Although many approaches have been attempted in the evaluation of liver size such as measurement of length,area and volume, the linear measurements have been used most frequently because of simplicity. We measured theliver size using 4 linear measurements for evaluation of hepatic pliability on plain abdominal film in the erectand the supine position. Our cases consisted of 125 persons who have no symptom or signs clinically and havenormal liver function test. The results were as follows: 1. The measurements of the liver size using diagonaldiameter(DD), oblique diameter of right lobe(OD), midline vertical diameter(MD) and height of right dome of theliver(HD) were ; 19.6+-1.8cm, 13.7+-1.6cm, 2.03+-0.4cm in the supine position; and 20.5+-2.1cm, 21.9+-2.1cm,15.4+-2.1cm, 1.87+-0.4cm in the erect position, respectively. 2. The differences of each diameter between erectand supine position were 0.9+-1.0cm in DD, 0.9+-1.0cm in OD and 1.7+-1.4cm in MD, and they were longer in thesupine position (p<0.001). 3. The HD was slinghtly longer in the supine position than in the erect position(p<0.001). 4. Among the 4 measurements, the largest difference of linear diameter between the erect and the supineposition was by MD. 5. We found the change or size and shape of the normal liver in the different position.
Humans ; Liver ; Liver Function Tests ; Pliability ; Supine Position

No abstract available.
Renal Insufficiency, Chronic*

No abstract available.
Renal Dialysis

No abstract available.
Humans ; Kidney ; Niacin

No abstract available.
Humans ; Kidney ; Niacin

Prevention, early detection, and treatment of renal disease in diabetic patients are becoming major healthcare issues. It is well known that hyperglycemia is a major risk factor for the development and progression of diabetic nephropathy. Therapeutic options such as strict glycemic control and early antihypertensive treatment effectively prevent or slow the progression of renal disease in both types of diabetes, depending on the clinical manifestations. The mainstay of diabetic nephropathy therapy is good glycemic control and maintaining optimal blood pressure with angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs). Additionally, correction of dyslipidemia and cessation of smoking are additional important factors to prevent and slow the progression of diabetic nephropathy. Biochemical and hemodynamic hypotheses have been proposed and are supported by animal models as the principal causes of the development and progression of diabetic nephropathy. This review discusses new insights into the recent trend focusing on new therapies, including hemodynamic agents and biochemical agents for preventing and delaying the progression of diabetic nephropathy.
Angiotensin Receptor Antagonists ; Blood Pressure ; Delivery of Health Care ; Diabetic Nephropathies ; Dyslipidemias ; Hemodynamics ; Humans ; Hyperglycemia ; Models, Animal ; Peptidyl-Dipeptidase A ; Risk Factors ; Smoke ; Smoking

Prevention, early detection, and treatment of renal disease in diabetic patients are becoming major healthcare issues. It is well known that hyperglycemia is a major risk factor for the development and progression of diabetic nephropathy. Therapeutic options such as strict glycemic control and early antihypertensive treatment effectively prevent or slow the progression of renal disease in both types of diabetes, depending on the clinical manifestations. The mainstay of diabetic nephropathy therapy is good glycemic control and maintaining optimal blood pressure with angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs). Additionally, correction of dyslipidemia and cessation of smoking are additional important factors to prevent and slow the progression of diabetic nephropathy. Biochemical and hemodynamic hypotheses have been proposed and are supported by animal models as the principal causes of the development and progression of diabetic nephropathy. This review discusses new insights into the recent trend focusing on new therapies, including hemodynamic agents and biochemical agents for preventing and delaying the progression of diabetic nephropathy.
Angiotensin Receptor Antagonists ; Blood Pressure ; Delivery of Health Care ; Diabetic Nephropathies ; Dyslipidemias ; Hemodynamics ; Humans ; Hyperglycemia ; Models, Animal ; Peptidyl-Dipeptidase A ; Risk Factors ; Smoke ; Smoking

Therapeutic manipulation of the renin-angiotensin-aldosterone system (RAAS) is an important strategy for improving hypertension, diabetes, cardiovascular disease, and chronic kidney disease. Development of hyperkalemia after the administration of RAAS inhibitors is of particular concern because patients at highest risk for this complication are often the same patients who derive the greatest cardiovascular or renoprotective benefit. Based on an overview of the incidence of hyperkalemia during treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers alone and in combination, this review suggests approaches for monitoring, detecting, and managing hyperkalemia in patients treated with RAAS inhibitors. Although the incidence of hyperkalemia with RAAS inhibitors is generally low, hyperkalemia can be associated with increased mortality. When using RAAS inhibitors, it is important to monitor on-treatment electrolyte levels and renal function parameters in patients with a high risk for hyperkalemia.
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Cardiovascular Diseases ; Humans ; Hyperkalemia ; Hypertension ; Incidence ; Organothiophosphorus Compounds ; Peptidyl-Dipeptidase A ; Renal Insufficiency, Chronic ; Renin-Angiotensin System

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, and its pathogenesis is complex and has not yet been fully elucidated. Abnormal glucose and lipid metabolism is key to understanding the pathogenesis of DN, which can develop in both type 1 and type 2 diabetes. A hallmark of this disease is the accumulation of glucose and lipids in renal cells, resulting in oxidative and endoplasmic reticulum stress, intracellular hypoxia, and inflammation, eventually leading to glomerulosclerosis and interstitial fibrosis. There is a growing body of evidence demonstrating that dysregulation of 5' adenosine monophosphate-activated protein kinase (AMPK), an enzyme that plays a principal role in cell growth and cellular energy homeostasis, in relevant tissues is a key component of the development of metabolic syndrome and type 2 diabetes mellitus; thus, targeting this enzyme may ameliorate some pathologic features of this disease. AMPK regulates the coordination of anabolic processes, with its activation proven to improve glucose and lipid homeostasis in insulin-resistant animal models, as well as demonstrating mitochondrial biogenesis and antitumor activity. In this review, we discuss new findings regarding the role of AMPK in the pathogenesis of DN and offer suggestions for feasible clinical use and future studies of the role of AMPK activators in this disorder.
Adenosine* ; AMP-Activated Protein Kinases ; Anoxia ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies* ; Endoplasmic Reticulum Stress ; Fibrosis ; Glucose ; Homeostasis ; Inflammation ; Kidney Failure, Chronic ; Lipid Metabolism ; Models, Animal ; Organelle Biogenesis ; Oxidative Stress ; Protein Kinases*

Kimura's disease is a granulomatous disease which develops in the skin, subcutaneous tissues and lymph nodes and is characterized histologically by the presence of lymphoid follicles, vascular proli- feration and infiltration with eosinophils. The disease shows geographical predilection to Japan, China and South East Asia. The exact etiology and pathogenesis remain uncertain. Some patients had proteinuria or nephrotic syndrome. We have recently experienced the superimposed oliguric acute renal failure associated with Kimura's disease in a male patient with chronic renal failure who had been managed conservatively. Inguinal lymph node biopsy revealed Kimura's disease. He recovered from acute renal failure after being treated with hemodialysis and prednisolone. Lymphadeno- pathy and fever subsided with steroid treatment. We report a case of Kimura's disease which was complicated by acute renal failure in the patient with chronic renal failure.
Acute Kidney Injury* ; Biopsy ; China ; Eosinophils ; Far East ; Fever ; Humans ; Japan ; Kidney Failure, Chronic* ; Lymph Nodes ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Renal Dialysis ; Skin ; Subcutaneous Tissue