• Clinical and Experimental Pediatrics
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• 제46권9호
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• pp.854-857
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• 2003

목 적 : 단일 제대 동맥을 가진 건강한 신생아의 약 1/3에서 위장관 폐색 및 요로 기형을 동반할 수 있으므로 요로 기형을 발견하기 위해 초음파 검사를 관습적으로 시행하고 있지만 실제초음파 검사상 이상이 발견되는 경우는 드물다. 이에 저자는 단일 제대 동맥을 가진 건강한 신생아에서 신장 초음파 검사의 유용성을 알아보고자 본 연구를 실시하였다. 방 법 : 1995년 1월부터 2002년 7월까지 출생 후 이학적 검사상 단일 제대 동맥이 있는 신생아에서 단일 제대 동맥이면서 증후군의 일부이거나 수술적 치료가 필요한 심각한 질환이 동반된 경우는 제외하고 건강한 신생아 총 30명을 대상으로 하였다. 임상적 배경과 출생 72시간 이후 신장 초음파를 실시하였고, 신장초음파상 이상이 있는 경우 지속적 추적관찰과 더불어 배뇨성 방광요도 조영술 및 technetium-99m-mercaptoacetyl-triglycerine(MAG3) 신스캔 검사를 실시하여 수신증의 크기, 폐쇄의 정도 및 신기능 변화를 분석하였다. 결 과 : 총 30명의 남녀비는 1 : 1이었으며 평균 재태 연령은 $38.0{\pm}2.56$주, 평균 출생 체중은 $2,780{\pm}690g$이었다. 단일 제대동맥을 가진 건강한 신생아 30명 중 신장 초음파상 이상이 발견 된 례는 5명으로 16.7%이었고, 의미 있는 요로 기형은 1명으로 3.3%이었다. 이상이 발견된 5명 중 4명은 경도의 수신증으로 추적 검사상 자연 소실되었고, 1명은 심한 수신증으로 배뇨성 방광 요도 조영술상 역류는 없었고 MAG3 검사상 좌측 신장 기능 저하가 보여 외래 추적 관찰 중이다. 결 론 : 단일 제대 동맥을 가진 건강한 신생아에서 신장 초음파 검사상 발견된 신장 이상은 16.7%로 일반인에서 보이는 신장 이상의 빈도와 큰 차이는 없었고 1명을 제외한 4명(80.0%)에서 자연 소실되었으므로, 비용-이익 면에서 볼 때 단일 제대 동맥을 가진 건강한 신생아에서 관습적으로 신장 초음파 검사를 실시하는 것에 대해 고려해 볼 필요가 있다고 사료된다.

• 대한핵의학회지
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• 제37권3호
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• pp.199-201
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• 2003

A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later Tc-99m $MAG_3$ renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m $MAG_3$ caused by acute renal artery thrombosis.

• Journal of Chest Surgery
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• 제49권6호
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• pp.427-434
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• 2016

Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

• 약학회지
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• 제28권3호
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• pp.149-160
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• 1984

In order to certify the diuretic mechanism of dopamine, this study was performed in dog. The following results were obtained. Dopamine, when given intravenously, produced diuresis, and increased glomerular filtration rate (GFR), renal plasma flow (RPF), and amount of sodium excreted in urine. When infused directly into a renal artery, dopamine elicited a marked diuresis confined only to the infused side, with concomitant rises in osmolar clearance and sodium excretion as well as a slight increase in free water clearance. Simultaneously total renal plasma flow and medullary plasma flow increased markedly with a increase of glomerular filtration rate and renal plasma flow. Medullary concentration gradient of sodium also markedly lowered in the infused kidney. These changes were not observed during mannitol diuresis and renal action of dopamine were not apparent in dog pretreated with haloperidol. From the above experimental results, it is thought that dopamine, when given into a vien or infused directly into a renal artery, induces diuresis, and the mechanism of its action is due to dual actions which are hemodynamic effect along with glomerular filtraction rate, and the increased response in the medullary blood flow.

• 약학회지
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• 제38권5호
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• pp.568-578
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• 1994

This study was performed in order to investigate the effect of diltiazem, which is a $Ca^{2+}$ channel blocker of benzothiazepine derivatives, on renal function in the dog. Diltiazem, when infused into the vein or carotid artery, produced the antidiuresis accompanied with the decreased excretion rates of sodium and potassium in urine$(E_{Na},\;E_K)$ and the increased reabsorption rates of sodium and potassium in renal tubules$(R_{Na},\;R_K)$. Diltiazem, when infused into a renal artery, exhibited the diuresis along with the increased renal plasma flow(RPF), osmolar clearance$(C_{osm})$, $E_{Na}$ and $E_K$, and decreased $R_{Na}$ and $R_K$ in only infused kidney. Above results suggest that diltiazem possess both antidiuretic action through central action and diuretic action by direct inhibition of electrolytes reabsorption rates in renal tubules, mainly distal tubule.

• 대한핵의학회지
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• 제24권2호
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• pp.325-331
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• 1990

Radionuclide renal scintigraphies were performed in a 24-year-old man with right renal artery branch stenosis. Captopril enhanced $^{99m}Tc-DTPA$ renal scintigraphy revealed no abnormal finding in the right kidney. But, $^{99m}Tc-DMSA$ renal scintigraphy showed regional cortical photon deficient area corresponding to the area supplied by the stenotic branch artery. The defect size increased in captopril enhanced $^{99m}Tc-DMSA$ renal scintigrphy and nearly disappeared after successful transluminal renal angioplasty. This case suggests that the captopril enhanced $^{99m}Tc-DMSA$ renal scintigraphy may be a useful method in the evaluation of renovascular hypertension, especially due to branch renal srtery stenosis.

• 약학회지
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• 제45권6호
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• pp.683-693
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• 2001

This study was attempted to investigate the effect of raclopride, a dopamine $D_2$ receptor antagonist, on renal function in dog. Raclopride (70-220$\mu\textrm{g}$/kg), when given intravenously, Produced antidiuresis along with the decrease in free water clearance ( $C_{H_2O}$), urinary excretion of sodium and potassium ( $E_{Na}$ , $E_{K}$), partially decreased osmolar clearance ( $C_{osm}$) and increased reabsorption rates of sodium and potassium in renal tubules ( $R_{Na}$ , $R_{K}$). Raclopride administered into a renal artery did not influence on renal function in small doses (10 and 30$\mu\textrm{g}$/kg), whereas exhibited the decrease of urine volume (Vol) and $C_{H_2O}$ both in experimental and control kidney in much dose (100$\mu\textrm{g}$/kg), at this time, the decreased rates of both Vol. and $C_{H_2O}$) were more prominent in control kidney rather than that elicited in experimental kidney, and then only via was decreased in control kidney but increased in experimental kidney. Raclopride administered via carotid artery (30-200$\mu\textrm{g}$/kg) did not influence at all on renal function. Antidiuretic action induced by raclopride given intravenously was not affected by renal denervation. Raclopride given into carotid artery was little effect on renal function without relation to renal denervation. Above results suggest that raclopride produces antidiuresis by potentiation of antidiuretic hormone (ADH) action in blood without increase of ADH secretion in posterior pituitary gland, it is not related to renal nerve function in dogs.ogs.s.

• 대한수의학회지
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• 제29권2호
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• pp.19-24
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• 1989

To elucidate the physiological characteristics of histamine receptor of the isolated renal artery in dog, effects of various receptor blockers and $Ca^{{+}{+}}$ channel blockers on the contractile responses of histamine were investigated in the isolated renal artery of dog. The results were summarized as follows: 1. Histamine caused the contraction in the isolated renal artery of dog, and the contractile responses increased between the concentration of $5{\times}10^{-6}M$ and $10^{-2}M$ in dose-dependent manner. 2. The contractile response induced by histamine ($10^{-3}M$) was not blocked by pretreatment with atropine ($10^{-6}M$), phentolamine ($10^{-6}M$), propranolol ($10^{-6}M$) or cimetidine ($10^{-6}M$), but was completely blocked by pretreatment with pyrilamine ($10^{-6}M$). 3. The contractility induced by histamine ($10^{-3}M$) was decreased in the $Ca^{{+}{+}}$ free medium. 4. The contractile response induced by histamine ($10^{-3}M$) was markedly inhibited by pretreatment with papaverine ($5{\times}10^{-5}M$) or verapamil ($5{\times}10^{-5}M$). 5. After the pre-contraction induced by norepinephrine ($10^{-7}M$) or prostaglandin $F2{\alpha}$ ($5{\times}10^{-6}M$), the contractile response induced by the additional treatment of histamine ($10^{-3}M$) was markedly increased compared with that of histamine ($10^{-3}M$) alone.

• 대한수의학회지
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• 제43권4호
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• pp.573-578
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• 2003

The effects of removing the endothelium on the vasodilatory response to substance P, calcitonin gene-related peptide (CGRP), and vasoactive intestinal peptide (VIP) was examined in the isolated rabbit renal artery. The vasodilator response to substance P ($0.1{\mu}M$) was completely absent in vessels in which the endothelium had previously been removed. There was no significant difference in the vasodilatation produced in response to CGRP ($0.1{\mu}M$), or VIP ($0.1{\mu}M$) in the intact and removed-endothelium rabbit renal artery segments. L-NAME ($100{\mu}M$) significantly reduced the vasodilatory response to substance P ($0.1{\mu}M$). This inhibition was significantly attenuated when L-arginine (10 mM) was also present in the organ bath along with L-NAME ($100{\mu}M$). Indomethacin ($1{\mu}M$) did not significantly affect the vasodilatation produced in response to substance P ($0.1{\mu}M$). The inhibitory effect of L-NAME ($100{\mu}M$) and indomethacin ($1{\mu}M$) on the vasodilatory response to substance P ($0.1{\mu}M$) was not significantly different from that produced by L-NAME ($100{\mu}M$) alone. This study indicates that substance P induced vasodilatation via an endothelium-dependent mechanism in the isolated rabbit renal artery. It also established that CGRP and VIP induced vasodilatation by an endothelium-independent mechanism and substance P-induced vasodilatation is at least partially via NO.

• Journal of Chest Surgery
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• 제29권4호
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• pp.393-396
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• 1996

본 인제대학교 서울백병원 흉부외 과에서는 지난 8년간 술전 적극적 인 항고혈압제 투여에도 불구하 고 혈압 조절에 실패한9명의 신혈관성 고혈압 환자를 수술 치험하였다. 수술방법은9명중8명에서는 자가복재 정맥을 이용한 대동맥 신동맥간우회술을시행하였으며,나머지 1명은내장골동맥을이용한 신동맥 재건술을 시행하였다. 술후 9명의 환자중 사망한 예는 없었으며, 수술전후 비교한 혈압 수치의 선정 기준은, 술전에는 환자의 여러 차례 측정된 혈압중 대표적 인 혈압수치로 선정하였고, 술후혈압은 최종적으로 외래 추적 관찰한 혈 압수치를 선정 하였다. 술후 장기 추적한 걸과 9명의 환자 모두에서 혈압 호전을 보여 좋은 수술 결과를 얻었기 에, 중증 신혈관성 고혈압환자에 있어서 수술적 치료가 가장 효과적이고 유용한 치료법으로 생각 되는 바이다.