• Childhood Kidney Diseases
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• 제14권1호
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• pp.94-99
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• 2010

Obesity-related glomerulopathy (ORG)는 단백뇨를 보이는 비만아에서 신장 조직학적 소견상 사구체 비대, 국소 분절성 사구체 경화 소견이 관찰되고 기저막 비후, 국소 간질조직 증식, 중등도의 발 돌기 소실 등을 보이는 질환으로 정의된다. 특발성 국소분절 사구체경화증과 비교하여 신증후군이 적으며 콜레스테롤 상승이 적고, 병의 진행이 느리다는 점에서 차이가 있다고 알려져 있으며, 체중감소를 통해 신장 기능이 회복될 수 있다고 알려져 있다. 본 증례의 9세된 비만아는 임상증상과 신장 조직검사에서 ORG로 진단되어 치료하였으나, 지속적인 체중 증가와 단백뇨로 말기 신부전으로 진행하여 소아 ORG 환아에서는 드문 경과를 취하여 이를 보고하는 바이다.

• 한국임상수의학회지
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• 제38권5호
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• pp.249-253
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• 2021

We describe the case of a Jindo dog that presented with a 2-month history of an abscess-like mass on the skin of the left hip. The patient was initially diagnosed with a suspected insect bite and was treated with a topical dressing. After observing no improvements, surgical debridement was done to remove the abscess. Nine days after surgery, the patient started showing severe anorexia, vomiting, lethargy, and oliguria. Azotemia was detected, and the patient was diagnosed with acute kidney injury. Ultrasonography depicted an abdominal mass (4.6 × 7.5 cm) in the right ureter, and severe hydronephrosis in the right kidney. The patient was euthanatized. Results of the necropsy, histopathologic examination, and immunohistochemistry for tumor cells, confirmed that the patient had developed hydronephrosis and disseminated histiocytic sarcoma which had metastasized to the lungs. To the best of our knowledge, this is the first report of acute renal failure produced by ureter invasion and urinary tract obstruction resulting from the abdominal mass of disseminated histiocytic sarcoma in dogs.

• Childhood Kidney Diseases
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• 제22권1호
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• pp.12-16
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• 2018

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital malformation syndrome that is characterized by a triad of uterine didelphys, blind hemivagina, and ipsilateral renal agenesis. There is a wide variety of phenotypic presentation which is recognized as a spectrum of disease rather than a separate entity. The exact incidence and pathogenesis of HWW syndrome are yet to be investigated. While this disease typically involves adolescent girls who present with abdominal pain or a pelvic mass that is secondary to hematocolpos, nowadays, a majority of potential patients with HWW are being prenatally screened for renal anomalies. Therefore, it is recommended to search for uterovaginal anomalies whenever a multicystic dysplastic kidney or the absence of a kidney is noted in a newborn female, and the role of pediatric nephrologists has become ever more important for early recognition of the disease.

• 한국임상약학회지
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• 제27권2호
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• pp.83-91
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• 2017

Background: Piperacillin/tazobactam (TZP) is an antibiotic against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. Due to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate and monitor TZP based on their renal functions and Body Mass Index (BMI) levels. The purpose of this study was to determine the appropriateness of administration doses of TZP based on renal functions of obese cancer patients in a tertiary hospital. Methods: This study was retrospectively conducted with obese cancer patients with $BMI{\geq}30kg/m^2$ in a tertiary hospital, Korea from September 2004 to August 2014. Data were collected through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Results: Among 7,058 patients during the study period, 102 prescriptions were selected based on inclusion and exclusion criteria and classified by their renal functions. Although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with $20mL/min{\leq}CrCl{\leq}40mL/min$ received domestically 4.5 g instead of 2.25 g as the TZP starting dose. Conclusion: The appropriate doses of TZP were administered to almost all of obese cancer patients; however, the recommended TZP dose was different between Korea and other countries by twice the amount. Further related studies are necessary to clearly determine the results, to optimize TZP treatment for obese patients with cancer in clinical practice, and to design and develop new TZP formulations for them in pharmaceutical industry.

• Nuclear Medicine and Molecular Imaging
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• 제43권6호
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• pp.588-591
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• 2009

A 26-year-old man with renal cell carcinoma underwent $^{99m}Tc$-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. $^{99m}Tc$-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. $^{99m}Tc$-HDP bone scintigraphy and $^{18}F$-FDG PET/CT were underwent for further evaluation. $^{99m}Tc$-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in $^{18}F$-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in $^{99m}Tc$-HDP bone scintigraphy and compare with $^{18}F$-FDG PET/CT.

• 한국임상수의학회지
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• 제24권1호
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• pp.51-55
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• 2007

A 13-year-old male Yorkshire terrier was Presented with Persistent weight loss anorexia and dark brown urine of 3-month duration. On physical examination, a firm oval mass was palpated at left renal region. In hematology and blood chemistry, neutrophilia, anemia, thrombocytopenia and elevation of ALKP were found. Abdominal radiography, ultrasonography and ultrasound-guided percutaneous pyelogram revealed masses originated from left kidney, mildly dilated renal Pelvis and intact ureter. Urinalysis showed hematuria and proteinuria. Because the state of dog became deteriorated during transfusion and the frail renal tumor was suspected to be the cause of inflammation and anemia, nephrectomy was performed. Renal masses, approximately $2{\times}3cm\;and\;5{\times}4cm$ respectively in size, was surrounded by swollen and congested mesentery and ascites. Metastatic lesion was not found in other organs. During recovery, the dog showed cardiopulmonary arrest and did not respond to critical care. Histologically the kidney was affected by necrotic and hemorrhagic change. This hemangiosarcoma most likely arose from the renal parenchyma resulting In diffuse lesions in the kidneys thought to be the cause of chronic anorexia and weight loss.

• 한국임상수의학회지
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• 제29권2호
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• pp.165-168
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• 2012

14년 령의 중성화 하지 않은 수컷 Siberian Husky는 1개월 전부터 혈뇨, 기면, 식욕부진을 보였다. 신체검사상 복부 팽만과 통증을 확인할 수 있었다. 혈액 및 혈청 화학 검사상 빈혈과 질소혈증을 확인할 수 있었다. 방사선 검사 상 신장의 비대를 확인할 수 있었으며 초음파 검사 상 피수질의 경계가 불분명하며 피질의 에코가 증가한 신장을 확인할 수 있었다. 뇨검사 상에서는 혈뇨와 단백뇨를 확인할 수 있었으며 초기의 감별 진단으로는 신부전, 방광염, 신우신염과 종양을 생각했다. 환자의 상태는 내원 후 계속적으로 악화되었으며 폐사했다. 부검 상에서 복강 내 출혈과 양측 신장의 종양을 확인할 수 있었다. 조직검사 상에서 혈관육종을 진단하였다. 본 증례에서는 개에서 비특이적으로 발생하는 양측성의 신장원성 혈관육종에 대해서 다룬다.

• 한국임상수의학회지
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• 제37권4호
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• pp.208-212
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• 2020

A 6-year-old castrated male Russian Blue cat was presented for evaluation of dyschezia. Abdominal ultrasound revealed hyperechoic nodules in both kidneys, heterogeneous mass in abdomen, and extensive mesenteric thickening with multiple hypoechoic nodules. Computed tomography showed multiple hypodense lesions in both kidneys and diffuse nodular infiltration around the mesentery. Fine needle aspirates (FNA) acquired under ultrasound guidance from the mesentery consisted of large lymphocytes which have round to irregular nuclei with granular chromatin, prominent nucleoli and a small amount of basophilic cytoplasm. Polymerase chain reaction (PCR) for antigen receptor gene rearrangement result of FNA sample revealed a T-cell malignancy. The cat died from acute renal failure after 1 cycle of modified Madison-Wisconsin L-CHOP protocol. Postmortem examination revealed bilaterally enlarged lumpy-bumpy shaped kidneys. Histopathologic examination showed an infiltration of malignant lymphocytes into the renal parenchyma and mesentery. Immunohistochemical staining of the renal sample displayed a negative expression of CD3, PAX5, MUM-1, and CD79. The clinical features and prognosis of the cat with renal lymphoma with mesenteric lymphomatosis have been described in this report.

• Korean Circulation Journal
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• 제54권3호
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• pp.113-123
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• 2024

Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA₂DS₂-VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions: ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.

• 대한영상의학회지
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• 제83권1호
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• pp.162-167
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• 2022

신장 점액종은 신장에서 발생하는 드문 양성 종양이다. 최근까지 영미권에서 적은 수의 증례 보고가 되어 있으나 대부분의 경우 비뇨의학적 혹은 병리학적으로 접근하여 점액종의 영상의학적 소견은 잘 분석되지 않았다. 우리는 62세 남자 환자에서 발생한 신장 점액종의 영상 소견을 보고하고자 한다. 해당 종양은 좌측 신장동에 위치하고 있었으며, 자기공명영상의 T2 강조영상에서는 중등도의 고신호강도로 T1 강조영상에서는 저신호강도로 보였다. 또한 종양은 역동적 조영증강 영상에서는 점진적인 조영증강을 보였다.