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빈기태(Ki Tai Bin),나기량(Gi Ryang Na),오선미(Seoun Mee Oh),김종섭(Jong Sub Kim),김성숙(Seong Suk Kim),이강욱(Kang Wook Lee),신영태(Young Tai Shin),서광선(Kwang Sun Seo),이정호(Jeong Ho Lee) 대한내과학회 1996 대한내과학회지 Vol.51 No.6
N/A Objectives: IgA nephropathy is the commonest glomerulonephritis in the world. In contrast to initial report indicated a favorable prognosis, subsequent reports have shown a highly variable outcome leading to end-stage renal failure in significant proportion of patients. Because IgA nephropathy is a disease with variable rate of progression to chronic renal failure, identification of clinical and pathologic prognostic indicators for these patients is very important. Methods: To evaluate the clinical features of IgA nephropathy and clinicopathological parameters that are associated with deteriorated renal function, we analyzed retrospectively 149 patients who were diagnosed as IgA nephropathy at Chungnam National University Hospital from January, 1986 to June, 1994. We also evaluated the clinicopathological fin- dings of 23 patients who were followed for more than 36 months in order to determine the prognostic signigificance of various renal histopathological alterations and clinical parameters, Results: l) IgA nephropathy was disgnosed to 149 patients(26.5%) for same period among 565 biopsied patients. 2) It is most common in the 3rd and 4th decades. The mean age of the patients was 28.9 years, and male to female ratio ratio was 1: 1,25. 3) Fifty two percents of the patients presented with gross hematuria. Upper respiratory tract infection preceded grosss hematuria in 85% of the patients. 4) At the time of renal biopsy, 9,4% of the patients showed heavy proteinuria and nephrotic syndrome, 5) In Comparison of clinicopathological parameters between 14 patients with normal renal function and 9 patients with deteriorated renal function who had a follow-up period of more than 36 months, the results of the findings are as follows: 24 hours total urine protein more than 2.0 grams, elevated BUN and serum creatinine concentration and severe degree of renal histopathologic findings, such as mesangial proliferation and sclerosis, interstitial fibrosis and tubular atrophy showed poor prognostic results. Conclusion: Clinical features such as 24 hours total urine protein more than 2 grams, higher serum blood urea nitrogen and serum creatinine and severe degree of histopathologic features such as mesangial proliferation and sclerosis, interstitial fibrosis and tubular atrophy were associated with deteriorated renal function.
신이식 후 Trimethoprim-Sulfamethoxazole과 Omeprazole에 의한 급성간질성신염
장동석 ( Dong Seok Jang ),나소영 ( So Young Na ),이수윤 ( Soo Youn Lee ),권오경 ( O Kyong Kwon ),이한규 ( Han Kyu Lee ),이영모 ( Young Mo Lee ),나기량 ( Ki Ryang Na ),이강욱 ( Kang Wook Lee ),서광선 ( Kwang Sun Suh ),신영태 ( Youn 대한신장학회 2005 Kidney Research and Clinical Practice Vol.24 No.6
혈액투석 중인 말기신부전 환자에서 발생한 양측 신장의 자발성 파열
정사라 ( Sa Rah Chung ),최대은 ( Dae Eun Choi ),나기량 ( Ki Ryang Na ),설종구 ( Chong Koo Sul ),이강욱 ( Kang Wook Lee ),신영태 ( Young Tai Shin ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
Bilateral spontaneous renal rupture is a rare event that has been documented in only a few reports. We report a spontaneous, but not simultaneous rupture of both kidneys in a 64-year-old man with end-stage renal disease who had been treated with hemodialysis for 78 months. He complained of sudden left flank pain. Abdominal computed tomography (CT) revealed a huge perirenal hematoma with multiple renal cysts. The patient underwent an urgent left nephrectomy and was diagnosed as multiple acquired renal cysts with rupture and focal incidental papillary renal cell carcinoma. Twentytwo days after the left nephrectomy, he complained of sudden right flank pain and abdominal CT showed another massive perirenal hematoma. The patient underwent a right nephrectomy and was diagnosed as renal cyst rupture with perirenal hemorrhage. However, there was no evidence of renal cell carcinoma in the right kidney. Postural hypotension and frequent hypotensive episodes developed during hemodialysis several months after both nephrectomies. He was diagnosed as primary adrenal insufficiency with rapid adrenocorticotropic hormone (ACTH) stimulation test and the level of plasma ACTH and was treated with prednisolone and fludrocortisone. The patient died of acute myocardial infarction 32 months after bilateral nephrectomies.
IgA 신병증 환자에서 신장조직내 TGF - β , IL-6 Osteopontin 및 MCP-1 유전자 발현에 관한 연구
이강욱(Kang Wook Lee),송정헌(Jung Hun Song),박기현(Ki Hyun Park),이상주(Sang Joo Lee),장윤경(Youn Kyung Chang),양종오(Jong Oh Yang),나기량(Ki Ryang Na),서광선(Kwang Sun Suh),신영태(Young Tai Shin) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.4
In many experimental models and human renal diseases, TGF- 0, IL-6, osteopontin and MCP-1 have been thought to be involved in progressive re- nal injury mechanism. In order to evaluate the renal expression of these genes in six control patients (Group A) whose renal biopsy had shown only minimal lesion and no immune deposition on the light and immunofluorescent microscopic examinations and sixteen patients(Group B) who had been confirmed with primary IgA nephropathy by renal biopsy frorn Jan. 1999 to Jan. 2000 in Chungnam National University Hospital were included in this study. Competitive RT-PCR was performed to estimate the each gene studied and GAPDH expression levels of kidney biopsy specimens. The magnitude of each gene expression was represented as the ratio to GAPDH. Twenty-four hour urinary protein excretion of Group B(mean 3,882 mg/day) was significantly higher than that of Group A(mean 560 mg/day, p<0.01). The TGF- β, MCP-1, and IL-6 gene expressions of Group B(0.88±0.21, 0.85±0.14, 1.59±0.24, and 1.50±0.24, respectively) were significantly higher than those of Group B(0.19±0.14, 0.18±0.03, and 0.57±0.18, respectively, p<0.05, p<0.05, p<0.05, p<0.05). The MCP-1, osteopontin and IL-6 gene expressions of 6 IgA nephropathy patients with crescents in glomeruli and marked tubulointerstitial mononuclear cell infiltration on light microscopic examination(1.40>0.32, 2.07±0.40, 1.85>0.31, respectively) were significantly higher than those of 10 IgA nephropathy patients without crescents or marked tubulointerstitial mononuclear cell infiltration(0.59±0.24, 0.74±0.18, 1.050.18, respectively, p<0.05, p<0.05, p<0.05). The level of MCP-1 gene expression was significantly positively correlated with the magnitude of 24 hour protein excretion(r2=0.54, p<0.05). However, the level of TGF-0, osteopontin and IL-6 gene expressions were not significantly correlated with the magnitude of proteinuria. With the above results, we speculate that upregulation of osteopontin, MCP-1, IL-6 genes of the kidney may be related to rapid progressive renal in- jury process in patients with IgA nephropathy.