• Title/Summary/Keyword: renal lesion

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Pathologic change of an arterialized giant venous aneurysm of a brachiocephalic arteriovenous fistula

  • Su Wan Kim;Jonggeun Lee;Seogjae Lee;Jee Won Chang;Chang Lim Hyun
    • Journal of Medicine and Life Science
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    • v.20 no.4
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    • pp.178-182
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    • 2023
  • Aneurysmal venous dilatation is a frequent complication of arterio venous fistulas (AVFs) created for hemodialysis. Venous aneurysm rupture can lead to lethal hemorrhage. A 49-year-old male patient presented with a giant aneurysmal dilatation of his AVF 10 years after its creation. The patient had complaints of pulsating pain and discomfort due to swelling of the left forearm. We performed an aneurysm resection and revised the overlying dermal lesion through a brachial plexus block. Here, we describe the pathological features of the arterialized venous aneurysm compared to simple venous aneurysms.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

A Case of Henoch-Shönlein Purpura Caused by Rifampin (결핵 환자에서 Rifampin에 의한 Henoch-Shönlein Purpura 1예)

  • Kim, Hye Ryun;Park, Byung Hoon;Son, Ji-Young;Jung, Ji Ye;Ahn, Jung Ryun;Jung, Yoon Suk;Lim, Ju Eun;Jung, Ju Won;Moon, Ji Ae;Byun, Min Kwang;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Lee, Kwang Kil;Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.116-120
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    • 2008
  • Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-$Sh{\ddot{o}}nlein$ purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-$Sh{\ddot{o}}nlein$ purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-$Sh{\ddot{o}}nlein$ purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-$Sh{\ddot{o}}nlein$ purpura are observed.

Hand-Foot syndrome induced by sorafenib, a multitargeted tyrosine kinase inhibitor, in a patient with advanced renal cell carcinoma (진행된 신세포암 환아에게 sorafenib 투여시 발생한 Hand-Foot syndrome 1예)

  • Lee, Seung Hyun;Noh, Sung Hun;Kim, Sun Young;Jang, Kyu Yun;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.119-123
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    • 2009
  • Renal cell carcinoma (RCC) arising from epithelial cells of the renal tubules is a highly aggressive and malignant tumor in all ages; however, it rarely occurs in children. the standard treatment for RCC is radical nephrectomy with lymph node dissection when the tumor is localized and can be completely resected. Adjuvant chemotherapy, radiotherapy, and immunotherapy are used for pediatric patients with advanced RCC involving lymph nodes or metastatic lesions. Sorafenib is an oral, multikinase inhibitor that has recently been approved for use in metastatic RCC. Common toxicities that have been reported include dermatologic changes such as rash or desquamation and hand-foot skin reaction, diarrhea, fatigue, alopecia, and hypertension. In particular, hand-foot syndrome (HFS) an erythematous skin lesion of the palms and solesis most often caused by cytostatic chemotherapeutic agents. In this report, we have studied a 14-year-old female patient with hand-foot syndrome that occurred in association with sorafenib for the treatment of metastatic RCC. Furthermore, this case demonstrates that reversal of complications can be achieved by discontinuing the drug and intervention with topical steroids, vitamin E, and high-dose pyridoxine.

Morphologic Study of Renal Arteries in Rats Fed High-salt Diet (과량(過量)의 식염투여(食鹽投與)가 백서(白鼠)의 신동맥(腎動脈)의 형태학적(形態學的) 구조(構造)에 미치는 영향(影響)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Choi, Won-Hee;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.107-113
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    • 1984
  • To evaluate the morphologic changes of the renal arteries in the condition of high-salt diet, we scheduled the control group which fed routine animal diet added 0.06% of Sodium chloride, low-salt group which fed with 2.0% of sodium chloride, and high-Salt group which fed with 8.0% of sodium chloride. The experimental animals were sacrificed every two week until 20 weeks of final experimental week. The results obtained were as follows; 1. Slight intimal thickening of the renal arteries is observed from 16th experimental week and continued the end of the experiment in the rats of control group. 2. In low-salt group slight intimal thickening of the renal arteries is observed from 12th experimental week and continued to the end of the experiment. 3. In high-salt group the intimal thickening began from 6th experimental week and its degree was hasten with week, and provoked moderate to high degree of lesion at the end of the experiment. Medial proliferation and degeneration of the intima and media, though their quality is mild, also associated at the end of the experiment.

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A Clinicopathological Analysis of 52 Cases of Renal Biopsy in Children (소아에서 시행한 신장 조직검사 52례에 대한 임상병리적 분석)

  • Yang Jong-Il;Lee Jae-Ho
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.205-213
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    • 2004
  • Purpose: To evaluate the clinical manifestations of various glomerular diseases in children, a clinicopathological study was performed in 52 children who had renal biopsy. The type and relative incidence of the glomerular pathologies were analyzed, and the clinical predictability and usefulness of renal biopsy in glomerular diseases were assessed. Methods: Medical records of fifty two children with renal disease who had undergone percutaneous renal biopsy under ultrasonic guidance at Chungnam University Hospital from October 1995 to August 2003 were reviewed. In addition, we compared the clinical findings before renal biopsy with the pathological diagnosis. Results: The male to female ratio was 1.6:1 and they were $9.8\pm2.6$ years old on average. The chief complaints for biopsy were hematuria in 22 cases which was the most common (42.3%), proteinuria in 16 cases(30.8%), and hematuria & proteinuria(26.9%). Among the 22 cases of hematuria, there were 15 cases of gross hematuria(68.2%) and 7 cases of microscopic hematuria(31.8%). In terms of histopathologic diagnosis, most of them were primary glomerular diseases(84.6%), which included IgA nephropathy(28.8%), thin glomerular basement membrane disease(25.0%), focal segmental glomerulosclerosis(FSGS)(11.5%), membranous proliferative glomerulonephritis(7.7%), minimal change lesion(3.8%), acute poststreptococcal glomerulonephritis(3.8%) and membranous glomerulonephritis(3.8%). The clinical manifestations and pathologic diagnosis were not correlated. Conclusion: The clinical manifestations could not predict the pathological diagnosis. Therefore, renal biopsy would be inevitable in diagnosis of glomerular diseases for effective management and assessment of prognosis.

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Pathological studies on exudative epidermitis in experimentally infected pigs I. Macroscopical and histopathological observations (실험적 돼지 삼출성 표피염에 관한 병리학적 연구 I. 육안적 및 병리조직학적 관찰)

  • Oh, Kyu-shil;Lee, Cha-soo
    • Korean Journal of Veterinary Research
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    • v.34 no.4
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    • pp.787-799
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    • 1994
  • To elucidate morphologic lesion of porcine exudative epidermitis which is occurred sporadically in Korea, Staphylococcus hyicus subsp. hyicus isolated from the naturally affected pigs was inoculated to suckling pigs. The infected piglets were observed grossly and histopathologically. Although affected piglets were taking acute, subacute, or chronic course, some piglets suffered from chronic disease showed poor prognosis and marked growth depression. Affected peglets had erythematous skin on the face, ear, and abdomen and these localized lesions appear as brownish spots of exudative epidermitis and fromed crust in the early stage. But, after this stage, the skin were covered by viscous greasy exudate and formed blackish brown crust and appeared fissures and hypertrophy. Grossly, there has been hemorrhage with the removal of crust-like materials of epidermis and edematous subcutis. The superficial lymph nodes were edematous and swollen or congested and hemorrhagic. Some piglets had swollen ureters, cysts in the renal cortex, or polyarthritis. A few cases had mild edematous swelling of kidney, intestinal catarrh and congestion of brain. Microscopically, skin lesions had detachment of keralinized layer and parakeratosis of epidermis, hydropic degeneration of epidermal cell, and retrogressive degeneration of hair root sheath. Dermis had edema, and infiltration of neutrophils and mononuclear cells. As the disease was proceeded, there was marked perivasculitis with lots of mononuclear inflammatory cells. More chronic lesions formed granuloma-like bodies(nodules) due to more mononuclear, perivascular inflammatory cell infiltration and proliferation of fibroblast. Lots of plasma cells and eosinophils were also present in dermis. Epidermis was hyperplastic by proliferation of basal cells stratum germinativum and epidermal pegs often extended into the dermis. In secondary infection, lots of neutrophils could be seen in epidermis and derms. Kidney had neutrophilic infiltration, necrotic and cystic glomeruli, and dilation of renal tubules and ureters. Purulent arthritis was sometimes observed in joints. Three days old mice administrated Staphylococcus hyicus subsp hyicus subcutaneously before had focal congestion and hemorrhage, necrosis, and subcutaneous edema of the skin. This observation was also seen in the study of mice administrated exfoliatin toxin of Staphylococcus which evoked human staphylococcal scalded skin syndrome.

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The Comparative Study between the Transformations(傳變症) of Sogal(消渴) and the Complications of Diabetes Mellitus (소갈(消渴)의 전변증(傳變症)과 당뇨병(糖尿病)의 만성합병증(慢性合倂症)에 대한 비교고찰(比較考察))

  • Kang, Seok-Bong
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.137-152
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    • 1998
  • Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.

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Antioxidant effects of Geagibokrounghwan in experimental mouse fed cholesterol (고(高)Cholesterol 식이 생쥐에 미치는 계지복령환의 항산화효과(抗酸化效果))

  • Lee, Seung-Hun;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.35-49
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    • 1999
  • This study was made to investigate the antioxidative effects of Geagibokrounghwan on the hepatic and renal lesion induced by cholesterol in mouse. The normal group was fed basal diet and water ; control groups were fed basal diet containing 0.5% of cholesterol ; test groups were fed the Geagibokrounghwan extract($10m{\ell}/kg$) after fed basal diet containing 0.5% of cholesterol for 6 weeks. In the liver and kidney of control group, lipid peroxidation(LPO) was significantly increased, however, the activities of superoxidation dismutase(SOD) and catalase and the amount of glutathion(GSH) were significantly decreased. In the liver and kidney of test group, lipid peroxidation(LPO) was decreased significantly as compared with control group. Contrary to this, the activities of superoxide dismutase(SOD), catalase and the amount of glutathion(GSH) were significantly increased. These results indicate that Geagibokrounghwan revealed the antioxidant effects, which may reduce the hepatic and renal damage induced by cholesterol in mouse.

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Expression of the Ki-67 antigen Using Monoclonal Antibody MIB-1 in Children with Glomerulonephritis (사구체신염에서 MIB-1을 이용한 Ki-67 항원의 발현)

  • Chung, Woo-Yeong;Song, Min-Seop;Kim, Young-Ju
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.104-109
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    • 1998
  • Purpose : The proliferative nuclear antigen Ki-67, present in all cell cycle phases except G0, is a useful marker for the detection of proliferative cells in vivo. MIB I has been found to recognize an antigen in formalin-fixed and wax-embedded material. The aim of this study was to assess the efficacy of MIB-1 expression as a marker of representing the status of mesangial cell proliferation in renal tissues. Methods : Immunohistochemical staining for Ki-67 Ag using monoclonal antibody MIB-1 (Immunotech,505) were performed in 41 renal tissuses which were obtained by percutaneous renal biopsy done between January 1994 and December 1996. Results : In both glomeruli and renal tubules, MIB-1 expression was observed only in 2 of 18 ($11.1\%$) cases of IgA nephropathy, in 2 of the 4 ($50\%$) cases of mebranoproliferative glomerulonephritis, in 4 of the 5 ($80\%$) cases of poststreptococcal glomerulonephritis. But MIB-1 expression was not detected in all cases of minimal lesion and membranous nephropathy. Renal tubules In another 7 cases of IgA nephropathy were MIB-1 positive. Conclusion : MIB-1 expression in renal tissues may relate to the cell proliferation in glomeruli and renal tubules. But the efficacy of MIB-1 expression as a marker of mesangial cell proliferation may reveal a limited value because of it's lower positive rate in IgA nephropathy.

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