• Journal of Yeungnam Medical Science
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• 제25권1호
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• pp.58-63
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• 2008

Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

• 한국임상수의학회지
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• 제23권2호
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• pp.211-217
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• 2006

Six patients (5 dogs, 1 cat) were referred with the complications of urinary tract injuries. Clinical signs were vomiting (4/6), oliguria (2/6) and anuria (3/6). Four females had been spayed, 1 male had cryptorchid orchiectomy and 1 male had been operated for removing calculi in the urethra. Both preoperative and intraoperative investigation were performed and they were confirmed as iatrogenic injuries in the urinary tract during surgery. Depending on the condition of the complications, urethral anastomosis, unilateral nephrectomy, ureteroneocystostomy, colonic urinary diversion, ureterourethral anastomosis, cystostomy and suture of the defect region were performed separately in individual cases. Postoperative observation revealed 50% (3 cases) survival rate of the patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.226-229
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• 2009

저자들은 하지의 자반과 함께 발생한 복통, 혈변, 구토, 핍뇨 등을 주소로 내원한 7세 소아에서 급성 췌장염과 저혈량성 급성 신부전이 함께 동반된 Henoch-Sch$\"{o}$nlein 자반증으로 진단하고 치료한 증례를 경험하였기에 문헌고찰과 함께 보고한다. 급성 췌장염은 Henoch-Schonlein 자반증 환자에서 매우 드문 합병증이지만 불필요한 개복술을 피하기 위하여 급성 복증의 다른 원인들과 반드시 감별 진단해야 한다.

• Journal of Chest Surgery
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• 제30권12호
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• pp.1251-1253
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• 1997

개심 수술후 위장관 계통의 합병증은 드물게 발생하지만 사망률은 매우 높은 심각한 합병증 중의 하나이 며 특히 십이지장의 합병증은 그 빈도가 매우 드문 것으로 알려져 있다. 본원에서는 개심 수술후 십이지장 출혈 1례, 십이지장 궤양 천공 2례를 치험하였다. 출혈의 경우 빈맥, 현기증, 흑색변 등의 증상이 임상적 의 심의 단서가 되었으며, 천공의 경우는 복통을 동반한 복부 팽만, 빈맥, 저혈압, 핍뇨 등이 임상적 단서가 되 었고 복막펀자술로 확진을 내릴 수 있었다. 십이지장 출혈의 경우 항제산제의 복용, 수혈 등 보존적인 방법 으로 치료되었으나 십이지장 천공의 경우에는 2례 모두에서 응급 개복수술을 필요로 하였고 1례는 병발되는 합병증으로 가퇴원하였으며, 나머지 1례에서는 장기간의 중환자실 처치를 필요로 하였다. 따라서 수술전 과 거력상 위장관 계통의 증상, 장시간의 심폐바이패스 사용등 위십이지장궤양의 위험인자가 있는 환자들에서 는 개심수술후 항궤양 약물의 예방적 사용뿐만 아니라 십이지장 합병증에 대한 임상적 의심, 조기 진단과 시의 적절한 치료가 십이지장 합병증의 이환율과 사망률을 줄이는데 필요한 것으로 생각된다.

• 한국임상수의학회지
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• 제37권2호
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• pp.91-95
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• 2020

A 13-year-old, intact male, Yorkshire terrier dog with oliguria and hematuria was presented to the Small Animal Clinic at the Gyeongsang National University animal medical center. There were no remarkable findings on serum chemistry values and complete blood counts. Abdominal radiographs revealed mild elevation of the descending colon at the pelvic level. On the excretory urographic images, a large filling defect was identified in urinary bladder with narrow urinary bladder wall contact and there were no remarkable findings in kidneys and ureters. The abdominal ultrasonography revealed that an irregularly marginated, heterogeneous mass in urinary bladder, central cavitary lesion and mild vascular flow were also observed. Computed tomography showed a heterogeneously attenuated mass within urinary bladder. The mass was surgically excised, and leiomyosarcoma was confirmed by histopathological examination. The patient was followed up for two months and there were no complications. This case is of interest because of the unusual findings of leiomyosarcoma of urinary bladder in a small breed dog.

• Childhood Kidney Diseases
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• 제23권1호
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• pp.53-57
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• 2019

Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• Childhood Kidney Diseases
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• 제8권2호
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• pp.159-165
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• 2004

목적: 본 연구는 지난 3여년간 연쇄상구균 감염후 사구체신염으로 진단 받은 환아들 중 초기에 육안적 혈뇨를 보인 환아들의 임상양상을 관찰하고 현미경적 혈뇨만을 보인 환아들과의 차이를 비교하여 경과 예측에 도움이 되고자 한다. 방법: 2000년 1월부터 2003년 4월까지 인제대학교부속 일산 백병원과 국민건강보험공단 일산병원에서 연쇄상구균 감염후 사구체신염으로 진단받은 환아 39례를 대상으로 하였다. 결과: 대상 환아들의 평균 발병 연령은 8.85세 남녀 비는 1.1:1이었으며, 육안적 혈뇨를 보인 환아들(A군)은 17례, 현미경적 혈뇨만을 보인 환아들(B군)은 22례이었다. 두 군간의 부종, 핍뇨, 상기도 감염의 기왕력등의 빈도의 차이는 없었으나, 고혈압의 빈도는 A군 17례중 3례(17.6%), B군 22례중 11례(50.0%)로 B군에서 높았다. 검사 소견상 백혈구수, BUN, creatinine, ASO치는 차이가 없었으나 혈청 보체치 C3와 C4는 B군에서 낮게 측정되었고 단백뇨의 정도를 나타내는 소변 내 단백/creatinine의 비와 24시간 소변내 단백량은 A군에서 높은 수치를 보였다. 그러나 질환에 의한 합병증의 발생이나 사망은 없었다. 결론: 초기에 육안적 혈뇨를 가진 환아들(A군)은 현미경적 혈뇨만을 보였던 환아들(B군)보다 고혈압의 빈도는 낮았으며, 단백뇨의 양은 많았다. 그러나 두 군간의 임상경과 및 예후의 유의한 차이는 없었으며 대상 환아 전례에서 임상적인 호전을 보였다.

• 한국임상수의학회지
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• 제30권1호
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• pp.57-60
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• 2013

개에서 포도중독에 의한 신부전 치료결과에 대한 임상적 분석을 위하여 205-2008년 기간 중 강원대학교 수의과대학 동물병원에 내원한 환자의 의료기록부를 분석하였다. 총 11두 (암컷 8두) 중 4두는 완전히 회복하였고, 3두는 폐사, 4두는 안락사로 처리되었다. 1두를 제외한 모든 환자는 포도를 섭취하였으나 정확한 섭취량은 알 수 없었다. 환자의 평균 연령은 5.3세 (범위 0.2-11.3세), 체중은 4.1 kg (범위 1.4-13 kg)였으며, 평균 입원기간은 7.1일 (범위 2-22일)로 나타났다. 모든 환자에서 구토와 식욕부진 증상을 보였으며, 일부 환자는 설사 (4두), 핍뇨 (5두), 무뇨 (4두) 소견을 보였다. 모든 환자에서 혈청 phosphorous, creatinine, BUN 농도가 증가된 소견을 보였으며, 고칼슘혈증 2두, 저칼슘혈증 2두, 나머지 7두는 정상소견이었다. 혈청 농도가 증가한 항목은 amylase 8두, ALP 7두, ALT 5두였으며, 혈액 가스 분석에서 8두는 대사성산증을 보였다. 경미하거나 중등도의 빈혈 소견이 5두에서 관찰되었으며, 회복한 환자와 비교할 때 폐사축의 경우 혈소판과 림프구 수가 상대적으로 낮았다.

• 대한약침학회지
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• 제13권4호
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• pp.91-107
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• 2010

Objectives : The purpose of this study was to analyze the propensity and find out the Syndrome Differentiation of teeth-mark tongue by taking survey and body examinations with 178 male patients. 164 patients out of 178 were checked up on Heart Rate Variability (HRV), Accelerated Photoplethysmograpy (APG), Body Composition. This study was also planned to find out the distinctive characteristics of teeth-mark tongue diagnosis and compare differences between Qi-Deficiency and Accumulation of Dampness and Phlegm patients group. Methods : The questionnaire was carried out targeting 178 male with teeth-mark tongue respondents among who had Oriental Health Examination and patients from the 3rd oriental-internal medicine department in Dongeui Hospital from $1^{st}$, March 2005 to $30^{th}$, April 2010. Only 164 patients were checked on HRV, APG and Body composition examinations. Results : It showed that 86 patients had Qi-Deficiency and 78 had Dampness and Phlegm but 14 couldn't be categorized. The major symptoms of Qi-Deficiency compared to Dampness and Phlegm were 'Frequent running nose', 'Soft stool', 'Chronic fatigue', and 'Eyestrain'. On the contrary, Dampness and Phlegm's dominant symptoms were 'Chest discomfort', 'Feeling bloated', 'Back pain', 'Feeling sluggish', and 'Itchy skin'. However, all symptoms were not matched with the Syndrome Differentiation of Qi-Deficiency or Dampness and Phlegm. It also showed that teeth-mark tongue patients' frequent symptoms were 'Stuffy nose', 'Feeling bloated', 'Oliguria', 'Shoulder pain', 'Chronic fatigue' 'Eyestrain' and these symptoms were matched with the Syndrome Differentiation of Qi-Deficiency and Dampness and Phlegm. In the results from this study, there were no significant differences between Qi-Deficiency and Dampness and Phlegm. Conclusions : It is hard to conclude that teeth-mark tongue could be only one to diagnose Qi-Deficiency or Dampness and Phlegm with 3 examinations.