1.Rhabdomyolysis in children: a case report.
Hong-mei QIAO ; Huan-ji CHENG ; Hong-bo WANG
Chinese Journal of Pediatrics 2013;51(2):150-152
Biomarkers
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analysis
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Biopsy
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Child
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Female
;
Fluid Therapy
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Humans
;
Kidney Diseases
;
etiology
;
Rhabdomyolysis
;
diagnosis
;
etiology
;
therapy
;
Virus Diseases
;
complications
2.Cardiac Autonomic Neuropathy as a Predictor of Deterioration of the Renal Function in Normoalbuminuric, Normotensive Patients with Type 2 Diabetes Mellitus.
Yong Kyun KIM ; Jung Eun LEE ; Yoon Goo KIM ; Dae Joong KIM ; Ha Young OH ; Chul Woo YANG ; Kwang Won KIM ; Wooseong HUH
Journal of Korean Medical Science 2009;24(Suppl 1):S69-S74
Our study was performed to determine whether cardiac autonomic neuropathy can predict deterioration of the renal function in normoalbuminuric, normotensive people with type 2 diabetes mellitus (DM). One hundred and fifty-six normoalbuminuric, normotensive people with type 2 DM were included in our retrospective longitudinal study. We categorized normal patterns, early patterns, and definite or severe patterns according to the results of the cardiac autonomic function test. Of 156 patients included, 54 had normal patterns, 75 had early patterns, 25 had definite or severe patterns, and 2 had atypical patterns. During a median follow-up of nine years, glomerular filtration rates (GFR) remained stable in the normal and early pattern groups (mean changes, 4.50% and 0.77%, respectively) but declined in those with definite or severe patterns (mean change, -10.28%; p=0.047). An abnormal heart response to the deep breathing test of the cardiac autonomic function tests was an independent predictor of GFR decline. Our data suggest that cardiac autonomic neuropathy, especially with a definite or severe pattern, might be associated with a subsequent deterioration in renal function in normoalbuminuric, normotensive people with type 2 DM.
Aged
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Blood Pressure
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Diabetes Complications
;
Diabetes Mellitus, Type 2/*diagnosis/*pathology
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Female
;
Follow-Up Studies
;
Glomerular Filtration Rate
;
Heart Diseases/*complications
;
Heart Rate
;
Humans
;
Kidney/*pathology
;
Kidney Diseases/*therapy
;
Male
;
Middle Aged
;
Nephrology/methods
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Neurodegenerative Diseases/*complications
3.Successful Management of Recurrent Colon Ulcer in Hemodialysis Patient after Conversion to Peritoneal Dialysis.
Ji Young LEE ; In Tae MOON ; Hye Young LEE ; Hang Lak LEE ; Dong Soo HAN
The Korean Journal of Gastroenterology 2015;66(6):350-353
Lower gastrointestinal complications often develop in end stage renal disease patients, and among the more problematic is recurrent colon ulcer. The exact pathogenesis of this condition is not known and there were no specific therapeutic modalities concerning this type of disease entity. We report, with a literature review, a case of recurrent colon ulcer with intermittent hematochezia in an end stage renal disease patient on long term hemodialysis that improved after conversion to peritoneal dialysis.
Aspirin/therapeutic use
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Colon/pathology
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Colonic Diseases/complications/*diagnosis/drug therapy
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Colonoscopy
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Drug Therapy, Combination
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Gastrointestinal Hemorrhage
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Humans
;
Kidney Failure, Chronic/*complications
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Male
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Middle Aged
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Peritoneal Dialysis
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Recurrence
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Ticlopidine/therapeutic use
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Ulcer/complications/*diagnosis/drug therapy
4.Renal Parenchymal Malakoplakia Presenting as Acute Renal Failure in a Young Woman.
Guo-Qin WANG ; Xiao-Yi XU ; Yi-Pu CHEN ; Hong CHENG
Chinese Medical Journal 2016;129(15):1880-1881
Acute Kidney Injury
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diagnosis
;
drug therapy
;
etiology
;
Adult
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Anti-Bacterial Agents
;
therapeutic use
;
Cyclophosphamide
;
therapeutic use
;
Female
;
Humans
;
Kidney Diseases
;
diagnosis
;
drug therapy
;
Levofloxacin
;
therapeutic use
;
Malacoplakia
;
complications
;
diagnosis
;
drug therapy
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Prednisone
;
therapeutic use
5.Renal outcomes and clinical course of nondiabetic renal diseases in patients with type 2 diabetes.
Ja Min BYUN ; Cheol Hyun LEE ; Sul Ra LEE ; Ju Young MOON ; Sang Ho LEE ; Tae Won LEE ; Chun Gyoo IHM ; Kyung Hwan JEONG
The Korean Journal of Internal Medicine 2013;28(5):565-572
BACKGROUND/AIMS: In several recent studies, renal biopsies in patients with type 2 diabetes and renal disease have revealed a heterogeneous group of disease entities. Our aim was to study the prognosis and clinical course of nondiabetic renal disease (NDRD) and to determine risk factors for NDRD in patients with type 2 diabetes. METHODS: Renal biopsy reports of 110 patients with type 2 diabetes who were seen at Kyung Hee University Medical Center and Kyung Hee University Hospital at Gangdong, Seoul, Korea between January 2000 and December 2011 were retrospectively analyzed. RESULTS: Of 110 patients with type 2 diabetes, 41 (37.3%) had diabetic nephropathy (DN), 59 (53.6%) had NDRD, and 10 (9.1%) had NDRD superimposed on DN. Immunoglobulin A nephropathy (43.5%) was the most common NDRD. Patients with NDRD had a shorter duration of diabetes, lower frequency of diabetic retinopathy, and better renal outcomes, which might have resulted from the use of aggressive disease-specific treatments such as steroids and immunosuppressants in patients with NDRD. CONCLUSIONS: Compared with DN, NDRD was associated with better renal outcomes in patients with type 2 diabetes, as evidenced by a higher cumulative renal survival rate and lower rate of end-stage renal disease (ESRD). Shorter duration of diabetes and absence of retinopathy were independent predictors of NDRD in patients with type 2 diabetes and renal involvement. Renal biopsy is recommended for patients with type 2 diabetes and risk factors for NDRD, to obtain an accurate diagnosis, prompt initiation of disease-specific treatment, and ultimately better renal outcomes with the avoidance of ESRD.
Adult
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Biopsy
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Chi-Square Distribution
;
Diabetes Mellitus, Type 2/*complications/diagnosis/therapy
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Diabetic Nephropathies/diagnosis/etiology
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Disease Progression
;
Female
;
Glomerulonephritis, IGA/complications/diagnosis
;
Hospitals, University
;
Humans
;
Kaplan-Meier Estimate
;
Kidney Diseases/*complications/diagnosis/therapy
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Kidney Failure, Chronic/diagnosis/etiology
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Logistic Models
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Male
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Middle Aged
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Multivariate Analysis
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Odds Ratio
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Prognosis
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Retrospective Studies
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Risk Factors
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Time Factors
6.Whole blood versus serum ionized calcium concentrations in dialysis patients.
Seok Hui KANG ; Kyu Hyang CHO ; Jong Won PARK ; Kyung Woo YOON ; Jun Young DO
The Korean Journal of Internal Medicine 2014;29(2):226-230
BACKGROUND/AIMS: The aim of this study is to measure the difference of ionized calcium between heparinized whole blood and serum. METHODS: We recruited 107 maintenance hemodialysis (HD) patients from our hospital HD unit. The clinical and laboratory data included ionized calcium in serum and in whole blood (reference, 4.07 to 5.17 mg/dL). RESULTS: The level of ionized calcium in serum was higher than that in whole blood (p < 0.001). Bland-Altman analysis showed that difference for ionized calcium was 0.5027. For the difference, the nonstandardized beta was -0.4389 (p < 0.001) and the intercept was 2.2418 (p < 0.001). There was a significant difference in the distribution of categories of ionized calcium level between two methods (kappa, 0.279; p < 0.001). CONCLUSIONS: This study demonstrates that whole blood ionized calcium is underestimated compared with serum ionized calcium. Positive difference increases as whole blood ionized calcium decreases. Therefore, significant hypocalcemia in whole blood ionized calcium should be verified by serum ionized calcium.
Aged
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Biological Markers/blood
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Calcium/*blood
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Female
;
Humans
;
Hypercalcemia/blood/*diagnosis/etiology
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Hypocalcemia/blood/*diagnosis/etiology
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Kidney Diseases/blood/complications/diagnosis/*therapy
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Male
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Middle Aged
;
Predictive Value of Tests
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*Renal Dialysis/adverse effects
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Reproducibility of Results
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Specimen Handling/*methods
7.Intrathoracic kidney with left-sided Bochdalek hernia in a woman with bacteremic acute pyelonephritis due to Escherichia coli.
Yong Sun NOH ; Yeonguk KIM ; Yun SEO ; Seong Heon WIE ; U Im CHANG
The Korean Journal of Internal Medicine 2015;30(2):267-268
No abstract available.
Acute Disease
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Adult
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Anti-Bacterial Agents/therapeutic use
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Choristoma/*complications/radiography
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Escherichia coli Infections/diagnosis/drug therapy/*microbiology
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Female
;
Hernias, Diaphragmatic, Congenital/*complications/radiography
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Humans
;
*Kidney
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Predictive Value of Tests
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Pyelonephritis/diagnosis/drug therapy/*microbiology
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Thoracic Diseases/*complications/radiography
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Tomography, X-Ray Computed
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Treatment Outcome
8.Characteristics of urinary retention in female inpatients managed with medical treatments.
Chang Yong LEE ; Chul Sung KIM ; Won Jin CHO
Korean Journal of Urology 2015;56(12):817-822
PURPOSE: We aimed to analyze the characteristics of urinary retention (UR) in female inpatients managed with medical treatments. MATERIALS AND METHODS: We retrospectively analyzed the medical records of female inpatients referred to the department of urology for UR at our institution from January 2009, to December 2014. UR was defined as a difficulty in self-voiding despite a sufficient urine volume or >300-mL postvoid residual. The data included patients' age, body mass index (BMI), ambulatory status, medical and surgical history, classes of taking drugs, and urinary tract infection. RESULTS: A total of 182 women were included as retention group, mean age of 72.64±12.94 years and BMI of 22.94±3.10 kg/m2. In the chi-square analysis, cardiovascular disorders (p=0.000), diabetes mellitus (p=0.008), metastatic malignancy (p=0.008), chronic renal disorders (p=0.028) were found significantly. In the multiple logistic regression analysis, cardiovascular disorders (p=0.002; odds ratio [OR], 0.491), metastatic malignancy (p=0.013; OR, 2.616) were found to increase the risk of UR. The most common surgical history was anti-incontinence surgery (7.2%). In term of medication use, the most prescribed agents were nonsteroidal anti-inflammatory drugs (NSAIDs) (53.8%). The patients taking multiple drugs with antimuscarinic effects except of NSAIDs, narcotics and diuretics were 48 (26.4%). Urinary tract infection was identified in 43 patients (23.6%). CONCLUSIONS: UR in females managed with medical treatments could be occurred occasionally. We think that thorough attentions are needed for UR to patients with cardiovascular disorders including diabetes mellitus, metastatic malignancy, chronic renal disorders urinary tract infection, and more careful interests when managing with drugs with antimuscarinic effects.
Age Factors
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Aged
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Aged, 80 and over
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Anti-Inflammatory Agents, Non-Steroidal/adverse effects
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Cardiovascular Diseases/complications
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Diabetes Complications
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Female
;
Hospitalization
;
Humans
;
Kidney Diseases/complications
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Middle Aged
;
Muscarinic Antagonists/adverse effects
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Neoplasm Metastasis
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Retrospective Studies
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Risk Factors
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Urinary Retention/diagnosis/*etiology/therapy
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Urinary Tract Infections/etiology
9.Predictive Factors of Mortality in Population of Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH): Results from a Korean PNH Registry.
Jun Ho JANG ; Jin Seok KIM ; Sung Soo YOON ; Je Hwan LEE ; Yeo Kyeoung KIM ; Deog Yeon JO ; Jooseop CHUNG ; Sang Kyun SOHN ; Jong Wook LEE
Journal of Korean Medical Science 2016;31(2):214-221
Paroxysmal nocturnal hemoglobinuria (PNH) is a progressive, systemic, life-threatening disease, characterized by chronic uncontrolled complement activation. A retrospective analysis of 301 Korean PNH patients who had not received eculizumab was performed to systematically identify the clinical symptoms and signs predictive of mortality. PNH patients with hemolysis (lactate dehydrogenase [LDH] > or = 1.5 x the upper limit of normal [ULN]) have a 4.8-fold higher mortality rate compared with the age- and sex-matched general population (P < 0.001). In contrast, patients with LDH < 1.5 x ULN have a similar mortality rate as the general population (P = 0.824). Thromboembolism (TE) (odds ratio [OR] 7.11; 95% confidence interval [CI] (3.052-16.562), renal impairment (OR, 2.953; 95% CI, 1.116-7.818) and PNH-cytopenia (OR, 2.547; 95% CI, 1.159-5.597) are independent risk factors for mortality, with mortality rates 14-fold (P < 0.001), 8-fold (P < 0.001), and 6.2-fold (P < 0.001) greater than that of the age- and sex-matched general population, respectively. The combination of hemolysis and 1 or more of the clinical symptoms such as abdominal pain, chest pain, or dyspnea, resulted in a much greater increased mortality rate when compared with patients with just the individual symptom alone or just hemolysis. Early identification of risk factors related to mortality is crucial for the management of PNH. This trial was registered at www.clinicaltrials.gov as NCT01224483.
Adolescent
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Adult
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Aged
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Aged, 80 and over
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Antibodies, Monoclonal/therapeutic use
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Antibodies, Monoclonal, Humanized/therapeutic use
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Area Under Curve
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Child
;
Dyspnea/etiology
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Female
;
Hemoglobinuria, Paroxysmal/*diagnosis/drug therapy/mortality
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Hemolysis
;
Humans
;
Kaplan-Meier Estimate
;
Kidney Diseases/complications/diagnosis
;
L-Lactate Dehydrogenase/metabolism
;
Male
;
Middle Aged
;
Odds Ratio
;
ROC Curve
;
Registries
;
Republic of Korea
;
Retrospective Studies
;
Risk Factors
;
Thromboembolism/complications/diagnosis
;
Young Adult
10.A case of allopurinol-induced granulomatous hepatitis with ductopenia and cholestasis.
Jae Young YOON ; Sun Yang MIN ; Ju Yee PARK ; Seung Goun HONG ; Sang Jong PARK ; So Ya PAIK ; Young Min PARK
The Korean Journal of Hepatology 2008;14(1):97-101
Allopurinol-induced hypersensitivity syndrome is characterized by an idiosyncratic reaction involving multiple-organs, which usually begins 2 to 6 weeks after starting allopurinol. In rare cases, the adverse reactions to allopurinol are accompanied by a variety of liver injury, such as reactive hepatitis, granulomatous hepatitis, vanishing bile duct syndrome, or fulminant hepatic failure. Here we report a case with granulomatous hepatitis and ductopenia. A 69-year-old man with chronic renal failure, hyperuricemia, and previously normal liver function presented with jaundice, skin rash, and fever 2 weeks after taking allopurinol (200 mg/day). In histopathology, a liver biopsy specimen showed mild spotty necrosis of hepatocytes, marked cholestasis in parenchyma, and some granulomas in the portal area. There were vacuolar degeneration in the interlobular bile ducts and ductopenia in the portal tracts. Pathologic criteria strongly suggested the presence of allopurinol-induced granulomatous hepatitis with ductopenia and cholestasis. The patient fully recovered following the early administration of systemic corticosteroid therapy.
Aged
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Allopurinol/*adverse effects/therapeutic use
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Antimetabolites/*adverse effects/therapeutic use
;
Bile Duct Diseases/*chemically induced/diagnosis/pathology
;
Bile Ducts, Intrahepatic/*drug effects/pathology
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Cholestasis/*chemically induced/diagnosis/pathology
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Drug Eruptions/pathology
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Granuloma/*chemically induced/pathology
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Hepatitis, Toxic/*pathology
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Humans
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Kidney Failure, Chronic/complications/drug therapy
;
Male