• 제목/요약/키워드: Dosing

검색결과 529건 처리시간 0.02초

당뇨병성 말초혈관병증 환자에게 Beraprost Sodium이 미치는 영향에 대한 적외선 체열검사를 통한 연구 (Effects of Beraprost Sodium Evaluated by Digital Infrared Thermal Imaging in Diabetic Patients with Peripheral Arterial Disease)

  • 박현우;소재완;박성현;정재중
    • 대한족부족관절학회지
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    • 제22권3호
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    • pp.105-110
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    • 2018
  • Purpose: This study examined the effects of beraprost sodium on digital infrared thermal images in patients with peripheral arterial disease caused by type 2 diabetes mellitus. Materials and Methods: Twenty-five diabetic patients with peripheral arterial disease were treated with beraprost sodium in a prospective, multicenter, cohort study from February 2013 to December 2014. Beraprost sodium ($40{\mu}g$) was administered orally 3 times daily ($120{\mu}g/day$) for 6 months. The visual analogue scale (VAS) and digital infrared thermal imaging (DITI) were performed to compare the blood flow improvement between before and after dosing. Results: Among the 25 patients included in the evaluation, 22 patients completed the study. A significant increase in body temperature was observed in the front and left side, particularly in the plantar side in DITI compared to that before and after administration. An increase in body temperature was observed at the frontal part from $28.1^{\circ}C{\pm}2.3^{\circ}C$ to $29.1^{\circ}C{\pm}2.1^{\circ}C$ (p=0.021), at the left side from $27.8^{\circ}C{\pm}2.4^{\circ}C$ to $28.6^{\circ}C{\pm}1.9^{\circ}C$ (p=0.028), at the plantar part at $24.0^{\circ}C{\pm}1.5^{\circ}C$, and at the plantar part at $27.1^{\circ}C{\pm}2.4^{\circ}C$ (p<0.01). The VAS decreased significantly from $5.4{\pm}1.3$ to $2.7{\pm}2.0$ after 6 months of treatment (p<0.01). Conclusion: Beraprost sodium is a safe and easy-to use oral medication for diabetes peripheral arterial disease. It can be expected to increase the blood flow and decrease the lower extremity pain statistically after being taken for 6 months.

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea

  • Jun, Jin-Su;Seo, Ji-Hyun;Park, Ji-Sook;Rhee, Kwang-Ho;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권5호
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    • pp.417-430
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    • 2019
  • The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

Determination of dietary Ca and P levels and their equivalence values of phytase and vitamin D3 for improved growth performance in weanling pigs

  • Ogola, Oketch Elijah;Choi, Jun Seung;Hong, Jun Seon;Kim, Yu Bin;Nawarathne, Shan Randima;Yu, Myunghwan;Heo, Jung Min
    • 농업과학연구
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    • 제48권3호
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    • pp.397-412
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    • 2021
  • In Experiment 1, the impact of using diets sufficient in P on the performance of weaned piglet growth with or without a super dose of phytase was investigated. One hundred and twelve piglets were randomized into four treatments with 7 replicates (4 piglets·cage-1). Bodyweight (BW), daily gain (ADG), daily intake (ADFI) and feed conversion ratios (FCR) were measured over three weeks. Treatments included a positive control (PC) with a Ca : P ratio of 0.80 : 0.50%. and the negative control (NC) had a Ca : P ratio of 0.60 : 0.50%. The PC plus phytase was denoted as PC+, and the NC with the phytase diet was designated as NC+. The PC diet was formulated to meet or exceed the NRC (2012) standards for pigs weighing 7 - 25 kgs. Better results were obtained with the PC diet (p > 0.1) compared to the NC diet. The super dose of phytase in the PC+ diet significantly improved the overall FCR (p < 0.1). For Experiment 2, the impact of different calcium (Ca)/phosphorous (P) ratios with or without supplementation of vitamin D3 was determined. Ninety-six piglets were randomized into four treatments with 6 replicates (4 piglets·cage-1). The PC, NC1 and NC2 diets had ratios of 0.80 : 0.50, 0.80 : 0.45, and 0.60 : 0.45%, respectively. The fourth diet (PCV) was the PC diet fortified with vitamin D3. Improved results were observed with the PC diet (p > 0.1) compared to the NC diets. Supplementing dietary 25-OH-D3 in the PCV diet led to numerically higher ADG and ADFI scores with lower FCR values at the early nursery stage (p = 0.0044), but the vitamin supplement did not significantly influence the growth.

Denosumab (Prolia®)의 투여 간격 및 칼슘·비타민 D 복합제제 처방 여부에 따른 임상적 결과 평가 (Evaluation of Clinical Outcomes by Therapeutic Dosing Interval of Denosumab (Prolia®) and Calcium-Vitamin D Prescriptions)

  • 김유경;김정현;도현정;정영미;이정화;이주연;김은경
    • 한국임상약학회지
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    • 제32권3호
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    • pp.185-190
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    • 2022
  • Background: Denosumab (Prolia®) is administered every 6 months for osteoporosis treatment. Co-administration of calcium and vitamin D is required to minimize hypocalcemia risk. We evaluated clinical outcomes based on the administration interval of denosumab and co-prescription with calcium-vitamin D combination products. Methods: A retrospective study was conducted using electronic medical records from 668 patients who started denosumab therapy between January 1 and December 31, 2018, at Seoul National University Bundang Hospital. Clinical outcomes, as measured by changes in T-score, were evaluated by the intervals and concurrent prescriptions with calcium-vitamin D combination products. Results: Of the 668 patients, 333 patients met the eligibility criteria. These patients were divided into two groups based on appropriateness of the administration interval: "Appropriate" (304 patients, 91.3%) and "Inappropriate" (29 patients, 8.3%). T-score changes were significantly higher in the "Appropriate" than in the "Inappropriate" group (0.30±0.44 vs. 0.13±0.37, p=0.048). At the beginning of the treatment, 221 patients (66.4%) were prescribed calcium-vitamin D combination products, but the changes in T-scores were not significantly different by the prescription status of the product (0.29±0.46 vs. 0.28±0.38, p=0.919). Conclusion: T-scores were significantly improved in patients with appropriate administration intervals. No significant changes in T-scores were observed by the prescription status with calcium-vitamin D combination products. For optimal treatment outcomes, prescribers should encourage adherence to the approved prescription information on dosage and administration, and pharmacists should provide medication counseling for patients.

Single Oral Dose Toxicity Test of Persicae Semen Aqueous Extracts in Mice

  • Cho, Hun-Bum;Park, Ji-Ha;Seo, Bu-Il;Cho, Su-Yeon;Park, Kyu-Ryul;Choi, Seung-Hoon;Han, Chang-Kyun;Song, Chang-Hyun;Park, Soo-Jin;Ku, Sae-Kwang
    • 대한본초학회지
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    • 제28권3호
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    • pp.17-24
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    • 2013
  • Objectives : This study was to evaluate the single dose toxicity of Persicae Semen (PS) in ICR mice. Methods : Aqueous extracts of PS (Yield = 18.60%) were administered as an oral dose of 2,000, 1,000 and 500 mg/kg (body weight) according to the recommendation of Korea Food and Drug Administration (KFDA) guidelines (2009-116, 2009). Animals were monitored for the mortality and changes in body weight, clinical signs and gross observation during 14 days after dosing, upon necropsy; organ weight and histopathology of 12 principle organs were examined. Results : Amygdalin contents in PS aqueous extracts were detected as $32.50{\pm}5.96{\mu}g/ml$. We could not find any PS extracts treatment related mortalities, clinical signs, changes on the body and organ weights, gross and histopathological observations up to 2,000 mg/kg in both female and male mice, except for transient and slight loss of locomotion detected in female and male mice treated with 2,000 mg/kg. In addition, pharmacological immunomodulatory effects related findings were also demonstrated in 2,000mg/kg treated female and male mice as hypertrophy and hyperplasia of lymphoid cells in the submandibular lymph nodes. Conclusions : Based on the results of this experiment, the approximate lethal dose (ALD) of PS extracts after single oral treatment in female and male mice were considered above 2,000 mg/kg, respectively. It should be carefully used in clinics because the possibilities of respiratory or neurological disorders were observed when administered over 2,000 mg/kg of PS extract related to amygdalin.

Effects of stress after road transportation and oral administration of chromium and meloxicam on plasma cortisol concentrations and behavior in dairy calves

  • Jung, Da Jin Sol;Lee, Jaesung;Kim, Do Hyun;Beak, Seok-Hyeon;Hong, Soo Jong;Jeong, In Hyuk;Yoo, Seon Pil;Lee, Jin Oh;Cho, In Gu;Fassah, Dilla Mareistia;Kim, Hyun Jin;Baik, Myunggi
    • Animal Bioscience
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    • 제35권3호
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    • pp.503-510
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    • 2022
  • Objective: This study was performed to determine the effects of stress after road transportation and oral administration of chromium and meloxicam on growth performance, plasma cortisol, serum metabolites, and behavior in dairy calves. Methods: A total of 50 Holstein heifers (average body weight [BW]: 172±4.19 kg; average age: 5.53±0.12 months) were randomly assigned to five groups including NL (not transported + D-lactose; 1 mg/kg BW), TL (transported + D-lactose; 1 mg/kg BW), TC (transported + chromium; 0.5 mg/kg dry matter [DM] feed), TM (transported + meloxicam; 1 mg/kg BW), and TMC (transported + combination of meloxicam and chromium; 1 mg/kg BW and 0.5 mg/kg DM, respectively). Doses of D-lactose monohydrate, meloxicam, and chromium were prepared for oral administration by suspension in 15 mL of water in a 20-mL dosing syringe. Blood was collected before transportation, immediately after 120 km of transportation (IAT), and at 6, 24, and 48 h after transportation. Results: Neither transportation nor administration of meloxicam and/or chromium affected (p = 0.99) average daily gain and feed intake. Plasma cortisol concentrations in the NL group (average 0.13 and 0.18 nmol/L, respectively) were lower (p<0.001) compared to the TL group (average 0.39 and 0.61 nmol/L, respectively) at IAT and 48 h after transportation. At 48 h after transportation, cortisol concentrations were lower (p<0.05) in the TC group (average 0.22 nmol/L) than in the TL group (average 0.61 nmol/L), and TC calves had similar cortisol concentrations to NL calves. Lying duration (min/d) was shorter (p<0.05) in the TL group than in the NL group at 2 d after transportation. Lying duration was longer (p<0.05) for the TC and TMC groups than for the TL group at 2 d after transportation. Conclusion: Transportation increased cortisol concentrations and affected lying behavior, while chromium administration reduced cortisol concentrations and changed lying behavior. Thus, chromium administration before transportation may be a viable strategy to alleviate stress elicited by road transportation.

선퇴 추출물의 Sprague-Dawley rat를 이용한 단회 경구 투여 독성시험 (Single Dose Oral Toxicity Study of Cicadidae Periostracum Extracts in Sprague-Dawley Rats)

  • 전병석;정희영;이수은;서윤수;김중선;남현화;이지혜
    • 대한본초학회지
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    • 제39권3호
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    • pp.107-114
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    • 2024
  • Objective : Cicadae Periostracum (CP), which is the discarded shell of the Cryptotympana atrata (Fabricius, 1775), is a recognized component of oriental medicine for treatment sore throat, itching, shock, sedation, edema. However, the safety and toxicity of CP have not yet been established. It has been reported that symptoms of addiction or side effects may occur in patients who take high doses of CP or who are hypersensitive to it. Therefore, we investigated the acute toxicity of an CP extracts in Sprague-Dawley (SD) rats. Methods : To study acute toxicity, five SD rats of each sex per group were treated with CP extracts at single doses of 0, 500, 1000, or 2000 mg/kg administrated by oral gavage, and body weight, clinical signs, and mortality were observed after dosing. At the end of 14-day observation period, all animals were sacrificed and complete hematological and macroscopic examinations were performed. Results : There were no dead animal and test article-related effects on body weight change or the gross finding. No toxicologically significant results were observed between control and treated groups in hematology. Although salivation related to stress at the highest dose was observed in clinical signs immediately after administration, it is considered to have no toxicological significance. Conclusion : As the results, we did not find any adverse effect at the dose levels of 500, 1000, or 2000 mg/kg in rats. The minimal lethal dose was considered to be over 2000 mg/kg body weight in rats.

Cefoperazone(T-1551)의 약리학적 연구 (Pharmacological Studies of Cefoperazone(T-1551))

  • 임정규;홍사악;박찬웅;김명석;서유헌;신상구;김용식;김혜원;이정수;장기철;이상국;장우현;김익상
    • 대한약리학회지
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    • 제16권2호
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    • pp.55-70
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    • 1980
  • The pharmacological and microbiological studies of Cefoperazone (T-1551, Toyama Chemical Co., Japan) were conducted in vitro and in vivo. The studies included stability and physicochemical characteristics, antimicrobial activity, animal and human pharmacokinetics, animal pharmacodynamics and safety evaluation of Cefoperazone sodium for injection. 1) Stability and physicochemical characteristics. Sodium salt of cefoperazone for injection had a general appearance of white crystalline powder which contained 0.5% water, and of which melting point was $187.2^{\circ}C$. The pH's of 10% and 25% aqueous solutions were 5.03 ana 5.16 at $25^{\circ}C$. The preparations of cefoperazone did not contain any pyrogenic substances and did not liberate histamine in cats. The drug was highly compatible with common infusion solutions including 5% Dextrose solution and no significant potency decrease was observed in 5 hours after mixing. Powdered cefoperazone sodium contained in hermetically sealed and ligt-shielded container was highly stable at $4^circ}C{\sim}37^{\circ}C$ for 12 weeks. When stored at $4^{\circ}C$ the potency was retained almost completely for up to one year. 2) Antimicrobial activity against clinical isolates. Among the 230 clinical isolates included, Salmonella typhi was the most susceptible to cefoperazone, with 100% inhibition at MIC of ${\leq}0.5{\mu}g/ml$. Cefoperazone was also highly active against Streptococcus pyogenes(group A), Kletsiella pneumoniae, Staphylococcus aureus and Shigella flexneri, with 100% inhibition at $16{\mu}g/ml$ or less. More than 80% of Escherichia coli, Enterobacter aerogenes and Salmonella paratyphi was inhibited at ${\leq}16{\mu}/ml$, while Enterobacter cloaceae, Serratia marcescens and Pseudomonas aerogenosa were somewhat less sensitive to cefoperagone, with inhibitions of 60%, 55% and 35% respectively at the same MIC. 3) Animal pharmacokinetics Serum concentration, organ distritution and excretion of cefoperazone in rats were observed after single intramuscular injections at doses of 20 mg/kg and 50 mg/kg. The extent of protein binding to human plasma protein was also measured in vitro br equilibrium dialysis method. The mean Peak serum concentrations of $7.4{\mu}g/ml$ and $16.4{\mu}/ml$ were obtained at 30 min. after administration of cefoperazone at doses of 20 mg/kg and 50 mg/kg respectively. The tissue concentrations of cefoperazone measured at 30 and 60 min. were highest in kidney. And the concentrations of the drug in kidney, liver and small intestine were much higher than in blood. Urinary and fecal excretion over 24 hours after injetcion ranged form 12.5% to 15.0% in urine and from 19.6% to 25.0% in feces, indicating that the gastrointestinal system is more important than renal system for the excretion of cefoperazone. The extent of binding to human plasma protein measured by equilibrium dialysis was $76.3%{\sim}76.9%$, which was somewhat lower than the others utilizing centrifugal ultrafiltration method. 4) Animal pharmacodynamics Central nervous system : Effects of cefoperazone on the spontaneous movement and general behavioral patterns of rats, the pentobarbital sleeping time in mice and the body temperature in rabbits were observed. Single intraperitoneal injections at doses of $500{\sim}2,000mg/kg$ in rats did not affect the spontaneous movement ana the general behavioral patterns of the animal. Doses of $125{\sim}500mg/kg$ of cefoperazone injected intraperitonealy in mice neither increased nor decreased the pentobarbital-induced sleeping time. In rabbits the normal body temperature was maintained following the single intravenous injections of $125{\sim}2,000mg/kg$ dose. Respiratory and circulatory system: Respiration rate, blood pressure, heart rate and ECG of anesthetized rabbits were monitored for 3 hours following single intravenous injections of cefoperazone at doses of $125{\sim}2,000mg/kg$. The respiration rate decreased by $3{\sim}l7%$ at all the doses of cefoperazone administered. Blood pressure did not show any changes but slight decrease from 130/113 to 125/107 by the highest dose(2,000 mg/kg) injected in this experiment. The dosages of 1,000 and 2,000 mg/kg seemed to slightly decrease the heart rate, but it was not significantly different from the normal control. All the doses of cefoperazone injected were not associated with any abnormal changes in ECG findings throughout the monitering period. Autonomic nervous system and smooth muscle: Effects of cefoperazone on the automatic movement of rabbit isolated small intestine, large intestine, stomach and uterus were observed in vitro. The autonomic movement and tonus of intestinal smooth muscle increased at dose of $40{\mu}g/ml$ in small intestine and at 0.4 mg/ml in large intestine. However, in stomach and uterine smooth muscle the autonomic movement was slightly increased by the much higher doses of 5-10 mg/ml. Blood: In vitro osmotic fragility of rabbit RBC suspension was not affected by cefoperazone of $1{\sim}10mg/ml$. Doses of 7.5 and 10 mg/ml were associated with 11.8% and 15.3% prolongation of whole blood coagulation time. Liver and kidney function: When measured at 3 hours after single intravenous injections of cefoperaonze in rabbits, the values of serum GOT, GPT, Bilirubin, TTT, BUN and creatine were not significantly different from the normal control. 5) Safety evaluation Acute toxicity: The acute toxicity of cefoperazone was studied following intraperitoneal and intravenous injections to mice(A strain, 4 week old) and rats(Sprague-Dawler, 6 week old). The LD_(50)'s of intraperitonealy injected cefoperazone were 9.7g/kg in male mice, 9.6g/kg in female mice and over 15g/kg in both male and female rats. And when administered intravenously in rats, LD_(50)'s were 5.1g/kg in male and 5.0g/kg in female. Administrations of the high doses of the drug were associated with slight inhibition of spontaneous movement and convulsion. Atdominal transudate and intestinal hyperemia were observed in animals administered intraperitonealy. In rats receiving high doses of the drug intravenously rhinorrhea and pulmonary congestion and edema were also observed. Renal proximal tubular epithelial degeneration was found in animals dosing in high concentrations of cefoperazone. Subacute toxicity: Rats(Sprague-Dawley, 6 week old) dosing 0.5, 1.0 and 2.0 g/kg/day of cefoperazone intraperitonealy were observed for one month and sacrificed at 24 hours after the last dose. In animals with a high dose, slight inhibition of spontaneous movement was observed during the experimental period. Soft stool or diarrhea appeared at first or second week of the administration in rats receiving 2.0g/kg. Daily food consumption and weekly weight gain were similar to control during the administration. Urinalysis, blood chemistry and hematology after one month administration were not different from control either. Cecal enlargement, which is an expected effect of broad spectrum antibiotic altering the normal intestinal microbial flora, was observed. Intestinal or peritoneal congestion and peritonitis were found. These findings seemed to be attributed to the local irritation following prolonged intraperitoneal injections of hypertonic and acidic cefoperazone solution. Among the histopathologic findings renal proximal tubular epithelial degeneration was characteristic in rats receiving 1 and 2g/kg/day, which were 10 and 20 times higher than the maximal clinical dose (100 mg/kg) of the drug. 6) Human pharmacokinetics Serum concentrations and urinary excretion were determined following a single intravenous injection of 1g cefoperazone in eight healthy, male volunteers. Mean serum concentrations of 89.3, 61.3, 26.6, 12.3, 2.3, and $1.8{\mu}g/ml$ occured at 1,2,4,6,8 and 12 hours after injection respectively, and the biological half-life was 108 minutes. Urinary excretion over 24 hours after injection was up to 43.5% of administered dose.

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자궁비대시험 연구에서 에틸, 프로필, 이소프로필, 부틸, 이소부틸 파라벤의 내분비독성 (Oestrogenic Activity of Parabens in Uterotrophic Assay)

  • 조은혜;정지윤;박철범;박선희;심용희;강대혁;이성호;유종훈;김선중;이성훈;박정란;이영순;강경선
    • 한국식품위생안전성학회지
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    • 제21권2호
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    • pp.118-128
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    • 2006
  • 본 시험은 암컷 랫드에 파라벤류(에틸, 프로필, 이소프로필, 부틸, 이소부틸)를 생후 19일령부터 21일령까지3일간 투여하여 자궁비대반응을 관찰하고, 이를 토대로 시험물질의 내분비계 장애작용을 검색하고자 실시하였다. 본 시험의 투여기간 동안 사망은 발생하지 않았으나, 용량결정시험에서 관찰된 것과 같이 투여부위의 피하결절 및 부종의 증상이 관찰되었으며, 이러한 증상들은 용량의존적으로 증가되는 경향을 나타내었고, 점차 투여부위의 탈모 및 가피형성 등의 과정을 거치면 발전되었다, 이러한 증상은 투여용량이 다소 낮은 음성대조군 및 양성대조군에서 발생하지 않아, 분말상태의 시험물질이 고용량으로 현탁되어 투여되며 생긴 물리적인 영향에 의한 것으로 사료되었으며, 시험물질의 에스트로겐성의 영향과는 무관한 것으로 사료되었다. 체중, 사료 및 음수섭취량에서 대조군과 시험물질간의 영향은 없는 것으로 판단되었다. 혈중 호르몬 농도에서 혈중 에스트로겐의 농도는 음성대조군, 양성대조군 및 에틸 파라벤 투여군에서 대조군에 비해 유의성있는 감소를 보였고, 이외의 시험물질에서 차이는 관찰되지 않았다. 또한, 혈중 난포자극 호르몬 및 혈중 황체형성 호르몬의 변화도 관찰되지 않아 파라벤류에 의한 혈중 에스트로겐, 난포자극 호르몬 및 황체형성 호르몬의 변화는 없는 것으로 사료되었다. 장기중량에서 생식기계를 제외한 장기에서 시험물질에 의한 영향은 없는 것으로 사료되었으며, 또한 난소 및 질의 중량에서 시험물질과 연관된 변화는 없는 것으로 판단되었다. 그러나 자궁의 wet weight 및 blotted weigh에서는 각 시험물질군에서 대조군에 대해 증가가 관찰되었다. 이소부틸 파라벤 투여군은 모든 용량군이 자궁중량에서 유의성있는 증가를 보여 가장 에스트로겐성 영향이 큰 것으로 사료되었고, 250 및 1,000 mg/kg 투여군에서 유의성있는 증가를 보인 이소프로필 투여군이 그 다음으로 에스트로겐 영향이 큰 것으로 판단되었다. 부검결과, 자궁의 확장정도는 자궁의 중량에서 관찰된 바와 대부분 일치하였으며, 조직병리학적 검사를 통해 자궁상피세포를 관찰한 결과, 이소부틸 파라벤 투여군이 가장 높은 세포질과 핵의 비율을 나타내었으며, 이소프로필 파라벤 및 부틸 파라벤 1,000 mg/kg 투여군에서는 다소 작게 관찰되었다. 자궁의 영상분석결과, 대부분의 시험물질투여군에서 자궁직경의 장축 및 단축, 자궁벽의 최소 및 최대치에서 대조군에 대해 유의성있는 변화가 없거나 감소하는 경향을 나타냈으나, 이소부틸 파라벤 투여군의 경우에는 증가하는 경향을 나타내었다. 이상의 결과를 토대로, 에틸 파라벤, 프로필 파라벤, 이소프로필 파라벤, 부틸 파라벤, 이소부틸 파라벤에서 자궁비대 반응이 관찰되어 파란벤류의 물질은 내분비 장애물질로서 검토되어야 할 것으로 사료되며, 이소부틸 파라벤이 가장 높은 에스트로겐성 영향을 주는 것으로 판단되었다.

비타민 D와 소아 호흡기 감염의 위험성: 무작위 대조 연구에 대한 체계적 문헌고찰 및 메타분석 (Vitamin D and Risk of Respiratory Tract Infections in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 안종균;이도경;김경효
    • Pediatric Infection and Vaccine
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    • 제23권2호
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    • pp.109-116
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    • 2016
  • 목적: 최근 관찰연구들에서 낮은 혈중 25(OH)D 농도가 호흡기 감염과 관련이 있다는 결과들이 보고되고 있다. 하지만, 소아의 무작위 대조 연구에서 비타민 D의 투여가 호흡기 감염을 예방하는 효과에 대해서는 아직 논란의 여지가 있다. 이번 연구는 비타민 D 보충 요법이 호흡기 감염 예방에 미치는 영향을 체계적 문헌고찰과 메타분석을 통하여 알아보고자 한다. 방법: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trial을 이용하여 소아의 호흡기 감염 예방을 위해 비타민 D 보충을 실험한 무작위 대조 연구들이 분석 대상에 포함되었다. 문헌의 비뚤림 위험도를 평가하기 위해 코크란 연합의 질 평가 방법(Cochrane Collaboration's tool for assessing the risk of bias)을 사용하였다. 연구별로 상대위험도와 95% 신뢰구간을 추출한 후, Review Manager 5.3을 이용하여 메타분석을 시행하였다. 결과: 총 7편의 무작위 대조 연구들이 메타분석 대상에 포함되었다. 임의효과모형을 사용하여 산출된 전체 비타민 D 보충군에서 상대적 위험도는 0.82 (95% CI: 0.69-0.98)이었고, 이질성에 대한 $I^2=62%$ 이었다. 연구 간의 이질성 원인을 파악하기 위해 시행한 하위 집단 분석에서 추적 관찰 기간이 1년 미만인 경우, 대상군의 나이가 5세 이상인 경우, 대상군이 환자인 경우, 비타민 D 투여 요법이 매일 요법인 경우 이질성이 감소하였다. 깔때기 그림에서 출판 비뚤림의 가능성을 시사하는 비대칭 소견을 보였다. 결론: 메타분석 결과는 소아에서 비타민 D 보충요법이 호흡기 감염을 예방하는 데 효과가 있을 수 있음을 보여준다. 하지만, 이번 연구에서는 분석대상에 포함된 연구들이 적고, 연구들 간에 이질성이 존재하며, 출판 비뚤림이 존재할 가능성이 있어 결과를 주의해서 해석할 필요가 있다.