• Title/Summary/Keyword: Acute Kidney Injury

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Clinical features and management of snake bites in 70 dogs in Korea

  • Dongseok, Kim;Seonghoon, Kim;Jin-Kyung, Kim;Jae Hyun, Lim;Geonho, Choi;Seulgi, Bae;Young-Sam, Kwo;Min, Jang
    • Journal of Veterinary Science
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    • v.23 no.6
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    • pp.81.1-81.10
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    • 2022
  • Background: Snakebites remain a devastating and life-threatening environmental hazard. While the management of snakebites has been well described in humans, few clinical data and guidelines exist for dogs, especially in Korea. Objectives: This retrospective study evaluated the clinical features of 70 dogs with snakebite wounds in Korea. Methods: The medical records of 72 dogs that presented to three animal hospitals from June 2008 to July 2021 were reviewed; among these, 70 dogs that met the inclusion criteria were enrolled. Their signalment, history, clinical signs, physical examination, blood analysis, treatment, and prognosis were also evaluated. Results: Of 70 dog owners, 35 (50%) witnessed the bite, with a mean time between bite and hospital presentation of 9.7 ± 4.1 h in 58 dogs. Blood smears were evaluated in 45 dogs, of which 28 (62%) showed echinocytosis. Anemia and acute kidney injury were found in 21 (29%) and 2 dogs (3%), respectively. A total of 37 dogs (53%) were hospitalized, 5 (7%) of which died. Conclusions: The most significant finding was the high prevalence of echinocytosis. The data from this retrospective study could inform the management of dogs bitten by snakes in Korea.

SARS-CoV-2 infection induces expression and secretion of lipocalin-2 and regulates iron in a human lung cancer xenograft model

  • Sangkyu Park;Dongbum Kim;Jinsoo Kim;Hyung-Joo Kwon;Younghee Lee
    • BMB Reports
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    • v.56 no.12
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    • pp.669-674
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    • 2023
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to various clinical symptoms including anemia. Lipocalin-2 has various biological functions, including defense against bacterial infections through iron sequestration, and it serves as a biomarker for kidney injury. In a human protein array, we observed increased lipocalin-2 expression due to parental SARS-CoV-2 infection in the Calu-3 human lung cancer cell line. The secretion of lipocalin-2 was also elevated in response to parental SARS-CoV-2 infection, and the SARS-CoV-2 Alpha, Beta, and Delta variants similarly induced this phenomenon. In a Calu-3 implanted mouse xenograft model, parental SARSCoV-2 and Delta variant induced lipocalin-2 expression and secretion. Additionally, the iron concentration increased in the Calu-3 tumor tissues and decreased in the serum due to infection. In conclusion, SARS-CoV-2 infection induces the production and secretion of lipocalin-2, potentially resulting in a decrease in iron concentration in serum. Because the concentration of iron ions in the blood is associated with anemia, this phenomenon could contribute to developing anemia in COVID-19 patients.

Nephroprotective effect of astaxanthin against trivalent inorganic arsenic-induced renal injury in wistar rats

  • Wang, Xiaona;Zhao, Haiyuan;Shao, Yilan;Wang, Pei;Wei, Yanru;Zhang, Weiqian;Jiang, Jing;Chen, Yan;Zhang, Zhigang
    • Nutrition Research and Practice
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    • v.8 no.1
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    • pp.46-53
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    • 2014
  • Inorganic arsenic (iAs) is a toxic metalloid found ubiquitously in the environment. In humans, exposure to iAs can result in toxicity and cause toxicological manifestations. Arsenic trioxide ($As_2O_3$) has been used in the treatment for acute promyelocytic leukemia. The kidney is the critical target organ of trivalent inorganic As ($iAs^{III}$) toxicity. We examine if oral administration of astaxanthin (AST) has protective effects on nephrotoxicity and oxidative stress induced by $As_2O_3$ exposure (via intraperitoneal injection) in rats. Markers of renal function, histopathological changes, $Na^+-K^+$ ATPase, sulfydryl, oxidative stress, and As accumulation in kidneys were evaluated as indicators of $As_2O_3$ exposure. AST showed a significant protective effect against $As_2O_3$-induced nephrotoxicity. These results suggest that the mechanisms of action, by which AST reduces nephrotoxicity, may include antioxidant protection against oxidative injury and reduction of As accumulation. These findings might be of therapeutic benefit in humans or animals suffering from exposure to $iAs^{III}$ from natural sources or cancer therapy.

Comparative Analysis between Spinning and Other Causes in Exercise-Induced Rhabdomyolysis

  • Shim, Do Won;Hyun, Sung Youl;Woo, Jae Hyug;Jang, Jae Ho;Choi, Jae Yeon
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.159-165
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    • 2018
  • Purpose: Spinning-induced rhabdomyolysis (SIR) has been increasing in recent years and accounts for a large proportion of exercise-induced rhabdomyolysis (EIR). The purpose of this study was to compare the clinical features between SIR and non-spinning exercise-induced rhabdomyolysis (NSIR), and to analyze each of these clinical features. Methods: A retrospective chart review was conducted on patients treated due to EIR from January 2006 to March 2018. Patients were divided into the SIR and NSIR groups, and their clinical factors, outcome, and blood chemistries were compared and analyzed. Results: Sixty-two patients were enrolled in this study, with 23 (37.1%) and 39 (62.9%) patients categorized in the SIR and NSIR groups, respectively. The SIR group were mostly women (78.3% vs. 38.5%, p=0.002), more frequent EIR occurrence in the first exercise class (60.9% vs. 15.4%, p=0.001), and had most complaints of thigh pain (91.3% vs. 43.6%, p=0.001). The SIR group had a higher incidence rate despite its shorter exercise duration (90.5% vs. 62.9%, p=0.024), longer hospital stay (6.0 [4.5-7.0] vs. 5.0 [3.5-6.0] days, p=0.080), and higher rate of peak CPK (15,000 U/L or higher) (91.3% vs. 74.4%, p=0.182) compared to the NSIR group. Conclusions: SIR occurs at a higher rate during the first exercise class in women compared to NSIR, and the incidence rate is higher in SIR than in NSIR despite its shorter exercise duration (less than 60 minutes). It is necessary to recognize these risks during spinning exercises and to perform these exercises sequentially and systematically.

One Year Experience of the Hand Allotransplantation First Performed after Korea Organ Transplantation Act (KOTA) Amendment

  • Nara Lee;Woo Yeol Baek;Yun Rak Choi;Dong Jin Joo;Won Jai Lee;Jong Won Hong
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.415-421
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    • 2023
  • The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy

  • Ra, Moni;Kim, Myungkyu;Kim, Mincheol;Shim, Sangwoo;Hong, Seong Yeon
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.84-88
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    • 2018
  • A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

Resuscitation Fluids for Patients at High Risk of Multiple Organ Dysfunction Syndromes: A Systematic Review and Meta-analysis

  • Nam, Jae Hyun;Kwack, Hee Jin;Ha, Woo Seob;Chung, Jee-Eun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.251-259
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    • 2022
  • Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent

  • Bomi Lim;Su-Mi Shin;Mi Seon Han
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.155-160
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    • 2022
  • Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

In vivo Acute Toxicity of Silicon Dioxide Nanoparticle to Mice after Intraperitonial Injection (이산화규소 나노입자의 마우스 복강 내 주입에 의한 급성독성)

  • Cha, Chun-Nam;Jung, Won-Chul;Lee, Yeo-Eun;Yoo, Chang-Yeul;Kim, Gon-Sup;Kim, Eui-Kyung;Kim, Suk;Lee, Hu-Jang
    • Journal of Food Hygiene and Safety
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    • v.26 no.1
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    • pp.43-48
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    • 2011
  • For the application of nano-sized material in various fields, the evaluation of nano-sized material toxicity is important. In the present study, various concentrations of 200 nm-sized silicon dioxide nanoparticle suspension were intraperitonially injected into mice to identify the toxicity of silicon dioxide nanoparticle in vivo. In the hematological analysis of group II treated with silicon dioxide nanoparticle 100 mg/kg body weight, lymphocytes and monocytes were significantly different compared to the control group. In group III treated with silicon dioxide nanoparticle 200 mg/kg body weight, lymphocytes, monocytes and hemoglobin were significantly different compared to the control group. In blood biochemical analysis of group III, the concentration of AST, ALT, BUN, and creatinine were significantly different compared to the control group. Histopathologic examination of the kidney indicated a mild injury only in mice received 200 mg/kg silicon dioxide nanoparticle. According to the results of the present study, the significant differences in the hematological and blood biochemical analyses and abnormal histopathological findings in the mouse kidney may have been related to exposure to silicon dioxide nanoparticle.

Inhibitory Effects of Chimeric Decoy Oligodeoxynucleotide in the Regulation of Transcription Factors NF-κB and Sp1 in an Animal Model of Liver Cirrhosis (간경화 동물모델에서 Chimeric decoy oligodeoxynucleotide로 억제되는 NF-κB와 Sp1 전사인자 발현 억제 효과에 대한 연구)

  • Kim, Kyung-Hyun;Park, Ji-Hyun;Kim, Soo-Jung;Lee, Woo-Ram;Chang, Young-Chae;Kim, Hyun-Chul;Park, Kwan-Kyu
    • Journal of Life Science
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    • v.19 no.10
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    • pp.1360-1367
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    • 2009
  • Liver fibrosis is a process of healing and scarring in response to chronic liver injury. Following injury, an acute inflammation response takes place resulting in moderate cell necrosis and extracellular matrix damage. To develop a novel therapeutic approach in hepatic fibrogenesis, we examined the simultaneous suppression of the transcription factors NF-$\kappa$B and Sp1, which regulate acute inflammation and continuous deposition of extracellular matrix in liver fibrosis. We employed chimeric decoy oligodeoxynucleotide containing the consensus sequences of both NF-$\kappa$B and Sp1 binding sites, to suppress these transcription factors simultaneously. Treatment of chimeric decoy oligodeoxynucleotide reduced the activity of hepatic stellate cells in vitro, and decreased the expression of fibrotic and proinflammatory gene responses in a mouse model of liver fibrosis. These results suggest that chimeric decoy oligodeoxynucleotide strategy can be a potential therapeutic application to prevent liver fibrosis.