• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.5-12
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• 2003

The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.

• Proceedings of the KAIS Fall Conference
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• 2000.10a
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• pp.243-244
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• 2000

Serum albumin은 혈청 단백질 중 50-60%를 차지한다. 알부민은 순환계 내에서 삼투압을 유지시켜 세포내외의 체액을 유지 및 지용성 물질치 이동에 관여한다. 신사구체와 기저막의 투과성이 증가하거나 세뇨관의 흡수감소 등으로 단백질의 요배설량이 하루에 150mmg 이상되는 단백뇨는 신장내의 병변이 있음을 나타내는 중요한 지표이다. 이러한 단백뇨는 크게 사구체성 단백뇨, 세뇨관성 단백뇨, 혼합성 단백뇨로 나눌수 있는데 이중 사구체 기저막의 손상으로 발생되는 사구체성 단백뇨는 알부민과 같은 고분자량의 단백질이 소변 내로 배설되는 현상이다. 일반적으로 알부민이 정상치 이상으로 소변을 통하여 배설되는 것을 'microalbuminuria'라고 하며 당뇨병으로 인한 신장병변을 예견하는데 중요한 지표로 알려져 있다. Microalbuminuria는 방사 면역확산법, 방사성 면역측정법, 면역혼탁측정법, 비탁측정법, 효소결합면역측정법(ELISA) 등으로 검출할 수 있으나 최근에는 안전하면서도 민감도가 높고 측정이 용이한 방법인 ELISA를 이용한 면역분석방법이 많이 사용되고 있다. 면역특이성이 떨어지는 다세포군 항체를 사용한 방법의 문제점을 극복하기 위해서 세포융합기술을 이용한 단세포군항체를 생산하는 세포주를 개발하였고 그 특성을 규명하였다. 따라서 본 연구에서 세포융합기술을 도입하여 개발된 인간 혈청 알부민에 대한 단세포군항체는 glycohemoglobin에 대한 단세포군항체와 더불어 당뇨병의 진행 정도를 진단할 수 있는 키트의 원료로 사용될 수 있다.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.99-117
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• 2009

Diabetic nephropathy is a major cause of chronic renal failure in developing countries, and the prevalence rate has markedly increased during the past decade. Diabetic nephropathy shows various specific histological changes not only in the glomeruli but also in the tubulointerstitial region. In the early stage, the effacement of podocyte foot processes and thickened glomerular basement membrane (GBM) is noticed even at the stage of microalbuminuria. Nodular, diffuse, and exudative lesions, so-called diabetic glomerulosclerosis, are well known as glomerular lesions. Interstitial lesions also exhibit fibrosis, edema, and thickened tubular basement membrane. Diabetic nephropathy is considered to be multifactorial in origin with increasing evidence that one of the major pathways involved in the development and progression of diabetic nephropathy as a result of hyperglycemia. Hyperglycemia induces renal damage directly or through hemodynamic alterations, such as, glomerular hyperfiltration, shear stress, and microalbuminuria. Chronic hyperglycemia also induces nonhemodynamic dysregulations, such as, increased production of advanced glycosylation endproducts, oxidative stress, activation of signal pathway, and subsequent various cytokines. Those pathogenic mechanisms resulted in extracellular matrix deposition including mesangial expansion and GBM thickening, glomerular hypertrophy, inflammation, and proteinuria. In this review, recent opinions on the histopathologic changes and pathophysiologic mechanisms leading to initiation and progression of diabetic nephropathy will be introduced.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.398-404
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• 1999

Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of $^{99m}Tc$-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of $^{99m}Tc$-DMSA in predicting early diabetic nephropathy Materials and Methods: $^{99m}Tc$-DMSA scan was performed and a total renal uptake of $^{99m}Tc$-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of $^{99m}Tc$-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of $^{99m}Tc$-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of $^{99m}Tc$-DMSA of Group II ($40.8{\pm}11.0%$) was significantly lower than that of Group I ($54.4{\pm}6.3%$, p<0.001). The uptake of Group III ($27.7{\pm}12.0%$) was significantly lower than those of both Group I and Group II (p<0.001). $^{99m}Tc$-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.102, p<0.001). Conclusion: $^{99m}Tc$-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, $^{99m}Tc$-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

• Journal of the Semiconductor & Display Technology
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• v.10 no.3
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• pp.95-98
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• 2011

System to urinalysis using FT-IR instruments is presented based on fuzzy logic knowledge. Linguistic expressions of the possibility of infection and the importance were quantified and membership functions were determined based on general quantitative criteria. Diseases considered were Diabetes Mellitus, Proteinuria, Microalbuminuria. Glucose, Protein, Albumin, Creatinine in 30 samples were analyzed by the present system, which resulted in 74% accuracy. The simple mathematical formulation of present system would enable an easy implementation in commercial analysis instruments. Also, the identical fuzzy logic can be applied to similar diagnostic environments in general.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.158-163
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• 1994

Slightly elevated urinary albumin excretion rate (microalhuminuria) is a marker of early diabectic nephropathy, but it is unclear if the established definition of microalbuminuria ($20-200{\mu}g/min$) is correct for children and adolescents. We investigated th.: albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reterence value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevated albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean $3.2{\mu}g/min$, 95 percentile ($15.1{\mu}g/min$). In girls. a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a screening level for elevated albumin excretion ($15{\mu}g/min$) showed a high positive (0.88) and negative (0.99) predictive value.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1290-1295
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• 2018

Objectives: This case reports a certain level of improvement for asymptomatic proteinuria with short-term administration of herbal medicine. Methods: In the first treatment phase, the patient was treated with Dangguisu-san (DGSS) for his rib fracture. In the second treatment phase, the patient was treated with a herbal formulation of Astragali and Angelicae Sinensis (A&As particle) for asymptomatic proteinuria. Results: Treatment with herbal medicine resulted in a decrease in the patient's complaints regarding symptoms. Also, proteinuria-related items in hematology and urinalysis were improved. Conclusions: Herbal medicine therapy may be effective for proteinuria treatment.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.190-197
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• 2007

Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.31-39
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• 2022

Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.242-247
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• 2009

Type 1 diabetes mellitus (T1DM) commonly occurs in childhood and adolescence and diabetic nephropathy is a serious metabolic complication of T1DM that leads to serious morbidity. With poor glycemic control prepubertal diabetes duration contributes to the risk of long-term microvascular complications, however, the younger age at onset or longer prepubertal diabetes duration seems to prolong the time to development of microalbuminuria or later end-stage renal disease (ESRD). Therefore, there have been a few cases of diabetic nephropathy in prepubertal patients and therefore the ESRD cases developed during adolescence in T1DM children were very rare. Here we report an adolescent with T1DM who had poor glycemic control and was diagnosed as diabetic nephropathy in a prepubertal period and leading to end-stage renal disease during adolescence.