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Poster Session:PS 0485 ; Nephrology : Acute Kidney Injury Due to Povidone-Iodine Ingestion
( Chang Seong Kim ),( Sung Sun Kim ),( Eun Hui Bae ),( Seong Kwon Ma ),( Soo Wan Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Povidone-iodine is a broad spectrum antiseptic for topical application in the treatment and prevention of infection in wound. There are few case reports of acute kidney injury (AKI) after povidone-iodine irrigation in burn patients and in patients with its irrigation for management of post-renal transplantation lymphocele. However, AKI has not been described in patients after ingestion of povidone-iodine. We report a case of a 47-year-old man who was suspected ingestion of povidone-iodine solution and presented with nausea, vomiting, and reduced urine output. Laboratory data revealed blood urea nitrogen of 124 mg/dl, serum creatinine of 6.3 mg/dl, impaired liver function and leukocytosis. Urine iodine/creatinine ratio marked increased. The patient was admitted to the intensive care unit and performed continuous venovenous hemodiafi ltration. The kidney biopsy was showed feature of acute tubular necrosis and interstitial nephritis. Unstained section showed to tan-colored pigmentations that suspected iodine cast in tubular lumen. Renal function recovered after hemodialysis and steroid mediation, but not recovered completely. We observed the fi rst case of biopsy proven AKI accompanied by increased urine iodine concentration after povidone-iodine ingestion. Although a specifi c treatment for povidone-iodine intoxication is not available, the patients might be partially recovered from AKI in treatment with hemodialysis and steroid as in our case.
( Chang Seong Kim ),( Kyung-do Han ),( Jin Hyung Jung ),( Hong Sang Choi ),( Eun Hui Bae ),( Seong Kwon Ma ),( Soo Wan Kim ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.1
Background/Aims: Despite recent improvements in the quality of life of patients with systemic lupus erythematosus (SLE), osteoporosis, and osteoporotic fractures are one of the major complications of SLE. Furthermore, limited data are available on the incidence and predictor of osteoporotic fractures in Korean patients with SLE. Herein, we aimed to assess the incidence and risk factors for osteoporotic fractures in Korean SLE patients compared to those without SLE. Methods: SLE patients aged ≥ 40 years (n = 10,434; mean age, 51.3 ± 9.1 years; women, 89.7%) were selected from the Korean National Health Insurance Service database, spanning a period from 2008 to 2014. Age- and sex-matched controls (n = 52,170) were randomly sampled in a 5:1 ratio from non-SLE individuals. The primary outcome was the first occurrence of osteoporotic fracture. Results: The incidence of osteoporotic fractures was significantly higher in the SLE patients (19.085 per 1,000 person-years) than in matched controls (6.530 per 1,000 person-years). According to the multivariable Cox proportional analysis, patients with SLE exhibited a higher osteoporotic fracture rate than the control group (hazards ratio, 2.964; 95% confidence interval, 2.754 to 3.188), even after adjustment for confounding variables. In the subgroup analysis, male SLE patients or SLE patients aged 40 to 65 years were associated with a higher osteoporotic fracture rate than women SLE patients or SLE patients aged ≥ 65 years, respectively. Conclusions: We found a 2.964-fold increased risk of osteoporotic fracture in SLE patients compared to age- and sex-matched non-SLE controls. Male or middle-aged SLE patients had a relatively higher fracture risk among patients with SLE.
Reviews : Pharmacologic Management of the Cardio-renal Syndrome
( Chang Seong Kim ) 대한전해질학회 2013 Electrolytes & Blood Pressure Vol.11 No.1
Cardio-renal syndromes are disorders of the heart and kidney wherein acute or long-term dysfunction in one organ may induce acute or long-term dysfunction of the other. Because of this complex organ interaction, management of cardiorenal syndrome must be tailored to the underlying pathophysiology. Clinical guidelines exist for the treatment of heart failure or renal failure as separate conditions. Thus far, however, there has been no consensus about managing patients with cardio-renal and reno-cardiac syndromes. Pharmacologic treatment remains a controversial subject. Standard cardiac drugs such as diuretics and inotropes may have limited effect because resistance often develops after long- term use. Recent studies of patients with acute cardio-renal syndromes have focused on newer therapies, including phosphodiesterase inhibitors, vasopressin antagonists, adenosine A1 receptor antagonists, and renal protective dopamine. Initial clinical trials of these agents have shown encouraging results in some patients with heart failure, but have failed to demonstrate a clear superiority over more conventional treatments. Similarly, the benefits of diuretics, aspirin, erythropoietin agents, and iron supplements for management of chronic cardiorenal syndromes are unknown.
Prediction of Electromagnetic Wave Propagation in Space Environments Based on Geometrical Optics
Changseong Kim,Yong Bae Park 한국전자파학회JEES 2017 Journal of Electromagnetic Engineering and Science Vol.17 No.3
We predict the electromagnetic wave propagation in space environments using geometrical optics. The effective indices of the troposphere, stratosphere, and ionosphere are computed, and the reflection, refraction, and attenuation of electromagnetic waves in space environments are calculated based on the ray tracing technique and geometrical optics. The influence of the refractive index and loss of atmosphere and the incident angle of the antenna on electromagnetic wave propagation is discussed.
Case Report : Hyponatremia Associated with Bupropion
( Chang Seong Kim ),( Joon Seok Choi ),( Eun Hui Bae ),( Soo Wan Kim ) 대한전해질학회 2011 Electrolytes & Blood Pressure Vol.9 No.1
Bupropion is widely used for the treatment of depressive disorder and smoking cessation. Hyponatremia, including a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), is not rare complication of treatment with antipsychotic drugs. We report a 60-year-old man who experienced severe hyponatremia after a treatment with bupropion for depressive disorder for the first time in the Korea.
( Chang Seong Kim ),( Dong-chan Jin ),( Young Cheol Yun ),( Eun Hui Bae ),( Seong Kwon Ma ),( Soo Wan Kim ) 대한신장학회 2017 Kidney Research and Clinical Practice Vol.36 No.4
Background: It is thought that hyperuricemia might lower the risk of mortality among hemodialysis patients, unlike in the general population, but the evidence is controversial. The aim of the current study was to evaluate the impact of serum uric acid level on the long-term clinical outcomes of hemodialysis patients in Korea. Methods: Retrospective analysis was performed on data from the End-Stage Renal Disease Registry of the Korean Society of Nephrology. This included data for 7,333 patients (mean age, 61 ± 14 years; 61% male) who received hemodialysis from January 2001 through April 2015. Initial laboratory data were used in the analysis. Results: The mean serum uric acid level in this study was 7.1 ± 1.7 mg/dL. Body mass index, normalized protein catabolic rate, albumin, and cholesterol were positively correlated with serum uric acid level after controlling for age and sex. After controlling for demographic data, comorbidities, and residual renal function, a higher uric acid level was independently associated with a significantly lower all-cause mortality (hazard ratio [HR], 0.90 per 1 mg/dL increase in uric acid level; 95% confidence interval [CI], 0.83-0.97; P = 0.008), but not cardiovascular mortality (HR, 0.90; 95% CI, 0.80-1.01; P = 0.078). Comparing uric acid levels in the highest and lowest quintiles, the HR for allcause mortality was 0.65 (95% CI, 0.42-0.99; P = 0.046). Conclusion: Hyperuricemia was strongly associated with a lower risk of all-cause mortality, but there seems to be no significant association between serum uric acid level and cardiovascular mortality among Korean hemodialysis patients with end-stage renal disease.
REVIEW : Vitamin D and chronic kidney disease
( Chang Seong Kim ),( Soo Wan Kim ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.4
Chronic kidney disease (CKD) has been recognized as a significant global health problem because of the increased risk of total and cardiovascular morbidity and mortality. Vitamin D deficiency or insufficiency is common in patients with CKD, and serum levels of vitamin D appear to have an inverse correlation with kidney function. Growing evidence has indicated that vitamin D deficiency may contribute to deteriorating renal function, as well as increased morbidity and mortality in patients with CKD. Recent studies have suggested that treatment with active vitamin D or its analogues can ameliorate renal injury by reducing fibrosis, apoptosis, and inflammation in animal models; this treatment also decreases proteinuria and mortality in patients with CKD. These renoprotective effects of vitamin D treatment are far beyond its classical role in the maintenance of bone and mineral metabolism, in addition to its pleiotropic effects on extramineral metabolism. In this review, we discuss the altered metabolism of vitamin D in kidney disease, and the potential renoprotective mechanisms of vitamin D in experimental and clinical studies. In addition, issues regarding the effects of vitamin D treatment on clinical outcomes are discussed.