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Changes in Plasma and Urine Endothelin Levels During Acute Exacerbation of Asthma (급성 천식발작시 혈장 및 요중 Endothelin 농도 변동)

  • Chang, Jung-Hyun;Shin, Tae-Rim;Woo, Ga-Eun;Kim, Jong-Seon;Hong, Eun-Soon;Seo, Gi-Yeoul;Cha, Joo-Hyun;Kim, Mi-Seon;Kim, Yeung-Seon;Cho, Young-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.844-852
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    • 1997
  • Background : Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. Method : Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. Results : Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls.,However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. Conclusion : The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.

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Cortical Dysplasia: Tc-99m ECD SPECT Findings and Comparative Study with MRI according to Pathologic Grading (뇌피질 이형성증: Tc-99m ECD SPECT 소견과 병리적 등급에 따른 MRI와 비교 연구)

  • Park, Soon-Ah;Lim, Seok-Tae;Sohn, Myung-Hee;Chung, Gyung-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.23-32
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    • 2001
  • Purpose: Cortical dysplasia (CD) designates a diverse group of malformations resulting from one or more abnormalities in the development of the cerebral cortex. We investigated the findings of interictal SPECT and the diagnostic usefulness of interical and ictal SFECT according to pathological grading (PG) in comparison with MRI. Materials and Methods: This study included 16 patients (M:F=9:7, age: $19.9{\pm}11.8$ yrs) with pathologically proven CD. Tc-99m ECD SPECT was performed in all patients: interictal 11, interictal and ictal 3, ictal 2. MRI were obtained in all patients and image analysis was done blindly as to the result of SPECT. Pathologic findings of CD were classified into grade 1 G1, dyslamination), grade 2 (G2, dysplastic neurons) and grade 3 (G3, balloon cells). We compared SFECT with MRI in lesions-to-lesions and analyzed the result according to PG. Results: In SFECT and MRI. 38 and 27 lesions were visually recognized. In 14 interictal SPECT, variable findings in 35 lesions were demonstrated: 25 were hypoperfusion, 7 hyperperfusion, 2 heterotopic perfusion in the white matter. By comparison between two studios, missed lesions were founded: SPECT were 1 lesion, MRI 12. Review of missed 12 lesions of MRI were followed according to PG: G1 patients were 16.7% (4/19), G2 40.0% (6/15), and G3 50% (2/4). Conclusion: Interictal SFECT in CD showed variable findings such as hypoperfusion, hyperperfusion or heterotopic perfusion. However, for detection of missed CD on MRI, SFECT may help to detect a functional abnormality of the lesion with high PG.

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Comparison of occurrence rate of the epileptiform discharge between awake EEG and sleep EEG in childhood epilepsy (소아청소년 간질 환자에서 수면 뇌파와 각성 뇌파의 간질파 발현율의 비교)

  • Jung, Yu Jin;Kwon, Kyoung Ah;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.861-867
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    • 2008
  • Purpose : We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. Methods : This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. Results : Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. Conclusion : The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.

A Case of End-Stage Renal Disease with Joubert Syndrome due to CEP290 Mutation (CEP290 돌연변이로 인해 발생한 Joubert 증후군 말기 신부전 1례)

  • Kim, Sung Hoon;Lee, Sang Taek;Seong, Moon-Woo;Kim, Man Jin;Lee, Jun Hwa
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.1
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    • pp.29-35
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    • 2020
  • Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.

Trial of Mycophenolate Mofetil Treatment on Necrotizing Meningoencephalitis in a Yorkshire Terrier Dog (요크셔 테리어 견에서 발생한 괴사성 수막뇌염을 Mycophenolate Mofetile로 치료 시도한 증례)

  • Jeon, Hyo-Won;Park, Chul;Jung, Dong-In;Kang, Byeong-Teck;Kim, Ha-Jung;Kim, Ju-Won;Lim, Chae-Young;Ko, Ki-Jin;Lee, So-Young;Cho, Sue-Kyung;Gu, Su-Hyun;Heo, Ra-Young;Park, Hyo-Jin
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.344-348
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    • 2006
  • A 5-year-old, male Yorkshire terrier dog was presented with progressive seizure and anorexia. Definitive diagnosis of necrotizing meningoencephalitis(NME) was made based on characteristic clinical features, brain lesion with MRI, and histopathologic examination. The dog was treated with prednisolone for 20 days, firstly. Prednisolone and mycophenolate mofetil(MMF) were then administered for 40 days following the initial therapy. However, the clinical signs were not improved and seizure frequency was increased. This patient survived around 2 months after diagnosis. This case report described the clinical findings, imaging characteristics and pathologic features of NME in a Yorkshire terrier with trial treatment using MMF.

EFFECT OF METHANOL EXTRACT OF CNIDII RHIZOMA ON THE FUNCTION OF RECEPTORS FOR GABA AND GLYCINE (천궁(Cnidii Rhizoma)의 메탄올 추출물이 GABA 및 Glycine 수용체에 미치는 영향)

  • Lee, Jong-Tae;Lee, Keung-Ho;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.55-66
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    • 2005
  • Cnidii Rhizoma (CR) was subjected to extraction with 70% methanol and tested to determine whether it has anxiolytic activity in mouse by employing staircase and rotarod tests. In addition, to understand the mechanism of anxiolytic action, CR, picrotoxin, yohimbine, isoniazid and strychnine were utilized to deliniate the potential involvement of GABA and glycine receptors in the action of Cnidii Rhizoma. To gain insights into the safety of Cnidii Rhizoma extract, behavioral and MTT tests were carried out. The results were obtained as follows: 1. CR extract had little effect on climbing numbers in the stair case test. 2. CR extract had considerable anti-anxiety effects as evidenced by the reduction of rearing numbers in the stair case test. 3. CR extract had little effect on muscle relaxation. 4. Anxiolytic actions of CR extract appeared to be mediated by glycine receptor activation. 5. Cytotoxicity in the neuronal cell was not observed and no strange behaviors were found. In short, these results indicate that CR extract has the ability to exert anxiolytic activity, possibly by activating glycine receptor with little side effects in mouse.

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DENTAL TREATMENT OF A PATIENT WITH LENNOX-GASTAUT SYNDROME UNDER GENERAL ANESTHESIA: CASE REPORT (Lennox-Gastaut syndrome 환아의 전신마취 하 치아우식 치료: 증례보고)

  • Suh, Heewon;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.1
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    • pp.22-25
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    • 2018
  • Lennox-Gastaut syndrome (LGS) is one of the most severe epileptic encephalopathies of childhood onset. It is characterized by multiple types of generalized seizures, slowness of intellectual growth, and specific electroencephalogram pattern. It is one of the most difficult epilepsy syndromes to treat and is frequently resistant to treatment. In this case report, we report a case of dental treatment under general anesthesia in a child with LGS. A 4-year-6-month old boy with LGS visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. If a LGS patient requires dental treatment, a treatment plan should be established to take into account the degree of seizure, the medication being used, and the cooperation of the patient. If the degree of seizure is severe and the patient's cooperation is poor, dental treatment under general anesthesia would be advantageous.

Impact of Asymmetric Middle Cerebral Artery Velocity on Functional Recovery in Patients with Transient Ischemic Attack or Acute Ischemic Stroke (일과성허혈발작 및 급성뇌경색환자에서 경두개도플러로 측정된 중간대뇌동맥 비대칭 지수가 환자 예후에 미치는 영향)

  • Han, Minho;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.2
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    • pp.126-135
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    • 2018
  • This study examined whether the difference in the middle cerebral artery (MCA) velocities can predict the prognosis of stroke and whether the prognostic impact differs among stroke subtypes. Transient ischemic attack (TIA) or acute ischemic stroke patients, who underwent a routine evaluation and transcranial Doppler (TCD), were included in this study. The MCA asymmetry index was calculated using the relative percentage difference in the mean flow velocity (MFV) between the left and right MCA: (|RMCA MFV-LMCA MFV|/mean MCA MFV)${\times}100$. The stroke subtypes were determined using the TOAST classification. Poor functional outcomes were defined as a mRS score ${\geq}3$ at 3 months after the onset of stroke. A total of 988 patients were included, of whom 157 (15.9%) had a poor functional outcome. Multivariable analysis showed that only the MCA asymmetry index was independently associated with a poor functional outcome. ROC curve analysis showed that adding the MCA asymmetry index to the prediction model improved the discrimination of a poor functional outcome from acute ischemic stroke (from 88.6% [95% CI, 85.2~91.9] to 89.2% [95% CI, 85.9~92.5]). The MCA asymmetry index has an independent prognostic value for predicting a poor short-term functional outcome after an acute cerebral infarction. Therefore, TCD may be useful for predicting a poor functional outcome in patients with acute ischemic stroke.

척담(滌痰).축어(逐瘀).고본치료효천적경험(固本治療哮喘的經驗) -척담(滌痰).축어(逐瘀).고본(固本)의 방법에 따른 천식에 관한 치험-

  • Hwang Geum-Seong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.39-45
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    • 2001
  • 본 논문은 척담(滌痰) 축어(逐瘀) 고본(固本)의 방법으로 천식을 완화시킨 치험에 관한 내용이다. 천식의 병인병기는 폐(肺) 비(脾) 신(腎) 삼장(三臟)의 본허(本虛)로 인한 알레르기성 체질이 내적인 근본요인으로 간주된다. 담어복폐(談瘀伏肺)는 천식의 병리적인 결과로서 증상유발의 요인이기도 하다. 즉 담어(痰瘀)는 천식의 병리적인 부산물이며, 동시에 천식을 일으키는 치병요인이 된다. 담어(痰瘀)가 내복(內伏)하여 철저히 제거되지 않으면 천식은 결코 완치될 수 없다. 이와 같은 한의학적인 관점은 현대의학에서 천식을 기도의 만성 염증에 의하여 유발된 증상으로 파악하고 있는 기전과 일맥상통하다. 또한 담(痰) 어(瘀) 허(虛)는 천식의 병리변화 과정에서 전반적으로 영향을 미치고 있다는 인식이 지배적이며, 이는 천식치료를 위한 처방구성에 이론적 근거를 제시하고 있다. 치료: 천식은 발작기와 완화기로 분류하여 치료하며, 발작기는 냉효(冷哮)와 열효(熱哮)로 구분된다. 냉효(冷哮)의 경우 치료원칙은 온폐산한(溫肺散寒), 척담평천(滌痰平喘), 화어행체(化瘀行滯)를 기본으로 한다. 처방은 구마황(灸麻黃) 행인(杏仁) 황금(黃芩) 세신(細辛) 계지(桂枝) 오미자(五味子) 당귀(當歸) 울김(鬱金) 목단피(牧丹皮) 지룡(地龍) 정력자(?歷子) 담남성(膽南星) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 열효(熱哮)의 경우 치료원칙은 청열사폐(淸熱瀉肺) 척담평천(滌痰平喘), 화어행체(化瘀行滯)를 근본으로 삼고, 처방으로는 구마황(灸麻黃) 행인(杏仁) 황금(黃芩) 목단피(牧丹皮) 적작약(赤芍藥) 당귀(當歸) 정력자(?歷子) 담남성(膽南星) 지룡(地龍) 어성초(魚腥草) 포공영(蒲公英) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 완화단계도 역시 두가지 유형으로 나누어지는데, 폐신음허형(肺腎陰虛型)은 익기양음(益氣養陰) 척담행어(滌痰行瘀)를 치료원칙으로 하고, 처방에는 남북사삼(南北沙蔘) 구자울(灸紫?) 및 관동화(款冬花) 당귀(當歸) 목단피(牧丹皮) 울김(鬱金) 정력자(?歷子) 세신(細辛) 오미자(五味子) 구기자(枸杞子) 산수황육(山茱黃肉) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 비신양허형(脾腎陽虛型)은 온보비신(溫補脾腎) 화어척담(化瘀滌痰)을 원칙으로 하며, 처방에는 구마황( 灸麻黃) 세신(細辛) 오미자(五味子) 당귀(當歸) 단삼(丹蔘) 울김(鬱金) 정력자(?歷子) 반하(半夏) 보골지(補骨脂) 선령비(仙靈脾) 태자삼(太子蔘) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 치험(治驗): (1) 천식의 실증(實證)은 치료를 한 뒤 완화단계에 접어들면서 허증(虛證)으로 전화되는데, 허천(虛喘)도 역시 천식이니 만큼 단순히 보법(補法)만 사용하여서는 안된다. 시종일관 천식치료에는 척담화어(滌痰化瘀)의 원칙을 지켜야 한다. 폐내(肺內)의 담어(痰瘀)가 철저하게 제거되어야 폐(肺)의 순환기능을 개선시켜 기도(氣道)의 염증을 신속히 흡수하고 치유할 수 있다. 이와 같은 치료과정은 약 3-6개월이 필요하다. 완화단계의 기간이 길어질수록 완치될 확률도 높아진다. (2) 급성기 천식은 폐(肺)를 다스려야 한다. 폐(肺)를 다스리는 방법에는 선폐(宣肺), 청폐(淸肺), 온폐(溫肺), 윤폐(潤肺) 및 척담거어(滌痰祛瘀) 등이 있다. (3) 증상이 완화되면 신(腎)을 다스린다. 천식은 신허(腎虛)가 근본적인 원인이므로 완화단계에서 심지어 발작기에도 보신제(補腎劑)를 추가하여 사용하면 배의 효과를 얻을 수 있다. (4) 비(脾)의 기능을 강화하여 근본을 채우는 부비배본(扶脾培本)도 중요하다. 후천의 수곡정미(水穀精微)로 선천을 충족시키고 자양하는 것은 질병에 대한 저항력을 키우고 재발을 경감시키거나 방지하는 효과를 기대할 수 있으므로 역시 천식치료의 중요한 방법 중 하나이다.

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Clincal Effect of Ketotifen in Allergic Rhinitis (알레르기성 비염에 대한 Ketotifen($Zaditen^{(R)}$)의 임상적 효과)

  • Eun, Sun-Jin;Kim, Yang-Dae;Park, Mun-Heum;Suh, Jang-Su;Song, Kei-Won
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.105-112
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    • 1990
  • Ketotifen, a benzocycloheptathiophene, has an orally effective antiallergic as well as antihistaminic properties. In pervious studies, Ketotifen has shown encouraging results in patient with allergic rhinitis, either perennial or seasonal. 39 patients with allergic rhinitis had been treated with Ketotifen 1 mg twice daily for 8 weeks. And we obtained following results. 1) The efficacy rate in sneezing attack was 73.5%, in nasal discharge 71%, in nasal obstruction 58%. 2) Some improvements in at least one of three major symptoms were noted within 1 week in 30.7%, within 2 weeks in 55.8%, within 3 weeks in 66.7%, within 8 weeks in 87.2%. 3) Physical findings such as colour, swelling of turbinate, character of rhinorrhea were not improved significantly. 4) Side effect was observed only in one patient with abdominal pain and diarrhea, which was subsided after interruption of administration. These results suggested that Ketotifen was effective in treatment of allergic rhinitis.

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