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The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal in Rehabilitation Patients (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오 투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myoyoung;Choi, Namgil;Han, Jaebok;Song, Jongnam;Kim, Weonjin
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.1-7
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    • 2015
  • Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

Study on the Single Oral Dose Toxicity of High Quality Rice Varieties (국내육성 벼 주요 품종의 Ethanol 추출물 단회 경구투여 안전성 연구)

  • Shin, Jin-Chul;Choi, Sung-Sook;Han, Hye-Kyoung;Chung, Ha-Sook
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.2
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    • pp.146-152
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    • 2007
  • The present study was carried out to investigate the potential acute toxicity of ethanol extracts of the aleurone layer of Oryza sativa cvs. Obongbyeo, Ilpumbyeo, and Aranghyangchalbyeo by a single oral dose in ICR mice. The test article was orally administered once by gavage to male and female mice at dose levels of 0, 2.5, 5.0, and 10.0 g/kg body weight (n=10 for male and female mice for each dose). We examined numbers of deaths, general signs, weight measurement and biochemical analysis for sexes and doses of mice control and experimental groups. All mice were alive during the experimental period so can not yield death rate and $LD_{50}$. Any significant clinical symptom was not observed in all treated groups. No significant body weight changes in treatment groups in comparison with those of control groups was observed at any dose levels in experimental groups. Plasma glucose levels were valued both control and treated groups and there were no significant differences between groups. The activities of ALT and AST were not increase in all sample treated groups when compared with the control groups. The results suggest that the toxicity of Oryza sativa cvs. Obongbyeo, Ilpumbyeo, and Aranghyangchalbyeo are low and its $LD_{50}$ is over 10.0 g/kg body weight in both male and female mice.

Clinical and Cytogenetic Analysis of Children with Maternal Chromosomal Balanced Translocation (모체의 염색체 균형전좌를 가진 환아들의 임상적 세포 유전학적 관찰)

  • Lim, Han Hyuk;Jeong, Hee Jeong;Park, Kyung Duk;Kim, Sook Ja
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.701-705
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    • 2005
  • Purpose : Parents' genetic information plays an important role in their children's genetic expression. Human chromosome has 23-paternal chromosomes and 23-maternal chromosomes. Parental chromosomal translocation can induce clinical problems in their children because of imbalance in genetic information. We intent to analyze the cytogenentic and clinical features about children with maternal balanced translocation between chromosome 15 and 18. Methods : We detected by one family's FISH study of chromosome 15. We have evaluated children born to clinically normal parents about peripheral bood analysis, endocrine, metabolic, radiologic study, electroencephalogram and social & intelligence scale. and We analysis their clinical manifestation by hospital records. Results : Patient's father and elder sister are normal clinically and genetically. Her mother's chromosome show balanced translocation, 46, XX, t(15;18)(p11.2;p11.3). One child has 46, XX, der(18) t(15;18)(p11.2;p11.3), mental retardation, growth retardation, speech & social developmental delay, recurrent infection and mild mitochondria dysfunction. Her young brother has 46, XY, der(15) t(15;18) (p11.2;p11.3), mental retardation, aggressive behavior, obesity and speech developmental delay. Conclusion : In this study we observed the children with developmental delay, dysmorphic facial features, mental retardation, growth retardation associated with growth hormone deficiency and aggressive behavior due to unbalanced translocation between chromosome 15 and 18.

THE EXPRESSION OF MSX GENES DURING EARLY CRANIAL SUTURE EMBRYOGENESIS (두개골 봉합부의 초기 형태발생과정에서 Msx 유전자들의 발현양상)

  • Lee, Sang-Youp;Park, Mi-Hyun;Ryoo, Hyun-Mo;Nam, Soon-Hyeun;Kim, Young-Jin;Kim, Hyun-Jung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.171-180
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    • 2003
  • The development of calvarial bones is tighly co-ordinated with the growth of the brain and needs of harmonious interactions between different tissues within the calvarial sutures. Premature fusion of cranial sutures, known as craniosynostosis, presumably involves disturbance of these interactions. Mutations in the homeobox-containg gene Msx2 cause human craniosynostosis syndrome. Msx genes, which are consist of Msx1, Msx2 and Msx3, are homeobox-containg transcripton factors, and were originally identified as homologue of Drosophila msh(muscle segment homeobox) gene. Msx1 and Msx2 genes, expressed mostly in overlapping patterns at multiple site of tissue interactions during vertebrate development, are associated with epithelial-mesenchymal interactions during organogenesis, targets of BMP and FGF signaling. To elucidate the function of Msx genes in the early morphogenesis of mouse cranial suture, we analyzed the expression of them by in situ hybridization during embryonic(E15-E18) stage, and did vivo experiments in E15.5 mouse using rhBMP-2, rhFGF-2 protein soaked bead. In the sagittal suture, Msx1 was expressed in the mesenchyme of suture and the dura mater, Msx2 was intensely expressed in the sutural mesenchyme and the dura mater. In the coronal suture both of Msx genes were expressed intensely in the sutural mesenchyme and expressed in the periosteum also. Msx1 had a broader expression pattern than Msx2. BMP2 beads induced expression of both Msx1 and Msx2, FGF2 beads induced expression of Msx1, but not Msx2. Taken together, these data suggest that Msx1 and Msx2 genes have important role in regulating the morphogenesis and maintenance of embryonic cranial suture. Both of Msx genes are expressed similarly but because of their upstream signaling, they function dependently or cooperatively according to change of signaling molecule.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

A Retrospective Study of Invasive Bacterial Infections in Children with Asplenia (18세 이하 무비증 환자에서 발생한 침습성 세균 감염증에 대한 후향적 연구)

  • Choe, Yong-Joon;Seo, Euri;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.160-167
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    • 2017
  • Purpose: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. Methods: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. Results: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H. influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. Conclusions: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.

Changes of pH, Meat Color, Cooking Loss, Shear Force and Sensory Evaluation on Hanwoo Meat Fed with Supplemental Fig Fermentation during Storage Period (무화과 발효물을 급여한 한우고기의 저장기간 중 pH, 육색, 가열감량, 전단력 및 관능평가의 변화)

  • Kook, Kil;Kim, Kwang-Hyun
    • Food Science of Animal Resources
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    • v.22 no.4
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    • pp.289-293
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    • 2002
  • This study was conducted to investigate changes of pH, meat color, cooking loss, shear force and sensory evaluation on Hanwoo meat fed with supplemental fig fermentation(SFF) during storage period. A total of 10 Hanwoo bulls were subjected to one of two treatment diets (control and 10% SFF) from live weight of 400kg far 6 months. After slaughter, longissimus muscles were removed, zipper-wrapped and stored at 4$\^{C}$ for 21 days. The pH, meat color, cooking loss, shear force and sensory evaluation of the samples were measured at 1, 3, 9, 15, 21 days of storage. There were no differences in pH, meat objective color(Hunter L, a and b) and cooking loss (%) of longissimus muscles between control and SFF treatment during storage. Shear force values of longissimus muscle from SFF treatment showed lower level in 1, 3 and 9 days and tended to decrease during storage. No differences in odor and appearance of sensory evaluation were observed between control and SFF treatment during storage. The taste induced by SFF was increased(f<0.05) at 1, 3 and 9 days of storage. These results indicate that the SFF may improve meat quality of Hanwoo during storage.

The Change of Cortical Activity Induced by Visual Disgust Stimulus (시각혐오자극으로 유발된 대뇌 피질 활성도 변화)

  • Jung, Wook;Park, Doo-Heum;Yu, Jae-Hak;Ryu, Seung-Ho;Ha, Ji-Hyeon;Shin, Byoung-Hak
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.75-81
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    • 2013
  • Objectives: There are a lot of studies that analyze the interaction between the emotion of disgust and the functional brain images using fMRI and PET. But studies using sLORETA (standardized low resolution brain electromagnetic tomography) almost do not exist. The aim of this research is to explore the relationship of the emotion of disgust and the cortical activation using sLORETA analysis. Methods: Forty five healthy young adults ($27.1{\pm}2.6$ years) participated in the study. While they were watching 4 neutral images and 4 disgusting images associated with mutilation selected from the international affective picture system (IAPS), participants' EEGs were taken for 30 seconds per one picture. Through these obtained EEG data, sLORETA analysis was performed to compare EEGs associated with neutral and negative images. Results: During looking for visual disgusting stimulus, all participants reported unpleasantness, arousal and stress. In sLORETA analysis, the decrease of current density in theta wave was shown at left frontal superior gyrus (BA10) and middle gyrus (BA10, 11). This voxel cluster consists of a total of 11 voxels and the threshold of t value indicating statistically significant decreases in the current density (p<0.05) was -1.984. There were no differences between male and female in the degree of being disgusted by the stimuli. Conclusion: This finding may suggest that the activation of dorsolateral prefrontal cortex might be associated with regulating disgust emotion.

Mammalian Reproduction and Pheromones (포유동물의 생식과 페로몬)

  • Lee, Sung-Ho
    • Development and Reproduction
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    • v.10 no.3
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    • pp.159-168
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    • 2006
  • Rodents and many other mammals have two chemosensory systems that mediate responses to pheromones, the main and accessory olfactory system, MOS and AOS, respectively. The chemosensory neurons associated with the MOS are located in the main olfactory epithelium, while those associated with the AOS are located in the vomeronasal organ(VNO). Pheromonal odorants access the lumen of the VNO via canals in the roof of the mouth, and are largely thought to be nonvolatile. The main pheromone receptor proteins consist of two superfamilies, V1Rs and V2Rs, that are structurally distinct and unrelated to the olfactory receptors expressed in the main olfactory epithelium. These two type of receptors are seven transmembrane domain G-protein coupled proteins(V1R with $G_{{\alpha}i2}$, V2R with $G_{0\;{\alpha}}$). V2Rs are co-expressed with nonclassical MHC Ib genes(M10 and other 8 M1 family proteins). Other important molecular component of VNO neuron is a TrpC2, a cation channel protein of transient receptor potential(TRP) family and thought to have a crucial role in signal transduction. There are four types of pheromones in mammalian chemical communication - primers, signalers, modulators and releasers. Responses to these chemosignals can vary substantially within and between individuals. This variability can stem from the modulating effects of steroid hormones and/or non-steroid factors such as neurotransmitters on olfactory processing. Such modulation frequently augments or facilitates the effects that prevailing social and environmental conditions have on the reproductive axis. The best example is the pregnancy block effect(Bruce effect), caused by testosterone-dependent major urinary proteins(MUPs) in male mouse urine. Intriguingly, mouse GnRH neurons receive pheromone signals from both odor and pheromone relays in the brain and may also receive common odor signals. Though it is quite controversial, recent studies reveal a complex interplay between reproduction and other functions in which GnRH neurons appear to integrate information from multiple sources and modulate a variety of brain functions.

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Influence of Yohimbine on the Central Dopaminergic Regulation of Renal Function (신장기능의 중추 Dopamine성 조절에 미치는 Yohimbine의 영향)

  • Kook, Young-Johng;Kim, Kyung-Keun;Cho, Kang-Seon;Min, Byung-Kap
    • The Korean Journal of Pharmacology
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    • v.22 no.2
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    • pp.79-87
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    • 1986
  • Recently it has been shown that central dopaminergic system regulates the renal function and that intracerebroventricularly (icv) administered dopamine (DA) produces antidiuresis and antinaturiuresis, resembling icv norepinephrine, and evidence has been accumulated which would suggest the involvement of adrenergic system in the DA effects. It was attempted therefore in this study to see whether the DA effect is influenced by pretreatment of yohimbine which is known as a specific ${\alpha}_2-adrenoceptor$ antagonist. Yohimbine produced, when given icv in doses of $100\;{\mu}g/kg$, marked antidiuresis and antinatriuresis along with decreases in renal perfusion and glomerular filtration. DA, in doses of $15\;{\mu}g/kg$, also produced antidiuresis and antinaturiuresis. However, after yohimbine-pretreatment DA $15\;{\mu}g/kg$ improved renal hemodynamics, and electrolyte excretion and urine flow rate transiently increased. With $150\;{\mu}g/kg$ DA, the antidiuresis was more marked in the control group. But the yohimbine-pretreated animals responded with marked diuresis and natriuresis, sodium excretion increasing more than three-fold, which lasted for 20 minutes. $K^+-excretion$, osmolar clearance as well as free-water reabsorption increased. Renal hemodynamics improved partly. Apomorphine, a DA agonist, when given icv in doses of $150\;{\mu}g/kg$, produced diuresis and naturiuresis, concomitant with increased renal hemodynamics. Yohimbine-pretreatment however did not abolish the apomorphine-induced diuresis and naturiuresis. Antidiuresis and antinatriuresis elicited by norepinephrine, $10\;{\mu}g/kg$, was not affected by yohimbine-pretreatment. These results indicate that the renal effects of icv DA is not so simple as those of norepinephrine, and the diuretic natriuretic cffect which had been masked by the hemodynamic effect becomes manifest only when the decreases in hemodynamics were removed by the pretreatment of yohimbine. It was further suggested that those DA receptors which mediate the natriuretic response to icv DA is not affected by yohimbine, whereas those receptors involved in the decrease in renal hemodvnamics are blocked by yohimbine. And the possibility of involvement of adrcnergic system in the DA action is not substantiated.

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