• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.92-98
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• 2017

Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment ($SCr_0$ vs. $SCr_1$; $0.85{\pm}0.80$ vs. $1.00{\pm}0.82mg/dL$, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health $system^a$. Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. $^a$ : SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.78-84
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• 2020

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

• Animal cells and systems
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• v.7 no.4
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• pp.309-315
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• 2003

Renal dipeptidase (RDPase, membrane dipeptidase, dehydropeptidase 1, EC 3.4.13.19) has been widely studied since it was first purified from porcine kidney brush border membrane. It was reported that RDPase activity in urine samples of acute and chronic renal failure patients decreases. Nitric oxide (NO) is a highly reactive free radical involved in a number of physiological and pathological processes. NO is able to act in a dual mode, leading either to induction of apoptosis or to blunted execution of programmed cell death. NO inhibited the RDPase release from porcine renal proximal tubules, which could be blocked by L-NAME. Chitosan, the linear polymer of D-glucosamine in $\beta$(1\longrightarrow4) linkage, not only reversed the decreased RDPase release by NO but also increased NO production in the proximal tubule cells. The stimulatory effect of NO on RDPase release from proximal tubules in the presence of chitosan must be different from the previously proposed mechanism of RDPase release via NO signaling pathway. Chitosan stimulated the RDPase release in the proximal tubules and increased RDPase activity to 220% and 250% at 0.1% and 1%, respectively. RDPase release was decreased to about 40% in the injured proximal tubules and was recovered in proportion to the increase of chitosan. Chitosan may be useful in recovery of renal function from $HgCl_2$injury.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.810-814
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• 2008

Most inflammatory disorders are usually treated using anti-inflammatory drugs including non-steroidal anti-inflammatory drugs (NSAID) and steroidal anti-inflammatory drugs (SAID). Prolonged uses of NSAIDs and SAIDs may frequently cause adverse side-effects such as nausea, vomiting, diarrhea, constipation, decreased appetite, kidney and liver failure, ulcers, and prolonged bleeding after an injury or surgery. Thus, it is necessarily required to develop a new anti-inflammatory drug with little side-effects. Dandelion (Taraxacum officinale) possesses the therapeutic abilities to eliminate body heat and toxins and to remove swelling and inflammation. In order to verify the anti-inflammatory activity of dandelion, TPA(12-O-tetra decanoylphorbol-acetate)-induced or croton oil-induced acute edema was developed in the mouse ears, and dandelion extract dissolved in acetone was applied to both sides of inflamed ears. It was found that dandelion could significantly reduce the ear swelling, compared to that of non-treated control. In the case of $20{\mu}{\ell}$ application of $100mg/m{\ell}$ dandelion solution (DA-100), its anti-inflammatory effect was comparable to that of indomethacin, a non - steroidal anti-anflammatory drug. Taken together, it could be concluded that topically applied dandelion extract exhibited its potentials as a new drug candidate with an effective anti-inflammatory activity.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.81-84
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• 2005

Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis that can affect multiple organs predominantly the skin, joints, gastrointestinal tract and kidney. Although the specific pathogenesis of HSP is not known, there are several hypotheses. Although the importance of the complement activation in glomerular injury in HSP has been suggested, the complement levels and the blood pressure in those patients are usually normal and massive proteinuria is not common. And pathologic renal changes also have been reported to show a large variety of glomerular changes. However, to our knowledge, a membranoproliferative glomerulo-nephritis (MPGN) is a rare renal clinicopathologic manifestation of HSP. We report a 6-year-old boy with HSP who developed MPGN with hypertension, massive proteinuria, and hypo-complementemia revealed activation of the classical complement pathway, although we could not exclude the possibility of other hypocomplementemic glomerulonephritis including post-streptococcal acute glomerulonephritis.

• The Journal of Internal Korean Medicine
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• v.16 no.1
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• pp.1-16
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• 1995

This study was done in order to investigate the etiology and pathology of dementia in the variety literature. Dementia in elderly persons(above the age of 60) mainly classfied Alzheimer disease and Cerebral vascular dementia. The results were as follows: 1. Dementia patients have abnormal mental function, who have no mental weakness but defects of memory, verbal disturbance, behavior disturbance and loss of intellectual function. 2. Dementia regard as 'me-beng(?病)', 'jeon-gwang(癲狂)', and 'heo-ro(虛勞)' in oriental medicine and the symptom is a silence with no response, mixing, a crying or a laugh, a stranger behavior and a amnesia; disturbances of speech, emotion, behavior. 3. Dementia caused by Alzheimer disease, Multi infarct dementia, Parkinson's disease, sequelae of acute CO poisoning, head injury and alcoholism(occidental medically) and the 'Dam(痰) and Damhwa(痰火), weakness of heart and spleen(心脾虛) caused by pent up anger of seven emotions(七情鬱結), the weakness of liver and kidney(肝腎不足)(oriental medically). 4. The causes of Alzheimer disease are various; a heredity factor, a morphological factor of brain tissues, a psychological factor and a biochemical factor (occidental medically) ; the 'Dam(痰) and Damhwa(痰火) caused by weakness of the internal organs and disturbance of the emotions(oriental medically). 5. Cerebral vascular dementia caused by loss of the certain cerebral neurons and oriental medically caused by obstruction of 'dam(痰)' or 'eo heul(瘀血)'. It is recommended that further study of many sided investigations, specially against a weakness of spiritual functions and a certain neurotoxin in the future.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.100-103
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• 2016

Patients with hemolytic-uremic syndrome (HUS) can rapidly develop profound anemia as the disease progresses, as a consequence of red blood cell (RBC) hemolysis and inadequate erythropoietin synthesis. Therefore, RBC transfusion should be considered in HUS patients with severe anemia to avoid cardiac or pulmonary complications. Most patients who are Jehovah's Witnesses refuse blood transfusion, even in the face of life-threatening medical conditions due to their religious convictions. These patients require management alternatives to blood transfusions. Erythropoietin is a glycopeptide that enhances endogenous erythropoiesis in the bone marrow. With the availability of recombinant human erythropoietin (rHuEPO), several authors have reported its successful use in patients refusing blood transfusion. However, the optimal dose and duration of treatment with rHuEPO are not established. We report a case of a 2-year-old boy with diarrhea-associated HUS whose family members are Jehovah's Witnesses. He had severe anemia with acute kidney injury. His lowest hemoglobin level was 3.6 g/dL, but his parents refused treatment with packed RBC transfusion due to their religious beliefs. Therefore, we treated him with high-dose rHuEPO (300 IU/kg/day) as well as folic acid, vitamin B12, and intravenous iron. The hemoglobin level increased steadily to 7.4 g/dL after 10 days of treatment and his renal function improved without any complications. To our knowledge, this is the first case of successful rHuEPO treatment in a Jehovah's Witness child with severe anemia due to HUS.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.40-50
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• 2016

Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.122-130
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• 2017

Purpose: To evaluate the effects of low-dose intravenous N-acetylcysteine on the prevention of contrast-induced nephropathy (CIN) in patients undergoing computed tomography (CT). Methods: All patients presenting to our emergency department and undergoing CT with intravenous contrast media between August 2014 and April 2016 were retrospectively enrolled. We included hospitalized patients with renal dysfunction [estimated glomerular filtration rate (GFR) between 30 and $89mL/min/1.73m^2$]. A 600-mg injection of N-acetylcysteine was given to patients once before and once immediately after CT, depending on the preference of physician. The primary outcome was CIN defined as an increase in creatinine level of ${\geq}25%$ or ${\geq}0.5mg/dL$ from the baseline within 48 to 72 hours after CT. A trained person blindly reviewed all medical records. Results: Of the 1903 admitted patients, CIN occurred in 9.8% of patients who received 1200 mg intravenous N-acetylcysteine (24/244) and 6.8% of patients who did not (113/1659, p=0.090). In a multivariable regression analysis, N-acetylcystine was not relevant to the prevention of CIN (odds ratio=1.42 [95% CI, 0.90-2.26]). Even in the stratified analysis using the propensity score matching, N-acetylcysteine was irrelevant (GFR 30-59: odds ratio=1.06 [95% CI, 0.43-2.60]; GFR 60-89: odds ratio=1.76 [95% CI, 0.75-4.14]). After adjustment, crystalloids were significantly associated with the reduction in CIN compared with dextrose water (odds ratio=0.60 [95% CI, 0.37-0.97]). Conclusion: No effect was found when low-dose intravenous N-acetylcysteine was used to prevent CIN. However, there seems to be an association between crystalloids and reduction in CIN.

• Journal of health informatics and statistics
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• v.43 no.4
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• pp.329-335
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• 2018

Objectives: In recent years, there has been an increased need for a way to extract desired information from multiple medical literatures at once. This study was conducted to confirm the usefulness of unstructured data analysis using previously published medical literatures to search for new indications. Methods: The new indications were searched through text mining, network analysis, and topic modeling analysis using 5,057 articles of atorvastatin, a treatment for hyperlipidemia, from 1990 to 2017. Results: The extracted keywords was 273. In the frequency of text mining and network analysis, the existing indications of atorvastatin were extracted in top level. The novel indications by Term Frequency-Inverse Document Frequency (TF-IDF) were atrial fibrillation, heart failure, breast cancer, rheumatoid arthritis, combined hyperlipidemia, arrhythmias, multiple sclerosis, non-alcoholic fatty liver disease, contrast-induced acute kidney injury and prostate cancer. Conclusions: Unstructured data analysis for discovering new indications from massive medical literature is expected to be used in drug repositioning industries.