• Clinical and Experimental Pediatrics
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• 제53권7호
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• pp.770-773
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• 2010

A 13-year-old girl was diagnosed with non-cystic fibrosis (CF)-related multifocal bronchiectasis accompanied by nephrotic-range proteinuria of unknown cause. On renal biopsy, there were many segmental homogeneous deposits of amyloid tissue with positive Congo red staining in the glomeruli and interstitium. On electron microscopy, relatively straight, non-branching, randomly arranged amyloid fibrils were showed in the mesangium of the glomeruli. These fibrils were approximately 10 nm in diameter, compatible with secondary amyloidosis. Her level of serum amyloid A was remarkably elevated. To our knowledge, this girl is the first case of secondary renal amyloidosis induced by bronchiectasis in Korean children.

• 동의생리병리학회지
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• 제18권3호
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• pp.868-873
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• 2004

Renal dysfunction could be developed as the secondary disease of liver cirrhosis. Delayed or suppresed lipid peroxidation by the treatment with physiological active substances could be explained as the antioxidative and protective effect in tissue damage. In this study, we investigated an antioxidative effect and renal function improvement of Hovenia dulcis in liver fibrosis(cirrhosis) induced rats. The female Sprague-Dawley rats (180∼210 g) were divided into 3 groups (Normal, AC: CCl₄ mixture treated group, AC-HV: CCl₄ mixture+ Hovenia dulcis treated group) and renal damage was developed by CCl₄ mixture administration in 4 weeks (0.8 ㎖/rat). The tissue of kidney and liver and sera were used for quantitative measurement of enzyme activity, MDA and Hyp. The histological change and gene expression of collagen α1(III) mRNA and a1(IV) mRNA were observed by Masson's trichrome staining and RT-PCR. As a result, the clinical biochemical parameters of liver function (AST and ALT) in sera of AC-HV group showed significantly 46.4% and 104.8% lower (p<0.005), and the level of ALP and BUN as the parameter of protein urine and azotemia showed 17.8 % and 25.8 % lower than in AC group. In AC-HV group, the concentration of MDA in kidney and liver was decreased significantly 15.8% and 21.3% when compared with AC group (p<0.01 -0.005). The content of Hyp in kidney of AC-HV group is merely higher than in AC group, in contrast to liver tissue. The expression of collagen α1(III) mRNA and collagen α1(IV) mRNA was decreased in AC, but both of collagen mRNA in normal and AC-HV group expressed fast similar. More massive lipid droplets, thicker collagen fiber bundles in portal triads and more formation of portal central septum were observed in the liver of AC group than in AC-HV group. In conclusion, CCl₄ mixture intoxication could be developed not only liver fibrosis(cirrhosis) but also renal dysfunction by the massive lipid peroxidation and suppression of interstitial collagen and basement membrane collagen synthesis. And the water extract of Hovenia dulcis may be possessed the antioxidative and protective effect and improvement of kidney function in renal dysfunction induced rats.

• 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.

• Kidney Research and Clinical Practice
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• 제36권2호
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• pp.200-204
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• 2017

Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.

• Childhood Kidney Diseases
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• 제23권1호
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• pp.48-52
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• 2019

The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

• Childhood Kidney Diseases
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• 제11권1호
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• pp.100-105
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• 2007

Cockayne 증후군은 지능저하와 발육부전을 특징으로 하며 피부의 광과민성, 색소성의 망막증, 백내장, 신경전도성 귀머거리 외에 다기관 이상을 동반하는 드문 질환이다. 신장학적 이상 소견 또한 드물지 않게 동반되는 합병증 중 하나이며 병리학적으로 사구체의 유리질화, 세뇨관의 위축 및 간질 내 섬유화가 관찰될 수 있다. 저자들은 7세된 남아에서 Cockayne 증후군의 특징적인 외모와 임상양상을 확인하고 동반된 국소 분절성 사구체 경화증을 진단하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Nutrition and Health
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• 제53권1호
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• pp.1-12
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• 2020

본 연구에서는 고혈당으로 인해 유발되는 당뇨병성 신장병증의 대표적인 증상인 사구체 경화증을 완화시키는 nobiletin의 효능에 대해 알아보고자 하였다. 신장 세포인 HRMC를 이용하여 고혈당에서의 세포외 기질 축적 단백질의 발현과 경화에 관여하는 신호 전달 억제 효능을 확인한 결과 nobiletin은 고혈당의 자극에 의해 증가하는 섬유화 단백질인 collagen IV, fibronectin 그리고 CTGF의 발현을 억제하였으며, 여기에 관여하는 TGF-β1-Src-caveolin-1 신호 전달 경로를 통해 사구체 경화증을 억제하는 것을 확인하였다. 따라서 nobiletin은 고혈당으로 유도된 당뇨병성 신장병증에 있어 사구체 경화증을 예방하는 기능성 성분으로서의 활용 가능성을 확인하였다.

• Childhood Kidney Diseases
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• 제6권1호
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• pp.75-84
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• 2002

목 적 :성장기 신장에서의 급성신우신염은 신반흔으로 진행된다. 신반흔의 형성에는 세균자체보다도 숙주의 염증반응과 면역반응의 산물인 TGF-${\beta}1$이 세포 고사를 증가시키고 세포증식을 억제함으로서 섬유화를 촉진한다고 하였다. 이에 저자는 항염증제인 methyl-prednisolone (MP)이 실험적으로 급성신우신염을 일으킨 이유기 백서에서 신반흔 형성에 미치는 영향을 관찰하고자 하였다. 대상 및 방법 : 생후 3주(체중 50-60g)된 이유기 Sprague-Dawley 백서의 방광에 삽입된 16 guage의 실리콘 도관내로 107/mL 농도의 E coli (ATCC No. 25922, pili형)를 5 mL씩 주입하여 급성신우신염을 유발하였다. 실험군은 1군 (ceftriaxone 단독투여, n=31)과 2군 (MP와 ceftriaxone투여, n=28)으로 나누었고 대조군 (n=43)에는 약제를 투여하지 않았다. 실험 1주와 3주에 실험동물을 희생하여 병리 조직학적 소견상 염증점수, 세포고사 지수와 TGF-${\beta}1$ 발현점수 및 섬유화 점수를 관찰하였다. 결 과 : 사망률은 II군이 $21.4\%$였으나 대조군 $41.9\%$, I군 $32.3\%$와 유의한 차이는 없었다. 염증 점수는 실험 1주에 II군에서 $0.8{\pm}0.87$로 대조군의 $2.3{\pm}0.87$, I군의 $1.7{\pm}0.79$에 비하여 유의하게 낮았다 (P<0.05. 세포고사 지수는 실험 1주에 II군에서 $2.9{\pm}2.15$로 대조군의 $10.0{\pm}1.95$, I군의 $8.3{\pm}2.53$에 비하여 유의 하게 낮았다 (P<0.05). TGF-${\beta}1$발현도 실험 1주에 II군에서 $0.8{\pm}0.72$로 대조군의 $1.90{\pm}67$, I군의 $1.8{\pm}0.60$에 비하여 유의하게 낮았다 (P<0.05). 섬유화 지수는 실험 3주에 II군에서 $0.8{\pm}0.63$로 대조군의 $1.8{\pm}0.83$에 비하여 유의하게 낮았다 (P<0.05) 결 론 : 성장기 백서의 실험적 급성 신우신염에서 MP는 ceftriaxone단독 투여에 비하여 염증 반응, 세포고사, TGF-${\beta}1$발현, 섬유화를 모두 감소 시켰다. 즉 항생제 외에 항염증제의 병용투여가 신반흔의 정도를 감소시킬 수 있으므로 치료지연등 신반흔의 위험인자가 있는 경우에 고려할 수 있을 것으로 생각된다.

• 한국임상수의학회지
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• 제29권4호
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• pp.352-355
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• 2012

Hypospadias is a rare congenital malformation of the urethra reported in cattle. The urethral lumen of male indigenous Korean calf is open along the ventral aspect of the penis in the perineal region. Renal abscess and renal stone formation causing urinary tact infection has not been reported in hypospadia calves. The objective of this study was investigation for renal abscess and renal stone formation through autopsy. Histopathological examination and laboratory tests were performed. At autopsy, the pustules were formed on the right renal cortex, and the renal medulla abscess were formed on right and left part of the renal pelvis. Histopathological finding, this case was diagnosed as severe acute suppurative and necrotizing pyelonephritis, and severe chronic interstitial nephritis with fibrosis and moderate multifocal acute cystitis with edema. Milky exudate of the kidney has been identified as Actinomyces meyeri using the VITEK-2 system for identification of bacteria, and the stone has been identified as carbonate apatite using FT-IR system for quantification analysis. This case report describe the hypospadias complicated with urinary tract infection due to carbonate apatite stones and Actinomyces meyeri.

• Journal of Nutrition and Health
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• 제34권8호
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• pp.843-849
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• 2001

This study was performed to investigate the effect of n-3 fatty acids and dietary protein levels on renal function. Fifteen-month old male Sprague-Dawley rats were divided into 4 diet groups. Two-month old rats were used as a control group. The experimental diets contained either a% or 25% casein and lipid levels of the diets were 20% by weight. For the control group, the lipid was composed of beef tallow and corn oil on a 1:1 basis, and fish oil was comprised 75% of the fat mixture for the fish oil group. Rats were fed the diets ad libitum for 8 weeks. GFR and urinary protein excretion were higher in high protein groups, while fish oil exhibited no effects. Renal medulla TXB$_2$and PGE$_2$ concentrations tended to be higher in high protein groups and lower in fish oil groups. Light microscopic examinations showed that glomerulosclerosis, tubular atrophy, tubular cast, interstitial inflammation and interstitial fibrosis fended to be higher in aged rats and in high protein groups and lower in fish oil groups. Serum levels of total lipid, triglyceride and total cholesterol were higher in aged rats and lower in fish oil groups while serum HDL-cholesterol level was higher in young rats and in fish oil groups. However, dietary protein level had no effect on serum lipid levels. Serum TBARS concentration was higher in aged rats and in fish oil groups. In conclusion, fish oil caused changes in serum lipid concentrations and eicosanoids metabolism. The effect of fish oil on renal function was less obvious than dietary protein. However, fish oil seemed to be effective in lessening deterioration of renal function due to aging and/or high protein diets through changes in lipid and eicosanoids metabolism.