• Title/Summary/Keyword: 비치료적 약물사용

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Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

A CLINICAL STUDY ON MANDIBULAR MOVEMENT AFTER ORTHOGNATHIC SURGERY (악교정 수술환자의 술전후 하악운동 양상변화에 관한 임상적 연구)

  • Baek, Sang-Heum;Jang, Hyun-Jung;Lee, Sang-Han;Kim, Hyun-Soo;Cha, Doo-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.239-249
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    • 2001
  • The purpose of this study is to evaluate the relationship of the factors which could be influenced by orthognathic surgery especillay SSRO. We measured the amounts of the maximum opening, lateral movements, maximum velocity and pattern of mandibular path during the opening and closing of mandible at the following times ; preoperative, 1 month after operation, 6 months after operation respectively using MKG. And the results were compared according to the categorized subgroups. Following results were obtained : 1. The change of the amounts of mandibular lateral movement and maximum opening velocity were statistically different between male and female (p<0.05), but the others were not. 2. According to the method of operation, there was no difference in the change of the mandibular movements between the group of SSRO and SSRO plus LeFort I osteotomy (p>0.05). 3. According to the amounts of mandibular movement, the recovery of left lateral movement of the group of $6{\sim}10mm$ was better than the other groups (p<0.05). 4. In the frontal pattern of the opening and closing of the mandible, the complex deflected type (F5), simple deflected type (F4), complex deviated type (F3), simple deviated type (F2), straight type (F1) were obtained in order at the time of preoperative, simple deflected type, simple deviated type, complex deviated type, straight type, complex deflected type in order at the time of 1 month after surgery, and the result at the time of 6 months after surgery was the same with that of the time of preoperative. In the sagittal pattern, non-coincident type (S2) was predominant at the time of preoperative, and coincident type (S1) was predominant at the time of 1 month after surgery. After 6 months, the result was also the same with that of the preoperative in sagittal pattern. 5. There was not a statistical difference in the change of the mandibular movement between group of presence of the preoperative TMJ symptoms and non-presence group (p>0.05). 6. There was not a statistical difference in the change of the mandibular movement between repositioning device applied group and non-applied group (p>0.05). 7. Sixty three percents of the patients who had preoperative TMJ symptoms were improved after surgery and preoperative TMJ symptoms were more improved after operation in the repositioning device non-applied group statistically (p<0.05).

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Effects of Mifepristone and Tamoxifen on Calcium Modulation in DU-145 Prostate Cancer Cells (DU-145 전립선 암세포에 있어서 mifepristone과 tamoxifen이 칼슘조절에 미치는 영향)

  • Kim, Yeo-Reum;Kim, Byeong-Gee
    • Journal of Life Science
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    • v.20 no.9
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    • pp.1324-1331
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    • 2010
  • Mifepristone (MIF) and Tamoxifen (TAM) have been used in the treatment of prostate cancer and breast cancer for more than a decade. MIF can induce apoptosis in both AR-positive and negative prostate cancer cells. Because of its pleiotropic ligand-receptor properties, TAM exerts cytotoxic activity in estrogen (ER)-positive and various ER.negative cancer cells. However, the molecular mechanisms of these two substances are not yet clear. In the present work, we report that the cytotoxic effects of MIF and TAM are due to the modulation of intracellular $Ca^{2+}$ level in DU-145, androgen-insensitive cells. When the cells were treated with micromolar concentrations of either MIF or TAM, the growth and viability were significantly decreased in a dose- and time-dependent manner. The apoptosis induced by MIF or TAM was further proved and analyzed by confocal laser scanning microscopy (CLSM) and fluorescence-activated cell sorting (FACS). In the cells cultivated in a normal 1.5 mM $Ca^{2+}$ medium, both MIF and TAM also induced an increase of the intracellular $Ca^{2+}$ level in a dose-dependent fashion. Since a change in calcium level could not be found in cells of the $Ca^{2+}$-free medium, the increase of intracellular $Ca^{2+}$ level might be due to an increase in extracellular calcium uptake. Our results show that the apoptotic effect was more prominent in TAM treatment compared to MIF treatment in DU-145 cells. The above findings might be due to the difference in the uppermost pathways of apoptosis induced by either MIF or TAM. When we checked the level of procaspase-8 activation, TAM showed minor level of activation, as opposed to MIF, which exerted strong activation. In both treatments, the levels of anti-apoptotic protein Bcl-2 decreased, and pro-apoptotic protein Bax level increased more than 2-fold. The activation of caspase-3, a key protease enzyme in the downstream pathway of apoptosis, was much higher in the cells treated with TAM, compared to the MIF treatment. The overall apoptotic activity shown in the present work was closely related to intracellular $Ca^{2+}$ concentration levels. Therefore, the cytotoxic activity induced by MIF and TAM might have been due to intracellular calcium modulation.

Thermographic Assessment on Temperature Change of Eye Surface in Cataract Surgery Observation (백내장수술 안에서 열화상카메라를 이용한 안구표면 온도의 변화)

  • Park, Chang Won;An, Young-Ju;Kim, Hyojin
    • The Korean Journal of Vision Science
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    • v.20 no.4
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    • pp.497-504
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    • 2018
  • Purpose : The purpose of this study was to investigate the temperature changes of the ocular surface before and after cataract surgery using thermography of a thermal imaging camera. Methods : The study included 75 patients (75 eyes) aged from 50 to 79 years who underwent cataract surgery. In the past, those who underwent corneal-related surgery, wearing contact lens, disorder of tear secretion and taking medication for systemic disease were excluded from this study. The temperature changes of the eyeball surface were measured using a thermal imager (Cox CX series, Answer, Korea) following Tear Break Up Time (TBUT) test, Mcmonnies questionnaire and Schirmer's Test in real time, Results : While the temperature of preoperative ocular surface was $35.20{\pm}0.54^{\circ}C$ and that of postoperative temperature was $35.30{\pm}0.53^{\circ}C$, the difference was not significant. The temperature changes in the ocular surface were statistically significant at $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) before the surgery and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) after the surgery. In comparison of the age groups, it was shown that the changes in the surface temperature before the surgery were from $-0.19{\pm}0.05{\Delta}$ ($^{\circ}C/sec$) to $-0.14{\pm}0.09{\Delta}$ ($^{\circ}C/sec$) in the 50s group, and from $-0.12{\pm}0.08{\Delta}$ ($^{\circ}C/sec$) to $-0.15{\pm}0.07{\Delta}$ ($^{\circ}C/sec$) in 60s group, and $-0.18{\pm}0.07{\Delta}$ ($^{\circ}C$) to $-0.12{\pm}0.08{\Delta}/sec$) in the 70s group, showing significant changes in the ocular surface temperature at all ages. Conclusion : Following the cataract surgery, all the indicators of dry eye syndrome were decreased, and eye surface temperature changes were significant. The thermography technique of the ocular surface would be expected to be useful for the evaluation of various dry eye syndromes because it is easy to evaluate dry eye syndrome noninvasively and can be quantified.