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Bile Duct Ligation and Insulin-like Growth Factor-I on the Ischemia-Reperfusion Injury of the Small Bowel (쥐에서 허혈-재관류 소장 손상에 대한 담관결찰 및 Insulin-like Growth Factor-I의 영향)

  • Cha, Je-Sun;Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.98-107
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    • 1997
  • To determine whether bile juice exclusion can prevent the mucosal damage, and Insulin-like growth factor-I can promote mucosal regeneration in ischemia-reperfusion injury of the bowel, 39 weanling rats with 10 cm of Thiry-Vella loop were studied. Animal groups were; Control, BL(common bile duct ligation), IGF{insulin-like growth factor-I(IGF-I) infusion} and IGF-BL(combined treatment). IGF-I(1.5 mg/kg/day) was continuously delivered through a subcutaneously implanted miniosmotic pump. After 15 minutes of superior mesenteric artery clamping, a tissue specimen(P) was taken after 30 minutes of reperfusion. Intestinal continuity was restored to allow oral feeding. A specimen of main tract(M) and another of the Thiry-Vella loop(T) were collected for histomorphometry after 48 hours of reperfusion and free feeding. Villus size ratio(VSR), crypt depth(CD), crypt-depth/villus-height ratio(CVR) and injury score(IS) were measured in 15 consecutive villi. The postoperative mortalities of bile duct ligation groups(BL and IGF-BL) were higher than those of other groups. In control group, VSR of M was lower(P<0.05) than P or T, but not in the other groups. VSR of M in control was lower than those in other groups. CD of T in control, IGF and IGF-BL group were higher than those of M. CD of M and T showed gradual increments from control, IGF and IGF-BL group, respectively. CVR of M and T in IGF group were higher than those in control. CVR in IGF-BL group, T was higher than M, and M was higher than P. About IS, M of BL($20.1{\pm}2.5$) and IGF-BL($20.9{\pm}3.3$) groups were significantly lower than that of control($32.4{\pm}2.5$). These results suggest that the exclusion of bile juice reduces the severity of the reperfusion injury of the mucosa, by inability to activate pancreatic enzymes and IGF-I stimulates mucosal regeneration in injured bowel, and the effect is potentiated by bile juice exclusion.

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Clinical Characteristics and Prognostic Factors in Patients with Pulmonary Tuberculosis Admitted to Intensive Care Units (중환자실로 입원한 폐결핵 환자의 임상 양상과 예후 인자)

  • Kang, Ji-Young;Kim, Myung-Sook;Kim, Ju-Sang;Kang, Hyeon-Hui;Kim, Seung-Soo;Kim, Yong-Hyun;Kim, Jin-Woo;Lee, Sang-Haak;Kim, Seok-Chan;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.259-266
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    • 2010
  • Background: Pulmonary tuberculosis (TB), requiring the intensive care unit (ICU) care, has been a high-mortality condition until now. In the present study, we aimed to investigate clinical features and parameters associated with TB mortality. Methods: From August 2003 to December 2008, patients with microbiologically or histologically confirmed pulmonary TB then admitted to the ICU, were retrospectively enrolled into the study. Upon enrollment, their medical records were reviewed. Results: Forty three patients (30 males, 13 females) were included and their mean age was 63.8 years (range: 17~87 years). Twelve patients died, an overall in-hospital mortality of 27.8%. The main reason for the ICU care was dyspnea or hypoxemia requiring mechanical ventilation (n=17). Other diagnoses for ICU care were hemoptysis, monitoring after procedures, neurologic dysfunction, shock, and gastrointestinal bleeding. On univariate analysis, the factors affecting the mortality were malnutrition-related parameters including low body mass index, hypoalbuminemia, lymphocytopenia, and hypocholersterolemia, as well as severity-related variables such as high acute physiology and chronic health evaluation (APACHE) score, number of involved lobes, and high C-reactive protein. In addition, respiratory failure requiring mechanical ventilation and acute respiratory distress syndrome contributed to patient fatality. It was shown on multivariate analysis that respiratory failure and hypoalbuminemia were significantly independent variables associated with the mortality. Conclusion: Acute respiratory failure is the most common reason for the ICU care and also the most important factor in predicting poor outcome. In addition, our data suggest that the parameters associated with malnutrition could be possible factors contributing to mortality.

Tolerability, Safety and Effectiveness of Paliperidone ER in Patients with Schizophrenia : A 24-Week Interim Analysis of the 48-Week Open-Label, Prospective, Switch Study (조현병 환자에서 Paliperidone Extended Release의 효능, 안전성 및 내약성 : 48주 개방형, 전향적 연구의 24주 중간 분석)

  • Choi, You Ra;Jung, Dong Chung;Kim, Eun Young;Kim, Se Hyun;Lee, Hyun Jeong;Lee, Nam Young;Chang, Sung Man;Shim, Joo Cheol;Joo, Eun Jeong;Kim, Jae Jin;Lee, Sang Hyuk;Chung, Young Chul;Kim, Yong Sik;Ahn, Yong Min
    • Korean Journal of Biological Psychiatry
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    • v.20 no.1
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    • pp.12-20
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    • 2013
  • Objectives We investigated the tolerability, safety, and treatment response to flexible-dose paliperidone ER in patients with non-acute schizophrenia in whom previous antipsychotic drugs were ineffective. Methods This 24-week interim analysis of the 48-week multicenter, prospective, open-label study assessed effectiveness using the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia-Severity (CGI-SCH-S) Scale, Personal and Social Performance (PSP) and Drug Attitude Inventory (DAI). Safety and tolerability were assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) and Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS). Results Effectiveness was assessed in 169 patients. Significant improvement in the PANSS total score was observed by week-1 and continued until week-24. The response rate was 33%. The CGI-SCH-S and PSP total scores significantly improved during 24 weeks ; however, no change occurred in the total DAI. Fifty-nine percent of patients reported adverse events, of which extrapyramidal symptoms were the most frequent (19.0%). The DIEPSS and LUNSERS scores were improved after 24 week. Conclusions Switching to the flexible-dose paliperidone ER from an ineffective antipsychotic drug was safe, tolerable, and showed a good treatment response in Korean patients with schizophrenia.

Effect of Jeseupwiryeongtang-gagam on Atopic Dermatitis-like Skin NC/Nga Mouse Induced by Dermatophagoides Farinae Crude Extract (제습위령탕가감이 집 먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향)

  • Na, Dong-Gyu;Han, Jae-Kyung;Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.22 no.2
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    • pp.81-114
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    • 2008
  • Objectives : The purpose of this study is to investigate the effect of Jeseupwiryeongtang-gagam(JWTG) on atopic dermatitis by in vivo experiment using NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to the atopic dermatitis of human. Methods : To investigate the effect of JWTG on AD, we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis-like skin NC/Nga mouse in vivo. Results and Conclusions : In vivo, clinical skin severity score were significantly lower in JWTG group than control group. IgE, IL-6, $TNF-{\alpha}$, IgM, IgG2a and IgG2b levels in serum were decreased remarkably in JWTG group than control group and $IFN-{\gamma}$ production, secreted in Th1 cell were increased by JWTG. After experiment ended, we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+$$CD69^+$, $CD4^+$$CD25^+$ and $CD49b^+$) by flow cytometry. It resulted that total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as normal and $CD3^+$$CD69^+$ were decreased significantly compared with control group in isolated DLN and PBMCs from NC/Nga mouse and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by JWTG. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E) and toluidine staining (mast cells marker) and obtained results that JWTG were effective to histological symptoms (dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration). Ear thickness was decreased significantly than the control group and the size of inflammatory lymphocytes cells(ILC) and plasma cells(PC) in DLN were also decreased.

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Change of Psychological Characteristics after Joining the Army According to Internet Addiction Tendency in Young Male Army Recruits (군 병사들에서 인터넷 중독 경향에 따른 입대 후 심리특성 변화)

  • Kang, Hyun Mook;Kim, Hyun Soo;Cho, Hyun Sang;An, Suk Kyoon;Oh, Byoung Hoon;Lee, Kang Soo;Hong, Chang Hyung;Bae, Hwallip;Kook, So Dahm;Son, Sang Joon
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.86-90
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    • 2013
  • Objectives The aim of this study was to find out the psychological changes associated with internet addiction between before and after the military drill among the young male army recruits. Methods All 1091 participants were army recruits aged from 19 to 22 years who participated in the 5-week military drill. They were assessed with some self-reported questionnaires [Sociodemographic questionnaires, Young's Internet Addiction Scale (IAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Barratt Impulsiveness Scale (BIS), the Attention-Deficit/Hyperactivity Disorder Self-Rated Scale (ASRS)]. They were divided into two groups, One is the internet addiction tendency group and the other is non-addiction group according to the IAS score. And the severity of the internet addiction tendency, depression, anxiety and impulsiveness were evaluated by the IAS, the STAI, the BDI, the BIS, the ASRS before and after military drill. Results The result of the paired t-test shows that the IAS, the STAI, the BDI, the BIS, the ASRS scores decreased after military drill in both non-addiction group and internet addiction tendency group. The result of the repeated measures ANOVA shows that there is an interaction effect between the changes of ASRS-hyperactivity (F = 23.437, p < 0.001), ASRS-impulsiveness (F = 4.896, p = 0.027), BIS-total (F = 4.057, p = 0.044), BIS-motor impulsiveness (F = 13.609, p < 0.001) scores and groups. The result of the generalized estimating equation shows that internet addiction tendency is associated with ASRS-inattention (${\beta}=0.075$, p < 0.001), ASRS-hyperactivity (${\beta}=0.092$, p = 0.002), STAI-trait anxiety (${\beta}=0.046$, p < 0.001), BIS-motor impulsiveness (${\beta}=0.119$, p = 0.028). Conclusions The results show that psychopathologies such as internet addiction tendency, depression, anxiety, impulsiveness may improve after military drill regardless of the groups. Internet addiction tendency may be related to the ASRS-inattention, ASRS-hyperactivity, STAI-trait anxiety, motor-impulsiveness. So these findings may be considered in the treatment of internet addiction in terms of the impulsiveness control.

Effectiveness of a Health Educational Program Based on Self-Efficacy and Social Support for Preventing Liver Fluke Infection in Rural People of Surin Province, Thailand

  • Kaewpitoon, Soraya J;Thanapatto, Sirisuda;Nuathong, Wimonya;Rujirakul, Ratana;Wakkuwattapong, Parichart;Norkaew, Jun;Kujapun, Jirawoot;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1111-1114
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    • 2016
  • Opisthorchiasis is a major problem in Thailand particularly in northeast region which also has a high incidence of cholangiocarcinomas. Since health modification is needed, this quasi-experimental study aimed to assess the effectiveness of a health education program based on self-efficacy and social support in Tha Tum district, Surin province, Thailand. A total of 70 participants were purposive selected with a history of opisthorchiasis. Participants were divided into experimental and control groups, each with 35 subjects. The experimental group received a health education program composed of: (1) knowledge improvement, lectured with multimedia, demonstration, brochure, and handbook; (2) group discussion about their health beliefs, sharing their ideas and experience; and (3) social support from village health volunteers (VHV), heads of villages (HV), friends, and members of families, and public health officer (PHO). Follow-up was by PHO/VHV/HV, with provision of certificates and flasg for household that did not eat raw fish. Data were collected by predesigned questionnaires after implementation of the program for 3 months. Comparative data was analyzed by paired simple t-test and independent t-test. The results revealed that the experimental group had mean score of knowledge higher more than before the experiment (mean difference=3.1, t=3.915, 95%CI-3.3, -1.8 p-value=0.001), and the control group (mean difference=2.5, t=4.196, 95%CI=1.4, 3.6, p-value=0.001) with statistical significance. The mean scores of practice were higher than before the experiment (mean difference=4.6, t=4.331, 95%CI-5.3, -3.1, p-value=0.001), and control group (mean difference=4.4, t=6.142, 95%CI=4.2, 7.9, p-value=0.001). The mean scores of perceived susceptibility and perceived severity of opisthorchiasis, al well as perceived benefits and perceived barriers to prevention of opisthorchiasis, were also higher than before the experiment and in the control group (p-value <0.001). In conclusion, this was a successful health education program for liver fluke avoidance. Therefore, it may useful for further behavior modification in the other epidemic areas.

Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury

  • Lim, Tae Kyoo;Yu, Byug Chul;Ma, Dae Sung;Lee, Gil Jae;Lee, Min A;Hyun, Sung Yeol;Jeon, Yang Bin;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.140-144
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    • 2017
  • Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI). Methods: A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP). Results: The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were $24.2{\pm}6.1$ and $5.4{\pm}0.8$, respectively. The mean ONSD of the TBI group ($5.5{\pm}1.0mm$) was higher than that of the non-TBI group ($4.7{\pm}0.6mm$). Some significant differences in age ($55.3{\pm}18.1$ vs. $49.0{\pm}14.8$, p<0.001), GCS ($11.7{\pm}4.1$ versus $13.3{\pm}3.0$, p<0.001), and ONSD ($5.5{\pm}1.0$ vs. $4.7{\pm}0.6$, p<0.001) were observed between the TBI and the non-TBI group. An ROC analysis was used to assess the correlation between TBI and ONSD. Results showed an area under the ROC curve (AUC) value of 0.752. The same analysis was used in the TBI with midline shift group, which showed an AUC of 0.912. Conclusions: An ONSD of >5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.

Comparison of Moxifloxacin Monotherapy versus Cephalosporin-Azithromycin Combination Therapies for the Treatment of Community Acquired Pneumonia (원외획득폐렴 환자 치료에서 Moxifloxacin 단독요법과 Cephalosporin-Azithromycin 병용요법의 비교)

  • Cheong, Eun-Jin;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.75-81
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    • 2005
  • Community acquired pneumonia (CAP) remains a prevalent and potentially life threatening illness. American Thoracic Society and Infectious Disease Society America recommend combination therapies with ${\beta}-lactam$ plus a macrolide or a fluoroquinolone monotherapy for the empirical treatment of CAP. The aim of this study was to compare moxifloxacin monotherapy with cephalosporin plus azithromycin combination therapies. From January 2004 to March 2005, 18 patients in the moxifloxacin group(MG) and 21 patients in the cefuroxime or ceftriaxone plus azithromycin group(CAG) with CAP were retrospectively reviewed with regard to clinical, laboratory and microbiological data. Each patient was stratified into mild (risk class I-II), moderate (risk class III) and severe (risk class VI, V) group according to and PSI (Pneumonia Severity Index) score. Each group was compared for microbiological eradication, clinical assessment, the length of hospital stay. As results, Total 39 patients with CAP were reviewed. The appropriateness of admission was 83.3% in MC vs. 76.2% in CAC. The mean length of the hospital day was for 8.31 days vs. 7.39 days, days switching parenteral to oral antibiotics in 5.19 days vs. 5.28 days, clinical improvement in 2.43 days vs. 2.61 days in MG vs. CAC. Radiological improvement required 3.75 days vs 3.63 days in MG vs. CAG and bacteriological eradication rate at discharge was the same in the both groups. Mortality rate was 11.1% (2 of 18) vs 14.3% (3 of 21) in MG vs. CAG (p=0.77). Drug cost of the mean 5 hospital days requiring parenteral antibiotics was the most inexpensive in moxifloxacin group for the 147,045 won, and ceftriaxone 1g-azithromycin group for the 170,285 won, cefuroxime bid-azithromycin group for the 207,800 won, ceftriaxone 2g-azithromycin group far the 220,570 won, cefuroxime tid-azithromycin group for the 251,700 won. There was no significant statistical difference in clinical, bacterial, radiological cure and hospital days, and switch to oral days. In conclusion, that i.v. moxifloxacin monotherapy was as effective as azithromycin plus cefuroxime or ceftriaxone combination therapies fur the treatment of CAP. In drug cost analysis, moxifloxacin is less expensive than CAG.

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Anger-Related Characteristics and Childhood Adversity in Somatic Symptom Disorder (신체증상장애와 관련된 분노정서특질과 아동기 역경 경험)

  • Kang, Sung-Hyuk;Park, Chun Il;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Anxiety and mood
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    • v.16 no.2
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    • pp.49-56
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    • 2020
  • Objective : The present study aims to investigate differences in anger-related features in patients with somatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and anger regulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examined the relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessed with State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed using the somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory Amplification Scale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis of covariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725, F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they had a high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, a directed inward style of anger expression was significantly associated with somatization symptom severity (p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSD group than the control group (p=0.012). Within the SSD group, childhood extreme illness was associated with higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversity of extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-related features and its relationship with childhood adversity in the pathophysiology of SSD.

Mobile Phone Use Pattern and Visual Display Terminal Syndrome Symptom Experience in Female Adolescents (여자 청소년들의 휴대전화 사용행태와 컴퓨터단말기증후군 증상경험)

  • Park, Soonjoo;Yang, Sumin;Yoon, Jihye;Choi, Hannha;Han, Jayeon;Kwon, Sooyeon
    • The Journal of the Korea Contents Association
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    • v.16 no.4
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    • pp.45-55
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    • 2016
  • The purpose of this study was to identify the relation between mobile phone use and visual display terminal syndrome symptom experience in female students from middle school and high school. The convenience sample consisted of 349 female students in four schools. The data were collected from May to June in 2013 using VDTS Subjective Symptom Questionnaire. Descriptive statistics, Kruskal-Wallis test, and Mann-Whitney U test were used to analyze the data using SPSS 21.0. Almost all (96.3%) female students use mobile phone. Among them, 87.7% of the subjects experienced more than one VDTS symptom and the average score was $.39{\pm}.41$ in VDTS symptom experience. Eye related symptom was most experienced and musculoskeletal symptom was the highest in severity among five subdomain of VDTS symptoms. There were significant differences in VDTS symptom scores in accordance with posture, hours of use, and break type during mobile phone use. These findings suggest that the education program for adolescents would be necessary, and the development of checklist would be useful for adolescents to check themselves.