Kim, Sae-Yoon;Choi, Jung-Youn;Ha, Jeong-Ok;Park, Yong-Hoon
Childhood Kidney Diseases
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v.13
no.2
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pp.130-137
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2009
Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.
There has recently been increasing interest in the use of NMDA receptor antagonists as potential neuroprotective agents for the treatment of ischemic stroke. To evaluate the neuroprotective effect of the selective non-competitive NMDA receptor antagonist MK-801 in focal cerebral ischemia, local cerebral glucose utilization (ICGU) was examined in 15 neuroanatomically discrete regions of the conscious rat brain using the 2-deoxy-D[$^{14}C$] glucose quantitative autoradiographic technique 24 hr after left middle cerebral artery occlusion (MCAO). Animals received MK-801 (5 mg/kg i.v.) or saline vehicle before (20-30 min) or after (30 min) MCAO. Both pretreatment and posttreatment of MK-801 increased occluded/non-occluded ICGU ratio in 7 and 5 of the 15 regions measured, respectively (most notably in cortical structures). Following MK-801 pretreatment, there was evidence of widespread increases in ICGU not only in the non-occluded hemisphere (12 of the 15 areas studied) but also in the occluded hemisphere (13 of the 15 areas studied), while MK-801 postreatment did not significantly increase ICGU both in the normal and occluded hemispheres. These data indicate that MK-801 has a neuroprotective effect in focal cerebral ischemia and demonstrate that MK-801 provides widespread alterations of glucose utilization in conscious animals.
Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.
Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.
This study is a descriptive investigation for understanding factors influencing the length of stay in the postanesthesia care unit of elderly patients. Retrospective investigation was conducted on 300 patients aged 65 or older among those who had received an operation under general anesthesia and treated in postanesthesia care unit of hospital C located in Gyeonggi-do, from January 1 to December 31, 2014. The patients' average postanesthesia care unit stay was found to be 48.4 minutes and the 30-59 minute section accounted for the highest part with 58.0%. The postanesthesia care unit stay time according to intra-operative factors showed significant differences depending upon muscle relaxants, transfusion, ABGA, body temperature and total hours under anesthesia. Concerning the post anesthesia care unit stay length according to post-operative factors, significant differences were observed depending upon complications, PCA device, and circulatory drug use. In order to find out factors influencing the post anesthesia care unit stay length, the multiple regression analysis was conducted. As a result, the circulatory drug use and intra-operative lower body temperature were found to have an effect on the post anesthesia care unit stay length with the total explanatory power of 13%. Based on these findings above, it is deemed helpful to carefully monitor factors related to the post anesthesia care unit stay length and provide swift response accordingly for shorter post anesthesia care unit stay time of elderly general anesthesia patients.
Sequential bilateral lung transplantation may result in a variety of perioperative and postoperative complications, showing high perioperative morbidity and mortality rates. This research was performed to investigate the hemodynamic changes in adult mongrel dogs after bilateral reimplantation, two methods preferred for avoiding or minimizing graft rejection. The anterior portion of the pulmonary artery and the left atrium proximal to the superior and the inferior pulmonary veins were resected out and then re-anastomosed one hour later to prevent torsion or stenosis of the anastomotic site and the formation of a thrombosis in the left atrium. An everted suture technique was employed for the left atrium; An hour after the division, however, the main bronchus was tightly anastomose by interrupted sutures of No. 4-0 prolene in a telescope method. A modified I-C solution mixed with PGEI was infused into the cut portion of the pulmonary artery at the rate of 15 mllkglmin and at a pressure of 40 cmH20 for a total dosage of 70 mlfkg in order to preserve the transected lung. Topical cooling using wet gauzes soaked with cold I-C solution was performed for one hour to prevent ischemic lung injury. The above procedures are considered to be beneficial for achieving a satisfactory outcome for bilateral lung reimplantation.
Nine infants with transposition of great arteries have undergone arterial switch operation from May 1989 to May 1994 in the Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. Patients' age ranged from 3 days to 90 days, averaging 30$\pm$21 days. Diagnosis was made by two-dimensional echocardiography in all patients. Eight patients were diagnosed as transposition of great arteries with ventricular septal defect and one patient was a simple transposition of great arteries. Associated anomalies were patent ductus arteriosus (8), atrial septal defect (7) and coarctation of aorta(1). The anatomy of the coronary arteries were 7 (77 %) type A and 2 (23 %) type D according to the Yacoub classification. Pulmonary artery reconstruction was done according to Lecompte maneuver with tautologous pericardial patch in 8 patients. Overall operative mortality rate was 55% Left heart failure and pulmonary hypertensive crisis were the cause of death on postoperative 1~2 days in three patients, and two succumbed to death due to sepsis on postoperative 2~ 3 weeks. The mean follow-up period was mean 17 months. No patient had clinically significant postoperative aortic regurgitation and supravalvular pulmonary stenosis. The excessive use of inotropic support postoperatively was identified as a stastically significant risk factor following the arterial switch operation. But other variables such as low body weight, long cardiopulmonary bypass time, excessive hemodilution during cardiopulmonary bypass, hypothermia and volume loading were not significant risk factors.
This study was conducted to evaluate the association between periodontal disease and diabetes mellitus. The final analysis population of this study was composed of 4,830 adults with diabetes mellitus or periodontal disease and aged 19 years or older, based on the third-edition data of the 4th Korea National Health and Nutrition Examination Survey (KNHANES) (in 2009). Diabetic status and potential confounders were used in questionnaire materials and physical examination materials, and the presence of periodontal disease was used in the materials for oral health examination by a dentist. For diabetic status, fasting plasma glucose (FPG) levels <100 mg/dl were subcategorized into normal group and FPG levels ${\geq}100mg/dl$ into impaired fasting glucose group; glycosylated hemoglobin (HbA1c) levels <7% into normal group and HbA1c ${\geq}7%$ into diabetes group, on the basis of the American Diabetes Association. According to the 2009 Korea Health Statistics, the case where the pocket depth is 3 mm or more was defined as periodontal disease. The association between the two diseases was evaluated through $x^2$-test and logistic regression analysis using R-commander 2.14. In impaired fasting glucose group, community periodontal index (CPI) groups 3 to 4 had higher risks for periodontal disease 1.23 times (95% confidence interval, 1.07~1.42) than those of CPI groups CPI 0~2, even after adjustment for several confounders. In addition, periodontal disease and diabetes mellitus showed statistically significant differences depending on age, sex, income level, educational background, smoking status, alcohol consumption, and snack intake. The analyses of the third-edition data of the 4th KNHANES showed that there was a statistically significant association between periodontal disease and diabetes mellitus as examined by means of CPI in this study.
Kim, Su-Kyoung;Jang, Jin Woo;Jo, Yong Rok;Kim, Jun-Hwan;Kim, Su Kyoung
Korean Journal of Environmental Biology
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v.37
no.2
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pp.136-143
/
2019
This study investigates the effect of denitrified biofloc water on changes in the water quality parameters and the physiological characteristics of shrimps. Biofloc rearing water contains a large number of microorganisms and can rapidly stabilize the water quality and energy saving if reusable due to high water temperatures. Rearing water contain floating bacteria with both aerobic and anaerobic bacteria. Therefore, when the carbon source is added in limited air supply, the anaerobic state is activated and the denitrification process is possible. In this study, the denitrification water had the following properties: ammonia (6.9 mg L-1), nitrite (0.3 mg L-1), nitrate concentration (9.2 mg L-1), high pH (8.42) and alkalinity (590 mg L-1). The experimental group consisted of seawater (SW, control), a mixture of Seawater and denitrified biofloc water (DNW) in the ratio of 3:1, 1:1 and DNW only. All experiments were done in triplicate. As a result, the survival rate never changed even when 100% of the denitrification water was utilized. However, a body fluid analysis showed that creatine and BUN were increased due to index of stress and the tissue damage resulting from the high denitrified water content. Body fluid ions (Na+, K+, and Cl-) significantly decreased as the denitrified water content increased. It was recommended that the denitrification water be mixed with a certain ratio (less than 50%) in the future as it may affect the osmotic pressure control in shrimps.
Objectives : The purpose of this study is to compare the effects of laser acupuncture to the 532 nm on the five transport points with the heart meridian for treatment to hypertensive disease in rats with L-NAME induced hypertensive. Methods : Hypertensive was induced by L-NAME for 3 weeks. The laser acupuncture therapy on the five transport points of heart meridian(Laser Well Point-HT9, Laser Brook Point-HT8. Laser Stream Point-HT7, Laser River Point-HT4 and Laser Sea Point-HT3) was treated twice a week for 5 times. The hypertensive was measured using a cardiac hypertrophy, atherogenic index, TG/HDL-cholesterol ratio, TCHO, HDLC, TG, AST, ALT, antioxidative effectiveness and glutathione peroxidase quality of hypertensive rats induced by L-NAME. Results : Blood pressure were decreased significantly after the laser acupuncture of Well, Brook and Sea Point groups. Cardiac hypertrophy were decreased at the laser acupuncture of Brook and Stream Point groups. Athrogenic index was decreased at the laser acupuncture of Well, Stream, River and Sea Point groups. TG/HDL-cholesterol ratio was decreased at the laser acupuncture of all groups. Total cholesterol was decreased significantly at the laser acupuncture of Well Point group. High density lipoprotein cholesterol and total cholesterol were decreased significantly at the laser acupuncture of Well, Stream and River Point groups. Triglyceride was decreased significantly at the laser acupuncture of Stream Point group. Cu/Zn-Superoxide Dismutase (Cu/Zn-SOD) and glutathione peroxidase(GPX) were increased significantly at the laser acupuncture of Well Point group. Conclusions : The laser acupuncture treatment in five transport points of the Heart Meridian was effective for lowering blood pressure, cardiac hypertrophy, Atherogenic index and HTR, and for enhancing antioxidant activity.
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