• 제목/요약/키워드: kidney surgery

검색결과 360건 처리시간 0.028초

Use of intraoperative impression smear cytology to guide successful treatment of a large renal cyst in a dog: a case report

  • Balda, Ignacio Otero;Vagias, Michail;Cassidy, Joseph;O'Brien, Peter J.;Mullins, Ronan A.
    • Journal of Veterinary Science
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    • 제23권2호
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    • pp.34.1-34.7
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    • 2022
  • A 13-yr-old Shih tzu was referred for surgical management of right-sided cranial abdominal mass, which corresponded to large, cavitated renal mass on ultrasonography, and was suspected to represent neoplasia. Intraoperative impression smear cytology (ISC) of the renal mass wall was consistent with benign renal cyst (RC), without evidence of neoplasia or infection. Deroofing and omentalisation were performed and histopathology was consistent with benign RC. Chronic kidney disease was diagnosed 4 mon postoperatively, however, the dog was asymptomatic, without cyst reoccurrence. Intraoperative ISC is an expedient and inexpensive diagnostic technique that can guide most appropriate treatment in dogs with large RCs.

Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center

  • Jeong, Hyung Joo;Ahn, Yo Han;Park, Eujin;Choi, Youngrok;Yi, Nam-Joon;Ko, Jae Sung;Min, Sang Il;Ha, Jong Won;Ha, Il-Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • 제60권3호
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    • pp.86-93
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    • 2017
  • Purpose: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. Methods: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. Results: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. Conclusion: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.

복부 컴퓨터단층촬영 영상에서 다중 아틀라스 기반 위치적 정보를 사용한 계층적 장기 분할 (Hierarchical Organ Segmentation using Location Information based on Multi-atlas in Abdominal CT Images)

  • 김현진;김현아;이한상;홍헬렌
    • 한국멀티미디어학회논문지
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    • 제19권12호
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    • pp.1960-1969
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    • 2016
  • In this paper, we propose an automatic hierarchical organ segmentation method on abdominal CT images. First, similar atlases are selected using bone-based similarity registration and similarity of liver, kidney, and pancreas area. Second, each abdominal organ is roughly segmented using image-based similarity registration and intensity-based locally weighted voting. Finally, the segmented abdominal organ is refined using mask-based affine registration and intensity-based locally weighted voting. Especially, gallbladder and pancreas are hierarchically refined using location information of neighbor organs such as liver, left kidney and spleen. Our method was tested on a dataset of 12 portal-venous phase CT data. The average DSC of total organs was $90.47{\pm}1.70%$. Our method can be used for patient-specific abdominal organ segmentation for rehearsal of laparoscopic surgery.

Neuropeptide Y protects kidney against cisplatin-induced nephrotoxicity by regulating p53-dependent apoptosis pathway

  • Kim, Namoh;Min, Woo-Kie;Park, Min Hee;Lee, Jong Kil;Jin, Hee Kyung;Bae, Jae-sung
    • BMB Reports
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    • 제49권5호
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    • pp.288-292
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    • 2016
  • Cisplatin is a platinum-based chemotherapeutic drug for treating various types of cancers. However, the use of cisplatin is limited by its negative effect on normal tissues, particularly nephrotoxicity. Various mechanisms such as DNA adduct formation, mitochondrial dysfunction, oxidative stress, and apoptosis are involved in the adverse effect induced by cisplatin treatment. Several studies have suggested that neuropeptide Y (NPY) is involved in neuroprotection as well as restoration of bone marrow dysfunction from chemotherapy induced nerve injury. However, the role of NPY in chemotherapy-induced nephrotoxicity has not been studied. Here, we show that NPY rescues renal dysfunction by reducing the expression of pro-apoptotic proteins in cisplatin induced nephrotoxicity through Y1 receptor, suggesting that NPY can protect kidney against cisplatin nephrotoxicity as a possible useful agent to prevent and treat cisplatin-induced nephrotoxicity.

Disseminated adenovirus infection in a 10-year-old renal allograft recipient

  • Lee, Bora;Park, Eujin;Ha, Jongwon;Ha, Il Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.414-417
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    • 2018
  • Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.

A Case of Henoch-Schönlein Purpura with Fulminant Complications and Its Long-term Outcome

  • Lee, Dong Hyun;LEE, Eun-So;Hong, Jeong;Park, Kwang-Hwa;Pai, Ki Soo
    • Childhood Kidney Diseases
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    • 제23권2호
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    • pp.128-133
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    • 2019
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic vasculitis characterized by purpura, arthritis, abdominal pain, and nephritis. Gastrointestinal involvement can manifest as pain, intussusception, intestinal bleeding, and intestinal perforation. We report a case of fulminant HSP at an age of eight in 1994, with multiple complications of intra-thoracic bleeding, massive intestinal perforation, nephritis, and various skin rashes. The brisk bleeding findings of intestinal on Technetium-99m-labeled red blood cell scan ($^{99m}Tc$ RBC scan) were well matched to those of the emergency laparotomy and the resected intestine. The patient's abdominal conditions improved gradually but nodular skin eruptions developed newly apart from improving preexisting lower limb rashes and the urine findings continued abnormal, so skin and kidney biopsy were done for the diagnosis. After cyclosporine therapy, skin eruptions and urine findings returned to normal gradually. On a follow-up after 25 years in 2019, the patient is 33-year-old, healthy without any abnormality on blood chemistries and urine examination.

5/6 NTX로 유발된 만성 신부전 랫트에 대한 형방지황탕(荊防地黃湯)의 효과 (Efficacy of Hyeongbangjihwhang-tang on the 5/6 Nephrectomy(NTX) induced Chronic Renal Failure(CRF) Rats)

  • 하진호;최애련
    • 사상체질의학회지
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    • 제25권4호
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    • pp.359-372
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    • 2013
  • Objectives The object of this study was to observe the effects of Hyeongbangjihwhang-tang (HB; Soyangin prescription) on the 5/6 NTX induced CRF rats. Methods Each of Hyeongbangjihwhang-tang aqueous extracts 200mg/kg were orally administered once a day for 35 days from 4 weeks after 5/6 NTX surgery. Four groups, each of 8 rats per group were used in this study, were sham group, CRF group, ${\alpha}$-Tocoperol group and HB group. Changes on the left remnant kidney weights, serum BUN, creatinine levels, caspase-3, PARP immunoreactivities were observed to nephroprotective effects, and relative immunomodulatory effects were monitored based on the changes of lymphatic organ weights and splenic cytokine contents. In addition, the changes on the kidney MDA, GSH contents and SOD, CAT activities were also calculated for antioxidant effects, and the effects on the CRF related cachexia were demonstrated based on the changes of body and epididymal fat pad weights, serum TG, TC, LDL and HDL levels. Results and Conclusions 1) HB was significantly decreased the left remnant kidney weights, serum BUN, creatinine levels and caspase-3, PARP immunoreactivities. 2) HB was significantly increased lymphatic organ weights and splenic cytokine contents. 3) HB was significantly increased body and epididymal fat pad weights, and was significantly decreased serum TG, TC, LDL and HDL levels. 4) HB was significantly decreased MDA contents, and was significantly increased GSH contents and SOD, CAT activities. The results obtained in this study suggest that HB significantly retarded immunosuppressions and cachexia related to the 5/6 NTX induced CRF through modulations of oxidative defense systems. Especially HB showed the highest favorable effects more than those of ${\alpha}$-tocoperol.

소아에서 신장 이식 후 발생한 Parvovirus Bl9 감염 2례 (Parvovirus B19 Infection in Two Korean Pediatric Kidney Transplant Patients)

  • 구소은;이주훈;한혜원;한덕종;박영서
    • Childhood Kidney Diseases
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    • 제9권2호
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    • pp.275-281
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    • 2005
  • 저자들은 생체신장이식을 받은 후 발열과 빈혈을 주소로 내원한 2명의 환아에서 혈청 PCR을 통해 PV B19 감염을 진단한 후 면역글로불린 정맥투여로 싱공적으로 치료하고 재발 없이 관찰중인 2례를 경험하였기에 보고하는 바이다.

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외과환자에 발생한 급성신부전의 진단과 치료 (Diagnosis and Management of Acute Renal Failure in Surgical Patient)

  • 권굉보
    • Journal of Yeungnam Medical Science
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    • 제1권1호
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    • pp.13-23
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    • 1984
  • Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

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망아지의 개방요막관과 관련된 다발성 농양 증례 (A Case of Multiple Abscesses Associated with Patent Urachus in a Thoroughbred Foal)

  • 김재훈;정지열;강상철;양재혁;배종희;김재훈
    • 한국임상수의학회지
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    • 제25권2호
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    • pp.102-105
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    • 2008
  • The most common abnormality of the umbilicus in the foal is the patent urachus. Patent urachus may be a congenital or acquired condition in foals in which the urachus fails to close spontaneously at or shortly after parturition. A 17-day-old male Thoroughbred foal was requested to the Veterinary Pathology Laboratory of Cheju National University. The foal showed clinical signs such as umbilical urination, anorexia, depression, lethargy, and abdominal pain for 10 days. Because of the umbilical urination, the surgery for patent urachus was performed, but he died next day. Grossly, many pale yellowish foci 10-20 mm in diameter were scattered on the throughout surface of lungs. Severe subcapsular hemorrhage was observed in left kidney. Large milky yellow mass 10X6-7 cm in size was found in the adjacent area of right kidney. Histopathologically, many abscesses with bacterial cocci were scattered in the blood vessels or adjacent pulmonary parenchyma of lungs. Severe numerous abscesses with intralesional bacterial cocci were mostly occupied in the abdominal mass from right kidney. Gram staining for tissue sections demonstrated numerous Gram positive cocci in pulmonary and abdominal abscesses. In bacterial culture, catalase-positive beta-hemolytic colonies were isolated and confirmed as Staphylococcus (S.) aureus by Vitek system. Based on the results, acquired patent urachus and then multiple abscesses may be originated from the umbilical cord infected with S. aureus in this foal.