• Title/Summary/Keyword: Acute stage

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An Epidemiologic Study of Kawasaki Disease(1987-2000) : Incidence of Coronary Artery Complication in the Acute Stage (가와사끼병의 역학적 연구(1987-2000년) : 관상 동맥 이상을 중심으로)

  • Lee, Kyung-Yil;Park, Min-Young;Han, Ji-Whan;Lee, Hyung-Shin;Choi, Jin;Whang, Kyung-Tai
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.783-789
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    • 2002
  • Purpose : We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment. Methods : We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000. Results : The mean annual incidence was $36.1{\pm}11.1$ cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was $2.4{\pm}1.7$ years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated($400-500mg/day{\times}4-5days$, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case. Conclusion : In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.

The Effect of Steroid Therapy in Patients with Late ARDS (후기 급성호흡곤란증후군환자에서 스테로이드의 사용 효과)

  • Huh, Jin Won;Lim, Chae-Man;Jegal, Yang-Jin;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Youn Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.376-384
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    • 2002
  • Background : The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is ${\geq}80%$. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit (MICU). Methods : Over a 3-year period, the medical records of 48 ARDS patients who had been on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the $8^{th}$ day of ARDS as first day of the study. Results : Initially, the groups had similar PF($PaO_2/FiO_2$) ratio, LIS, APACHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). Conclusion : Although the data of this study was retrospective and was not randomized, in order to improve the patient's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.

Effect of Di(2-ethyl hexyl)phthalate(DEHP) on the Onset of Puberty in Female Rat (암컷 흰쥐의 사춘기 개시에 미치는 di(2-ethyl hexyl)phthalate(DEHP)의 효과)

  • Lee, Kyeung-Yeup;Lee, Sung-Ho
    • Development and Reproduction
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    • v.10 no.2
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    • pp.147-154
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    • 2006
  • Phthalates such as di(2-ethyl hexyl)phthalate(DEHP) are industrial chemicals with wide-ranging human exposures because of their use in plastics and other common consumer products. Consequently, their adverse effects as endocrine disruptor in the reproductive physiology of both laboratory rodents and human have been studied extensively. The present study was undertaken to examine whether prepubertal exposure to DEHP affects on the onset of puberty and the associated reproductive parameters such as hormone receptor expressions in female rats. DEHP(100mg/kg/day) was administered daily from postnatal day 25(PND 25) through the day when the first vaginal opening(VO) was observed, and the animals were sacrificed on the next day. Gross anatomy and weight of reproductive tissues were compared to test the DEHP's effects on the cell proliferation. Furthermore, histological studies were performed to assess the structural alterations in the tissues. Specific radioimmunoassay was carried out to measure serum LH levels. To determine the transcriptional changes in progesterone receptor(PR), total RNAs were extracted and applied to the semi-quantitative reverse transcription polymerase chain reaction(RT-PCR). As a result, delayed VO was shown in the DEHP group(PND $37.3{\pm}0.7$) compared to the control group(PND $35.3{\pm}0.7$; p<0.05). DEHP treatment significantly decreased the wet weight of ovaries and uteri compared to the control group(p<0.05). Interestingly, elevation of serum LH levels was shown in the DEHP group(p<0.05). Graafian follicles and corpora lutea were observed only in the ovaries from the control animals. Numerous primary, secondary follicles and small atretic follicles were observed in the ovaries from DEHP-treated animals. Similarly, hypotrophy of luminal and glandular uterine epithelium was found in the DEHP-treated group. These effects were probably due to the inhibitory effects of DEHP on the synthesis and secretion of estrogen from granulosa cells. In the semiquantitative RT-PCR studies, the transcriptional activities of PR in both ovary(p<0.05) and uterus(p<0.01) from DEHP-treated animals were significantly lower than those from the control animals. The present studies demonstrated that the acute exposure to DEHP during the critical period of prepubertal stage could inactivate the reproductive system resulting delayed puberty in female rats.

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Ecological Risk Assessment of Alachlor using Medaka (Oryzias latipes) and Earthworm (Eisenia fetida) (송사리(Oryzias latipes)와 지렁이(Eisenia fetida)를 이용한 Alachlor의 생태 위해성평가)

  • Lee, Chul-Woo;Kim, Hyun-Mi;Yoon, Jun-Heon;Song, Sang-Hwan;Ryu, Ji-Sung;Kim, Eun-Kyoung;Yang, Chang-Yong;Chung, Young-Hee;Choi, Kyung-Hee;Lee, Moon-Soon
    • Korean Journal of Environmental Biology
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    • v.25 no.1
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    • pp.1-7
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    • 2007
  • Medaka(Oryzias latipes) and earthworm(Eisenia fetida) toxicity tests were carried out and ecological risk assessment in water and soil was performed with national monitoring data. NOEC of alachlor was $100\;{\mu}g\;L^{-1}$ in the medaka early life-stage test. Embryonic development, hatchability and time to hatching of medaka eggs were affected by this chemical. The $LC_{50}$ and NOEC of alachlor were $94.1\;mg\;kg^{-1}\;and\;55.0\;mg\;kg^{-1}$, respectively, in the earthworm acute toxicity test. The environmental monitoring has been carrying out by NIER since 1999. Exposure levels of alachlor in water and soil were $ND{\sim}0.54\;{\mu}g\;L^{-1}\;and\;ND{\sim}0.9\;{\mu}g\;kg^{-1}$, respectively, in national monitoring data which had been performed from 2000 to 2004. The measured water and soil exposure levels were applied to evaluate the environmental risk assessment. The PNEC of alachlor in water and in soil were determined as $1\;{\mu}g\;L^{-1}\;and\;55.0\;{\mu}g\;kg^{-1}$, respectively using the safety factors which were suggested in EU and OECD. The HQs (PEC/PNEC) were determined to be below 1 for both water and soil when the maximum exposure levels ($0.54\;{\mu}g\; L^{-1}$ in water and $0.9\;{\mu}g\;kg^{-1}$ in soil) were applied. Conclusively, our study indicated that there was not significant ecological risk of alachlor in water and soil of our monitoring sites.

Shoulder Uptake in the Bone Scintigraphy in Patients with Hemiplegic Reflex Sympathetic Dystrophy Syndrome (반신마비성 반사성교감신경 이영양증후군 환자의 골스캔상 견관절 섭취)

  • Lee, Jong-Jin;Chung, June-Key;Lee, Dong-Soo;Hong, Joon-Beom;Han, Tai-Ryoon;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.288-293
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    • 2004
  • Purpose: increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was $63{\pm}10$ yrs. Ter normal volunteer (mean age: $60{\pm}5$, M:F=1:9) data was used as control group. TPBS was performed $59{\pm}32$ days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Conclusion: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.

Effect of Vinclozolin on the Onset of Puberty in Immature Female Rats (미성숙 암컷 흰쥐의 사춘기 개시에 미치는 Vinclozolin의 영향)

  • An, Na-Kyung;Lee, Sung-Ho
    • Development and Reproduction
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    • v.11 no.3
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    • pp.245-251
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    • 2007
  • Vinclozolin(VCZ), a systemic dicarboximide fungicide, has been used in the control of diseases caused by microorganism of some species in fruits, vegatables and ornamental plants. Although VCZ itself is a very weak antagonist for androgen receptor binding, both melabolites M1 and M2 are effective antagonists. The present study was undertaken to examine whether prepubertal exposure to VCZ affects on the onset of puberty and the associated reproductive parameters such as hormone receptor expressions in female rats. VCZ(10 mg/kg/day) was administered daily from postnatal day 21(PND 21) through the day when the first vaginal opening(V.O.) was observed. Gross anatomy and weight of reproductive tissues were compared to test the VCZ's effects on the cell proliferation. Furthermore, histological studies were performed to assess the structural alterations in the tissues. To determine the transcriptional changes in progesterone receptor(PR), total RNAs were extracted and applied to the semi-quantitative reverse transcription polymerase chain reaction(RT-PCR). As a result, delayed V.O. was shown in the VCZ group(PND $34.00{\pm}1.22$) compared to the control group(PND $38.20{\pm}1.92$; p<0.01). VCZ treatment significantly decreased the wet weight of ovaries and uteri compared to the control group(p<0.01). Graafian follicles and corpora lutea were observed only in the ovaries from the control animals, while numerous primary, secondary follicles and small atretic follicles were observed in the ovaries from VCZ group. Similarly, hypotrophy of luminal and glandular uterine epithelium was found in the VCZ group. In the semi-quantitative RT-PCR studies, the transcriptional activity of PR in ovary(p<0.01) from VCZ group were significantly lower than those from the control group while in uterus were similar compared with the control group. The present studies demonstrated that the acute exposure to VCZ during the critical period of prepubertal stage could inactivate the reproductive system resulting delayed puberty in female rats.

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A Survey of Cancer Patients Who Visited Emergency Room (일 대학병원 응급실에 내원한 암 환자 실태)

  • Yang, Sun-Ae;Cho, Ok-Hee;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.228-233
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    • 2009
  • Purpose: The purpose of this study was to retrospectively examine the factors and characteristics of cancer patients who visited the emergency room, as well as to offer some educational materials for to manage acute symptoms. Methods: Data for this study were selected from the period of January to December, 2006. A total of 564 patients were examined using the tool which we developed by ourselves for the study. The collected data were analyzed using the SAS program for frequencies and percentage. Results: As for disease-related characteristics of the subjects, 28.9% of them had gastric and colorectal cancer; 66.9% were in stage 4; 51.6% had been in chemotherapy prior to visiting the emergency room; and 82.5% had their anticancer drug administrated average 1~5 times. As for the characteristics in regard to visit the emergency room, 62.9% were admitted to hospital within 2 weeks of being treated. As for chief complaints for visiting the emergency room, the worst symptom was pain, followed by symptoms such as gastro-intestinal symptoms, respiratory symptoms, high fever, and weakness. As for the disease-related symptoms, the worst symptom that gastric, colorectal, pancreatic, liver and gallbladder cancer patients complained of was pain, high fever for lymphoma patients was respiratory symptoms for lung cancer patients, and gastrointestinal symptoms for head and neck cancer and other patients. Conclusion: Therefore, according to their need and background, an individualized consultation and teaching program should be provided to cancer patients.

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Analyses of CO2 Concentration and Balance in a Closed Production System for King Oyster Mushroom and Lettuce (밀폐형 식물생산시스템 내 새송이 버섯과 상추의 혼합 재배 비율에 따른 CO2 농도 변화 및 균형 분석)

  • Jung, Dae Ho;Kim, Chan Kyo;Oh, Kyung Hun;Lee, Dong-Hyeon;Kim, Minsu;Shin, Jong Hwa;Son, Jung Eek
    • Horticultural Science & Technology
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    • v.32 no.5
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    • pp.628-635
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    • 2014
  • The large amount of $CO_2$ emitted from mushrooms during incubation and developmental stages can be utilized in plant production systems as a $CO_2$ source. The objectives of this study were to measure the $CO_2$ emission and absorption rates of mushroom and lettuce, respectively, and to analyze the $CO_2$ concentrations at various ratios of mushroom and lettuce in a closed production system. The $CO_2$ emission rate of king oyster mushrooms (Pleurotus eryngii ( DC.) Qu$\acute{e}$l) and $CO_2$ absorption rate of lettuces (Lactuca sativa L. cv. Asia Heuk Romaine) were measured by using two closed acryl chambers ($1.0m{\times}0.8m{\times}0.5m$) in which indoor temperatures were maintained at $18^{\circ}C$ and $22^{\circ}C$, respectively. The lettuce was grown at a light intensity of PPF $340mol{\cdot}m^{-2}{\cdot}s^{-1}$ and with nutrient solution at EC $1.2dS{\cdot}m^{-1}$. The air was periodically circulated between the two chambers using a diaphragm pump. The $CO_2$ emission rate of the mushroom increased until the $15^{th}$ day after scratching (DAS) and then decreased. The rate also increased with increased indoor temperature. In particular, the $CO_2$ emission rate per fresh weight of fruit body increased by about 3.1 times after thinning compared to before thinning. In terms of $CO_2$ balance, the $CO_2$ emission rates from a bottle (950 mL) of the mushroom at 9, 12, and 14 DAS were equivalent to those of 3, 4.5, and 5.5 lettuce plants at 7, 10, and 12 DAT (days after transplanting), respectively. This work shows that balance in $CO_2$ concentration could be achieved using an appropriate ratio of the two crops in a closed production system.

A Change of Adrenal Androgen and Cortisol in Kawasaki Disease (가와사끼병에서 부신 안드로겐과 코티솔의 변화)

  • Lee, Sun-Hee;Yu, Jae-Hong;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.654-658
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    • 2002
  • Purpose : Endocrine and immune systems are connected and interdependent. Adrenal glands play an important role in this network and control the balance between serum levels of dehydroepiandrosterone sulfate(DHEAS) and cortisol. These steroids have an antagonistic effect on the T cell progression into Th1 and Th2 cells and on the induction of correlated interleukins. Therefore we evaluated the role of adrenal androgen and cortisol as immune modulators in Kawasaki disease( KD) with changes of T cell immunity. Methods : From April to August in 2001, we examined serum DHEAS and 24 hour urine free cortisol(F) before administration of immunoglobulin and steroids by radioimmunoassay in 14 KD patients. It's clinical severity was determined by Harada score and coronary lesion. Results : The age of the patient group ranged from 4 months to 4 years; its average age was 2.3 years. Three patients(21.4%) were below 1 year, 2(14.3%) between 1 and 2 years, 5(35.7%) between 2 and 3 years, 4(28.6%) between 3 and 4 years of age. Male to female ratio was 1:1.3. DHEAS was significantly decreased in patients($11.1{\pm}6.0{\mu}g/dL$) more than controls($81.6{\pm}13.3{\mu}g/dL$)(P<0.05). Twenty-four hour urine free cortisol was significantly increased in patients($36.9{\pm}21.9{\mu}g/dL$) more than controls($13.6{\pm}5.5{\mu}g/dL$)(P<0.05). Ratio of DHEAS/F was decreased remarkably in patients($0.33{\pm}0.20$) more than controls($6.65{\pm}2.56$)(P=0.016). There was no difference between ratio of DHEAS/F and Harada score, but its ratio was very low in patients with coronary aneurysm. Conclusion : These data demonstrate that there are changes of DHEAS and cortisol in acute stage of KD and the dis-equilibrium between two steroids may be relevant in the T cell immune response induction of Kawasaki disease. These changes support the use of DHEAS/F ratio as one of the predictive factors of coronary arteries complication.

A Study on the Blood-Letting Therapy in Elementary Questions (("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究))

  • Lee, Jun-Geun
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.1
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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