• Journal of Trauma and Injury
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• 제23권1호
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• pp.16-20
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• 2010

Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury.

• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.266-271
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• 2017

Purpose: The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children. Methods: We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children's Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally, 17 patients were enrolled and divided into a renal-origin hypertension group and a non-renal-origin hypertension group according to the underlying cause. We compared the clinical features and brain MRI findings between the 2 groups. Results: The renal group included renal artery stenosis (4), acute poststreptococcal glomerulonephritis (2), lupus nephritis (2), and acute renal failure (1); the nonrenal group included essential hypertension (4), pheochromocytoma (2), thyrotoxicosis (1), and acute promyelocytic leukemia (1). The mean systolic blood pressure of the renal group ($172.5{\pm}36.9mmHg$) was higher than that of the nonrenal group ($137.1{\pm}11.1mmHg$, P<0.05). Seizure was the most common neurologic symptom, especially in the renal group (P<0.05). Posterior reversible encephalopathy syndrome (PRES), which is the most typical finding of hypertensive encephalopathy, was found predominantly in the renal group as compared with the nonrenal group (66.6% vs. 12.5%, P<0.05). Conclusion: We conclude that the patients with renal-origin hypertension had a more severe clinical course than those with non-renal-origin hypertension. Furthermore, the renal-origin group was highly associated with PRES on brain MRI.

• The Korean Journal of Physiology
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• 제25권2호
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• pp.171-177
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• 1991

This study was carried out to determine effect of acute renal ischemia on transport function of organic cation, tetraethylammonium (TEA), in rabbit kidney proximal tubule. Clamping of the renal artery for 30 and 60 min produced a polyuria which was accompanied by an increase in $Na^+$ excretion. The capacity of kidney cortical slices to accumulate TEA was increased after 30 and 60 min of ischemia. When blood flow was restored for 30 min after 30 and 60 min of ischemia, the augmented TEA uptake was recovered to the control values. Oxygen consumption of cortical slices was stimulated after 30 min of ischemia, whereas it was not altered by 60 min of ischemia. A 90-min ischemia produced a significant inhibition of TEA uptake and tissue oxygen consumption. These results suggest that the basolateral transport system for organic cation persists after ischemic periods of 60 min despite evidence that tubular reabsorptive mechanism of $Na^+$ and water is markedly impaired. This may indicate that the active secretory systems of proximal tubule are more resistant to ischemic injury than the reabsorptive systems.

• Journal of Chest Surgery
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• 제23권3호
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• pp.482-487
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• 1990

The leading cause of death in patients with chronic renal failure is cardiovascular diseases. The problems relevant to cardiac surgery in these patients are occurring more frequently with a growing number of patients at risk. Among these, important risk factors related to uremic patients undergone open heart surgery are fluid and electrolytes imbalance, coagulopathy, increased susceptibility to infection. Since 1968 when Lansing and colleagues reported the first successful aortic valve replacement in patients with chronic renal failure and infective endocarditis, there have been increasing reports of the cardiopulmonary bypass surgery in chronic renal failure patients with acceptable perioperative morbidity and mortality From Jan. 1988 to Nov. 1989 we have experienced four uremic patients necessitating open heart surgery ; one needing a coronary artery bypass graft and the other 3 needed cardiac valve replacement. Based on our observations we would like to suggest followings 1]Intraoperative ultrahemofiltration during C-P bypass thought to be an excellent means for the control of hyperkalemia and fluid balance. 2] The immediate postoperative application of peritoneal dialysis instead of hemodialysis is beneficial in controlling fluid and electrolyte imbalance. 3]The cause of one early postoperative death was not associated to renal failure, rather it was the result of an accidental rupture in the right ventricular wall.

• 대한본초학회지
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• 제28권3호
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• pp.7-15
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• 2013

Objectives : Interruption and subsequent restoration of blood flow into the kidney result in renal injury. As an approach to preventing the renal injury, we determined the optimal conditions and the underlying mechanisms by which supernatant of hot water extract of ground Triticum aestivum L. (extract) attenuated ischemia/reperfusion (I/R) injury. Methods : One hour after administration of the extract (400 mg/kg) by intraperitoneal injection, renal I/R injury was generated by clamping the left renal artery in rats after surgical removal of the right kidney, followed by reperfusion. The maximal difference between the vehicle-treated and the extract-treated group under ketamine/xylazine or enflurane anesthetization was assessed at varying periods of ischemia (30-45 min) and reperfusion (3-48 hr), based on the renal function assessed with serum creatinine levels, tissue injury with hematoxylin/eosin staining, and apoptosis with terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling staining. Results : Enflurane anesthetization with 40 min of ischemia and 24 hr of reperfusion was identified to be the optimal condition, under which condition serum creatinine levels and tubular damage in the extract-treated group were significantly reduced compared with those in the vehicle-treated group ($1.3{\pm}0.2$ versus $2.7{\pm}0.3$ mg/dL, P < 0.01, and average score $1.8{\pm}0.1$ versus $3.5{\pm}0.3$, P < 0.01, respectively). These beneficial effects were mediated by inhibition of apoptotic cascades through attenuation of renal tissue malondialdehyde levels, Bax/Bcl-2 ratio and caspase-3 levels. Conclusions : The extract conferred renal protection against ischemia/reperfusion injury in rats by scavenging reactive oxygen species and consequently blocking apoptotic cascades, plausibly augmented by enflurane protection.

• Journal of Yeungnam Medical Science
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• 제12권1호
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• pp.96-104
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• 1995

여러가지 색전물질이 조직내에서 어떤 변화를 야기시키며 또한 시간경과에 따라 어떤 변화를 보이게 되는지를 알아보기 위해 EVAL, Histoacryl, Ivalon을 이용하여 토끼의 신동맥을 통해 색전을 실시하였으며 시간경과에 따라 조직학적으로 검사하여 다음과 같은 결과를 얻었다. EVAL은 1주일이내의 초기단계에는 혈관 내에서 별다른 조직변화를 일으키지 않았으나 2주일 이내의 중기단계에는 혈관벽의 비후를 나타냈다. Histoacryl은 1주일이내의 초기단계에 벌써 심한 섬유소양 변성을 보여 심한 조직변화를 일으킨다는 것을 알 수 있었고 실험 예의 반수에서 신동맥의 폐쇄에 의한 경색을 볼 수 있어 강한 조직유착성을 시사해 주었으며 실제 환자에 적용함에 있어 주의를 환기시켜 주었고 혈류가 빠르거나 누공등이 있는 경우에 더욱 적절히 사용될 수 있음을 알 수 있었다. Ivalon은 초기에는 혈관염의 소견을, 중기에는 이물질반응에 의한 거대세포를, 후기에는 심한 섬유화의 소견을 보여 주었고 수술을 대신하는 치료적인 목적보다는 혈류를 줄여 수술을 보다 용이하게 해주는 등 수술의 보조적인 이용에 바람직할 것으로 기대된다.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.166-169
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• 1997

The nutcracker syndorme refers to compression of the left renal vein between the aorta and the superior mesentric artery which results in renal vein, left gonadal vein varices, hematuria and left sided flank pain. We report this experience of 11yr-11mon of girl has typical Nutcracker syndrome with persistent proteinuria and without typical hematuria. According to the renal biopsy for persistent proteinuria, biopsy shows pathologic findings similar to minimal change nephrotic syndrome. All symtpoms relieved without any specific treatments but she had no response to steroid treatment for persistent proteinuria. Now she was followed up through OPD base without symptom and consideration of surgical intervention.

• 대한약리학회지
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• 제5권1호
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• pp.57-64
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• 1969

Acetylsalicylic acid, administered intravenously in a dose of 120 mg+250 mg/h, markedly decreased the urinary excretion of sodium and chloride, and slightly depressed potassium excretion, so that the ratio of urinary concentrations of potassium to sodium increased after ASA. Osmolar and free water clearances also diminished during water diuresis, and free water reabsorption $(T^cH_2O)$ decreased after ASA during mannitol diuresis. Glomerular filtration rate and urine flow rate changed little. When infused directly into a renal artery, ASA exhibited identical action on both kidneys, indicating that the renotropic action is mediated by some endogenous humoral agents or by some metabolites of ASA. A dose of 100 mg i.v. of spironolactone, a aldosterone antagonist, slightly reversed the renal reflect when given during maximum action of ASA. Ethacrynic acid could display its full diuretic action unhindered during maximum ASA action. Above observations lead to the suggestion that acetylsalicylic acid might release aldosterone and the action on electrolyte excretion may be mediated by the mineralocorticoid.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1977년도 제16차 학술대회
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• pp.97.2-97.2
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• 1977

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2002년도 창립10주년기념 및 국립독성연구원 의약품동등성평가부서 신설기념 국재학술대회:생물학적 동등성과 의약품 개발 전략을 위한 국제심포지움
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• pp.233-233
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• 2002