• 제목/요약/키워드: Chronic Kidney Disease

검색결과 407건 처리시간 0.027초

녹용약침(鹿茸藥鍼)요법을 겸한 신허이명환자(腎虛耳鳴患者) 3예(例)에 대한 임상적(臨床的) 고찰(考察) (A case study of three patients who have tinnitus that is diagnosed as weakness of the kidney, treated with Cervi Pantotricuhum Cornu hereat-acupunture)

  • 배진석;박용호;김대수;박수연;김종한;최정화;유미경
    • 한방안이비인후피부과학회지
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    • 제19권2호
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    • pp.249-255
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    • 2006
  • Object : The tinnitus is a very common otorhinolaryngologic disease. But, we don't know the exact cause and the healing method of that. Treatment : We have three cases report of the patients who have tinnitus. Their tinnitus is diagnosed weakness of the kidney because of chronic symptoms, the Cheek pulse weakening, the whole body weakness, fatigue. So we treat them with herbal medicine and Cervi Pantotricuhum Cornu herbal-acupunture. Result : In the result, their symptoms is reduced. So we report these cases for the improvement of tinnitus treatment efficacy and making the best use of Cervi Pantotricuhum Cornu herbal-acupunture.

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쇼그렌 증후군 환자에서의 단백뇨 치험 1례 (A Case Report of Proteinuria with Sjogren's Syndrome)

  • 정종진;김수연;선승호;김병우
    • 대한약침학회지
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    • 제11권4호
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    • pp.95-99
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    • 2008
  • Objective Sjogren's Syndrome is a chronic inflamatory disorder characterized by lymphocytic infiltration of lacrimal and salivary gland. It may be associated with renal disease such as tubulonephritis or glomerulonephritis. Proteinuria is a kidney disorder resulting in an abnormally high amount of protein in the urine. When the glomeruli are damaged, proteins of various sizes pass through them and are excreted in the urine. This report is a case of proteinuria with Sjogren's Syndrome. Methods The patient was diagnosed as kidney yang deficiency syndrome and treated with Woogyu-eum, Sa-am acupuncture therapy and bee venom acupuncture therapy. Visual Analog Scale was used to estimate the clinical symptoms. Results Clinical symptoms and proteinuria were improved without steroid therapy. Conclusion Therefore, we concluded that oriental medical therapy may be useful to treat proteinuria with Sjogren's Syndrome.

Therapeutic potential of targeting kinase inhibition in patients with idiopathic pulmonary fibrosis

  • Kim, Suji;Lim, Jae Hyang;Woo, Chang-Hoon
    • Journal of Yeungnam Medical Science
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    • 제37권4호
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    • pp.269-276
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    • 2020
  • Fibrosis is characterized by excessive accumulation of extracellular matrix components. The fibrotic process ultimately leads to organ dysfunction and failure in chronic inflammatory and metabolic diseases such as pulmonary fibrosis, advanced kidney disease, and liver cirrhosis. Idiopathic pulmonary fibrosis (IPF) is a common form of progressive and chronic interstitial lung disease of unknown etiology. Pathophysiologically, the parenchyma of the lung alveoli, interstitium, and capillary endothelium becomes scarred and stiff, which makes breathing difficult because the lungs have to work harder to transfer oxygen and carbon dioxide between the alveolar space and bloodstream. The transforming growth factor beta (TGF-β) signaling pathway plays an important role in the pathogenesis of pulmonary fibrosis and scarring of the lung tissue. Recent clinical trials focused on the development of pharmacological agents that either directly or indirectly target kinases for the treatment of IPF. Therefore, to develop therapeutic targets for pulmonary fibrosis, it is essential to understand the key factors involved in the pathogenesis of pulmonary fibrosis and the underlying signaling pathway. The objective of this review is to discuss the role of kinase signaling cascades in the regulation of either TGF-β-dependent or other signaling pathways, including Rho-associated coiled-coil kinase, c-jun N-terminal kinase, extracellular signal-regulated kinase 5, and p90 ribosomal S6 kinase pathways, and potential therapeutic targets in IPF.

Reasons and Risk Factors for Readmission Following Hospitalization for Community-acquired Pneumonia in South Korea

  • Jang, Jong Geol;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • 제83권2호
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    • pp.147-156
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    • 2020
  • Background: Limited studies have been performed to assess readmission following hospitalization for community-acquired pneumonia (CAP) in an Asian population. We evaluated the rates, reasons, and risk factors for 30-day readmission following hospitalization for CAP in the general adult population of Korea. Methods: We performed a retrospective observational study of 1,021 patients with CAP hospitalized at Yeungnam University from March 2012 to February 2014. The primary end point was all-cause hospital readmission within 30 days following discharge after the initial hospitalization. Hospital readmission was classified as pneumonia-related or pneumonia-unrelated readmission. Results: During the study period, 862 patients who survived to hospital discharge were eligible for inclusion and among them 72 (8.4%) were rehospitalized within 30 days. In the multivariable analysis, pneumonia-related readmission was associated with para/hemiplegia, malignancy, pneumonia severity index class ≥4 and clinical instability ≥1 at hospital discharge. Comorbidities such as chronic lung disease and chronic kidney disease, treatment failure, and decompensation of comorbidities were associated with the pneumonia-unrelated 30-day readmission rate. Conclusion: Rehospitalizations within 30 days following discharge were frequent among patients with CAP. The risk factors for pneumonia-related and -unrelated readmission were different. Aspiration prevention, discharge at the optimal time, and close monitoring of comorbidities may reduce the frequency of readmission among patients with CAP.

Comprehensive Laboratory Analysis of Korean Acute Alcoholic Intoxication Patients Reveals the Need for a National Hepatitis B Virus Vaccination Program in Korea

  • Shin, Sang-Yong
    • 가정의학회지
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    • 제39권6호
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    • pp.360-363
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    • 2018
  • Background: Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem. Methods: We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017. Results: A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia ($<150{\times}10^9/L$). Twelve patients (12/159, 7.5%) showed low serum albumin level (<3.5 g/dL). Three patients (3/160, 1.9%) had chronic kidney disease stages 3-4 based on estimated glomerular filtration rate. Six patients (6/27, 22.2%) had high hemoglobin A1c (HbA1c) level (>7.0%). Positive rates of hepatitis B surface antigen and antiHBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively. Conclusion: Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 만성 신장병으로 발전한 사례 (A Case of Progressive FSGS and Chronic Kidney Disease in Congenital Chloride Diarrhea with SLC26A3 Mutation)

  • 서영준;정한빈;안석민;신우철;배은주;윤종형;정활림;이홍진
    • 대한유전성대사질환학회지
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    • 제18권3호
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    • pp.87-94
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    • 2018
  • 선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 말기 신장병으로 발전한 사례를 보고 하고자 한다. 20세 여자 환자로, 본원에서 출생 전 산전진단에서 양수과다 및 초음파 소견으로 선천성 염소성 설사가 의심되었으며, 출생 직후 확진 되어 신생아기 때부터 KCl 보충을 통하여 증상 조절을 시작하였다. 환아는 이후 특별한 건강의 문제가 없었으나 12세에 단백뇨가 관찰되었고, 16세때 본원에서 국소분절 사구체경과증 과 2기 만성신장병 진단을 받았다. 이후 보존적 치료를 하였으며, 지속적인 단백뇨에 대한 재 평가를 위하여 입원하게 되었다. 입원 후 확인된 검사에서 사구체여과율(GFR)은 4기 신장병으로 악화되어 있었으며 신생검에서도 국소분절 사구체신염으로 인한 만성 신장병이 재 확인 되었다. 환아 및 가족을 대상으로 시행한 유전자 검사(diagnostic exome sequencing)에서는 SLC26A3 유전자의(c.2063-1G>T) 동형 접합체 변이가 각각 부모에서 전달된 것을 확인하였다. 선천성 염소성 설사 환자는 적절한 전해질 보충에도 불구하고 신기능 손상이 되기 쉬운 경향이 있으며, 따라서 조기 진단 및 충분한 전해질 보충이 이루어지는 경우에서도 환자의 신장 기능에 대한 정기적 관찰 및 적절한 보조 치료가 필요할 것으로 사료된다.

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$^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰 (Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan)

  • 배현철;김현영;김병길;한상원
    • Childhood Kidney Diseases
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    • 제1권1호
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    • pp.31-37
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    • 1997
  • 목적 : DMSA스캔은 신장의 형태학적 질환의 진단에 유용한 방사선과적 검사이다. 본원에서 DMSA스캔을 시행한 환아중 일측성으로 동위원소 섭취가 안되는 환아를 대상으로 이들의 성별, 연령별 분포와 임상적 소견, 원인질환 및 동반질환을 분석하고 이에 대한 치료 및 예후를 알아보고자 하였다. 방법 : 1980년부터 1995년까지 16년간 본원에 내원하여 DMSA 스캔을 시행한 생후 1일부터 15세 환아중 일측성으로 신기능을 상실한 경우와 5% 이내로 매우 저하되어 있는 61명을 대상으로 이들의 성별, 연령별 분포와 내원하게 된 주소, 내원당시의 임상적 소견, 정맥내 신우조영술, 복부초음파, 배뇨성 방광요관조영술, 최종 진단명, 동반되어있는 반대편 신장 및 전신 질환, 내원당시의 혈액검사, 치료, 그리고 추적 관찰후의 결과 등에 대한 항목을 조사하고 상호 연관관계를 분석하였다. 결과 : 1) 대상 환아의 연령 분포는 평균 3.3세였으며, 특히 1세이하가 전체의 46%였고 성별 분포는 남녀 1.4:1의 비율로 남아가 많았다. 2) 내원하게된 주소는 산전초음파에서 신장 이상이 발견된 경우가 31.2%로 가장 많았으며, 다음으로 반복적 요로감염, 복부종괴 촉지, 육안적 혈뇨, 복통 순이였으며, 다른 질환의 평가중 우연히 신장 이상이 발견된 경우도 26.2%를 차지하였다. 3) 내원당시 임상적 소견은 발열, 농뇨 등의 요로감염 증상이 가장 많았고, 고혈압, 복부종괴 촉지, 육안적 혈뇨, 변비, 무증상, 현미경적 혈뇨 순이였다. 4) 비기능성 신장의 최종진단명은 다낭성 신이형성(multicystic dysplastic kidney)이 36.1%로 가장 많았고, 수신증, 신발육부전, 신형성부전 순이였다. 5) 비기능성 신장의 치료는 47.5%에서 수술적 치료를 시행받았고, 수술적 치료중 신적출술이 75.9%(전체의 36.1%)로 가장 많았으며 그외에는 근피적 방광루조성술, 요관방광문합술, 신적출 및 신이식 순이였고, 32.8%는 치료없이 추적관찰만 했던 환아들이였다. 6) 반대측 신장에 침범된 질환은 수신증이 90.5%로 가장 많았고 신형성부전, 신원거대감소증이 각각 1례였다. 7) 총 61명의 환아중 4명이 만성 신부전으로 이행하였는데 이들은 모두 반대편 신장에도 심한 병변이 동반되었던 경우였으며 그 외의 환아들은 비교적 예후가 좋았다. 결 론 : 신기능을 상실한 신장중 대부분은 선천적인 질환에 의한 경우였으며 양측성으로 침범된 경우 만성신부전으로 이행한 경우도 있었으나 편측으로 침범된 경우 예후가 좋은 편이였으며 양측성인 경우도 조기진단 후 수술 받은 경우 신기능이 잘 유지되었다. 본 연구를 통하여 주산기 신장 병변에 대한 평가는 중요하며, 출생후 민감도가 높은 검사방법으로 조기에 진단하고 처치하면 비교적 예후가 좋다는 것을 알 수 있었다.

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앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病) (Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death)

  • 이차수;박청규
    • 대한수의학회지
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    • 제27권2호
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    • pp.277-290
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    • 1987
  • This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

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강직성척추염(Ankylosing Spodylitis)에 대한 한의학적 이해 (A Study on Ankylosing Spodylitis in Traditional Korean Medical Perspective)

  • 김종현;윤은경;백유상;정창현;장우창;류정아
    • 대한한의학원전학회지
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    • 제25권3호
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    • pp.23-38
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    • 2012
  • Objective : Ankylosing Spodylitis(AS) is a chronic inflammatory disease that is notorious for its difficulty to cure. This study aims to interpret the mechanism of AS in the Traditional Korean Medical(TKM) perspective, and to understand the role of the spine. Method : Clinical manifestations of AS, epidemiological data and clinical cases were interpreted by traditional methodology. Result : The young age group of patients suffering from this condition suggests that the cause of this condition is not solely linked to deficiency of the Kidney[腎], which is a general cause for bone disease. Its symptoms are linked to obstruction in the upper body, which results in disturbance of Jeong(精) collection in the lower body. Based on other accompanying symptoms, together with its character as an autoimmune disease, a strong link to the spirit of the heart[心神] can be suggested. Conclusion : AS is closely linked not only to essence of kidney[腎陰], but to the spirit of the heart[心神] as well. From the TKM analysis of the spine, we can understand it as the basic pathway for the fundamental Gi(氣) circulation.

Clinical features of Senior-Loken syndrome with IQCB1/NPHP5 mutation in a Filipino man

  • Chiu, Harold Henrison C.;Sucaldito, Ma. Sergia Fatima P.;Maceda, Ebner Bon G.;Montemayor, Jan Andre S.;Tamondong-Lachica, Diana R.
    • Journal of Genetic Medicine
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    • 제17권1호
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    • pp.39-42
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    • 2020
  • The Senior-Loken syndrome was first described in 1961 as an oculo-renal disease consisting of familial juvenile nephronophthisis and Leber congenital amaurosis. It is a rare autosomal recessive disorder with a prevalence of 1:1,000,000 caused by mutations in nine genes (NPHP 1-8 and NPHP 10). Ocular manifestations (e.g., photophobia, nystagmus, and extreme hyperopia) occur within the first few years of life while renal manifestations (e.g., formation of multiple cysts impairing kidney function and end-stage renal disease) appear in late childhood to adolescence. Here, we report a case of a Filipino male presenting with rotatory nystagmus and progressive deterioration of vision since childhood. He had congenital amaurosis and juvenile nephronophthisis that progressed to end stage renal disease by age 19. All laboratory and imaging findings were consistent with chronic kidney disease. Molecular genetic testing of ciliopathy-related genes was performed revealing a homozygous mutation in exon 11 of the IQCB1/NPHP5 gene, c.1090C>T (p.Arg364). This sequence change created a premature translational stop signal resulting in a truncated protein product, nephrocystin-5 and its consequent loss of function. His symptoms eventually improved with initiation dialysis. The prognosis of Senior-Loken syndrome remains dismal and a high index of suspicion, early diagnosis and timely intervention of renal complications are warranted.