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The Comparison between High Dose and Low Dose Morphine in Terminal Cancer Patients During the Last 1 Week to Death (고용량과 저용량의 몰핀을 쓰는 말기 암 환자에서 임종 1주일동안 비교)

  • Cho, Doo-Yeoun;Cha, Kyu-Jin;Yoon, Bang-Boo;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.24-30
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    • 2002
  • Background : Pain is one of the most feared consequences of cancer. $65{\sim}85%$ of cancer patients experienced severe pain, and sometimes high dose morphine is used to these patients. But many doctors still have 'opioid-phobia' and hesitate to use high dose morphine. We investigated the morphine therapy in terminal cancer patients during the last 1 week to death, and found any differences according to the morphine dosage. Methods : 93 patients admitted to National Health Insurance Corporation Ilsan Hospital, department of family medicine for hospice care between September 2000 and the end of October 2001 and lived more than 1 week entered in the study. We investigated the demographic data, laboratory tests and sufficient dosage of morphine for pain control. According to the calculated dosage by OME(oral morphine equivalent), patients were divided into low dosage group (${\leq}150mg/day$) and high dosage group (>150 mg/day). The chi-squared test were used to evaluate the influence of age, gender, tumor sites, metastasis and adverse effects of morphine. Results : Mean age was $65.0{\pm}13.1year$ in low dosage group and $59.9{\pm}11.6year$ in high dosage group. 32 men (50.0%) and 32 women (50.0%) were included in low dosage group and 15 men (51.7%) and 14 women (48.3%) in high dosage group. Stomach was the most frequent tumor site and lung was the next. Metastasis were found 58 (90.6%) in low dosage group and 28 (96.6%) in high dosage group. In other palliative radiotherapy and adverse effects, there were no differences in both group. Conclusion : During the last 1 week to death in cancer patients, there were no difference according to the morphine dosage. So we don't have to have 'opioid-phobia' in treating the terminal cancer patients.

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Characterization of Toxicity Symptoms of Molybden and Determination of Tissue Threshold Levels for Diagnostic Criteria in Korean Bred Strawberries (국내육성 주요 딸기 품종에서 발생하는 Mo 과잉 증상 및 영양진단을 위한 식물체 내 한계농도)

  • Choi, Jong-Myung;Nam, Min-Ho;Lee, Chi-Won W.;Chun, Jong-Pil
    • Horticultural Science & Technology
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    • v.30 no.4
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    • pp.392-399
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    • 2012
  • This study was carried out to investigate the influence of molybden (Mo) concentrations in fertilizer solution on the growth of and nutrient uptake by domestically bred strawberries. Tissue analysis based on the dry weight was also conducted to determine the threshold levels in plants when Mo toxicity developed in strawberries. The leaf chlorophyll contents decreased lineally as Mo concentrations in the fertilizer solution were elevated. The differences among treatments in chlorophyll contents were statistically significant. The fresh and dry weights decreased significantly when the Mo concentrations in fertilizer solution were higher than 3.0 mM in 'Keumhyang' and 'Maehyang' strawberries and 1.0 mM in 'Seolhyang' strawberry. The elevation of Mo concentrations in fertilizer solution resulted in severe toxicity and crops developed the unique symptoms. The margin of older leaves became yellow and desiccated. Then, the margin of leaf blade rapidly became bronze colored and died as the symptoms spread up the plants. The interveinal area of the young leaves became yellowing. The elevation of Mo concentrations in fertilizer solution did not influence the tissue P, K, and Mg contents based on the dry weight. The tissue Ca contents were higher in 1.0 mM treatment than other treatments of 'Keumhyang' and 'Seolhyang' strawberries. The tissue Mo contents based on the dry weight of 'Keumhyang', 'Maehyang', and 'Seolyahng' strawberries were 76.5, 104.0, and 187.3 $mg{\cdot}kg^{-1}$, respectively, in the 0.25 mM treatments and 4,155, 5,367, and 2,190 $mg{\cdot}kg^{-1}$, respectively, in the 4.0 mM treatments. The contents increased lineally as Mo concentrations in fertilizer solution were elevated. When the concentration of Mo at which growth of crops were retarded by 10% is regarded as threshold level, the Mo contents based on dry weight of above ground plant tissue should be lower than 653.4, 686.2, and 589.7 $mg{\cdot}kg^{-1}$, in 'Keumhyang', 'Maehyang', and 'Seolyahng' strawberries, respectively.

X-linked Adrenoleukodystrophy in Childhood (X 염색체 연관 부신백질이영양증 환아들의 임상양상)

  • Yoo, Eun Jung;Kim, Eun Young;Kook, Hoon;Woo, Young Jong
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.5 no.1
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    • pp.33-43
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    • 2005
  • Purpose: X-linked adrenoleukodystrophy(ALD) is a rare disorder that shows a great deal of phenotypic variability. We subdivided chidhood X-linked ALD patients into several phenotypes by the age at onset, the sites of most severe clinical involvement and the rate of progression of neurologic symptoms. Methods: Thirteen patients who had been diagnosed as X-linked ALD and followed up for at least one year were enrolled from 1996 to 2003. Results: 1. Ten had childhood cerebral ALD, who showed first neurologic symptoms at 7.02 years and progressed rapidly: interval between first symptoms and vegetative state was 1.35 years, and interval from initial symptoms to death was 3.35 years. Treatment with Lorenzo's oil did not prevent neurologic progression. Two patients who underwent umbilical cord blood transplantation died. 2. Two had adolescent cerebral ALD. They had first symptoms at 11.5 years, and showed tendency to progress less rapidly than childhood cerebral form patients. 3. One "Addison only" patient who had adrenal insufficiency without nervous system involvement remained asymptomatic during Lorenzo's oil treatment. 4. All cerebral form patients except one showed the lesions in both parieto-ocipital white matter in brain magnetic resonance imaging. Conclusion: The cerebral ALD was the most common form in childhood and was asoociated with a serious prognosis.

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Cytotoxicity of Paraquat or Bentazone and Compensatory Effects of 3-Methylcholanthrene on the Rat Liver (Paraquat 및 Bentazone의 세포독성과 흰쥐 간에서 3-Methylcholanchrene의 독성경감효과)

  • Rim, Yo-Sup;Han, Du-Seok
    • Korean Journal of Environmental Agriculture
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    • v.20 no.3
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    • pp.155-161
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    • 2001
  • This study was carried out to investigate cytotoxicity of paraquat or bentazone on NIH 3T3 fibroblasts, toxicity of paraquat or bentazone, and compensatory effects of 3-Methylcholanthrene(3-MC) on the rat liver. In order to MTT assay, the $5.0{\times}10^4$ cell/mL of NIH 3T3 fibroblast in each well of 24 multidish were cultured. After 24 hours, the cells were treated with solution of paraquat or bentazone(1, 25, 50, 100 ${\mu}M$ respectively). After the NIH 3T3 fibroblast of all groups were cultured in same condition for 48 hours. MTT assay were performed to evaluate the cytotoxicity of cell organelles. Paraquat or bentazone $MTT_{50}$ were 1668.97 ${\mu}M$ and 1506.97 ${\mu}M$, respectively. These $IC_{50}$ of paraquat or bentazone were decided low cytotoxicity by Borenfreund. In order to observe the toxicity and compensatory effects of paraquat or bentazone on the rat liver, Sprague-Dawley male rats were used as experimental animals and divided into paraquat or bentazone only treated group and simultaneous application group of paraquat or bentazone and 3-MC. At 30 min and 1, 3, 6, 12, 24, 48 and 96 hrs interval after each treatment, the animals were sacrificed by decapitation and liver were immediately removed, immersed in fixatives, and processed with routine method for light microscopic study. Paraffin sections were stained with H-E, PAM and Best Carmine. Under the light microscope, degenerative changes of hepatic lobules were frequently observed in portal area from 3 hrs after paraquat or bentazone treatment. All hepatic cells were induced degenerative change at 12 hrs and more severe degenerative change at 48 hrs after paraquat or bentazone treatment. Especially, hepatic cells of bentazone only treated group were distinctly showed pyknotic. Glycogen granules were increased in portal area at 3 hrs, all hepatic cells at 12 hrs and remarkably increased at 48 hrs after paraquat or bentazone treated group. But hepatic cells of bentazone only treated group were regeneration at 48 hrs from portal area and glycogen granules of hepatic cells of paraquat or bentazone and 3-MC combination treated group showed in central area only at 48 hrs. The results indicate that 3-MC may be decrease paraquat or bentazone cytotoxicity on the rat liver.

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Evaluations of Ecological Habitat, Chemical Water Quality, and Fish Multi-Metric Model in Hyeongsan River Watershed (형산강 수계의 생태 서식지, 화학적 수질 및 어류의 다변수모델 평가)

  • Kim, Yu-Pyo;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.43 no.2
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    • pp.279-287
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    • 2010
  • This study was to evaluate ecological conditions of Hyeongsan River watershed from April to September 2009. The ecological health assessments was based on Qualitative Habitat Evaluation Index (QHEI), water chemistry during 2000~2009, and the fish multi-metric model, Index of Biological Integrity (IBI). For the study, the models of IBI and QHEI were modified as 8 and 11 metric attributes, respectively. Values of IBI averaged 25.4 (n=6), which is judged as a "fair" condition (C) after the criteria of Barbour et al. (1999). The distinct spatial variation was found in the IBI. Physical habitat health, based on the values of QHEI, varied from 76 in the downriver (H6) to 150.5 in the headwater (H1) and was evidently more disturbed in the downriver reach. Values of BOD and COD averaged 2.4 $mgL^{-1}$ (range: 0.3~13.8 $mgL^{-1}$) and 4.3 $mgL^{-1}$ (scope: 0.6~12.8 $mgL^{-1}$), respectively during the study period. Total nitrogen (TN) and total phosphorus (TP) averaged 3.0 $mgL^{-1}$ and 103.5 ${\mu}gL^{-1}$, respectively, indicating a severe eutrophication, and the nutrients increased more in the downriver than the headwater. Overall, physical, chemical and IBI parameters showed a typical downriver degradation along main axis of the river from the headwater-to-the downriver. This was mainly attributed to livestock waste and residential influences along with industrial discharge from the urban region.

The Review of Environment, Food and Exercise on Allergy Anaphylaxis (환경, 음식 및 운동 알레르기 반응에 대한 고찰)

  • Kwak, Yi-Sub;Baek, Young-Ho;Kim, Seung-Hyun;Kim, Young-Il;Yoo, Byung-In
    • Journal of Life Science
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    • v.20 no.1
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    • pp.147-152
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    • 2010
  • Exercise-induced anaphylaxis (EIA) is a physical allergy, sometimes severe, triggered by exertion following specific food intake. It was defined for the first time in 1980. EIA is associated with different kinds of exercise. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the findings of an elevated serum histamine level during exhaustive exercise. As predisposing factors of EIA, a specific or even nonspecific sensitivity to food has been reported. Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise which was preceded by the ingestion of the causal food allergens. The diagnosis of FDEIA is heavily dependent on clinical history. Allergy tests may need to be performed using a broad panel of food and food additives. As with food allergies, FDEIA diagnosis is based on interview, biological test and skin test. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episodes. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise. Two cases of EIA are presented (EIA to circumstances; FDEIA) in this paper, The diagnosis, pathophysiology and therapy of FDEIA are also reviewed.

AN EXPERIMENTAL STUDY ON THE EFFECT OF Ca(OH)2 UPON THE HEALING PROCESS OF THE PULP AND PERIAPICAL TISSUE IN THE DOGS' TEETH (수산화칼슘이 손상치수조직 및 치근조직의 치유에 미치는 영향에 관한 연구)

  • Lim, S.S.;Yoon, S.H.;Lee, C.S.;Lee, M.J.;Kim, Y.H.;Kwon, H.C.;Um, C.M.
    • Restorative Dentistry and Endodontics
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    • v.8 no.1
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    • pp.123-131
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    • 1982
  • The purpose of this study was to observe the responses of the remaining pulp tissue after pulpotomy upon the several kinds of $Ca(OH)_2$ products and the responses of periapical tissue upon some root canal filling materials after extirpation. For pulpotomy, the class V cavities were prepared on the premolars, molars and upper canines, and the pulp was amputated. Each drug was placed over the amputated tissue and cavity was sealed with zinc oxide eugenol cement. The drugs which were used for the study were Dycal (Caulk Co. U.S.A.), Cavitec (Kerr Co. U.S.A.), Calvital, Nobudyne and Neodyne (Neo Dental Chemical Products). For extirpation, the endodontic cavities were prepared on the lingual surfaces of anterior teeth, and the pulp tissues were extirpated as routine method. After enlarging, irrigation, and measuring of root length by taking X-ray, each root canal filling material was filled in the canal with gutta percha cone, and endodontic cavity was sealed with zinc oxide eugenol cement. Zinc oxide eugenol, $Ca(OH)_2$ (Eli Lilly Co. U.S.A.) and Vitapex (Neo Dental Chemical Products) were used as root canal filling materials. Animals were sacrificed after 1, 3 and 6 weeks following the operation. The teeth were decalcified in formic acid, sectioned and stained with hematoxylin eosin. Microscopic examination revealed as follows. 1. Dycal: The dentin bridge formation was observed at the 3rd week after pulpotomy. Inflammatory conditions which were infiltration of inflammatory cells and dilatation of blood vessels were kept in remaining pulp tissue at the 6th week. 2. Calvital: The dentin bridge was observed at the 1st week after pulpotomy. As the time clasped, the pulp tended to be the fibrous degeneration. 3. Cavitec, Nobudyne and Neodyne: In the case of Cavitec and Nobudyne, the incompleted and irregular dentin bridge was observed at the 6th week, and in Neodyne, was observed at the 3rd week. The severe inflammatory changes were seen in the remaining pulp tissue. As the time clasped, the fibrous degeneration tended to spread in the remaining pulp tissue. 4. $Ca(OH)_2$: Osteocementum was formed at the 3rd week, the matrix of cementum and dentin were resorted, and infiltration of lymphocytes was seen in periapical tissue when $Ca(OH)_2$ was used as canal-filling materials. S. ZOE and Vitapex The cementum like substance was seen in periapical portion at the 1st week, when ZOE and Vitapex were used as root canal filling materials. As the time elapsed, the matrix of cementum and dentin tended to be resorted. At the 6th week, the inflammatory condition of periapical tissue was continued in the case of ZOE, but was reduced in the case of Vitapex.

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A Study on Recent Research Trend in New Product Development Using Keyword Network Analysis (키워드 네트워크 분석을 이용한 NPD 연구의 진화 및 연구동향)

  • Pyun, JeBum;Jeong, EuiBeom
    • Journal of Korea Society of Industrial Information Systems
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    • v.23 no.5
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    • pp.119-134
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    • 2018
  • Today, many firms face the environment of high uncertainty and severe competition due to the rapid technology development and the diverse needs of customers. In the business environment, one of the most important ways to gain sustainable competitive advantage and future growth engine is related to NPD (New Product Development), which is a very important issue for practice and academia. Thus, this study intends to provide new values to practitioners and researchers related to NPD by analyzing current research trends and future trends in NPD field. For this, we bibliometrically analyzed keyword networks which consist of keywords that were already published in the eminent journals from Scopus database to generate insights that have not been captured in the previous reviews on the topic. As a result, we could understand the extant research streams in NPD field, and suggest the changes of specific research topics based on the connected relationships among keywords over the time. In addition, we also foresaw the general future research trends in NPD field based on the keywords according to preferential attachment processes. Through this study, it was confirmed that NPD keyword network is a small world network that follows the distribution of power law and the growth of network is formed by link formation by keyword preferential attachment. In addition, through component analysis and centrality analysis, keywords such as Innovation, New product innovation, Risk management, Concurrent engineering, Research and development, and Product life cycle management are highly centralized in NPD keyword network. On the other hand, as a result of examining the change of preferential attachment of keywords over the time, we suggested the required new research direction including i) NPD collaboration with suppliers, ii) NPD considering market uncertainty, iii) NPD considering convergence with the other academic areas like technology management and knowledge management, iv) NPD from SME(Small and medium enterprises) perspective. The results of this study can be used to determine the research trends of NPD and the new research themes for interdisciplinary studies with other disciplines.

Effects of Treadmill Exercise on Alpha-synuclein Mutation and Activated Neurotrophins in Nigrostriatal Region of MPTP-induced Parkinson Models (MPTP 파킨슨 모델의 트레드밀 운동이 알파시누크린 변성과 흑질선조체내 신경성장인자 활성화에 미치는 영향)

  • Park, Jae-Sung;Kim, Jeong-Hwan;Yoon, Sung-Jin
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.2
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    • pp.73-88
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    • 2009
  • Objectives : Neuronal changes that result from treadmill exercise for patients with Parkinson's disease(PD) have not been well documented, although some clinical and laboratory reports suggest that regular exercise may produce a neuroprotective effect and restore dopaminergic and motor functions. However, it is not clear if the improvements are due to neuronal alterations within the affected nigrostriatal region or result from a more general effect of exercise on affect areas and motivation. In this study, we demonstrate that motorized treadmill exercise improves the neuronal outcomes in rodent models of PD. Methods : We used a chronic mouse model of parkinsonism, which was induced by injecting male C57BL/6 mice with 10 doses(Every 12 hour) of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (30 mg/kg) and probenecid (20 mg/kg) over 5 days. These mice were able to sustain an exercise training program on a motorized rodent treadmill at a speed of 18 m/min, $0^{\circ}$ of inclination, 40 min/day, 5 days/week for 4 weeks. At the end of exercise training, we extracted the brain and compared their neuronal and neurochemical changes with the control(saline and sedentary) mice groups. Synphilin protein is the substance that manifestly reacts with ${\alpha}$-synuclein. In this study, we used Synphilin as a manifest sign of recovery from neurodegeneration. We analyze the brain stems of the substantia nigra and striatum region using the western blotting technique. Results : There were no expression of synphilin in the saline-induced groups. The addition of MPTP(1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) greatly accelerated synphilin expression which meant an aggregation of ${\alpha}$-synuclein. But, the MPTP-induced treadmill exercise group showed significantly lower expression than the MPTP-induced sedentary group. This means treadmill exercise has a definite effect on the decrease of ${\alpha}$-synuclein aggregation. Conclusions : In this study, our results suggest that treadmill exercise promoted the removal of the aggregation of ${\alpha}$-synuclein, resulting in protection against disease development and blocks the apoptotic process in the chronic parkinsonian mice brain with severe neurodegeneration.

The effect of fluoridation on discoloring of bleached teeth (불소 도포가 미백 처리된 치아의 색변화에 미치는 영향)

  • Jang, Hyang-Ah;Suh, Kyu-Won;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.257-265
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    • 2009
  • Statement of problem & Purpose: To study the effect of different fluoridation methods after in-office bleaching on the color of teeth during severe staining with coffee. Material and methods: 44 specimens were randomly divided into four groups. Group 1 (no bleaching, no fluoride, coffee) was served as control for the influence of coffee on the color of untreated teeth. Group 2, 3 and 4 were undergone bleaching with 35% $H_2O_2$ for 30 minutes a day on 3 consecutive days. Group 2 was remained without fluoridation. Group 3 and 4 were fluoridated for 1 hour with either Cavity shield$^{(R)}$ or pH 7 Gel$^{(R)}$. All of groups were immersed in coffee solution for 7 days. Color determination was accomplished using the spectrophotometer (VITA Easyshade$^{(R)}$). Results: ${\Delta}L$ and ${\Delta}h$ increased, whereas ${\Delta}C$ decreased in the bleached groups. Pairwise comparisons with Tukey's HSD showed that there were statistically significant differences for ${\Delta}L$ and ${\Delta}h$ between the bleached groups and the non-bleached group (P < .05). ${\Delta}L$ and ${\Delta}h$ decreased continuously, while ${\Delta}C$ showed an increase after a decrease in all of groups during immersion in coffee solution. After immersion in coffee solution for 7 days there were no statistically significant differences for ${\Delta}L$, ${\Delta}C$ and ${\Delta}h$ between the groups (P > .05). Also there were no statistically significant differences for ${\Delta}L$, ${\Delta}C$ and ${\Delta}h$ between the group 3 treated with Cavity shield. and the group 4 treated with pH 7 Gel. (P > .05). Conclusion: It was concluded that fluoridation was not beneficial to the prevention of extrinsic stains after bleaching.