Background : A decreased level of serum arginine vasopressin(AVP) and an increased sensitivity to an exogenous AVP is expected in patients with septic shock who often require a high infusion rate of catecholamines. The goal of the study was to determine whether an exogenous AVP infusion to the patients with septic shock would achieve a significant decrement in infusion rate of catecholamine vasopressors while maintaining hemodynamic stability and adequate urine output. Method : Eight patients with septic shock who require a high infusion rate of norepinephrine had received a trial of 4-hour AVP infusion with simultaneous titration of norepinephrine. Hemodynamic parameters and urine output were monitored during the AVP infusion and the monitoring continued up to 4 hours after the AVP infusion had stopped. Results : Mean arterial pressure showed no significant changes during the study period(p=0.197). Norepinephrine infusion rate significantly decreased with concurrent AVP administration(p=0.001). However, beneficial effects had disappeared after the AVP infusion was stopped. In addition, hourly urine output showed no significant changes throughout the trials(p=0.093). Conclusion : Concurrent AVP infusion achieved the catecholamine vasopressor sparing effect in the septic shock patients, but there was no evidence of the improvement of renal function. Further study may be indicated to determine whether AVP infusion would provide an organ-protective effect to the septic shock patients.
Background : Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. Methods : We checked BMD, $FEV_1$(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. Results : Mean(${\pm}$) age was $69{\pm}9$ yrs, body mass index(BMI) $21{\pm}3kg/m^2$, $FEV_1$$50{\pm}18%$ of predicted, lumbar spine T-score $-3.0{\pm}1.2$, lumbar spine Z-score $-2.0{\pm}1.2$, and lumbar spine BMD $0.76{\pm}0.13g/cm^2$. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-score between -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationship between BMD and $FEV_1$(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to $FEV_1$(% of predicted) (group1 : ${\geq}65%$, group2 : 50-64%, group3 : ${\leq}49%$), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. Conclusion : BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.
Kim, Tae-Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
Tuberculosis and Respiratory Diseases
/
v.59
no.4
/
pp.361-367
/
2005
Background : Differential diagnosis of lymphocytic pleural effusion is difficult even with many laboratory findings. Nitric oxide(NO) level is higher in the sputum or exhaled breath of patients with active pulmonary tuberculosis than in those without tuberculosis. In addition, there are some reports about the increased level of NO metabolites in body fluids of cancer patients. However, there is no data on the NO levels in the pleural fluid of patients with tuberculous pleurisy. Method : The serum and pleural fluid NO in the patients with acute lymphocytic pleural effusion were analyzed. Results : Of total 27 patients, there were 14 males and average age of patients was 48 years. The final diagnosis was tuberculous pleurisy in 17 cases and malignant pleural effusion in 10. The pleural fluid NO level was $540.1{\pm}116.4{\mu}mol$ in the tuberculous pleurisy patients and $383.7{\pm}71.0{\mu}mol$ in the malignant pleural effusion patients. The serum NO level was $624.7{\pm}142.0{\mu}mol$ in tuberculous pleurisy patients and $394.4{\pm}90.4{\mu}mol$ in malignant pleural effusion patients. There was no significant difference in the serum and pleural fluid NO level between the two groups. The NO level in the pleural fluid showed a significant correlations with the pleural fluid neutrophil count, the pleural fluid/serum protein ratio, and pleural fluid/serum albumin ratio (p<0.05 in each). The protein concentration, leukocyte and lymphocyte count in the pleural fluid were significantly higher in the tuberculous pleurisy patients than the malignant pleural effusion patients (p<0.05 in each). Conclusion : NO is not a suitable marker for a differential diagnosis of lymphocytic pleural effusion. However, the NO level in the pleural fluid might be associated with the neutrophil recruitment and protein leakage in the pleural space.
Background : For biological dosimetry of radiation exposure, both observing hematologic change and calculating Ydr by chromosomal analysis as biological indicators are widely used. However, due to the lack of studies on biological dosimetry of radiation dose absorbed in the body such as in the cases of radioactive iodine therapy, the maximal and safe dose is not well known, nor is the extent to which the body can safely endure radiation exposure. Purpose : To investegate the practical applicability of hematologic changes and Ydr as an indicator for estimating radiation exposure, to patients with thyroid diseases after doses of radioactive iodine. Material and Methods : 5 patients with hyperthyroidism and 35 patients who have had thyroid cancer operation were under treatment with radioactive iodine, changes in number of lymphocytes were tracked and Ydr was calculated for more than 2 months by chromosomal analysis in peripheral lymphocytes. Results ; 1) The number of lymphocytes began to decrease 2 weeks after doses of radioactive iodine, and reached the nadir after 6 and 8 weeks, then gradually recovered. 2) The nadir count of lymphocytes was reversely correlated with the administered dosage of radioactive iodine. 3) Ydr was generally stable between 2 and 8 weeks. 4) The maximal value of Ydr was correlated with the administered dosage of radioactive iodine. 5) Ydr value at the 2nd week increased with augmented dosage of radioactive iodine. 6) Ydr value at the 2nd week was correlated with fall of lymphocyte count. Conclusion : Patients must be closely observed, because temporary bone marrow suppression and slight chromosomal aberration can be produced by even generally used dosages of radioactive iodine for diagnosis and therapy. Maximal percent fall of lymphocyte count, Ydr at the 2 week interval and maximal Ydr can be used as the biological predictor of administered dosage of radioactive iodine.
This study was performed to compare the effects of hydrocolloid(Duoderm$\circledR$, HC in this study) and hydrogel (Nu-Gel$\circledR$, HG in this study) occlusive dressing materials on degree of exudate, wound contraction, epithelialization, and healing of full-thickness skin wound in dogs. Three wounds measuring 2${\times}$2 cm in size were created bilaterally(6 wounds/dog) on the dorsolateral aspect of the trunk of 12 dogs. In each dog, the wounds were treated with HC, HG, and normal saline, respectively. For a 4 week period, the wounds were evaluated gross aspects and histopathological aspects. There were no statistically significant differences between treatment groups in percentage of wound contraction, percentage of epithelialization, and percentage of wound total healing during the first week. Significant differences were first detected on day 14. On day l4(P < 0.01) and 21 (P < 0.05), mean percentage of epithelialization of HG-treated wound was significantly greater than those in HC- and normal saline-treated wound. Mean percentage of wound contraction of HG-treated wound was significantly greater than that in HC- and control wounds on day 21(P< 0.05). On day 21, mean percentage of wound healing of HG-treated wound was significantly greater than that in HC- and control wounds(P < 0.02). On day 1, 4, and 7 after wound creation, although severe infiltration of PMN (polymorphonuclear leukocyte) cells in HC- and control wounds were observed in the subcutis and moderate infiltration of PMN cells in HG-treated wound were observed in the subcutis, we did not detect significant differences. On day 14 after wounding creation, in the wounds treated with HG dressing, epithelial cells were found over the surface, and edema further decreased in the tissue under the wounds, and the granulation tissue was replaced with collagen fibers. On day 21 after wound creation, in HG-treated wound compared with other experimental material-treated wounds, regenerated epidermis covered most of the wound surface, and the granulation tissue was more replaced with collagen fibers than that on day 14. Overall results indicated that the use of hydrogel dressing materials(Nu-Gel$\circledR$) as hydrocolloid dressing (Duoderm$\circledR$) materials and normal saline treatment on full-thickness skin wounds in dogs increased the rate of healing at repair stage.
The purpose of this study was to evaluate the factors related to xerostomia in patients with systemic diseases, and the results were analyzed through t-test, ANOVA, and multiple linear regression analysis. There were 62 respondents (56.9%) who reported dry mouth and the season of the most severe dry mouth was reported to be the highest during winter. According to the analysis made in the relationship of xerostomia with the awareness of general health and health behavior, the group that understood their own health poorly, had more than two kinds of diseases, and had been administered more than two kinds of daily medication showed higher xerostomia. Also, those who experienced desperation, had high dryness in other parts of the body, and heavy snoring were more aware of xerostomia (p<0.05). According to the analysis made in the relationship between xerostomia and awareness of oral health state, the group that understood their oral health poorly and had pain in the oral mucous membrane and halitosis was more aware of xerostomia (p<0.05). According to the analysis made in the relationship between quality of life and xerostomia, the group that showed high level of problem in daily living and stress and were self-conscious and felt tense due to halitosis reported more xerostomia (p<0.05). Finally, xerostomia was most correlated with consciousness of the eyes of others due to halitosis followed by the number of transferred systemic diseases and stress level. Based on such results, xerostomia was understood to be an obstacle in maintaining favorable social life and health. Since xerostomia was shown to be related to the number of transferred systemic diseases, the dental professions are asked to further improve their understanding not only on oral health but also systemic diseases. Therefore, these efforts are expected to prevent xerostomia and reduce various complications caused by xerostomia.
The aim of this study was to analyze the dental caries of chilren's deciduous teeth in relation to their mothers' socioeconomic factors and their oral health beliefs to increase the effect on children's oral health. One hundred seventy four children and their mothers were selected for the study. The children were 5 and 6 years old in children house in Kun-san, Korea. Research was conducted by oral examination, their mothers' socioeconomic factors and dental health belief model. The finding of analysis can be summaried as follows; In regard to the caries in deciduous teeth status, the five-year-old boy children's dft index was 3.39 and that of the girls of the same age was 2.76. The dft index of the boys of six was 3.86 and that of the girls of the same age was 3.27. The five-year-old boy children had the highest df rate(81.8%), and their dt rate was more than their ft rate. But for the six-year-old girl children, ft rate was higher than dt rate. For the five years old, the boy children's ft rate was significantly higher than that of the girls(p<0.05). Concerning the caries in deciduous teeth states by socioeconomic factors, their oral health status was significantly different according to mother employment and householder age. The df rate of the preschoolers with working mothers(84.7%) was significantly higher than that of those with nonworking mothers(66.7%)(p<0.05). The dft index of the group whose households were over forty was highest with 4.07, followed by the children of the households aged 35 to 39 with 3.83, those of the households aged 25 to 29 with 3.33, and those of the households aged 30 to 34 with 2.15. The difference between the groups was significant(p<0.05). As to the difference of maternal dental health beliefs by maternal socioeconomic factors, households educational background and whether to live with parents or parents-in-law under the same roof made a significant difference to maternal oral health beliefs. The mothers whose households were college graduates or better-educated were stronger in oral health susceptibility and seriousness(p<0.01, p<0.05). The salience was recognized more by those who lived with parents or parents-in-law than by the others who didn't(p<0.05). The dft index of the preschoolers was related to maternal dental health beliefs. That was lower when their mothers perceived dental health benefit better.
Kim, Mi-Na;Lim, Do-Seon;Kim, Myoung-Hee;Kim, A-Reum;Kim, Sung-Im;Ahn, Yong-Soon
Journal of dental hygiene science
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v.15
no.2
/
pp.129-137
/
2015
This study is conducted with the aim of providing basic data for oral health improvement of pregnant woman and development of oral health education program by analyzing factors influencing the oral health related behavior of pregnant woman applying health belief model which is theoretical model of explaining individual's behavior change. For 217 expectant mothers who visited 8 obstetrics and 1 maternity class located in Seoul, Gyeonggi and Incheon from August 1 to 31, 2014, data analysis was implemented using self-administered questionnaire. Before the completion of self-administered questionnaire, the subjects were fully informed of explanatory note and consented on taking part in the research for the consideration of ethical aspect. Collected materials were treated by PASW Statistics ver. 18.0 program and following results were acquired. Health belief factor which infuences oral health related behavior of pregnant woman resulted that perceived severity influences on oral examination during pregnancy and dental treatment during pregnancy, and perceived benefits influences on oral examination during pregnancy, and perceived barriers on toothbrushing after having a snack, toothbrush with rotation method and oral examination during pregnancy, and self-efficacy influences on use of oral hygiene products after toothbrushing and oral examination during pregnancy. With these research results, I suggest that perceived severity of health belief factor, perceived benefits, perceived barrier and self-efficacy influence oral health related behavior of pregnant woman. And specific oral health education program for pregnant woman is necessary to increase perceived severity of pregnant woman, perceived benefits and self-efficacy and to reduce perceived barriers.
Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.
The balance between bone-resorbing osteoclasts and bone-forming osteoblasts is key to bone health. An imbalance between osteoclasts and osteoblasts leads to various bone-related disorders, such as osteoporosis, osteomalacia, and osteopetrosis. However, the bone-resorption inhibitor drugs that are currently used may cause side effects. Natural substances have recently received much attention as therapeutic drugs for the treatment of bone health. This study was designed to determine the effect of Tenebrio molitor larvae ethanol extract (TME) on receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differentiation. To measure the effect of TME on osteoclast differentiation, RAW264.7 cells were treated with RANKL with or without TME for 5 days. The tartrate-resistant acid phosphatase (TRAP) activity was significantly inhibited by treatment of TME without cytotoxicity up to 2 mg/ml. In addition, TME effectively suppressed expression of osteoclast differentiation-related marker genes and proteins such as TRAP, NFATc1, and c-Src. TME also significantly inhibited the p38 mitogen-activated protein kinase (MAPK) signaling pathway without affecting ERK and JNK signaling in RANKL-induced RAW264.7 cells. Consequently, we conclude that TME suppresses osteoclast differentiation by inhibiting RANKL-induced osteoclastogenic genes expression through the p38 MAPK signaling pathways. These results suggest that TME and its bioactive components are potential therapeutics for bone-related diseases such as osteoporosis.
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