• Title/Summary/Keyword: kidney surgery

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The Noxiousness of Aldosterone Analogue-induced Senile Disease-related Hypertension and Inhibition of the Aldosterone by Silver Spike Point Electrical Stimulation in Elderly People -The Approach of Basic Physical Therapy for the Study of Cardiovascular Disease-related Specialized Physical Therapy- (알도스테론 동족체-유도 노인성질환-연관 고혈압의 유해와 노인에 적용한 은침점전기자극의 알도스테론 억제 -심혈관질환전문물리치료 연구를 위한 기초물리치료학적 접근을 중심으로-)

  • Lee, Sook-Hee;Kang, Joon-Hwan;Lee, Sang-Bin;An, Ho-Jung;Kim, Moo-Gi;Kim, Soon-Hee;Kim, Jung-Hwan
    • Journal of Korean Physical Therapy Science
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    • v.13 no.2
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    • pp.67-83
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    • 2006
  • The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.

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Unilateral Renal Subcapsular Abscess Associated with Pyelonephritis in a Cat (고양이의 신우신염을 동반한 편측신장의 피막하 농포 증례)

  • Lee, Hye-Yeon;Chang, Jin-Hwa;Jung, Joo-Hyun;Oh, Sun-Kyung;Kim, Jae-Hong;Kim, Wan-Hee;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.79-82
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    • 2010
  • A 1-year-old intact male Russian blue cat was admitted with a history of depression, partial anorexia, vomiting and dysuria. Through the blood analysis, ultrasonography and urinalysis, this cat was diagnosed as feline lower urinary tract disease with cystitis. Despite antibiotic therapy the cat showed stranguria and urinary catheterization were repeated several times. One week after, this patient appeared depression, hyperthermia and leukocytosis. Ultrasonography revealed a small amount of hypoechoic fluid around the right kidney and bacteria were found in the urine. The amount of the right subcapsular fluid was increased and bacteria were found in the fluid. On the excretory urography, leakage of contrast media were detected. The right kidney was surgically removed and suppurative fluid between the renal parenchyma and the thickened capsule was identified. After surgery, subcapsular abscess of the right kidney associated with pyelonephritis was confirmed histologically and this cat recovered without complications.

Clinical Outcomes and Contributors in Contemporary Kidney Transplantation: Single Center Experience (근래의 신장이식 임상성적과 관련인자들: 단일기관 연구)

  • Ahn, Jae-Sung;Park, Kyung Sun;Park, Jongha;Chung, Hyun Chul;Park, Hojong;Park, Sang Jun;Cho, Hong Rae;Lee, Jong Soo
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.182-192
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    • 2017
  • Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.

A Prospective Study on the Changes of Serum 3,5,3'-Triiodothyronine Levels after Cardiopulmonary bypass in Pediatric Age (소아환자에서 개심술후 혈중 3,5,3'- 삼옥소타이로닌 [triiodothyronine] 농도 변화에 관한 연구)

  • Kim, Yeong-Tae;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1209-1217
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    • 1992
  • Triiodothyronine[T3] is an important regulator of the tissue metabolism, and may have potential use as an inotropic agent. The change of serum T3 level was studied in the pediatric age patients after cardiopulmonary by pass. Thyroid function was tested pre-operatively in 33 patients and total triiodothyronine[TT3] levels were serially measured during and after cardiopulmonary bypass[CPB]. After correction of dilutional effect, effects of various factors on the TT3 levels were analyzed. Abrupt fall of TT3 level was demonstrated at 15 minutes after CPB[80.1$\pm$5.9ng/dL] from the initial level of 133.6$\pm$5.3ng/dL, with some recovery at 6 hours[115.4$\pm$6.7ng/dL]. After then, gradual decrease occured reaching to the level of 77.2$\pm$4.2ng /dL at 24 hours. These falls of the TT3 after CPB were statistically significant. [p<0.01 ANOVA] Statistically significant correlation were found between the degree of hemodilution and TT3 concentration at 15 and 30 minutes after CPB[p<0.05]. But, other factors were analyzed to have no effect on TT3 levels. As the degree of the hemodilution increases, TT3 decreased less. This observation probably supports the fact that decrease of TT3 during CPB may be a result of sequestration of T3 into peripheral tissue. Although it was not statistically significant[p=0.08], the fall of TT3 was greater in the group to which plasmanate was added, than those not added. This finding seemed to be due to the increase of albumin and other thyroid-hormone-binding-proteins in the serum. Increase of these binding proteins might potentiate the sequestration of T3 into the liver and the kidney from serum, and as a consequence, decrese the serum TT3 level further.

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Abdominal Injury by Falls from a Height in Children (소아에서 추락사고에 의한 복부손상)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.11 no.2
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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.

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A Case of Lymphangioleiomyomatosis with Renal Angiomyolipoma (신장평활근종증을 동반한 폐임파관평활근종증 1례)

  • Kang, Soon-Bock;Park, Sung-Jin;Lee, Sang-Hoon;Jung, Do-Young;Yoo, Ji-Hoon;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Son, Dong-Sub;Kim, Mee-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.245-251
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    • 2001
  • Recently we have experienced one case of pulmonary lymphangioleiomyomatosis(LAM). A 49 year-old woman visited the outpatient department complaining of longstanding dyspnea, which was aggravated by exercise. Although the chest PA film showed nothing more than a slight increase in interstitial marking, a lung HRCT revealed multiple cystic lesions of a similar size that were scattered through out the whole field in both lungs. An abdominal CT detected an angiomyolipoma located in the midbody of the left kidney. Video-assisted thoracic surgery(VATS) was performed for the pathologic diagnosis. On gross examination of the biopsy lung, a pulmonary LAM was confirmed by a finding of smooth muscle proliferation in the interstitum of the lung. After the final diagnosis, oral medroxyprogesterone was prescribed and she is presently in a stable condition.

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Analysis of the Occurrence of Diseases Following Gastrectomy for Early Gastric Cancer: a Nationwide Claims Study

  • Seo, Ho Seok;Na, Yewon;Jung, Jaehun
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.279-297
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    • 2021
  • Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

Comparative study of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional hilar control, laparoscopic partial nephrectomy (HCLPN) for renal tumors: One-year follow-up results of renal function change

  • Kang, Su Hwan;Rhew, Hyun Yul;Kim, Taek Sang
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.191-199
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    • 2018
  • Objectives: We designed the study to compare the oncologic and renal function outcomes of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional laparoscopic partial nephrectomy (HCLPN) for renal tumors. Methods: Between March 2008 and July 2015, 114 patients who underwent laparoscopic partial nephrectomy (LPN) of a renal neoplasm were studied. We performed LPN without hilar clamp on 40 patients (OCLPN, Group 1), and conventional LPN with hilar control and renorrhaphy on another 40 patients (HCLPN, Group 2). We retrospectively reviewed the medical records of each patient's age, sex, R.E.N.A.L. nephrometry score (RNS), operation time, complications, hospitalization period, tumor size, positive resection margin, histologic classification of tumor, pathologic stage, Fuhrman grade, estimated blood loss (EBL), warm ischemic time (WIT), and estimated glomerular filtration rate (eGFR) before and one year after surgery. Results: There were no significant differences in age, sex, preoperative eGFR, EBL, surgical (anesthesia) time, and tumor size between the two groups. The mean eGFR was not significantly different between the OCLPN and HCLPN groups 1 month (95 and $86.2mL/min/1.73m^2$, respectively; P = 0.106), 6 months (92.9 and $83.6mL/min/1.73m^2$, respectively; P = 0.151) and 12 months (93.8 and $84.7mL/min/1.73m^2$, respectively; P = 0.077) postoperatively. The change in eGFR after one year was 3.9% in the OCLPN group and -7.9% in the HCLPN group. Conclusions: OCLPN was superior to HCLPN in preserving renal function one year after surgery, and there was no statistically significant difference in tumor treatment results.

Research on the Development of Artificial Organs based on the Physical Properties of the Human Body (인체의 물리적 성질을 이용한 인공장기 개발 연구)

  • Lee, SeungBock
    • The Journal of the Korea Contents Association
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    • v.22 no.7
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    • pp.670-675
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    • 2022
  • In the era of the 4th industrial revolution, everything is data-centric. The type and amount of data may be central, and new data may be required in special circumstances. As 3D printers are used in various fields, there are fields that are newly challenged. In particular, in the medical field, new attempts that have not been considered before are taking place. This paper is a study to enable research in fields that require physical properties of the human body. In the meantime, research using human organs has mainly used the materials made of silicon. We measure the physical properties of the human body from cadavers, apply these characteristics to develop new materials, and develop artificial organs with 3D printers. Using the artificial organs made in this way, you can practice surgery with a robot that removes kidney stones. In this paper, we would like to introduce a series of research processes to develop advanced materials similar to human organs.

Recovery of Delayed Graft Function after Calcineurin Inhibitor Sparing Regimen in a Renal Transplant Patient with Calcineurin Inhibitor Toxicity: A Case Report

  • Kang, Seok Hui;Yun, Woo Sung;Cho, Kyu Hyang;Do, Jun Young;Yoon, Kyung Woo;Park, Jong Won
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.165-168
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    • 2014
  • The recipient candidate was a 51-year-old male with end-stage renal disease owing to diabetes mellitus. The initial immunosuppressive regimen included basiliximab for induction and tacrolimus, mycophenolate mofetil, and steroids. Urine output was 413 mL/day on the operative day and 100 mL/day on the postoperative day (POD) 1. There was no definite stenosis of the ureter or vessels. He had anuria on POD 2~4 and he had undergone hemodialysis. His serum creatinine level did not decrease. Therefore, a graft biopsy was performed on POD 4. The pathologic finding was consistent with acute calcineurin inhibitor (CNI) toxicity. There was no evidence of rejection or acute tubular necrosis. Anuria continued on POD 6; therefore, we started sirolimus instead of a CNI based regimen. Graft function was gradually recovered 1 day after reduction of CNI dose and hemodialysis was stopped. The serum creatinine level was normalized on POD 10. He was discharged on POD 21.