Effects of Lipoxygenase Inhibitor on Diabetic Nephropathy in Rats: Decreasing Proteinuria and Preserving Renal Function / 대한신장학회지

PURPOSE: Oxidative stress leads to an increased production of lipoxygenase derivatives in diabetic nephropathy. Thus, we hypothesized that lipoxygenase inhibitor, nordihydroguaiaretic acid (NDGA), ha the effects of decreasing proteinuria and preserving renal function in streptozotocin (STZ)-induced diabetic rats. METHODS: 45 Sprague-Dawley rats were divided into three groups; (A) treatment with lipoxygenase inhibitor, NDGA in diabetic nephropathy rats, (B) treatment with dimethyl sulfoxide (DMSO) as a vehicle in STZ-induced diabetic rats, (C) normal control group with subcutaneous injection of normal saline. Diabetes was induced by a single intraperitoneal injection of STZ (65 mg/kg) in rats of group A and B. After the 4th week of STZ injection, NDGA (10 mg/kg) and DMSO were given subcutaneously for another 4 weeks in group A and B respectively. RESULTS: The NDGA-treated diabetic rats exhibited significantly decreased urinary albumin excretion. Serum creatinine and blood urea nitrogen concentrations were increased in both group A and B, and tend to be higher in group B than group A. Twenty-four-hour urine creatinine clearances were increased in both group A and B after injection of STZ. Pathologic alterations of kidney were observed after injection of STZ, and then attenuated after administration of NDGA. CONCLUSION: These results suggest the potential of lipoxygenase inhibitor as a complementary therapy for the prevention and treatment of diabetic nephropathy.

Renal and Splenic Infarction Associated with Hyperthyroidism / 대한신장학회지

A 59-year-old female was admitted with left flank pain. She had heat intolerance and dyspnea for the last 3 years. She was diagnosed as having renal and splenic infarction. 2 phase computed tomography (CT) scan on abdomen and pelvis showed a non-enhancing portion at the anterior aspect of the left kidney and multifocal low density at the spleen. Laboratory examinations revealed TSH 0.0004 uIU/mL, Free T4 2.69 ng/dL, T3 1.67 ng/mL, anti TPO antibody 207 U/mL (positive), anti TG antibody 52.7 U/mL (positive) and TSH receptor antibody >40 U/mL. A diagnosis of hyperthyroidism was made. Factor VIII activity increased over 160% (normal range 60-140), which has been known to increase in the cases of hyperthyroidism. Except for an increased factor VIII activity there were no thrombogenic abnormalities. She recovered well after the treatment with methimazole in addition to warfarin followed by intravenous heparin. This case is consistent with the assumption that hyperthyroidism, probably through a factor VIII-mediated hypercoagulability, may be a predisposing factor for the development of renal and splenic infarction.

Antiretroviral drug resistance among drug-naive HIV-1 infected patients / 대한내과학회지

BACKGROUND: The prevalence of HIV drug resistance mutations in drug-naive patients has been shown to differ with geographic origin. The purpose of this study is to assess the prevalence of transmitted antiretroviral drug resistance mutations in drug-naive patients in Korea. METHODS: Genotypic resistance was determined by the use of the Viroseq Genotyping System in 42 antiretroviral treatment naive HIV-infected patients between March 2005 and July 2006. Transmitted drug resistance was estimated according to the IAS-USA 2005 definition, taking into account only major mutations in the protease and all mutations in the reverse transcriptase, including revertant mutations at codon 215. RESULTS: The median age of the patients was 42 years and 37 (88%) were male. The median CD4+T cell count was 136/mm3 and the mean plasma RNA level was 4.98 log copies/mL. Among 42 patients studied, 37 (88%) were newly diagnosed patients. None of the patients were recent seroconverters; 38 patients (90%) were infected with subtype B and 4 patients were infected (10%) with the non-B subtype strains (2 patients with CRF01-AE 1 as CRF02-AG; 1 patient with subtype A). Of the 42 subjects tested, we found 2 (4.8%) mutations in NRTI (V118I), but did not find a mutation in NNRTI as well as in the PI region. CONCLUSIONS: The prevalence of transmitted antiretroviral drug resistance in drug-naive patients is still low in Korean patients.

Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure / 결핵및호흡기질환

BACKGROUND: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. METHODS: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. RESULTS: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, PaO2, PaCO2, SaO2 were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. CONCLUSION: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.