• 제목/요약/키워드: Minimal change disease

검색결과 65건 처리시간 0.025초

미세변화신증후군 환아에서 Tumor Necrosis Factor-${\alpha}$의 혈중 및 요중 변화와 알부민 투과성에 미치는 영향 (Changes of Plasma and Urinary $TNF-{\alpha}$ in Children with Minimal Change Nephrotic Syndrome and Its Role in Albumin Permeability)

  • 조민현;이환석;오현희;정기영;구자훈;고철우
    • Childhood Kidney Diseases
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    • 제7권1호
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    • pp.16-22
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    • 2003
  • 목적 : 미세변화신증후군은 소아 원발성 신증후군의 가장 흔한 원인이다. 최근 $TNF-{\alpha}$가 미세변화신증후군의 병인기전과 밀접한 관계가 있다고 보고되고 있다. 이에 저자들은 미세변화신증후군 환아에서의 $TNF-{\alpha}$의 변화를 살펴보고 $TNF-{\alpha}$가 사구체 기저막의 투과성에 미치는 직접적인 영향을 알아보기 위하여 본 연구를 시행하였다. 방법 : 대상 환아는 신생검으로 미세변화신증후군이 확진된 만 2-15세 사이의 소아로서 이들에게서 혈액과 요를 채취하여 ELISA 방법으로 $TNF-{\alpha}$를 측정하였고, Millicell system을 사용하여 알부민에 대한 투과성을 측정하였다. 결과 : 재발시에 요중 $TNF-{\alpha}$는 대조군과 관해시에 비하여 유의하게 증가되어 있었으나(P<0.01), 혈중 $TNF-{\alpha}$는 유의한 변화를 보여주지 않았다. Millicell system을 이용한 알부민 투과성에 대한 실험결과 생리적인 농도 이상의 $TNF-{\alpha}$에서 알부민에 대한 투과성에 특이한 변화가 관찰되지 않았다. 결론 : 이상의 결과를 종합할 때 $TNF-{\alpha}$는 미세변화신증후군의 발병기전에서 일차적인 역할을 한다기 보다는 아마도 질환자체에 의한 이차적인 현상에 의하여 요중에서 증가된 것으로 생각된다.

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A Case of Immunoglobulin A Nephropathy in a Patient with Kimura's Disease

  • Park, Hye Jung;Kim, Jae Kyung;Kim, Hyun Ju;Park, Kwan-Kyu;Bae, Yoon Sung;Lee, Yong Kyu;Kim, Beom Seok
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.149-151
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    • 2013
  • Kimura's disease is an angiolymphoid-proliferative disorder that manifests with benign subcutaneous swelling predominantly in the head and the neck. Kidney involvement, including proteinuria, occurs in 12-16% of patients with the disease, and 60-78% of such cases is nephrotic syndrome. Reported etiologies of nephrotic syndrome in Kimura's disease include membranous glomerulonephritis, mesangial proliferative glomerulonephritis, minimal-change disease, focal segmental glomerulosclerosis, diffuse proliferative glomerulonephritis and immunoglobulin A (IgA) nephropathy. There have been only two case reports of IgA nephropathy in Kimura's disease, in 1998. In this report, we present a third case of IgA nephropathy associated with Kimura's disease.

Association between Minimal Change Esophagitis and Gastric Dysmotility: A Single-Center Electrogastrography and Endoscopy Study in Children

  • Lim, Kyung In;Shim, Sung Bo;Tchah, Hann;Ryoo, Eell
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권1호
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    • pp.20-27
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    • 2018
  • Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially associated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. Results: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, $1.68{\pm}3.37$ vs. normal, $0.76{\pm}1.06$; p<0.05), whereas the other parameters, such as dominant frequency, dominant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correlations were noted between erythema and power ratio (p<0.05), friability and postprandial dominant frequency (p<0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p<0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, $33.59{\pm}15.52$ vs. normal, $28.10{\pm}17.23$; p<0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis. Conclusion: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.

Complications of nephrotic syndrome

  • Park, Se-Jin;Shin, Jae-Il
    • Clinical and Experimental Pediatrics
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    • 제54권8호
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    • pp.322-328
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    • 2011
  • Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

미세변화형 신증에서 cyclosporine A 투여 후 혈액 및 요중 endothelin-1치의 변화 (Effect of Cyclosporine A on Plasma and Urine Levels of Endothelin-1 in Steroid Dependent Minimal Change Nephrotic Syndrome)

  • 김제우;김지홍;이진성;김병길;김현숙
    • Childhood Kidney Diseases
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    • 제2권1호
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    • pp.20-25
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    • 1998
  • 목적 : Endothelin-1은 cyclosporine A와 관련된 신독성의 발생에 관련될 것으로 생각되고 있다. 이에 저자 등은 cyclosporine A가 혈액 및 요중 endothelin-1치에 미치는 영향을 알아보고자 하였다. 방법 : 1996년 2월부터 1997년 3월까지 스테로이드 의존성 미세변화형 신증으로 진단받고 cyclosporine A를 투여받은 15세 미만의 환아 9례를 대상으로 cyclosporine A 투여 전과 투여 3개월 후의 혈장과 소변에서 endothelin-1치를 측정하였다. 평균 연령은 $8.3{\pm}4.6$세였다. 결과 : (1) 혈중 endothelin-1치는 cyclosporine A 투여 전에 $3.22{\pm}0.39$ pg/mL였고, cyclosporine A 투여 3개월 후에 $3.84{\pm}1.52$ pg/mL로 유의한 차이가 없었다(P=0.64). (2) 요중 endothelin-1치는 cyclosporine A 투여 전에 $21.8{\pm}5.8$ pg/mL였고 cyclosporine A 투여 3개월 후에 $20.3{\pm}3.1$ pg/mL로 유의한 차이가 없었다(P=0.30). 결론 : 혈액 및 요중 endothelin-1치는 비교적 단기간의 cyclosporine A 투여에 의해서는 유의한 변화를 보이지 않았으며, 향후 장기간의 cyclosporine A 투여가 endothelin-1치에 미치는 영향에 대한 연구도 필요할 것으로 생각된다.

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황련(黃連) 전탕액(煎湯液)이 Staphylococcus species(S.aureus, S.epidermidis)의 배양일에 따른 항균효과의 지속성에 관한 연구 (The Experimental Study on the continuous Anti-bacterial Potency of Coptidis rhizoma extract on Cultivation of Staphylococcus species(S. aureus, S. epidermidis))

  • 서형식
    • 대한약침학회지
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    • 제10권3호
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    • pp.71-76
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    • 2007
  • Objectives This experimental study was performed to investigate the continuous anti-bacterial potency of Coptidis rhizoma extract on cultivation of Staphylococcus species(S. aureus, S. epidermidis) that induce eye disease. Methods Minimal inhibitory concentration(MIC) was measured by dropping to $50{\mu}l$ diluted Coptidis rhizoma extract(100%, 10%, 1%, 0.1%) on S. aureus, S. epidermidis that were cultivated from 2 to 6 days. Anti-bacterial potency was measured by the size of inhibition zone with change of volume($20{\mu}l,\;30{\mu}l,\;40{\mu}l,\;50{\mu}l$). Results 1. Anti-bacterial potency of Coptidis rhizoma extract on S. aureus was appeared in 100%, 10% and was the same as anti-bacterial potency of 2 days and 6 days. Anti-bacterial potency with change of volume(100%) was increased in propotion to increase volume on all samples. Anti-bacterial potency with change of volume(10%) was increased in propotion to increase volume on all samples except $20{\mu}l$. Anti-bacterial potency of Coptidis rhizoma extract on S. aureus was appeared continuous. 2. Anti-bacterial potency of Coptidis rhizoma extract on S. epidermidis was appeared in 100%, 10% and was the same as anti-bacterial potency of 2 days and 6 days. Anti-bacterial potency with change of volume(100%) was increased in propotion to increase volume on all samples. Anti-bacterial potency with change of volume(10%) was appeared in $50{\mu}l$. Anti-bacterial potency of Coptidis rhizoma extract on S. epidermidis was appeared continuous. Conclusions Anti-bacterial potency of Coptidis rhizoma extract on cultivation of S. aureus & S. epidermidis was showed continuous.

방사선조사와 cis-dichlorodismmineplstinum(II)가 휜쥐의 심근에 미치는 효과에 관한 실험적 연구 (An Experimental Study on the Effect of Irradiation and cia- dichlorodiBmmineplatinum(II) on the myocardium of Rats)

  • 이경자
    • Radiation Oncology Journal
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    • 제12권3호
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    • pp.285-293
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    • 1994
  • Purpose : The study was designed to investigate the effect of cis-dichlorodiammineplatinum(II)(cis-DDP) on the radiation-induced cardiomyopathy in the rat. Materials and Methods : The myocardial damage was assessed by histopathologic changes. In radiation alone group, radiation dose ranged from 10-40 Gy X-ray in a single dose and in combined group, cis-dichlorodiammineplatinum(II) at a dose of 6 mg/kg was given intraperitoneally immediately after irradiation of same dose with X-ray alone group. Results : The early changes by radiation included congestion, inflammatory cell infiltrations and fibrosis in myocardial interstitium with focal myocardial necrosis, which was noted in 10 Gy group, Myocardial fibrosis was increased by increasing dose of radiation but myocardial necrosis was not Proportional to radiation dose. cis-DDP alone group showed minimal degeneration of myocardium with surrounded by inflammatory cell infiltrations. In combined group, myocardial fibrosis in 10 Gy group were similar to radiation alone group, but 30 Gy and 40 Gy groups showed severer changes. Electron microscopic examination showed disruption of Z-band and edema of mitochondria with decreased matrix density in 20 Gy radiation group which were severer in 40 Gy radiation group. Combined group showed endothelial changes and disruption of Z-band worse than radiation alone group as well as increased connective tissue, which was considered as a hallmark of late change in radiation-induced heart disease. Conclusion : This results showed minimal enhancement of the radiation-induced cardiomyopathy in rats by cis-DDP.

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초점성 분절성 사구체 경화증의 병리와 분류 (Pathology and Classification of Focal Segmental Glomerulosclerosis)

  • 김용진
    • Childhood Kidney Diseases
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    • 제16권1호
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    • pp.21-31
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    • 2012
  • 초점성 분절성 사구체 경화증(focal segmental glomerulosclerosis; FSGS)은 경화증을 주 병변으로 하는 질환으로서 일차성 사구체 질환의 하나이면서 진행된 사구체 질환의 형태적 변화를 기술하는 단어로도 사용되고 있다. 사구체에는 경화증, 유리질 형성, 거품세포의 출현, 발세포의 공포화, 광륜형성 등이 보이고, 간질의 섬유화와 염증세포의 침윤, 세뇨관의 위축, 혈관의 비후 및 내막 섬유화 등을 특징으로 한다. 면역형광검사에서 부분적으로 IgM과 C3 등의 침착을 보이지만 면역관련 질환은 아니다. 전자현미경 검사에서는 발세포의 손상 현상으로 세포질 내의 공포화와 족돌기가 상실되는 것이 중요 소견이다. 2004년 표준화 된 FSGS의 분류는 과거의 형태학적 변형들을 모아서 임상과의 상관관계를 지웠다. 그 결과 tip형이 가장 예후가 좋으며, collapsing형이 가장 나쁜 것으로 알려졌다. 그러나 이 분류가 증례에 따라서는 적용하기가 애매한 경우가 많고, collapsing형을 FSGS에 분류하는 것에 대한 반론 등이 제기되고 있다. 한편, 임상적으로는 FSGS를 원인에 따라 분류하여 거꾸로 형태학적 공통점을 찾으려는 노력을 하고 있다. 사구체의 수가 적어서 일어나는 과여과로 인한 FSGS는 perihilar형이 많고 유전적 질환에 의한 것은 diffuse mesangial sclerosis가 특징인 것으로 주장되고 있다. FSGS는 이와 같이 아직도 밝혀져야 할 것이 많은 질환이며, 계속적인 연구가 이루어져야 할 필요가 있다.

간(肝)스캔상(上) 체위변동(體位變動)에 따른 간형태(肝形態) 변화(變化)에 대(對)한 고찰(考察) (A Study on the Effects of Position Change on the Liver Shape on Radioisotope Scan)

  • 홍기석;최두혁;양영태;고창순
    • 대한핵의학회지
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    • 제16권1호
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    • pp.49-54
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    • 1982
  • For this study, the authors obtained and examined anterior views of the liver and spleen in two different positions, upright and supine, of 39 normal subjects and 20 patients with hepaticpathology by means of $^{99m}Tc-colloid$ and gamma camera. This examination confirms the following findings. In general, it is shown, left lobe of the liver in upright position becomes longer in height than in supine position, while the distance between lateral margin of the liver and that of the spleen becomes father in with in supine position than in upright position. The upper margin of liver moves more downward in upright position than in supine. It is noticeable that as for 5 cases with severe chronic liver disease, there is minimal alteration of the liver shape between in two positions. The comparison of the both positions for the better liver scan shows the following finding. Prominent caudate and/or left lobe are marked in the upright position in 16 cases out of the total 59, while none is found in the supine. The false cold area in lower part of the liver disappears in 7 cases in the upright position, while only one shows the disappeance of the false cold area in the supine. Left liver margin due to close contact of spleen is blurred in 3 cases in the upright position. In total 23 cases out of 59 support that the upright position is better for the liver scan, while only 4 cases support the supine position is better. These findings support two assumptions. One is that upright view can bo expected more improved resoluton than supine view for liver scan. Second is that minimal change of the liver shape in both views indicate the serious abnormality in the liver.

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탕포산(湯泡散)이 Staphylococcus species(S. aureus, S. epidermidis)의 배양일에 따른 항균효과의 지속성에 관한 연구 (The Experimental Study on the continuous Anti-bacterial Potency of Tangpo-san on Cultivation of Staphylococcus species(S. aureus, S. epidermidis))

  • 서형식
    • 대한약침학회지
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    • 제10권2호통권23호
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    • pp.67-71
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    • 2007
  • Objectives : This experimental study was performed to investigate the continuous anti-bacterial potency of Tangpo-san on cultivation of Staphylococcus species(S. aureus, S. epidermidis)that induce eye disease. Methods : Minimal inhibitory concentration(MIC) was measured by dropping to 50 ${\mu}$l diluted Tangpo-san(100%, 10%, 1%, 0.1%) on S. aureus, S. epidermidis that were cultivated from 2 to 6 days. Anti-bacterial potency was measured by the size of inhibition zone with change of volume(20 ${\mu}$l,30 ${\mu}$l,40 ${\mu}$l,50 ${\mu}$l). Results : 1. Anti-bacterial potency of Tanpo-san on S. aureus was not appeared all samples. Anti-bacterial potency with change of volume was increased in propotion to increase volume, and the Anti-bacterial potency of 2 days was equal to 6 days. Anti-bacterial potency of Tangpo-san on S. aureus was appeared continuous. 2. Anti-bacterial potency of Tangpo-san on S. epidermidis was appeared in 100%, 10% on 2 and 6 days, and the Anti-bacterial potency of 6 days was decreased. In 2 days, Anti-bacterial potency was appeared 40 and 50u1, in 6 days, Anti-bacterial potency was appeared all samples. Anti-bacterial potency with change of volume was increased in propotion to increase volume and increased on 6 days, but bacteria was increased. Anti-bacterial potency of Tangpo-san on S. epidermidis wasn't appeared continuous. Conclusions : Anti-bacterial potency of Tangpo-san on cultivation of S. aureus showed continuous, but on cultivation of S. epidermidis was not showed continuous.