• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.10-17
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• 1980

Gentamicin is useful to the Gram negative bacterial infection, but its nephrotoxicity is a serious problem and the incidence is probably increasing. The toxicity of gentamicin to the kidney is site-specific to the proximal tubule. In this study, we measured daily peak and trough level of gentamicin, serum creatinine, serum $Beta_2$-microglobulin and 24-hr urine $Beta_2$-microglobulin in 10 gentamicin treated patients. All the patients had their peak levels of gentamicin in the safe therapeutic range, and their trough level showed no evidence of gentamicin accumulation. There was no patient who showed his daily serum creatinine and $Beta_2$-microglobulin rise significantly. But 24-hour urine $Beta_2$-microglobulin showed significant rise from basal level (mean $5.8{\pm}1.62{\times}$) on the 5 th day of gentamicin treatment. Thus, serial monitoring of proximal tubular function with urinary $Beta_2$-microglobulin excretion has potential value in the assessment of insults of gentamicin to this site. But clinical significance of raised urinary $Beta_2$-microglobulin excretion in relation to the serum creatinine should be further studied.

• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.81-86
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• 1985

To evaluate the significance of serum $beta_2-microglobulin$ in patients with various liver diseases, serum $\beta_2m$ levels were measured in 44 cases of normal controls, 32 cases of asymptomatic HBsAg carriers and 134 patients with various liver diseases, by radioimmunoassay using Phadebas $Beta_2-micro$ test kits. The following results were obtained: 1) The mean level of serum $\beta_2m$ was $1.39{\pm}0.25mg/l(Mean{\pm}S.D.)$ in normal controls ($1.39{\pm}0.23mg/l$ in 24 males, $1.38{\pm}0.27mg/l$ in 20 females). 2) The serum levels of $\beta_2m$ in patients with various liver diseases and asymptomatic HBsAg carriers were as follows; $1.40{\pm}0.27mg/l$ in asymptomatic HBsAg carriers, $2.42{\pm}0.37mg/l$ in 45 patients with acute viral hepatitis, $2.10{\pm}0.26mg/l$ in 46 patients with chronic persistent hepatitis, $2.60{\pm}0.34mg/l$ in 23 patients with chronic active hepatitis, and $2.60{\pm}0.49mg/l$ in 20 patients with liver cirrhosis. Serum $\beta_2m$ levels of each disease group were significantly higher than that of normal controls(p<0.001). 3) There was significant correlation between the levels of serum $\beta_2m$ and the degrees of lymphocytic infiltration in patients with chronic active hepatitis(p<0.001). 4) Significant correlations were observed between the levels of serum $beta_2-microglobulin$ and serum alanine aminotransferase(r=0.68, p<0.05) and bilirubin(r=0.63, p<0.05) in 15 patients with acute viral hepatitis. In conclusion, the serum $beta_2-microglobulin$ levels were increased in patients with various liver diseases, and it may serve as a new index of liver disease activity.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.191-201
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• 1989

Nowadays, in spite of the remarkable development of the results of open heart surgery, the incidence of postoperative acute renal failure [ARF] has been increased due to the expansion of the candidates and prolonged operation time for complicated cases. It is also well known that ARF after open heart surgery, if once occurred, is a critical complication, therefore early diagnosis and treatment about it are very important for prognosis. Recently a low molecular weight [2 * microglobulin [[2* MG]has been used as a indicator of renal function. Because of the properties of [2 * MG, serum concentration of it is increased in glomerular dysfunction and urine excretion of it is increased in tubular dysfunction. Author studied about the perioperative changes of serum [2* MG and BUN concentration in 25 children and 30 adults for evaluation of significances of [2* MG as a parameter of postoperative renal function in open heart surgery, and the results were obtained as follows. l. In open heart surgery, the serum [2* MG concentration was elevated postoperatively in the all cases from the first postoperative day. 2. There were a significant correlation between the preoperative BUN and [2* MG concentration [P< 0.01]. The correlation factor[r] in child group was 0.8512, and in adults 0.8636. 3. The maximum level of serum [2* MG in the both child and adult groups were noticed in 4th postoperative day as 2.61*0.80mg/ 1 in child group and 3.39*1.47 mg/ 4 in adult group, and there was a significant difference between the two groups statistically[P < 0.05]. 4. The pattern of changes of serum concentration of [2* MG with time was very similar with the changes of BUN, but in a case of ARF [expired with it] the changes of [2* MG was more remarkable. 5. There was a significant differences in the maximum level of [2* MG between the 2 group according to the ECC time [groups of below and above 60 minutes] [P< 0.01].

• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.127-136
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• 1985

To evaluate change of serum $beta_2-microglobulin$ concentration$(s\beta_2-MG)$ and the usefulness of $s\beta_2-MG$ and $s\beta_2-MG/serum$ creatinine concentration(sCr) ratio in various renal diseases, $s\beta_2-MG$ and sCr were measured in 25 normal controls and 90 patients of various renal diseases(16 cases of glomerulonephritis, 12 cases of acute renal failure, 8 cases of chronic renal failure, 24 cases of nephrotic syndrome, 15 cases of tubulointerstitial diseases and 15 cases of lupus nephritis) using $Phadebas^\circledR$ $Beta_2-Micro$ Test kits. The results were as follows; 1) In normal control, the mean value of $s\beta_2-MG$ was $1.65{\pm}0.41mg/l$ and the mean value of $s\beta_2-MG/sCr$ ratio was $0.14{\pm}0.05$. 2) In various renal diseases, the mean value of $s\beta_2-MG$ was $6.74{\pm}5.47mg/l$. The mean value of $s\beta_2-MG/sCr$ ratio was $0.24{\pm}0.11$ and significantly elevated than that of normal control. (p<0.05) 3) The correlation between $s\beta_2-MG$ and sCr in glomerular and tubulointerstitial disease was log $s\beta_2-MG-0.90$ log sCr-0.48 and its correlation coefficient was 0.78(p<0.05). 4) In glomerular disease, the correlation between $s\beta_2-MG$ and sCr was log $s\beta_2-MG-0.89$ log sCr-0.46(r - 0.76) and in tubulointerstitial disease, it was log, $s\beta2-MG-0.95$ log sCr-0.59 (r-0.87). There was no significant difference between the two groups(p<0.05). 5) Among 32 cases of glomerular and tubulointerstitial disease patients, whose sCr was within normal range, 17 cases showed elevated $s\beta_2-MG$. The mean values of $s\beta_2-MG/sCr$ ratio in these patients was $0.30{\pm}0.14$ and significantly elevated than that of normal control(p<0.05). 6) In 15 cases of lupus nephritis, 12 cases showed elevated $s\beta_2-MG$ with normal sCr and 12 cases showed elevated $s\beta_2-MG/sCr$ ratio. With above results, it was found that the $s\beta_2MG$ can be used as an index of glomerular filtration rate as in the case of sCr and that $s\beta_2-MG/sCr$ ratio can be used as a tool in early detection of slightly decreased glomerular filtration rate and in detection of the renal disease of increased $\beta_2-MG$ production.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.105-111
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• 2016

Background: Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. Methods: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. Results: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum ${\beta}2$-microglobulin levels than the non-UTI group ($1.56{\pm}0.43mg/L$ vs. $1.2{\pm}0.43mg/L$, p<0.028). Conclusion: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum ${\beta}2$-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

• Clinical and Experimental Pediatrics
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• v.56 no.1
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• pp.13-18
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• 2013

Purpose: Kawasaki disease (KD) is a systemic vasculitis and affects many organ systems. It often presents sterile pyuria, microscopic hematuria, and proteinuria due to renal involvement. The aims of this study were to define clinical characteristics of acute KD patients with pyuria and to analyze meaning of pyuria in KD. Methods: The medical records and laboratory findings including serum and urine test of 133 patients with KD admitted to Yeungnam University Hospital from March 2006 to December 2010 were reviewed retrospectively. Results: Forty patients had sterile pyuria and their clinical characteristics including age, gender and body weight were not significantly different with those who did not have pyuria. Fever duration after treatment was significantly longer in KD patients with pyuria. Erythrocyte sedimentation rate, C-reactive protein and serum concentration of alanine aminotransferase were significantly higher in patients with pyuria. Hyponatremia and coronary artery lesion were seen more often in patients with pyuria but there was no significant difference. Also serum blood urea nitrogen was significantly higher in KD patients with pyuria. Urine ${\beta}_2$-microglobulin was elevated in both patients groups and showed no difference between two groups. Conclusion: We found more severe inflammatory reaction in KD patients with pyuria. We also found elevation of some useful parameters like ${\beta}_2$-microglobulin that indicate renal involvement of KD through the urine test. Careful management and follow up will need for KD patients with pyuria and it is necessary in the future to study the specific parameters for renal involvement of KD.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.143-149
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• 2008

Purpose : Urinary N-acetyl-beta-D-glucosaminidase(NAG) and beta 2-microglobulin(B2M) is considered to be a marker of tubulointerstitial injury. The aim of this study was to examine the urinary levels of NAG and B2M in children with various renal diseases. Methods : We studied 21 children(8.9$\pm$4.5 years, Male:Female=14:7) and they were divided into three groups: group I(steroid-sensitive nephrotic syndrome-4 patients), group II(various kinds of glomerulonephritis-4 patients), and group III(normal urinalysis or non-glomerular renal diseases-13 patients). Results : Urinary NAG levels in groups I and II were significantly higher than those in group III(19.4$\pm$11.5 and 30.0$\pm$30.1 vs. 4.7$\pm$3.9, P=0.01), while urinary B2M levels did not differ among the 3 groups, although urinary NAG levels were positively correlated with urinary B2M levels(r=0.49, P=0.03). Urinary NAG and B2M levels were all correlated with proteinuria(r=0.79, P<0.001 and r=0.68, respectively, P=0.001) serum albumin(r=-0.72, P<0.001 and r=-0.57, respectively, P=0.01) and cholesterol(r=0.58, P=0.006 and r=0.56, respectively, P=0.013) levels. Conclusions : Urinary excretions of NAG and B2M are increased in children with steroidsensitive nephrotic syndrome and various kinds of glomerulonephritis, suggesting tubular dysfunction might be present in these diseases.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.133-137
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• 1998

Purpose : To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. Methods : 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine ${\beta}_2$-microglobulin/creatinine(${\beta}_{2}MG/cr$) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. Results : There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine ${\beta}_{2}MG/cr$ and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. Conclusion : There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.11 no.2
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• pp.153-160
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• 2001

Objectives : The authors evaluated the effects on renal function of workers chronically exposed to low-level organic solvent mixtures. Methods : The authors measured the level of urine ${\beta}2$-microglobulin(${\beta}2$-MG) and microalbumin as biochemical markers of renal function and damage in 29 male workers exposed to organic solvents for more than five years and compared their results with those of 30 male office clerks as a reference group. Results : 1. The mean values of hemoglobin, hematocrit, SGOT, SGPT, ${\gamma}$-GTP were all within normal limits and there was no significant difference, except for hemoglobin(p<0.01), between exposed and reference group. 2. The values of BUN and serum creatinine were within reference limits and there was no significant difference between exposed and reference group. 3. The difference of mean values of urine microalbumin corrected by urine creatinine were statistically significant (p<0.01), but those of urine ${\beta}2$-MG was not. 4. There were no correlation of urine hippuric acids with BUN, serum creatinine, urine microalbumin and ${\beta}2$-MG. 5. There were no significant difference of BUN, serum creatinine, urine microalbumin and ${\beta}2$-MG upon work duration. Conclusions: It is assumed that chronic low-level organic solvent exposure in these workers shows early renal dysfunction, glomerular changes. The result corresponds to previous studies showing the relationship between hydrocarbon exposure and glomerulonephritis. For evaluation of impairment on kidney tubules, we need further study using more precise markers and long-term follow-up.

• Clinical and Experimental Pediatrics
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• v.55 no.4
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• pp.136-142
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• 2012

Purpose: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG) and ${\beta}_2$-microglobulin (${\beta}_2$-M) was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR) urinary NAG, and urinary ${\beta}_2$-M. Methods: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr), serum cystatin C, urinary ${\beta}_2$-M and urinary NAG were measured. Results: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Sch$\ddot{o}$nlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; $P$ <0.01), and between the GFR (as determined by Schwartz method) and urinary NAG (r=-0.821; $P$ <0.01). In addition, there was a significant correlation between the GFR (as determined by Bokencamp method) and urinary NAG (r=-0.858; $P$ <0.01). Conclusion: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary ${\beta}_2$-M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.