• 제목/요약/키워드: Acute and Subacute

검색결과 224건 처리시간 0.033초

Methotrexate에 의한 약제 유발 과민성 폐렴 1례 (A Case of Hypersensitivity Pneumonitis Caused by Methotrexate)

  • 서현주;정만표;박은하;신성철;전경만;유창민;편유장;이경수;한정호
    • Tuberculosis and Respiratory Diseases
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    • 제56권2호
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    • pp.203-209
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    • 2004
  • MTX는 골육종이나 진행된 비호치킨씨 임파종과 같은 종양성 질환 뿐아니라 건선이나 류마치스 관절염, 유육종증, 웨그너씨 육아종증등의 양성질환에서도 널리 쓰여지는 약물이다. MTX에 의한 폐독성은 약제를 투여받은 환자들 중 0.3-7.5%정도에서 나타나는 것으로 알려져 있다. 급성 또는 만성의 경과로 나타나는 MTX 폐렴의 예가 기술되어 있지만 전형적으로는 MTX를 투여한지 수개월내에 증상이 나타나는 아급성의 임상경과를 취하는 경우가 많다. 조직병리학적으로는 NSIP의 형태로 나타나는 경우가 가장 흔한 것으로 되어 있으나 BOOP나 DAD로 나타나는 경우도 드물게 보고되고 있으며 그 중 육아종의 형성을 보이는 예는 34.7% 정도로 알려져 있다. 우리나라에서는 NSIP나 DAD로 나타난 MTX 폐장염의 예가 보고되어있다. 저자들은 과민성 폐장염의 형태로 발현한 MTX에 의한 폐독성의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

한국산 고사리의 독성조사에 관한 연구 (A Toxicological Study of Young Fronds of Bracken Fern (Pteridium aquilinum var latiusculum) Collected in Kwang Ju Area)

  • 서화중;이명렬
    • 한국식품영양과학회지
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    • 제18권3호
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    • pp.255-264
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    • 1989
  • 고사리의 ethanol extract를 독성실험한 결과는 mouse에 시료 10g/kg까지는 급성독$(LD_{50})$을 나타내지 않았다. Rat에 매일 시료40mg/kg, 400mg/kg, 1200mg/kg을 경구투여한 처음 7일간에는 체중, 해부소견, 혈액의 생화학적 검사에서 별이상이 없었다. 14일째 전시료투여군의 체중증가율은 대조군보다 평균 약 7% 감소를 보이고 혈청의 생화학적 측정치가 대부분 약간 증가하였다. 21일째 400mg/kg군과 1200mg/kg군의 체중증가율이 대조군보다 $6.7{\sim}5.7%$ 감소되고 1200mg/kg군 1필이 황색간증세를 보였다. 모든 시험군 GPT 및 GOT는 각각 $88{\sim}102u$$164{\sim}200u$로 증가하고 alkaline phosphatase도 상승하여 중독의 징후를 보였다. 28일째 400mg/kg군과 1200mg/kg군의 체중증가율이 대조군보다 감소되고 이들군에서 각각 $1{\sim}2$필이 황색간을 보였다. 1200mg/kg군 2필이 소장염을 보였다. 모든 시험군은 GPT $92{\sim}116u$와 GOT $56{\sim}215u$ 및 alkaline phosphatase $57{\sim}70u$로 증가 되었다.

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간(肝) Scintigram의 임상적(臨床的) 고찰(考察) (Clinical Observation of Liver Scintigram)

  • 문성수;오경식;김열자;김영철;이종석;이학중
    • 대한핵의학회지
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    • 제14권2호
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    • pp.19-27
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    • 1980
  • Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.

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Association of GSTP1 and RRM1 Polymorphisms with the Response and Toxicity of Gemcitabine-cisplatin Combination Chemotherapy in Chinese Patients with Non-small Cell Lung Cancer

  • Yuan, Zhi-Jun;Zhou, Wen-Wu;Liu, Wei;Wu, Bai-Ping;Zhao, Jin;Wu, Wei;He, Yi;Yang, Shuo;Su, Jing;Luo, Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4347-4351
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    • 2015
  • Background: Previous studies showed that genetic polymorphisms of glutathione S-transferase P1 (GSTP1) were involved in glutathione metabolism and genetic polymorphisms of ribonucleotide reductase (RRM1) were correlated with DNA synthesis. Here we explored the effects of these polymorphisms on the chemosensitivity and clinical outcome in Chinese non-small cell lung cancer (NSCLC) patients treated with gemcitabine-cisplatin regimens. Materials and Methods: DNA sequencing was used to evaluate genetic polymorphisms of GSTP1 Ile105Val and RRM1 C37A-T524C in 47 NSCLC patients treated with gemcitabine-cisplatin regimens. Clinical response was evaluated according to RECIST criteria after 2 cycles of chemotherapy and toxicity was assessed by 1979 WHO criteria (acute and subacute toxicity graduation criteria in chemotherapeutic agents). Results: There was no statistical significance between sensitive and non-sensitive groups regarding the genotype frequency distribution of GSTP1 Ile105Val polymorphism (p>0.05). But for RRM1 C37A-T524C genotype, sensitive group had higher proportion of high effective genotype than non-sensitive group (p=0.009). And according to the joint detection of GSTP1 Ile105Val and RRM1 C37A-T524C polymorphisms, the proportion of type A (A/A + high effective genotype) was significantly higher in sensitive group than in non-sensitive group (p=0.009). Toxicity showed no correlation with the genotypes between two groups (p>0.05). Conclusions: Compared with single detection of genetic polymorphisms of GSTP1 Ile105Val or RRM1 C37A-T524C, joint detection of both may be more helpful for patients with NSCLC to receive gemcitabine-cisplatin regimens as the first-line chemotherapy. Especially, genetic polymorphism of RRM1 is more likely to be used as an important biomarker to predict the response and toxicity of gemcitabine-cisplatin combination chemotherapy in NSCLC.

파라벤류의 독성과 내분비계장애 효과 (Toxicity and Endocrine Disrupting Effect of Parabens)

  • 안혜선;나원흠;이재은;오영석;계명찬
    • 환경생물
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    • 제27권4호
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    • pp.323-333
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    • 2009
  • 파라벤은 p-하이드록시 벤조산(p-hydroxybenzoic acid)의 알킬에스테르로, 비교적 빠르게 흡수, 대사 및 배설되는 살균성 보존제로 식품, 화장품, 약품 등에 널리 사용되고 있다. 실제 인체는 파라벤 복합물에 노출된다. 파라벤의 안전성에 관한 연구결과들에 대한 고찰 결과 파라벤 종류에 따라 다양한 독성종말점을 대상으로 파라벤의 급성, 아급성 및 만성독성 영향은 비교적 적은 것으로 나타났다. 파라벤은 에스트로젠 유사활성을 가지며 화장품을 통한 경피흡수를 통해 유방암과의 상관성이 보고되었으나, 이와 상반된 견해도 있다. 파라벤의 항안드로젠성은 남성생식기계의 장애를 유발할 수 있으나 이와 상반된 견해도 있다. 파라벤은 정자의 미토콘드리아 기능 및 남성호르몬 생성을 저해할 수 있으나 이와 상반된 견해도 있다. 배아발달에는 독성이 없는 것으로 나타났다. 세포독성으로는 세포용혈, 미토콘드리아 막투과성 변화, 세포사멸 등을 유발할 수 있다. 수환경에서 파라벤은 환경에스트로젠으로 작동하여 어류에서 내분비장애 효과를 발휘한다. 결론적으로 파라벤은 저독성물질로 분류할 수 있으나, 인체 및 수생동물들에서 파라벤의 노출경로 및 농도, 사용기간 등에 따른 독성과 내분비계장애 효과에 대하여는 다양한 종말점을 대상으로 좀 더 구체적인 독성자료들이 요구된다.

요추 추간판 탈출증 환자의 침치료와 평형침법 병행치료에 대한 비교 연구 (A Controlled Trial on the Effect of Complex Oriental Medical Treatment with or without Balanced Acupuncture on Treatment of Herniated Intervertebral Disc of Lumbar Spine Patients)

  • 김경욱;유제혁;김현호;김종한;임세훈;정인태;김지혜;이재동;최도영
    • Journal of Acupuncture Research
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    • 제30권4호
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    • pp.139-149
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    • 2013
  • Objectives : The aim of this study was to observe the effect of balanced acupuncture on herniated intervertebral disc of lumbar spine patients. Methods : We investigated 23 cases of in-patients with acute & subacute herniated intervertebral disc of lumbar spine in oriental hospital, and divided patients into two groups. We treated one group(12 people) by complex oriental medical treatment with Balanced acupuncture, and the other group(11 people) by complex oriental medical treatment without Balanced acupuncture. To evaluate the effectiveness of treatment applied for two groups, we used visual analog scale(VAS) and rating scale for low back pain at admission and discharge. Results : 1. In balanced acupuncture group and control group, compared with baseline and final. VAS was significantly improved. 2. In Balanced acupuncture group and control group, compared with baseline and final. Rating scale for low back pain was significantly improved. 3. VAS and rating scale for low back pain improvement rate in balanced acupuncture group were no statistical significance compared with control group. Conclusions : Balanced acupuncture might be used for relieving symptoms related with herniated intervertebral disc of lumbar spine, but it's no statistical significance.

불포화도가 다른 식물성 유지를 섭취시킨 흰쥐에서 정상적 간 및 지질대사변화의 고찰 (The Effect of the Unsaturated Oil on the Normal Liver and Lipid Metabolism of Rats Fed Several Plant Oils)

  • 서화중;김선희;정두례
    • 한국식품영양과학회지
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    • 제20권5호
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    • pp.426-432
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    • 1991
  • Rat에 들깨유, 옥수수유, 올리브유를 28일간 매일 투여하여 rat성장율과 간대사 및 지질대사에 미치는 영향을 측정한 결과는 다음과 같다. 체중 증가율은 2주째까지는 대조군 11.72~23,07%에 비교한 실험군 모두 7.86~20.89%로 약간 둔화되나 대체로 정상으로 볼 수 있고, 3, 4주째 들깨유 투여군(A군)이 7.57~8.63%로 대조군의 17.53~13.81%에 비해 현저히 감소되고 기타 B, C군은 대조군과 거의 같은 수준이다. 혈액의 생호학적 검사결과에서 GOT, GPT값은 전 4주간 대조군의 평균 158.8와 178.8u와 비교한 B, C군은 각각 148.1~72.5u와 153.71~83.58u로 별 영향이 없으나 들깨군(A군)은 GOT, GPT가 174.87과 93,46u로 대조군 보다 약간 증가된 값이다. Alk-P는 대조군의 58.5u에 비교한 전 실험군의 평균 58.62~61.95u는 별차이가 없다. Cholesterol과 triglyceride값은 시료의 불포화도 증대에 비례하여 감소하는 경향이고 대조군의 cholesterol과 triglyceride값 60.33mg/dl~50mg/dl과 비교한 A, B, C군이 각각 54.6~36, 61.89~44, 63.71~51mg/dl을 보여 큰 폭의 차이는 없었다. 간조직 검사 결과 A, B, C군 모두 4주재 1필에서 kupffer cell의 증식내지 활동도 증가를 보이고 특히 들깨유군의 경우는 담관의 팽대, 옥수수유군은 vesicular nuclei의 관찰, 올리브유군은 mild fatty metamorphosis가 관찰되었으나 나머지는 대부분 정상이었다. 이상의 결과에서 들깨유, 옥수수유, 올리브유를 1개월간 rat kg당 1.57ml을 매일 투여하니 유지의 불포화도의 증가에 따라 혈중 중성지방과 cholesterol 농도의 근소한 감소를 보였지만 들깨유의 4주간 투여군은 간기능에 다소 부담을 주는 것으로 보이나 대부분 실험군은 별다른 증상을 보이지 않아 . 따라서 들깨유의 장기간 복용은 간기능에 다소 유해적으로 작용할 것으로 보인다.으로 보인다.

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뇌졸중으로 인한 운동 관련 후유증의 한의 치료 연구에서 뇌졸중 시기 및 평가 척도에 대한 국내 문헌 고찰 (A Review of the Stroke Stage and Outcome Measures in Stroke Motor Sequelae Clinical Studies in Korea)

  • 이지은;천세은;전민결;신용진;임정태;신선호
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.656-679
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    • 2022
  • Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

류마티스 관절염 환자에서 Methotrexate에 의해 발생한 간질성 폐렴 1예 (A Case of Methotrexate Induced Pneumonitis in a Patient with Rheumatoid Arthritis)

  • 박찬석;이상학;심건호;김완욱;이숙영;김석찬;김관형;문화식;송정섭;박성학
    • Tuberculosis and Respiratory Diseases
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    • 제57권3호
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    • pp.273-277
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    • 2004
  • 저자들은 급성호흡곤란을 주소로 내원한 류마티스 관절염 환자에서 임상소견과 흉부 방사선소견, 기관지폐포세척액 및 경기관지폐생검을 통해 methotrexate에 의한 간질성 폐렴 1예를 진단하였기에 문헌 고찰과 함께 보고하는 바이다.

The Role of Bone Cement Augmentation in the Treatment of Chronic Symptomatic Osteoporotic Compression Fracture

  • Kim, Hyeun-Sung;Kim, Sung-Hoon;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제48권6호
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    • pp.490-495
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    • 2010
  • Objective : Bone cement augmentation procedures such as percutaneous vertebroplasty and balloon kyphoplasty have been shown to be effective treatment for acute or subacute osteoporotic vertebral compression fractures. The purpose of this study was to determine the efficacy of bone cement augmentation procedures for long standing osteoporotic vertebral compression fracture with late vertebral collapse and persistent back pain. Methods : Among 278 single level osteoporotic vertebral compression fractures that were treated by vertebral augmentation procedures at our institute, 18 consecutive patients were included in this study. Study inclusion was limited to initially, minimal compression fractures, but showing a poor prognosis due to late vertebral collapse, intravertebral vacuum clefts and continuous back pain despite conservative treatment for more than one year. The subjects included three men and 15 women. The mean age was 70.7 with a range from 64 to 85 years of age. After postural reduction for two days, bone cement augmentation procedures following intraoperative pressure reduction were performed. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period after bone cement augmentation procedures was 14.3 months (range 12-27 months). The mean injected cement volume was 4.1 mL (range 2.4-5.9 mL). The unipedicular approach was possible in 15 patients. The mean pain score (visual analogue scale) prior to surgery was 7.1, which decreased to 3.1 at 7 days after the procedure. The pain relief was maintained at the final follow up. The kyphotic angle improved significantly from $21.2{\pm}4.9^{\circ}$ before surgery to $10.4{\pm}3.8^{\circ}$ after surgery. The fraction of vertebral height increased from 30% to 60% after bone cement augmentation, and the restored vertebral height was maintained at the final follow up. There were no serious complications related to cement leakage. Conclusion : In the management of even long-standing osteoporotic vertebral compression fracture for over one year, bone cement augmentation procedures following postural reduction were considered safe and effective treatment in cases of non-healing evidence.