• Title/Summary/Keyword: kidney surgery

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Amelioration Effects of Irrigation-Aspiration on Renal Ischemia-Reperfusion Injury in Canine Model (개에서 신장의 허혈-재관류 손상에 대한관류-흡인의 감소효과)

  • Lee, Jae-Il;Son, Hwa-Young;Jeong, Seong-Mok;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.257-262
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    • 2008
  • Renal ischemia-reperfusion injury is great clinical important because viability of the transplanted organ depends on the tolerance of the graft to ischemia-reperfusion injury, an inevitable processing during surgery. The purpose of this study was to investigate the effects of irrigation-aspiration in ischemia-reperfusion injury model induced by cross-clamping of renal vessels. Blood samples were collected from these dogs for measurement of kidney function and antioxidant enzyme activity, and RI at the intrarenal artery was measured at different time intervals. And the kidneys were taken for histopathologic evaluation at day 14. Kidney function (Cr and BUN) showed a significant increasing in untreated group compared to treated group. Resistive index of intrarenal artery was no significant difference among the groups. Activity of antioxidant enzymes in plasma was significant decrease in untreated group compare to control group while in treated group was no significant difference compared to control group. In histopathologic finding, treated group was showed less damage than that of untreated group. This result suggests that the processing of irrigation-aspiration is useful to reducing ischemia-reperfusion injury.

Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw

  • Kim, Yun-Ho;Park, Han-Kyul;Choi, Na-Rae;Kim, Seong-Won;Kim, Gyoo-Cheon;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.16-22
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    • 2017
  • Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and 'responder group' and 'non-responder group,' but there was no significant difference with the 'worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage. Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

Prognosis in the Patients with Prolonged Extracorporeal Membrane Oxygenation

  • Kim, Tae-Hun;Lim, Cheong;Park, Il;Kim, Dong-Jin;Jung, Yo-Chun;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.236-241
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    • 2012
  • Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.

Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

Nature of Lesions Undergoing Radical Nephrectomy for Renal Cancer

  • Mustafa, Gunes;Ilhan, Gecit;Necip, Pirincci;Kerem, Taken;Kadir, Ceylan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4431-4433
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    • 2012
  • Aim: The aim of the present study was to evaluate retrospectively histopathologically-diagnosed lesions that were detected in the kidney after radical nephrectomy for a preoperative diagnosis of kidney cancer. Methods: The medical records of 83 patients (51 male, 32 female) were included. Preoperative staging was accomplished by various methods including physical examination, blood hemography and biochemistry, abdominal ultrasonography (US), chest x-ray, abdominal computed tomography (CT) and abdominal magnetic resonance imaging (MRI). Results: Totals of 70 patients underwent radical nephrectomy and 13 nephron sparing surgery. Of the 83 patients, 70 had malignant lesions (renal cell carcinoma, squamous cell carcinoma or other malignancies) 13 had a variety of benign lesions, the most frequently detected being oncoytoma (6), angiomyolipoma (3), xanthogranulamatous pyelonephritis (2), cortical cyst (1) and chronic pyelonephritic change (1). Conclusion: It was concluded that in spite of great technological developments regarding radiological imaging modalities such as US, CT and MRI, benign lesions might still be detected pathologically in patients who undergo radical nephrectomy with the preoperative diagnosis of renal cancer. But, all renal masses should be regarded as malignant and should be managed surgically otherwise proven benign.

$^{18}F$-FDG PET/CT Finding in a Case of Xanthogranulomatous Pyelonephritis (황색육아종성 신우신염 환자의 $^{18}F$-FDG PET/CT 소견 1예)

  • Choi, Bong-Hoi;Hong, Sun-Pyo;Yoon, Joon-Kee;Pai, Ki-Soo;Hong, Jeong;Yim, Hyun-Ee
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.150-153
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    • 2009
  • Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased $^{18}F$-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of $^{18}F$-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.

A Study on Evaluation of Isolated Rabbit Kidney Function with Computed $^{99m}Tc-DTPA$ Scintigraphy ($^{99m}Tc-DTPA$ Scintigraphy에 의한 분리보존가토신의 기능평가에 관한 연구)

  • Chung, Sun-Il;Ha, Woo-Song
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.95-100
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    • 1991
  • Computerized scintigraphv using $^{99m}Tc-DTPA$ was performed to 37 isolated rabbit kidneys after preservation for 48 hours in perfusates differing in their compositions, i. e., Group 1 (N 9) in Collins' solution, Group 2 (N 10) in Collins' plus trifluoperazine, Group 3 (N 9) in Collins' plus urokinase and Group 4 (N 9) in Collins pius urokinase plus verapamil. Satisfactory images, and statistically analyzable quantitative indices such as perfusion score, filtration rate and cortical uptake ratio (CUR) were obtained by the evaluations of first-pass perfusion, equilibration slopes and postequilibration images. Significant improvements in CUR were observed by adding trifluoperazine (Group 2) and urokinase (group 3) as compared to Collins' only group (Group 1), p<0.05 for each, and all of the three indices (perfusion score, filtration rate and CUR) were also significantly (p=0.0092 p<0.05 and p<0.05) improved by adding urokinase plus verapamil (Group 4). We concluded that the computerized scintigraphy with Tc-99m DTPA provide valuable quantitative indices for evaluation of preserved kidney funcitions and suggest its possible clinical applicability in cadaver kidney transplantation considering the safety and easiness of the prodedure.

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Management of Chronic Kidney Disease in Obesity Patients (비만환자의 만성콩팥병 관리)

  • Han, Kunhee
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.66-73
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    • 2022
  • Obesity is an increasing public health and medical issue worldwide. It has been associated with several comorbidities, including diabetes, cardiovascular disease, stroke, and cancer. Chronic kidney disease (CKD) is another important comorbidity of obesity. Other major causes of CKD include hypertension and diabetes. However, the association between obesity and CKD is often overlooked. Among patients with CKD, patients with obesity were more vulnerable to have rapid kidney function decline than that of those with normal weight. Additionally, CKD is more prevalent among patients with obesity. These aggravations are induced through multiple mechanisms, specifically metabolic impairment of obesity and mechanical burden because of increasing intraabdominal renal pressure. Furthermore, the inflammation and lipotoxicity, caused by obesity, are critical in the CKD aggravation in patients with obesity. To prevent this, all adult patients with obesity are tested for CKD. The workup includes the estimated glomerular filtration rate and regular follow-up. Step-wise management is required for patients with obesity with CKD. Prompt reduction and management of obesity effectively delay CKD progression among patients with obesity and CKD. Therefore, weight loss is a core management for patients with obesity and CKD. Based on several studies, this article focused on the association between CKD and obesity, as well as the diagnosis and weight management of patients with obesity and CKD.

Transposition of great arteries [S.D.D.] with VSD and PS: report of an autopsy case (완전대혈관전위증 [S.D.D., Kidd type IV] 에 대한 Rastelli 수술 치험)

  • 이명희
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.331-337
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    • 1982
  • Complete TGA is a common congenital cardiovacular anomaly, and without palliative or corrective surgery, the infant born with TGA rarely survives the first year of life. Hemodynamically, recirculated blood flow in the systemic and pulmonary circuit has a key role in systemic arterial oxygen saturation and the status of the pulmonary vascular bed. Recently a d-TGA with VSD and PS, in a 12 year old male patient had been tried for inversion of the ventricular flow with Rastelli operation. An intracardiac tunnel was constructed between the VSD and the aortic orifice to connect the ventricle to the aorta. The right ventricle was connected with the pulmonary circulation by anastomosis of an valved conduit between the right ventricle and the distal end of the pulmonary artery. During the postop, period, the irreversible renal failure, accompanied by metabolic acidosis and pulmonary edema, occured under relative stabilized cardiac performance state. The autopsy was done, which revealed diffuse infarcted area in both kidney and preserved intra & extracardiac graft constructed.

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Surgical Treatment of Metastatic Lung Cancer (전이성 폐암의 외과적 치료)

  • 박재길
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.815-820
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    • 1987
  • Excision of the metastatic pulmonary sarcoma or carcinoma in the selected cases is now the accepted and the most effective method of treatment. From January 1978 to July 1987, 14 patients with metastatic lung cancer were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. Ages ranged from 26 years to 68 years [mean=38.0 years]. Primary sites were uterus in 6 patients, colorectum in 2, sarcoma of extremities in 2, and 1 case of pancreas, kidney, skin and melanoma of hand. Fourteen posterolateral thoracotomies were done and resected the 36 metastatic masses in 14 patients. Surgical mortality was none. The performed procedures of resection were as follows; lobectomy with wedge resection in 2, lobectomy in 3, segmentectomy in 1 and wedge resection in 8. Eleven patients were received radiotherapy or chemotherapy, or both postoperatively. Among the 14 patients, there were 5 survivors. They are 6, 7, 21, 35, and 63 months postoperatively. Among them, 9 patients were dead. Within one year in 2, two years in 6, and three years in l.

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