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당뇨병성 신증쥐에서 retinoid와 PPAR-γ 촉진제 병합투여에 관한 연구
한상엽 ( Sang Youb Han ),김시현 ( Cy Hyun Kim ),한금현 ( Kum Hyun Han ),차대룡 ( Dae Ryong Cha ),김한성 ( Han Seong Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.5
Purpose : An inflammatory mechanism has been suggested to contribute to the progression of diabetic nophropathy. Both retinoid and PPAR-7 agonist, known anti-inflammatory agents, have been reported to be beneficial in diabetic nephropathy. Because they form heterodimer for transcription within the nucleus, we investigated the effect of a combination treatment with them in streptozotocin (STZ)-induced diabetic rats. Methods: STZ-induced diabetic rats were treated with retinoid and PPAR- r agonist. The effects were determined by measuring urinary monocyte chemoattractant peptide (MCP)-i, proteinuria, and intrarenal ED-1 expression. Results Blood glucose concentration was higher in diabetic rats than in control rats. Retinoid and PPAR- r agonist did not affect blood glucose concentration. Urinary protein excretion (8.6 I 0.69 vs. 22.1 mg/mgCr, p<0.0l) and urinary MCP-1 (19.8z3.4 vs. 61.5±6.1 pg/mgCr, p`cO.Ol) were significantly higher in diabetic rats at four weeks after the induction of diabetes compared with controls. Proteinuria in the group with retinoic acid (16.9 1.4, mg/mgCr, pcz0.05) and PPAR-7 agonist (14.6 `1.5 mg/mgCr, pc0.05) were decreased. Retinoic acid (42.2±2.7 pglmgCr, p<O.05) and PPAR- agonist (40.5 `4.2pg/mgCr, pc0.05) significantly suppressed MCP-1 level in diabetic rats. However, combination treatment ment was not effective to proteinuria and urinary MCP-1 concentration. Urinary protein excretion was significantly correlated with MCP-1 (r0.9, p`c0.0i). Immunohistochemistry revealed a significant increase in staining for ED-i protein in the diabetic kidneys. Both retinoid and PPAR-γagonist significantly suppressed intrarenal ED-i synthesis. However combination treatment didnt show any additional beneficial effects. Conclusion: Both retinoic acid and PPAR-γagonist suppressed preteinuria and inflammatory changes in diabetic rats. However, there were no additional effects of the combination treatment present. Further ressrch is needed to determine the effect of the combination treatment on diabetic nephropathy.
이혁 ( Hyuk Lee ),한금현 ( Kum Hyun Han ),전준성 ( Joon Seong Jeon ),서정욱 ( Jung Wook Seo ),한상엽 ( Sang Youb Han ) 대한신장학회 2009 Kidney Research and Clinical Practice Vol.28 No.5
The main feature of acute renal failure is a decline in the glomerular filtration rate. However, urine leakage into the peritoneal cavity due to bladder rupture may cause pseudo-renal failure. This is a situation in which renal function is normal, along with the presence of elevated serum creatinine. A 47-year-old woman presented with abdominal distension and pretibial pitting edema on both lower extremities. She had no traumatic history. She did not complain of abdominal pain, and exhibit neither oliguria nor anuria. Her blood urea nitrogen (BUN) and serum creatinine was 105 and 11.2 mg/dL. Ascites showed that urea nitrogen and creatinine were 160 and 29 mg/dL, respectively. We confirmed bladder rupture by an abdominal CT scan and retrograde cystography. She underwent an emergency laparotomy to repair the ruptured bladder. Azotemia was normalized 2 days after the operation. Here we present a rare case of uremia due to bladder rupture.
지속성 외래 복막투석환자에서 Kocuria varians에 의해 발생한 재발성 복막염 1예
류우선 ( Woo Sun Rou ),이효근 ( Hyo Keun Lee ),곽이경 ( Yee Gyung Kwak ),한상엽 ( Sang Youb Han ),한금현 ( Kum Hyun Han ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Kocuria species are the normal flora of skin, mucosa and oropharynx, and can be the causative organisms of complications associated with intravenous catheterization, ambulatory peritoneal dialysis, and ventricular shunt. We report a case of relapsing peritonitis by Kocuria varians in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD). A 62 year old woman was admitted to the hospital with a complaint of abdominal pain and a turbid peritoneal dialysate. The patient was treated with a combination of intraperitoneal antibiotics. A culture of the peritoneal dialysate revealed K. varians, and the patient was discharged after she showed improvement with the treatment. Although the organism was sensitive to the administered antibiotics, the patient experienced 2 episodes of peritonitis. This continuing recurrence could be attributed to an insufficient treatment period or biofilm formation. Therefore, the patient underwent further treatment with intraperitoneal antibiotics and showed no recurrence for 1 year thereafter. This is the first report of relapsing peritonitis by K. varians. Although peritonitis caused by rare pathogens has been described recently, K. varians is known to have a low pathogenecity and occurs rarely. The findings in this case emphasize the importance of careful consideration on the rare pathogen and administration of the appropriate antibiotics for a sufficient duration.
이차 부갑상샘기능항진증이 있는 혈액투석 환자에게서 발생한 종양성 석회증
류우선 ( Woo Sun Rou ),이효근 ( Hyo Keun Lee ),한금현 ( Kum Hyun Han ),김덕원 ( Deok Weon Kim ),김용훈 ( Yong Hoon Kim ),주미 ( Mee Joo ),한상엽 ( Sang Youb Han ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.3
Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca×P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.