• Title/Summary/Keyword: uremia

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A case of hemolytic uremic syndrome preceded by intussusception

  • Ko, Eun-Young;Kim, Joo-Young;Lee, Hye-Jin;Lee, Hyun-Seung;Han, Ji-Whan;Kim, Young-Hoon;Kim, Jin-Tack;Cheong, Hae-Il;Jang, Pil-Sang
    • Clinical and Experimental Pediatrics
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    • v.54 no.4
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    • pp.176-178
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    • 2011
  • Hemolytic-uremic syndrome (HUS) is the most common cause of acute renal failure in young children. It is classically characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and uremia. Further, not only is intussusception one of the differential diagnoses of HUS but it may also become a complication during disease progression. We report a case of HUS. preceded by intussusception in a previously healthy 17-month-old boy. The patient presented at the emergency department with bloody stools that developed the day after reduction of intussusception. HUS was diagnosed 4 days after the reduction of intussusception. The patient was provided only supportive care and his laboratory test findings were normal at discharge.

Effects of Youngkaechulgamtang on Hepatotoxicity (영계출감탕의 간독성에 미치는 영향)

  • Kim, Tae-Hee;Yang, Ki-Sook;Park, Seung-Ah
    • Korean Journal of Pharmacognosy
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    • v.30 no.1
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    • pp.12-17
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    • 1999
  • The youngkaechulgamtang (Y) composed of four herb drugs, including Hoelen (H). Cinnamomi Ramulus (C). Atractylodis Rhizoma Alba (A) and Glycyrrhizae Radix (G). In oriental medicine literatures, Youngkaechulgamtang is described to be effective in headache, inflammation, uremia, gastritis, diarrhea and hypertension. To estimate the clinical effectiveness of Youngkaechulgamtang, several pharmacological experiments were carried out. The results are summerized as follows; On acetaminophen-induced hepatotoxicity, C+A, Y-G, Y-H, MIX and Y showed the significant elevation of glutathione-S-transferase. But, C+A, Y-G, Y-H, MIX and Y showed the significant suppression of serum aminotransferases. On ANIT-induced cholestasis, U (Ursodesoxycholic acid 50 mg/kg)+$Y_l$ (760 mg/kg) showed the significant increase of bile juice volume. $Y_l,\;Y_2$ (1520 mg/kg), U, $U+Y_l$ showed the remarkable increase of cholic acid. U and $U+Y_l$ showed the significant decrease of total bilirubin. From these results, it is suggest that Y shows liver protective effect against various hepatic injury. Especially, Youngkaechulgamtang was more effective than mixture of 4 ingredients in the elevation of glutathione-S-transferase in acetaminophen-induced hepatotoxicity.

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One Case Report of Chronic Renal Failure Patient Prescribed Gyulpyjeonwon (귤피전원(橘皮煎元)을 처방한 만성신부전 환자 1례에 대한 보고)

  • Jung, Gi-Hun;Chang, Sun-Kyu;Cho, Chung-Sik;Kim, Chul-Jung
    • Journal of Haehwa Medicine
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    • v.16 no.2
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    • pp.229-234
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    • 2007
  • Objectives : Chronic renal failure(CRF) is a pathophysiologic process with multiple etiologies, resulting in the inexorable attrition of nephron number and function and frequently leading to end-stage renal disease. It causes various symptoms(edema, general body weakness, nausea, anorexia, uremia, osteodystrophy and so on) which impair quality of life and long term complications. The purpose of this case is to report the improvement of a patient with chronic renal failure. Methods : We treated the patient with herbal medication(Gyulpyjeonwon) and measured the creatinine, BUN, albumin, hemoglobin in the serum. Results : Gyulpyjeonwon decreased serum creatinine and BUN level and increased serum albumin and hemoglobin level. And the symptoms of CRF(edema, general body weakness, anorexia) was improved significantly. Conclusions : This case suggests the efficacy of herbal medication(Gyulpyjeonwon) to patient who was involved CRF.

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An Analysis of Guange (關格) in 『Yixuerumen (醫學入門)』 from the Perspective of Emergency Medicine (응급의학 측면에서 『의학입문(醫學入門)』 관격(關格)의 분석)

  • JO Hak-jun
    • The Journal of Korean Medical History
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    • v.35 no.1
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    • pp.69-86
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    • 2022
  • This study examined guange (關格) in Yixuerumen (醫學入門) from a new perspective and evaluated its value in terms of emergency medicine. We compared and analyzed the definition, symptoms, and treatment methods of guange in Yixuerumen with related clinical presentations in modern medicine. Guange includes nausea and vomiting, dysphagia, dysuria, and constipation without diarrhea. A representative disease related to dysuria is uremia, while one related to constipation, nausea, and vomiting is enterocleisis, and and a third related to dysphagia is chronic esophagitis and esophagus cancer. Li Chan, the author of Yixuerumen, recognized guange as an emergency of serious eating and elimination disorder as various symptoms of diseases (病症) gradually get worse from the perspective of external diseases (外感病) and miscellaneous diseases (雜病) and handled it in various ways including yin-tonifying medicinals (補陰藥), qi-tonifying medicinals (補氣藥), qi-regulating formulas (理氣劑), phlegm-dispelling formulas (去痰劑), and "water rising, fire falling" formulas (水升火降) in addition to emetic formulas (催吐劑), diuretic formulas (滲利劑), and interior-attacking formula (攻裏劑). Concepts like guange in Yixuerumen were somewhat useful when handling the applicable emergencies at the level of then medical treatment.

An Analysis of Health Problems Experienced by the Clients Receiving Hemodialysis (혈액투석 환자들이 경험한 건강문제 분석)

  • 신미자
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.903-916
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    • 1996
  • The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows : 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric keratosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul oder of uremia.

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Oryeong-san Ameliorates High Glucose-induced Mesangial Cell Proliferation (오령산에 의한 고포도당 유도 사구체간질세포 이상증식 개선효과)

  • Yoon, Jung Joo;Lee, Yun Jung;Lee, So Min;Kim, Dae Hwan;Lee, Ho Sub;Kang, Dae Gill
    • Herbal Formula Science
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    • v.21 no.2
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    • pp.53-62
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    • 2013
  • Objectives : Diabetic nephropathy is associated with morbidity and mortality of diabetes mellitus patients. Mesangial cell proliferation is known as the major pathologic features such as glomerulosclerosis. Oryeong-san, Korean formula, is widely used for the treatment of nephrosis, edema, and uremia. Oryeong-san is composed of five herbs: Alismatis Rhizoma, Polyporus, Atractylodis Rhizoma Alba, Hoelen, and Cinnamomi Cortex. Methods : The present study was performed to investigate potent inhibitory effect of Oryeong-san on high glucose (HG)-induced rat mesangial cells (RMC) proliferation. Results : RMC proliferation under 25 mM glucose was significantly accelerated compared with 5.5 mM glucose, which was inhibited by Oryeong-san in dose dependent manner. Pre-treatment of Oryeong-san induced down-regulation of cyclins/CDKs and up-regulation of CDK inhibitor, p21waf1/cip1 and p27kip1 expression. In addition, Oryeong-san reduced HG-induced RMC proliferation by suppressed the mitogen-activated protein kinase (MAPK) phospholyration such as extracellular signal regulated kinase (ERK), Jun N-terminal Kinase (JNK), and p38. Oryeong-san significantly suppressed HG-induced ROS production. Conclusions : Oryeong-san consequently inhibited HG-induced mesangial cell proliferation through the inhibition of MAPK and ROS signaling pathway. These results suggest that Oryeong-san may be effective in the treatment of renal dysfunction leading to diabetic nephropathy.

ORTHROGNATHIC SURGERY IN SEVERE CHRONIC RENAL FAILURE PATIENT (중증의 만성신부전 환자에서의 악교정 수술)

  • Shin, Sang-Hun;Kim, Ki-Hyun;Jeung, Suck-Young;Park, Sung-Hwan;Kim, Cheol-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.652-657
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    • 2000
  • The kidneys play a vital role in the maintenance of normal body fluid volumes and in the composition of the extracellular fluid compartments. There are normally more than 2 million functioning glomeruli that regulate total body water and solute concentrations. As renal failure progresses, there is a decrease in the number of functioning nephrons. Chronic renal failure(CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Azotemia is an elevation in blood urea nitrogen(BUN) and serum creatinine levels subsequent to a decreased glomerular filtration rate(GFR), which results in uremia. This loss of renal function can cause functional and metabolic abnomalities of body. For this problem, oral & maxillofacial surgeons have demanded to routinely treat patients with CRF. However, there has not been a reported case of orthognathic surgery by bilateral sagittal split ramus osteotomy(BSSRO) in patients with CRF, which can cause multiple complications in healthy patients. We report developmental mechanism of complication associated with CRF and preop. and postop. care of orthognathic surgery by BSSRO in Cl III patient with severe chronic renal failure.

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The study on oriental and western medicine of esophagitis (식도염(食道炎)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Choi, Chang-woo;Son, Chang-gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.10 no.2
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    • pp.91-96
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    • 2002
  • We arrived at the following conclusions after we have studied esophagitis through the literatures of oriental and western medicine. 1. The western medical causes of acute esophagitis are corrosiveness chemical material, esophageal or gastric disease, trauma, blister stomatitis, filamentous fungus infection and uremia of chronic patient etc, and the oriental medical causes are qi and blood stagnation, blood stasis and stagnation, stagnant phlegm by coldness, heating, dyspepsia and food poisoning etc. 2. The western medical causes of chronic esophagitis are malfunction of lower esophageal sphincter, esophageal tom chink and hernia, increase of gastric pressure by overeating, fatness, pregnancy and ascites etc, and the oriental medical causes are asthenic cardiac qi, hepatic qi attacking stomach by seven kinds of depression, cold-damp stagnation and insufficiency of gastric qi by overeating, excessive drinking and sexual indulgence etc. 3. The main symptoms of acute esophagitis are severe chest pain, instantly vomiting, swallowing pain etc, and chronic esophagitis are occasionally light chest pain, heart bum, anorexia, dysphagia, dizziness, general body weakness etc. These symptoms are come under thoracic obstruction, acid regurgitation, vomiting and chest pain of oriental medicine. 4. The western medical diagnoses of acute and chronic esophagitis have used radiation test, esophageal endoscopy, esophageal pressure test and biopsy etc, and the oriental medical diagnoses have used syndrome differentiation by four examination of inspection, listening and smelling examination, inquiring, pulse-taking and palpitation. 5. The western medical treatments of acute esophagitis have regarded preservation stability of esophagus as a principle, and the oriental medical treatments mainly have used expelling pathogen of expelling cold and regulating qi, cooling and removing stasis, promoting blood circulation to remove blood stasis, eliminating phlegm and regulating qi. 6. The western medical treatments of chronic esophagitis have regarded decrease flowing backward of gastric juice as a purpose, and the oriental medical treatments mainly have used strengthening body resistance of replenishing and strengthening cardioqi, dispersing stagnated hepatoqi, expelling cold and dehygrosis, invigorating stomach and nourishing qi.

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Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia (지역사회 획득 폐렴환자의 중증도 평가에서 혈청 코티졸의 유용성)

  • Yoon, Kyung-Hwa;Kim, Yeon-Jae;Kim, Mi-Young;Kim, Eun-Young;Bae, Myoung-Nam;Bae, Sang-Mook;Kim, Min-Su;Park, Hun-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.450-455
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    • 2010
  • Background: High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP). Methods: This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively. Results: In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ${\geq}22.82{\mu}g/dL$, CRP, PCT, CURB-65 score, and mortality were significantly elevated. Conclusion: These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

Inhaled Corticosteroids May Not Affect the Clinical Outcomes of Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

  • Min-Seok Chang;In-So Cho;Iseul Yu;Sunmin Park;Seok Jeong Lee;Suk Joong Yong;Won-Yeon Lee;Sang-Ha Kim;Ji-Ho Lee
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.319-328
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    • 2024
  • Background: Although inhaled corticosteroids (ICS) is reportedly associated with a higher risk of pneumonia in chronic obstructive pulmonary disease (COPD), the clinical implications of ICS have not been sufficiently verified to determine their effect on the prognosis of pneumonia. Methods: The electronic health records of patients hospitalized for pneumonia with underlying COPD were retrospectively reviewed. Pneumonia was confirmed using chest radiography or computed tomography. The clinical outcomes of pneumonia in patients with COPD who received ICS and those who received long-acting bronchodilators other than ICS were compared. Results: Among the 255 hospitalized patients, 89 met the inclusion criteria. The numbers of ICS and non-ICS users were 46 and 43, respectively. The CURB-65 (confusion, uremia, respiratory rate, blood pressure, age ≥65 years) scores at the initial presentation of pneumonia were comparable between the two groups. The proportions of patients with multilobar infiltration, pleural effusion, and complicated pneumonia in the radiological studies did not vary between the two groups. Additionally, the defervescence time, proportion of mechanical ventilation, intensive care unit admission, length of hospital stays, and mortality rate at 30 and 90 days were not significantly different between the two groups. ICS use and blood eosinophils count were not associated with all pneumonia outcomes and mortality in multivariate analyses. Conclusion: The clinical outcomes of pneumonia following ICS use in patients with COPD did not differ from those in patients treated without ICS. Thus, ICS may not contribute to the severity and outcomes of pneumonia in patients with COPD.