidney tissue and immunohistochemical staining (CD4, CD8) of kidney were observed. Results: The level of proteinuria significantly decreased and serum albumin increased in the group treated with cBSA and HHMSB extract compared with the control. Total cholesterol decreased but not significantly. CD3e+/CD19cells ratio of peripheral blood is decreased, but CD4+/CD8cells ratio has no significancy. CD3e+/CD19+ and CD4+/CD8 cells percentage of kidney and spleen has no significancy. Level of $IL-1{\beta}$, IL-6 is significantly decreased, and IFN-$\gamma$ is significantly increased on HHMSB compared with control. Total IgG level significantly decreased on HHMSB compared with the control. Thickness of GBM decreased on histological analysis of kidney. Deposition of CD4 and CD8 decreased on immunohistochemical staining of kidney. Conclusions: We conclude that Hwalhyulmaksung-bang treatment may could be a useful remedy agents for treating Membranous Neuropathy(MN) induced by cationized bovine serum albumin.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.283-315
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• 1997

The effects of Geumguesingitang and Dohongsamultang on rats with nephrosis induced by a single tail-intravenous injection of puromycin aminonucleoside(PAN), 2.5mg/l00g of body weight were evaluated in the present study. The effects of Geumguesingitang and Dohongsamultang on PAN nephrosis were evaluated by measuring (1)the concentrations of albumin, total protein, total lipid, cholesterol, triglyceride, creatinine, blood urea nitrogen(BUN) and uric acid in the serum, (2)the concentrations of protein, creatinine, glucose, occult blood and volume of the 24 hours urine and (3)the volume of intake water. The results are summerized as follows; 1. In the Control group as compared to the Normal. the amount of protein of 24 hours urine was significantly increased, the concentrations of albumin and total protein were significantly decreased. Total lipid, cholesterol and triglyceride in the serum were significantly increased. The concentrations of creatinine, BUN, uric acid in the serum, the amount of glucose and occult blood of 24 hours urine were also increased significantly. 2. In the Geumguesingitang group as compared to the Control, the increase in the amount of urinary protein during 24 hours induced by PAN was significantly suppressed, and the concentrations of total protein and albumin in the serum were significantly increased. The concentrations of total lipid, cholesterol and triglyceride in the serum were significantly inhibited. The decrease of the concentrations of creatinine and uric acid in the serum were also observed significantly. 3. In the Dohongsamultang group as compared to the Control, the increase of the amount of protein and glucose of the 24 hours urine induced by PAN were significantly inhibited, and the concentrations of total protein and albumin in the serum were increased significantly. The concentrations of total lipid, cholesterol and triglyceride in the serum were decreased significantly. The decrease of the concentrations of creatinine and uric acid in the serum were observed significantly. It can be inferred that Geumguesingitang has effects on improving proteinuria, hypoproteinemia effectively. It has an effect on hyperlipidemia significantly relieved. And relieving azotemia when nephrotic syndrome is accompanied by the acute renal failure. It can be inferred that Dohongsamultang improves hyperlipidemia effectively. It has effects on proteinuria, hypoproteinemia in nephrotic syndrome significantly relieved. And relieving azotemia when nephrotic syndrome is accompanied by the acute renal failure.

• The Journal of Korean Medicine
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• v.30 no.5
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• pp.61-76
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• 2009

Background: Membranous nephropathy (MN) is the most common cause of adult nephrotic syndrome worldwide and has been defined as granular subepithelial deposition of immune complexes along the glomerular basement membrane (GBM). MN has few known treatments and gives rise to side effects under treatment with steroids and immunosuppressives. Objective: The purpose of this experimental study was to demonstrate the effects of Scutellariae Radix extract (SRE) treatment on MN mouse model induced by cBSA. Methods: We divided mice into 4 groups. The Normal group had no treatment. We induced MN mouse model to the other 3 groups by injecting cBSA into the abdominal cavity. The control group was treated with cBSA (10 mg/kg, i.p.) only. The second group, 'SRE-250', was treated with cBSA (10 mg/kg, i.p.) and SRE (250 mg/kg, p.o.). The third group, 'SRE-500', was treated with cBSA (10 mg/kg, i.p.) and SRE (500 mg/kg, p.o.). After cBSA and SRE treatment for 4 weeks, gain in body weight, 24hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN and creatinine of all groups were measured. TNF-$\alpha$, IL-6, IL-1$\beta$, IL-10, IFN-$\gamma$, IgA, IgM and IgG levels of all groups were gauged. H&E staining and electron microscopy of the kidney were observed. Results: SRE showed significant decrease in the 24hrs proteinuria, serum triglyceride, BUN, TNF-$\alpha$, IL-6, serum IgA, IgM and IgG levels compared with the control group. SRE showed increase in the serum IL-10 and IFN-$\gamma$ levels compared with control on RT-PCR. SRE considerably decreased in the thickening of the GBM on H&E staining and deposition of electron-density on electron microscopy of the kidney compared with the control. Conclusions: According to the above results, it is suggested that SRE decreases the symptoms of MN induced by cBSA in mouse model. Therefore, SRE seems to be applicable to MN in clinical practice.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.251-257
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• 1984

Low birth weight baby, defined as the baby born with less than or equal to 2,500g of body weight by WHO has been a great concern in the fold of maternal and child health since the low birth weight is a major cause of high perinatal mortality. Any measure to prevent the low birth weight baby is most desirable not only for saving the life of a baby but also for levelling up the health of the whole society. The authors attempted to figure out how some known maternal risk factors are related to the low birth weight and to measure their strengh of associations in terms of relative risk using hospital birth records. For this study, hospital birth records of 66 low birth weight cases and sex-parity matched 198 normal controls were chosen from Kangnam St. Mary's Hospital, Catholic Medical Center, and the data were analyzed in regards to several maternal factors. The risk factors studied were mother's age, mother's ABO blood type, previous histories of abortion, low birth weight baby, fetal wastage, and maternal diseases represented by anemia, hypertension, proteinuria, and glucosuria. The results obtained in this study were as follows: 1. The mean body weight of the cases and controls were 1,955g and 3,251g, respectively, and the heights were 41cm for cases and 50cm for controls. Mean gestation periods of cases and controls were 34 weeks and 39 weeks, respectively. 2. Young mother(less than or equal to 20 years of age) or old mother(more than or equal to 30 years of age) experienced more frequently the delivery of low birth weight babies than mothers in between 21 and 29 years of age. But the difference was not statistically significant. 3. Mothers whose blood type was O tended to have slighty higher frequency of low birth weight babies while B mothers have lower frequency. But the difference was not statistically significant too. 4. Those mothers who had experienced low birth weight baby in the past tended to give more births of low birth weight babies. This factor is even statistically significant and the relative risk of the prior experience of low birth weight was 6.7. 5. Mothers with experience of fetal losses and mothers of more than two pregnancies had higher frequency of low birth weight than the mothers with no fatal losses and of first pregnancy, but the difference was not statistically significant. 6. Statistically significant higher frequency of low birth weight were found in mothers with hypertension(odds ratio=4.07), anemia(odds ratio=22,33), and proteinuria(odds ratio=2.79). In summary, these study results strongly suggest that in order to prevent the low birth weight, special care should be made when the mother is too young or too old, and when the mother has experienced deliveries of low birth weight and fetal deaths. Medical control for the maternal diseases such as anemia and hypertension is also needed before or during the pregnency.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.259-268
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• 1984

The Korean government launched the medicaid program for the poor people as a wing of the social development and welfare programs beginning in 1977 when the fourth 5-year national economic development program started. The charts of the medicaid recipients who visited Jonglo-Gu Health Center for the period from 1981 to 1983 were reviewed and analysed. Major findings from the analysis are as follows. 1. The medicaid recipients occupied 5.19% in 1981, 2.90% in 1982 and 2.00% among the total residents of Jonglo district in 1983, respectively. 2. The mean number of physician visits per person year of medicaid recipients who visited the Jonglo-Gu Health Center was 4.73 in 1981, 4.90 in 1982 and 4.41 in 1983, respectively. 3. The consultation/referral rate at the Jonglo-Gu Health Center was 2.65% in 1981, 1.77% in 1982 and 2.18% in 1983 while the rate at the department of family practice, Seoul National University Hospital was 3.18% in 1983. 4. Classifying into 17 major categories, the pattern of diseases of the poor outpatients who visited the Hallym College Medical Center both in 1981 and 1982 showed a statistically similar pattern of the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981 and 401 patients in 1983. 5. Classifying into 17 major categories, the disease of outpatient visits at the department of family practice, Seoul National University Hospital from 1st May, 1983 to 31s1 Oct., 1983 revealed statistically significant similarity with both the 5,169 medicaid patients in 1981 and the 401 patients sampled in 1983. 6. Classifying into 17 major categories, the diseases of community diagnosis at the Ihwa Dong, Jonglo-Gu also showed a statistically significant similarity with the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981. 7. Classifying into 17 major categories, the diseases of 5,169 medicaid patients at Jonglo-Gu Health Center in 1981 showed a statistically significant similar distribution with that of the 401 sampled medicaid patients at this center in 1983. 8. Among the medicaid patients who utilized the Jonglo-Gu Health Center in 1983, 401 sampled patients who are practicable routine urinalysis composed of 131 indigent group and 270 low-income group. The sample composed of 127 males and 274 females. There were more old patients than the young ones among the 401 sampled patients. 9. Age-adjusted prevalence rate of the hypertension computed by the direct method using estimated of midyear population of 1980 year as the standard is the highest in the Yonsei area and the lowest in the Shindongmyun. Furthermore age-adjusted prevalence rate was higher for males than that of females. 10. The group of hypertension patients using routine urinalysis profile composed of pyuria, hematuria, proteinuria and glycosuria is the most statistical significant, the pyuria alone is very significant, hematuria is significant and proteinuria is also significant.