• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.277-283
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• 2007

목 적 : 급성 신부전은 횡문근 융해증의 중요 합병증 중의 하나이다. 저자들은 횡문근 융해증으로 진단된 환아를 대상으로 원인, 임상 경과, 검사실 소견을 분석하고 급성 신부전 및 사망의 위험 인자를 밝히고자 한다. 방 법 : 1997년 1월부터 2005년 5월까지 경상 대학교 병원 소아과에 횡문근 융해증으로 입원한 60명의 환아들의 임상 기록지와 병리 기록지를 후향적으로 조사하였다. 횡문근 융해증 진단 기준은 creatine phosphokinase (이하 CK)치가 1,000 IU/L이상이고 CK isoenzyme 검사에서 MM형이 95%이상이거나 혈중 미오글로빈이 300 mg/dL 이상이거나 소변 미오글로빈이 양성이면서 급성 심근 경색증이나 뇌졸중의 증거가 없는 경우로 정의하였다. 결 과 : 혈중 입원 시 CK 및 최고 CK는 급성 신부전의 예측 인자가 아니었고 입원 시 혈중 크레아티닌, 요산, pH 및 칼륨, 입원 당시의 수축기 혈압, 의식 상태와 급성 신부전은 유의한 상관 관계가 있었다. 입원 당시 혈중 CK, 요산, pH와 최고 혈중 크레아티닌 등의 검사실 소견과 입원 당시의 의식 상태 및 수축기 혈압과 사망과는 상관 관계를 보이지 않았으며 최고 CK는 사망과 상관 관계가 있었다. 결 론 : 소아에서 횡문근융해증과 동반된 급성 신부전의 사망률은 매우 높게 나타났으므로 급성 신부전으로 진행 여부를 예측 할 수 있는 인자를 조기에 파악하여 적극적인 치료를 해야 할 것이다. 특히 검사실 소견뿐 아니라 입원시 혈압이나 의식 상태, 유발 요인 등의 임상 상태가 예후를 예측하는 중요 인자임을 명시해야 할 것이다.

• 대한한방내과학회지
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• 제27권2호
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• pp.416-428
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• 2006

Objectives : Arterial stiffness and pulse pressure are related to cardiovascular and cerebrovascular survival and longevity. This study is aimed at examining the effects of Chungpyesagan-tang on arterial stiffness and Pulse pressure in acute stroke Patients. Methods: The subject of this study was acute strike Patients within 1 week after ictus, with Cardio-ankle vascular index(CAVI) higher than 9.0. They were divided into two groups: A treatment group (n=44) and a control group(n=46). For two weeks, Chungpyesagan-tang was given to the former, other herbal medicines to the latter. used for stroke patients for the control group for 2 weeks. At the end of first and second week, CAVI, pulse Pressure, National Institute of Health stroke scale(NIHSS), Modified Barthel Index(MBI) were measured. Serum lipid Profile, aspartate transaminase(AST), alanine transaminase(ALT). blood urea nitrogen(BUN), creatinine were also measured at the end of the study. Results : After 2 weeks, CAVI and Pulse Pressure in Chungpyesagan-tane group were significantly tower than those in the control group(P<0.05). NIHSS and MBI were improved in both groups. But there was no significant difference between the treatment group and the control group in terms of the NIHSS and MBI. Conclusions : We suggest Chungpyesagan-tanghas desirable effects on arterial stiffness and Pulse Pressure of acute stroke patients. It can improve morbidity and mortality of patients on the basis of influencing vascular stiffness and increased pulse pressure.

• 동의신경정신과학회지
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• 제20권2호
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• pp.111-120
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• 2009

Objectives : This study was performed to investigate the effects of Needle Electrode Electrical Stimulation (NEES) on ischemia-induced cerebrovascular accidents. After obstruction and reperfusion of ${\ast}{\ast}$ arteries in white mice, the amounts of necrosis and inflammation related substances IL-6, Caspase-3, and PARP, C-fos were measured in neurons of the hippocampus. The following results were obtained. Methods : This study used 21 male specific pathogen free (SPF) SD (Sprague Dawley) rats, 8 weeks of age and approximately 300 g in weight, that were given at least 1 week to adapt to the lab environment Each exposed artery was completely occluded with non-absorbent suture thread and kept in that state for 5 minutes. The sutures were then removed to allow reperfusion of blood. Test group is control group for comparison with the common carotid artery occlusion models, a GI group that underwent common carotid artery occlusion, and a needle electrode electrical stimulation (NEES) group that underwent NEES after artery occlusion. The GI and NEES groups were given 12, 24, or 48 hours of reperfusion before NEES. NEES device (PG6, ITO, Japan, 9V, current, 2Hz) was used to stimulate the right and left acupoint ST36 of the SD rats for 30 minutes while they were sedated with 3% isoflurane. An immunohistochemistry test was done on the forebrains of the GI induced rats. All the data collected from this study was symbolized and analyzed using a statistics processing program (SPSS 12.0K/PC). The level of significance was set at ${\alpha}$=0.05 and a T-TEST analysis was used to find out the effects of treatment on each of the groups: the normal group, the CVA induced group, and the treatment after CVA induction group. Results : Both PARP and C-fos immuno-reactive cells, related to apoptosis, were greater in the GI groups than the NEES group. Caspase and IL-6 immuno-reactive cells, related to inflammation, were greater in the GI and NEES groups than the control group. Conclusions : This research was conducted to study the effects of NEES on CVA due to ischemia. Occlusion and reperfusion was performed on the common carotid arteries of white rats, after which amounts of substances related to neuron necrosis and inflammation - PARP, IL-6, Caspase-3, and C-fos - were measured in the Hippocampus

• Childhood Kidney Diseases
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• 제11권2호
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• pp.294-298
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• 2007

모야모야병은 주로 뇌혈관 협착을 유발하여 측부순환을 생성하는 질환으로 최근 뇌혈관 이외의 혈관에도 침범할 수 있음이 보고되고 있다. 지금까지 모야모야병에서 폐동맥, 관상동맥, 말초동맥 및 신동맥의 협착을 동반한 증례들이 발표되고 있다. 이 중 신동맥 협착을 동반한 경우 이로 인한 신성고혈압을 보이는 증례들이 보고되고 있으며 이는 모야모야병에서 지속적인 고혈압을 보여 2차적인 뇌경색이나 뇌출혈 등의 합병증을 유발할 수 있으므로 모야모야 환자의 치료에 있어서 항상 면밀하게 평가되어야 할 부분이다. 저자들은 모야모야병으로 양측 뇌경질막동맥간접문합술을 시행 받고 경과관찰 하던 환아에서 지속되는 고혈압으로 인해 발견된 신동맥 협착 및 이로 인한 신성 고혈압을 경험하였기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제19권4호
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• pp.569-577
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• 1986

Between October 1979 and June 1986, modified Fontan procedures have been performed on 22 patients by the Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. Twelve patients had tricuspid atresia; one, congenital tricuspid stenosis; five, single ventricle; two, I-transposition of the great vessels; one, double outlet right ventricle, and one, pulmonary atresia with an intact ventricular septum. There were 9 operative deaths [mortality; 40.9%]. The causes of death were right heart failure in six patients and pulmonary venous hypertension in one who misdiagnosed preoperatively. Another two were deceased due to sepsis and cerebrovascular accident at postoperative 35 and 34 days in each. There were 7 patients below 4 years of age at the time of operation and among them 4 patients were deceased. The operative death was not related with patients` age above and below 4[p=0.211]. The relation between operative death of tricuspid anomaly and another cardiac malformations was statistically significant [p=0.048]. The operative procedures with or without valved conduit [woven dacron] was related significantly [p=0.043] in the case of the 21 of the patients, but the modified Fontan operation with a valved conduit was performed early stage in this series. Since 1982, we operated on 4 patients, doing a right atrium-right ventricle anastomosis without a conduit. All survived and remained in functional class I [NYHA]. The right atrial pressure [RAP] was elevated significantly after operation [mean 9.9$\pm$4.8 ~16.9$\pm$3.6 mmHg, p<0.001]. The relation between the postoperative RAP of the survival group [16.5$\pm$4.3 mmHg] and the group who died [17.4$\pm$2.2 mmHg] was statistically significant [p=0.047]. There was no relation between any operative death and any previous palliation. All patients were followed for 4 months to 80 months, except one who was lost to follow up at 2 months following surgery [mean 11.4 months, 238 patient. months]. All were in functional class I with 5 on medications and 7 not. One was reoperated at 70 months following the first operation, due to conduit stenosis. She was moderately impaired in activity, with hepatomegaly after the second operation.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.175-185
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• 1994

In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

• 동의생리병리학회지
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• 제19권6호
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• pp.1676-1680
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• 2005

There are few topic about a pulmonary thromboembolism(PTE) especially in Korean medical research. This case report is dealt with a rare situation that a PTE and a lacunar infarction are complicated in one patient. They have a similarity in that both are caused by the thrombosis. The former is the thrombosis in lung and the latter is the cerebral infarcion within the territory of a single perforating artery Recently the attack rate of PTE somewhat grow because of the development of medicine such as the increasing use of indwelling catheters, trauma or surgery of pelvis and lower extrimity, major surgery especially in senior, the use of estrogen containing compounds, cerebrovascular disease, obesity, etc. A 70 year-old lady was stroked by the cerebral infarction and has been getting rehabilitating therapy. She had the sudden onset of dyspnea, chest pain and those symptoms looked like a myocardial infarction. But she was diagnosed as PTE by ventilation perfusion lung scan. We cured her with the integrated therapy of Korean and Western medicine.

• Biomolecules & Therapeutics
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• 제22권3호
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• pp.223-231
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• 2014

In this study, we prepared cordycepin-enriched (CE)-WIB801C, a n-butanol extract of Cordyceps militaris-hypha, and investigated the effect of CE-WIB801C on collagen-induced human platelet aggregation. CE-WIB801C dose-dependently inhibited collagen-induced platelet aggregation, and its $IC_{50}$ value was $175{\mu}g/ml$. CE-WIB801C increased cAMP level more than cGMP level, but inhibited collagen-elevated $[CA^{2+}]_i$ mobilization and thromboxane $A_2$ ($TXA_2$) production. cAMP-dependent protein kinase (A-kinase) inhibitor Rp-8-Br-cAMPS increased the CE-WIB801C-downregulated $[CA^{2+}]_i$ level in a dose dependent manner, and strongly inhibited CE-WIB801C-induced inositol 1, 4, 5-trisphosphate receptor ($IP_3R$) phosphorylation. These results suggest that the inhibition of $[CA^{2+}]_i$ mobilization by CE-WIB801C is resulted from the cAMP/A-kinase-dependent phosphorylation of $IP_3R$. CE-WIB801C suppressed $TXA_2$ production, but did not inhibit the activities of cyclooxygenase-1 (COX-1) and $TXA_2$ synthase (TXAS). These results suggest that the inhibition of $TXA_2$ production by WIB801C is not resulted from the direct inhibition of COX-1 and TXAS. In this study, we demonstrate that CE-WIB801C with cAMP-dependent $CA^{2+}$-antagonistic antiplatelet effects may have preventive or therapeutic potential for platelet aggregation-mediated diseases, such as thrombosis, myocardial infarction, atherosclerosis, and ischemic cerebrovascular disease.

• 대한한방내과학회지
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• 제10권1호
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• pp.25-38
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• 1989

Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

• Journal of Pharmaceutical Investigation
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• 제40권2호
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• pp.117-123
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• 2010

Ibudilast, 3-isobutyryl-2-isopropyrazolo[1,5-a]pyridine, is a nonselective inhibitor of cyclic nucleotide phosphodiesterase (PDE). It preferentially inhibits PDE 3A, PDE4, PDE10 and PDE11 as well as a number of the other PDE families, albeit to a lesser extent. Ibudilast is used clinically to treat bronchial asthma and cerebrovascular disorders. Thes e clinical uses are based on the ability of ibudilast to inhibit platelet aggregation, improve cerebral blood flow and attenuate allergic reactions. The purpose of the present study was to evaluate the bioequivalence of two ibudilast capsules, Ketas capsule (Handok Pharmaceuticals Co., Ltd.) and Pinatos capsule (Sam Chun Dang Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The in vitro release of ibudilast from the two ibudilast formulations was tested using KP Apparatus method with various dissolution media. Twenty six healthy male subjects, 23.31${\pm}$1.09 years in age and 70.45${\pm}$8.51 kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After a single capsule containing 10 mg as ibudilast was orally administered, blood samples were taken at predetermined time intervals and the concentrations of ibudilast in serum were determined using HPLC/UV detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and computer programs (Equiv Test and K-BE Test 2002) were utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, Ketas, were 6.99%, -2.48% and 9.93% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.8791~log 1.1861 and log 0.8347~log 1.1199 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Pinatos capsule was bioequivalent to Ketas capsule.