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Analysis of Bone Mineral Density and Related Factors after Pelvic Radiotherapy in Patients with Cervical Cancer (골반부 방사선 치료를 받은 자궁경부암 환자의 골밀도 변화와 관련 인자 분석)

  • Yi, Sun-Shin;Jeung, Tae-Sig
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.15-22
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    • 2009
  • Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

A CLINICAL STUDY ON TOURETTE'S DISORDER (뚜렛 장애의 임상적 연구)

  • Min, Sung-Kil;Noh, Kyung S.;Shin, Dong-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.92-100
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    • 1997
  • Objective:The objective of this study is to examine the clinical characteristics and behavioral comorbidity of patients with Tourette’s disorder. Method:Subjects consisted of 157 patients with Tourette’ disorder diagnosed by DSM-IIIR, who were examined and diagnosed from Jan. 1988 to May 1994 at the Tourette’s Clinic of Yonsei University Medical Center. Characteristics and behavioral comorbidity of Patients were assessed by a semi-structured interview schedule. Behavioral problems like hyperactivity, obsession-compulsion, self destructiveness, enuresis, sleep problem were assessed by global clinical impression. Results:The mean age of patients was 14.49(${\pm}7.99$) years. Patients consisted of 138 males (87.9%) and 19 females(12.1%). The sex ratio was 7:1, showing a male preponderance. The number of right-handers was 133(84.7%), and the number of non-right handers was 24(15.3%). Mean age of onset was 8.85(${\pm}4.56$) years, ranging from 2-to-16 years. More than half of the patients had their age of onset at 6-10 years. Bimodal peak in age of onset was observed;the first peak was around 6 and the second peak was around 10 years. There was no sex difference in bimodal age of onset. The most common initial symptom was eye blinking. More than 55% of patients reported eye blinking as their first symptom. The second common initial symptom was head turning and the third was vocal tic. The most common symptoms that patients reported on their first visit since onset were eye blinking(82.2%), head turning or nodding(57.9%), shoulder shrugging(52.7%) and forearm movement(32.6%). Of 157 cases, 101(64.3%) patients showed downward progression of symptoms, and 25(15.9%) showed upward progression of symptoms. Nineteen fathers(12%) of patients had a past history of obsessive-compulsive disorder(OCD). Seventeen fathers(10.6%) had a history of tic disorder. SSevenmothers(4.5%) had OCD, 4 mothers (2.5%) had tic disorder. One hundred and eighteen patients(75.1%) had comorbid hyperactivity, 95 patients(60.5%) had obsession, 55 patiens(35.0%) had self destructiveness, 46 patients(29.3%) had impulsivity, and 35 patients(22.3%) had enuresis. Age of onset had a significant positive correlation with age, duration, and the global severity of obsession;and a negative correlation with the severity of hyperactivity. Hyperactivity had a significant positive correlation with impulsivity, obsession-compulsion, enuresis, and self destructiveness. Obsession-compulsion had a significant positive correlation with hyperactivity, sleep problems, and self destructiveness. Conclusion:These data suggest that clinical characteristcs and behavioral comorbidity of patients with Tourette’ disorder in this study are similar to previous research findings in Korea and other contries. The younger the age of onset was, the more severe hyperactivity was, and the less severe obsession-compulsion was. And severity of hyperactivity had a positive correlation with the severity of obsession-compulsion, impulsivity, enuresis, and self destructiveness.

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Effect of Flywheel Weight on the Vibration of Diesel Engine (플라이휠 중량(重量)이 디젤 기관(機關)의 진동(振動)에 미치는 영향(影響))

  • Myung, Byung Soo;Kim, Sung Rai
    • Korean Journal of Agricultural Science
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    • v.20 no.2
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    • pp.167-180
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    • 1993
  • Most of small size diesel engines are widely used with the same size and weight flywheel in the levels of 6.0kW and 7.5kW. This study was conducted to obtain basic data which affect the engine performance of the power tiller. The flywheel weight was considered as a major factor in this research. Basically, fuel consumption ratio, motoring loss, torque, vibration and mechanical efficiency of the engine were measured and analyzed on four levels of flywheel weight, 32.2, 29.4, 26.2 and $24.2kg_f$, respectively. Results were obtained as follows: 1. The weights of flywheel were $23.7kg_f$ from design program of JSME and $24.5kg_f$ from ASME and SAE design criteria. Therefore, the flywheel weight of $32.2kg_f$ might be reduced about $8kg_f$ in 7.5kW engine. 2. The rated outputs of 6.0kW and 7.5kW engine were actually 7.43kW and 7.85kW, respectively. When flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, outputs were increased from 7.43kW to 7.70kW in 6.0kW engine and from 7.85kW to 8.25kW in 7.5kW engine. 3. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, fuel consumption ratio was decreased from 300.8 to 296.8g/kW-hr in 6.0kW engine and also from 313.6 to 312.8g/kW-hr in 7.5 kW engine, respectively. 4. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, mechanical efficiency of engine was increased from 76.1% to 76.8% in 6.0kW engine and also from 76.7% to 77.0% in 7.5kW engine, respectively. 5. When the flywheel weight was reduced from $32.2kg_f$ to $24.2kg_f$, vibration was decreased at X-axis and Z-axis in 6.0kW engine, however, slightly increased at Y-axis in 6.0kW engine and at all axes in 7.5kW engine. 6. When the flywheel weight was reduced from $32.2kg_f$ to $24.4kg_f$ motoring loss was decreased from 2.33kW to 1.75kW in 6.0kW engine and also from 2.46kW to 1.84kW in 7.5kW engine.

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Antioxidant Properties of the Lotus Leaf Powder Content of Cheongpomuk (연잎 분말 첨가량에 따른 청포묵의 항산화 특성)

  • Moon, Jong-Hee;Hong, Ki-Woon;Yoo, Seung Seok
    • Culinary science and hospitality research
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    • v.22 no.7
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    • pp.112-130
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    • 2016
  • In this study the moisture content and chromaticity of fresh made lotus leaf powder added Cheongpomuk to utilize various efficacy of lotus leaf for processed food, as well as chromaticity, moisture content change, texture, total phenolic compound content, DPPH radical scavenging ability and preference of lotus leaf powder added Cheongpomuk with different storage period have been measured and analyzed. From the texture of lotus leaf powder added mung bean as per the storage period, the hardness of fresh Cheongpomuk were $0.38g/cm^2$ from control group, $0.40g/cm^2$ from CCD 1% group, $0.42g/cm^2$ from CCD 3% group, $0.37g/cm^2$ from CCD 5% group, $0.42g/cm^2$ from GGD 1% group, $0.39g/cm^2$ from GGD 3% group, $0.35g/cm^2$ from GGD 5% group, $0.39g/cm^2$ from JLD 1% group, $0.33g/cm^2$ from JLD 3% group, and $0.32g/cm^2$ from JLD 5% group. It has shown that JLD 5% group was the lowest, while CCD 3% group and GGD 1% group were the highest, and there were significant differences among sample groups. For DPPH radical scavenging ability, that of GLD 5% group was 22 times higher than that of control group. In addition, the tendency was increasing by increasing the adding rate of lotus leaf powder though there was some tolerance among sample groups. For total phenolic compound content, that of control group was 6.65 mg CE/100 g, and others were 7.48 mg CE/100 g from CCD 1% group, 15.82 mg CE/100 g from CCD 3% group, 20.15 mg CE/100 g from CCD 5% group, 15.55mg CE/100 g from GGD 1% group, 23.02 mg CE/100 g from GGD 3%, 26.95 mg CE/100 g from GGD 5% group, 3.92 mg CE/100 g from JLD 1% group, 16.72 mg CE/100 g from JLD 3%, and 26.58 mg CE/100 from JLD 5% group. From the analyzing result of responses for color and scent, taste, elasticity, and total preference of lotus leaf powder added Cheongpomuk between two panel groups, there was significant difference for the color, higher from professional cooking instructor group, but there were no significant difference between two groups for all other factors among professional cooking instructors and cooking department students. According to the results, it is expected that various functional foods can be developed by utilizing lotus leaf powder, depending on the growth condition and cultural environment of each region by adding 3% of lotus leaf powder, would be the most suitable recipe for Cheongpomuk.

Antibiotic Resistance for Common Hospital Acquired-pneumonia Pathogens in the Intensive Care Unit of Newly Opened Hospital (새로 개원한 병원 중환자실에서 주요 원내획득 폐렴 감염균의 연도별 항생제 내성율 변화)

  • Lee, Jae-Hyung;Shin, Sung-Joon;Kim, Young-Chan;Oh, Seung-Il;Kim, Mi-Ok;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.207-218
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    • 2002
  • Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

Standard Chemotherapy with Excluding Isoniazid in a Murine Model of Tuberculosis (마우스 결핵 모델에서 Isoniazid를 제외한 표준치료의 예비 연구)

  • Shim, Tae Sun;Lee, Eun Gae;Choi, Chang Min;Hong, Sang-Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Cho, Sang-Nae;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.177-182
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    • 2008
  • Background: Isoniazid (INH, H) is a key drug of the standard first-line regimen for the treatment of tuberculosis (TB), yet some reports have suggested that treatment efficacy was maintained even though INH was omitted from the treatment regimen. Methods: One hundred forty C57BL/6 mice were infected with the H37Rv strain of M. tuberculosis with using a Glas-Col aerosol generation device, and this resulted in depositing about 100 bacilli in the lung. Four weeks after infection, anti-TB treatment was initiated with varying regimens for 4-8 weeks; Group 1: no treatment (control), Group 2 (4HREZ): 4 weeks of INH, rifampicin (R), pyrazinamide (Z) and ethambutol (E), Group 3: 1HREZ/3REZ, Group 4: 4REZ, Group 5: 4HREZ/4HRE, Group 6: 1HREZ/3REZ/4RE, and Group 7: 4REZ/4RE. The lungs and spleens were harvested at several time points until 28 weeks after infection, and the colony-forming unit (CFU) counts were determined. Results: The CFU counts increased steadily after infection in the control group. In the 4-week treatment groups (Group 2-4), even though the culture was negative at treatment completion, the bacilli grew again at the 12-week and 20-week time points after completion of treatment. In the 8-week treatment groups (Groups 5-7), the bacilli did not grow in the lung at 4 weeks after treatment initiation and thereafter. In the spleens of Group 7 in which INH was omitted from the treatment regimen, the culture was negative at 4-weeks after treatment initiation and thereafter. However, in Groups 5 and 6 in which INH was taken continuously or intermittently, the bacilli grew in the spleen at some time points after completion of treatment. Conclusion: TThe exclusion of INH from the standard first-line regimen did not affect the treatment outcome in a murine model of TB in the early stage of disease. Further studies using a murine model of chronic TB are necessary to clarify the role of INH in the standard first-line regimen for treating TB.

The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix (다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究))

  • Kim, Ho-Kyoung;Ma, Jin-Yeul;Cheon, Won-Kyung;Yun, Su-Young;Kang, Eun-Jung;Joo, Hye-Jeong;Ko, Byoung-Seob
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.183-197
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    • 1997
  • In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri (足三里) of rat, repeatedly. We compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days(p<0.05) and after 7 days(p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight : In Palkang aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of Hwanggum aqua-aqupuncture$({\times}10\;group)$ was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture$({\times}100\;group)$, D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound(CPA group) and HG, there were significant value iii statistically. The diluted solution was more significant decrease than Hwanggum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupunture tended to decrease level of TG, regardless of its concentration. In acupunture guoup, we gained some interesting result In meaningful decrease in 7G. 5. Haematological examination showed significant increment of granulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

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Antitumor and Antimetastatic Effects of Toxoplasma Gondii in Mice with Lewis Lung Carcinoma (Lewis 폐암 마우스 모델에서 톡소포자충에 의한 항암 및 항전이 효과)

  • Kim, Ju-Ock;Jung, Sung-Soo;Park, Hee-Sun;Kim, Myoung-Hoon;Kim, Sun-Young;Lee, Young-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.317-329
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    • 2002
  • Background : Immunotherapy is another treatment modality for various cancers. There is little information on the antitumor effects of immunotherapy on implanted lung cancer mouse models. Toxoplasma gondii is able to potently induce a nonspecific stimulation of the host immune system. Therefore, this study evaluated the antitumor and antimetastatic effect of nonspecific immune stimulation by T. gondii in a Lewis lung cancer mouse model. Methods : Female C57BL/6 mice were injected with either Lewis lung cancer cells ($1{\times}10^6$ per mouse) or 5 cysts from the T. gondii Me49 strain with various schedules. The number of survival days, the tumor size of the implanted muscle and the histopathological findings of each group were noted. In addition to these mice, the Toxoplasma antigen($50{\mu}g$ per mouse) or a lymphokine (0.5 ml per mouse) was added to boost the immunotherapy. Results : No mouse in the Toxoplasma-infected group had died, whereas the mice receiving only the cancer cells (cancer control) survived for $29.1{\pm}4.4$ days. Cancer cells were revealed from 1 week after cancer cell inceulation in the muscle and from 3 weeks in the lung of the cancer control, whereas cancer cells were found in both the preinfection control and coinfection control groups from 2 weeks and 4 weeks in the lung respectively. The in the number of survival days were $32.4{\pm}3.3$ in the mice receiving T. gondii 2 weeks prior to the cancer cells inoculation (preinfection control), $30.9{\pm}5.1$ in mice received both simultaneously (coinfection control), and $34.9{\pm}2.9$ in mice received T. gondii 2 weeks after cancer cells implantation (postinfection control). These 3 infection groups had significantly longer survival days and suppressed tumor growth than those of the cancer control. In addition to these mice, and injection with the Toxoplasma antigen alone or in combination with lymphokine resulted in a significant increase in the number of survival days. Conclusion : These findings suggest that an injection with T. gondii can induce the antitumor and antimetastatic effects in Lewis lung cancer mouse models. Moreover, these effects were increased with an injection of the Toxoplasma antigen alone or in combination with lymphokine. However, this therapy can not prevent the development of cancer.

Effects of NG-monomethyl-L-arginine and L-arginine on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion after cerebral hypoxia-ischemia in newborn piglets (급성 저산소성 허혈성 뇌손상이 유발된 신생자돈에서 재산소-재관류기 동안 NG-monomethyl-L-arginine과 L-arginine이 뇌의 혈역학 및 에너지 대사에 미치는 영향)

  • Ko, Sun Young;Kang, Saem;Chang, Yun Sil;Park, Eun Ae;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.317-325
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    • 2006
  • Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.