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.
The purpose of this study was to investigate the relationship between quadriceps composition and its functional contractility in obese and nonobese elderly individuals. Thirty-four ($70{\pm}2yr$) individuals (obese, n=21; nonobese, n=13) participated in the study. The thigh composition was assessed with a CT scan, and its functional contractility was measured with an isotonic dynamometer. Variables were analyzed with a $2{\times}2$ two-way ANOVA and a contrast test (p<0.05). There were no between-group differences in the subjects' ages and heights, but individuals in the obese group were approximately 23% heavier and had 18% more fat than those in the nonobese group, regardless of gender. The total thigh volume of the obese elderly was greater (~29%) than that of the nonobese elderly, regardless of gender, and the fat volume (~39%) of the obese elderly was greater than that of the nonobese elderly, regardless of gender (p<0.05). Interestingly, the obese elderly tended to have a greater thigh muscle volume (~17% for males [p<0.05] and ~10% for females) than the nonobese. Despite the greater muscle volume, the peak knee extensor torque of the two groups was comparable or slightly greater in the obese individuals. However, when this was normalized by the total thigh volume, the nonobese males showed significantly greater peak torque (~26% for right and ~20% for left; p<0.05) compared to the obese males. The nonobese females also showed greater peak torque (~8% for both legs) than the obese females after normalization, but the result was not statistically significant. In conclusion, although the obese elderly individuals had greater quadriceps muscle mass than the nonobese, the normalized peak torque of the obese was significantly lower than that of the nonobese, implying a lower degree of muscle contractility.
Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
Journal of Trauma and Injury
/
v.33
no.1
/
pp.1-12
/
2020
Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.
Journal of the Korean Society of Physical Medicine
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v.3
no.1
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pp.27-37
/
2008
Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.
Proliposomal patch of clenbuterol, ${\beta}_2-agonist$ bronchodilator, was prepared and its feasibility as a novel transdermal drug delivery system was examined. Proliposomal granules containing clenbuterol was prepared by a standard method using sorbitol and lecithin with (Rx 2) or without cholesterol (Rx 1). The porous structure of sorbitol in the proliposomes was maintained allowing tree flowability of the granules. Following contact with water, the granules were converted probably to liposomes almost completely within several minutes. It indicates that proliposomes may be hydrated, when they are applied on the skin under occlusive condition in vivo, by the sweat to form liposomes. Clenbuterol release from Rx 1 and Rx 2 proliposomes to pH 7.4 isotonic phospate buffer (PBS) across cellulose membrane (mol. wt. cut-off of 12000-14000) was retarded significantly compared with that from the mixture of clenbuterol powder and blank proliposomes. Interestingly, proliposomes prepared with lecithin and cholesterol (i.e., Rx 2 proliposomes) showed much more retarded release of clenbuterol than proliposomes prepared only with lecithin (i.e.. Rx 1 proliposomes), indicating that clenbuterol release from proliposomes can be controlled by the addition of cholesterol to the proliposomes. Proliposomal patches were prepared using PVC film as an occlusive backing sheet, two sides adhesive tape (urethane, 1.45 mm thickness) as a reservoir for proliposome granules and Millipore MF-membrane (0.45 mm pore size) as a drug release-controlling membrane. Rx 1 or Rx 2 proliposomes containing 4.6 mg of clenbuterol were loaded into the reservoir of the patch. Clenbuterol release from the patches to pH 7.4 PBS was determined using USP paddle (50 rpm)-over-disc release method. Clenbuterol release from the proliposomal patches was much more retarded even than from a matrix type clenbuterol patch (Boehringer Ingelheim ltd). Being consistent with clenbuterol release from the proliposomal granules, the release from the patches was highly dependent on the presence of cholesterol in the proliposomes : Patches containing Rx 2 proliposomes showed several fold slower drug release than patches containing Rx 1 proliposomes. When the patch containing Rx 1 proliposomes was applied on to the back of a hair-removed rat, clenbuterol concentration in the rat blood was maintained during 6-72 hrs. Transdermal absorption of clenbuterol from the patch was accelerated when the patch was prehydrated with 50 ml of pH 7.4 PBS before topical application. Above results indicate that sustained transdermal delivery of clenbuterol is feasible using proliposomal patches if the cholesterol content and pore size of the release rate-controlling membrane of patches, for example, are appropriately controlled.
Kim, Gi-Do;Lee, Yun-Jung;Choi, Wan-Suk;Lee, Dong-Woo;Jung, Dae-In;Kim, Kyung-Yoon
The Journal of the Korea Contents Association
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v.12
no.3
/
pp.233-243
/
2012
The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.
This study was aimed to design and formulate the moisture-activated patches containing ofloxacin and lidocaine for antibacterial and local anesthetic action. The solubility of lidocaine at $32^{\circ}C$ in various vehicles decreased in the rank order of PG $759.5{\pm}44.5\;mg/mL$ > PGL > IPM > PEG 300 > PEG 400 > Ethanol > PGMC > DGME > PGML > OA > $Captex^{\circledR}\;300$ > $Captex^{\circledR}\;200$ > water $(4.0{\pm}0.1\;mg/mL)$. Ofloxacin revealed very low solubility, which the highest solubility was obtained from PEG 400 $(18.7{\pm}6.3\;mg/mL)$ among the vehicles used. The addition of lactic acid increased the solubility of ofloxacin dramatically; the solubility at 5% lactic acid was $133.7{\pm}9.7\;mg/mL$. As $2-hydroxypropyl-{\beta}-cyclodextrin$ was added at the concentrations of 40, 80, 120, 160 and 200 mM, the solubilities of lidocaine and ofloxacin were enhanced up to three and two times, respectively, with concentration-dependent pattern. Gel intermediates for filmtype patches were prepared with mucoadhesive polymer, viscosity builders, lidocaine or ofloxacin at pH values from 5 to 7. Gels were cast onto a release liner and dried at room temperature. Dried patch was attached onto an adhesive backing layer, thus forming a patch system. Patches containing a single drug component were characterized by in vitro measurement of drug release rates through a cellulose barrier membrane. The release study was carried out at $37^{\circ}C$ using a Franz-type cell. Receptor solutions were isotonic phosphate buffers (pH 7.4). Samples $(100\;{\mu}L)$ were taken over 24 hours and quantitated by a verified HPLC method. The releases from all tested were proportional to the square root of time. The release rates were 0.9, 157.3 and $281.7\;{\mu}g/cm^{2}/min^{1/2}$ for the lidocaine patches and 19.8,37.2 and $50.7\;{\mu}g/cm^{2}/min^{1/2}$ for the ofloxacin patches at the concentrations of 0.3, 0.5 and 1 %, respectively. The release rates were dose dependent in both drug patches $(R^{2}\;=\;0.9077\;for\;lidocaine;\;R^{2}\;=\;0.9949\;for\;ofloxacin)$ and those were also thickness-dependent $(R^{2}\;=\;0.9246\;for\;lidocaine;\;R^{2}\;=\;0.9512\;for\;ofloxacin)$.
This study tried to observe the ability to inhibit vasocontriction in phloretin - the primary ingredient of apple tree leaves and the Manchurian apricot - through ROCK(Rho-associdated, coiled-coil containing protein kinase) inactivation in rat aortae. A piece of artery that was separated from Sprague-Dawley male rats and retained or damaged the endothelium was suspended in myograph tank with two metal rings, the lower ring fixed to the bottom of the tank, and the upper ring connected to the isotonic force transducer. Interestingly, phloretin inhibited fluoride- or phorbol ester-provoked contraction implying that additional pathways dissimilar from endothelial nitric oxide synthesis such as ROCK or MEK (mitogen activated protein kinase kinase) inactivation might be involved in the vasorelaxation. Therefore, this study provides that phloretin participates in the reduction of ROCK or MEK activity in smooth muscle in addition to the endothelial-dependent action of the endotheliuim in complete blood vessels, and consequently inhibits actin-myosin interaction in smooth muscle. Furthermore, phloretin inhibited thromboxane A2-induced contraction suggesting the mechanism including inhibition of ROCK and MEK.
Kim, Hyeon-Jeong;Kim, Min-Ji;Kim, Ki-Hyun;Ji, Seung-Jun;Lim, Kyung-Hun;Park, Kwon-Hyun;Shin, Joon-Ho;Heu, Min-Soo;Kim, Jin-Soo
Korean Journal of Fisheries and Aquatic Sciences
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v.45
no.3
/
pp.215-223
/
2012
This study was conducted to prepare canned skipjack tuna Katsuwonus pelamis in the mixture of isotonic beverage and tomato paste (ST-S) for use as a health food. An analysis of the time-temperature profile and viable cells showed that a reasonable F0 value for ST-S preparation was 4 min. The proximate composition of ST-S was 76.8% moisture, 20.2% crude protein, 0.8% crude lipid, 1.7% ash and 0.5% carbohydrate. The calorie content of ST-S was 94.8 kcal, which is 47.4% lower than that of commercial canned skipjack tuna in oil (ST-O) and 2.2% lower than that of commercial chicken breast in water (CB-B). The total amino acid content of ST-S was 18.54 g/100 g, which is 31.4% lower than that of ST-O and 7.9% lower than that of CB-B. The major amino acids in ST-S were aspartic acid and glutamic acid. An enrichment effect due to such minerals as phosphorus, potassium and iron would be expected on consuming 100 g of ST-S. The major fatty acids in ST-S were 16:0 (27.4%), 18:1n-9 (14.3%) and 22:6n-3 (27.8%), which are different from those in ST-O and CB-B. The major free amino acids in ST-S were glutamic acid (8.1%), histidine (38.6%) and its related dipeptide, such as anserine (15.7%). In an evaluation of taste, flavor and color, ST-S was found to be superior to ST-O and CB-B.
Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of PAS positive lipoproteinaceous material in the alveolar spaces sparing septum. The therapy which has enjoyed the greatest success is whole lung lavage. The authors reported here, a case of 44 year old male patient with pulmonary alveolar proteinosis, and this is the 7th case in Korea. The patient underwent whole lung lavage but expired due to brain edema complicated by the procedure. He complained exertional dyspnea and cyanotic lips, and presented fine inspiratory crackle at both lower lung fields, decreased arterial oxygen pressure, and diffuse infiltration at whole lung field. Light microscopic finding of lung tissue obtained by transbronchial lung biopsy revealed PAS positive amorphous, granular material filled in the alveolar spaces, and electron microscopy of bronchoalveolar lavage fluid concentrate showed many electron-dense multi-lamellated structures. To treat the disease, the authors tried whole lung lavage of left lung with $37^{\circ}C$ isotonic saline under general anesthesia. However, he expired due to brain edema probably due to dilutional hyponatremia complicated by the procedure, 11 days after the procedure. Whole lung lavage is known relatively safe, but fatal complication may occur like this case.
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