• Title/Summary/Keyword: proteinuria

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School Urine Screening Program in Korea (우리나라의 학교소변검사 프로그램)

  • Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.57-63
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    • 2014
  • A number of kidney diseases of childhood may present as isolated proteinuria or/and hematuria, without any overt signs or symptoms. Urinalysis is a simple and inexpensive test used to evaluate various renal disorders. A school urine screening (SUS) program for kidney disease was conducted in Korea in 1998. Several research reports, including case reports and systemic reviews of SUS data, claimed that early detection and confirmatory diagnosis by renal biopsy seems to be helpful for determining the prognosis and intervention of progressive chronic renal disease. However, there is no global consensus as to whether screening for chronic kidney disease (CKD) should be undertaken in children and adolescents. This paper reviews the SUS for CKD in Korea, including the history and structure of the program, its assessment, related research, and associated problems.

Nutcracker Syndrome combined with Superior Mesenteric Artery Syndrome in a Pediatric Patient: A Case Report

  • Min, Kyung Wook;Lee, Oh Kyung;Kim, Mi Kyung
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.75-80
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    • 2018
  • Nutcracker syndrome is a phenomenon that the left renal vein (LRV) is pressed between the superior mesenteric artery (SMA) and the aorta. Clinical characteristics include gross or microscopic hematuria, orthostatic proteinuria, abdominal pain, and back pain. It occurs due to LRV squeezing caused by narrowed aortomesenteric angle. SMA syndrome is a disease that the third part of the duodenum is prone to intestinal obstruction by narrowed angle between the SMA and the abdominal aorta. Clinical symptoms include postprandial abdominal distension, epigastric pain, nausea, and vomiting. SMA syndrome and nutcracker syndrome have common features that result from narrowed aortomesenteric angle. However, it is very rare for both syndromes to occur simultaneously, so the two syndromes are regarded as separate diseases. This is a report on a case of nutcracker syndrome with SMA syndrome in a child who presented gross hematuria, recurrent abdominal pain and vomiting. To our knowledge, nutcracker syndrome simultaneous with SMA syndrome has not been previously reported in pediatric patient, especially with an exhibition of gross hematuria. This case suggests that the simultaneous presence of SMA syndrome with the same pathogenesis needs to be considered when nutcracker syndrome is suspected in pediatric patients with hematuria.

A Case of Acute Acalculous Cholecystitis Superimposed on the Nephrotic Syndrome (미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례)

  • Shin Youn-Ho;Park Jee-Min;Shin Jae-Il;Kim Myung-Jun;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.91-95
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    • 2003
  • The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.

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A Case of $Henoch-Sch\"{o}nlein$ Nephritis Mimicking Acute Poststreptococcal Glomerulonephritis in Histology (급성 사구체신염의 조직소견을 보인 $Henoch-Sch\"{o}nlein$ 자반증 신염 1례)

  • Chung Hyo-Seok;Lee Hyun-Kyung;Kim Yong-Jin;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.73-76
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    • 2003
  • A girl aged 21 months with $Henoch-Sch\"{o}nlein$ purpura(HSP) developed heavy proteinuria with hematuria 8 days after the appearance of purpuric rash, swelling and tenderness of both ankle joints. Her clinical and laboratory features demonstrated nephrotic and nephritic syndrome. The percutaneous renal biopsy revealed diffuse mesangial proliferative glomerulonephritis. Unlike usual HSP nephritis, immunoglobulin A deposition was not detected in the mesangium or the capillary of the glomeruli. Instead, numerous subepithelial electron-dense deposits('humps') mimicking acute poststreptococcal glomerulonephritis were found.

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Nutcracker Syndrome in Siblings (형제에서 발생한 호두까기 증후군 증례보고 및 문헌 고찰)

  • Lee, Na-Ra;Oh, Jung-Min;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.240-245
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    • 2010
  • Nutcracker syndrome refers to the compression of the left renal vein between the abdominal aorta and superior mesenteric artery which can lead to renal vein hypertension. Patients can present with hematuria, proteinuria, dysuria or abdominal pain. In diagnosing the nutcracker syndrome, measurement of the peak velocity ratio of aorto-mesenteric border versus renal hilum by Doppler sonography is useful. Currently, there are few reports about the genetic correlation in this syndrome. We report two cases of the nutcracker syndrome found in male siblings with hematuria.

A Case of Microscopic Polyangiitis Presenting As Diffuse Alveolar Hemorrhage (미만성 폐포출혈 양상을 나타낸 현미경적 다발성 혈관염 1례)

  • Seo, Chang-Gyun;Lee, Seung-Hyun;Kim, Sang-Hyun;Kim, Kyung-Chan;Kim, Min-Su;Han, Seung-Beom;Park, Kwan-Kyu;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.202-208
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    • 2002
  • A diffuse alveolar hemorrhage is a rare manifestation in microscopic polyangiitis. Recently we experienced a case of diffuse alveolar hemorrhage associated with microscopic polyangiitis, which was diagnosed with the typical clinical manifestations, ANCA and a renal biopsy. A 71 year old female was admitted complaining of coughing and dyspnea. A chest X-ray, HRCT and BAL revealed a diffuse alveolar hemorrhage. A diffuse alveolar hemorrhage was noted during a bronchoscopy. She also had proteinuria, microscopic hematuria and mild azotemia. The renal biopsy showed necrotic glomerulonephritis without immune complex deposits or granuloma. Under the diagnosis of microscopic polyangiitis, she was treated with steroid pulse therapy, and prednisolone with cyclophosphamide subsequently. She showed marked improvement in the clinical manifestations.

Successful EDTA-Tris treatment of Pseudomonas aeruginosa infection of urinary bladder secondary to urolithiasis in a dog

  • Lee, Sang-Gwan;Hoh, Woo-Pil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Korean Journal of Veterinary Research
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    • v.46 no.1
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    • pp.83-86
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    • 2006
  • About 8 year-old castrated male Yorkshire terrier was presented for evaluation of dysuria, stranguria, hemtauria, and pollakiuria. On history taking, dysuria first was observed three months ago and these signs were waxed and waned. Physical examination revealed mild left perineal swelling. On routine laboratory examination, no significant findings were identified. Positive contrast urogram identified peritoneal herniation of urinary bladder. Urinalysis showed proteinuria and hematuria. Urine sediment revealed epithelial cells, white blood cells and rod-shaped bacteria. Pseudomonas aeroginosa was isolated from urine obtained through cystocentesis, and had resistance against fourteen antibiotics. Cystitis caused by P. aeruginosa concurrent with cystolithiasis and perineal hernia was diagnosed. Cystotomy, herniorrhaphy and EDTA-Tris solution lavage of bladder were performed. The patient was recovered to normal condition 2 days after treatment. Two weeks later, bacterial culture of urine was negative and any abnormality in ultrasonogram and urinalysis was not observed except calcium oxalate dihydrate crystals.

Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.2
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    • pp.215-230
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea. Most of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites),chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress, early Psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests(CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT), endoscopy (gastroscopy, colonoscopy) , sonography(abdormen, thyroid, pelvis, breast) , cytology(cervix) ,bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MIRI, MIRI/Angio, molecular testings) were widely usedin hospital health screening programmes. In summary, a variety of were utilized by stages or programmes, however a few subjects. tests were utilized in health screening in Korea. Those tests according to sex and age in most of health screening program used tests to excess disregarding health screening subject.

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Nephrin phosphorylation regulates podocyte adhesion through the PINCH-1-ILK-α-parvin complex

  • Zha, Dongqing;Chen, Cheng;Liang, Wei;Chen, Xinghua;Ma, Tean;Yang, Hongxia;van Goor, Harry;Ding, Guohua
    • BMB Reports
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    • v.46 no.4
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    • pp.230-235
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    • 2013
  • Nephrin, a structural molecule, is also a signaling molecule after phosphorylation. Inhibition of nephrin phosphorylation is correlated with podocyte injury. The PINCH-1-ILK-${\alpha}$-parvin (PIP) complex plays a crucial role in cell adhesion and cytoskeleton formation. We hypothesized that nephrin phosphorylation influenced cytoskeleton and cell adhesion in podocytes by regulating the PIP complex. The nephrin phosphorylation, PIP complex formation, and F-actin in Wistar rats intraperitoneally injected with puromycin aminonucleoside were gradually decreased but increased with time, coinciding with the recovery from glomerular/podocyte injury and proteinuria. In cultured podocytes, PIP complex knockdown resulted in cytoskeleton reorganization and decreased cell adhesion and spreading. Nephrin and its phosphorylation were unaffected after PIP complex knockdown. Furthermore, inhibition of nephrin phosphorylation suppressed PIP complex expression, disorganized podocyte cytoskeleton, and decreased cell adhesion and spreading. These findings indicate that alterations in nephrin phosphorylation disorganize podocyte cytoskeleton and decrease cell adhesion through a PIP complex-dependent mechanism.

Treatment of Henoch-Sch$\ddot{o}$nlein Purpura with Intravenous Immunoglobulin

  • Chung, Hyo-Seok;Kim, Won-Duck;Lee, Eun-Sil;Choi, Kwang-Hae;Park, Yong-Hoon;Kim, Yong-Jin
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.246-252
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    • 2001
  • We report the result of a high-dose intravenous immunoglobulin therapy in a Henoch-Schnlein purpura patient with severe abdominal pain and nephrotic syndrome who did not respond to methylprednisolone pulse therapy. Kidney biopsy showed diffuse mesangial cell proliferative glomerulonephritis with fibrocellular crescent formation in approximately 50% of glomeruli. Mesangium of all glomeruli were strong positive for IgA and C3 antibodies. High-dose intravenous immunoglobulin treatment was introduced and dramatic improvement of gastrointestinal symptom and proteinuria as well as hematuria was noted. Immunoglobulin administration should be considered in Henoch-Schnlein purpura patients with steroid-resistant intractable gastrointestinal manifestation and renal involvement.

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