• Title/Summary/Keyword: Pulse therapy

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A Clinicopathological Study of Rapidly Progressive Glomerulonephritis in Children (소아 급속 진행성 사구체 신염의 임상-병리학적 고찰)

  • Cho Hee-Yeon;Chung Dae-Lim;Kang Ju-Hyung;Ha Il-Soo;Choi Yong;Cheong Hae-Il
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.176-185
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    • 2004
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

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Primary nephrotic syndrome in children : A nationwide survey in Korea (전국 병원을 대상으로 조사한 소아 특발성 신증후군의 임상적 고찰 - 다기관 공동연구 결과보고 -)

  • Cho Bytung-Soo;Kang Hyeon-Ho
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.1-10
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    • 1999
  • Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results: Results were as follows; 1) Among 2193 cases, male was 1655($75.5\%$), female was 538 cases($24.5\%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43\%$), pathologic findings were as follows; MCNS 646 cases($68.6\%$), FSCS 149 cases($15.8\%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2\%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5\%$ among patients with MCNS, $35.8\%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4\%$, n=1305). 7) 994 cases($73.1\%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1).

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Initial Analysis of the Underground Air Among Jeju Lava Forest(Sumgol) and its Healing Effect on the Human Body (제주 현무암 '숲' 지하 공기(숨골: Sumgol)의 분석과 인체에 미치는 치유 효과)

  • Sin, SBangsik;Kim, Hyek Nyeon;Lee, Deok Hee;Kim, Tae Seung;Kim, Yong Hwan;Kang, Chang Hee;Song, Kyu Jin;Lee, Hyung H.
    • Journal of Naturopathy
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    • v.11 no.1
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    • pp.18-30
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    • 2022
  • Background: It was to develop an air purification system (APS) using an underground air purification layer to verify the effect of basalt forest's underground air (sumgol) on a volcanic Jeju. Finally, it is necessary to analyze these purified air components and their usefulness to the human body in an air experience center. Purpose: It was to collect basalt forest air, analyze its composition, and explore its effect on the human body. Methods: We APS devices installed at four points in the Papaville area of Jeju. The air discharged from the APS was collected and analyzed the recycling components. An installed experience room filled with negative ions is about 5,000 ions/m3. After allowing the participants to stay for 60 to 120 minutes, we investigated the state of blood vessels. Results: In the analysis of the underground air, the O2 concentration was 21.18%, which was higher than the average oxygen concentration of 20.94% in the atmosphere. However, Formaldehyde was not detected, and the CO2 was 419 ppm, which was lower than that of indoor air. The PM2.5 concentration was less than 24 ㎍/m3 and detected anions over 5.000 /m3. The experiencer's vascular states improved, and the increase in pulse rate and stress relief were high. Conclusions: The valuable ingredients identified by analyzing the air were precious for natural healing. The experience results showed that it effectively improved the pulse rate, blood vessels, and stress. These conditions may be highly beneficial as a new area for expanding the basalt lava forest in the Jeju area into the natural healing and wellness industry.

Study on Effect of Varience of Physiological Responses in Color Foot Reflexology Using Color Light (컬러광을 활용한 발반사요법이 인체 생리적 반응 변화에 미치는 영향에 관한 연구)

  • Jin, Hye-Ryeon;Yu, Mi;Park, Kyung-Jun;Kim, Nam-Gyun;Chung, Sung-Whan;Kim, Dong-Wook
    • Science of Emotion and Sensibility
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    • v.13 no.1
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    • pp.187-196
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    • 2010
  • Recently, people have been suffering from stress-related fatigue and psychological disorders. Most people depend on medicine for pain relief; many treat pain also through alternative medicine or replacement therapy. However, drug therapy has many side effects, including increased stress after the therapy. In comparison, alternative therapies such as massage and foot reflexology are less damaging to the body, and such therapies can be provided without physical or psychological discomfort. In this regard, the author had previously co-developed color foot reflexology, which combines the merits of color therapy and foot reflexology; color foot reflexology has been shown to have beneficial effects without undue pain. This study investigates the effects of color foot reflexology on the physiological response of the body by comparing the body’s response to the signal with that to the placebo. Healthy adult subjects were selected for the experiment, which was conducted under optimal experimental conditions and design. The results indicated that when stimulated, parasympathetic nerves increased in HRV and that blood pressure, pulse, body heat, peripheral blood flow were dramatically activated. However, the results for the placebo indicated minimal changes or irregular outcomes. The results provide strong evidence for the beneficial effects of the color foot reflexology instrument on the autonomic nervous system and on the physiological response of the body. Future research is warranted to verify the results of the current study by examining patients suffering from diseases and disorders arising from irregular physiological functions in the context of the foot.

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An Epidemiologic Study of Kawasaki Disease(1987-2000) : Incidence of Coronary Artery Complication in the Acute Stage (가와사끼병의 역학적 연구(1987-2000년) : 관상 동맥 이상을 중심으로)

  • Lee, Kyung-Yil;Park, Min-Young;Han, Ji-Whan;Lee, Hyung-Shin;Choi, Jin;Whang, Kyung-Tai
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.783-789
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    • 2002
  • Purpose : We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment. Methods : We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000. Results : The mean annual incidence was $36.1{\pm}11.1$ cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was $2.4{\pm}1.7$ years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated($400-500mg/day{\times}4-5days$, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case. Conclusion : In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.

Early Response of Cardiopulmonary Exercise Test(CPET) in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Radiation (방사선 치료 후 폐암환자의 운동부하 심.폐 기능의 초기변화)

  • Shin, Kyeong-Cheol;Lee, Deok-Hee;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.466-473
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    • 2000
  • Background : Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. Method : Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. Results : The forces vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$ and maximal voluntary ventilation (MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity (DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption ($VO_2$max), carbon dioxide production ($VCO_2$), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. Conclusion : Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.

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Clinical Characteristics in Patients with Kawasaki Disease Who Received Intravenous Gamma-globulin Retreatment (가와사끼병에서 감마글로불린 재투여가 필요했던 경우의 임상적 특징)

  • Kim, Deok-Soo;Hahn, Yoon-Soo;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1411-1416
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    • 2002
  • Purpose : Although the use of intravenous gamma-globulin(IVGG) in Kawasaki disease(KD) is effective in reducing clinical symptoms and coronary artery complications, 20-30% of patients have persistent or recrudescent fever and ongoing clinical symptoms. In these patients, the additional infusion of IVGG is considered. The authors studied the characteristics of patients who received IVGG retreatment, and compared them with the patients who did not need IVGG retreatment, for determination of IVGG retreatment. Methods : We reviewed the medical records of 117 KD patients who could be followed up at least six months. We studied the conventional laboratory findings, electrocardiogram(EKG), signal averaged ECG(SAECG) and echocardiogram. Results : Twenty three patients had early cardiac complications during the six months of follow-up. Four patients had late cardiac complications after six months. The early cardiac complication rate was higher in the IVGG retreatment group than the single infusion group(P<0.0001). The late complication rate was also higher in the retreatment group(P<0.0001). The patients who received methyl-prednisolone(m-PD) pulse therapy had much higher rates of early and late cardiac complications than those who received a single IVGG infusion. Among the clinical data and laboratory findings, only CRP increased significantly in patients who have had the cardiac complications. The IVGG retreatment group had increased CRP than the single infusion group. Conclusion : The patients with increased initial CRP may have an increased incidence of complications and an increased possibility of IVGG retreatment. We thought that retreated KD patients might have inflammations severe enough to need high dose IVGG as shown by high CRP levels, and IVGG retreatment could not prevent coronary artery lesions sufficiently.

Combined Primary IgA nephropathy and Membranous Glomerulonephritis in a Child (소아에서 IgA 신병증과 막성 사구체신염이 병발한 사구체신염 1례)

  • Kim Mi-Kyung;Choi Jeong-Hoon;Won Nam-Hee;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.232-236
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    • 1999
  • IgA 신병증은 사구체 중맥에 IgA가 침착하는 것이 특징적인 질환이며 막성 사구체 신염은 IgG가 사구체 기저막의 상피하에 미만성으로 침착하는 질환이다. 원발성 사구체 질환중 IgA 신병증과 막성 사구체신염은 비교적 흔한 질환이나 전체적인 빈도는 낮은 편으로, 한 환자의 사구체에서 두 질환이 동시에 발생하는 경우는 매우 드물다. IgA 신병증과 막성 사구체신염의 중복 신염은 Doi등이 1983년 원발성 신질환으로서 처음 보고한 이래, 성인에서 20여례가 보고되었다. 저자들은 신증후군이 발생한 환아에서 신생검을 시행한 결과 원발성 신질환으로서 IgA 신병증과 막성 사구체신염의 소견이 동시에 보이는 중복신염의 드문 예를 경험하였기에 보고하는 바이다. 환아는 7세된 남아로 내원 한달 전부터 발생한 전신부종을 주소로 내원하였다. 가족력과 과거력상 특이 소견없었으며, 내원시 이학적 소견상 전신적인 허약감과 안와부종, 복부팽만, 하지의 함요부종이 관찰되었고, 검사소견에서는 WBC $19,800/mm^3$, Hb 14.1g/dL, Platelet $397,000/mm^3$, BUN/Cr 10/0.4mg/dL, protein/albumin 4.43/2.73g/dL, cholesterol 429mg/dL, IgA 85mg/dL, $C_3$ 68.8mg/dL, $C_4$ 13.4mg/dL, ANA(-), ANCA(-), RF(-), HBsAg/Ab(-/-)이었다. 뇨검사에서는 RBC many/HPF, WBC 2-3/HPF, protein ${\le}\;300mg/dL$ 였으며, 24시간 소변 검사상 protein 9.18g/day, Ccr 66.67ml/min의 소견을 보였다. 신생검을 시행한 결과 광학현미경상에서 몇몇 사구체의 분절성 경화와 중맥역의 증식이 관찰되었고, 면역형광현미경검사에서는 IgA(3+)가 과립상으로 미만성 분포를 보이며 중맥역에 침착되어 있고, 미세한 과립상과 위선의 양상으로 IgG(1+)가 모세혈관벽에 침착되어 있었으며, 전자현미경 소견상 중맥역과 모세혈관 기저막 상피하에 소량의 전자 고밀도 침착이 함께 관찰되었다. 환아는 prednisolone을 경구 투여 받았으나 단백뇨와 혈뇨가 지속되어 solumedrol pulse therapy, captopril과 cyclophophamide로 치료 받은 후, 전신 상태 호전되고, 혈뇨가 사라졌으며, 24시간 소변 검사상 단백뇨가 487.5mg/day로 감소하여 외래에서 추적 관찰 중이다.

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The Literature Study on Macula among the Symptoms of Warm Factor Disease (온병(溫病)의 증상(症狀) 중(中) 반진(斑疹)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Jang, Yunjeong;Ryu, Sangchae;Kim, Jeongsoon;Jeon, Hoseong;Yu, Donghee;Kim, Nanyeong;Chong, Myongsoo;Lee, Kinam
    • Journal of Korean Medical Ki-Gong Academy
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    • v.11 no.1
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    • pp.80-116
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    • 2009
  • It studies into viewpoints of 7 doctors of Wenbing studies on macula. The results concerning characteristics, remedy and prevention of macula are as follows; Macule does not protrude on the surface of skin and does not have any color change for external stimulus, but rash out on the surface and becomes white when pushed. It becomes macule when the blood leaks beneath skin as stomach-heat of yangming enters into blood system and damages it. On the other hand, when heat enters lung meridian, penetrates beneath the skin and congeals inside the vessel, it becomes rash. When you combine symptoms of body and pulse with numbers, color, shape and distribution status of macula, you can diagnose the depth of rash, seriousness, the possibility of treatment and prognosis of macula. The remedy for macule consists of cooling heat of yaming, removing heat from the blood and relieving feverish rash, and the one for rash consists of facilitating meridian with aroma, expelling pathogenic factors from muscles with drugs of pungent flavor and cool nature and clearing away heat from the blood systems. It relieves the inhibited functional activities of lung-Ki, and helps extermination of rash as well as clearing heat of the vessel. Also, it is the most important to preserve resin of stomach for every treatment. It is good to avoid expelling pathogenic factors with drugs of pungent flavor and warm nature, raising drugs and invigorating drugs during treating macula. Moreover, the patients should not over dose cold-natured drugs and purgative therapy. There are common clinical symptoms of macula in advance, so right recognition of symptoms can contribute to prevention of macula.

Unresolving Pneumonia (치료에 대한 반응이 없는 폐렴)

  • Bang, Do Seok;Jung, In Sung;Kang, Ki Man;Park, Bum Chul;Yoon, Young Gul;Kim, Jae Su;Park, Yol;Lee, Sung Hoon;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.604-608
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    • 2004
  • A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of $39^{\circ}C$, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still $39^{\circ}C$ despite the aggressive therapy of community-acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.