• Title/Summary/Keyword: 동시치료

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The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

THE STUDY OF RELATION TO VARIABLES RELATED TO CHILDREN'S DEPRESSION AND PARENTS' DEPRESSION (아동 우울에 관련된 요인 및 부모 우울과의 관계 연구)

  • Seo, Min-Jung;Jung, Chul-Ho;Chang, Eun-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.245-255
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    • 2001
  • Objectives:This study was conducted to investigate variables related to children's depression, and also the relationships between children's depression and parents' depression. Methods:258 5th and 6th grade elementary school students in Taegu, and their parents were asked to complete self-report questionnaires including the children's depression Inventory(CDI) and the Beck's depression Inventory(BDI). Correlation analysis, T-test, One-way ANOVA were used for the statistical analysis and the statistically significant level is p<0.05. Results:1) CDI mean for total children is $13.5{\pm}6.77$, BDI mean for their mother is $13.3{\pm}7.25$, and BDI mean for their father is $11.6{\pm}7.03$. 2) There are significant differences in CDI for children variables related to sex, health, school achievement, economic status. 3) Mother's health slightly affect children's depression, but there are no significant differences in CDI for parents' education, religion, father's health. 4) Children's school achievement and economic status among variables related to children affect mother's BDI scores and children's school achievement affect father's BDI scores. 5) For CDI item analysis, there are significant differences in 10 items for children's sex, in 8 items for health, and in 6 items for economic status. Especially, there are significant differences in 20 items among 27 items for children's school achievement. 6) There is significant correlation between parents' BDI scores and children's CDI scores, and especially high correlation to mother for both boys and girls. Conclusion:Children's depression are significantly affected by children's sex, health, school achievement, economic status. And especially school achievement affect grossly children's depression and their mother's depression, so we know that children and their mother have much burden about school achievement. There is high correlation between children's depression and parents'(especially mother) depression. Therefore, these result imply that in the therapy for children's depression, we must include not only children's problems but also parents' depression and parent-children relationship.

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Low-intensity Oral Anticoagulation Versus High-intensity Oral Anticoagulation in Patients with Mechanical Bileaflet Prosthetic Heart Valves (이엽성 기게 심장판막 환자에 대한 낮은 강도의 항응고제 요법의 결과에 대한 임상분석)

  • Jeong, Seong-Cheol;Kim, Mi-Jung;Song, Chang-Min;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.430-438
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    • 2008
  • Background: All the patients with mechanical valves require warfarin therapy in order to prevent them from developing thromboembolic complications. According to the ACC/AHA practice guidelines, after AVR with bileaflet mechanical prostheses in patients with no risk factors, warfarin is indicated to achieve an INR of 2.0 to 3.0. After MVR with any mechanical valve, warfarin is indicated to achieve an INR of 2.5 to 3.5. But in our clinical experience, bleeding complications (epistaxis, hematuria, uterine bleeding, intracerebral hemorrhage etc.) frequently developed in patients who maintained their INR within this value. So, we retrospectively reviewed the patients with bileaflet mechanical heart valve prosthesis and we determined the optimal anticoagulation value. Material and Method: From January 1984 to February 2007, 311 patients have been followed up at a national medical center. We classified the AVR patients (n=60) into three groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II and an INR from 2.5 to 3.0 in Group III. We classified the MVR (n=171) and DVR (n=80) patients into four groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II, an INR from 2.5 to 3.0 in Group III and an INR from 3.0 to 3.5 in Group III. We compared the groups for their thromboembolic and bleeding complications by means of the Kaplan Meier method. Result: In the AVR patients, 2 thromboembolic complications and 4 bleeding complications occurred and the log rank test failed to identify any statistical significance between the groups for thethromboembolic complication rate, but groups I and II had lower bleeding complication rates than did group III. Thirteen thromboembolic complication and 15 bleeding complication occurred in the MVR and DVR patients, and the log rank test also failed to identify statistical significance between the groups for the thromboembolic complication rate, but groups I and II had lower bleeding complication rates that did groups III and IV. Conclusion: The thromboembolic complication rate was not statistically different between groups I and II and groups III and IV, but the bleeding complication rates of groups I and II were lower than those of groups III and IV. So this outcome encouraged us to continue using our low intensive anticoagulation regime, that is, an INR of 1.5 to 2.5.

DEVELOPMENT OF THREE DIMENSIONAL MEASURING PROGRAM WITH FRONTAL AND LATERAL CEPHALOMETRIC RADIOGRAPHS -PART 1. COMPUTATION OF THE THREE-DIMENSIONAL COORDINATES BY COMPENSATION OF THE ERROR OF THE HEAD POSITION IN ORDINARY NON-BIPLANAR CEPHALOSTAT- (정모 및 측모 두부 방사선 규격사진을 이용한 3차원 계측 프로그램의 개발 -1. 단일 방사선원으로 촬영된 두부 방사선사진의 두부 위치 보정을 이용한 3차원 좌표의 산출-)

  • Lee, Geun-Ho;Lee, Sang-Han;Jang, Hyon-Joong;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.214-220
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    • 2001
  • The clinical application of the three-dimensional radiographic technique had been limited to standard Broadbent-Bolton cephalometer with biplanar stereoradiography. We developed a new method for compensating the error of head position in ordinary non-biplanar cephalostat. It became to possible to use the three dimensional cephalogram commonly in clinical bases. 1. The method of methemetical compensation of head positioning error in non-biplanar condition was evaluated with dry skull. The error of the method of first and the second trial was $0.46{\pm}1.21$, $0.33{\pm}0.90mm$, which means the error of the head positioning correction in conventional cephalogram was within clinical acceptance. 2. The reproducibility of this system for clinical application was 0.54 mm ($-2.99{\sim}2.26mm$) which defines the absolute mean difference of the first and second trial. Compare to the The landmark identification error $1.2{\pm}1.6mm$, the error of the measurement was within the range of landmark identification error. The result indicates the adequate clinical accuracy of the computation of three-dimensional coordinates by compensation of the error of the head position in ordinary non-biplanar cephalostat.

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Comparison of Actigraphic Performance between $ActiWatch^{(R)}$ and $SleepWatch^{(R)}$:Focused on Sleep Parameters Utilizing Nocturnal Polysomnography as the Standard (활동기록기($ActiWatch^{(R)}$$SleepWatch^{(R)}$) 성능 비교 연구:야간수면다원기록을 표준으로 한 수면변인을 중심으로)

  • Shin, Hong-Beom;Lee, Ju-Young;Lee, Yu-Jin;Kim, Kwang-Jin;Lee, Eun-Young;Han, Jong-Hee;Im, Mee-Hyang;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.27-31
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    • 2005
  • Objectives: We attempted to compare the performance of 2 commercially available actigraphies with focus on sleep parameters, using polysomnography as standard comparison tool. Methods: Fourteen normal volunteers (5 males and 9 females, mean age of $28{\pm}4.6\;years$) participated in this study. All the participants went through one night of polysomnography, simultaneously wearing 2 different kinds of actigraphies on each wrist. Polysomnographic and actigraphic data were stored, downloaded, and processed according to standard protocols and then statistically compared. Results: Both $ActiWatch^{(R)}$ and $SleepWatch^{(R)}$ tended to overestimate the total sleep time, compared to the polysomnography. $SleepWatch^{(R)}$ tended to underestimate the sleep latency. The two actigraphs and the polysomnograph did not show significant difference of sleep efficiency, when compared with one another. In addition, all of the sleep parameters from the instruments showed linear correlations except in $SleepWatch^{(R)}'s$ sleep latency. The sleep parameters from the two actigraphs did not show much noteworthy difference, and linear relationships were found between the sleep parameters from the two actigraphs. There was no significant distinction in the results of the two different actigraphs. Conclusion: The results of two actigraphies can be used interchangeably since the sleep parameters of the two different actigraphies do not show significant differences statistically. Overall, it is not legitimate to use actigraphy as a substitute for polysomnography. However, since sleep parameters except sleep latency show linear correlations, actigraphy might possibly be used to follow up patients after polysomnography.

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List-event Data Resampling for Quantitative Improvement of PET Image (PET 영상의 정량적 개선을 위한 리스트-이벤트 데이터 재추출)

  • Woo, Sang-Keun;Ju, Jung Woo;Kim, Ji Min;Kang, Joo Hyun;Lim, Sang Moo;Kim, Kyeong Min
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.309-316
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    • 2012
  • Multimodal-imaging technique has been rapidly developed for improvement of diagnosis and evaluation of therapeutic effects. In despite of integrated hardware, registration accuracy was decreased due to a discrepancy between multimodal image and insufficiency of count in accordance with different acquisition method of each modality. The purpose of this study was to improve the PET image by event data resampling through analysis of data format, noise and statistical properties of small animal PET list data. Inveon PET listmode data was acquired as static data for 10 min after 60 min of 37 MBq/0.1 ml $^{18}F$-FDG injection via tail vein. Listmode data format was consist of packet containing 48 bit in which divided 8 bit header and 40 bit payload space. Realigned sinogram was generated from resampled event data of original listmode by using adjustment of LOR location, simple event magnification and nonparametric bootstrap. Sinogram was reconstructed for imaging using OSEM 2D algorithm with 16 subset and 4 iterations. Prompt coincidence was 13,940,707 count measured from PET data header and 13,936,687 count measured from analysis of list-event data. In simple event magnification of PET data, maximum was improved from 1.336 to 1.743, but noise was also increased. Resampling efficiency of PET data was assessed from de-noised and improved image by shift operation of payload value of sequential packet. Bootstrap resampling technique provides the PET image which noise and statistical properties was improved. List-event data resampling method would be aid to improve registration accuracy and early diagnosis efficiency.

The effect of using laser for ceramic bracket bonding of porcelain surfaces (세라믹 브라켓 부착 시 레이저를 이용한 포세린 표면처리 효과)

  • An, Kyung-Mi;Sohn, Dong-Seok
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.275-282
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    • 2008
  • Objective: The purpose of this study was to investigate the effect of using laser for ceramic bracket bonding of porcelain surfaces and to compare it with conventional treatment of porcelain surfaces. Methods: Ninety feldspathic porcelain specimens were divided into 9 groups of 10, with each group having different surface treatments performed. Surface treatment groups were orthophosphoric acid, orthophosphoric acid with silane, hydrofluoric acid, hydrofluoric acid with silane, sandblasted, sandblasted with silane, laser etched, laser etched with silane, and glazed surface served as a control group. In the laser etched groups, the specimens were irradiated with 2-watt superpulse carbon dioxide ($CO_2$) laser for 20 seconds. Ceramic brackets were bonded with light-cure composite resin and all specimens were stored in water at $37^{\circ}C$ for 24 hours. Shear bond strength was determined in megapascals (MPa) by shear test at 1 mm/minute crosshead speed and the failure pattern was assessed. For statistical analysis, one-way ANOVA and tukey test were used. Results: Statistical analysis showed significant differences between the groups. The HFA + S group showed the highest mean shear bond strength ($13.92{\pm}1.94\;MPa$). This was followed by SB + S ($10.16\;{\pm}\;1.27\;MPa$), HFA ($10.09\;{\pm}\;1.07\;MPa$), L + S ($8.25\;{\pm}\;1.24\;MPa$), L ($7.86\;{\pm}\;0.96\;MPa$), OFA + S ($7.22\;{\pm}\;1.09\;MPa$), SB ($3.41\;{\pm}\;0.37\;MPa$), OFA ($2.81\;{\pm}\;0.37\;MPa$), G ($2.46\;{\pm}\;1.36\;MPa$), Bond failure patterns of HFA and silane groups, except L + S, were cohesive modes in porcelain while adhesive failure was observed in the control group and the rest of the groups. Conclusions : A 2-watt superpulse $CO_2$ laser etching of porcelain surfaces can provide a satisfactory result for porcelain surface treatment for ceramic bracket bonding. Laser irradiation may be an alternative conditioning method for the treatment of porcelain surfaces.

Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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Effects of 2-methoxy-1,4-naphthoquinone (MQ) on MCP-1 Induced THP-1 Migration (MCP-1에 의해 유도된 THP-1 유주에 미치는 2-methoxy-1,4-naphthoquinone (MQ)의 영향)

  • Kim, Si Hyun;Park, Bo Bin;Hong, Sung Eun;Ryu, Sung Ryul;Lee, Jang Ho;Kim, Sa Hyun;Lee, Pyeongjae;Cho, Eun-Kyung;Moon, Cheol
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.245-251
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    • 2019
  • This study examined the effects of 2-methoxy-1,4-naphthoquinone (MQ) on the monocyte chemoattractant protein-1 (MCP-1)-induced migration of monocytes, which is an important phenomenon for the body defense and immune response. MQ is a major component extracted from Impatiens balsamina leaves, which have been used for many years in Asian medicine for the treatment of a range of diseases and pain. The cytotoxicity of MQ began to appear at a concentration of $10{\mu}M$, and approximately 50% cytotoxicity was confirmed at $100{\mu}M$. The MCP-1 induced migration of the THP-1 monocyte cell line increased after MQ treatment in a dose dependent manner and the largest increase was observed at $0.1{\mu}M$. The level of cAMP expression decreased after a treatment with $0.1{\mu}M$ MQ. The phosphorylation of extracellular signal-regulated kinases 1/2 (Erk1/2), a key signaling protein involved in the signaling pathway of C-C motif chemokine receptor 2 (CCR2), a receptor for MCP-1, was increased by the simultaneous treatment of $0.1{\mu}M$ MQ. These results show that MQ increases the MCP-1-induced migration of THP-1, decreases the level of cAMP expression, and increases the level of Erk1/2 phosphorylation.

The effects of Allomyrina dichotoma larval extract on palmitate-induced insulin resistance in skeletal muscle cells (장수풍뎅이 유충 추출물이 고지방산 처리 골격근세포의 인슐린 저항성에 미치는 영향)

  • Kim, Kyong;Sim, Mi-Seong;Kwak, Min-Kyu;Jang, Se-Eun;Oh, Yoon Sin
    • Journal of Nutrition and Health
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    • v.55 no.4
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    • pp.462-475
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    • 2022
  • Purpose: Allomyrina dichotoma larvae are one of the approved edible insects with nutritional value and various functional and medicinal properties. Previously we have demonstrated that the Allomyrina dichotoma larval extract (ADLE) ameliorates hepatic insulin resistance in high-fat diet (HFD)-induced diabetic mice through the activation of adenosine monophosphate-activated protein kinase (AMPK). This study investigated the effects of ADLE on insulin resistance in the skeletal muscle and explored mechanisms for enhancing the glucose uptake in palmitate (PAL)-treated C2C12 myotubes. Methods: To induce insulin resistance, the differentiated C2C12 myotubes were treated with PAL (0.5 mM) for 24 hours, and then treated with a 0.5 mg/ml concentration of ADLE, and the resultant effects were measured. The expression levels of glucose transporter-4 (GLUT4), AMPK, and the mitochondrial metabolism-related proteins were analyzed by western blotting. The mRNA expression levels of lipogenesis- related genes were determined by quantitative reverse-transcriptase PCR. Results: The exposure of C2C12 myotubes to 0.5 mg/ml of ADLE increased cell viability significantly compared to PAL-treated cells. ADLE upregulated the protein expression of GLUT4 and enhanced glucose uptake in the PAL-treated cells. ADLE increased the phosphorylated AMPK in both the PAL-treated C2C12 myotubes and HFD-treated skeletal muscle. The reduced expression levels of peroxisome-proliferator-activated receptor gamma co-activator-1 alpha (PGC1α) and uncoupling protein 3 (UCP3) due to the PAL and HFD treatment were reversed by the ADLE treatment. The citrate synthase activity was also significantly increased with the PAL and ADLE co-treatment. Moreover, the mRNA and protein expressions of fatty acid synthesis-related factors were reduced in the PAL and HFD-treated muscle cells, and this effect was significantly attenuated by the ADLE treatment. Conclusion: ADLE activates AMPK, which in turn induces mitochondrial metabolism and reduces fatty acid synthesis in C2C12 myotubes. Therefore, ADLE could be useful for preventing or treating insulin resistance of skeletal muscles in diabetes.