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Neonatal Diabetes Mellitus Due to KCNJ11 (KIR6.2) Mutation Successfully Treated with Sulfonylurea

  • Jang, Sehun;Yang, Misun;Ahn, So Yoon;Sung, Se In;Chang, Yun Sil;Park, Won Soon
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.94-98
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    • 2021
  • Neonatal diabetes mellitus (NDM) is a rare disease that occurs at less than 6 months of age and is presumably caused by a mutation in the gene that affects pancreatic beta-cell function. Approximately 80% of NDM cases reveal a known genetic mutation, and mutations in potassium inwardly rectifying channel subfamily J member 11 (KCNJ11) and ABCC8 affecting the pancreatic beta-cell adenosine triphosphate-sensitive potassium channel may be treated with oral sulfonylurea. Early recognition of mutations in KCNJ11 and ABCC8 is important because early administration of sulfonylurea can not only control blood glucose levels but also improve neurodevelopmental outcomes. In the present study, we report a case of NDM that initially presented as diabetic ketoacidosis at the age of 1 month, accompanied by seizures during hospitalization. After confirmation of the KCNJ11 gene mutation (c.989A>C), we started administering oral sulfonylurea (glimepiride) at the age of 2 months. After gradually increasing the dosage of glimepiride, insulin was discontinued at the age of 3 months. To date, the infant's blood glucose levels have been well controlled without significant hypoglycemic events. No further episodes of seizures have occurred, and his developmental status is favorable.

Development of an Infographic-Based STEAM Program (인포그래픽 기반 STEAM 프로그램 개발 및 효과성 검증)

  • Hyun, Eun Ryung;Kim, Jeong Hyun;Shin, Tae Seob
    • Journal of Engineering Education Research
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    • v.25 no.5
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    • pp.68-74
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    • 2022
  • The purpose of this study was to develop an infographic-based STEAM program for high school students and test its effectiveness. In this study, we converged high school 'art' education with 'Korean language' and 'mathematics.' The program was divided into four phases. The effectiveness of the program was analyzed by conducting matched pair t-test for 377 students at a girl's high school in Seoul before and after the program. The study found that the students' self-concept on mathematics and their attitude towards choosing science and engineering career showed significant increases after the program. By connecting high school courses through data visualization based on cognitive information design, findings from this study suggest that our infographic-based STEAM program should be implemented more frequently at high schools.

HeartMate 3 Implantation via Only Left Thoracotomy: A Case Report

  • Mi Young Jang;Jun Ho Lee;Su Ryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.224-227
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    • 2023
  • Median sternotomy is a standard surgical technique used for left ventricular assist device (LVAD) implantation. However, if sternotomy has a prohibitive surgical risk, LVAD implantation can be performed through only left thoracotomy. We managed a patient with end-stage heart failure who had recently undergone coronary artery bypass grafting (CABG) elsewhere. The patient also had a deep sternal wound infection and bacteremia. Because of refractory cardiogenic shock, we performed extracorporeal membrane oxygenation (ECMO). After multiple mediastinal washouts and omental flap placement, ECMO was converted to extracorporeal LVAD (from the left ventricular apex to the descending aorta) through a left thoracotomy. The extracorporeal LVAD was maintained for 18 days and replaced by the HeartMate 3 LVAD. The patient was discharged in good condition 115 days after CABG.

Tamoxifen Induces Apoptosis of Leishmania major Promastigotes in Vitro

  • Doroodgar, Masoud;Delavari, Mahdi;Doroodgar, Moein;Abbasi, Ali;Taherian, Ali Akbar;Doroodgar, Abbas
    • Parasites, Hosts and Diseases
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    • v.54 no.1
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    • pp.9-14
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    • 2016
  • Tamoxifen is an antagonist of the estrogen receptor and currently used for the treatment of breast cancer. The current treatment of cutaneous leishmaniasis with pentavalent antimony compounds is not satisfactory. Therefore, in this study, due to its antileishmanial activity, effects of tamoxifen on the growth of promastigotes and amastigotes of Leishmania major Iranian strain were evaluated in vitro. Promastigotes and amastigotes were treated with different concentrations (1, 5, 10, 20, and $50{\mu}g/ml$) and time periods (24, 48, and 72 hr) of tamoxifen. After tamoxifen treatment, MTT assay (3-[4,5-dimethylthiazol-2-yl]-2,5 biphenyl tetrazolium bromide assay) was used to determine the percentage of live parasites and Graph Pad Prism software to calculate $IC_{50}$. Flow cytometry was applied to investigate the induction of tamoxifen-induced apoptosis in promastigotes. The half maximal inhibitory concentration ($IC_{50}$) of tamoxifen on promastigotes was $2.6{\mu}g/ml$ after 24 hr treatment. Flow cytometry analysis showed that tamoxifen induced early and late apoptosis in Leishmania promastigotes. While after 48 hr in control group the apoptosis was 2.0%, the $50{\mu}g/L$ concentration of tamoxifen increased it to 59.7%. Based on the in vitro antileishmanial effect, tamoxifen might be used for leishmaniasis treatment; however, further researches on in vivo effects of tamoxifen in animal models are needed.

Comparison of Educational Effects on Hands-only Cardiopulmonary Resuscitation (CPR) with Basic Cardiopulmonary Resuscitation (CPR) by Elementary School Students (초등학생 가슴압박소생술과 기본심폐소생술의 교육효과 비교)

  • Ahn, Myung Ja;Kim, Young Im
    • Journal of the Korean Society of School Health
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    • v.27 no.3
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    • pp.130-139
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    • 2014
  • Purpose: The object of this study was to compare the educational effect about self-efficacy and the quality of chest compressions of Hands-only CPR and Basic CPR. Methods: It's a nonequivalent control group pre-post repeated quasi-experiment study conducted with entire fifth grade students belong to one school in H city. The study participants are 68 persons, and data were collected from December 2, 2013 to February 7, 2014. Self-efficacy was measured by 10 items, and the quality of chest compressions was measured by 5 variables which are average compression depth(mm), average rate (n/min), average count per minutes (n), abnormal placement (n), compression accuracy (%). Results: Self-efficacy of the experimental group and control group showed no significant difference but showed significant difference over time and was the highest at posttest 1 (immediately after education), the lowest at pretest (before education), middle at posttest 2 (8weeks after education) (p<.001). Experimental group was significantly higher than control group in average rate per minute. At posttest 1, experimental group was $130.0{\pm}9.38$ times, control group was $95.1{\pm}11.82$ times. At posttest2, experimental group was $124.0{\pm}14.89$ times, control group was $90.8{\pm}14.89$ times.(p<.001). Average rate (n/min) was significantly declined at control group in the quality of chest compressions over time (t=-2.400, p=.022). Average count per minute and compression accuracy were declined significantly so it were not maintained to posttest2. Conclusion: We need continuous CPR education because self-efficacy of CPR getting lower significantly over time. Hands-only CPR can't be seen as a way to increase the CPR ability of elementary school students having difficulty to perform artificial breathing. And, because the effect of education is not maintained 8wks after training, the technique centered repeated training is needed and a method which can increase compression accuracy is also needed.

Moderate and Deep Hypothermia Produces Hyporesposiveness to Phenylephrine in Isolated Rat Aorta

  • Cho, Jun Woo;Lee, Chul Ho;Jang, Jae Seok;Kwon, Oh Choon;Roh, Woon Seok;Kim, Jung Eun
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.402-412
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    • 2013
  • Background: Moderate and severe hypothermia with cardiopulmonary bypass during aortic surgery can cause some complications such as endothelial cell dysfunction or coagulation disorders. This study found out the difference of vascular reactivity by phenylephrine in moderate and severe hypothermia. Methods: Preserved aortic endothelium by excised rat thoracic aorta was sectioned, and then down the temperature rapidly to $25^{\circ}C$ by 15 minutes at $38^{\circ}C$ and then the vascular tension was measured. The vascular tension was also measured in rewarming at $25^{\circ}C$ for temperatures up to $38^{\circ}C$. To investigate the mechanism of the changes in vascular tension on hypothermia, NG-nitro-L-arginine methyl esther (L-NAME) and indomethacin administered 30 minutes before the phenylephrine administration. And to find out the hypothermic effect can persist after rewarming, endothelium intact vessel and endothelium denuded vessel exposed to hypothermia. The bradykinin dose-response curve was obtained for ascertainment whether endothelium-dependent hyperpolarization factor involves decreasing the phenylnephrine vascular reactivity on hypothermia. Results: Fifteen minutes of the moderate hypothermia blocked the maximum contractile response of phenylephrine about 95%. The vasorelaxation induced by hypothermia was significantly reduced with L-NAME and indomethacin administration together. There was a significant decreasing in phenylephrine susceptibility and maximum contractility after 2 hours rewarming from moderate and severe hypothermia in the endothelium intact vessel compared with contrast group. Conclusion: The vasoplegic syndrome after cardiac surgery might be caused by hypothermia when considering the vascular reactivity to phenylephrine was decreased in the endothelium-dependent mechanism.

Therapeutic effect of intraductal irrigation of the salivary gland: A technical report

  • Lee, Chena;Kim, Jo-Eun;Huh, Kyoung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.47 no.2
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    • pp.123-127
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    • 2017
  • Purpose: Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Materials and Methods: Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. Results: The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Conclusion: Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

Nodal tumor response according to the count of peripheral blood lymphocyte subpopulations during preoperative chemoradiotherapy in locally advanced rectal cancer

  • Heo, Jaesung;Oh, Young-Taek;Noh, O Kyu;Chun, Mison;Park, Jun-Eun;Cho, Sung-Ran
    • Radiation Oncology Journal
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    • v.34 no.4
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    • pp.305-312
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    • 2016
  • Purpose: The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer. Materials and Methods: From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT. Results: Among 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count - cell count at 4 weeks) was associated with node down staging (p = 0.034). Conclusion: Our results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.

Effect of cardiopulmonary resuscitation(CPR) education performed by health teachers on middle school students (보건교사가 수행한 중학생 심폐소생술 교육 효과)

  • Jun, Ho-Sun;Sohn, Hae-Sook
    • Journal of Digital Convergence
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    • v.13 no.10
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    • pp.385-395
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    • 2015
  • CPR education to school students is one of the key points to higher bystander CPR rate. The object of this study is to evaluate the results after CPR education to middel school students by health teachers compared to that of pre-education status. During 3 monthes from Mar. to Jun. 2014, the observation data before and after CPR education were analysed through Chi-square test and McNemar's test using SPSS, SAS programs from 812 middle school students in Busan prov. After stratifying those surveyed by genders and previous CPR education experiences, each stratified groups showed positive changes of statistical significnace in all aspects of the knowledge, will, and self-confidence about CPR. (p<0.05). It is the more desirable method to increase bystander CPR that the CPR education including knowledge and practice was done to middle school students by health teachers. To come true these CPR education, more studies are necessary about policy development to support education tranining tools in a community.

The Development and Evaluation of the Active Gait Training System for the Patients with Gait Disorder (보행 장애인을 위한 능동형 보행훈련 시스템 개발 및 평가)

  • Hwang, S.J.;Tae, K.S.;Kang, S.J.;Kim, J.Y.;Hwang, S.H.;Kim, H.I.;Park, S.W.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.218-228
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    • 2007
  • Modem concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. In this study, we developed an active gait training system for patients with gait disorder. This system provides joint movements to patients who cannot carry out an independent gait. It provides a normal stance-swing ratio of 60:40 using an eccentric configuration of two gears. Joint motions of the knee and the ankle were evaluated with using the 3D motion analysis system and compared with the results from the multi-body dynamics simulation. In addition, clinical investigations were also performed for low stroke patients during the 6-week gait training. Results from the dynamics simulation showed that joint movements of the knee and the ankle were affected by the gear size, the step length and the length of the foot plate, except the radius of curvature of the foot guide plate. Also, the 6-week gait training revealed relevant improvements of the gait ability in all low subjects. Functional ambulation category levels of subjects after training were 2 in three patients and 1 in a patient. The developed active gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke.