• Title/Summary/Keyword: 치료적 관계

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The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis (복막 투석중인 만성 신부전 환자의 혈압 조절에 관한 연구)

  • Jung, Hang-Jae;Bae, Sung-Hwa;Park, Jun-Bum;Jo, Kyoo-Hyang;Kim, Young-Jin;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.333-341
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    • 1999
  • Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

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Urinary Tract Infection and Vesicoureteral Reflux in Children (소아에서의 요로감염과 방광요관역류에 관한 고찰)

  • Lim Hyun-Suk;Park Chang-Ro;Ko Cheol-Woo;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.46-52
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    • 1997
  • Urinary tract infection (UTI) in children has been known to be a cause of renal damage, leading to scar formation, hypertension and renal failure. And vesico-ureteral reflex (VUR), frequently accompanying UTI in young children, has been incriminated as the main factor causing scar formation. This retrospective study has been undertaken to see the relationship among UTI, VUR and renal scar formation. Study population consisted of 291 children (boy 134, girl 42) with UTI, who have been admitted to the Pediatric Department of Kyungpook University Hospital during 6 1/2 year period from January 1990 to June 1996. VUR was diagnosed by VCUG and renal scar by ultrasonogram, DMSA scan (or DMSA SPECT) and IVP. The following result were obtained. Sexual difference showed male predominance (male to female, 134:42) below 1 year of age, and female predominance (male to female, 11:35) over 5 years of age were rioted. VUR has been found in 64 children (22%) and the degree of reflux, classfied by the method proposed by 'International Reflux Study in Children', were as follows ; Grade I : 4.0%, Grade II : 3.0%, Grade III : 2.7%, Grade IV : 5.8% and Grade V : 6.2%. There was no sexual difference E.coli was the most predominant infecting agent occurring in 167 children (57%), and end-stage renal failure was diagnosed at the time of first admission in 5 children with Grade V VUR. Renal scar has been noted in 49 out of 582 kidneys (8.4%), and the incidence of scar foramation according to the degree of VUR were as follow ; Grade 0 (No reflux) : 1.2%, Grade I : 6.7%, Grade II 27.3%, Grade III 29.4%, Grade IV : 57.1%, and Grade V : 100%. In summary, present study shows that renal scar formation in UTI has close correlation with the severity of VUR occurring more frequently in severe reflux, so that early diagnosis and proper treatment of UTI and VUR is of paramount importance in preventing renal damage in children with UTI.

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Film Dosimetry for Intensity Modulated Radiation Therapy : Dosimetric Evaluation (필름을 사용한 세기변조치료법에 대한 선량측정)

  • Ju Sang Gyu;Yeo Inhwan Jason;Huh Seung Jae;Choi Byung Ki;Park Young Hwan;Ahn Yong Chan;Kim Dae Yong;Kong Young Kun
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.172-178
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    • 2002
  • Purpose : X-ray film over responds to low-energy photons in relative photon beam dosimetry because its sensor is based on silver bromide crystals, which are high-Z molecules. This over-response becomes a significant problem in clinical photon beam dosimetry particularly in regions outside the penumbra. In intensity modulated radiation therapy (IMRT), the radiation field is characterized by multiple small fields and their outside-penumbra regions. Therefore, in order to use film dosimetry for IMRT, the nature the source of the over-response in its radiation field need to be known. This study is aimed to verify and possibly improve film dosimetry for IMRT. Materials and Method : Modulated beams were constructed by a combination of five or seven different static radiation fields using 6 MeV X-rays. In order to verify film dosimetry, we used X-ray film and an ion chamber were used to measure the dose profiles at various depths in a phantom. In addition, in order to reduce the over-response, 0.01 inch thick lead filters were placed on both sides of the film. Results : The measured dose profiles showed a film over-response at the outside-penumbra and low dose regions. The error increased with depths and approached 15% at a maximum for the field size of $15{\times}15cm^2$ at 10 cm depth. The use of filters reduced the error to 3%, but caused an under-response of the dose in a perpendicular set-up. Conclusion : This study demonstrated that film dosimetry for IMRT involves sources of error due to its over-response to low-energy Photons. The use of filers can enhance the accuracy in film dosimetry for IMRT. In this regard, the use of optimal filter conditions is recommended.

Prevalence of Feline Leukemia Virus Infection in Cats in Bangladesh (방글라데시의 고양이 백혈병 바이러스의 감염율 조사)

  • Rahman, Siddiqur;Bhuiyan, Salauddin;Islam, Taohidul;Nahar, Azimun;Sarker, Roma Rani;Alam, Emtiaj;Chakrabarty, Amitavo;Sarker, Abu Sayed;Akhter, Laila;Chae, Joon-Seok
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.1-5
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    • 2014
  • Feline leukemia virus (FeLV) is a retrovirus that represents one of the most common and important infectious diseases of cats worldwide and it is responsible for more deaths among cats than any other infectious diseases. Prevalence data are necessary to define prophylactic, management and therapeutic measures for stray, feral and owned cats which are lacking in Bangladesh. The study was carried out to determine the prevalence of FeLV infection in Mymensingh district of Bangladesh using RapiGEN$^{(R)}$ FeLV Ag Test Kit (RapiGEN$^{(R)}$ Inc., Republic of Korea), a rapid one-step immunochromatographic assay. Blood samples from total 130 cats (23 owned cats and 107 unowned cats) were collected and tested following the manufacturer's instruction. An overall prevalence of FeLV infection was 1.54% (2/130). Prevalence was found 1.79% (2/112) on Day 0-up to one year aged cats (young) but no positive case was found in above 1 year (Adult) aged group. In male and female cats, the prevalence was 1.72% (1/58) and 1.39% (1/72), respectively. In un-owned cats the prevalence was 1.87%. Positive cases to FeLV were found only in clinically sick cats. No significant relationship was found according to age, sex, ownership status and health status. To the best of our knowledge this is the first report of the prevalence of FeLV infection in Bangladesh using RapiGEN$^{(R)}$ FeLV test kits which is very much effective because it is easy to apply, less expensive and quick screening of such type of infection.

Cryosurgery of Lung with 2.4 mm Cryoprobe: An Experimental in vivo Study of the Cryosurgery in Canine Model (냉동침을 이용한 폐 냉동수술의 동물실험: 냉동수술 방법의 비교 실험)

  • Kim Kwang-Taik;Chung Bong-Kyu;Lee Sung-Ho;Cho Jong-Ho;Son Ho-Sung;Fang Young-Ho;Sun Kyung;Park Sung-Min
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.520-526
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    • 2006
  • Background: The clinical application of cryosurgery the management of lung cancer is limited because the response of lung at low temperature is not well understood. The purpose of this study is to investigate the response of the pulmonary tissue at extreme low temperature. Material and Method: After general anesthesia the lungs of twelve Mongrel dogs were exposed through the fifth intercostal space. Cryosurgical probe (Galil Medical, Israel) with diameter 2.4 mm were placed into the lung 20 mm deep and four thermosensors (T1-4) were inserted at 5 mm intervals from the cryoprobe. The animals were divided into group A (n=8) and group B (n=4). In group A the temperature of the cryoprobe was decreased to $-120^{\circ}C$ and maintained for 20 minutes. After 5 minutes of thawing this freezing cycle was repeated. In group B same freezing temperature was maintained for 40 minutes continuously without thawing. The lungs were removed for microscopic examination on f day after the cryosurgery. In four dogs of the group A the lung was removed 7 days after the cryosurgery to examine the delayed changes of the cryoinjured tissue, Result: In group A the temperatures of T1 and T2 were decreased to the $4.1{\pm}11^{\circ}C\;and\;31{\pm}5^{\circ}C$ respectively in first freezing cycle. During the second freezing period the temperatures of the thermosensors were decreased lower than the temperature during the first freezing time: $T1\;-56.4{\pm}9.7^{\circ}C,\;T2\;-18.4{\pm}14.2^{\circ}C,\;T3\;18.5{\pm}9.4^{\circ}C\;and\;T4\;35.9{\pm}2.9^{\circ}C$. Comparing the temperature-distance graph of the first cycle to that of the second cycle revealed the changes of temperature-distance relationship from curve to linear. In group B the temperatures of thermosensors were decreased and maintained throughout the 40 minutes of freezing. On light microscopy, hemorrhagic infarctions of diameter $18.6{\pm}6.4mm$ were found in group A. The infarction size was $14{\pm}3mm$ in group B. No viable cell was found within the infarction area. Conclusion: The conductivity of the lung is changed during the thawing period resulting further decrease in temperature of the lung tissue during the second freezing cycle and expanding the area of cell destruction.

Studies of vindoline metabolism in Catharanthus roseus cell cultures using deuterium-labeled tabersonine (Catharanthus roseus 세포 배양액에 deuterium이 치환된 tabersonine을 사용한 vindoline 생합성 경로 연구)

  • Lee, Soo;Lee, Hyang-Yeol
    • Journal of the Korean Applied Science and Technology
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    • v.29 no.1
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    • pp.71-80
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    • 2012
  • Vinca alkaloids produced from Catharanthus roseus are one of the most important natural product drugs in treatments of human cancers. These anticancer drugs are derived from coupling of the two monomeric indole alkaloids, catharanthine and vindoline. In order to investigate vindoline biosynthesis, tabersonine-$CD_3$ 1a is synthesized to use as a deuterium labeled precursor, which is distinguished clearly from the natural counterpart. We show that these deuterium labeled tabersonine 1a are successfully incorporated into the vindoline biosynthetic pathway to yield three deuterated vindoline intermediates. 16-Hydroxytabersonine-$CD_3$ (m/z 356) 2a, 16-Methoxytabersonine-$CD_3$ (m/z 370) 3a, 16-Methoxy-2,3-dihydro-3-hydroxytabersonine-$CD_3$ (m/z 388) 4a are produced from the cell suspension culture measured by UPLC/MS at 5 and 13 days after feeding tabersonine. The conversion rates from 1a to 2a and 2a to 3a are fast, whereas that from 3a to 4a is much slower. This indicates that the rate determining step among the first three vindoline biosynthesis is the last step. As a result of the slow conversion rate from 3a to 4a, the accumulation level of 16-Methoxytabersonine-$CD_3$ 3a is significantly increased up to 13 days. The accumulation ratio among 2a, 3a and 4a is 1, 2 and 0.1 at 5 days. However, the peaks of desacetoxyvindoline-$CD_3$ 5a, deacetylvindoline-$CD_3$ 6a and vindoline-$CD_3$ 7a are not found from the cell extracts even after 13 days of incubation which may indicate no presence of their corresponding enzymes.

Expression of nitric oxide synthase isoforms and N-methyl-D-aspartate receptor subunits according to transforming growth factor-β1 administration after hypoxic-ischemic brain injury in neonatal rats (신생 백서의 저산소 허혈 뇌손상에서 Transforming Growth Factor-β1 투여에 따른 Nitric Oxide Synthase 이성체와 N-methyl-D-aspartate 수용체 아단위의 발현)

  • Go, Hye Young;Seo, Eok Su;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.594-602
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    • 2009
  • Purpose : Transforming growth factor (TGF)-${\beta}1$ reportedly increases neuronal survival by inhibiting the induction of inducible nitric oxide synthase (NOS) in astrocytes and protecting neurons after excitotoxic injury. However, the neuroprotective mechanism of $TGF-{\beta}1$ on hypoxic-ischemic (HI) brain injury in neonatal rats is not clear. The aim of this study was to determine whether $TGF-{\beta}1$ has neuroprotective effects via a NO-mediated mechanism and N-methyl-D-aspartate (NMDA) receptor modulation on perinatal HI brain injury. Methods : Cortical cells were cultured using 19-day-pregnant Sprague-Dawley (SD) rats treated with $TGF-{\beta}1$ (1, 5, or 10 ng/mL) and incubated in a 1% O2 incubator for hypoxia. Seven-day-old SD rat pups were subjected to left carotid occlusion followed by 2 h of hypoxic exposure (7.5% $O_2$). $TGF-{\beta}1$ (0.5 ng/kg) was administered intracerebrally to the rats 30 min before HI brain injury. The expressions of NOS and NMDA receptors were measured. Results : In the in vitro model, the expressions of endothelial NOS (eNOS) and neuronal NOS (nNOS) increased in the hypoxic group and decreased in the 1 ng/mL $TGF-{\beta}1-treated$ group. In the in vivo model, the expression of inducible NOS (iNOS) decreased in the hypoxia group and increased in the $TGF-{\beta}1$-treated group. The expressions of eNOS and nNOS were reversed compared with the expression of iNOS. The expressions of all NMDA receptor subunits decreased in hypoxia group and increased in the $TGF-{\beta}1$-treated group except NR2C. Conclusion : The administration of $TGF-{\beta}1$ could significantly protect against perinatal HI brain injury via some parts of the NO-mediated or excitotoxic mechanism.

Bond strength of fiber reinforced composite after repair (섬유 강화 컴포지트의 수리 후 접합 강도)

  • Kim, Min-Jung;Kim, Kyung-Ho;Choy, Kwang-Chul
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.188-197
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    • 2006
  • Fiber reinforced composite (FRC) is usually used as a connector joining a few teeth into one unit in orthodontics. However, fracture often occurs during the two to three years of the orthodontic treatment period due to repeated occlusal loading or water sorption in the oral environment. We simulated the repair by overlapping and attaching portions of two FRC strips in the middle and performed a three-point bending test to investigate the changes of the repair strength among the different FRC groups. The specimens were grouped according to the overlapping lengths of the two FRC strips, which were 1, 2, 3 and 4 mm (group E1, E2, E3 and E4, respectively) and the control group consisted of unrepaired, intact FRC strips. Each group consisted of 6 specimens and were cured with a light emitting diode curing unit. Group E4 showed the highest maximum loads of 2.67 N, then the control group (2.39 N), group E3 (2.35 N), E2 (2.10 N), and E1 (1.75 N) in decreasing order. Group E4 also showed the highest stiffness, which was 2.32 N/mm, however, the stiffness of group E3 (2.06N/mm) was higher than that of the control group (1.88 N/mm). According to the visual examination, the specimens tended to be bent rather than being fractured into two pieces with an increased length of overlapping portions. The above results suggest that a minimum overlapping length of 3 mm was necessary to obtain an adequate repair of a 10 mm length of FRC connector. In addition, the critical section adjacent to the joint area, where the thickness decreased abruptly, should be reinforced with flowable resin to minimize the bending tendency.

The immunogenicity and safety of three-component DTaP vaccine in Korean infants (우리나라 영아에서 3가 정제 백일해 항원 DTaP 백신의 면역원성 및 안전성)

  • Kang, Jin Han;Kim, Jong Hyun;Lee, Jung Hyun;Lee, Soo Young;Hong, Young Jin;Kim, Chang Hwi
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.355-362
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    • 2007
  • Purpose : We conducted the study to evaluate the immunogenicity and safety of three component DTaP vaccine ($Infanrix^{(R)}$) in a group of Korean healthy infants on a three-dose primary vaccination. And we compared the immunogenicity of this DTaP vaccine with two component DTaP vaccine which has been widely used in Korea. Methods : We enrolled one hundred fifty one healthy infants aged 8-9 weeks. These infants were vaccinated at age 2, 4 and 6 months of age with three component DTaP vaccine. Solicited adverse events were actively monitored for 72 hours following each vaccination, and all adverse events after each vaccination were observed for three weeks. Anti-diphtheria toxoid Ab., anti-tetanus toxoid Ab., anti-pertussis toxin Ab., anti-filamentous hemagglutinin Ab., and anti-pertactin Ab. were measured using ELISA for assessing immunogenicity of study vaccine in 60 infants. Immunogenicity analysis of two component DTaP vaccine was performed with same methods in 14 infants as control. Results : The seroconversion rates of anti-diphtheria toxoid Ab, anti-tetanus toxoid Ab. anti-filamentous hemagglutinin Ab. were 100% in both group. Seroconversion rate of anti-pertactin Ab in study group was 100%, but the rate in control group was 50%. However, geometric mean concentration of anti-pertussis toxin Ab. was higher in control group. Mild local and systemic reactions were observed within three days after vaccination, and no serious adverse events related study vaccine were happened during study period. Conclusion : Our study results suggest that three component DTaP vaccine ($Infanrix^{(R)}$) is a well-tolerable and high immunogenic vaccine, especially anti-Pertactin Ab. of the study vaccine is very immunogenic. It can be available as routine DTaP vaccination in our infants.

The Prevalence of Obesity and Metabolic Abnormalities in Korean Pediatric Population (한국 소아 청소년에서 비만 및 대사 이상의 유병률)

  • Nho, Han-Nae;Kim, Cu-Rie;Uhm, Ji-Hyun;Kim, Jeong-Tae;Jin, Sun-Mi;Seo, Ji-Young;Hahn, Hye-Won;Park, Hwa-Young;Yoon, Hye-Sun;Ahn, Young-Min;Shon, Keun-Chan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.207-214
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    • 2009
  • Purpose: Childhood obesity can be complicated by hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and diabetes mellitus. The aim of this study was to evaluate the prevalence of obesity and metabolic complications of children and adolescents based on the degree of obesity. Methods: We analyzed the records of 8,880 students who received student health examinations between May 2006 and October 2008 at the Eulji General Hospital. The prevalence of obesity was evaluated by the body mass index and obesity index. A total of 1,076 obese students had blood tests. We analyzed aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting glucose, total cholesterol, and blood pressure according to the degree of obesity. Results: According to the body mass index, the overall prevalence of obesity was 7.2% (7.8% of male and 6.5% of female students). Based on the obesity index, 12.3% of students (mild: 6.3%, moderate: 5.0%, and severe: 1.0%) were obese. The prevalence of hypercholesterolemia, ALT elevation, and hypertension were increased as a function of the degree of obesity (p<0.05), but hyperglycemia showed no significant differences (p=0.298). The overall prevalence of ALT elevation was 17.7% (mild obese group, 10.4%; moderate obese group, 20.5%; and severe obese group, 46.8%). The prevalence of hypercholesterolemia, hypertension, and hyperglycemia were significantly higher in the elevated ALT group (24.7%, 42.6%, and 5.2%, respectively) compared to the normal ALT group (11.1%, 29.8%, and 2.0%, respectively; p<0.05). Conclusion: Hypercholesterolemia, liver function test abnormalities, and hypertension were associated with the degree of obesity. We should focus our attention on managing obese children and adolescents to prevent metabolic complications.

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