BACKGROUND: The cardiovascular complications are one of the main causes of deaths in chronic renal failure patients, and anemia is also the frequent complication. It has been reported that zinc and copper are participated in the process of the atherosclerosis and anemia directly or indirectly. The increased oxidative stress in the chronic renal failure which has the decreased anti-oxidative activity is correlated with the progression of the atherosclerosis and anemia. The decreased activity of anti-oxidative defense come from the decreased activity of the superoxide dismutase, which is considered to be followed by the decreased serum level of zinc and copper. METHODS: In this study, We designed to know how much significant correlation between the respective level of the copper & zinc and the clinical items of anemia & atherosclerosis, in addition to that, we observed the blood level of copper and zinc in chronic renal failure, what kind of change will be shown according to dialysis duration, dialysis method, whether the dialysis is done or not. Only zinc, not copper was positively related to the hemoglobin level(p<0.05). RESULTS: Only copper, not zinc was negatively related to the triglyceride level(p<0.05). The blood level of copper was generally increased in chronic renal failure, but was insignificant. The blood level of zinc was generally decreased in chronic renal failure, especially significantly decreased in pre-dialysis chronic renal failure patients. No significant correlation was found between the blood level of copper & zinc and the dialysis duration & dialysis method. However, there was the increasing tendency of blood level of zinc, following to the time passage of duration of dialysis. In the survey about the correlation with the growing age, this was related to the copper in the positive pattern, and the zinc in the negative pattern. CONCLUSION: Taken together, We observed the indirect clinical evidence the blood level of copper is correlated with the lipid level, as well as the blood level of zinc is correlated with the anemia. The blood level of copper and zinc in chronic renal failure patients was expected increased, but two weren't increased, and weren't affected by dialysis method,duration of dialysis. But some correlation was observed with the growing age.

No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

Acute renal failure is a rare complication of acute pyelonephritis. Therefore, acute pyelonephritis is not usually considered in the differential diagnosis of acute renal failure. However, it is important to consider this entity because of potential for recovery of renal function if appropriate early antibiotics are instituted. We report a case of biopsy proven acute pyelonephritis which was manifested as acute renal failure. A 38 year old women was admitted to this hospital owing to abdominal distension and generalized edema. On admission she was started on hemodialysis because of severe hyperkalemia and marked uremic sypmtoms. She had pyuria and hematuria, but no organism was isolated at urine. We initially don't know the cause of renal failure. She was improved with antimicrobial therapy and hemodialysis. A kidney biopsy was performed on the 26th hospital day because of persistent proteinuria. Microscopic examination revealed focal tubular atrophy, necrosis or loss with heavy infilteration of leukocytes and histocytes in interstitium. Atrophic tubules contain pus casts. The patient was treated with ciprofloxacin for 4 weeks. At about 2 month follow up, proteinuria completely disappeared and serum creatinine level decreased to 1.0 mg/dL.
Acute Kidney Injury* ; Adult ; Anti-Bacterial Agents ; Atrophy ; Biopsy ; Ciprofloxacin ; Creatinine ; Diagnosis, Differential ; Edema ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Hyperkalemia ; Kidney ; Leukocytes ; Necrosis ; Proteinuria ; Pyelonephritis* ; Pyuria ; Renal Dialysis ; Renal Insufficiency ; Suppuration

Agenesis of dorsal pancreas is a rare congenital anomaly that arises from the failure of the dorsal pancreatic bud of endodermal cells to form the body and tail of the pancreas. It may be associated with diabetes mellitus, pancreatic exocrine dysfunction, or abdominal pain. Complete or partial agenesis of dorsal pancreas has been reported in a small number of pediatric and adult patients. A case is herein described involving a complete agenesis of dorsal pancreas and diabetes mellitus. A 38-year-old man with a 7-months history of non-insulin dependent diabetes mellitus was admitted due to weight loss and abdominal pain. Abdominal ultrasonography and computed tomography showed a normal biliary tree and enlarged head of the pancreas without visualization of the pancreatic body and tail. Endoscopic retrograde cholangiopancreatography (ERCP) revealved the short duct of Wirsung in the uncinate process and a head without opacification of any ducts in the pancreatic body or tail. The patient underwent explo-laparotomy for evaluation of the suspected pancreatic cancer. The patient was diagnosed as having complete agenesis of the dorsal pancreas by ERCP, CT, and surgery.
Abdominal Pain ; Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diabetes Mellitus ; Endoderm ; Head ; Humans ; Pancreas* ; Pancreatic Ducts ; Pancreatic Neoplasms ; Ultrasonography ; Weight Loss

BACKGROUND: Either of the angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) has been known to be effective on the inhibition of progressive renal disease. The ACEI can cause angiotensin-II to be decreased, but make an plasma activity of renin and kinin to be increased. The ARB increase both activities of renin and angiotensin-II, while it block the function of angiotensin-II on the AT-1 receptor. This kind of process might influence on the activation of AT-2 receptor and lead to the activated state of antiproliferative change. Therefore, if the ARB and ACEI are treated at same time, that is, on the condition that angiotensin-II is somewhat suppressed and AT-1 receptor is blocked, this is strongly assumed to make the more positive effect on the inhibition of renal progression and hypertension control. METHODS: Experimental animals were chosen as a Spontaneously Hypertensive Rat (SHR) and a Wistar Kyoto Rat (WKR). Used total number were 32, including 11 (SHR 5, WKR 6) as a control. The other 21 SHR were allocated to pharmacy treated 3 groups (7 in each group as an ACEI treat, ARB treat, ACEI and ARB combination treat). The study on these animals was built by an observation on the BP, histopathologic change, the apoptosis & PCNA, the expression of AT-1 and AT-2 receptor. RESULTS: The mean arterial blood pressure (MAP) of SHR of a 5-month age was 153.2+/-3.4 mmHg, which was significantly high as compared to the control, 121.1+/-18.0 mmHg (p<0.01). The average of MAP in treated groups, 125.1+/-24.6 mmHg, was significantly decreased, as compared to untreated animals, 167.3+/-14.1 mmHg (p<0.01). The MAP in combination treatment animals is significantly lower than either of treatment group (p<0.05). The apoptotic process at the proximal tubule was observed less in case of treated animals, but the difference among treated 3 groups was not confirmed. CONCLUSION: The MAP decreasing effect by the combination treatment with ACEI and ARB was significant, however, the additive effect by this treatment on the inhibition of renal damage progression was not observed.
Angiotensin II* ; Angiotensins* ; Animals ; Apoptosis* ; Arterial Pressure ; Hypertension ; Kidney* ; Peptidyl-Dipeptidase A* ; Pharmacy ; Plasma ; Proliferating Cell Nuclear Antigen ; Rats ; Rats, Inbred SHR* ; Receptors, Angiotensin* ; Renin

PURPOSE: We tried to estimate the clinical efficacy of hemodiafiltration in the paraquat poisoning, as compared with that of other various extracorporeal extraction treatment. METHODS: We prepared the fresh frozen plasma mixed with paraquat concentrated up to 30 mg/L. The experiment was designed to remove paraquat by use of various extracorporeal treatment, such as hemodialysis (HD), hemoperfusion (HP), hemofiltration (HF), hemodia-filtration (HDF), hemodiafiltration & hemoperfusion (HDFP), respectively. The efficacy was analyzed on the basis of counting extraction ratio, observing the decreasing concentration of paraquat with the lapse of time. Four pigs (Yorkshire) were prepared and poisoned by paraquat (40 mg/kg) intramuscularly. Two poisoned animals were assigned for hemoperfusion and hemodiafiltration respectively and other two were assigned for the control. We observed extraction ratio, decreasing concentration of paraquat in blood, remained amount of paraquat in major organs, in addition to pathologic change of major organs after sacrifying the animals. RESULTS: The mean of extraction ratio is 0.84+/-0.27 in case of HP, 0.81+/-0.21 in HD, 0.74+/-0.40 in HDFP, 0.53+/-0.24 in HDF, 0.5+/-0.14 in HF. The extraction ratio of HP & HD & HDFP was significantly higher than that of HDF & HF (p<0.01). The extraction ratio was counted as the difference between the paraquat concentration of inlet and outlet was divided by the concentration of inlet. The slope of paraquat concentration undergoing extracorporeal treatment was the most acutely decreased in the case of HDFP, the less decreased in HP, and sequentially in HD, HDF and HF (the least) in the order of the decrease. The more decreased paraquat concentration in plasma was observed, the higher flow rate of dialysate of HDF was conducted. The mean of extraction ratio in animal study was 0.61 in HP and 0.36 in HDF. The blood concentration of paraquat was observed to be much lower in case of HP & HDF, as compared with the control animals. The remained concentration of paraquat in major organs, 7 hours later after being poisoned, was observed to be higher in the vascular structure like kidney and heart. However, it was observed to be lower in kidney, lung & muscle, when either of HDF and HP was conducted, than control. Especially, it was much lower in HP and much less pathologic change in HP. HDF is the less effective measure than HP, but is effective as a continuous treatment to make paraquat concentration to be lower as much as it possible. CONCLUSION: The HDF is the effective measure to keep the blood paraquat level low, even though it is behind the HP in effectiveness.
Animals ; Bays ; Heart ; Hemodiafiltration* ; Hemofiltration ; Hemoperfusion ; Kidney ; Lung ; Paraquat* ; Plasma ; Poisoning ; Renal Dialysis ; Swine

PURPOSE: We tried to estimate the clinical efficacy of hemodiafiltration in the paraquat poisoning, as compared with that of other various extracorporeal extraction treatment. METHODS: We prepared the fresh frozen plasma mixed with paraquat concentrated up to 30 mg/L. The experiment was designed to remove paraquat by use of various extracorporeal treatment, such as hemodialysis (HD), hemoperfusion (HP), hemofiltration (HF), hemodia-filtration (HDF), hemodiafiltration & hemoperfusion (HDFP), respectively. The efficacy was analyzed on the basis of counting extraction ratio, observing the decreasing concentration of paraquat with the lapse of time. Four pigs (Yorkshire) were prepared and poisoned by paraquat (40 mg/kg) intramuscularly. Two poisoned animals were assigned for hemoperfusion and hemodiafiltration respectively and other two were assigned for the control. We observed extraction ratio, decreasing concentration of paraquat in blood, remained amount of paraquat in major organs, in addition to pathologic change of major organs after sacrifying the animals. RESULTS: The mean of extraction ratio is 0.84+/-0.27 in case of HP, 0.81+/-0.21 in HD, 0.74+/-0.40 in HDFP, 0.53+/-0.24 in HDF, 0.5+/-0.14 in HF. The extraction ratio of HP & HD & HDFP was significantly higher than that of HDF & HF (p<0.01). The extraction ratio was counted as the difference between the paraquat concentration of inlet and outlet was divided by the concentration of inlet. The slope of paraquat concentration undergoing extracorporeal treatment was the most acutely decreased in the case of HDFP, the less decreased in HP, and sequentially in HD, HDF and HF (the least) in the order of the decrease. The more decreased paraquat concentration in plasma was observed, the higher flow rate of dialysate of HDF was conducted. The mean of extraction ratio in animal study was 0.61 in HP and 0.36 in HDF. The blood concentration of paraquat was observed to be much lower in case of HP & HDF, as compared with the control animals. The remained concentration of paraquat in major organs, 7 hours later after being poisoned, was observed to be higher in the vascular structure like kidney and heart. However, it was observed to be lower in kidney, lung & muscle, when either of HDF and HP was conducted, than control. Especially, it was much lower in HP and much less pathologic change in HP. HDF is the less effective measure than HP, but is effective as a continuous treatment to make paraquat concentration to be lower as much as it possible. CONCLUSION: The HDF is the effective measure to keep the blood paraquat level low, even though it is behind the HP in effectiveness.
Animals ; Bays ; Heart ; Hemodiafiltration* ; Hemofiltration ; Hemoperfusion ; Kidney ; Lung ; Paraquat* ; Plasma ; Poisoning ; Renal Dialysis ; Swine

Bipartite scaphoid is a rare anomaly and it has been questioned as whether it is of congenital origin or traumatic. However, many authors have reported that congenital origin is more probable. There was no case report in Korea about bipartite scaphoid, but this article reports a case of a 38-year-old male with bilateral bipartite scaphoid.
Adult ; Humans ; Korea ; Male

PURPOSE: To evaluate the risk factors of sliding after internal fixation with sliding compression hip screw in stable intertrochanteric fracture of the femur. MATERIALS AND METHODS: From March 2000 to April 2003, 61 stable intertrochanteric fractures (Kyle-Gustilo type II) were treated operatively with sliding compression hip screws. The patients were 40 females and 21 males with an average age of 74 (range, 54~99). We measured vertical and horizontal shortening in regard to age, sex, bone mineral density, neck-shaft angle, cancellous bone defect, and the existence of lessor trochanter fracture on postoperative 6 months. RESULTS: The average vertical shortening was 4.1 mm (0~22 mm) and the average horizontal shortening was 7.3 mm (0~30 mm). Age, sex, bone density and neck-shaft angle were not significantly related with vertical and horizontal shortening (p>0.05). Vertical shortening was significantly greater in the group with cancellous bone defect and in the group without lesser trochanter fracture (p<0.05). CONCLUSION: Proper management for fracture site and fixation was needed to make it stable because the stable intertrochanteric fracture with cancellous bone defect and intact lesser trochanter could be induced into unexpected sliding.
Bone Density ; Female ; Femur* ; Hip ; Hip Fractures ; Humans ; Male ; Risk Factors

PURPOSE: We investigated relationship between displacement and morphologic changes of medial meniscus and articular cartilage loss on magnetic resonance (MR) Images in early osteoarthritis of the knee. MATERIALS AND METHODS: Ninety-three cases with symptomatic knee and early osteoarthritis on the plain radiographs underwent MR imaging of the knee. We measured displacement, tear, and morphological changes of medial meniscus according to the amount of articular cartilage loss on coronal and sagittal MR images. RESULTS: The mean medial meniscal displacement was greater in cartilage loss group(4.3+/-2.8 mm) than control group(2.2+/-1.9 mm). The mean anterior meniscal displacement was greater in cartilage loss group (3.6+/-2.3 mm) than control group(1.9+/-1.2 mm). But meniscal displacement was not correlated with articular cartilage loss (p>0.05). The morphological changes of medial meniscus were 53.4%(31/58) in cartilage loss group and 11.4% (4/35) in control group (p<0.05). CONCLUSION: In early osteoarthritis of the knee, displacement and morphological changes of medial menisci had correlation with articular cartilage loss in MRI study.
Cartilage ; Cartilage, Articular ; Knee* ; Magnetic Resonance Imaging ; Menisci, Tibial* ; Osteoarthritis*