• 한국임상수의학회지
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• 제30권3호
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• pp.201-205
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• 2013

일 년 령, 중성화 하지 않은 체중 20 kg의 진도견이 7일간의 구토와 식욕부진, 기면을 주호소로 내원하였다. 본 환자는 임상증상과 뇨검사, 혈청화학검사, 영상검사, 복부 초음파 검사를 통해 만성 신부전으로 진단되었다. 10일간의 치료를 실시하였으나, 임상증상의 개선이 없었다. 환자는 안락사 되었으며, 사후 부검이 실시 되었다. 신장 조직검사 결과 소아 신증으로 진단되었으며, 이는 진도견에서 최초 보고되는 증례이다.

• 디지털산업정보학회논문지
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• 제19권4호
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• pp.97-115
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• 2023

In South Korea, chronic kidney disease(CKD) impacts around 4.6 million adults, leading to a high reliance on hemodialysis. For effective dialysis, vascular access is crucial, with decisions about vascular surgeries often made during dialysis sessions. Anticipating these needs could improve dialysis quality and patient comfort. This study investigates the use of Artificial Intelligence(AI) to predict the timing of surgeries for dialysis vessels, an area not extensively researched. We've developed an AI algorithm using predictive maintenance methods, transitioning from machine learning to a more advanced deep learning approach with Long Short-Term Memory(LSTM) models. The algorithm processes variables such as venous pressure, blood flow, and patient age, demonstrating high effectiveness with metrics exceeding 0.91. By shortening the data collection intervals, a more refined model can be obtained. Implementing this AI in clinical practice could notably enhance patient experience and the quality of medical services in dialysis, marking a significant advancement in the treatment of CKD.

• 대한임상검사과학회지
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• 제52권3호
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• pp.165-171
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• 2020

본 연구의 목적은 대한민국 20세 이상(50.32±16.14세)의 당뇨질환이 없는 성인에서 만성신장질환과 인슐린저항성(homeostasis model assessment of insulin resistance, HOMA-IR) 및 베타세포기능(homeostasis model assessment of beta cell function, HOMA-B)의 관련성에 대하여 조사하였다. 본 연구는 2015년도 국민건강영양조사 자료를 이용하여 당뇨질환이 없는 20세 이상의 대한민국 성인 4,380명을 대상으로 하였다. 본 연구결과에서 중요한 결과는 다음과 같다. 첫째, 만성신장질환과 HOMA-IR와 관련하여, 관련변수를 보정한 후의 결과에서(Model 4), 그룹 1 (G1; estimated glomerular filtrationrate [eGFR], ≥90 mL/min/1.73 ㎡), 그룹 2 (G2; eGFR, 60~89 mL/min/1.73 ㎡), 그룹 3a (G3a; eGFR, 30~59 mL/min/1.73 ㎡), ≥그룹 3b (≥G3b; eGFR, <30 mL/min/1.73 ㎡)의 HOMA-IR 평균값(M±SE, 95% confidence interval [CI])은 각각 1.78±0.03 (1.73~1.83), 1.87±0.03 (1.81~1.93), 2.16±0.13 (1.91~2.42) 및 2.59±0.24 (2.12~3.06)으로 만성신장질환이 진행됨에 따라 HOMA-IR은 증가하였다(P<0.001). 둘째, 만성신장질환과 HOMA-B와 관련하여, 관련변수를 보정한 후의 결과에서(Model 4), G1, G2, G3a 및 ≥G3b의 HOMA-B 평균값(M±SE, 95% CI)은 각각 87.46±1.21 (85.08~89.84), 89.11±1.38(86.40~91.81), 104.82±5.91 (93.23~116.42) 및 123.97±10.87 (102.66~145.29)으로 만성신장질환이 진행됨에 따라 HOMA-B도 증가하였다(P<0.001). 대한민국 당뇨질환이 없는 성인에서 만성신장질환이 진행됨에 따라 인슐린 저항성이 증가하였고, 베타세포기능 또한 증가하였다.

• Childhood Kidney Diseases
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• 제27권1호
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• pp.34-39
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• 2023

Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.338-346
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• 2018

Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

• 한국식생활문화학회지
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• 제37권3호
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• pp.248-255
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• 2022

Spinach (Spinacia oleracea L.), a green leafy vegetable, is well known as a functional food due to its biological activities. Vascular calcification is associated with several disease conditions including atherosclerosis, diabetes, and chronic kidney disease (CKD), and is known to raise the risk of cardiovascular diseases related morbidity and mortality. However, there are no previous studies that have investigated the effects of fermented spinach exract (FSE) against aortic and its underlying mechanisms. Therefore, this study investigated the effects and action of possible mechanisms of FSE on inorganic phosphate (PI)-induced vascular calcification in ex vivo mouse aortic rings. PI increased vascular calcification through calcium deposition in ex vivo aortic rings. FSE inhibited calcium accumulation and osteogenic key marker, runt-related transcription factor 2 (Runx2), and bone Morphogenetic Protein 2 (BMP-2) protein expression in ex vivo aortic rings. And, FSE inhibited PI-induced extracellular signal-regulated kinase (ERK) and p38 phosphorylation in ex vivo aortic rings. These results show that FSE can prevent vascular calcification which may be a crucial way for the prevention and treatment of vascular disease association with vascular calcification.

• 대한임상검사과학회지
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• 제53권3호
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• pp.208-216
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• 2021

코로나바이러스 감염증 19는 중증급성호흡기증후군 코로나바이러스 2의 명칭에서 명명되었다. 이 연구는 코로나바이러스 감염증 19 환자의 신기능 상태를 조사하는 것을 목적으로 하였다. 본 연구는 경기도 남부 한 병원에서 코로나바이러스 감염증 19로 입원한 649명 환자를 대상으로 하였다. 이번 연구에서 검토한 코로나바이러스 감염증 19 환자의 혈액요소질소와 크레아티닌은 증가된 패턴을 보였다. 본 연구의 대상자 중 남성의 혈액요소질소는 정상 범위보다 높았다. 특히 60대, 80대 이상에서 높게 나타났고, 크레아티닌 수치도 비슷하게 나타났다. 이 연구에서 환자의 전해질 검사는 정상 범위에서 벗어나는 결과는 관찰되지 않았다. 이 연구의 대상에서 80세 이상의 남성은 60 mL/min/1.73 m² 이하의 만성신장질환 역학협력 사구체여과율을 나타냈다. 최근 연구에 따르면 COVID-19의 일부 심각한 사례는 코로나바이러스에 감염되기 전에 기저 신기능의 문제가 없었던 사람들에게도 콩팥 손상의 징후를 보이고 있다. 따라서 여러 지표 평가의 신기능 검사는 검사결과의 검토는 코로나19 환자의 비정상 신기능 발견에 도움이 될 수 있다.

• 사상체질의학회지
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• 제36권2호
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• pp.65-75
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• 2024

Objectives This case study was aimed to report improvement of taeum-in patient with chronic kidney disesase who had voiding dysfunction after intracerebral hemorrhage using Yeoldahanso-tanggamibang. Methods A patient who complained of voiding dysfunction after intracerebral hemorrhage was administered with Yeoldahanso-tanggamibang through sasang consitutional medicine approach. To evaluate the improvement of voiding dysfunction, the number of nelaton catheterizations after removal of foley catheter and the amount of post void residual volume were compared, and laboratory follow-up was performed to determine whether renal function deteriorated. Results After treatment with Yeoldahanso-tanggamibang for 8 weeks, the number of nelaton catheterizations after removal of foley catheter decreased, the amount of post void residual volume decreased, and the renal function did not change. Conclusions This case study suggests the significance of Yeoldahanso-tanggamibang treatment for taeum-in patient who had voiding dysfunction after intracerebral hemorrhage.

• 한국임상수의학회지
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• 제34권3호
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• pp.197-199
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• 2017

A 14-year-old castrated male ShihTzu diagnosed with chronic kidney disease (CKD) 6 months prior was referred to our clinic. The patient had been experiencing symptoms such as vomiting, poor appetite and hind limbs weakness. Hematology tests showed that he had a non-regenerative anemia. With aggressive treatment, the patient's state had gotten worse. He showed ragged breath, vomiting blood and loss of consciousness temporarily. Hematocrit maintained low level. Gastric hemorrhage was strongly suspected by hematemesis. Whole blood transfusion was performed and heparin was used as an anticoagulant. Prior to transfusion, the blood cross matching between donor and patient was performed and the result was compatible. After the transfusion was stabilized, 1 mg of protamine sulfate for each 100 units of heparin was prepared and given intravenously over 3 minutes to reverse the effects of heparin. Immediately after protamine injection, the patient conducted severe anaphylactic shock. Protamine sulfate is used to reverse the anticoagulant action of heparin in dogs and humans. The adverse reaction of protamine sulfate range from mild reaction to fetal cardiac arrest. When using protamine sulfate as heparin neutralization, it can lead to the death of a patient cause of anaphylactic shock. For this reason, the protamine sulfate should be injected slowly with antihistamine and the clinician should carefully monitor patients.

• Journal of Cardiovascular Imaging
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• 제26권4호
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• pp.217-225
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• 2018

BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.