• 제목/요약/키워드: Renal recovery

검색결과 92건 처리시간 0.02초

유소아 신질환에서 치료후 신기능회복에 대한 $^{99m}Tc$-DMSA 신티그램의 임상적 고찰 ($^{99m}Tc$-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children)

  • 문태용;손현주;김인주;윤종병;이석홍;김병수
    • 대한핵의학회지
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    • 제28권1호
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    • pp.69-74
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    • 1994
  • 유소아 신질환에서 치료후 신기능회복을 관찰하기 위하여 $^{99m}Tc$-DMSA 신스캔을 추적 검사하였다. 치료전과 치료후에 $^{99m}Tc$-DMSA 신스캔을 시행한 9세 이하의 유소아환자는 15명 20예였다. 이들중 10명이 방광요관역류증으로 코헨식요관방광조구술을, 2명의 수신증은 신우성형술을, 1명은 좌요관신우연결부협착증으로 항생제로 치료하였다. $^{99m}Tc$-DMSA 신스캔상 정량적 신섭취율은 y=0.591x-2.105의 회귀 방정식을 이용하여 구하였다. 질병에 이환되어 치료를 받은 환신은 모두 29개였으며, 치료후 $^{99m}Tc$-DMSA 신스캔상 섭취증가를 나타내어 신기능 회복으로 나타내었던 신장은 20개 (69%)였다. 신기능회복소견을 보였던 예들은 연령에 따른 회복의 차이도 없고 치료후 시간경과에 따른 회복의 차이도 없었다. 유소아 신질환에서 $^{99m}Tc$-DMSA 신스캔은 측정상의 큰 오차로 치료후 미세한 신기능회복을 평가하는데는 도움이 되지 않았다.

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한국형(韓國型) 출혈열(出血熱)에서의 Renogram에 대(對)한 연구(硏究) (A Study of Renogram in Korean Hemorrhagic Fever)

  • 최태규;이정상;고창순;이문호
    • 대한핵의학회지
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    • 제8권1_2호
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    • pp.13-24
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    • 1974
  • The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using $^{131}I$-ortho-iodohippurate and hippuran renogram was analysed by means of quantitative and qualitative methods in 26 patients of Korean hemorr hagic fever. The results obtained with this study were as follows; 1. During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairement of renal function and grave prognosis than the group with obstructive pattern of renogram. 2. During the diuretic phase, the renogram showed obstructive or dysfunction or normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3. During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunnction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4. The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5. There was significant correlationship between the pattern of renogram and the decreace of renal plasma flow in the patients with Korean hemorrhagic fever. The decreace of renal plasma flow was maked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairement, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

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Effect of Cisplatin on $Na^+/H^+$ Antiport in the OK Renal Epithelial Cell Line

  • Kim, Jee-Yeun;Park, Yang-Saeng
    • The Korean Journal of Physiology and Pharmacology
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    • 제2권1호
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    • pp.69-76
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    • 1998
  • Cis-diamminedichloroplatinum II (cisplatin), an effective antitumor agent, induces acute renal failure by unknown mechanisms. To investigate direct toxic effects of cisplatin in the renal proximal tubular transport system, OK cell line was selected as a cell model and $Na^+/H^+$ antiport activity was evaluated during a course of cisplatin treatment. The cells grown to confluence were treated with cisplatin for 1 hour, washed, and incubated for up to 48 hours. At appropriate intervals, cells were examined for $Na^+/H^+$ antiport activity by measuring the recovery of intracellular pH (pHi) after acid loading. Cisplatin of less than 50 ${\mu}M$ induced no significant changes in cell viability in 24 hours, but it decreased the viability markedly after 48 hours. In cells exposed to 50 ${\mu}M$ cisplatin for 24 hours, the $Na^+-dependent$ pHi recovery (i.e., $Na^+/H^+$ antiport) was drastically inhibited with no changes in the $Na^+-independent$ recovery. Kinetic analysis of the $Na^+-dependent$ pHi recovery indicated that the Vmax was reduced, but the apparent Km was not altered. The cellular $Na^+$ and $K^+$ contents determined immediately before the transport measurement appeared to be similar in the control and cisplatin group, thus, the driving force for $Na^+-coupled$ transport was not different. These results indicate that cisplatin exposure impairs the $Na^+/H^+$ antiport capacity in OK cells. It is, therefore, possible that in patients treated with a high dose of cisplatin, proximal tubular mechanism for proton secretion (hence $HCO_3^-$ reabsorption) could be attenuated, leading to a metabolic acidosis (proximal renal tubular acidosis).

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Glycerol-유도 급성신부전에서 표피성장인자 발현 및 조직학적 변화에 관한 스쿠알렌의 효과 (Effects of Squalene on The Epidermal Growth Factor (EGF) Expression and Histological Changes by Glycerol-Induced Acute Renal Failure in Mice)

  • 최영복;김영호;이준행;김종세
    • Applied Microscopy
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    • 제34권4호
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    • pp.241-254
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    • 2004
  • 신장은 독성물질, 빈혈, 재관류-유도 상해, 급성신부전에 회복 기능을 가지고 있다. 뇨 표피성장인자(EGF)는 신장 사구체연접장치에서 생산된다. 신장은 EGF를 축적하거나 배설한다. 신장 질환의 경우에는 EGF 배설이 감소한다. 본 연구에서는 glycerol-유도 급성신부전에서 스쿠알렌의 효과를 연구하였다. In vitro에서 RT-PCR를 통해 EGF 발현을 관찰하였다. 근위세뇨관 세포를 분리한 후, glycerol (1, 2, 4 mM) 혹은 스쿠알렌(0.1, 0.05 or 0.1%)을 첨가하였다. In vivo에서 BUN, creatine, 조직학적 변화를 관찰하였다. 실험군은 다음과 같다. 실험군 1은 정상군, 실험군 2는 glycerol (50%, 8 ml/kg) 처치 후, 스쿠알렌을 처치하지 않은 군, 실험군 3은 glycerol (50%, 8 ml/kg) 처치 후, 스쿠알렌(180 mg/kg)을 함께 처치한 군으로 각 실험군 당 생쥐 7마리를 사용하였다. 실험 결과, glycerol이 신장에 손상을 주어 EGF mRNA 발현이 감소됨을 확인할 수 있었다. 그러나, 스쿠알렌을 처치한 군에서는 EGF mRNA 발현이 증가함을 관찰할 수 있었다. 또한, BUN과 creatine 수치의 빠른 회복이 관찰되었다(P<0.01). 조직학적 관찰에서도 실험군 2는 사립체의 심한 손상이 관찰되었는데, 실험군 3의 경우 사립체의 빠른 회복이 관찰되었다. 결론적으로, 스쿠알렌이 glycerol-유도 급성신부전에 회복 효과가 있을 것으로 사료된다.

패혈증과 신부전에서 회복된 환자에서 급속하게 발생한 미만성 심근 석회화: 증례 보고 (Rapid Development of Diffuse Myocardial Calcification in a Patient after Recovery from Sepsis and Renal Failure: A Case Report)

  • 강미현;김성수;선병주;박재형
    • 대한영상의학회지
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    • 제83권5호
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    • pp.1104-1108
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    • 2022
  • 심근 석회화는 다양한 원인으로 인해서 발생할 수 있다. 하지만 패혈증과 신부전으로 인해서 발생하는 경우는 흔하지 않다. 저자들은 컴퓨터단층촬영과 자기공명영상에서 패혈증과 신부전을 회복한 환자에서 급속하게 좌심실벽에 미만성 석회화를 보이는 증례를 보고하고자 한다.

Clinical Comparison of 30-Day Mortalities and 6-Month Functional Recoveries after Spontaneous Intracerebral Hemorrhage in Patients with or without End-Stage Renal Disease

  • Kim, Kang Rae;Kim, Young Zoon
    • Journal of Korean Neurosurgical Society
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    • 제54권3호
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    • pp.164-174
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    • 2013
  • Objective : The aim of this study was to determine 30-day mortality and 6-month functional recovery rates in spontaneous intracerebral hemorrhage (S-ICH) patients undergoing hemodialysis treatment for end-stage renal disease (ESRD), and to compare the outcomes of these patients and S-ICH patients without ESRD. Methods : The medical records of 1943 S-ICH patients from January 2000 to December 2011 were retrospectively analyzed with focus on demographic, radiological, and laboratory characteristics. Results : A total of 1558 supratentorial S-ICH patients were included in the present study and 102 (6.5%) were ESRD patients. The 30-day mortality of the S-ICH patients with ESRD was 53.9%, and 29.4% achieved good functional recovery at 6 months post-S-ICH. Multivariate analysis showed that age, Glasgow Coma Scale (GCS) score, pupillary abnormality, ventricular extension of hemorrhage, hemorrhagic volume, hematoma enlargement, anemia, and treatment modality were independently associated with 30-day mortality in S-ICH patients with ESRD (p<0.05), and that GCS score, volume of hemorrhage, conservative treatment, and shorter hemodialysis duration was independently associated with good functional recovery at 6 months post-S-ICH in patients with ESRD (p<0.05). Conclusion : This retrospective study showed worse outcome after S-ICH in patients with ESRD than those without ESRD; 30-day mortality was four times higher and the functional recovery rate was significantly lower in S-ICH patients with ESRD than in S-ICH patients without ESRD.

Primary Subcapsular Reflux as an Etiology of Subcapsular Renal Abscess

  • Yoo, Eun Ju;Oh, Jae Hyuk;Jung, Hyun Joo;Lee, Su Jin;Park, Ji Eun;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • 제25권2호
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    • pp.133-139
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    • 2021
  • Herein, we report two rare cases of renal infection. The first case was renal subcapsular urine reflux in a 8-month-old girl with recurrent urinary tract infection and the second was subcapsular abscess in a 14-year-old girl with diabetes, who was successfully treated with percutaneous drainage. It has been suggested that renal subcapsular abscesses could be caused by the direct reflux of urine into the subcapsular space, rather than spread of infection from an existing parenchymal lesion, and that complete recovery can be achieved if percutaneous drainage is performed in a timely manner. We propose primary subcapsular reflux, in which urine directly refluxes upwards into the subcapsular space of the kidney, as one of the mechanisms for development of renal subcapsular abscesses.

개심술시 체외순환이 신장기능에 미치는 영향 (Effect of the Extracorporeal Circulation on Renal Function in Adult Open Heart Patients)

  • 이재원;서경필
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.718-731
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    • 1985
  • Renal dysfunction is a common complication of open-heart surgery: a form of controlled hemorrhagic shock, and successful perioperative management of renal dysfunction depends on recognition of the risk factors and optimal management of factors influencing renal function, including cardiopulmonary bypass, and early detection of renal failure. Changes in renal functional parameters including Ccr, Cosm, CH2O, FENa, and RFI were observed prospectively in forty five patients operated on at Dept. of Thoracic and Cardiovascular Surgery, S.N.U.H., from April to June, 1985. They were 23 males and 22 females with 35 acquired and 10 congenital heart diseases and the mean age and body surface area of them were 38.010.3 years [22-63] and 1.5518 M2[1.151.92] respectively. Followings are the conclusion. 1. The Ccr, representative of renal function, is significantly improved from 90.231.3 ml/min/M2 preoperatively to 101.536.4 ml/min/M2 postoperative and day [P<0.05], and all patients were classified as postoperative renal functional class I of Abel, which representing adequate renal protection during our cardiopulmonary bypass. 2. The Cosm is significantly elevated at immediate postperfusion time and remained high at postoperative one day representing osmotic diuresis at that time, but CH2O shows no significant changes at immediate postperfusion period and is decreased significantly at postoperative one day, representing recovery of renal concentrating ability at that time with decreasing urine flow. 3. The absolute value and changing tendency in FENa and RFI during perioperative period shows no diagnostic reliability on these parameters, but those of CH2O appear to reveal future renal function more accurately than Ccr 4. The depth of hypothermia may be protective upon renal function against the ill effects of prolonged nonpulsatile cardiopulmonary bypass. 5. The depth of the hypothermia, pump time of more than 150 minutes, poor cardiac function, and intraoperative events such as embolism appear to be related with immediate postperfusion renal function. 6. Hemoglobinuria and hemolysis, poor preoperative renal function, history of cardiac surgery, and massive transfusion associated with bleeding appear not to be related with renal dysfunction.

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급성신우신염 환아에서 DMSA 스캔상 발견된 신결손의 예후 인자 (Prognostic Factors of Renal Defects on the Initial DMSA Scan in Children with Acute Pyelonephritis)

  • 서영선;권덕근;신윤혜;배기수
    • Childhood Kidney Diseases
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    • 제14권2호
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    • pp.195-202
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    • 2010
  • 목 적 : 요로감염 환아에서 영구적 신장손상을 예측하기 위하여, 연령, 발열기간 및 농뇨 지속기간, 방광요관역류나 수신증 여부 등을 비교, 분석하였다. 방 법 : 2000년 1월부터 2005년 1월까지 아주대학교 병원에서 요로감염으로 입원한 환아 중 DMSA에서 신장 결손을 보인 160명의 환아를 대상으로 6개월 후 추적 DMSA에서 회복된 회복군과 반흔이 남은 반흔군으로 나누어 각각의 특징을 비교분석하였다. 결 과 : 전체 대상 환아 160명 중 106명이 추적 DMSA에서 회복을 보였고, 54명이 반흔이 남아 33.8%의 발생률을 보였다. 반흔군에서 처음 진단 당시의 나이가1세 이상인 환자가 회복군에 비해 많았고(P=0.01), 발열기간, 농뇨지속 기간 등이 회복군에 비해 길었으며, 발열의 기왕력이 있었다. VCUG, Ultra-sound sonography에서도 반흔군이 회복군에 비해 비정상적 결과를 보인 경우가 많았다. 결 론 : 급성신우신염을 앓은 소아에서 감염당시 환아의 나이가 많을수록, 발열 기간이나 농뇨 지속 기간이 오래 될수록, 방광요관역류나 초음파검사 이상소견이 있는 초기 신결손이 신반흔으로 고착되는 경향을 확인할 수 있었다. 특히 잦은 발열 기왕력이 있는 경우 신손상 발생률이 높은 것을 볼 때, 이는 임상에서 미처 진단되지 못한, 혹은 잘 못 진단된 급성신우신염이 있음을 시사해 준다.

Severely modified lipoprotein properties without a change in cholesteryl ester transfer protein activity in patients with acute renal failure secondary to Hantaan virus infection

  • Kim, Ji-Hoe;Park, Hyun-Ho;Choi, In-Ho;Kim, Young-Ok;Cho, Kyung-Hyun
    • BMB Reports
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    • 제43권8호
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    • pp.535-540
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    • 2010
  • Patients with hemorrhagic fever with renal syndrome (HFRS) often exhibit altered serum lipid and lipoprotein profile during the oliguric phase of the disease. Serum lipid and lipoprotein profiles were assessed during the oliguric and recovery phases in six male patients with HFRS. In the oliguric phase of HFRS, the apolipoprotein (apo) C-III content in high-density lipoproteins (HDL) was elevated, whereas the apoA-I content was lowered. The level of expression and activity of antioxidant enzymes were severely reduced during the oliguric phase, while the cholesteryl ester transfer protein activity and protein level were unchanged between the phases. In the oliguric phase, electromobility of $HDL_2$ and $HDL_3$ was faster than in the recovery phase. Low-density lipoprotein (LDL) particle size was smaller and the distribution was less homogeneous. Patients with HFRS in the oliguric phase had severely modified lipoproteins in composition and metabolism.