• 핵의학기술
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• 제13권3호
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• pp.61-66
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• 2009

목적: 사구체여과율(Glomerular Filtration Rate, GFR)은 신장 기능의 평가, 의심되는 신장질환의 진단 및 만성적인 신질환에서의 질병의 경과 관찰에 중요한 지표가 되며 다양한 방법을 이용하여 측정할 수 있다. 본 연구에서는 Gates 방법으로 측정되는 사구체여과율, 혈청 크레아티닌을 기초로 한 Cockcroft-Gault (C-G), Modification of Diet in Renal Disease (MDRD) 공식으로 계산한 사구체여과율을 비교하고자 하였다. 실험재료 및 방법: 18세 이상의 다양한 신기능을 가진 217명(남자 127명, 여자 90명, 평균 연령 $51.3{\pm}16.9$세)을 대상으로 하였다. $^{99m}Tc$-DTPA GFR과 혈청 크레아티닌(Serum Cr)을 기초로 한 C-G공식, MDRD 공식으로 계산한 사구체여과율을 비교 분석하였다. 결과: $^{99m}Tc$-DTPA (Gates) GFR은 C-G공식(r=0.864, p<0.0001) 및 MDRD 공식(r=0.831, p<0.0001)과 각각 유의한 상관관계가 있었고, C-C 공식과 MDRD 공식을 이용한 사구체 여과율 사이에도 상관관계가 우수하였다(r=0.933, p<0.0001). 혈청 크레아티닌의 평균은 $3.0{\pm}3.1\;mg/dL$으로 정상 신기능(Scr<1.5mg/dL) 환자에서 $^{99m}Tc$-DTPA GFR (Gates)과 C-G공식(p<0.0001), MDRD 공식(p<0.0001)은 통계적으로 유의하였다. 경증 신부전(Scr 1.5~4.0 mg/dL) 환자에서 Tc-99m DTPA (Gates) GFR과 C-G 공식(p=0.181), MDRD 공식(p=0.127)은 유의한 차이는 없었다. 중증 신부전(Scr>4.0 mg/dL) 환자에서 $^{99m}Tc$-DTPA (Gates) GFR과 C-G 공식(p<0.0001), MDRD 공식(p<0.0001)은 통계적으로 유의하였다. 결론: Gates 방법을 이용한 사구체여과율, C-G, MDRD 공식으로 계산한 사구체여과율 사이에 유의한 상관관계를 확인하였다. 정상 신기능 환자에서 $^{99m}Tc$-DTPA (Gates) GFR은 C-G, MDRD 공식보다 각각 낮았다. 경증 신부전 환자에서 $^{99m}Tc$-DTPA (Gates) GFR과 C-G 공식, MDRD 공식으로 계산한 사구체여과율은 유사하였고, 중증 신부전 환자에서 $^{99m}Tc$-DTPA (Gates) GFR은 C-G, MDRD 공식에 비해 사구체여과율을 과대평가하였다. 신기능의 정도에 따라 사구체여 과율을 평가하는데 있어 어떠한 측정방법이 더 우월한지는 분명하지 않다.

• 대한핵의학회지
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• 제25권2호
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• pp.227-236
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• 1991

Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ were R=0.9190 (p < 0.001), R: 0.9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p < 0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake $^{99m}Tc-DTPA$ had the best correlation with relative glomerular filteration rate of $^{99m}Tc-DTPA$ and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.

• 한국동물번식학회:학술대회논문집
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• 한국동물번식학회 2003년도 학술발표대회 발표논문초록집
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• pp.54-54
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• 2003

The activation of protooncogenes or the inactivation of their gene products may be a specific and effective functional study for human neoplasia. To examine this possibility, we have used the tetracycline regulatory system to generate transgenic mice that conditionally express the HccR-2 protooncogene in vivo. The new human cervical cancer protooncogene (HccR-2) was detected from cervical cancer cell line. To elucidate its biological functions, we generated transgenic mice that expressed the HccR-2 gene. The sustained expression of the HccR-2 transgene culminated chronic neutrophilic leukemia (CNL). CNL is a rare chronic myeloproliferative disorder that presents as a sustained, mature neutrophilic leukocytosis with few or no circulating immature granulocytes, the absence of peripheral blood monocytosis, basophilia, or eosinophilia, and infiltration of neutrophils at the liver, spleen and kidney. Mice expressing the HccR-2 and tetracycline-transactivating protein (tTa) transgene were found to have altered myeloid development that was characterized by increased percentages of mature neutrophil and band form neutrophil in the peripheral blood, liver and spleen. Activation of the transgene causes CNL. In our model, expression of HccR-2 transgene mice was similar in many respects to the human CNL. This model will be valuable not only for investigating the biological properties of the HccR-2 and other protooncogenes in vivo but also for analyzing the mechanism involved in the progression of CNL.

• Pediatric Infection and Vaccine
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• 제27권2호
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• pp.83-89
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• 2020

목적: A군 사슬알균은 소아 환자들에 있어서 흔한 감염원으로 다양한 임상양상을 보인다. 급성편도염이나 피부 및 연조직 감염이 흔하며 상당한 이환율과 사망률을 동반하는 혈류감염 또한 발생할 수 있다. 본 연구는 국내 소아 A군 사슬알균 혈류감염 환자들의 임상양상과 치료 결과를 확인하고자 하였다. 방법: 이 연구는 단일기관의 후향적 연구로, 2000년 1월부터 2016년 12월까지 A군 사슬알균 혈류감염으로 입원치료 받은 18세 이하 소아 환자들을 대상으로 하였다. 균혈증 발생시 임상양상, 기저질환, 중환자실 치료 여부, 그리고 균주의 항생제 감수성을 조사하였다. 결과: 19명에서 A군 사슬알균 혈류감염이 확인되었다. 10명(53%)이 남자였으며 연령의 중앙값은 7.4세였다(범위, 0.3-17.4세). 14명(74%)의 환자들이 만성 기저질환을 가지고 있었다. 5명(26%)은 면역저하(백혈병 및 만성신질환) 환자였다. 8명(42%)이 림프낭종, 혈관종, 정맥 기형 등 림프관 및 혈관 기형이 있었으며 그 중 7명은 발열과 병변부 국소 염증소견이 있었다. 3명(16%)의 환자들에게 폐렴이 발생했고 이 중 2명은 인공호흡기 치료를 받았다. 환자들의 30일째 사망률은 6% (1/19)였으며 해당 환자는 균혈증을 동반한 폐렴으로 사망하였다. 모든 검출된 A군 사슬알균은 페니실린에 감수성을 보였다. 15균주(79%)는 에리스로마이신과 클린다마이신에 감수성을 보였다. 결론: 본 연구에서 A군 사슬알균 혈류감염이 발생한 소아 환자들의 임상양상을 분석하였다. A군 사슬알균은 소아에 있어 균혈증을 유발할 수 있는 심각한 감염의 원인균으로 고려가 필요하다.

• 한국임상약학회지
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• 제22권2호
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• 대한한의학방제학회지
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• 제19권1호
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• pp.1-22
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• 2011

Objectives : This study was performed to investigate applications of 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex in Dongeuibogam. Methods : 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex which have been used separately or concurrently in Oriental Medicine for a long time as a treatment for various disease in Dongeuibogam were studied through order of frequency, symptoms, dosages, and etc. Results : 1. 19(15.57%) prescriptions are recorded in fatigue chapter, 11(9.02%) in mental or emotional disorder as a result of repressed anger or stress chapter, 9(7.38%) in urine and cough chapters respectively and 8(6.56%) in eyes, ears and glycosuria chapters respectively, which are arranged in order of frequency. 2. Burning stress resulted from Yin deficiency treat herbs are ranked top, Yin deficiency treat herbs, dim eyes, Yin-yang deficiency treat herbs, kidney function deficiency treat herbs are ranked in order of frequency among 78 symptoms in prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 3. The dosages of Anemarrhenae Rhizoma which is more used than Phellodendri Cortex are ranged from 5 puns:4 puns ~ 2 nyangs:1 nyang. 1 jeon:5 puns is recorded 3(30.00%), 1 jeon:7 puns is 2 times(20.00%), the others are 1 (10.00%) used among 10 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 4. The dosages of Anemarrhenae Rhizoma which is used same amount Phellodendri Cortex are ranged from 3 puns each ~ 4 nyangs each, same amount each or unidentified dosages. Same amount each or unidentified dosages each is recorded 36 times(38.71%), 5 puns each is 15 times(16.85%), 1 nyang each is recorded 12 times(13.48%), 0.7 jeon each is recorded 7 times (7.87%) and 1 jeon each is recorded 6 times(6.74%) used among 89 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 5. The dosages of Anemarrhenae Rhizoma which is less used than Phellodendri Cortex are ranged from 3 puns:1 jeon ~ 4 nyangs:8 nyangs. 1 nyang:2 nyangs is recorded 4(17.39%), 0.5 jeon:1 jeon is 3(13.40%) each, the others are 1 time(4.35%) used among 23 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 6. The less using dosage of Anemarrhenae Rhizoma and Phellodendri Cortex has a more percentage of decoctions groups, The more using dosage of Anemarrhenae Rhizoma and Phellodendri Cortex has a more percentage of the other groups except decoctions. The less using prescriptions have an effects of controlling yin and blood deficiency, enhancing Qi, etc, as a whole. The more using prescriptions as a form of compound powder have an effects in incurableness disease, chronic diseases, and etc. Conclusions : The 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex in Dongeuibogam are mainly composed of Gamree-hwan, Samool-tang, Naebo-hwan, Sagoonja-tang and Gobangpoong-tang, and etc.

• 대한간호학회지
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• 제17권3호
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• pp.204-217
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• 1987

It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t＝-5.29, df＝62, p＝.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t＝2.72, df＝62, p＝.009, for diastolic blood pressure t＝1.95, df＝62, p＝.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r＝-.2981, p＝.008, for diastolic pressure r＝-.1720, p＝.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

• 한국임상수의학회지
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• 제41권2호
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• pp.71-78
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• 2024

Changes in elimination behavior, including urination and defecation, are common clinical signs of numerous disorders in cats. Therefore, this study attempted to automatically measure the elimination behavior of cats using the litter box and develop an early warning system for the guardian in case of abnormalities. To construct an early warning system for abnormal changes through cat elimination behavior, it consisted of a litter box, an automatic sensor for data collection and data wifi transmission, a server for data analysis, and a mobile phone app for result transmission and early warning. To establish the reference interval (RI), the elimination behavior was monitored for more than 2 weeks using a motion sensor within a litter box in 37 healthy cats and 19 diseased cats. The data were expressed as daily total visits, daily total stay duration, average stay duration per elimination, weekly total visits, and weekly total stay duration. Healthy cats showed median daily total visits of 3 times/day (RI 1.0-7.0) and daily total stay duration of 192 s/day (RI 8.0-452.0). For weekly data, the median total visits were 20 times/week (RI 3.0-35.25) and the median total stay duration was 1,147 s/week (RI 80.0-2,249.5). The average stay duration per elimination was 59 s/elimination (RI 4.67-132.0). Diseased cats showed more frequent elimination behavior than healthy cats (p < 0.001). Otherwise, for each elimination, diseased cats had shorter stay durations than healthy cats (p < 0.001). This study established the RIs of elimination behavior parameters (frequency and duration) in healthy cats. The present study might help guardians and veterinarians detect changes in elimination behaviors in diseased cats at an early stage.

• Childhood Kidney Diseases
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• 제4권2호
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• pp.144-153
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• 2000

목 적 : 만성신부전 완자에서 1/scr, log Scr을 연속적으로 측정하여 신부전의 진행을 예측하고 있으나 연령에 따라 creatinine 생성율의 차이가 있는 소아에서는 정확한 진행예측에 어려움이 있다. 신장(height, Ht) 은 creatinine 생성율에 관여하는 중요한 인자이므로 따라서 저자들은 1/scr에 신장 (height, ht)을 도입한 Ht/Scr과 1/scr, log Scr을 연속적으로 측정하여 만성 신부전의 진행 예측도의 정확성을 비교하고저 하였다. 방 법 : 말기신부전으로 진행된 환아 63 명을 대상으로 혈청 크레아티닌 (Scr) 이 2 mg/dl에서 5 mg/dl 될 때까지 매 환자에서 1/Scr, log Scr, Ht/Scr을 연속적으로 측정하여 이들로부터 회기방정식을 구하여 Scr 이 10 mg/dl 이상인 시기를 예견하였다. 예측오차는 Scr 이 10 mg/dl 이상인 예측시기에서 실제시기를 뺀 것으로 하고 세군 간의 예측오차를 비교함으로써 만성신부전증 진행 예측의 정확도를 관찰하였다. 결 과 : 1) Ht/Scr 의 예측오차는 0.01 개월로 1/Scr, log Scr 의 예측오차인 2 개월, 10.6 개월보다 적었다(P<0.0001). 2) 선천성 신질환 환아의 Ht/Scr의 예측오차는 1.2 개월로 1/Scr, log Scr 의 예측오차인 3.2 개월, 8.2 개월보다 적었다 (p<0.000l). 사구체신염 환아의 경우 Ht/Scr, l/Scr, Ht/Scr의 예측오차는 각각 0.9 개월, 0.5 개월, 9.9 개월이었고 통계적인 차이는 없었다. 3) 13 세이전의 경우는 Ht/Scr 의 예측오차가 가장 적었고 그 이후 연령의 경우는 1/Scr의 예측오차가 적었으나 Ht/Scr과 통계적인 차이는 없었다. 4) Log Scr의 예측시기는 실재시기보다 늦었다. 결 론 : 소아 만성신부전 환아에서 시간에 따른 혈청 크레아티닌의 역수와 신장의 변화를 연속적으로 관찰함으로서 신부전의 진행 및 투석시기를 정확히 예측할 수 있었다.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.176-188
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• 2009

목적 : 복막투석요법은 말기 신부전 환아에서 신이식 다음으로 추천되는 신대체 요법으로 현재 말기 신부전 환아들의 장기 생존율 향상으로 복막투석요법 환아 수가 점차 증가하고 있다. 현재 한국 내 복막투석요법 소아에 대한 현황을 파악하고자 이번 연구를 시행하였다. 방법 : 2008년 5월 국내 4개 대학병원을 대상으로 전자우편 설문조사를 시행하였고 현재 3개월 이상 복막투석 중인 103명의 소아를 대상으로 자료를 분석하였다. 결과 : 대상 환아 103명의 남녀비는 1.6:1로 남아가 많았고, 평균 연령은 $11.5{\pm}4.9$세(0-19세), 투석시작 전 말기 신부전의 원인 중 원발성 사구체 질환이 34%로 가장 많았다. 복막투석의 형태는 지속적 외래 복막투석법이 42.7%로 가장 많았고, 주간 전체 Kt/V는 $2.1{\pm}0.7$ (0.3-4.1), 복막평형검사상 저 투과성이 36.8%, 저평균 투과성이 31.6%으로 가장 많은 비율을 차지했다. 체중 표준편차점수(Z-score)는 $-1.00{\pm}1.20$(-4.54-+2.50), 신장 표준편차점수(Z-score)는 $-1.55{\pm}1.65$(-9.42-+1.87)였고, 성장호르몬은 24.3%에서 투여 중이었다. 38.8%의 환아에서 이완기 혹은 수축기 혈압 95 백분위수 이상의 고혈압을 보였고, 64.0%의 환아가 항고혈압제 투여 중이었다. 평균 혈청 혈색소는 $10.5{\pm}1.4$ g/dL, 평균 혈청 칼슘은 $9.7{\pm}0.7$ mg/dL, 평균 혈청 인은 $5.4{\pm}1.4$ mg/dL, 평균 부갑상선 호르몬은 $324.2{\pm}342.8$ pg/mL였다. 결론 : 국내 복막투석요법 소아에서 원발성 사구체 질환이 소아 말기 신부전의 가장 흔한 원인이고, 지속적 외래 복막투석법이 가장 흔히 사용되는 복막투석 형태이며, 복막평형검사상 저 투과성과 저평균 투과성이 가장 많았다. 대부분의 환아가 적절한 신장과 체중을 유지하고 있었으나 저신장 환아의 경우 성장 호르몬 치료가 제대로 이루어지지 않고 있었고 여전히 많은 환아에서 빈혈과 고혈압이 관찰되었다. 혈청 칼슘과 인은 비교적 정상범위를 유지하고 있으나 많은 환아가 이차성 부갑상선 기능 항진증을 보였다.