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The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

An Analysis of the Psychiatric Characteristics of the Alopecia Areata in Female (여성 탈모증의 정신의학적 특성 분석)

  • Lee, Kil-Hong;Na, Chul;Lee, Young-Sik;Lee, Chang-Hoon;No, Byung-In;Hong, Chang-Kwon
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.31-45
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    • 2000
  • Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

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APICAL FITNESS OF NON-STANDARDIZED GUTTA-PERCHA CONES IN SIMULATED ROOT CANALS PREPARED WITH ROTARY ROOT CANAL INSTRUMENTS (전동화일로 형성된 근관에서 비표준화 Gutta-percha Cone의 적합성)

  • Kwon, O-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.25 no.3
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    • pp.390-398
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    • 2000
  • The purpose of this study was to evaluate the apical fitness of non-standardized gutta-percha cones in root canals prepared with rotary Ni-Ti root canal instruments of various tapers and apical tip sizes. Simulated sixty curved root canals of plastic blocks were prepared with crown-down technique using rotary root canal instruments of Maillefer ProFile$^{(R)}$ .04 and .06 taper (Maillefer Instrument SA, Switzerland). Specimens were divided into six groups and prepared as follows: Group 1, prepared up to size 25 of .04 taper ; Group 2, prepared up to size 30 of .04 taper ; Group 3, prepared up to size 35 of .04 taper ; Group 4, prepared up to size 25 of .06 taper ; Group 5, prepared up to size 30 of .06 taper ; Group 6 ; prepared up to size 35 of .06 taper. After cutting off the coronal portion of plastic, blocks perpendicular to the long axis of the canal with the use of a diamond saw, apical 5mm of canal space was analyzed. Prepared apical canal spaces were duplicated using rubber base impression material to evaluate two dimensional total area of apical canal space. Various sized gutta-percha cones were applied in the 5mm-apical canal space, which were size 25, size 30 and size 35 standardized gutta-percha cone, Diadent Dia-Pro ISO-.04$^{TM}$ and .06$^{TM}$(Diadent, Korea), and medium-fine (MF), fine (F), fine-medium (FM) and medium (M) sized non-standardized gutta-percha cones (Diadent, Korea). Coronal excess gutta-percha were cut off with a sharp blade. Photographs of impressed apical canal spaces and gutta-percha cones were taken with a CCD camera under a stereomicroscope and stored in a computer. Areas of the total canal space and gutta-percha cones were calculated using a digitalized image analysing program, CompuScope (Sungjin Multimedia Co., Korea). Ratio of apical fitness was obtained by calculating the area of gutta-percha cone to the total area of the canal space. The data were analysed statistically using One-way Analysis of Variance and Duncan's Multiple Range Test. The results were as follows: 1. In canals prepared up to size 25 ProFile$^{(R)}$ of .04 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 25 standardized ones (p<0.05). 2. In canals prepared up to size 30 ProFile$^{(R)}$ of .04 taper, non-standardized F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized MF cones occupied more canal space than size 30 standardized ones (p<0.05). 3. In canals prepared up to size 35 ProFile$^{(R)}$ of .04 taper, there was no significant difference in canal space occupation among non-standardized MF and F, size 35 standardized, and Dia-Pro ISO-.04$^{TM}$ cones (p>0.05). 4. In canals prepared up to size 25 ProFile$^{(R)}$ of .06 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$, or size 25 standardized ones (p<0.05), and Dia-Pro ISO-.06$^{TM}$, cones occupied significantly more space than size 25 standardized ones (p<0.05). 5. In canals prepared up to size 30 ProFile$^{(R)}$ of .06 taper, non-standardized FM cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized F cones occupied significantly more canal space than size 30 standardized ones (p<0.05). 6. In canals prepared up to size 35 ProFile$^{(R)}$ of .06 taper, non-standardized M and FM, Dia-Pro ISO-.06$^{TM}$ occupied significantly more canal space than size 35 standardized ones (p<0.05). In summary, in both canals prepared with .04 or .06 taper ProFile$^{(R)}$, non-standardized cones showed better fitness than Dia-Pro ISO$^{TM}$ or standardized ones, which was more characteristic in smaller canals.

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An Analysis of the Landscape Cognitive Characteristics of 'Gugok Streams' in the First Half of the 18th Century Based on the Comparison of China's 『Wuyi-Gugok Painting』 (중국 『무이구곡도』 3폭(幅)의 비교 분석을 통해 본 18세기 무이산 구곡계(九曲溪)의 경물 인지특성)

  • Cheng, Zhao-Xia;Rho, Jae-Hyun;Jiang, Cheng
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.37 no.3
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    • pp.62-82
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    • 2019
  • Taking the three Wuyi-Gugok Drawings, 『A Picture Showing the Boundary Between Mountains and Rivers: A』, 『Landscape of the Jiuqu River in the Wuyi Mountain: B』 and 『Eighteen Sceneries of Wuyi Mountain: C』, which were produced in the mid-Qing Dynasty as the research objects and after investigating the names recorded in the paintings, this paper tries to analyze the scenic spots, scene types and images in the literature survey. Also, based on the number of Scenic type and the number of Scenic name in each Gok, landscape richness(LR) and landscape similarity(LS) of the Gugok scenic spots, the cognitive characteristics of the landscape in the 18th century were carefully observed. The results are as follows. Firstly, according to the description statistics of scenic spot types in Wuyi Mountain Chronicle, there were 41 descriptions of scenery names in the three paintings, among which rock, peak and stone accounted for the majority. According to the data, the number of rocks, peaks and stones in Wuyi-Gugok landscape accounted for more than half, which reflected the characteristics of geological landscape such as Danxia landform in Wuyi-Gugok landscape. Secondly, the landscape of Gugok Stream(九曲溪) was diverse and full of images. The 1st Gok Daewangbong(大王峰) and Manjeongbong(幔亭峰), the 2nd Gok Oknyeobong(玉女峰), the 3rd Gok Sojangbong(小藏峰), the 4th Gok Daejangbong(大藏峰), the 5th Gok Daeeunbyeong(大隱屛) and Muijeongsa(武夷精舍), the 6th Gok Seonjangbong(仙掌峰) and Cheonyubong(天游峰) all had outstanding landscape in each Gok. However, the landscape features of the 7th~9th Gok were relatively low. Thirdly, according to the landscape image survey of each Gok, the image formation of Gugok cultural landscape originates from the specificity of the myths and legends related to Wuyi Mountain, and the landscape is highly well-known. Due to the specificity, the landscape recognition was very high. In particular, the 1st Gok and the 5th Gok closely related to the Taoist culture based on Muigun, the Stone Carving culture and the Boat Tour culture related to neo-confucianism culture of Zhu Xi. Fourthly, according to the analysis results of landscape similarity of 41 landscape types shown in the figure, the similarity of A and C was very high. The morphological description and the relationship of distant and near performance was very similar. Therefore, it could be judged that this was obviously influenced by one painting. As a whole, the names of the scenes depicted in the three paintings were formed at least in the first half of 18th century through a long history of inheritance, accumulated myths and legends, and the names of the scenes. The order of the scenery names in three Drawings had some differences. But among the scenery names appearing in all three Drawings, there were 21 stones, 20 rocks and 17 peaks. Stones, rocks and peaks guided the landscape of Gugok Streams in Wuyi Mountain. Fifthly, Seonjodae(仙釣臺) in A and C was described in the 4th Gok, but what deserved attention was that it was known as the scenery name of the 3rd Gok in Korean. In addition, Seungjindong(升眞洞) in the 1st Gok and Seokdangsa(石堂寺) in the 7th Gok were not described in Drawings A, B and C. This is a special point that needs to be studied in the future.

The Analysis of the Current Status of Medical Accidents and Disputes Researched in the Korean Web Sites (인터넷 사이트를 통해 살펴본 의료사고 및 의료분쟁의 현황에 관한 분석)

  • Cha, Yu-Rim;Kwon, Jeong-Seung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.297-316
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    • 2006
  • The increasing tendency of medical disputes is one of the remarkable social phenomena. Especially we must not overlook the phenomenon that production and circulation of information related to medical accidents is increasing rapidly through the internet. In this research, we evaluated the web sites which provide the information related to medical accidents using the keyword "medical accidents" in March 2006, and classified the 28 web sites according to the kinds of establishers. We also analyzed the contents of the sites, and checked and compared the current status of the web sites and problems that have to be improved. Finally, we suggested the possible solutions to prevent medical accidents. The detailed results were listed below. 1. Medical practitioners, general public, and lawyers were all familiar with and prefer the term "medical accidents" mainly. 2. In the number of sites searched by the keyword "medical accidents", lawyer had the most sites and medical practitioners had the least ones. 3. Many sites by general public and lawyers had their own medical record analysts but there was little professional analysts for dentistry. 4. General public were more interested in the prevention of medical accidents but the lawyers were more interested in the process after medical accidents. The sites by medical practitioners dealt with the least remedies of medical accidents, compared with other sites. 5. General public wanted the third party such as government intervention into the disputes including the medical dispute arbitration law or/and the establishment of independent medical dispute judgment institution. 6. In the comparison among the establishers of web sites, medical practitioners dealt with the least examples of medical accidents. 7. The suggestion of cases in counseling articles related to dental accidents were considered less importantly than the reality. 8. Whereas there were many articles about domestic cases related to the bloody dental treatment, in the open counseling articles the number of dental treatment regarding to non insurance treatment was large. 9. In comparing offered information of medical accidents based on the establishers, general public offered vocabularies, lawyers offered related laws and medical practitioners offered medical knowledge relatively. 10. They all cited the news pressed by the media to offer the current status of domestic medical accidents. Especially among the web sites by general public, NGOs provided the plentiful statistical data related to medical accidents. 11. The web sites that collect the medical accidents were only two. As a result of our research, we found out that, in the flood of information, medical disputes can be occurred by the wrong information from third party, and the medical practitioners have the most passive attitudes on the medical accidents. Thus, it is crucial to have the mutual interchange and exchange of information between lawyer, patients and medical practitioners, so that based on clear mutual comprehension we can solve the accidents and disputes more positively and actively.

Assessment of Estimated Daily Intakes of Artificial Sweeteners from Non-alcoholic Beverages in Children and Adolescents (어린이와 청소년의 비알콜성음료 섭취에 따른 인공감미료 섭취량 평가)

  • Kim, Sung-Dan;Moon, Hyun-Kyung;Lee, Jib-Ho;Chang, Min-Su;Shin, Young;Jung, Sun-Ok;Yun, Eun-Sun;Jo, Han-Bin;Kim, Jung-Hun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.8
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    • pp.1304-1316
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    • 2014
  • The aims of this study were to estimate daily intakes of artificial sweeteners from beverages and liquid teas as well as evaluate their potential health risks in Korean children and adolescents (1 to 19 years old). Dietary intake assessment was conducted using actual levels of aspartame, acesulfame-K, and sucralose in non-alcoholic beverages (651 beverages and 87 liquid teas), and food consumption amounts were drawn from "The Fourth Korea National Health and Nutrition Examination Survey (2007~2009)". To estimate dietary intake of non-alcoholic beverages, a total of 6,082 children and adolescents (Scenario I) were compared to 1,704 non-alcoholic beverage consumption subjects (Scenario II). The estimated daily intake of artificial sweeteners was calculated based on point estimates and probabilistic estimates. The values of probabilistic artificial sweeteners intakes were presented by a Monte Carlo approach considering probabilistic density functions of variables. The level of safety for artificial sweeteners was evaluated by comparisons with acceptable daily intakes (ADI) of aspartame (0~40 mg/kg bw/day), acesulfame-K (0~15 mg/kg bw/day), and sucralose (0~15 mg/kg bw/day) set by the World Health Organization. For total children and adolescents (Scenario I), mean daily intakes of aspartame, acesulfame-K, and sucralose estimated by probabilistic estimates using Monte Carlo simulation were 0.09, 0.01, and 0.04 mg/kg bw/day, respectively, and 95th percentile daily intakes were 0.30, 0.02, and 0.13 mg/kg bw/day, respectively. For consumers-only (Scenario II), mean daily intakes of aspartame, acesulfame-K, and sucralose estimated by probabilistic estimates using Monte Carlo simulation were 0.52, 0.03, and 0.22 mg/kg bw/day, respectively, and 95th percentile daily intakes were 1.80, 0.12, and 0.75 mg/kg bw/day, respectively. For scenarios I and II, neither aspartame, acesulfame-K, nor sucralose had a mean and 95th percentile intake that exceeded 5.06% of ADI.

An Appreciation of Functional Role of Macrophage in the Acute Lung Injury in the Neutropenic Rat. (호중구 감소증을 보이는 백서의 급성폐손상에서 대식세포의 기능적 역할)

  • Kim, Yong-Hoon;Ki, Sin-Young;Im, Keon-Il;Moon, Seung-Hyug;Cheong, Seung-Whan;Kim, Hyeon-Tae;Uh, Soo-Taek;Park, Choon-Sik;Jin, Byung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.379-390
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    • 1997
  • Background : It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pulmonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutropenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. Method : The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cells was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. Results : The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA : More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells : In the ETX-group, the number of total cells (p < 0.01) and of macrophage and neutrophil (p < 0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC-group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and it took part in less than 0.1% of total BAL cells (p < 0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF : In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p < 0.05 and < 0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p < 0.05 vs NC-group), but the value was statistically not different from that of ETX-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p < 0.05), but showed still a higher value compared to that of NC-group (p < 0.05). A change of cytokine concentration in the BALF : TNF -alpha and IL-6 were elevated in the ETX - and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells : There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p < 0.0008 vs NC-group), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion : Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveolar macrophages.

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The Evaluation of IL-8 in the Serum of Pneumoconiotic patients (진폐증 환자에서의 혈청내 IL-8 농도)

  • Ahn, Hyeong Sook;Kim, Ji Hong;Chang, Hwang Sin;Kim, Kyung Ah;Lim, Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.945-953
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    • 1996
  • Background : Many acute and chronic lung diseases including pneumoconiosis are characterized by the presence of increased numbers of activated macrophages. These macrophages generate several inflammatory cell chemoattractants, by which neutrophil migrate from vascular compartment to the alveolar space. Recruited neutrophils secrete toxic oxygen radicals or proteolytic enzymes and induce inflammatory response. Continuing inflammatory response results in alteration of the pulmonary structure and irreversible fibrosis. Recently, a polypeptide with specific neutrophil chemotactic activity, interleukin-8(IL-8), has been cloned and isolated from a number of cells including : monocytes, macrophages and fibroblasts. IL-1 and/or TNF-${\alpha}$ preceded for the synthesis of IL-8, and we already observed high level of IL-1 and TNF-${\alpha}$ in the pneumoconioses. So we hypothesized that IL-8 may be a central role in the pathogenesis of pneumoconiosis. In order to evaluate the clinical utility of IL-8 as a biomarker in the early diagnosis of pneumoconiosis, we investigated the increase of IL-8 in the pneumoconiotic patient and the correlation between IL-8 level and progression of pneumoconiosis. Method : We measured IL-8 in the serum of 48 patients with pneumoconiosis and 16 persons without dust exposure history as a control group. Pneumoconiotic cases were divided into 3 groups according to ILO Classification : suspicious group(n=16), small opacity group(n=16) and large opacity group(n=16). IL-8 was measured by a sandwich enzytne immunoassay technique. All data were expressed as the $mean{\pm}standard$ deviation. Results: 1) The mean value of age was higher in the small opacity and large opacity group than comparison group, but smoking history was even. Duration of dust exposure was not different among 3 pneumoconiosis groups. 2) IL-8 level was $70.50{\pm}53.63pg/m{\ell}$ in the suspicious group, $107.50{\pm}45.88pg/m{\ell}$ in the small opacity group, $132.50{\pm}73.47pg/m{\ell}$ in the large opacity group and $17.85{\pm}33.85pg/m{\ell}$ in the comparison group. IL-8 concentration in all pneumoconiosis group was significant higher than that in the comparison group(p<0.001). 3) IL-8 level tended to increase with the progression of pneumoconiosis. Multiple comparison test using Anova/Scheffe analysis showed a significant difference between suspicious group and large opacity group(p<0.05). 4) The level of IL-8 was correlated with the progression of pneumoconiosis(r=0.4199, p<0.05). Conclusion : IL-8 is thought to be a good biomarker for the early diagnosis of pneumoconiosis.

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Development of Formulas for the Estimation of Renal Depth and Application in the Measurement of Glomerular Filtration Rate in Koreans (사구체 여과율 측정을 위한 한국인의 신장 깊이에 관한 방정식 도출과 이용)

  • Yoo, Ie-Ryung;Kim, Sung-Hoon;Chung, Yong-An;Jung, Hyun-Seok;Lee, Hae-Giu;Park, Young-Ha;Lee, Sung-Yong;Sohn, Hyung-Seon;Chung, Soo-Kyo;Kim, Hyun-Mi;Lee, Hyung-Goo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.418-425
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    • 2000
  • Purpose: There is no established formula for estimating renal depths in Korean. As a result, we undertook this study to develop a new formula, and to apply this formula in the calculation of glomerular filtration rate (GFR). Materials and Methods: We measured the renal depth (RD) on the abdominal CT obtained in 300 adults (M:F: 167:133, mean age 50.9 years) without known renal diseases. The RDs measured by CT were compared with the estimated RDs based on the Tonnesen and Taylor equations. New formulas were derived from the measured RDs in 200 out of 300 patients based on several variables such as sex, age, weight, and height by multiple regression analysis. The RDs estimated from the new formulas were compared with the measured RDs in the remaining 100 patients as a control. In 48 patients who underwent Tc-99m DTPA renal scintigraphy, GFR was measured with three equations (new formula, Tonnesen and Taylor equations), respectively, and compared with each other. Results: The mean values of the RDs measured from CT were 6.9 cm for right kidney of the men (MRK), 6.7 cm for left kidney of the men (MLK), 6.7 cm for right kidney of the women (WRK), and 6.6 cm for left kidney of the women (WLK). The RDs estimated from Tonnesen equation were shorter than the ones measured from CT significantly. The newly derived formulas were 12.813 (weight/height)+0.002 (age)+ 2.264 for MRK, 15.344 (weight/height)+0.011 (age)+0.557 for MLK, 12.936 (weight/height)+ 0.014 (age)+1.462 for WRK and 13.488 (weight/height)+0.019 (age)+0.762 for WLK. The correlation coefficients of the RD measured from CT and estimated from the new formula were 0.529 in MRK, 0.729 in MLK, 0.601 in WRK, and 0.724 in WLK, respectively. The GFRs from the new formula were significantly higher than those from the Tonnesen equation significantly, which was the most similar to normal GFR values. Conclusion: We generated new formulas for estimating RD in Korean from the data by CT. By adopting these formulas, we expect that GFR can be measured by the Gates method accurately in Korean.

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Light and Electron Microscopy of Gill and Kidney on Adaptation of Tilapia(Oreochromis niloticus) in the Various Salinities (틸라피아의 해수순치시(海水馴致時) 아가미와 신장(腎臟)의 광학(光學) 및 전자현미경적(電子顯微鏡的) 관찰(觀察))

  • Yoon, Jong-Man;Cho, Kang-Yong;Park, Hong-Yang
    • Applied Microscopy
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    • v.23 no.2
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    • pp.27-40
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    • 1993
  • This study was taken to examine the light microscopic and ultrastructural changes of gill and kidney of female tilapia{Oreochromis niloticus) adapted in 0%o, 10%o, 20%o, and 30%o salt concentrations, respectively, by light, scanning and transmission electron microscope. The results obtained in these experiments were summarized as follows: Gill chloride cell hyperplasia, gill lamellar epithelial separation, kidney glomerular shrinkage, blood congestion in kidneys and deposition of hyalin droplets in kidney glomeruli, tubules were the histological alterations in Oreochromis niloticus. Incidence and severity of gill chloride cell hyperplasia rapidly increased together with increase of salinity, and the number of chloride cells in gill lamellae rapidly increased in response to high external NaCl concentrations. The ultrastructure by scanning electron microscope(SEM) indicated that the gill secondary lamella of tilapia(Oreochromis niloticus) exposed to seawater, were characterized by rough convoluted surfaces during the adaptation. Transmission electron microscopy(TEM) indicated that mitochondria in chloride cells exposed to seawater, were both large and elongate and contained well-developed cristae. TEM also showed the increased chloride cells exposed to seawater. The presence of two mitochondria-rich cell types is discussed with regard to their possible role in the hypoosmoregulatory changes which occur during seawater-adaptation. Most Oreochromis niloticus adapted in seawater had an occasional glomerulus completely filling Bowman's capsule in kidney, and glomerular shrinkage was occurred higher in kidney tissues of individuals living in 10%o, 20%o, 30%o of seawater than in those living in 0%o of freshwater, and blood congestion was occurred severer in kidney tissues of individuals living 20%o, 30%o of seawater than in those living in 10%o of seawater. There were decreases in the glomerular area and the nuclear area in the main segments of the nephron, and that the nuclear areas of the nephron cells in seawater-adapted tilapia were of smaller size than those from freshwater-adapted fish. Our findings demonstrated that Oreochromis niloticus tolerated moderately saline environment and the increased body weight living in 30%o was relatively higher than that living in 10%o in spite of histopathological changes.

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