• Title/Summary/Keyword: Chronic Kidney Disease

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Multiple Subcutaneous Nodular Metastasis from Transitional Cell Carcinoma of the Urinary Bladder in a Dog (한마리 개에서 발생한 방광 이행상피세포암종으로 인한 다수의 피하 전이)

  • Kim, Hye-young;Hong, Eun-ji;Park, Hyung-jin;Kwon, Hyo-jung;Song, Kun-ho;Seo, Kyoung-won
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.247-250
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    • 2015
  • A 10-year-old spayed female Pomeranian dog weighing 3.65 kg was presented with a 7-month history of urinary incontinence, stranguria and hematuria. The patient had mass lesions at left prescapular region ($3cm{\times}3cm$) and left axillary region ($5cm{\times}4cm$). Diagnosis of transitional cell carcinoma (TCC) with multiple cutaneous metastasis was made. Dog was treated with chemotherapy using mitoxantrone and piroxicam for 5 months. Although TCC size of urinary bladder was decreased during chemotherapy, there was no change of subcutaneous tumor size and mild relief of clinical signs. Partial anorexia for 3 weeks and multiple masses were noted at left caudal abdominal wall and left medial thigh (203 days after first presentation) and assessed as chronic kidney disease and additional subcutaneous metastasis of urinary bladder TCC by post-mortem and histopathological findings.

Captopril $^{99m}Tc-DTPA$ Renal Scintigraphy in Diagnosis of Renovascular Hypertension (신혈관성 고혈압의 진단에 있어서 캅토프릴 신스캔의 의의)

  • Yang, Hyung-In;Lee, Dong-Soo;Kim, Sung-Chul;Bae, Sang-Kyun;Choi, Chang-Woon;Chung, June-Key;Kim, Suhng-Gwon;Lee, Myung-Chul;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.312-317
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    • 1992
  • To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of $^{99m}Tc-DTPA$ renal scan was peformed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyetonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

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Bovine Tuberculosis of Korean Native Cattle in an Abattoir (도축장 내의 한우에서 발견된 소 결핵 보고)

  • Jang, Seong-Jun;Do, Sun-Hee;Ki, Mi-Ran;Hong, Il-Hwa;Park, Jin-Kyu;Ji, Ae-Ri;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.19 no.12
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    • pp.1847-1850
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    • 2009
  • Bovine tuberculosis is generally detected postmortem because it is a chronic debilitating disease. Since tuberculosis is mainly found in the lungs, clinical signs including coughing, nasal discharge, and difficulty breathing can occur in severe instances. In the present study, specimens were collected from the heart, liver, kidney, lung, pleural cavities, lymph nodes and intestines of carcasses found in an abattoir. According to post-mortem examination and inspection of carcasses, tuberculosis lesions were varied in appearance and size. Tubercles of a white cream color were disseminated throughout the pleural cavity including the lymph nodes, lungs and mesentery containing pus. Gram and Ziehl-Neelsen's acid-fast staining for the lung and lymph nodes revealed a highly positive histochemical reaction. The acid-fast organisms were observed histologically in the lesions under a microscope. This report demonstrated the histopathology of bovine tuberculosis based on the histological findings of Mycobacterium bovis, which is a suspected causative agent.

Gastric Adenoma in the Pyloric Outflow Tract of a Shih-tzu Dog (시츄견에서 위유문부에서 발생한 위선종 증례)

  • Lee, Hee-Chun;Kwon, Do-Hyung;Moon, Jong-Hyun;Kim, Young-Ki;Cho, Kyu-Woan;Kang, Byeong-Teck;Im, Keum-Soon;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.169-172
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    • 2012
  • A 12-year-old castrated male Shih-tzu dog presented with vomiting, anorexia, and weight loss. The patient's medical history and hematological, radiographic, ultrasonographic, and endoscopic findings were used for diagnosis. The patient's medical history showed that he was being treated for chronic kidney disease since a few weeks. The serum biochemical analysis showed moderate azotemia. However, abdominal radiographic and ultrasonographic findings showed the presence of a mass in the pylorus area of the stomach. On gastrointestinal endoscopic examination, the proliferative mass was found in the pyloric antrum. The histopathological results of the endoscopic biopsy specimen indicated that it was strongly suspected a gastric adenoma; therefore, we surgically excised the pyloric outflow region via a Y-U pyloroplasty. The histopathological examination of the surgically excised specimen also indicated that the mass was a gastric adenoma. After surgical treatment, the patient's condition improved gradually, and the clinical symptoms diminished in approximately 3 weeks after surgery. The patient's condition was well controlled until recently, i.e., 18 months after surgery. This case report describes the clinical findings, imaging characteristics, endoscopic findings, and histopathological features of a gastric adenoma in the pyloric outflow tract of a dog.

Relationship between the Estimated Glomerular Filtration Rate and the Urine Microalbumin/Creatinine Ratio and Ferritin in Korean Adults (한국 성인에서 사구체여과율 및 요 중 미세알부빈/크레아티닌 비율과 페리틴의 관련성)

  • Yoon, Hyun;Lee, Jun Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.145-154
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    • 2019
  • This study examined the relationship between the estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) with ferritin in Korean adults. This study included 4,948 adults aged ${\geq}20years$ from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) data. A covariance test adjusted for covariates was performed for the ferritin levels in relation to the decreased eGFR (eGFR<$60ml/min/1.73m^2$) and elevated uACR ($uACR{\geq}30mg/g$). Several key findings were made in the present study. First, after adjusting for the related variables, the ferritin level was higher in the decreased eGFR group [$103.04{\pm}6.59mL/min/1.73m^2$; 95% confidence interval (CI), 90.12~115.96] than in the normal eGFR group ($84.87{\pm}1.16mL/min/1.73m^2$; 95% CI, 82.59~87.14; P=0.007). Second, after adjusting for the related variables, the ferritin level ($M{\pm}SE$) was similar in the normal uACR group ($85.70{\pm}1.20mg/g$; 95% CI, 83.35~88.05) and elevated uACR group ($82.72{\pm}4.09mg/g$; 95% CI, 74.71~90.73) (P=0.487). Chronic kidney disease was positively associated with the ferritin level in Korean adults but albuminuria was not.

Mid-Term Outcomes and Angiographic Patency of Redo Coronary Artery Bypass Grafting: A Comparison between OffPump and On-Pump Surgery

  • Sohn, Suk Ho;Kim, Seung Hyun;Hwang, Ho Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.106-116
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    • 2021
  • Background: We evaluated the mid-term outcomes and angiographic patency of redo coronary artery bypass grafting (CABG). Methods: Of 2,851 patients who underwent isolated CABG at Seoul National University Hospital from 2000 to 2017, 88 underwent redo CABG. Patients' mean age at redo CABG was 66.0±8.0 years. The mean interval between the first-time and redo CABG was 113.0±62.4 months. The mean follow-up duration was 86 months. Early and mid-term clinical outcomes were evaluated. Angiographic patency rates were evaluated early (1-2 days), 1 year, and 5 years after surgery. Comparative analyses between on-pump and off-pump CABG were also performed. Results: The culprits for reoperation were previous grafts (65.6%), native coronary vessels (17.8%), and both (16.7%). Off-pump CABG was performed in 75 cases (85.2%), and the mean number of distal anastomoses was 1.8±0.8. The saphenous vein (39.7%) was used most frequently, followed by the right internal thoracic artery (28.4%), right gastroepiploic artery (21.3%), left internal thoracic artery (7.8%), and radial artery (2.8%). Operative mortality was 1.1%. The overall survival, cumulative incidence of cardiac death, and cumulative incidence of major adverse cardiac events were 71.3%,12.0%, and 23.3% at 5 years after surgery, respectively. The overall angiographic patency rates were 95.7%, 90.1%, and 92.2% on early, 1-year, and 5-year angiograms, respectively. The angiographic patency rates of saphenous vein grafts were 93.1%, 85.6%, and 91.3% on early, 1-year, and 5-year angiograms, respectively. No significant differences in clinical outcomes or angiographic patency rates were observed between the on-pump (n=13) versus off-pump (n=75) groups. Multivariable analysis revealed that age (hazard ratio [HR], 1.07; p=0.005) and chronic kidney disease (HR, 3.85; p=0.001) were risk factors for all-cause mortality. Conclusion: Redo CABG could mostly be performed using the off-pump technique and did not show increased operative mortality and morbidities.

Relationship between Hypertension and the Declining Renal Function in Korean Adults (한국 성인에서 고혈압과 신기능 저하와의 관련성)

  • Lee, Jun Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.1
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    • pp.32-40
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    • 2021
  • This study examined the association between hypertension (HTN), estimated glomerular filtration rate (eGFR), and urine microalbumin/creatinine ratio (ACR) in Korean adults. Data for 8,922 adults (3,941 men and 4,981 women) aged ≥20 years from the Sixth Korean National Health and Nutrition Examination Survey VI (2013~2014) were analyzed. In men, after adjusting for the related variables, the odds ratios (ORs) of HTN [systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or use of HTN medications] were significantly higher in the decreased eGFR group [eGFR <60 mL/min/1.73 ㎡, 1.98 (95% CI, 1.21~3.24)], elevated ACR group [ACR ≥30 mg/g, 2.03 (95% CI, 1.54~2.69)], and decreased eGFR plus elevated ACR group [eGFR <60 mL/min/1.73 ㎡ and ACR ≥30 mg/g, 6.03 (95% CI, 2.82~12.92)] than in the normal group (eGFR ≥60 mL/min/1.73 ㎡ and ACR <30 mg/g). In women, after adjusting for the related variables, the ORs of HTN were significantly higher in the decreased eGFR group (2.29, 95% CI, 1.27~4.13), elevated ACR group (2.22, 95% CI, 1.68~2.94), and decreased eGFR plus elevated ACR group (10.77, 95% CI, 3.89~29.82) than the normal group. In conclusion, HTN was associated with a decreased eGFR and elevated ACR in Korean men and women. In addition, the prevalence of HTN increased greatly when a decreased eGFR and elevated ACR occurred simultaneously.

Relationship between Albuminuria and Uric Acid to High-Density Lipoprotein Cholesterol Ratio in Korean Adults (대한민국 성인에서 알부민뇨와 요산 대 고밀도 지단백 콜레스테롤 비율의 관련성)

  • Hyun YOON
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.167-173
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    • 2023
  • This study assesses the urine microalbumin to urine creatinine ratio (uACR) with uric acid and the association with the high-density lipoprotein cholesterol (UA/HDL-C) ratio in Korean adults. Data from the 2019 Korean National Health and Nutrition Examination Survey was procured and included 5,845 adults aged 20 years or older. Several key findings were obtained in the present study. After adjusting for the related variables (age, gender, hypertension, obesity, type 2 diabetes mellitus, and chronic kidney disease), the uACR was found to be positively associated with the quartiles of the UA/HDL-C ratio (P=0.002). Moreover, after adjusting for related variables, the odds ratio (OR) of albuminuria (uACR≥30.0 mg/g) was not significant in quartile 2 (Q2) (OR, 1.015; 95% confidence interval [CI], 0.757~1.361) and Q3 (OR, 1.090; 95% CI, 0.811~1.465) but was significantly higher in Q4 (OR, 1.416; 95% CI, 1.044~1.921) as compared to Q1 of the UA/HDL-C ratio. We conclude that since the UA/HDL-C ratio is positively associated with albuminuria in Korean adults, an increased UA/HDL-C ratio could be applied as a useful measure to assess albuminuria in Korean adults.

Role of Chemical Exchange Saturation Transfer and Magnetization Transfer MRI in Detecting Metabolic and Structural Changes of Renal Fibrosis in an Animal Model at 3T

  • Anqin Li;Chuou Xu;Ping Liang;Yao Hu;Yaqi Shen;Daoyu Hu;Zhen Li;Ihab R. Kamel
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.588-597
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    • 2020
  • Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetization transfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction (UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). The obstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations, 18F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis was measured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at 1.2 ppm (MTRasym(1.2ppm)) derived from CEST and maximum standard uptake value (SUVmax) and between magnetization transfer ratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of contralateral kidneys (p < 0.05). On day 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of sham-operated kidneys (p < 0.05). The MTRasym(1.2ppm) of UUO renal medulla was fairly negatively correlated with SUVmax (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p < 0.001). Conclusion: CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosis in UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.

Associations between Anemia and Glomerular Filtration Rate and Albuminuria in Korean Adults by Metabolic Syndrome Status: Analysis of KNHNES V-3 Data (대한민국 성인의 대사증후군 유무에 따른 빈혈과 사구체 여과율 및 알부민뇨의 연관성: 국민건강영양조사 V-3 분석)

  • Hyun YOON
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.2
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    • pp.125-134
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    • 2024
  • The present study was conducted to explore relationships between anemia and estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) in Korean adults with or without metabolic syndrome (MetS). The data of 4,943 adults aged ≥20 years who participated in KNHNES V-3 (2012) were analyzed. In the non-MetS group, the odds ratio (OR) for anemia of those with a decreased eGFR {eGFR<60 mL/min/1.73 m2, 3.85 (95% confidence interval [CI], 2.03~7.30)} was significant as was the OR of those with decreased eGFR plus elevated uACR (eGFR<60 mL/min/1.73 m2 and uACR≥30 mg/g, 5.81 [95% CI, 2.60~13.02]). In the MetS group, ORs for anemia for those with an elevated uACR (2.18 [95% CI, 1.11~4.27]), a decreased eGFR (3.74 [95% CI, 1.11~12.55]), or a decreased eGFR plus an elevated uACR (16.79 [95% CI, 5.93~47.57]) were significant. In conclusion, in non-MetS, anemia was associated with a low eGFR, whereas in MetS, anemia was associated with a low eGFR and an elevated uACR. In addition, the OR for anemia was greatly increased when eGFR was diminished and uACR was elevated regardless of MetS and MetS status.