• 제목/요약/키워드: kidney surgery

검색결과 353건 처리시간 0.027초

Pathogenetic Overlapping of Renovascular Hypertension Developed in a Child with Takayasu Arteritis: 'One-clip, One and Half-kidney Model'

  • Lee, Su Jeong;Baek, Hee Sun;Jang, Hea Min;Kim, Hyung-Kee;Huh, Seung;Cho, Min Hyun
    • Childhood Kidney Diseases
    • /
    • 제20권1호
    • /
    • pp.33-36
    • /
    • 2016
  • There are two pathogenic models of renovascular hypertension (RVH) originating from renal artery stenosis. We noted a case of a boy who had severe hypertension with atrophic left kidney, hypertrophic right kidney, a segmental stricture of the abdominal aorta, and total occlusion of the right renal artery. Due to the atrophic change of the contralateral, unclipped left kidney, this patient presented with various clinical manifestations related to both models of pathogenesis of RVH occurring at the same time. We conclude that this patient presented with the middle stage of the two RVH pathogenetic models, so called the 'one-clip, one and half-kidney model.'

신장의 투명세포 육종 1예 (Clear Cell Sarcoma of the Kidney - a Case Report -)

  • 박재현;정재희;이아원;송영택
    • Advances in pediatric surgery
    • /
    • 제7권2호
    • /
    • pp.162-165
    • /
    • 2001
  • Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor with frequent metastasis to the bone. We report a case of right sided in a 5 month-old girl. A radical nephrectomy was performed. It was clinical stage III with renal capsular invasion and lymph node metastasis by the classification of NWTS-5. Histologic examination revealed the classic pattern of CCSK. Postoperative adjuvant chemotherapy with doxorubicin and radiotheraphy were applied.

  • PDF

분만 후 발생한 심근병증 및 만신신부전 환자의 심장-신장 동시이식 수술 체험 1예 (Combined Heart and Kidney Transplantation in Patient with Postpartum Cardiomyopathy and Renal Failure)

  • 이승철;함시영;김재중;한덕종;송명근
    • Journal of Chest Surgery
    • /
    • 제39권9호
    • /
    • pp.714-717
    • /
    • 2006
  • 심장과 신장의 경우 현대의학에서 이식이 중요한 치료방법으로 자리잡고 있으며 그 적응증이 확대되고 있다. 그러나 만성신부전은 심장이식의 금기였으며, 심부전도 신장이식의 금기로 심장과 신장의 동시이식이 이루어지는 경우는 흔치 않았다. 하지만 심부전과 신부전에 대한 치료의 발달로 심장-신장 동시이식의 필요성은 증가하고 있으며 동시에 면역학의 발달과 수술 기술 등의 발달로 그 가능성은 높아지고 있다. 우리나라에서는 지난 1969년과 1992년에 신장이식과 심장이식이 각각 성공하였으나 그동안 동시이식은 없었다. 본 증례는 분만 후 발생한 심근병증으로 심부전이 발생하고 이로 인한 신부전으로 투석을 받던 33세의 여자환자에 대해 본원에서 1년 전 시행한 '심장-신장 동시이식'에 대한 보고이다. 현재 환자는 정상 심장기능에 투석 없이 건강하게 생활하고 있으며 이에 그 결과를 문헌 고찰과 더불어 증례 보고하는 바이다.

소아의 수부골에 전이된 신장의 투명세포육종 -1례 보고- (Metastatic Clear Cell Sarcoma of the Kidney in a Child's Hand Bone - A Case Report -)

  • 심종섭;김지형;서연림
    • 대한골관절종양학회지
    • /
    • 제4권2호
    • /
    • pp.94-98
    • /
    • 1998
  • Clear cell sarcoma of the kidney (CCSK) is a rare malignant tumor of the renal origin in childhood, distinguished from Wilms tumor by its pathologic and clinical features. Bone metastasis is one of the characteristic clinical features. The common site of metastasis of the clear cell Sarcoma of the kidney is axial skeleton including skull, spines, ribs and femur. A cases of clear cell Sarcoma of the kidney presented to us, which solely metastasized to the hand bones without metastasizing to any other tissues including axial skeleton. We report this case with review of literatures.

  • PDF

Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene

  • Hahn, Hyung Min;Jeong, Kwang Sik;Park, Dong Ha;Park, Myong Chul;Lee, Il Jae
    • Annals of Surgical Treatment and Research
    • /
    • 제95권6호
    • /
    • pp.324-332
    • /
    • 2018
  • Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

신장 이식후 발생한 해리성 흉복부 대동맥류의 외과적 치험 (Thoracoabdominal Aortic Aneurysm Repair after Renal Transplantation)

  • 김대영;문광덕
    • Journal of Chest Surgery
    • /
    • 제29권4호
    • /
    • pp.449-453
    • /
    • 1996
  • 20개월 전에 신장이식을 시행한 환자에 있어서 해리성 흥복부 대동맥류를 성공적으로 절제하였다. 이 식된 신장은 정상 신장에 비하여 허혈에 보다 민감하므로 동맥혈 차단후 이식된 신장의 관류를 위하 여 대퇴 동-정맥으로 심페기를 연결하였다. 138분간의 대동맥 교차 차단중에 신장으로의 관류는 관류압이 (19-)1) 27 minHg이고 관류량은 0.53에서 0.83 Limin 였고, 32mm 크기의 헤마쉴드(길이 22cm)가 동맥류 부위 에 대용되 었다. 수술후 특별한 합병증은 없었으며 심폐기를 이용한 대퇴동-정맥 우회술은 이와같은 수술시 척수와 신 장을 보호하는 간단하고 효율적 인 방법으로 사료된다.

  • PDF

상악 전치부에 발생한 고립성 형질세포 골수종 (SOLITARY PLASMA CELL MYELOMA ON ANTERIOR MAXILLA: A CASE REPORT)

  • 정지아;서고은;송준호;박상준
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제32권1호
    • /
    • pp.77-80
    • /
    • 2010
  • Plasma cell myeloma is malignant disease of plasma cell in the bone marrow. Myeloma accounts for about 1% of all cancers. The solitary plasma cellmyeloma is rare tumors and account for less than 10% of plasma cell neoplasm. It is often progress to multiple myeloma at 30-40% despite successful local treatment with surgery and radiation therapy. We are reporting a case of solitary plasma cell myeloma on anterior maxillary region that developed after kidney transplantation and immunosuppressive therapy.

Clinical Features and Prognosis of Corneal Ulcers in Dogs with Chronic Kidney Disease

  • Choi, Heeyeon;Kim, Se Eun;Kim, Taehyun;Jang, Jaeyoung;Hwang, Sun Young;Seo, Kangmoon
    • 한국임상수의학회지
    • /
    • 제38권3호
    • /
    • pp.115-119
    • /
    • 2021
  • This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

MANAGEMENT OF HASĀH WA RAML AL-KULYA (NEPHROLITHIASIS) IN UNANI SYSTEM OF MEDICINE: A REVIEW

  • Khan, Khalid Ali;Khan, Rashid Ali;Zakir, Mohammad
    • 셀메드
    • /
    • 제10권3호
    • /
    • pp.19.1-19.6
    • /
    • 2020
  • The kidneys are exposed to toxicants and waste product and can be affected easily by these toxicants and by products of the metabolism. The consumption of adequate water is necessary to remove waste and to keep kidney healthy. Deficiency of liquid in the blood leads to various adverse effects on the kidney. The most common adverse deficiency of liquid in blood is deposition of solid matter in the kidney and subsequently formation of kidney stone. Nephrolithiasis (kidney stone) can be treated by drugs if it is small in size but if it blocks the route due to its big size then surgery is the only way to remove it. The recurrence rate of the problem is very high and it may reappear within 10 years. In Unani literature Hasāh wa Raml al-Kulya (nephrolithiasis) is described in detail. As per Unani literature stagnation of Ghalīz mādda (filthy and viscous matter) in the kidney is the main cause of the formation of kidney stone. Various single and compound formulations drugs are described for the management of kidney stone which are very effective as well as safe. Management is divided into two parts i.e. symptomatic treatment to relieve pain and to methods adopted to remove stone from the kidney. Musakkin-i-Waja'(analgesic) drugs are used for pain while Mufattit-i-Hasāh (lithotriptic) and Mudirr-i-Bawl (Diuretic) drugs are used to remove stone. Majoon Aqrab, Qurs Kaknaj and Dawa-e-Gurda etc. are compound drugs mentioned in literature for removal of kidney stone. Single drugs like Alu Balu, Tukhm Khayar, and Kharkhask etc. are also used for same purpose.

이식신 계획생검 및 재생검에서 Kidney Injury Molecule-1 표현과 이식신 기능 변화 (Changes of Kidney Injury Molecule-1 Expression and Renal Allograft Function in Protocol and for Cause Renal Allograft Biopsy)

  • 김연희;이아란;김명수;주동진;김범석;허규하;김순일;김유선;정현주
    • 대한이식학회지
    • /
    • 제28권3호
    • /
    • pp.135-143
    • /
    • 2014
  • Background: Kidney injury molecule-1 (KIM-1) is known as a good ancillary marker of acute kidney injury (AKI) and its expression has also been observed in acute rejection and chronic graft dysfunction. We tested usefulness of KIM-1 as an indicator of acute and chronic renal graft injury by correlating KIM-1 expression with renal graft function and histology. Methods: A total of 133 zero-time biopsies and 42 follow-up biopsies obtained within 1 year posttransplantation were selected. Renal tubular KIM-1 staining was graded semiquantitatively from 0 to 3 and the extent of staining was expressed as the ratio of KIM-1 positive/CD10 positive proximal tubules using Image J program. Results: KIM-1 was positive in 39.8% of zero-time biopsies. KIM-1 positive cases were predominantly male and had received grafts from donors with older age, deceased donors, and poor renal function at the time of donation, compared with KIM-1 negative cases. KIM-1 expression showed correlation with delayed graft function and acute tubular necrosis. In comparison of KIM-1 expression between stable grafts (n=23) and grafts with dysfunction (n=19) at the time of repeated biopsy, the intensity/extent of KIM-1 staining and renal histology at zero-time did not differ significantly between the two groups. Histologically, KIM-1 expression was significantly increased with both acute and chronic changes of glomeruli, tubules and interstitium, peritubular capillaritis, and arteriolar hyalinosis. Conclusions: KIM-1 can be used as an ancillary marker of AKI and a nonspecific indicator of acute inflammation and tubulointerstitial fibrosis. However, KIM-1 expression at zero-time is not suitable for prediction of long-term graft dysfunction.