• 제목/요약/키워드: kidney surgery

검색결과 355건 처리시간 0.026초

항 암태아성항원에 대한 단세포군항체의 $^{99m}Tc$ 표지법개발 및 생체분포 ($^{99m}Tc-Labeling$ of Monoclonal Antibody to Carcinoembryonic Antigen and Biodistribution)

  • 문대혁;정준기;이명철;고창순;정홍근;박재갑
    • 대한핵의학회지
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    • 제26권2호
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    • pp.380-391
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    • 1992
  • This study was designed to evaluate a direct method of $^{99m}Tc$ labeling using $\beta-mercaptoethanol$ as a reducing agent, and to investigate whether $^{99m}Tc$ labeled specific monoclonal antibody against carcinoembryonic antigen (CEA-92) can be used for the scintigraphic localization of human colon cancer xenograft. Purified CEA-92 IgG was fragmented into F $(ab')_2$ and then labeled with $^{99m}Tc$ by transchelation method using glucarate as a chelator. Labeling efficiency, immunological reactivity and in vitro stability of $^{99m}Tc$ CEA-92 F $(ab')_2$ were measured and then injected intravenously into nude mice bearing human colon cancer (SNU-C4). Scintigrams were obtained at 24 hour after injection. Then nude mice were sacrificed and the radioactivity was measured Labeling efficiency of injected $^{99m}Tc$ CEA-92 F $(ab')_2$, immunoreative fraction and in vitro stability at 24 hour of injected $^{99m}Tc$ CEA-92 F $(ab')_2$ was 45.2%, 32.8% and 57.4%, respectively. At 24 hour after injection, % ID/g in kidney (46.77) showed high uptake, but %ID/g in tumor (1.65) was significantly higher than spleen (0.69), muscle (0.16), intestine (0.45), stomach (0.75), heart (0.48) and blood (0.45). There was no significant difference between tumor and liver (1.81). Tumor contrast as quantitated by tumor to blood ratio of $^{99m}Tc$ CEA-92 F $(ab')_2$ was increased significantly (p<0.005) until 24 hours (3.70), and there was no statistical differece from tumor to blood ratio of I-131 CEA-92 F $(ab')_2$. The scintigram demonstrated localization of radioactivity over transplanted tumor, but significant background radioactivity was also noted over kidney and abdomen. It is concluded that CEA-92 F $(ab')_2$ can be labeled with $^{99m}Tc$ by a direct transchelation method using $\beta-mercaptoethanol$ as a reducing agent and $^{99m}Tc$ labeled CEA-92 F $(ab')_2$ can be used for the scintigraphic localization of human colon cancer xenograft in nude mice model.

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Evaluation of Renal Pathophysiological Processes Induced by an Iodinated Contrast Agent in a Diabetic Rabbit Model Using Intravoxel Incoherent Motion and Blood Oxygenation Level-Dependent Magnetic Resonance Imaging

  • Yongfang Wang;Xin Zhang;Bin Wang;Yang Xie;Yi Wang;Xuan Jiang;Rongjia Wang;Ke Ren
    • Korean Journal of Radiology
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    • 제20권5호
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    • pp.830-843
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    • 2019
  • Objective: To examine the potential of intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) magnetic resonance imaging for detecting renal changes after iodinated contrast-induced acute kidney injury (CI-AKI) development in a diabetic rabbit model. Materials and Methods: Sixty-two rabbits were randomized into 2 groups: diabetic rabbits with the contrast agent (DCA) and healthy rabbits with the contrast agent (NCA). In each group, 6 rabbits underwent IVIM and BOLD imaging at 1 hour, 1 day, 2 days, 3 days, and 4 days after an iohexol injection while 5 rabbits were selected to undergo blood and histological examinations at these specific time points. Iohexol was administrated at a dose of 2.5 g I/kg of body weight. Further, the apparent transverse relaxation rate (R2*), average pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) were calculated. Results: The D and f values of the renal cortex (CO) and outer medulla (OM) were significantly decreased compared to baseline values in the 2 groups 1 day after the iohexol injection (p < 0.05). A marked reduction in the D* values for both the CO and OM was also observed after 1 hour in each group (p < 0.05). In the OM, a persistent elevation of the R2* was detected for 4 days in the DCA group (p < 0.05). Histopathological changes were prominent, and the pathological features of CI-AKI aggravated in the DCA group until day 4. The D, f, and R2* values significantly correlated with the histological damage scores, hypoxia-inducible transcription factor-1α expression scores, and serum creatinine levels. Conclusion: A combination of IVIM and BOLD imaging may serve as a noninvasive method for detecting and monitoring CI-AKI in the early stages in the diabetic kidney.

Evaluation of Albumin Creatinine Ratio as an Early Urinary Biomarker for Chronic Kidney Disease in Dogs

  • Hyun-Min Kang;Heyong-Seok Kim;Min-Hee Kang;Jong-Won Kim;Dong-Jae Kang;Woong-Bin Ro;Doo-Won Song;Ga-Won Lee;Hee-Myung Park;Hwi-Yool Kim
    • 한국임상수의학회지
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    • 제40권6호
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    • pp.399-407
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    • 2023
  • Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.

대측 신장이 정상인 신종양 환자에서 신보존수술의 임상 경험 (Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney)

  • 이준영;김정현;이강민;문기학;정희창;박동춘
    • Journal of Yeungnam Medical Science
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    • 제16권1호
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    • pp.94-100
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    • 1999
  • 본 연구는 신보존수술의 임상적 가치를 알아보기 위해, 반대측 신장이 기능적으로 정상인 작은 크기의 고형 신종양 환자를 대상으로 신보존수술을 이용한 환자의 임상 경과를 후향적인 조사를 통하여 알아보고자 하였다. 21례의 환자중 술전 방사선 영상 소견상 신세포암으로 추정된 15례의 환자는 술후 병리조직학적 검사 결과 14례에서 신세포암($T_1N_0M_0$ : 14례)으로, 1례에서 호산성과립세포종으로 진단되었다. 신혈관지방종으로 추정된 4례는 역시 신혈관지방종으로 진단되었고, 또한 신세포암과 구별하기 어려웠던 2례는 선혈관지방종 및 해면상혈관종으로 각각 밝혀졌다. 신세포암의 재발, 원격 전이 및 신세포암으로 인한 사망 등은 추척 관찰 기간(평균 18.6개월, 1-103개월) 중 관찰되지 않았고 양성 신종양 환자군에서도 종양의 재발은 관찰되지 않았다(평균 추척 관찰 기간 : 43.8개월, 7-97개월). 신보존수술의 합병증으로는 1례의 신세포암에서 wedge resection을 시행한 후 술후 10일에 신출혈로 인한 육안적 혈뇨 및 혈압 저하의 소견이 나타나 근치적 신적출술을 시행하였고, 그 외 다른 환자에서는 요낭종, 후복막혈종 및 폐 색전증 등과 갈은 합병증은 관찰되지 않았다. 이상의 결과에서, 대측 신장의 기능이 정상인 작은 표기(4cm 이하)의 단일 고형 신종양 환자일 경우 신기능을 보존하기 위하여 신보존수술은 좋은 치료법으로 생각되며 일차적인 치료법으로 사용되어도 유익하리라 기대되나, 향후 보다 장기적인 추적 관찰이 필요하리라 생각된다.

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헤파린 표면처리된 국산화 혈관우회도관의 개발 (Development of Korean Version of Heparin-Coated Shunt)

  • 선경;박기동;백광제;이혜원;최종원;김승철;김택진;이승열;김광택;김형묵;이인성
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.97-107
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    • 1999
  • 배경: 흉부대동맥 수술에 사용하는 헤파린 우회도관의 국산화를 위해, 헤파린 표면처리기법 중 물리분산법을 이용하여 제작한 우회도관의 동물실험을 통해 혈전저항성 및 안정성을 증명하고자 하였다. 대상 및 방법: 성견 21마리(17.5∼25 kg)를 대상으로 하행흉부대동맥 우회모델을 만들었다. 사용한 우회도관의 종류에 따라 무처리 우회도관군(CONTROL; n=3), 무처리 우회도관 및 전신 헤파린 처치군(HEPARIN; n=6), Gott 헤파린 우회도관군(GOTT; n=6), 국산 헤파린 우회도관군(KIST; n=6)로 분류하였다. 관찰지표는 말초혈액검사, 혈액응고검사, 신장 및 간기능검사, 표면전자현미경 소견 등이었다. 각 지표는 우회도관의 원위부 대동맥 혈액에서 검사하여 우회 전과 우회 후 2시간 째의 군내 변화와군간 차이를 비교하였다. 결과: 모든 관찰지표의 우회 전 기초치는 군간에 차이가 없었다. 말초혈액검사 중 혈소판치는 HEPARIN군과 GOTT군에서 유의하게 높아졌으나(p<0.05) 군간 차이는 유의하지 않았다. 기타 혈구세포의 변화는 각 군에서 군내변화와 군간차이가 유의하지 않았다. Activated clotting time, activated partial thromboplastin time, thrombin time은 HEPARIN군에서 현저히 증가하였고(p<0.05) 군간차이도 유의하였다(p<0.005). Prothrombin time은 GOTT군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Fibrinogen은 각 군에서 군내변화와 군간차이가 유의하지 않았다. Antithrombin III는 HEPARIN군과 KIST군에서 유의하게 감소하였고(p<0.05) 군간차이도 유의하였다(p<0.05). Protein C는 HEPARIN군에서 유의하게 감소하였으나(p<0.05) 군간차이는 없었다. Blood urea nitrogen은 HEPARIN군과 KIST군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Creatinine, aspartate aminotransferase, alanine aminotransferase는 각 군에서 군내변화와 군간차이가 유의하지 않았다. 표면전자현미경 소견에서 혈소판 및 혈구세포 응집정도는 CONTROL군이 가장 심했고, HEPARIN군은 GOTT군이나 KIST군에 비해 많았다. 결론: 이상의 결과에서 전신 헤파린 처치(HEPARIN)는 출혈경향을 증가시키면서 이물질 표면의 응고반응을 효과적으로 차단하지 못하는 반면, 헤파린 표면처리된 우회도관(GOTT & KIST)의 경우는 출혈경향 없이 표면의 응고반응을 충분히 억제하였다. 또한 국산(KIST) 헤파린 우회도관은 상용화된 외국산(GOTT)과 동등한 항혈전 성능을 보였다.

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골반부 전이성 종양의 수술적 치료 (Surgical Treatment of Metastatic Tumor in Pelvis)

  • 김재도;박웅;조명래;손정환;이영구
    • 대한골관절종양학회지
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    • 제10권2호
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    • pp.61-70
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    • 2004
  • 목적: 골반부 전이성 종양의 수술적 치료 후 종양학적 결과, 기능 및 합병증의 발생을 통해 수술적 치료의 적응 가능성을 연구하고자 한다. 대상 및 방법: 1994년 5월부터 2003년 5월까지 골반부 전이성 종양 환자 중 고식적/수술적 치료를 받았던 9례/10례를 대상으로 하였으며 환자의 평균 연령은 57.6/48.0세, 남녀 비는 5:4/7:3이였다. 원발 병소로는 신장암과 자궁 경부암이 각 3례, 폐암, 골수종, 비호지킨 림프종이 각 2례, 유방암, 방광암, 고환암, 전립선암, 위암, 간암, 후복막 평활근육종이 각각 1례 이었다. 고식적 치료로는 방사선 단독 치료가 5례, 항암 화학 단독 치료가 1례, 방사선 치료와 항암 화학 요법의 병합 치료가 2례, 경피적 뼈시멘트 삽입술이 1례에서 행하여 졌으며, 수술적 치료로는 소파술 후 뼈시멘트 삽입술이 1례, 내골반 반절제술 후 Girdlestone 술식이 2례, 재건술이 7례에서 시행되었고, 재건술로는 뼈시멘트 삽입술이 1례, 방사선 조사 또는 저온 멸균 후 자가골 이식술 및 고관절 전치환술이 5례, saddle prosthesis를 이용한 관절 성형술이 1례에서 시행되었다. 치료 후 종양학적 결과 및 Eastern Cooperative Oncologic Group (ECOG) 운동 평가 지수, 술 후 합병증을 조사하였다. 결과: 고식적/수술적 치료군에서 종양학적 결과로는 NED 0/1례, AWD 2/6례, DOC 1/2례, DOD 6/1례였고, ECOG 운동 평가 지수는 고식적 치료군에서 치료 전 1.5에서 치료 후 4.3으로 악화되었으나 수술적 치료군에서는 2.6에서 2.2로 관찰되었다. 합병증으로는 금속 대치물 부전이 3례, 감염이 2례에서 관찰되었다. 결론: 골반부 전이성 종양의 수술 여부 및 수술의 방법은 환자의 상태, 원발 종양의 악성도 및 기대 생존 기간에 따라 결정되어야 될 것으로 사료되었다.

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폐주사(肺走査) - 심장질환(心臟疾患)의 폐관류주사(肺灌流走査) 소견(所見) - (Evaluation of Pulmonary Perfusion Scan in Heart Disease)

  • 이종태;김정규;박창윤;최병숙
    • 대한핵의학회지
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    • 제7권2호
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    • pp.27-34
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    • 1973
  • Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

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Risk factors affecting amputation in diabetic foot

  • Lee, Jun Ho;Yoon, Ji Sung;Lee, Hyoung Woo;Won, Kyu Chang;Moon, Jun Sung;Chung, Seung Min;Lee, Yin Young
    • Journal of Yeungnam Medical Science
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    • 제37권4호
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    • pp.314-320
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    • 2020
  • Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561-10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087-5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981-0.999), ulcer size (HR, 1.247; 95% CI, 1.107-1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224-0.73) were associated with risk of amputation. Conclusion: Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

급성염증유발 동물모델에서 포공영(蒲公英)의 염증억제 효과 (Anti-inflammatory Activity of Dandelion in Mice)

  • 함대현;서봉준;한동오;박재현;정은택;이혜정;고윤정;최희돈
    • 동의생리병리학회지
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    • 제22권4호
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    • pp.810-814
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    • 2008
  • Most inflammatory disorders are usually treated using anti-inflammatory drugs including non-steroidal anti-inflammatory drugs (NSAID) and steroidal anti-inflammatory drugs (SAID). Prolonged uses of NSAIDs and SAIDs may frequently cause adverse side-effects such as nausea, vomiting, diarrhea, constipation, decreased appetite, kidney and liver failure, ulcers, and prolonged bleeding after an injury or surgery. Thus, it is necessarily required to develop a new anti-inflammatory drug with little side-effects. Dandelion (Taraxacum officinale) possesses the therapeutic abilities to eliminate body heat and toxins and to remove swelling and inflammation. In order to verify the anti-inflammatory activity of dandelion, TPA(12-O-tetra decanoylphorbol-acetate)-induced or croton oil-induced acute edema was developed in the mouse ears, and dandelion extract dissolved in acetone was applied to both sides of inflamed ears. It was found that dandelion could significantly reduce the ear swelling, compared to that of non-treated control. In the case of $20{\mu}{\ell}$ application of $100mg/m{\ell}$ dandelion solution (DA-100), its anti-inflammatory effect was comparable to that of indomethacin, a non - steroidal anti-anflammatory drug. Taken together, it could be concluded that topically applied dandelion extract exhibited its potentials as a new drug candidate with an effective anti-inflammatory activity.

코커 스파니엘에서 신장세포암종 (Renal Tubular Carcinoma in a Cocker Spaniel Dog)

  • 계은영;윤성호;장환수;곽동미;구세광;장광호;권영삼
    • 한국임상수의학회지
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    • 제28권4호
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    • pp.431-434
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    • 2011
  • 7년령의 중성화된 수컷 코커 스파니엘이 왼쪽복부종괴, 식욕부진, 체중감소로 경북대학교 부속동물병원에 내원하였다. 혈액학적, 생화학적 검사로 중증의 백혈구증가증, 경도의 저알부민혈증, GGT의 급격한 증가를 나타내었다. 방사선학적 검사시 왼쪽신장의 거대한 종괴가 관찰되었으며, 폐전이는 관찰되지 않았다. 조직병리학적 소견에서 종괴는 신장세포암종으로 확진되었다. 편측성 신장요관절제술을 실시하였다. 추시 결과 수술 6개월 후 환축이 폐사되었음을 확인 할 수 있었다.