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Voriconazole Therapeutic Drug Monitoring is Necessary for Children with Invasive Fungal Infection (소아에서 보리코나졸 치료적 약물 농도 모니터링의 임상적 의의)

  • Kang, Hyun Mi;Kang, Soo Young;Cho, Eun Young;Yu, Kyung-Sang;Lee, Ji Won;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Ahn, Hyo Seop;Lee, Hyunju;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.9-21
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    • 2014
  • Purpose: To determine the clinical significance of voriconazole therapeutic drug monitoring (TDM) in the pediatric population. Methods: Twenty-eight patients with invasive fungal infections administered with voriconazole from July 2010 to June 2012 were investigated retrospectively. Fourteen received TDM, and 143 trough concentrations were analyzed. All 28 patients were assessed for adverse events and treatment response six weeks into treatment, and at the end. Results: Out of 143 samples, 53.1% were within therapeutic range (1.0-5.5 mg/L). Patients administered with the same loading (6 mg/kg/dose) and maintenance (4 mg/kg/dose) dosages prior to initial TDM showed highly variable drug levels. Adverse events occurred in 9 of 14 patients (64.3%) in both the TDM and non-TDM group. In the TDM group, voriconazole-related encephalopathy (n=2, 14.3%) and aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation (n=8, 57.1 %) occurred with serum levels in the toxic range (>5.5 mg/L), whereas blurred-vision (n=2, 14.3%) occurred within the therapeutic range (1.18 mg/L and 3.9 mg/L). The frequency of voriconazole discontinuation due to adverse events was lower in the TDM group (0.0% vs. 18.2%, P =0.481). Overall, 57.2% of the patients in the TDM group versus 14.3% in the non-TDM group showed clinical response after 6 weeks (P =0.055), whereas 21.4% in the TDM group versus 14.3% in the non-TDM group showed response at final outcome (P =0.664). In the TDM group, >67.0% of the serum levels were within therapeutic range for the first 6 weeks; however 45.5% were within therapeutic range for the entire duration. Conclusion: Routine TDM is recommended for optimizing the therapeutic effects of voriconazole.

Effects of Cytochalasin B on Parthenogenetic Development of Porcine Follicular Oocytes (돼지 난포란의 단위발생에서 Cytochalasin B의 영향)

  • Kim, Hyun-Jong;Son, Dong-Soo;Choi, Sun-Ho;Cho, Sang-Rae;Choe, Chang-Yong;Kim, Young-Gun;Han, Man-Hye;Ryu, Il-Sun;Kim, In-Cheul;Kim, Il-Hwa;Im, Kyung-Soon
    • Development and Reproduction
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    • v.9 no.1
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    • pp.49-52
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    • 2005
  • The effects of cytochalasin B was studied for the cleavage and development of in vitro matured porcine follicular oocytes. The follicular oocytes were collected from slaughtered pig ovaries and matured for 65 hours. The matured oocytes were activated by 7% ethanol(v/v) in DPBS and the activated oocytes were subjected to cytochalasin B concentrations of 2.5, 5.0 and $7.5\;{\mu}g/mL$ for 3, 5 and 7 hours, and then the treated oocytes were cultured in NCSU23 with 0.4% BSA for 7 days. The cleavage rates were not different significantly in each treatment. However, the oocytes treated with $5.0\;{\mu}g/mL$ for 5 hours yielded a significantly higher morula rate(19.7%) than oocytes treated with $2.5\;{\mu}g/mL$ for 3 and 5 hours(9.4%). The sum rate of $2.5\;{\mu}g/mL$ concentration(10.5%) by hour was also significantly lower than those of 5.0(18.0%) and $7.5\;{\mu}g/mL$ concentration(14.6%). The blastocyst rate in oocytes treated with $5.0\;{\mu}g/mL$ for 3(9.4%) and 5 hours(9.0%) was significantly higher than the rate in oocytes treated with $2.5\;{\mu}g/mL$ for 3 hours(0%). The sum rate of $5.0\;{\mu}g/mL$ concentration also significantly higher than those of 2.5 and $7.5\;{\mu}g/mL$ concentration. The results demonstrated that the treatment of oocytes with cytochalasin B of $5.0\;{\mu}g/mL$ for $3{\sim}5$ hours was the optimal concentration and duration for parthenogenetic activation and blastocyst formation of in vitro matured porcine oocytes.

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Effect of Mixtures with Lignite and Amino Acid Solution on the Growth of Rice Plant, Chinese Cabbage and Red Pepper, and the Chemical Properties of Soil (갈탄과 아미노산액 혼합제 시용이 벼, 배추와 고추의 생육 및 토양의 화학적 특성에 미치는 영향)

  • Han, Seong-Soo;Yoo, Ki-Yong;Park, Min-Su;Lee, Young-Il;Baek, Seung-Hwa
    • Korean Journal of Environmental Agriculture
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    • v.29 no.2
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    • pp.93-101
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    • 2010
  • For the study of possibility of practical use as an organic farm materials of the mixtures with lignite and amino acid solution, this experiment was carried out to investigate the effects of the mixtures on the growth and the yield of rice plant, chinese cabbage, and red pepper, and the effects of the mixtures on chemical properties of soil. Also, when the mixtures of the lignite plus amino acid solution and the chemical fertilizer were applied to these three crop cultivation area, authors want to know how can the loss in quantity of chemical fertilizer affects the growth and the yield of these crops. As the results, growth of rice plant applied with the mixtures of lignite and amino acid solution was better than that applied with the recommended rate of chemical fertilizer. Especially, the growth of rice plant appeared to be good at the treatment of 150 kg/ha of the mixed lignite with amino acid solution and at that of its mixtures and standard fertilization. Growth of chinese cabbage and red pepper was good at the application of 600 kg/ha of the mixed lignite with amino acid solution and at that of its mixtures and standard fertilization. Yield of rice and chinese cabbage was good at the treatment of 150 kg/ha of the mixed lignite with amino acid solution and at that of its mixtures and standard fertilization, and yield of red pepper was good at the application of 600 kg/ha of the mixed lignite with amino acid solution and at that of its mixtures and standard fertilization. The organic matter content increased and while the exchangeable cation decreased when the lignite mixed with amino acid solution and the loss in quantity of chemical fertilizer applied at paddy field. Incase of these treatments, pH and available phosphorus increase at upland field, but did not change at paddy field.

Prevalence and Its Correlates of Restless Legs Syndrome in Outpatients with Bipolar Disorders (양극성장애 환자의 하지불안증후군 유병율과 관련 특성)

  • Lee, Neung-Se;Yoon, Bo-Hyun;Lee, Hyun Jae;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Lee, Ji Seon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.121-129
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    • 2014
  • Objectives : This study was to assess the prevalence and its correlates of restless legs syndrome(RLS) in outpatients with bipolar disorder. Methods : A total of 100 clinical stabilized bipolar outpatients were examined. The presence of RLS and its severity were assessed using the International Restless Legs Sydrome Study Group(IRLSSG) diagnostic criteria. Beck's Depression Inventory(BDI), Spielberg's State Anxiety Inventory(STAI-X-1), Pittsburgh Sleep Quality Index(PSQI), Korean version Drug Attitude Inventory(KDAI-10), Subjective Well-Beings under Neuroleptic Treatment Scale-Short Form(SWN-K) and Barnes Akathisia Rating Scale(BARS) were used to evaluate the depressive symptomatology, level of anxiety, subjective quality of sleep, subjective feeling of well-being, drug attitude, presence of akathisia, respectively. Results : Of the 100 bipolar outpatients, 7(7%) were met to full criteria of IRLSSG and 36(36%) have at least one of the 4 IRLSSG criterion. Because of relatively small sample size, non-parametric analysis were done to compare the characteristics among 3 groups(full-RLS, 1 ${\geq}$positive RLS-symptom and Non-RLS). There were no significant differences in sex, age, and other sociodemographic and clinical data among 3 groups. BDI, STAI-X-1 and PSQI are tended to be impaired in RLS and 1 ${\geq}$positive RLS-symptom groups. Conclusions : This is the first preliminary study for studying the prevalence and its correlates of RLS in bipolar disorder. The results shows that relatively small proportion of RLS was present in bipolar disorder patients when compared to patients with schizophrenia. Same tendencies shown in schizophrenic patients were found that bipolar patients with RLS had more depressive symptoms, state anxiety and poor subjective sleep quality. Further systematic studies may be needed to find the characteristics of RLS in bipolar patients.

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The usefulness of CT for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture (족관절 골절에서 전하 경비 인대 견열 골절의 진단과 골편 고정술을 위한 전산화 단층 촬영의 유용성)

  • Na, Hwa-Yeop;Cho, Kook-Hee;Jung, Yu-Hun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.78-85
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    • 2011
  • Purpose: To evaluate the usefulness of computerized tomography (CT) for the diagnosis and the fragment fixation of anteroinferior tibiofibular ligament avulsion fracture in ankle fracture. Materials and Methods: We retrospectively studied 108 patients with an ankle fracture who had been checked with plain radiographs and CT from July 2006 to July 2010. They were divided into two groups; patients with (19 patients) and without (89 patients) an avulsion fracture of anteroinferior tibiofibular ligament. The two groups were evaluated with Lauge-Hansen classification, the energy of trauma, and the radiologic indices for syndesmotic injury, and were compared each other. Average follow up periods of two groups were 25 and 23 months each. Those who were unstable at stress test during surgery were divided into fragment fixation of anteroinferior tibiofibular ligament avulsion fracture group (8 patients) and transfixation one (11 patients) according to treatment method. Clinical and radiological results at last follow up were also compared. Results: Fourteen avulsion fractures of anteroinferior tibiofibular ligament were diagnosed by CT only. Incidences of pronation-external rotation injury, high energy trauma, positive radiologic indices for syndesmotic injury were significantly higher in patients with an avulsion fracture of anteroinferior tibiofibular ligament than those without it. Clinical and radiological results were satisfactory in both groups at last follow up, and were not significantly different between them. Conclusion: In patients who have an ankle fracture by pronation-external rotation injury, high energy trauma, or with positive radiologic indices for syndesmotic injury, CT is useful for diagnosis of an avulsion fracture of anteroinferior tibiofibular ligament. Fragment fixation of anteroinferior tibiofibular ligament avulsion fracture is a useful treatment option for syndesmotic injury.

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The Bibliographical investigation of the mallow, hollyhock, darkpull, sunflower (아욱(葵菜), 접시꽃(蜀葵), 닥풀(黃蜀葵), 해바라기(向日葵)에 대한 문헌고찰)

  • Kim, Jong-dug;Koh, Byung-hee
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.1
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    • pp.221-240
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    • 1999
  • 1. Purpose of study In the medical science of 'Sasang', a constitutional examination(diagnosis) and a medical treatment are important however a dietary cure is considered as very important at the medical prevention and treatment. But there has been a confusion due to the different view concerning the constitutional foods in between scholars. There it is necessary for us to bring up the theoretical basis of the 'Sasang' constitutional - dietary cure by means of the bibliographical study in relation to a historic, characteristics, efficiency of the major foods. A mellow as called "Baekchejiju" has been used as a source of adding food materials when we make a boiling soup, which is only in Korea but not other countries case. We also studied a hollyhock, a 'Darkpull', a sunflower together with a mellow, because these plants contains a similar characteristics and same chinese word of 'Gue' at their name. At this study we would like to bring up the basis correcting the evil of the misinterpretation to be translated 'Gue' into 'Sunflower', which would be helpful to the current academic circles studied very rarely for the introduction process of sunflower. 2. Method of study We did a comparative study based on not only 'Bonchoseo - original plants book' but also agricultural books, boos of the same kinds and private books. 3. Result of study 1) A mellow has been changed its inscribed name from 'Abushil' to 'A-uk', to 'A-ok', to 'A-uk'. And a winter mellow is called as 'Dol-a-uk' which means the thing is changed a year. 2) The heliotropism of mellow has been used as the symbol of the loyalty and the intelligence. Its meaning has been interpreted expansively engaging with the heliotropism of a hollyhock, a Darkpull, and a sunflower. 3) Once 'Darkpull' had been recognized as 'one day flower'. But after sunflower come, people have confused and misread 'Darkpull' by 'Sunflower'. 4) The first record of sunflower among the existing bibliographical documents is "Chung-jang-gam-chun-seo" (1795). And It is presumed thal the sunflower had introduced in Korea at the early to mid of the eighteen century. 5) The interpretation for mellow has been made s confusion by a several documentary and dictionary record, but should be corrected to be right.

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Antioxidant activity and anti-tumor immunity by Propolis in mice

  • Choi, In-Sook;Itokawa, Yuka;Maenaka, Toshihiro;Yamashita, Takenori;Mitsumoto, Morihide;Tano, Kaoru;Kondo, Hiroyo;Ishida, Torao;Nakamura, Takashi;Saito, Kiyoto;Terai, Kaoru;Monzen, Hajime;Oshima, Masami;Takeuchi, Tetsuo;Mituhana, Yuicti;Bamen, Kenichi;Ahn, Kyoo-Seok;Gu, Yeun-Hwa
    • Advances in Traditional Medicine
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    • v.5 no.2
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    • pp.100-109
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    • 2005
  • In South America, natural products with unknown drug effects are used as folk remedies and for preventive medicine. Among South American natural products, we directed our attention to Propolis, which have been known as medicinal plants, and examined the mechanisms by which these substances affect antioxidant activity, anti-tumor activity and immunoresponse. When the antioxidant activities of Propolis were examined by the DPPH and Rhoudan iron methods, since Propolis contains high levels of flavonoids, it is thought that flavonoids may be responsible for the antioxidant activity in this study. In the examination of immunoenhancement activity, we measured lymphocyte versus polymorphonuclear leukocyte ratios (L/P activity). The number of lymphocytes was significantly increased in groups treated with Proplolis. Specifically, slightly high levels of $IFN-{\gamma}$ were measured in mice bearing the S-180 carcinoma, after administration of Propolis. This strongly suggests that cellular immunity is especially activated by treatment with Propolis, because production of $IFN-{\alpha}$ is limited to the T cells and NK cells stimulated by mitogen and sensitized antigen. $TNF-{\alpha}$ shows a different extent and mechanism of action depending on the target cells. When $TNF-{\alpha}$ was measured in mice bearing the S-180 carcinoma, mice treated with Propolis showed slightly higher $TNF-{\alpha}$ levels as compared to the control group. This suggests that activated macrophages produce $TNF-{\alpha}$ in mice treated with Prapolis, since activated macrophages and lymphocytes are the source of most $TNF-{\alpha}$. When anti-tumor action was examined using two kinds of sarcoma (Ehrlich solid carcinoma and Sarcoma-180 carcinoma), tumor-suppressive ratios after treatment with Propolis was 29.1%. When Sarcoma-180 solid carcinoma was used, tumor-suppressive ratios were 62%. Thus, Propolis showed strong anti-tumor activity against two kinds of solid carcinoma. Taken altogether, this strongly suggests that Propolis enhances original functions of macrophages and NK cells, and as a result, secondarily enhances the immune reaction and suppresses tumor growth.

The Distribution of Oral Candida Species in Patient with Prosthetic Appliance (보철물 장착 환자의 구강 칸디다균 분포)

  • Son, Seung Hwa;Baek, Su Min;Park, Young Min
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.477-487
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    • 2014
  • Of the many pathogenic Candida species, Candida albicans is the main fungal pathogen of humans. The oral environmental factors considered in the Candida albicans colony forming unit test contain both host and microbial factors associated with candidiasis. In particular, Candida biofilms can develop on surfaces of prosthesis. The purpose of this study was to investigate the distribution of oral Candida species between the type of prosthesis and the situation of oral environment in patient with prosthetic appliance. The patients were 30 elderly subjects with different types of prosthesis, 7 who wore denture, 12 who wore implant and 15 who wore removable orthodontic appliance. We used Candida albicans colony forming unit test using saliva to exam the distribution of Candida albicans related with 5 oral environmental factors, gender, smoking or nonsmoking, alcohol/nonalcohol consumption, the type of prosthetic appliance and its treatment duration as well as tooth brushing frequency per day. In conclusion, for the patient's gender, site in the oral cavity and the type of prosthetic appliance and its treatment duration was associated with an increase in the distribution of Candida albicans in saliva. The distribution of Candida albicans within the oral cavity performs to be modulated to varying extents by oral environmental factors and, further investigations are required to elucidate these complex interactions.

The Effects of Nuclear Factor-κB Decoy Oligodeoxynucleotide on Lipopolysaccharide-Induced Direct Acute Lung Injury (리포다당질로 인한 직접성 급성폐손상에서 Nuclear Factor-κB Decoy Oligodeoxynucleotide의 효과)

  • Kim, Je Hyeong;Yoon, Dae Wui;Jung, Ki Hwan;Kim, Hye Ok;Ha, Eun Sil;Lee, Kyoung Ju;Hur, Gyu Young;Lee, Sung Yong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.95-104
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    • 2009
  • Background: The pathophysiologic mechanisms of early acute lung injury (ALI) differ according to the type of primary insult. It is important to differentiate between direct and indirect pathophysiologic pathways, and this may influence the approach to treatment strategies. NF-$\kappa$B decoy oligodeoxynucleotide (ODN) is a useful tool for the blockade of the expression of NF-$\kappa$B-dependent proinflammatory mediators and has been reported to be effective in indirect ALI. The purpose of this study was to investigate the effect of NF-$\kappa$B decoy ODN in the lipopolysaccharide (LPS)-induced direct ALI model. Methods: Five-week-old specific pathogen-free male BALB/c mice were used for the experiment. In the preliminary studies, tumor necrosis factor (TNF)-$\alpha$, interleukine (IL)-6 and NF-$\kappa$B activity peaked at 6 hours after LPS administration. Myeloperoxidase (MPO) activity and ALI score were highest at 36 and 48 hours, respectively. Therefore, it was decided to measure each parameter at the time of its highest level. The study mice were randomly divided into three experimental groups: (1) control group which was administered 50 ${\mu}L$ of saline and treated with intratracheal administration of 200 ${\mu}L$ DW containing only hemagglutinating virus of Japan (HVJ) vector (n=24); (2) LPS group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing only HVJ vector (n=24); (3) LPS+ODN group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing 160 ${\mu}g$ of NF-$\kappa$B decoy ODN and HVJ vector (n=24). Each group was subdivided into four experimental subgroups: (1) tissue subgroup for histopathological examination for ALI at 48 hours (n=6); (2) 6-hour bronchoalveolar lavage (BAL) subgroup for measurement of TNF-$\alpha$ and IL-6 in BAL fluid (BALF) (n=6); (3) 36-hour BAL subgroup for MPO activity assays in BALF (n=6); and (4) tissue homogenate subgroup for measurement of NF-$\kappa$B activity in lung tissue homogenates at 6 hours (n=6). Results: NF-$\kappa$B decoy ODN treatment significantly decreased NF-$\kappa$B activity in lung tissues. However, it failed to improve the parameters of LPS-induced direct ALI, including the concentrations of tumor necrosis factor-$\alpha$ and interleukin-6 in BALF, myeloperoxidase activity in BALF and histopathologic changes measured by the ALI score. Conclusion: NF-$\kappa$B decoy ODN, which has been proven to be effective in indirect models, had no effect in the direct ALI model.

Changes in Properties of Deer Antler by Proteolysis and Extraction Conditions (녹용의 단백질가수분해 및 추출조건에 따른 특성 변화)

  • Kim, Jae-Hwa;Yoo, Cheol-Jae;Sin, Kyung-A;Jang, Se-Young;Park, Nan-Young;Jeong, Yong-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.1
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    • pp.89-93
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    • 2011
  • This study was conducted to investigate the proteolysis and extraction conditions of deer antler for application of food materials. ProteAX (A) was the most effective enzyme for proteolysis of deer antler and the proteolysis condition was 0.5% (w/w) for enzyme concentration and 5 hr for proteolysis time. The effect of mixing enzyme ProteAX (A)+KFEN 2 (C) treatment in $60^{\circ}C$, 5 hr was investigated; soluble solid and protein content were the highest with A 0.5% (w/w) and B 0.5% (w/w) concentration. Result for DAH (deer antler hydrolysate) and DA (deer antler) prepared with extraction in $95^{\circ}C$ atmospheric pressure (AP, 6~18 hr) and extraction under $120^{\circ}C$ pressure condition (UP, 15~60 min) after hydrolysis on preceding established condition descriptions indicated that difference in pH according to enzyme treatment and extraction conditions was not significant. Sugar content of DA was $1.5^{\circ}Brix$, DA-UP (under pressure) and DAH-AP (atmospheric pressure) were $2.2^{\circ}Brix$; the highest sugar content of $2.7^{\circ}Brix$ was observed in DAH-UP for 60 min extraction. Also total free sugar, crude protein and collagen content were the highest in DAH-UP for 60 min recording at 1.97%, 742.7 mg/100 g and 498.8 mg/100 g, respectively. From these results, deer antler hydrolysate prepared with extraction under pressure was the most effective for functional characteristics enhancement. Hereafter, various practical uses of materials with enhanced characteristics of antler is expected.