Lee Ji-Eun;Lee Hyun-Ok;Paik Kyung-Hoon;Lee Suk-Hyang;Jin Dong-Kyu
Childhood Kidney Diseases
/
v.8
no.1
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pp.33-42
/
2004
Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.
This paper examines the situation and tasks of UK rail privatization, especially focusing on after the Hatfield rail accident. Earlier research which focused on the UK's Privatization had little knowledge of the explanations for recent changes. Moreover they had difficulty making a direct comparison between national rail and the privatized rail. Therefore we aye left without a good explanation which has a comprehensive perspective. I attempt to show the change in the rail privatization Process and its outcome, focusing on after the Hatfield rail accident. This Paper argues that the UK's vail privatization process has a regulatory framework which is too complicated with overlapping responsibilities that brought about inefficiency, increasing costs and a superficial safety regime. Especially the planning of rail and infrastructure maintenance did not come to play an appropriate role. However after 2000, the government took charge of setting the strategy for railways, and the Office of Rail Regulation covered safety performance and cost. explain that these changes present a good opportunity to solve the problem of passing the buck for poor performance. Through the analysis, I find that the passenger rail network is well-suited to deliver long distance business and commuters and that the subsidy from the government is decreasing. However, performance, for example punctuality and reliability. should be improved. Especially the Hatfield rail accident caused a reduction in the satisfaction of passengers. In future. the problems of rising costs and monopoly franchise system should be addressed.
Purpose : To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radio-therapy, a retrospective analysis was undertaken. Materals and Methods : I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radio-therapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dese rate intracavitary radiation. Results : Overall 5 year survival rate and relapse free survival rate were $75.4\%,\;73.5\%$, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node matastasis. tumor size and vaginal resection margin involvement were significant prognostic factos. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only $56\%$ and nine of twenty two patients recurred. Conculsion : Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.
This study was performed to determine the minimum dose of Poloxamer/Sodium alginate (PX/SA) mixture on preventing intraperitoneal adhesions to evaluate organ toxicity. Twenty five healthy adult mongrel dogs (weighing 4.68${\pm}$1.67 kg) were divided into five experimental groups composed of five dogs respectively; negative control group (NC, non-treated), positive control group (PC, 2% carboxymethyl chitosan solution treated), and experiment 1 group (E1, 0.25 ml PX/SA mixture of abraded area), experiment 2 group (E2, 0.5 ml PX/SA mixture of abraded area), experiment 3 group (E3, 1.0 ml PX/SA mixture of abraded area). Venous blood specimens were collected from all experimental animals for hematologic and biochemical analysis: WBC, fibrinogen, AST, ALT, ALP, BUN and creatinine. The anti-adhesion effect was evaluated using a serosa abrasion model. The denuded ileum was coated with PX/SA mixture, carboxymethyl chitosan solution or neither. The tensile strength of the adhesion site was evaluated with a tensiometer. For histopathological examination, tissue samples of the liver and kidney were collected from all dogs. According to the results, the frequency and tensile strength values for adhesion separation in PX/SA group were significantly lower than those in negative control group (p < 0.05). In E2 group, the tensile strength was significantly decreased in consideration of PX/SA dose. The values of AST, ALT, ALP, BUN and creatinine of the control and the experimental groups showed no statistical differences. No obvious microscopic differences were noted among tissue sections obtained from all groups. The results suggest that PX/SA mixture may be effective on reducing peritoneal adhesion formation in dog and that 0.5 ml PX/SA mixture of abraded area is most effective dose. Moreover, PX/SA mixture was considered not to have toxicity for the liver and the kidney.
It is well known that hepatobiliary agent are taken up by metastatic hepatocellular carcinoma(HCC) as well as primary HCC. But the reported cases of the extrahepatic metastasis of HCC diagnosed by hepatobiliary scintigraphy are for the most part hematogenous ones. The relation of the uptake pattern of hepatobiliary agent in the primary and metastatic HCC is also still remains unknown. So we undertook this study to evaluate the relation of the hepatobiliary scintigraphic patterns of primary and metastatic HCC with different metastatic routes. Nine patients with primary HCC and twelve cases of metastatic HCC including four lung metastases, one bone metastasis, one right atrial metastasis, one peritoneal wall metastasis, and five lymph node metastases were studied with $^{99m}Tc-DISIDA$ scintigraphy. The images were taken on 10, 30 minutes, 1, 2, 4-6 hours. The overall detection rates of hematogenous metastases(lung and bone) is 60%(3 of 5), direct metastasis(right atrium and peritoneal wall), 100%(2 of 2) and lymphatic metastases, 0%(0 of 5). In four of five metastatic cases demonstrated with hepatobiliary scintigraphy, biliary agent is also taken up by primary HCC lesions. And the appearing time of the radioactivity in the direct metastatic HCC lesioin is same as that of primary HCC and in the cases of hematogenous metastasis, earlier than that of primary HCC. Hepatobiliary scintigraphy is more useful in the diagnosis of the metastatic HCC than primary HCC, in the cases of hematogenous and direct metastasis.
This survey was done to investigate the pesticide residues on agricultural products on the markets in Incheon area from 2003 to 2005. A total of 10,431 samples was analyzed the residues by GC. The violation rates of the samples over maximum residue limits (MRLs) of pesticide residues established by Korean Food and Drug Administration (KFDA) in the survey of 2003, 2004 and 2005 were 1.3%, 0.9%, and 1.2%, respectively. The rate from the samples of 2005 surveyed in general wholesale markets was 3.1%, whereas that from agricultural wholesale market was 0.93%. Of the total violated samples, more than 70% of the rates were recorded from the samples of Gyeonggi-do and Incheon area in 2003 and 2004. However, the rates from Gyeonggi-do and Incheon in 2005 were remarkably reduced to 25.6% and 23.3%, respectively. Most commonly encountered agricultural commodity over MRLs was crown daisy. Positively detected pesticides were 12, 17 and 32 in the survey of 2003, 2004 and 2005, respectively. The pesticides detected yearly over MRLs during three years were chlorothalonil, chlorpyrifos, diazinon, endosulfan, procymidone. Decreasing tendency in detected and violated rates of the residues was observed in chlorpyrifos and diazinon, while increasing tendency in detected rates was recorded in chlorothalonil, endosulfan, procymidone.
The purpose of this study was to examine the influence of the disaster perception and satisfaction level of volunteer fire-fighters on the continuity of their volunteering. The 163 subjects in this study were selected from male and female volunteer fire-fighters who resided in urban and rural regions in Gangwon Province. After a this survey was conducted, the collected data were analyzed by a statistical package SPSS WIN 20.0, and frequency analysis, correlation analysis and multiple regression analysis were made. The level of statistical significance was all set at p<.05. The findings of the study were as follows: First, as for the correlation of disaster perception, satisfaction and volunteering continuity, perception of disaster countermeasures, satisfaction and the level of participation were negatively correlated with one another, and there was a positive correlation among disaster training, disaster preparation, regional disaster, the period of volunteering, and will of persistent volunteering. Second, as for perception of disaster, the volunteer fire-fighters were asked a question about disaster countermeasures, and the largest group replied they were partially aware of the countermeasures. Concerning questions about disaster training/education experience and triage, the biggest group replied they underwent the training and knew about triage on the whole. Regarding questions on the emergency contact system and emergency work schedule, they knew about the two in general. As to a question on the occurrence of human disaster, the greatest group answered that they knew about it yet not well. Third, in regard to the impact of satisfaction level on volunteering continuity, the period of volunteering was affected by needs for experience, social contact and social recognition among the subfactors of satisfaction level, and will of persistent volunteering was under the influence of social contact and achievement needs. The level of persistent volunteering was affected only by needs for experience and achievement needs.
The purpose of this study was to examine the appearance of norovirus in the water for food in food service institutions and the influence of physicochemical and microbial factors of norovirus in order to work out basic data to predict the detection of norovirus. Among 82 samples of water for food in food service institutions, norovirus appeared in 7 samples and the rate of appearance was 8.5%. As for the type of norovirus, one samples contained GI type (genotype GI-6) and six samples contained GII type (genotype GII-2, GII-4, GII-12). In the regression model of prediction of norovirus, the rate of appearance was correlated with $NH_3$-N, total solids and the consumption of $KMnO_4$, out of such variables as $NH_3$-N, total solids, the consumption of $KMnO_4$, depth, chloride and total colony counts, and its contribution rate for effectiveness was 78.60%. In order to examine the influential factor of environment upon the detection of norovirus, Pearson's correlation analysis was carried out. The predictable regression formula for appearance rate of norovirus was expressed as -1.818 + 42.677 [$NH_3$-N] + 0.023 [total solids] + 0.762 [consumption of $KMnO_4$] -0.009 [depth] -0.146 [chloride] + 0.007 [total colony counts] (R = 0.904, $R^2$ = 0.818, adjusted $R^2$ = 0.786, p < 0.05). The most influential factors upon the detection of norovirus were $NH_3$-N, total solids and the consumption of $KMnO_4$. In other words, when the measured values of $NH_3$-N, total solids and the consumption of $KMnO_4$ were higher, the possibility of appearance of norovirus increased.
Clinical observation was made on 161 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1994. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, hypertensive encephalopathy, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through western medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission, the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 11.4 days and with cerebral hemorrhage 22.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. The next was pneumonia. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.
Clinical observation was made on 226 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from January to December in 1995. 1. The CVA cases were classified into the following kinds: cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), transient ischemic attack, and the greatest in number among them were the cases of cerebral infarction. 2. The frequency of strokes was much the same between male and female cases and most cases were over 50 of age. 3. In the case of cerebral infarction the place of the most frequent occurrences was in the MCA territory, and as for cerebral hemorrhage, in the basal ganglia area. 4. The most ordinary preceding disease was hypertension. The next was diabetes mellitus. 5. Generally it is thought that CVA occurs frequently in winter. But on the contrary this study of observation confirmed that it occurs mostly in spring and summer. 6. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. 7. As concerns the course of hospitalization, most patients passed through vestern medical hospitals or oriental medical hospitals. 8. For the patients the condition of whose consciousness was bad at the time of admission. the prognosis in most cases was bad. 9. The common symptoms were motor disability and verbal disturbance. 10. With regard to cerebral infarction, the average time to start physical theraphy was 6.4 days and with cerebral hemorrhage 9.7 days after stroke. 11. The duration of hospitalization was in most cases more than one month. 12. The main complication was urinary tract infection. 13. At the time of admission to hospital, the blood pressure in most cases was high, but it well controlled at the time of discharge. 14. Most cases were given simultaneous treatment in both ways of western and oriental medicine.
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