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Simplistic QA for an Enhanced Dynamic Wedge using the Reversed Wedge Pair Method (역방향 조사방식을 통한 동적쐐기의 품질관리)

  • Lee Jeong Woo;Hong Semie;Suh Tae Suk
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.161-166
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    • 2004
  • A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

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Midwives' Perceptions of the Importance of Teaching the Lamaze Method of Childbirth Preparation, Their Practice of it and Inhibiting Factors. (조산사의 라마즈 산전교육에 대한 중요성 인식과 수행정도 및 저해요인에 관한 연구)

  • Yoon, Gui-Nam;Cho, Mi-Young
    • 모자간호학회지
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    • v.2 no.1
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    • pp.21-33
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    • 1992
  • This study was done to investigate how importantly midwives thought of Lamaze Method of Childbirth, how satisfactorily they performed their Lamaze Method of Childbirth and what inhibited their activities from being performed if not done satisfactorily. The subjects of this study were 76midwives at midwifery in Pusan, Deagu, Kyungnam and Kyungbok. Data were collected by using questionaire from Sep. 1 to Sep.30, 1991. The measurement tools was maded by the researcher based on Kim's scale for prenatal nursing activities. The statistical analysis was done with based statistical values likes frequencies, means, standard deviations and advanced methods such as Pearson's correlation coefficient, 1-test, F-test, F-test by using SPSS package program. The results of this study can be summarized as follows ; 1. The results of Investigating perception according to importance degree and performance degree of Lamaze Method of Childbring showed that midwives were slightly below both perception according to importance(2.17) and performance(2.16) of Lamaze Method of Childbirth 2. Inhibiting factors of Lamaze Method of Childbirth were abscence of husband(3.08), lack of teaching room(2.71), and lack of books or literature of Lamaze Method (2.58). 3. There appears to be a positive relation between perception according to importance degree and performance degree of Lamaze Method of Childbirth (r=0.69, P<0.01). There appears to be a negative relation between perception according to importance degree and inhibit factors of performance (r=-0.38, P<0.01). There appears to be a negative relation between performance and inhibit factors of performance (r=-0.22. P<0.01). 4. The item of highest perception defree in prenatal education is 1st, Consultation about sexual life (2.53), End, illustration of the importance of a bath and perinal cleanliness and Avoidance of excessive respiration method and also its comfortable application during uterine contractility(2.45). The item of lowest perception degree is about pregnant symptom sign and predicted date of birth (E.D.C.). On the other hand, The item of highest performance degree is education about nurtrition during pregnacy. 2nd, Illustration of the Importance of a bath and perineal cleanness(2.45). The lowest one is leaching the pregnant woman and her family about the role of husband and her family and also teaching the couple to learn exercise and respiration method (1.84). Though importance perception degree and performance degree is low. Midwives who wert subject in this research shoves that they perform general items concerning prenatal education well. 5. In the relationship between perception according to importance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in mean number of visiting pregnacies for 1 month. 6. In the relationship between performance degree of Lamaze Method of Childbirth and the general characteristics of subjects, the differences in age, marriage, and mean number of visiting pregnancies for 1 month. With the above information we see the importance of midwife prenatal care education and high correlation between performance degree and perception degree. When Lamaze prenatal education is well performed the number of pregnant woman who have follow-up, check-ups increase. Therefore in this research we can validity that there is a relation between Lamaze prenatal education and patient follow-up. This research showes in a situation where if one does not maximally perform a prenatal education there is a possibility that the popular use of midwife activities may encounter obstacles so the education to save new knowledge and training for prenatal education is needed as a function of Lamaze prenatal education, when a special Lamaze education is well performed for the pregnant woman, who follows-up at amidwife clinic. With the above conclusion we can suggest : 1. Continued research which minimized obstacles to Lamaze prenatal education is needed. 2. The official method of midwives is necessary.

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Cervicography as a Screening Test for Cervical Cancer (자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용)

  • Lee, Doo-Jin;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.169-180
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    • 1999
  • Background: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screening test of cervical cancer. Materials and Methods: Cervicography was taken from 482 women at department of obstetrics and gynecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999. Of the 482 women, 172 women were exc1uded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology (Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chronic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05). The sensitivity and specificity of cytology were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13. 3%) (p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%) (p<0.05). Conclusion: It seems inappropriate to use cervicography as a single screening test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder (한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구)

  • Park, Jae-Hong;Kim, Bung-Nyun;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Dong-Won;Shin, Yun-Mi;Yang, Su-Jin;Yoo, Hanik-K.;Yoo, Hee-Jeong;Lee, Soyoung Irene;Cheon, Keun-Ah;Hong, Hyun-Ju;Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.25-37
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    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

The Impact of Amalgam Exposure an Urinary Mercury Concentration in Children (어린이의 구강 내 아말감 노출이 요중 수은농도에 미치는 영향)

  • Jeon, Eun-Suk;Jin, Hye-Jung;Kim, Eun-Kyong;Im, Sang-Uk;Song, Keun-Bae;Choi, Youn Hee
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.7-14
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    • 2014
  • This study aims to evaluate the impact of varying exposure to dental amalgam on urinary mercury levels in children by measuring the number of amalgam-filled teeth and the variance of mercury concentration in urine over a period of 2 years. A total of 317 (male 158, female 159) elementary school children (1st~4th graders) attending 2 schools in urban regions participated in this study. At 6-month intervals, 4 oral examinations were conducted to check any variance in the conditions of dental caries and the status of dental fillings. Also, urine tests were conducted followed by a questionnaire survey. To elucidate the factors potentially affecting the mercury concentration in urine, t-test, ANOVA, chi-square test and a mixed model were used for the analysis. Regarding the status of dental fillings in line with examination time periods, deciduous teeth had more amalgam-filled surfaces than those filled with resin, whereas permanent teeth had more resin-filled surfaces than those filled with amalgam. A significant relevance was found between the exposure to dental amalgam and urinary mercury levels. Specifically, subjects whose teeth surfaces had been filled with dental amalgam showed higher urinary mercury levels than those who had no dental amalgam fillings. Based on the analysis using the mixed model, the increase in the number of teeth surfaces filled with amalgam was found to be the factor affecting the increase in urinary mercury levels. The urinary mercury levels were found to be highly associated with the exposure to dental amalgam. The more the teeth surfaces filled with amalgam, the higher the urinary mercury levels. Hence, even a trace of dental amalgam fillings can liberate mercury, affecting the variance in the urinary mercury levels. These findings suggest that some criteria or measures should be developed to minimize the exposure to dental amalgam. Moreover, relevant further studies are warranted.

Genotypes of commercial sweet corn F1 hybrids

  • Kang, Minjeong;Wang, Seunghyun;Chung, Jong-Wook;So, Yoon-Sup
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.107-107
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    • 2017
  • Sweet corns are enjoyed worldwide as processed products and fresh ears. Types of sweet corn are based on the gene(s) involved. The oldest sweet corn type has a gene called "sugary (su)". Sugary-based sweet corn was typically named "sweet corn". With its relatively short shelf life and the discovery of a complementary gene, "sugary enhanced (se)", the sweet corn (su only) was rapidly replaced with another type of sweet corns, sugary enhanced sweet corn, which has recessive homozygous su/su, se/se genotype. With the incorporation of se/se genotype into existing su/su genotype, sugary enhanced sweet corn has better shelf life and increased sweetness while maintaining its creamy texture due to high level of water soluble polysaccharide, phytoglycogen. Super sweet corn as the name implies has higher level of sweetness and better shelf life than sugary enhanced sweet corn due to "shrunken2 (sh2)" gene although there's no creamy texture of su-based sweet corns. Distinction between sh2/sh2 and su/su genotypes in seeds is phenotypically possible. The Involvement of se/se genotype under su/su genotype, however, is visually impossible. The genotype sh2/sh2 is also phenotypically epistatic to su/su genotype when both genotypes are present in an individual, meaning the seed shape for double recessive sh2/sh2 su/su genotype is much the same as sh2/sh2 +/+ genotype. Hence, identifying the double and triple recessive homozygous genotypes from su, se and sh2 genes involves a testcross to single recessive genotype, chemical analysis or DNA-based marker development. For these reasons, sweetcorn breeders were hastened to put them together into one cultivar. This, however, appears to be no longer the case. Sweet corn companies began to sell their sweet corn hybrids with different combinations of abovementioned three genes under a few different trademarks or genetic codes, i.g. Sweet $Breed^{TM}$, Sweet $Gene^{TM}$, Synergistic corn, Augmented Supersweet corn. A total of 49 commercial sweet corn F1 hybrids with B73 as a check were genotyped using DNA-based markers. The genotype of field corn inbred B73 was +/+ +/+ +/+ for su, se and sh2 as expected. All twelve sugary enhanced sweet corn hybrids had the genotype of su/su se/se +/+. Of sixteen synergistic hybrids, thirteen cultivars had su/su se/se sh2/+ genotype while the genotype of two hybrids and the remaining one hybrid was su/su se/+ sh2/+, and su/su +/+ sh2/+, respectively. The synergistic hybrids all were recessive homozygous for su gene and heterozygous for sh2 gene. Among the fifteen augmented supersweet hybrids, only one hybrid was triple recessive homozygous (su/su se/se sh2/sh2). All the other hybrids had su/su se/+ sh2/sh2 for one hybrid, su/su +/+ sh2/sh2 for three hybrids, su/+ se/se sh2/sh2 for three hybrids, su/+ se/+ sh2/sh2 for four hybrids, and su/+ +/+ sh2/sh2 for three hybrids, respectively. What was believed to be a classic super sweet corn hybrids also had various genotypic combination. There were only two hybrids that turned out to be single recessive sh2 homozygous (+/+ +/+ sh2/sh2) while all the other five hybrids could be classified as one of augmented supersweet genotypes. Implication of the results for extension service and sweet corn breeding will be discussed.

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A Study on Geology of Clay Mineral Deposits of Pohang-Ulsan Area and their Physico-Chemical Properties (포항-울산간의 점토자원의 지질과 그 물리화학적 특성에 관한 연구)

  • Kim, Ok Joon;Lee, Ha Young;Kim, Suh Woon;Kim, Soo Jin
    • Economic and Environmental Geology
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    • v.4 no.4
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    • pp.167-215
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    • 1971
  • I. Purpose and Importance of the Study The purpose of the present study is to clarify to geological, mineralogical, and physico-chemical properties of the clay minerals deposits imbedded in the Tertiary sediments in the areas between. Pohang and Ulsan along southeastern coastal region of Korea. These clays are being mined and utilized for filter and insecticide after activation or simple pulverizing, nontheless activated clays are short coming as chemical industry in Korea has been rapidly grown in recent years. In spite of such increase in clay demand, no goological investigation on clay deposits nor physico-chemical properties of the clays have been carried out up to date. Consequently activated clays produced in Korea is not only of low grade but also of shortage in supply, so that Korea has to import activated clays of better grade. The importance of the present study lies, therefore, on that guiding principle could be laid down by knowing stratigraphical horizons, of clay deposits and fundamental data of improving grade of activated clays might be derived from the results of physico-chemical examinations. II. Contents and Scope of the study The contents of the study are pinpointed down in the following two subjects: 1) General geological investigation of Tertiary formations distributed in the areas between Pohang and UIsan, and detail geological study of the bentonitic clay deposits imbedded in them. 2) To clarifty physico-chemical characteristics of the clays by means of chemical analysis, X-ray diffraction and electron microscope. The scope of the study involves the following there points: i) Regional geological investigation-This investigation has been carried out in order to find out the distribution of Tertiary sediments and exact location of clay mineral deposits in the areas between Pohang and UIsan. ii) Detail geological investigation-This has been concentrated in and around the clay deposits which. had been found out by the regional investigation. iii) Laboratory researchs include i) age determination and correlation of Tertiary sediments by paleontological study, and ii) Chemical analysis, X-ray diffraction, and electron microscopic studies on clays, samples taken from various clay deposits. III. Research Results and Suggestions 1) The geology of the area investigated is composed mainly of Janggi and Beomgokri groups of Miocene age in ascending order rested on the upper Silla system, Balkuksa granite and volcanic rocks of upper Cretaceous age as base. 2) Janggi group is composed in ascending order of Janggi conglomerate, Nultaeri rhyolitic tuff, Keumkwangdong shale, two beds of lignite-bearing formations which consist of alternation of conglomerate, sandstone and mudstone, and andesitic, rhyolitic, and basaltic tuff beds. 3) Beomgokri group is mainly composed of andesitic to rhyolitic tuff interlayered by conglomerate and tuffaceous sandstone. In the areas around boundary between North-and South Kyeongsang-do is distributed Haseori farmation which is composed of conglomerate, sandstone, mudstone and andesitic to rhyolitic tuff, and which is correlated to Eoilri formation of Janggi group. 4) Clay deposits of the area are interbedded in Eoilri, Haseori, Nultaeri tuff, Keumkwangdong shale, upper and lower horizon of the lower lignite-bearing seam, and Keumori rhyolitic tuff formations of Janggi group; and are genetically classi.fied into four categories, that is, i) those derived from volcanic ash beds(Haseori and Daeanri deposits), ii) those of secondary residual type from rhyolitic tuff beds(Seokupri deposits), iii) Clay beds above and beneath the lignite seams, (Janggi and Keumkwangdong deposits), and iv) those derived from rhyolitic tuff beds(Sangjeong and Tonghae deposits). 5) Mineral constituents of clay deposits are, according to X-ray diffraction, montmorillonite accompanied in different degree by cristobalite, plagioclase, quartz, stilbite, and halloysite in rare occasion. The clays are grouped according to mineral composition into four types; i) those consist mostly of montmorillonite, ii) those composed of montmorillonite and cristobalite, iii) those composed of montmorillonite and plagioclase, and iv) those composed of montmorillonite, plagioclase and quartz. 6) Clays interbedded in Haseori formation and vicinity of lignite seams belong to the first type, are of good quality and derived either from volcanic ash bed, or primary clay beds near lignite seams. Clays belonged to other types are derived from weathering of rhyolitic tuff formations and their quality varies depending upon original composition and degree of weathering. Few clays in secondary residual type contain small amount of halloysite. 7) Judging from analytical data, content of silica($SiO_2$) varies proportionally with content of cristobalite, and alumina($Al_2O_3$) content does not vary with that of plagioclase, but increases in the sedimentary bedded type of deposits. 8) It is unknown whether or not these days could be upgraded by beneficiation since no grain size of these impurities nor beneficiation test had been studied. 9) Clay beds derived from valcanic ash layers or sedimentary layers at the vicinity of lignite seams are thin in thickness and of small, discontinueous lenticular shape, although they are of good quality; and those derived from rhyolitic tuff formations or residual type from tuff are irregular in both occurrence and quality. It is, therefore, not only very difficult but also meaningless to calculate its reserve, and reserve estimation, even if done, will greatly be deviated from practically minable one. Consequently, way of discovery and exploitation of clay deposits in the area under consideration is to check the geologically favorable areas whenever needed.

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Effects of Cutting Time, Auxin Treatment, and Cutting Position on Rooting of the Green-wood Cuttings and Growth Characteristics of Transplanted Cuttings in the Adult Prunus yedoensis (왕벚나무 성목 녹지삽목에서 삽목시기, 옥신처리 및 삽수부위가 발근에 미치는 영향과 이식 삽목묘의 생육특성)

  • Kim, Chang-Soo;Kim, Zin-Suh
    • Horticultural Science & Technology
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    • v.30 no.2
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    • pp.129-136
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    • 2012
  • This study was conducted to develop an efficient mass propagation method for the mature $Prunus$ $yedoensis$ Matsumura (43 to 58 years old). Cutting was conducted depending on cutting time, auxin treatments (IBA and NAA treatments mixed with talc powder), and cuttings position on shoots in a plastic house equipped with a fog system without heating. Rooted cuttings were transplanted to a nursery bed, and their growth characteristics were investigated in order to check whether the cuttings are successful or not for roadside tree planting. The average rooting rate was highly significant ($P$ < 0.0001) in all treatments: cutting on June 1st (61.4%) was more than two times greater in rooting rate than that on August 1st (23.6%); IBA 1,000 $mg{\cdot}L^{-1}$ (90.8%) and IBA 500 $mg{\cdot}L^{-1}$ (89.2%) showed much greater rooting rates than those of the other treatments; upper part of the cuttings treated with IBA 1,000 $mg{\cdot}L^{-1}$ showed the highest rooting rate, 96.7%. The interactions among treatments in the average rooting rate were also significant. There were significant differences ($P$ < 0.0001) among the auxin treatments in the survival rate of leafed cuttings transplanted to a nursery bed. The average survival rate was 46.5%, and IBA 1,000 $mg{\cdot}L^{-1}$ treatment was the highest in leafed cuttings 79.2%, but most of leafless cuttings were dead. There were significant differences ($P$ < 0.0001) among the cuttings, grafts, and in the seedlings height, diameter at root collar, the number of roots, branches, and leaves, etc., and the cuttings was the best. We can expect a possibility of mass propagation of improved $P.$ $yedoensis$ Matsumura and a high planting survival rate through the transplanting of cuttings to a nursery bed in which the cuttings should be the following conditions: cutting in June to July, use of the upper part of cuttings, IBA treatment, and rooting in August in a cutting-greenhouse equipped with a fog system.

A Study on Decision-Making Processes of Organic Foods (무공해식품의 구매의사결정에 관한 연구)

  • NamKung, Sok
    • Journal of the Korean Society of Food Culture
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    • v.9 no.4
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    • pp.379-394
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    • 1994
  • The purpose of this study was to identify the correlation between the factors influencing on housewives' decision-making processes of organic foods and the relating variables, and the 5 stages of decision-making processes of the EBK model is utilized in this study. The sample was selected from 411 housewives living in Seoul from 1st of September through 20th of September, 1993. Frequency, Percentage, Mean, Factor analysis, One-way ANOVA, Duncan's multiple range test, t-Test, Correlation, Multiple regression analysis and Path analysis were measured. Major results are as follows: 1. Purchasing motivation of the organic foods were in order of the health care, nutritive value and taste care. 2. The major informations source for the knowledge of organic foods were in order of TV/radio, newspaper/magazine, recommendations informations and advice through a family/friends/acquaintances. 3. Evalution criteria in shopping of organic foods, the total degree of consideration over the purchasing factors of organic foods was fairly high level: consumers thought much of the sanitation/freshness, nutritive value and the food safety. In this regard opinion leaders was dominantly mass media. Consumers have a tendency to purchase organic foods in consideration of their children and husband. 4. Major place to purchase organic foods are super markets and department stores. And When shopping organic foods, housewives by all means confirm the check points in their own mind, which were expiry date, manufactured date and packing condition, but unexpectedly manufactured company was out of concern. 5. Housewives usually satisfy with decision after purchasing organic foods, while they were fairly unsatisfied with the price, quality, incomplete description for ingredients and manufactured date. 6. The variables influencing to the sincerity when selecting the most desired organic foods is how be cares about the natural freshness of the foods and the types of residents in order. Another interesting tendency is the richer they are very considerate to decide. It is to say the people who cares more about the natural freshness is the sincerer when making decision and also the class who lives in the apartment house enjoying high income do not easily accept the product quality.

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Cyclosporine A (Cipol-$N^{(R)}$) Therapy in Children with Idiopathic Nephrotic Syndrome (소아 특발성 신증후군에서의 cyclosporine A(Cipol-$N^{(R)}$)의 치료 효과)

  • Hong Ihn Hee;Ko Cheol Woo;Koo Ja Hoon;Kim Ji-Hong;Kim Pyung-Kil;Cho Byoung Soo
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.48-56
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    • 1999
  • Purpose : This multicenter collaboratory study was conducted to see the therapeutic efficacy and side effect of cyclosporine A (Cipol-$N^{(R)}$, Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing (FR), steroid dependent (SD), or steroid resistant (SR) pattern. Patients and methods : Thirty-nine children with SD/FR NS and 3 children with SR NS were enrolled in the study. After induction of remission (SD/FR NS) with steroid or after 4 weeks of steroid therapy (SR NS), cyclosporine A was started in a dose of 4-5 mg/Kg/day in two divided dose and steroid (prednisolone or equivalent dose of deflazacort) was tapered slowly. During 16 weeks of study period, monthly check up of physical examination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Results : Out of 39 children with SD/FR NS, 35($89.7\%$) maintained sustained remission and at 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Two out of 3 children with SR NS showed and sustained remission with cyclosporine A therapy. Side reaction to cyclosporine A therapy showed hypertrichosis in 8 cases and hyperuricemia in 5 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR (creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 16 weeks of study period. Conclusion : Cyclosporine A (Cipoi-$N^{(R)}$ Chong Kun Dang) can be utilized quite effectively on children with SD/FR or SR NS and further trial of cyclosporine A on long-term basis (1-2 year period) is needed to determine it's efficacy and side effect (especially nephrotoxicity) of long-term administration of cyclosporine A.

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