• Title/Summary/Keyword: 위장관 질환

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A Case of Diffuse Infiltrative Lymphocytosis Syndrome Associated with Human Immunodeficiency Virus Infection (사람면역결핍바이러스 감염에 동반된 미만성 침윤성 림프구 증가 증후군 1예)

  • Kwon, Sun Ok;Park, Won Wo;Lee, Hyun Kyung;Lee, Sung Soon;Kang, Youn Kyung;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Choi, Soo Jeon;Yum, Ho Kee
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.289-293
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    • 2006
  • Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection.

The Effect of Acupuncture on the Intestinal Smooth Muscle Dysfunction Caused by Enteric Bacterial Infection in Weaning Piglet (돼지의 세균성 위장관 질환에 따른 평활근 기능 이상에 대한 침술의 효과)

  • Kim, Tae-wan;La, Jun-ho;Sung, Tae-sik;Kang, Jeong-woo;Nam, Tchi-chou;Choi, Min-cheol;Yoon, Yeo-sung;Yang, Il-suk
    • Korean Journal of Veterinary Research
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    • v.43 no.3
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    • pp.415-421
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    • 2003
  • It is now generally accepted that acupuncture is effective in diarrhea caused by bacterial infection. However, its effect on the intestinal smooth muscle dysfunction is not clear. Therefore, we investigated the effect of acupuncture therapy at Jiao-chao (GV-1) on the intestinal muscle dysfunction in weaning piglets orally infected by Escherichia coli. The animals are divided into four groups; 1) E. coli + no-treatment, 2) E. coli + antibiotic, 3) E. coli + acupuncture, 4) normal group. In the three E. coli infected groups, low frequency electrical field stimulation (EFS, 1 Hz) provoked triphasic responses composed of initial relaxation followed by on-contraction and off-contraction. While in the normal group, EFS (1Hz) induced biphasic responses composed of relaxation during the stimulation and off-contraction. At the high frequency (16Hz) EFS, both on-contraction and off-contraction of the E. coli + antibiotic, E. coli + acupuncture and the normal group were larger than those of the E. coli + no-treatment group. In the non-adrenergic non-cholinergic (NANC) condition, only biphasic responses occurred to EFS in all experimental groups and the off-contraction of E. coli + antibiotic, E. coli + acupuncture and the normal group were larger than those of the E. coli + no-treatment group. The response to carbachol of those three groups was also significantly greater than that of the E. coli + no-treatment group. These results suggest that acupuncture is as effective as antibiotic in the dysfunction of colonic circular muscle caused by E. coli infection. The maintenance of contractile neuromuscular transmission seems to be involved in the mechanism of the acupuncture effects on diarrhea.

Effects of Erythromycin and New Macrolides on the Serum Theophylline Level and Clearance (혈중 Theophylline 농도 및 청소율에 대한 Erythromycin과 New Macrolides 항생제의 영향)

  • Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.546-552
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    • 1998
  • Background: Up to 90% of a theophylline dose is biotransformed, by interaction with one or more the variants of the cytochrome P-450 drug metabolism system. Macrolides affect the elimination of theophylline by influencing on the microsomal enzyme systems. We evaluate the effect of erythromycin and new macrolides on the serum theophylline level and clearance. Method : Subjects consisted of moderate asthmatic patients with normal renal and hepatic functions. All subjects were non-smokers and treated with oral theophylline 400 mg per day. We randomly assigned 53 patients into four groups. Each group was treated with one macrolides, the first group erythromycin(n:19, 500 mg bid), second roxithromycin (n:14. 150 mg bid), third clarithromycin (n:10, 250 mg bid) and fourth azithromycin(n:10, 250 mg bid). We measured the serum theophylline level and clearance at three intervals, at pretreatment, after the first and fourth week after receiving the following macrolides, erythromycin, roxithromycin and clarithromycin. When azithromycin was administered, the serum theophylline level was measured at pretreatment and after one week of treatment They were measured by a computerized program of Bayesian method. Results : When compared with control, erythromycin and roxithromycin-treated groups had a significantly elevated serum theophylline level and decreased clearance. However, there were no significant changes of the serum theophylline level and clearance in clarithromycin and azithromycin-treated groups. Conclusion : These results suggest that theophylline dose may need to be readjusted and have periodic drug monitoring when erythromycin or roxithromycin is administered concurrently.

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Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease (허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰)

  • Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.225-233
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    • 1996
  • From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.

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Early & Midterm Results after Redo Coronary Artery Bypass Grafting (관상동맥우회술 후 재수술의 단기 및 증기 성적)

  • 김준성;김홍관;장우익;김기봉
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.146-153
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    • 2004
  • As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

Antioxidant and Anti-inflammatory Activities of Atractylodes japonica According to Extract Methods (백출 용매추출 방법에 따른 항산화 활성 및 항염증 효과)

  • Oh, Hee-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.6
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    • pp.1543-1552
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    • 2021
  • Atractylodes japonica has been widely used in a traditional Korean herbal medicine exerting various pharmacological activities such as diauretic action, asriction, anti-allergy, neuroprotective activity, anti-cancer, immunomodulation and gastrointestinal protective effect. This study was to investigate the antioxidant, nitric oxide and inflammatory cytokines production of A. japonica extract by water and 70% ethanol. DPPH and ABTS free radical scavenging activity were increased in a dose-dependent manners with both extracts and there was no difference with extract solvents. 70% ethanol extract of A. japonica showed a very strong inhibitory effect on NO production. Both extracts of A. japonica significantly reduce the expression of iNOS and COX-2 proteins involved in NO prodction. A. japonica extract by water and 70% ethanol inhibited LPS-induced proinflammatory cytokines such as IL-6 and IL-1b. In this study, 70% ethanol extract of A. japonica significantly suppresses LPS-induced NO and inflammatory cytokine production. Therefore it can be widely used to treat and improve inflammatory diseases.

Evaluation of cyclooxygenase (COX) inhibition in rosemary extract (로즈마리 추출물의 cyclooxygenase (COX) 효소 및 유전자 발현에 미치는 영향)

  • Sehee Lee;Soo-yeon Park;Kyeong Jin Kim;Sonwoo Kim;Yanghoon P. Jung;Ji Yeon Kim
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.114-121
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    • 2023
  • Selective cyclooxygenase (COX)-2 inhibition is a novel strategy to reduce the risk of gastrointestinal side effects caused by conventional nonsteroidal anti-inflammatory drugs. However, some selective COX-2 inhibitors have become apparent to increase the risk of severe cardiovascular disease. The aim of this study was to examine the anti-inflammatory effect of rosemary extract (RE) and confirm the safety of cardiovascular side effects. Inhibition of COX enzyme activity was assessed, and the levels of COX-2 and prostaglandin E2 (PGE2) and COX-1 and thromboxane B2 (TXB2) were evaluated in lipopolysaccharide (LPS)-induced RAW 264.7 cells. The 40% RE group showed increased COX-2 inhibition activity in a dose-dependent manner, whereas the 50% RE group only exhibited at 100 ㎍/mL. In a cell-based study, COX-2 mRNA expression was similar in both RE groups and PGE2 levels tended to decrease in the 40% RE group compared to the LPS group in the LPS pretreatment condition. In the LPS posttreatment condition, the COX-2 mRNA expression decreased in the 40% RE group, and PGE2 levels were increased in the 40 and 50% RE groups. In both conditions, there was no significant difference in COX-1 and TXB2 levels. In conclusion, 40 and 50% RE showed significant COX-2 inhibition, similar to the positive control group. It was confirmed that the inhibition of the COX-2 expression, but the effect did not affect the balance between prostacyclin and TXB2. These results indicate that rosemary showed COX-2 inhibition activity with a low risk of cardiovascular diseases.

A STUDY ON THE EFFECTS OF CENTRIC RELATION OCCLUSION-MAXIMUM INTERCUSPATION DISCREPANCIES TO DENTAL WEAR (중심위 교합-최대교두감합위 불일치가 치아 마모에 미치는 영향에 관한 연구)

  • Hong, Min-Ah;Kim, Kwang-Nam;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.5
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    • pp.683-700
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    • 1998
  • 치아경조직의 소실은 반드시 치아우식증이나 사고에 의해서만 일어나는 것이 아니라 마모에 의해서도 일어난다. 마모에 영향을 미치는 인자들은 시간/나이, 성별, 이갈이와 같은 과기능, 저작력, 위장관장애, 음식물, 환경적인 영향, 타액의 상태 그리고 교합적인 조건들이 있다. 한편 중심위와 최대교두감합위 불일치가 악구강계에 미치는 영향에 관해서는 아직도 논란이 분분하다. 본 연구의 목적은 중심위와 최대교두감합위의 불일치가 치아마모에 미치는 영향과 중심위에서 제일 먼저 닿는 치아와 나머지 치아의 마모에 있어서 차이에 대해서 알아 보는 것이다. 본 연구는 두개하악관절과 저작습관에 이상이 없으며, 식이습관에 문제가 없으며 치아우식증과 치주질환, 수복물, 교정 또는 교합치료의 경험이 없는 21세에서 25세 사이의 서울대학교 치과대학생을 대상으로 하였다. 교합기를 이용하여 중심위 교합-최대교두교두감합위 불일치를 조사하여, 중심위 교합-최대교두감합위가 불일치가 작은 군과 큰 군으로 나누었다. 각 군은 각각 10명의 피검자들로 구성되었다. 각 피검자의 인상채득 후 CR mounting을 시행하고 중심위교합-최대감합위 불일치를 측정한 다음 임상검사로 ordinal scale을 측정하고 모형을 통해 arbitrary scale을 측정하였다. 평균치아마모도 그리고 중심위에서 먼저 닿는 치아와 나머지 치아, 나머지 구치의 마모도를 각각 조사하여 통계처리하였다. 1. 평균치아마모도는 ordinal scale로 측정하였을 때 중심위 교합-최대교두감합위 불일치가 작은 군과 큰 군 사이에 통계적으로 유의할만한 차이가 없었다(p>0.05) 2. 평균치아마모도는 arbitrary scale로 측정하였을 때 중심위 교합-최대교두감합위 불일치가 작은 군과 큰 군 사이에 통계적으로 유의할만한 차이가 없었다(p>0.05). 3. CR에서 먼저 닿는 치아와 나머지 치아, 나머지 구치의 마모도는 ordinal scale로 측정하였을 때 통계적으로 유의한 차이가 없었다(p>0.05). 4. CR에서 먼저 닿는 치아와 나머지 치아, 나머지 구치의 마모도는 arbitrary scale로 측정하였을 때 먼저 닿는 치아에서 통계적으로 유의한 높은 수준의 마모도를 보였다(p<0.05).

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Effect of Mokhyangsungi-tang(MHS) on antioxidative ability in human intestinal epithelial cells (목향순기탕(木香順氣湯)이 인간의 장관상피세포내에서 항산화효과에 미치는 영향)

  • Kim, Ji-Woong;Kim, Woo-Hwan;Kim, Won-Ill
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.383-391
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    • 2001
  • 목적 : 본 연구는 목향순기탕(木香順氣湯)이 인간의 장관상피세포 계열인 Caco-2 세포에서 항산화작용을 증진시키는 효과가 있는지 검증하기 위한 실험이다. 방법 : 배양된 인간장관 세포계열인 Caco-2 세포에서 세포의 사망은 trypan blue의 소실정도에 의해 평가했으며 $H_2O_2$는 표본산화제로 사용되었다. 결과 : $H_2O_2$에서 노출된 세포들은 용량에 비례하여 세포 사망하는 결과를 보였다. 목향순기탕(木香順氣湯)은 $H_2O_2$에 의해 유발된 세포사망을 방지하였고, 0.05-1%의 농도범위에 걸쳐서 효과가 극대화되었다. 목향순기탕(木香順氣湯)과 강력한 항산화제인 DPPD는 $H_2O_2$에 의해 억제된 SOD의 활성에는 영향을 주지는 못했다. 그러나 $H_2O_2$에 의해 유발된 catalase, glutathione peroxidase, hydroperoxide 탈취효소의 활성이 감소되는 것을 억제하였다. 또한 $H_2O_2$에 의해 유발된 glutathione의 감소는 목향순기탕(木香順氣湯)과 DPPD에 의해 억제되었다. 목향순기탕(木香順氣湯)은 $H_2O_2$에 의해 유발된 ATP의 소실을 회복시켰지만 DPPD는 ATP 소실을 회복시키지 못하였다. 결론 : 이러한 결과로 볼 때 Caco-2세포에서 목향순기탕이 세포사망을 억제하는 것은 다른 기전을 통하여 항산화작용을 하는 것으로 볼 수 있다. 따라서 본 연구는 목향순기탕(木香順氣湯)이 반응성산소기에 의해 유발된 인체 위장관질환의 치료에 사용할 수 있을 가능성을 제시하고 있다.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.