• Title/Summary/Keyword: Age of initiation

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Change of interictal epileptiform discharges after antiepiletic drug treatment in childhood epilepsy (소아 간질 환자에서 항경련제 치료 후 간질파의 변화)

  • Kim, Mun-Ju;Nam, Sang-Ook
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.560-564
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    • 2010
  • Purpose : Electroencephalography (EEG) findings can play a critical role in a variety of decisions, including initiation and withdrawal of antiepileptic drugs (AEDs) therapy. Interictal epileptiform discharges (IEDs) are predictor of recurrent seizures. We investigated IEDs in EEG after AED therapy and related factors in epileptic children. Methods : The subjects were 257 children [151 males and 106 females; age, 6.79 (3.40) years; duration of therapy, 2.48 (1.85) years] diagnosed with epilepsy at the Department of Pediatrics, Pusan National University Hospital between January 2001 and December 2007, who received AEDs for more than 6 months. EEG was performed at the intervals of 6-12 months. We divided patients into 4 groups according to IED detection before and after AEDs treatment. Related clinical factors, including gender, age at the start of treatment, seizure type, cause of seizure, AED frequency, seizure control, duration of AED therapy, and background activity were investigated in the 4 groups. Results : Generalized epilepsy was relatively frequen in patients who did not show IEDs in last follow-up EEG. There were no clinically significant differences according to gender, age at the start of treatment, cause of seizure, AED frequency, seizure control, duration of AED medication, and background activity in the 4 groups ($P$>0.05). Conclusion : IEDs changed after AED treatment in one-third of the patients. Generalized epilepsy is positive factor for negative IEDs in last follow-up EEG.

Effects of Quinone Reductase Induction and Cytotoxicity of the Angelica radix Extracts (당귀 추출성분의 세포독성 효과와 Quinone Reductase 유도활성 효과)

  • 배송자;한은주;노승배
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.29 no.1
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    • pp.147-152
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    • 2000
  • Various lines of evidence suggest that dietary components protect the initiation of carcinogenesis. In this study, the ethanol extracts (AGE) and the methanol and hexane partition layers (AGEM, AGEH) of the Angelica radix were screened for their cytotoxic effects using the MTT assay on HepG2, HeLa, MCF7 and SW626 cells and for their ability to induce quinone reductase (QR) in HepG2 cells. AGEM and AGEH of the Angelica radix showed the strongest cytotoxic effects on HepG2 and HeLa cells. Cell growth was inhibited by 99.8% and 99.8% on HepG2 cells and 99.3% and 99.4% on HeLa cells, at dose of $100\;\mu\textrm{g}/ml$ of AGEM and AGEH extracts respectively. AGE and AGEH significantly induced QR activities in the HepG2 cells. The QR activities of HepG2 cells grown in the presence of AGE, AGEH, and AGEM at the concentration of $50\;\mu\textrm{g}/mL$ were 313.5, 273.3 and 133.3 nmol/min/mg protein, respectively. Therefore, based on these studies, Angelica radix may be developed into a potentially useful cancer chemopreventive agent.

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Dietary Supplementation with Acanthopanax senticosus Extract Modulates Cellular and Humoral Immunity in Weaned Piglets

  • Kong, Xiangfeng;Yin, Yulong;Wu, Guoyao;Liu, Hejun;Yin, Fugui;Li, Tiejun;Huang, Ruilin;Ruan, Zheng;Xiong, Hua;Deng, Zeyuan;Xie, Mingyong;Liao, Yiping;Kim, Sungwoo
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.9
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    • pp.1453-1461
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    • 2007
  • This study was conducted to test the hypothesis that dietary supplementation with an herbal extract of Acanthopanax senticosus (AS) enhances the immune response in weaned piglets. Sixty piglets weaned at 21 days of age were randomly assigned to 3 treatment groups representing the addition of 0 or 1 g/kg of the AS extract or 0.2 g/kg of colistin (an antibiotic) to maize- and soybean meal-based diets (n = 20 per group). On days 7, 14 and 28 after initiation of the addition, total and differential counts of leucocytes, proliferating activity of peripheral lymphocytes, serum levels of immunoglobulins (Ig) and cytokines and the spleen index were determined. The AS extract decreased (p<0.05) the number of neutrophils on days 7 and 28 in comparison with the control group and reduced (p<0.05) serum interleukin-$1{\beta}$ level on day 28 compared with the other 2 groups. Dietary supplementation with the AS extract increased (p<0.05) the lymphocyte/leukocyte ratio on day 28 compared with the control group and increased the proliferating activity of lymphocytes on days 14 and 28 compared with the other 2 groups. The AS extract increased (p<0.05) the serum content of IgG on day 7 and of IgG and IgM on day 28 compared with the other 2 groups, as well as increasing the serum content of tumor necrosis factor on day 7 and spleen index on days 7 and 28 compared with the control group. Collectively, these findings suggest that the AS extract as a dietary additive enhances the cellular and humoral immune responses of weaned piglets by modulating the production of immunocytes, cytokines and antibodies.

Comparison of Extracorporeal Cardiopulmonary Resuscitation with Conventional Cardiopulmonary Resuscitation: Is Extracorporeal Cardiopulmonary Resuscitation Beneficial?

  • Lee, Seung-Hun;Jung, Jae-Seung;Lee, Kwang-Hyung;Kim, Hee-Jung;Son, Ho-Sung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.318-327
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    • 2015
  • Background: With improvements in cardiopulmonary resuscitation (CPR) techniques, the quality and the effectiveness of CPR have been established; nevertheless, the survival rate after cardiac arrest still remains poor. Recently, many reports have shown good outcomes in cases where extracorporeal membrane oxygenation (ECMO) was used during prolonged CPR. Accordingly, we attempted to evaluate the impact of extracorporeal cardiopulmonary resuscitation (ECPR) on the survival of patients who experienced a prolonged cardiac arrest and compared it with that of conventional CPR (CCPR). Methods: Between March 2009 and April 2014, CPR, including both in-hospital and out-of-hospital CPR, was carried out in 955 patients. The ECPR group, counted from the start of the ECPR program in March 2010, included 81 patients in total, and the CCPR group consisted of 874 patients. All data were retrospectively collected from the patients' medical records. Results: The return of spontaneous circulation (ROSC) rate was 2.24 times better in CPR of in-hospital cardiac arrest (IHCA) patients than in CPR of out-of-hospital CA (OHCA) patients (p=0.0012). For every 1-minute increase in the CPR duration, the ROSC rate decreased by 1% (p=0.0228). Further, for every 10-year decrease in the age, the rate of survival discharge increased by 31%. The CPR of IHCA patients showed a 2.49 times higher survival discharge rate than the CPR of OHCA patients (p=0.03). For every 1-minute increase in the CPR duration, the rate of survival discharge was decreased by 4%. ECPR showed superiority in terms of the survival discharge in the univariate analysis, although with no statistical significance in the multivariate analysis. Conclusion: The survival discharge rate of the ECPR group was comparable to that of the CCPR group. As the CPR duration increased, the survival discharge and the ROSC rate decreased. Therefore, a continuous effort to reduce the time for the decision of ECMO initiation and ECMO team activation is necessary, particularly during the CPR of relatively young patients and IHCA patients.

The Clinical Investigation of Gastric Lavage in Patients with Acute Poisoning (급성 약물 중독 환자에서 위세척의 치료 실태)

  • Ok Taek Geun;Cho Jun Hwi;Park Chan Woo;Cheon Seung Whan;Lee Seung Yong;Kim Sung Eun;Choi Ki-Hoon;Hae Ji Hoon;Seo Jeong Yeul;Ahn Hee Cheol;Ahn Moo Eob;Cho Byung Ryul;Kim Yong Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.22-26
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    • 2005
  • The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.

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p63 Cytoplasmic Aberrance is Associated with High Prostate Cancer Stem Cell Expression

  • Ferronika, Paranita;Triningsih, F.X. Ediati;Ghozali, Ahmad;Moeljono, Abraham;Rahmayanti, Siti;Shadrina, Arifah Nur;Naim, Awang Emir;Wudexi, Ivan;Arnurisa, Alfa Monica;Nanwani, Sandeep Tarman;Harijadi, Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1943-1948
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    • 2012
  • Introduction: Prostate cancer in Indonesia is the $3^{rd}$ ranking cancer among males and the $5^{th}$ rank for their cancer mortality. Prognostic markers that can identify aggressive prostate cancer in early stages and help select appropriate therapy to finally reduce the mortality are therefore urgently needed. It has been suggested that stem cells in the prostate gland have a role in initiation, progression, and metastasis of cancer, although controversy continues to exist. Maintenance of normal stem cell or reserve cell populations in several epithelia including prostate has been shown to be regulated by p63 and alteration of p63 expression is considered to have an oncogenic role in prostate cancer. We hypothesize that the expression of cytoplasmic aberrance of p63 is associated with high ALDH1A1 expression as a cancer stem cell marker, thus leading to progression of prostate cancer. Methods: Using a cross-sectional study during two years (2009-2010), a total of 79 paraffin embedded tissues of benign prostatic hyperplasia, PIN prostatic intraepithelial neoplasia, low and high Gleason score prostate cancer were investigated using immunohistochemistry. Associations between cytoplasmic p63 and ALDH1A1, as well as with pathological diagnosis, were analyzed by Chi-Square test using SPSS 15.0. Links of both markers with cell proliferation rate (KI-67) and apoptotic rate (cleaved caspase 3) were also analyzed by Kruskal-Wallis test. Results: The mean age of patient at the diagnosis is 70.0 years. Cytoplasmic aberrance of p63 was associated with ALDH1A1 expression (p<0.001) and both were found to have significant relationships with pathological diagnosis (including Gleason score), (p=0.006 and p<0.001 respectively). Moreover, it was also found that higher levels of cytoplasmic p63 were significantly associated with the frequency of proliferating cells and cells undergoing apoptosis in prostate cancers (p=0.001 and p=0.016 respectively). Conclusion: p63 cytoplasmic aberrance is associated with high ALDH1A1 expression. These components are suggested to have an important role in prostate cancer progression and may be used as molecular markers.

Extracorporeal Cardiopulmonary Resuscitation: Predictors of Survival

  • Kim, Dong Hee;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.273-279
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    • 2016
  • Background: The use of extracorporeal life support (ECLS) in the setting of cardiopulmonary resuscitation (CPR) has shown improved outcomes compared with conventional CPR. The aim of this study was to determine factors predictive of survival in extracorporeal CPR (E-CPR). Methods: Consecutive 85 adult patients (median age, 59 years; range, 18 to 85 years; 56 males) who underwent E-CPR from May 2005 to December 2012 were evaluated. Results: Causes of arrest were cardiogenic in 62 patients (72.9%), septic in 18 patients (21.2%), and hypovolemic in 3 patients (3.5%), while the etiology was not specified in 2 patients (2.4%). The survival rate in patients with septic etiology was significantly poorer compared with those with another etiology (0% vs. 24.6%, p=0.008). Septic etiology (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.49 to 5.44; p=0.002) and the interval between arrest and ECLS initiation (HR, 1.05 by 10 minutes increment; 95% CI, 1.02 to 1.09; p=0.005) were independent risk factors for mortality. When the predictive value of the E-CPR timing for in-hospital mortality was assessed using the receiver operating characteristic curve method, the greatest accuracy was obtained at a cutoff of 60.5 minutes (area under the curve, 0.67; 95% CI, 0.54 to 0.80; p=0.032) with 47.8% sensitivity and 88.9% specificity. The survival rate was significantly different according to the cutoff of 60.5 minutes (p=0.001). Conclusion: These results indicate that efforts should be made to minimize the time between arrest and ECLS application, optimally within 60 minutes. In addition, E-CPR in patients with septic etiology showed grave outcomes, suggesting it to be of questionable benefit in these patients.

An Outbreak of Tsutsugamushi Disease in Vicinity of Taegu City and Kyungpook Province in 1988 (1988년 가을 대구.경북 및 그 인접지역에서 발생한 쯔쯔가무시(Tsutsugamushi)병 26례에 대한 임상적고찰)

  • Kweon, Young-Su;Kim, Jong-Ho;Shon, Myung-Weon;Lee, Kwan-Ho;Hyun, Myung-Su;Chung, Moon-Kwan;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.31-41
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    • 1989
  • Since the first cases of tsutsugamushi disease reported in Korea in 1986. many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are ; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills(88%), myalgia(65%), headache(54%), nausea and vomiting(31%), and abdominal pain(27%). The eschar was detected on lower part of body in most of cases. and more frequently in male(M : F 100 vs 58%). 4. Patients were treated with tetracyclines(TC) and/or chlorampenicol(CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1 days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 cases of shock. and all cases were recovered without any sequlae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

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A Study on the Occurrences and Policy Development for Accident Prevention (한국의 사고발생 실태와 사고예방을 위한 정책 연구)

  • 이경자;이정렬;강규숙;한정석
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.362-371
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    • 1995
  • There is no national system to manage, evaluate, and analyse the information about accidents, even though it is necessary for accident prevention policies and health promotion of the general public. The existing studies are, also limited as they focus only on particular group(for example : inpatients, emergency room patients) or on particular geographic areas. Thus the results of the studies cannot be ap-plied to the general public. In order to overcome these limitations, this research focuses on data collection and analysis from accident information for the general population. By providing the analysis on types and causes af accidents, this research aims to produce the basic data necessary for accident prevention policy development. The specific aims of this research are to : 1. Analyse the actual occurrences and characteristics of accidents. 2. Suggest for the accident prevention policies and safety education. Accident report form three major newspaper printed in Korea between January 1, 1989 and December 31, 1993 were collected, and the cause, place, time, and personal injury related to the accidents were classified and then analyzed by de-scriptive statistics. The results of this research conclude : 1. The number of accidents reported by the three newspapers were 2155. 2. The highest proportion of accidents were as follows ; occurred during the June-August(31.2%), Sunday(24.8%), and 5 p.m. (7.6%) of the day. 3. The highest proportion of the accident occurred in Seoul(33. l%), Kyunggi province(14.5%), Kangwon province (7.8%), and Kyungnam prov-ince(6.7%) were next highest. 4. The main causes include car accidents(32.4%), drowning(10.9%), falls(8.8%), explosion(7.1%), and poisoning(5.8%). 5. Slightly more than half of injuries(50.5%) and about two fifths of deaths(40.3%) were caused by car accidents. Therefore, the most serious type of accidents were car accidents. 6. The number of males in accidents were almost three times higher than that of females(males 72.3%, females : 27.7%). 7. The age group from 10 to 19 years old represents the highest proportion(21%) of accidents. 8. The number of the accidents in Korea, based on the information collected from the newspapers, is estimated to be 14, 367 per year. The number of in-juries is estimated to be 88, 480 persons, and the number of deaths 29, 007 respectively. It is said that ninety percent of accidents can be prevented. Several accidents prevention policies are suggested here. 1. Safety education should be done more actively throughtout life, with special emphasis on safety education for children. 2. Safety measures for children(halmets for cycling, children car seats, seats belts, and so on) should be emphasized. 3. An injury surveillance system should be initiated. The initiation of injury reporting system in each factory and school could contribute considerably to the reduction of accidents.

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Subclinical Hypothyroidism in Patients with Bipolar Disorders Managed by Lithium or Valproic Acid (리튬 또는 발프로산으로 치료받은 양극성장애 환자의 무증상 갑상선저하증)

  • Choi, Hyeon Man;Chang, Jae Seung;Kim, Jayoun;Kim, Jeong Hyun;Choi, Jung Eun;Ha, Tae Hyon;Ha, Kyooseob
    • Korean Journal of Biological Psychiatry
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    • v.20 no.4
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    • pp.151-158
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    • 2013
  • Objectives To investigate the pattern of subclinical hypothyroidism (SCH) in patients with bipolar disorders managed by lithium or valproic acid. Methods The study participants were 106 patients with DSM-IV bipolar disorders receiving planned maintenance treatment at the Mood Disorders Clinic of Seoul National University Bundang Hospital (aged between 17 and 64, mean duration of follow-up = 875.65 days). Using the bipolar disorder registry, thyroid function data were analyzed to assess the frequency of and the risk factors for SCH in patients managed by lithium (n = 64) or valproic acid (n = 42) for more than 5 months. Results Overall frequencies of SCH were 20.3% (13/64) in the lithium group, 14.3% (6/42) in the valproic acid group, and between the two groups there is no difference (p = 0.43). No differences were observed in the potential risk factors for SCH between the two groups including age, sex, subtype of bipolar disorder, baseline TSH, and concomitant antipsychotic use. In cases with SCH, thyroid-stimulating hormone (TSH) showed a tendency to increase at 3 month after the initiation of lithium or valproic acid. A gradual increase in the number of patients showing SCH was found within the first 3 years of medication. Conclusions With regular monitoring and careful assessment, there was no difference in the risk of SCH between lithium and valproic acid maintenance. The risk of mood stabilizer-associated SCH may gradually increase within 3 years following the commencement of medication, thereby mandating close monitoring for the first 3 years of treatment. Further studies with large sample size would be needed to confirm these findings.