• Title/Summary/Keyword: renal artery

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실험적으로 신부전을 유발시킨 개에서 박동형 혈액투석기의 효능 (Efficacy of Pulsatile Hemodialyzer to Experimental Renal Failure in Dog)

  • 지혜정;윤영민;이주명;강태영;김재훈;정종태;최민주;민병구;이경갑
    • 한국임상수의학회지
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    • 제23권3호
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    • pp.320-324
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    • 2006
  • The purpose of the present study was to compare pulsatile type(Twin Pulse Life Support; TPLS) with rotary type hemodialyzer(AK95) in order to reduce the dialysis time and to improve dialysis effect. Three healthy dogs(about 30 kg BW) were used. Experimental renal failure was induced by the ligation of bilateral renal artery. A pair of catheters were implanted in jugular vein for dialysis. Daily investigated parameters included clinical signs such as vomiting, fecal appearance and activity, and also laboratory data such as PCV, TP, BUN and creatinine. Hemodialysis was started above 90 mg/100 ml BUN level and, laboratory data were measured every an hour for 4 hours. Heparin was administered 300 IU/Kg before dialysis and 150 IU/Kg via IV route every 90 minutes during dialysis. Clinical signs after induction renal failure were shown severe vomiting, anorexia, diarrhea, mucous feces, ataxia, dilated pupil and episcleral hyperemia. The average of BUN value decreased hourly $99{\pm}12.1,\;84{\pm}12.2,\;72{\pm}8.0,\;58{\pm}7.1,\;48{\pm}5.2,\;and\;39{\pm}3.2mg/100ml$ by hemodialysis. The average of creatinine value decreased $7.8{\pm}0.61,\;6.4{\pm}0.40,\;5.3{\pm}0.42,\;4.5{\pm}0.23,\;4.0{\pm}0.41,\;and\;3.4{\pm}0.42mg/100ml$ according to hemodialysis an hour. There are not significantly differences BUN, creatinine, PCV and TP values between pulsatile and rotary type hemodialysis. These results suggested that effects of hemodialysis with Pulsatile type(TPLS) are not significantly difference as compared with hemodialysis of rotary type(AK95). Further research is needed in order to estimate the influence of cardiovascular and pulmonary system in hemodialysis of pulsatile type.

Determination of Carnitine Renal Threshold and Effect of Medium-Chain Triglycerides on Carnitine Profiles in Newborn Pigs

  • Heo, K.N.;Odle, J.;Lin, X.;van Kempen, T.A.T.G.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권2호
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    • pp.237-242
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    • 2001
  • Colostrum deprived, newborn pigs (N=12, $1.64{\pm}0.05kg$) were used to study the renal threshold of carnitine, and effects of emulsified medium-chain triglyceride (MCT, tri-8:0) feeding on kinetics of plasma carnitine and urinary carnitine excretion. An arterial catheter was inserted through an umbilical artery, and a bladder catheter was inserted via the urachus. Piglets were oro-gastrically gavaged with one of six carnitine levels (0, 60, 120, 180, 240, $480{\mu}mol/kg\;W^{0.75}$) with (+MCT) or without medium-chain triglycerides (-MCT) in 0.9% NaCl solution. Blood was sampled into heparinized tubes at 0, 1, 2, 4, 6, 8, 14, and 20 h after gavage, and urine was collected and pooled into 1 h or 2 h composite samples to determine free- and short-chain carnitine concentrations. Plasma from the 12 newborn piglets before gavage contained $10.6{\pm}1.2{\mu}mol/L$ free carnitine and $7.2{\pm}0.6{\mu}mol/L$ acid-soluble acyl carnitine. The renal threshold for carnitine was similar between the MCT and the +MCT group (42.6 13.1 and $46.4{\pm}2.0{\mu}mol/L$, respectively), but the correlation between plasma free carnitine and urinary excretion was altered. Plasma free carnitine linearly increased with increasing carnitine dosage (-MCT group, $R^2=0.95$, p<0.001; +MCT group, $R^2=0.91$, p<0.001), but was decreased by 50% when medium-chain triglycerides were fed. The peak in plasma free carnitine concentration was depressed by medium-chain triglycerides feeding also. Therefore, the plasma and urinary short-chain/free carnitine ratio of the +MCT group was increased by 100% and 40%, respectively (p<0.01). Feeding of medium-chain triglycerides may delay plasma carnitine elevation via altering the kinetics of absorption. Similarly, the plasma and urinary short-chain/free carnitine ratio were affected by interaction between medium-chain triglycerides and time (p<0.01). The present study suggests that an oral carnitine dose over $480{\mu}mol/kg\;W^{0.75}$ may be needed to reach the free carnitine renal threshold within a short period, especially when provided together with medium-chain triglyceride.

Nutcracker Syndrome를 위해 왼콩팥정맥에 삽입한 스텐트의 우심실 이동 - 1예 보고 - (Intracardiac Migration of a Renal Stent from the Left Renal Vein to the Right Ventricle during the Treatment of Nutcracker Syndrome - A case report -)

  • 김재범;최세영;박남희;금동윤;박훈;황은아
    • Journal of Chest Surgery
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    • 제43권1호
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    • pp.100-103
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    • 2010
  • 저자들은 nutcracker syndrome을 치료하기 위해 삽입한 스텐트가 심장내 우심실로 이동하는 드문 합병증을 경험하였기에 보고하고자 한다. 29세 여자환자가 측복부 통증을 주소로 내원하였다. 복부 컴퓨터단층촬영에서 좌콩팥정맥이 복부대동맥과 상장간막동맥 사이에서 눌리는 것(nutcracker syndrome)이 발견되었다. Nutcracker syndrome을 치료하기 위해 자가확장 스텐트를 좌콩팥정맥에 삽입하는데 다음날 스텐트가 심장 내 우심실로 이동된 것을 발견할 수 있었다. 경피적 스텐트 제거를 시도하였으나 실패하여 심장수술로 제거하였다. 수술 후 6개월째 아무런 복부나 심장 증상없이 외래 추적관찰 중이다.

둔상 후 복부 전산화단층촬영에서 조영제 유출로 동맥색전술을 시행받은 환자의 복강내와 후복막강/골반강내 출혈 비교 (Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma)

  • 윤지영;김선휴;안력;황재철;홍은석
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.199-205
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    • 2009
  • Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

An Assessment of the Usefulness of Time of Flight in Magnetic Resonance Angiography Covering the Aortic Arch

  • Yoo, Yeong-Jun;Choi, Sung-Hyun;Dong, Kyung-Rae;Ji, Yun-Sang;Choi, Ji-Won;Ryu, Jae-Kwang
    • 방사선산업학회지
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    • 제12권4호
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    • pp.325-332
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    • 2018
  • Carotid angiography covering the aortic arch includes contrast-enhanced magnetic resonance angiography (CEA), which is applied to a large region and usually employs contrast media. However, the use of contrast media can be dangerous in infants, pregnant women, and patients with chronic renal failure (CRF). Follow-up patients informed of a lesion may also want to avoid constant exposure to contrast media. We aimed to apply time-of-flight (TOF) angiography to a large region and compare its usefulness with that of CEA. Ten patients (mean age, 58 years; range, 45~75 years) who visited our hospital for magnetic resonance angiography (MRA) participated in this study. A 3.0 Tesla Achieva magnetic resonance imaging (MRI) system (Philips, Netherland) and the SENSE NeuroVascular 16-channel coil were employed for both methods. Both methods were applied simultaneously to the same patient. Three TOF stacks were connected to cover the aortic arch through the circle of Willis, and CEA was applied in the same manner. For the quantitative assessment, the acquired images were used to set the regions of interest (ROIs) in the common carotid artery (CCA) bifurcation, internal carotid artery, external carotid artery, middle cerebral artery, and vertebral artery, and to obtain the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) for the soft tissues. Three radiologists and one radiological resident performed the qualitative assessment on a 5-point scale - 1 point, "very bad"; 2 points, "bad"; 3 points, "average"; 4 points, "good"; and 5 points, "very good" - with regard to 4 items: (1) sharpness, (2) distortion, (3) vein contamination, and (4) expression of peripheral vessels. For the quantitative assessment, we estimated the mean SNR and CNR in each of the 5 ROIs. In general, the mean SNR was higher in TOF angiography (166.1, 205.2, 154.39, 172.23, and 161.95) than in CEA(92.05, 95.43, 84.76, 73.69, and 88.3). Both methods had a similar mean CNR: 67.62, 106.71, 55.9, 73.74, and 63.46 for TOF angiography, and 67.82, 71.19, 60.52, 49.45, and 64.07 for CEA. In all ROIs, the mean SNR was statistically significant (p<0.05), whereas the mean CNR was insignificant (p>0.05). The mean values of TOF angiography and CEA for each item in the qualitative assessment were 4.2 and 4.28, respectively for item 1; 2.93 and 4.55, respectively, for item 2; 4.6 and 3.13, respectively, for item 3; and 2.88 and 4.65, respectively, for item 4. Therefore, TOF angiography had a higher mean for item 3, and CEA had a higher mean for items 2 and 4; there was no significant difference between the two methods for item 1. The results for item 1 were statistically insignificant (p>0.05), whereas the results for items 2~4 were statistically significant (p<0.05). Both methods have advantages and disadvantages and they complement each other. However, CEA is usually applied to a large region covering the aortic arch. Time-of-flight angiography may be useful for people such as infants, pregnant women, CRF patients, and followup patients for whom the use of contrast media can be dangerous or unnecessary, depending on the circumstance.

완전대혈관전위증 [S.D.D., Kidd type IV] 에 대한 Rastelli 수술 치험 (Transposition of great arteries [S.D.D.] with VSD and PS: report of an autopsy case)

  • 이명희
    • Journal of Chest Surgery
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    • 제15권3호
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    • pp.331-337
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    • 1982
  • Complete TGA is a common congenital cardiovacular anomaly, and without palliative or corrective surgery, the infant born with TGA rarely survives the first year of life. Hemodynamically, recirculated blood flow in the systemic and pulmonary circuit has a key role in systemic arterial oxygen saturation and the status of the pulmonary vascular bed. Recently a d-TGA with VSD and PS, in a 12 year old male patient had been tried for inversion of the ventricular flow with Rastelli operation. An intracardiac tunnel was constructed between the VSD and the aortic orifice to connect the ventricle to the aorta. The right ventricle was connected with the pulmonary circulation by anastomosis of an valved conduit between the right ventricle and the distal end of the pulmonary artery. During the postop, period, the irreversible renal failure, accompanied by metabolic acidosis and pulmonary edema, occured under relative stabilized cardiac performance state. The autopsy was done, which revealed diffuse infarcted area in both kidney and preserved intra & extracardiac graft constructed.

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단일판첨을 내재한 우심실유출로 Patch 를 이용한 활로 4 징증의 교정수 (Total correction of TOF using monocusp bearing outflow patch)

  • 박이태
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.636-643
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    • 1984
  • For the purpose of avoiding postoperative massive pulmonary insufficiency after transannular outflow tract reconstruction in patients with tetralogy of Fallot, we have used monocusp bearing outflow patch since June 1983. Right heart catheterization and pulmonary arteriography were performed in 7 patients among the total 11 patients corrected with monocusp bearing outflow patch during postoperative 14th day to 22nd day. Particular attention was paid to the evaluation of the pulmonary valve competence, and the results were; 1.One patient died of acute renal failure secondary to low cardiac output and the operative mortality was 9.1%. 2.The average PRV/FA ratio was 0.491 and the average systolic pressure gradient between right ventricle and pulmonary artery was 17.7mmHg. The average Qp/Qs was 1.13. 3.Inspite of using monocusp bearing outflow patch, the hemodynamic and pulmonary arteriographic results were unsatisfactory in respect to pulmonary valve competence.

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Type B Aortic Dissection with Visceral Artery Involvement Following Blunt Trauma: A Case Report

  • Han, Ahram;Lee, Min A;Park, Youngeun;Kang, Jin Mo;Kim, Jung Ho;Lee, Jungnam
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.206-211
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    • 2017
  • Aortic dissection caused by blunt trauma is a rare injury that can be complicated by malperfusion syndrome resulting from obstruction of branch vessels of the aorta. Here, we present a case of traumatic type B aortic dissection with right renal and small bowel ischemia, successfully managed by endovascular fenestration.

가토 적출 신동맥에 있어서 purinergic 신경 분포 (Purinergic innervation on the isolated renal artery of rabbit)

  • 김주헌;김용근
    • 대한수의학회지
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    • 제31권4호
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    • pp.389-395
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    • 1991
  • 가토 적출 신동맥에 있어서 purinergic 신경 분포를 perivascular nerve stimulation을 통해서 확인하였다. 1. 가토 적출 신동맥은 perivascular nerve stimulation에 의해 수축성 반응을 나타내었다. 2. Perivascular nerve stimulation에 의한 수축현상은 자극의 크기와 자극의 빈도에 의존적이었으며, 내피세포의 유무에는 영향을 받지 않았다. 3. Perivascular nerve stimulation에 의한 수축현상은 prazosin$(1{\mu}M)$에 의해 강하게 억제되어졌으며, tetrodotoxin$(1{\mu}M)$ 또는 ${\alpha},{\beta}-methylene$ATP$(10{\mu}M)$에 의한 $P_{2x}-purinoceptor $ desensitization에 의해 완전히 수축현상이 사라졌다. 이와같은 결과는 가토 신동맥에는 purinergic신경이 분포되어 있으며, perivascular nerve stimulation에 의해 purinergic 신경전달물질이 norepinephrine과 함께 유리되어지는 것을 시사하고 있다.

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미니돼지의 신허혈-재관류에 의한 급성신손상 모델에서의 유용한 바이오마커 (Effective Biomarkers for Miniature Pig in Acute Kidney Injury Using Renal Ischemia-Reperfusion Model)

  • 김세은;심경미;최석화;강성수
    • 한국임상수의학회지
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    • 제29권5호
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    • pp.372-376
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    • 2012
  • 급성신손상은 높은 이환율과 치사율을 나타내는 심각한 질환이며, 허혈-재관류에 의한 신손상은 급성신손상의 중요한 원인이 된다. 본 연구는 미니돼지에서 급성신손상을 진단하는데 임상적으로 유용한 바이오마커를 찾아내기 위해 실시되었다. 세 마리의 미니돼지에서 60분간 신동맥을 결찰하여 양측성 신허혈을 유도하였다. 각 미니돼지에서 결찰 전, 결찰 후 0, 1, 3, 5일에 혈액 및 뇨 검체를 채취하였다. 혈청 및 뇨 검체에서 BUN, creatinine, 나트륨 및 요산을 측정한 후 나트륨 및 요산의 분획배설율($FE_{Na}$, $FE_{UA}$)을 산출하였다. 또한 IL-6, IL-18, L-FABA 및 GST를 Western immunoblotting을 실시하여 측정하였다. 결과에서 세 마리 미니돼지 모두 혈청 BUN과 creatinine 농도는 결찰 후 1일째에 유의적으로 증가하였다. 그러나 $FE_{Na}$$FE_{UA}$는 현저한 개체차를 보였다. 수술 전과 후를 비교했을 때 허혈 이후의 뇨 검체에서는 IL-6, IL-18, L-FABP 및 GST의 농도가 유의적으로 증가하였다. 결론적으로, $FE_{Na}$$FE_{UA}$에 대해서는 추가적인 연구가 필요하다고 생각되며, 혈청 BUN, creatinine과 뇨 IL-6, IL-18, L-FABP 및 GST는 돼지의 허혈-재관류 모델에서 다른 바이오마커와 함께 급성신손상을 진단하는 민감한 바이오마커가 될 수 있을 것이라 생각된다.