• Childhood Kidney Diseases
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• 제17권1호
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• pp.13-18
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• 2013

발세포병증은 발세포의 손상을 특징으로 하는 사구체질환이다. 발세포의 손상은 여러 사구체질환에서 관찰될 수 있으나, 미소변화질환과 FSGS에서 주요 병인으로 작용한다. 이 글에서는 FSGS에서 발세포 손상의 형태 변화와 분절경화의 유형을 설명하고자 한다. 발세포가 손상되면 형태 변화로 발돌기의 소실, 발세포 세포질 내 공포, 발세포하 낭 등이 관찰되며, 심하면 발세포의 탈락 및 자멸사가 관찰된다. 그러나 분절경화가 초래되기까지에는 일정 수준 이상의 발세포의 소실이 있어야 하며, 손상된 발세포는 동일한 사구체 소엽 내 주변 발세포로 손상을 전파하여 병변이 커지게 된다. FSGS는 광학현미경 소견을 기초로 NOS형, perihilar형, cellular형, tip형, collapsing형의 다섯 가지 유형으로 나뉜다. 각 아형에 따라 임상 경과나 스테로이드 치료에 대한 반응이 다르고 흔히 동반되는 임상 조건들도 다르다고 보고되었으나 이에 대하여는 아직도 논란이 있는 실정이다. 앞으로 FSGS 발생에 관여하는 유전 정보와 혈액 내 투과인자의 성분 등 관련된 인자들에 대한 체계적인 연구가 이루어지면 FSGS에서 관찰되는 조직 변화나 병태생리를 더 잘 설명할 수 있을 것으로 기대해 본다.

• Advances in pediatric surgery
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• 제11권2호
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• pp.115-122
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• 2005

Falls from a height are the leading cause of injury and death among urban children. This study describes the incidence, clinical characteristics, and treatment results of children under 15 year of age who fell from a height of more than one meter and were admitted for abdominal injury. The medical records of 585 consecutive patients treated between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. The falling heights were 1 to 31.2 meters, and 28 patients(4.8 %) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The median age of the victims was 5.5 years, and the median height fallen was 3 meters. Fifteen patients (53.6 %) were injured during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3 %) of falls occurred in residential place and 19(67.8 %) of patients arrived at the emergency department within 30 minutes of the accident. Only 16 patients (57.1 %) complained of abdominal pain. Liver injuries were found in 12(42.9 %), spleen injuries in 5(17.9 %), kidney injuries 3(10.7 %), pancreatic injuries in 1(3.6 %) and nonspecific abdominal injuries in 9(32.1 %) cases. Increased SGOT and SGPT were found in 23(82.2 %) and 18(64.3 %) cases. Eleven patients (39.3 %) had associated head injuries. Limb injuries were present in 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3 %) recovered without operation. The median length of hospital stay was 6 days (2 -20 days). Despite the absence of abdominal symptoms or shock, falls from a height in children may carry significant intra-abdominal organ injuries. The height falling could not predict the degree of the abdominal injury. For the evaluation of potential abdominal injuries, CT scan should be utilized.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• 대한방사선치료학회지
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• 제5권1호
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• pp.120-125
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• 1992

홍삼 추출물의 방사선(5Gy)에 조사된 생쥐의 효소활성에 미치는 영향을 관찰하기 위하여 ICR계 생쥐를 대상으로 생리적 식염수구를 대구조로 하여, 홍삼 엑기스를 살균수 $10m{\ell}$에 50mg에 녹여, 매일 각각 $0.1m{\ell}$씩 10일간 복강내에 홍삼추출물 투여구와 방사선만을 조사한구 및 홍삼추출물 투여 후 방사선 조사구등 4그로 나누어 1일, 4일, 9일, 17일 및 30일 등 5회에 걸쳐 생체의 조직 중 간, 신장에서의 GOT, GPT의 활성을 측정하여 결과를 얻었다. GOT의 활성도 변화는 간, 신장에서 초기에 현저히 증가했으며 이후 회복하는 경향이었다. 방사선 조사구들에서는 홍삼추출물 투여구가 방사선만 조사한구보다 빠르게 회복하는 경향이었다. GPT 활성도 변화는 간, 신장에서 모두 초기에 증가하다가 점차 회복하는 경향이었으며 홍삼추출물 투여 후 방사선 조사구가 방사선만 조사한구보다 빠르게 회복하는 경향이었다. 이러한 결과로 볼 때 홍삼 추출물은 방사선 조사에 의하여 기인된 간 및 신장의 GOT와 GPT 활성도 회복에 효과가 있다고 생각된다.

• 동의생리병리학회지
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• 제23권1호
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• pp.166-173
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• 2009

Cyclosporine(CsA) is an immunosupressant drug widely used in post-allogeneic organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It has been studied in transplants of skin, heart, kidney, liver, lung, pancreas, bone marrow and small intestine. Initially isolated from a Norwegian soil sample, Both kidney and liver dysfunction are prominent side effects of CsA. The present study was designed to determine the possible protective effect of salidroside(Sal) isolated from the BuOH extract of Acer termentosum Max against oxidative damage in CsA-treated(50 mg/kg, ip) nephrotoxicity rats. Results showed oral administration of methanol and butanol extact of Acer termentosum Max(200 mg/kg, po) significantly reduced activities of marker enzymes(BUN, Creatinine) and LDH activity in serum to CsA induced experimental kidney injured rats. And significantly decrcease of protein amount level in urine and activities of free radical formation enzyme were significantly improved by the treatment of Sal. And significantly decrcease of MDA level in kidney and activities of calalase, glutathione peroxidation and SOD were significantly improved by the treatment of Sal(20 mg/kg, po). But glutathione concentration and glutathione S-transferase actitity was not affected. Results of this study revealed that Sal could afford a significant protection in the alleviation of CsA-induced nephrotoxicity injury.

• 한국환경보건학회지
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• 제20권2호
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• pp.64-72
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• 1994

Tolerance to toxic effects of cadmium (Cd), including lethality has been shown following pretreatment with cadmium and zinc. This study was designed to determine if tolerance also develops to Cd-induced hepatotoxicity and renal toxicity. Three groups of rats (A, B, C), each consisting of 108 rats, were studied and each group was divided into three subgroups (1, 2, 3), 12 rats for each subgroup. Rats were subcutaneously pretreated with saline (A), CdCl$_2$ (0.5 mg/kg, B), and ZnCl$_2$ (13.0 mg/kg, C) during time periods of 5 days. At the end of the period, rats were challenged with CdCIa (3.0 and 6.0 mg/kg) by intraperitoneal injection. As for the cadmium levels in rat tissues after pretreatments, it was highest in the liver. Then kidney, heart, blood and muscle followed it in that order. After 24, 48 and 96 hours of intraperitoneal injection by challenge doses the concentration of cadmium in liver and kidney increased proportionally to the increase of challenge dosage. However metallothioneins in liver and kidney were increased by the pretreatment of cadmium and zinc. These data indicate the liver is a major target organ of acute Cd poisoning, and suggest that cadmium induced hepatic injury, via release of Cd-MT, may play and important role in the nephrotoxicity observed in response to short-term exposure to cadmium. This result suggests that increasing cadmium concentrations, gradually accumulating in liver and kidney as the result of the pretteatmerit, served to induced the synthesis of metallothionein, thus making them resistant to the challenge from cadmium.

• 한국환경보건학회지
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• 제21권3호
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• pp.1-15
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• 1995

Tolerance to toxic effects of cadmium(Cd), including lethality has been shown following pretreatment with cadmium and zinc. This study was designed to determine if tolerance also develops to Cd-induced hepatotoxicity and renal toxicity. Three groups of rats(A, B, C), each consisting of 52 rats, were studied and each group was divided into three subgroups(1,2,3), 28 rats for each subgroup. Rats were subcutaneously pretreated with saline(A), $CdCl_2$(0.5 mg/kg, B), and $ZnCl_2$(13.0 mg/kg, C) during time periods of 5 days. At the end of the period, rats were challenged with $CdCl_2$(3.0 and 6.0 mg/kg) by intraperitoneal injection. As for the cadmium levels in rat tissues after 1,3,5,6 days of pretreatments, it was highest in the liver. Then kidney, heart, blood and muscle followed it in that order. After 24, 48 and 96 hours of intraperitoneal injection by challenge doses the concentration of cadmium in liver and kidney increased proportionally to the increase of challenge dosage. However metallothioneins in liver and kidney were increased by the pretreatment of cadmium and zinc. These data indicate the liver is a major target-organ of acute Cd poisoning, and suggest that cadmium induced hepatic injury, via release of Cd-MT, may play an important role in the nephrotoxicity observed in response to short-term exposure to cadmium. This result suggest that increasing cadmium concentrations, gradually accumulating in liver and kidney as the result of the pretreatment, served to induce the synthesis of metallothionein, thus making them resistant to the challenge from cadmium.

• 사상체질의학회지
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• 제23권1호
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• pp.53-62
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• 2011

1. Background: This is the first documented study on the four medications for the Mangeum symptomatology (亡陰證) in the Soyangin disease category. The four medications, Hyeongbangsabaek-san (荊防瀉白散), Jeoryeongchajeonja-tang (猪苓車前子湯), Hyeongbangjihwang-tang (荊防地黃湯), and Hwalseokgosam-tang (滑石苦蔘湯), were comparatively analyzed on their compositive principles and respective symptomatologies. 2. Methods: Previous literature, including classical works on earlier Sasang Constitutional Medicine (different editions of Donguisusebowon and Dongmuyugo), were reviewed for relevant material on the Mangeum medications. 3. Results and Conclusions: 1) Hyeongbangsabaek-san (荊防瀉白散) is used in pathologies of early stages of invasion of the internal heat in the lower-most burn-center (locus related to the Kidney system). 2) Jeoryeongchajeonja-tang (猪苓車前子湯) is used when pathogenic dampness-heat invades the lower-most burn-center (locus related to the Kidney system). 3) Hyeongbangjihwang-tang (荊防地黃湯) is used to treat deficient heat involving injury of the lower-most burn-center (locus related to the Kidney system). 4) Hwalseokgosam-tang (滑石苦蔘湯) is used when the lower-most burn-center (locus related to the Kidney system) is in the early stages of exhaustion, expecially accompanied by concomitant dampness-heat. 5) The Mangeum symptomatology (亡陰證) was fully understood only after the completion of the 1901 Sinchuk edition (辛丑本) of Donguisusebowon (東醫壽世保元).

• Journal of Ginseng Research
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• 제37권2호
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• pp.187-193
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• 2013

The effect of Korean red ginseng (KRG) on diabetic renal damage was investigated using streptozotocin (STZ)-induced diabetic rats. The diabetic rats showed loss of body weight gain, and increases in kidney weight and urine volume, whereas the oral administration of KRG at a dose of 100 or 250 mg/kg of body weight per day for 28 d prevented these diabetes-induced physiological abnormalities. Among the kidney function parameters, elevated plasma levels of urea nitrogen and creatinine in diabetic control rats tended to be lowered in KRG-treated rats. In addition, administration of KRG at a dose of 100 mg/kg body weight in the diabetic rats showed significant decreases in serum glucose and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), implying that KRG might prevent the pathogenesis of diabetic complications caused by impaired glucose metabolism and oxidative stress. KRG also significantly reduced advanced glycation end product (AGE) formation and secretion from kidney of diabetic rats. Furthermore, KRG decreased the levels of N-(carboxymethyl) lysine and expression of AGE receptor. KRG also reduced the overexpression of cyclooxygenase-2 and inducible nitric oxide synthase in the kidney via deactivation of nuclear factor-kappa B. We also found that KRG prevented STZ-induced destruction of glomerular structure and significantly suppressed high glucose-induced fibronectin production. Taken together, KRG ameliorates abnormalities associated with diabetic nephropathy through suppression of inflammatory pathways activated by TNF-${\alpha}$ and AGEs. These findings indicate that KRG has a beneficial effect on pathological conditions associated with diabetic nephropathy.

• BMB Reports
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• 제52권9호
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• pp.554-559
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• 2019

Despite reports suggesting that tissue-resident natural killer (trNK) cells cause ischemic kidney injury, their contribution to the development of tubulointerstitial fibrosis has not been determined. This study hypothesized that the depletion of trNK cells may ameliorate renal fibrosis by affecting transglutaminase 2/syndecan-4 interactions. Aristolochic acid nephropathy (AAN) was induced in C57BL/6 mice as an experimental model of kidney fibrosis. The mice were treated with anti-asialo GM1 (ASGM1) or anti-NK1.1 antibodies to deplete NK cells. Although both ASGM1 and NK1.1 antibodies suppressed renal $NKp46^+DX5^+$ NK cells, renal $NKp46^+DX5^-$ cells were resistant to suppression by ASGM1 or NK1.1 antibodies during the development of tubulointerstitial fibrosis in the AAN-induced mouse model. Western blot analysis showed that both antibodies increased the expression of fibronectin, transglutaminase 2, and syndecan-4. These findings indicate that trNK cells played an exacerbating role in tubulointerstitial fibrosis by activating transglutaminase 2 and syndecan-4 in the AAN-induced mouse model.