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Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Biological Effect of Vaccinium uliginosum L. on STZ-induced Diabetes and Lipid Metabolism in Rats (들쭉이 약물에 의해 유도된 당뇨 및 지질대사에 미치는 생리활성 효과)

  • Han, Eun-Kyung;Kwon, Hyuck-Se;Shin, Se-Gye;Choi, Yoon-Hee;Kang, Il-Jun;Chung, Cha-Kwon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.12
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    • pp.1727-1733
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    • 2012
  • This study was conducted to investigate the effects of Vaccinium uliginosum L. (bilberry) on chemically induced diabetes and hypercholesterolemia. Sprague Dawley (SD) rats were divided into six groups, control (CON), bilberry added group (CBB), streptozotocin (STZ)-induced diabetic group (STZ), STZ and bilberry added group (SBB), high fat fed group (HFF) and high fat and bilberry added group (HFB). Diabetes was chemically induced by intravenous injection of 45 mg/kg body weight STZ in citrate buffer (pH 4.5). Serum triglycerides decreased significantly (p<0.05) in the STZ group that was fed bilberry. Additionally, the athrogenic index (AI) decreased significantly (p<0.05) when compared to the STZ group, while the liver triglycerides tended to decrease in the STZ group. HDL-cholesterol also increased significantly in response to bilberry. When compared to the STZ group, steady attenuation of the blood glucose level was observed upon fasting, 15 min, 30 min, 60 min and 120 min after oral glucose administration. The blood glucose level in the bilberry fed group decreased by 24% when compared to STZ group, while the superoxide dismutase (SOD) became significantly higher (p<0.05) in the STZ group when compared to the CON group. Overall, the results of this study suggest that bilberry stimulates lipid metabolism in both the serum and liver and has a positive effect on glucose metabolism in chemically induced diabetic rats.

Quality Characteristics and Storage Properties of Sikhe Prepared with Extracts from Hovenia dulcis THUNB (헛개나무열매 추출물을 첨가한 식혜의 품질특성과 저장성)

  • Kim, Hyang-Hee;Park, Geum-Soon;Jeon, Jeong-Ryae
    • Korean journal of food and cookery science
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    • v.23 no.6
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    • pp.848-857
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    • 2007
  • Sikhe, a traditional Korean drink, was prepared with Hovenia dulcis extract (HDE), and its quality and storage characteristics were evaluated through sensory and microbial analyses. In the color analysis, the lightness of the Sikhe showed a decreasing tendency according to the addition of HDE, while redness and yellowness increased. The Sikhe prepared with 20% HDE had the highest sugar concentration at 12days of storage ($4^{\circ}C$). Interms of sensory quality, both the 20% and 40% HDE-added Sikhes had the highest overall preference. The microbial cell counts presented no distinct differences early in the storage. period, but the general bacteria counts of the Sikhe made with the increasing concentrations of extracts decreased with a longer storage period. The coliform counts of the Sikhe prepared without HDE (control) was 10.5 CFU/g at 10 days of storage, but the 100% HDE-added Sikhe had a level of 7.9 CFU/g at 16 days of storage. These results indicates that Hovenia dulcis may inhibit normal microbial growth and extend the shelf-life on Sikhe.

The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma (간세포암에서 방사선 치료의 역할)

  • Eun, Jong Ryul;Choi, Kyo Won;Lee, Heon Ju;Kim, Mung Se
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.137-145
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    • 2000
  • Background: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and Methods: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. Results: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. Conclusions: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

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Influence of Korean Red Ginseng Water Extract on Recovery of Hepatic Function in Hypercholesterolemic Mice Fed High Cholesterol Diet (홍삼물추출물이 고콜레스테롤 식이로 유도된 고콜레스테롤 혈증에서 간 기능 회복에 미치는 영향)

  • Song, Yong-Bum;Kyung, Jong-Soo;Park, Sung-Bum;Wee, Jae-Joon;Do, Jae-Ho;Kim, Young-Sook
    • Journal of Ginseng Research
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    • v.32 no.4
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    • pp.283-290
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    • 2008
  • Hypercholesterolemia is associated with many pathological states such as fat deposit in the tendon and skin, hepatomegaly, pancreatitis and heart attack. The present study was focused on the effect of Korean red ginseng water extract (RGWE) on the recovery of hepatic function that was deteriorated in high-cholesterol diet fed mice. Mice were divided into 6 groups ; normal diet group (AIN-2WK), 4 week-high-cholesterol diet group (CHOL-4WK), 2 week-high-cholesterol + 2 week-normal diet group (CHOL-2WK), 2 week-high-cholesterol + 2 week-normal diet + RGWE treated group (R100, R300, R500). RGWE treated group received normal diet and RGWE at daily doses of 100, 300, 500 mg/kg b.w. for 2 weeks after the 2 weeks feeding of high-cholesterol diet. The results are as follows : 1. The hepatic weight and total hepatic lipid weight were markedly lower in RGWE treated group than those in the CHOL-4WK or CHOL-2WK group, indicating that ginseng inhibited hepatic hypertrophy. 2. Total hepatic cholesterol and HDL-cholesterol in normal diet conversion group (CHOL-2WK) were significantly reduced compared with the high cholesterol group (CHOL-4WK). The lowering effect was significantly reinforced by RGWE administration. 3. Hepatic triglyceride level of CHOL-4WK group was markedly lower than that of the normal group (AIN-2WK). However, the level was significantly increased in CHOL-2WK and RGWE treated group. The result indicated that ginseng administration and diet conversion exert normalizing effects of hepatic function. 4. The lipid peroxide levels in RGWE treated groups were markedly lower than CHOL-2WK group. These results suggest that Korean red ginseng water extract can be useful as a dietary supplement for the treatment of obesity or hypercholesterolemia by improving lipid metabolism and hepatic function.

Cyclosporine A (Cipol-$N^{(R)}$) Therapy in Children with Idiopathic Nephrotic Syndrome (소아 특발성 신증후군에서의 cyclosporine A(Cipol-$N^{(R)}$)의 치료 효과)

  • Hong Ihn Hee;Ko Cheol Woo;Koo Ja Hoon;Kim Ji-Hong;Kim Pyung-Kil;Cho Byoung Soo
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.48-56
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    • 1999
  • Purpose : This multicenter collaboratory study was conducted to see the therapeutic efficacy and side effect of cyclosporine A (Cipol-$N^{(R)}$, Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing (FR), steroid dependent (SD), or steroid resistant (SR) pattern. Patients and methods : Thirty-nine children with SD/FR NS and 3 children with SR NS were enrolled in the study. After induction of remission (SD/FR NS) with steroid or after 4 weeks of steroid therapy (SR NS), cyclosporine A was started in a dose of 4-5 mg/Kg/day in two divided dose and steroid (prednisolone or equivalent dose of deflazacort) was tapered slowly. During 16 weeks of study period, monthly check up of physical examination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Results : Out of 39 children with SD/FR NS, 35($89.7\%$) maintained sustained remission and at 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Two out of 3 children with SR NS showed and sustained remission with cyclosporine A therapy. Side reaction to cyclosporine A therapy showed hypertrichosis in 8 cases and hyperuricemia in 5 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR (creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 16 weeks of study period. Conclusion : Cyclosporine A (Cipoi-$N^{(R)}$ Chong Kun Dang) can be utilized quite effectively on children with SD/FR or SR NS and further trial of cyclosporine A on long-term basis (1-2 year period) is needed to determine it's efficacy and side effect (especially nephrotoxicity) of long-term administration of cyclosporine A.

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Evaluation of Worker's Health and Occupational Exposure to Perchloroethylene in Laundries (Perchlotoethylene을 사용하는 세탁소 작업자들의 직업성 폭로와 건강에 관한 연구)

  • An, Sun-Hee;Lee, Jong-Hwoa;Park, Jong-An
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.4 no.2
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    • pp.224-239
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    • 1994
  • In this study we examined several subjective symptoms in an exposed group and an unexposed group to perchloroethylene. The exposed group consists to 30 workers employed in 23 dry-cleaning establishments located in Chung Cheung Do, whereas the unexposed group consists of 42 officers employed in a certain university. This study was conducted from October, 1993 to March, 1994. Also we investigated personal exposure levels and area concentration of PCE, and performed hematological and biochemical examination in blood and urine samples from the exposed group. The results are : 1. The exposed group highly complains several subjective symptoms, particularly in neuropsychiatry, eye, respiratory system and digestive system, compared with the unexposed group. But complaint rates in the exposed group are not related with PCE exposure levels. 2. PCE exposure levels for all dry-cleaning establishment varied widely, from 0.18 to 37.58ppm. The mean exposure level for centers of chain was 16.85ppm, and for local laundries was 8.83ppm, while for self-service establishment it was 3.07ppm. Eighty three percent of the workers were exposed less than the half-level(25.0ppm) of the Korea 50.0ppm standard for eight-hour PCE exposure. Seventeen percent of them exceeded the half-level of the Korea TLV. 3. Statistical correlation exists between the work load(number of operation cycles of equipment and the mass of processed textiles) and the personal exposure levels to be observed. 4. In hematological examination the values of WBC, RBC, Hgb, Hct, MCV, MCH, MCHC and PLT in the exposed group were within normal ranges. In biochemical examination(GOT, GPT, ALP, U-A and LDH) most of the items were within normal ranges. From this surveys conducted on 23 dry-cleaning establishments, the complaint rates of the exposed group to PCE in several subjective symptoms were higher than those of the unexposed group, and PCE exposure levels in all dry-cleaning establishment were below the Koera standard 50.0ppm. In hematological and biochemical examination the significant abnormalities by occupational exposure to PCE were not observed. However, the workers employed in dry-cleaning establishments are always faced with risk, becauses they are also exposed to several organic solvents used to remove stains. Therefore, various measures to improve occupational environment in dry-cleaning establishment should be considered.

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The Correlativity of Lipopolysaccharide and Houttuynia cordata Thunb Mixture Extract to Lipid Metabolism (Lipopolysaccharide와 어성초 혼합 추출물의 지질대사 상관성)

  • Kwon, Ryun-Hee;Kang, Kum-Suk;Kim, In-Deok;Ha, Bae-Jin
    • Toxicological Research
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    • v.23 no.4
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    • pp.341-345
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    • 2007
  • This study was designed to investige the effects of Houttuynia cordata Thunb mixture extract on the lipid metabolism in the lipopolysaccharide (LPS)-induced liver damage of rats. LPS-treatment increased the levels of total-lipid, LDH (lactate, dehydrogenas), triglyceride (TG) and malondialdehyde (MDA). But Houttuynia cordata Thunb mixture extract (HM) pretreatment decreased the levels of total lipid, LDL-cholesterol, TG and MDA. Also LPS-treatment decreased total cholesterol and HDL-cholesterol, but HM-pretreatment increased both of them. These results demonstrated that HM-pretreatment had the preventive effects against the dyfunction of lipid metabolism in the LPS-induced liver damage of rats.

Effects of Small Colored Potato Extracts by High-Pressure Extraction on Serum Lipid Levels in High Fat Diet Fed Rats (꼬마색깔감자 초고압 추출물이 고지방식이를 섭취한 흰쥐의 혈청지질농도개선 미치는 영향)

  • Rha, Young-Ah;Choi, Mi-Sook;Kwon, Min-Soo;Hwang, Young-Jeong;Park, Sung-Jin
    • Culinary science and hospitality research
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    • v.20 no.4
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    • pp.157-168
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    • 2014
  • We investigated the anti-obesity effects of small colored potato extracts by high pressure water extraction process on body weight, plasma lipid levels in high-fat diet-induced obese mice. Experimental groups were divided into basal diet only (Normal), high fat diet control (HFD), small colored potato water extracts (CP), and high-fat diet and small colored potato water high pressure extracts (HCP) groups. The levels of hematological variables were not significantly different among the four groups. Compared with the HFD group's serum total cholesterol level of $86.01{\pm}1.16mg/dL$, the levels of the CP and HCP groups were significantly lowered to $80.29{\pm}1.28$ and $77.21{\pm}4.21mg/dL$, respectively. Compared with the HFD group's LDL-cholesterol level of $18.92{\pm}2.44mg/dL$, the LDL-cholesterol levels of the CP and HCP groups were significantly lowered to $13.52{\pm}1.26$ and $12.93{\pm}1.26mg/dL$, respectively. Also, compared to the HFD group's serum triglyceride level of $82.71{\pm}3.94mg/dL$, the level of the HCP group was significantly lowered to $63.24{\pm}6.32mg/dL$. These results suggested that dietary supplementation of small colored potato extracts using high pressure water extraction does not have any adverse effects on the hematological variables, while improving the lipid content and reducing hepatic damage of the high-fat fed rats.

Morbidity Pattern of Residents in Urban Poor Area by Health Screening (도시 영세지역 주민의 건강진단 결과)

  • Kim, Chang-Yoon;SaKong, Jun;Kim, Seok-Beom;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.150-157
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    • 1991
  • The purpose of the this study was to assess the morbidity pattern of urban residents in the poor area by health screening for the community diagnosis. The items of health screening were history taking and physical examination by medical doctor and hearing test, check blood pressure, test for hematocrit, liver function(sGOT, sGPT), urine sugar and protein, and chest X-ray. The examinee in health screening were 437 persons and they occupied 16.9% of total residents in the poor area. Male examinee were 129 persons(9.9% of total residents) and female examinee were 308 persons(23.9% of total residents). Age group of above sixty years old, 42.0% of total residents in the poor area were participated, but only 5.9% were participated in age group of 10 to 19 years old. Among the 437 examinee, 191 persons(43.7%) had one or more abnormal findings in health screening. In male 38.7% had abnormal findings, and some what lower than that of female(45.8%). Age group of above sixty years had most high rate of abnormal findings(69.8%), in contrast to age group of 10 to 19 years old (10.9%). Diseases of the digestive system was the most common and which occupies 23.7% of total abnormal findings. And diseases of the circulatory system occupied 19.7%. Low hematocrit(14.6% of total participants of 437 persons) occupies the most common abnormal findings for screening test(hematocrit, blood pressure, hearing test, sGOT/sGPT, urine protein and urine sugar, chest X-ray) and high blood pressure(10.1%) occupied second, third; hearing impairment (5.5%), fourth ; abnormal liver function (4.1%), fifth ; sugar in urine (2.3%), sixth ; protein in urine(1.4%) and lastly abnormal chest X-ray (0.9%). The positive rate of abnormal findings in health screening was very high compared with morbidity rate by health interview. It is supposed that some portion of this high rate is by selection bias in examinee in health screening specially high participating rate in older age, and the other portion is due to the low socioecomic status and bad environment of the residents of the poor area. These findings will be good information for the research and development of health care system in the urban poor area.

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