• 제목/요약/키워드: Organ at risk

검색결과 156건 처리시간 0.029초

치주질환에 의한 심장질환 발생의 관련성 (Association between cardiovascular disease and periodontal disease prevalence)

  • 정미애;김지희
    • 한국융합학회논문지
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    • 제2권4호
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    • pp.47-52
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    • 2011
  • 치주질환(periodontal disease, 잇몸병)은 인구의 50%이상이 이환되는 만성질환이다. 치주질환을 치료하지 않으면, 치아 지지조직의 염증을 악화시켜 치아손실(tooth loss)을 가져온다. 고혈압은 성인의 30%에서 발병하며, 심혈관계통 질환의 이환(morbidity)과 사망(mortality)의 중요한 원인이다. 약 20년 전까지만 해도 두 가지 질환은 깊은 관련이 없어 보였지만, 최근 서로 연관성이 있다는 사실이 밝혀졌다. 심혈관계통의 위험요소에 대한 연구결과, 죽상경화증(atherosclerosis) 합병증 발생은 치주(periodontium) 질환과 관계가 있다. 즉, 뇌졸중(stroke), 관상동맥질환, 말초동맥질환에 대한 위험요소가 치주염이라는 증거가 있다. 이런 인과관계는 두 가지 질환이 서로 공통의 위험요소를 갖는다는 의미이다. C-reactive protein(CRP)은 치주염에서 증가하고, 치주질환 환자는 혈관운동 기능(vasomotor function)이 손상된다는 보고가 있었으며, 치주질환으로 인해 고혈압이 발생한다. 본 연구의 목적은 문헌 고찰을 통해, 치주염과 고혈압을 비롯한 심혈관계통 질환의 인과관계를 밝히고자 한다. 고혈압은 당뇨와 함께 대표적인 생활습관질병이기 때문에, 본 연구를 통해서 적절한 치아관리를 통해 고혈압으로 인한 여러 가지 합병증을 예방하고자 한다.

신장이식 수혜자의 대사증후군 발생 위험 관련 요인에 대한 융복합적 조사연구 (Convergence Analysis of Metabolic Syndrome Risk and Related Factors among Kidney Transplantation Recipients)

  • 정혜진
    • 디지털융복합연구
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    • 제18권5호
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    • pp.375-382
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    • 2020
  • 본 연구는 신장이식 수혜자들의 대사증후군 유병율을 조사하고 발생 위험 관련요인을 확인하기 위해 시행되었다. 본 연구는 의무기록을 이용한 후향적 조사연구로 국내 장기이식센터 신장이식 클리닉에 내원한 신장이식 수혜자 총 111명을 대상으로 관련 자료를 수집하였다. 자료 분석에는 t-test, χ2-test 및 Pearson's correlation, Point biserial correlation을 시행하였다. 연구 결과 신장이식 수혜자들의 대사증후군 유병 현황은 65.8%로 나타났으며 대사증후군 발생위험과 관련된 요인으로 나이, 이식 전 체질량지수, 이식 후 체질량지수, 흡연으로 확인되었다. 본 연구 결과는 신장이식 수혜자들의 대사증후군 진단 항목에 대해 지속적으로 모니터링하고 조절 가능한 생활습관 관련 요인들의 적극적 중재를 통해 조기 예방 및 관리가 필요함을 시사한다.

작업장에서 사용하는 포름아미드(Formamide)의 근로자 건강 유해성과 위험성 평가 (Worker Health Hazard and Risk Assessment of Formamide using in Workplaces in South Korea)

  • 김현영
    • 한국가스학회지
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    • 제20권2호
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    • pp.35-42
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    • 2016
  • 포름아미드(formamide)는 암모니아 냄새의 무색 액체로 흡입 시 자극성이 강하며, 급성독성 $LD_{50}$ 5,577 mg/kg(랫드), 표적장기(간장) 전신독성의 무유해영향농도(NOAEL)는 113 mg/kg/day) 및 생식독성물질(1B)로 작업환경 노출기준은 10 ppm이었다. 포름아마이드 취급사업장에 대한 작업환경 측정결과는 25개 시료 모두가 노출기준보다 매우 낮은 농도를 보였다. 그러나 작업강도, 국소배기장치의 가동 및 보호구(방독마스크)의 착용 여부 등 작업환경에 따라 노출농도가 변할 수 있어 가상 노출 시나리오별 노출량을 산출한 결과 노출량은 $5.16mg/m^3$, $1.72mg/m^3$, $0.43mg/m^3$으로 산출되었다. 이를 전신독성 및 생식독성의 유해성을 고려한 위험성을 평가한 결과 평균값은 0.02-0.58, 누적 90% 값은 0.02-0.66, 95% 값은 0.02-0.69로 모두 1보다 낮은 대체로 안전한 값으로 산출되었다. 단, 작업 상황에 따라 순간적 고농도에 노출될 위험도 있으며, 간독성 및 생식독성 물질이기에 건강장해 예방을 위해 노출되지 않도록 취급 시 주의가 요망된다.

면역억제제에 의한 당뇨 관련 유전자의 DNA microarray 분석 (DNA Microarrays Analysis of Gene Expression Profiles in Diabetes-related genes using Immunosuppressant)

  • 김경신;김병수
    • 혜화의학회지
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    • 제21권1호
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    • pp.11-21
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    • 2012
  • New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. The purpose of this study is to develop novel immune suppressants for PTDM using of action mechanism of them. The use of immunosuppressive drugs in transplanted patients is associated with the development of diabetes, possibly due to ${\beta}$-cell toxicity. To better understand the mechanisms leading to post-transplant diabetes, we investigated the actions of prolonged exposure of ${\beta}$-cells to therapeutical levels of tacrolimus (FK506) or cyclosporin A(CsA). The immunosuppressive drug cyclosporine(CsA) is a potent agent widely used after organ transplantations and various autoimmune disorders. After using CsA, some patients suffer severe complications including renal and vascular toxicity. The renal or vascular toxicity is influenced by the degree of the endothelial damage. FK506(tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. We found some interesting clusters and confirmed the feasibility of cDNA microarray in the study of Immunosuppressant. In this study, we investigated gene expression patterns induced by Immunosuppressant in RIN-m5F of rat insulinoma cell line. Gene expressions evaluated using cDNA microarry in two clusters were increased or decreased. this study provides comprehensive comparison of the patterns of gene expression changes induced by CsA and FK506 in ${\beta}$-cells. This study could establish that the mode of action mechanism by which currently used insulin inhibitors inducing PTDM could be elucidated at least in part, which raises the possibility that novel immune suppressive PTDM can be developed. The molecular biological study on PTDM will also contribute the progress in diabetes research field as well as in that of PTDM.

Evaluation of Dynamic Delivery Quality Assurance Process for Internal Target Volume Based RapidArc

  • Song, Ju-Young
    • 한국의학물리학회지:의학물리
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    • 제28권4호
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    • pp.181-189
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    • 2017
  • The conventional delivery quality assurance (DQA) process for RapidArc (Varian Medical Systems, Palo Alto, USA), has the limitation that it measures and analyzes the dose in a phantom material and cannot analyze the dosimetric changes under the motional organ condition. In this study, a DQA method was designed to overcome the limitations of the conventional DQA process for internal target volume (ITV) based RapidArc. The dynamic DQA measurement device was designed with a moving phantom that can simulate variable target motions. The dose distribution in the real volume of the target and organ-at-risk (OAR)s were reconstructed using 3DVH with the ArcCHECK (SunNuclear, Melbourne, USA) measurement data under the dynamic condition. A total of 10 ITV-based RapidArc plans for liver-cancer patients were analyzed with the designed dynamic DQA process. The average pass rate of gamma evaluation was $81.55{\pm}9.48%$ when the DQA dose was measured in the respiratory moving condition of the patient. Appropriate method was applied to correct the effect of moving phantom structures in the dose calculation, and DVH data of the real volume of target and OARs were created with the recalculated dose by the 3DVH program. We confirmed the valid dose coverage of a real target volume in the ITV-based RapidArc. The variable difference of the DVH of the OARs showed that dose variation can occur differently according to the location, shape, size and motion range of the target. The DQA process devised in this study can effectively evaluate the DVH of the real volume of the target and OARs in a respiratory moving condition in addition to the simple verification of the accuracy of the treatment machine. This can be helpful to predict the prognosis of treatment by the accurate dose analysis in the real target and OARs.

응급환자의 중증도 예측을 위한 APACHE II 기반 CAOPI 시스템 (A CAOPI System Based on APACHE II for Predicting the Degree of Severity of Emergency Patients)

  • 이영호;강운구;정은영;윤은실;박동균
    • 한국컴퓨터정보학회논문지
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    • 제16권1호
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    • pp.175-182
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    • 2011
  • 본 연구에서는 환자의 중증도 분류 및 인체 주요 장기의 상태 예측을 위하여 APACHE II(Acute Physiology And Chronic Health Evaluation) 기반 CDSS 도구인 CAOPI(Computer Aided Organ Prediction Index) 시스템을 제안한다. 기존 ICU 환자의 중증도 평가방법은 APACHE II를 이용하여 특정 시점의 중환자 위험도를 특정한 시점 데이터를 이용하여 산출하는 방식이었으나, 실시간으로 변화하는 환자의 상태에 맞춰 조치를 취하는데는 한계가 있다. CAOPI 시스템은 중환자실에 입실하는 환자들의 질병 중증도를 정확히 분류하고, 환자의 사망예측 뿐만 아니라장기 상태를 시각화 하여 위험도를 수치화 하였다. 또한 위험도를 특정 장기별로 구분하여 담당의 사가 환자의 상태에 맞는 맞춤형 응급조치를 취할 수 있도록 설계 및 개발 하였다.

두경부 전산화 단층촬영시의 주요 장기선량, 유효선량 및 위험도 (ORGAN DOSE, EFFECTIVE DOSE AND RISK ASSESSMENT FROM COMPUTED TOMOGRAPHY TO HEAD AND NECK REGION)

  • 김애지;조봉혜;나경수
    • 치과방사선
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    • 제25권1호
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    • pp.27-38
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    • 1995
  • The organ or tissue doses were determined with head and neck phantom measurement for multiple axial scans (36 slices), multiple coronal scans (13 slices), 3 types of single axial scans(orbit, maxillary sinus and mandibular canal) and single coronal scan (maxillary sinus). For each scan sequence 30 TLDs were placed in selected sites(16 internal sites and 14 external sites) in a tissue-equivalent phantom. The exposure was made at 120kVp, 500mAs with 5 mm slice width. The results were as follows : 1. In multiple axial scans, the greatest effective dose recorded was that delivered to the thyroid glands(2.77 mSv) and the least was that received by the skin(0.05 mSv). From these data, stochastic effects were 202.2x10/sup -6/ and 3.7×10/sup -6/, respectively. 2. In multiple coronal scans, the greatest effective dose recorded was that delivered to the salivary glands(0.58 mSv) and the least was that received by the skin(0.01 mSv). From these data, stochastic effects were 42.2×10/sup -6/ and 0.7×10/sup -6/, repectively. 3. Among single axial scans, the greatest effective dose recorded was that delivered to the salivary gland(0.38 mSv) in maxillary sinus scan. From this data, stochastic effect was 27.7×10/sup -6/. 4. In single coronal scan, the greatest effective dose recorded was that delivered to the salivary gland(0.01 mSv). From this data, stochastic effect was 1.0×10/sup -6/. 5. The equivalent dose measured that delivered to the lens of the eyes was 69.64 mSv in multiple axial scan, 39.32 mSv in multiple coronal scan and 36.77 mSv in single axial scan(orbit).

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Thimerosal의 발생독성에 관한 연구 (Study on the Developmental Toxicity of Thimerosal)

  • 곽승준;이규식;김순선;손경희;김소희;채수영;최요우;원용혁;박귀례
    • Toxicological Research
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    • 제19권4호
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    • pp.267-275
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    • 2003
  • The purpose of our study was to evaluate the toxicity of the thimerosal in embryos and neonates. Thimerosal (also known as mercurothiolate) is a mercury-containing compound used in trace amounts to prevent bacteria and other organisms from contaminating vaccines, especially in opened multi-dose vials. The toxicity of mercury is well known and those most at risk occurrs in unborn babies and newborn babies. Test methods included in vitro whole embryo culture (WEC) system and in vivo test of neonatal toxicity in Wistar rats. Ethylmercury and methylmercury were used as positive controls for the evaluating of toxic effects of mercury. In WEC assay, treated concentrations of thimerosal, ethylmercury and methylmercury were up to 0.01, 0.025, 0.05, 0.1, 0.25, 0.5, 1, 2.5 and 5 $\mu\textrm{g}$/$\textrm{m}{\ell}$, respectively. All compounds didn't show any morphological abnormalities, but showed retardation of growth and development in dose dependent manner (> 0.5 $\mu\textrm{g}$/$\textrm{m}{\ell}$). These data indicated that thimerosal showed developmental toxicity in vitro. In vivo neonatal toxicity, Wistar rats were administered subcutaneously with thimerosal, ethyl mercury, or methylmercury (5, 25, 50, 250, and 500 $\mu\textrm{g}$/kg) during from postnatal day (PND) 4 to 25. Significant effects of these compounds on relative organ weights and organ morphology were not observed in this experiment. However, accumulation of mercury was detected in the kidney and testis when treated with thimerosal, ethylmercury, or methylmercury. These results suggest that thimerosal may be a harmful compound to embryo and neonate, but used concentration of thimerosal in these experiments is much higher than that of clinical application. Further investigation is needed on the safety of vaccine components, i.e. a thimerosal using in vitro and in vivo tests in the future.

Comparative validity of microalbuminuria versus clinical mortality scores to predict pediatric intensive care unit outcomes

  • Nismath, Shifa;Rao, Suchetha S.;Baliga, B.S.;Kulkarni, Vaman;Rao, Gayatri M.
    • Clinical and Experimental Pediatrics
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    • 제63권1호
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    • pp.20-24
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    • 2020
  • Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival. Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5-254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P=0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%. Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores.

소아 구내촬영 시 방사선량 평가 및 최적화 방안에 대한 연구 (A Study of Radiation Dose Evaluation and Optimization Methods for Intra Oral Dental X-ray in Pediatric Patient)

  • 이현용;조용인
    • 대한방사선기술학회지:방사선기술과학
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    • 제44권3호
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    • pp.195-203
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    • 2021
  • Although intra oral dental x-ray is a lower dose than other radiological examinations, pediatric patients are known to have a higher risk of radiation damage than adults. For this reason, pediatric dental x-ray requires management of dose evaluation and imaging conditions during the examination. In this study, the dose calculation program ALARA-Dental(child/adult) was used to evaluate the organ dose and effective dose exposed to each examination site during intra oral imaging of children during dental radiographic examination, and dose analysis according to the imaging conditions was performed. As a result, the highest organ dose distribution was shown at 0.044 ~ 0.097 mGy in all are as of the mucous membrane of oral cavity except for the maxillary incisors and canines. Also, in the case of the thyroid gland, the maxillary canine and maxillary premolar examination showed 0.027 and 0.020 mGy, respectively, and the dose distribution was 15.4% to 70.0% higher than that of the mandibular examination. As for the effective dose calculated during intra oral imaging, the maxillary anterior and canine examinations showed the highest effective doses of 0.005 and 0.004 mSv, respectively, and the maxillary area examination showed a higher dose distribution on average than the mandible.