• 제목/요약/키워드: disease progression

검색결과 1,328건 처리시간 0.026초

3차원 컴퓨터단층촬영상을 이용한 신경공 협착률 측정방법 (A Measurement Method for Cervical Neural Foraminal Stenosis Ratio using 3-dimensional CT)

  • 김연민
    • 한국방사선학회논문지
    • /
    • 제14권7호
    • /
    • pp.975-980
    • /
    • 2020
  • 경추 신경공 협착은 모든 연령대의 비교적 많은 수의 사람들에게 침범하는 매우 흔한 척추 질환이다. 그러나 신경공 협착을 정량적으로 제공하는 영상검사법이 부족하므로, 본 연구는 3차원 전산화단층촬영상을 재구성하여 정량적인 측정방법을 제시하고자 한다. 3차원 영상처리 프로그램을 이용하여 경추의 후극돌기와 측돌기, 층뼈를 포함하여 신경공이 잘 관찰되도록 주변 뼈를 제거하였다. Image J를 이용하여 3차원 영상의 신경공 면적을 포함하는 관심영역을 설정하고, 신경공 면적의 화소수를 측정하였다. 측정 화소수에 화소크기를 곱하여 신경공 면적을 산출하였다. 가장 넓은 신경공 면적을 측정하기 위하여 측정 반대쪽 방향으로 40~50도 사이와, 머리쪽으로 15~20도 사이에서 측정하였다. 측정한 경추 신경공의 면적은 일관된 측정값을 보였다. 가장 크게 측정한 우측 신경공 C5-6 면적은 12.21 ㎟에서, 2년 후에 9.95 ㎟으로 18% 협착이 진행된 것을 알 수 있었다. 기존에 CT 검사 영상을 이용하여 3차원 재구성하므로 추가적인 방사선 피폭을 받지 않으며 신경공 협착 면적을 객관적으로 제시할 수 있다. 또한 3차원 영상을 보면서 신경공 협착 환자에게 설명하기 좋으며, 협착의 진행정도와 수술 후 평가에서도 사용하기 좋은 방법이라 사료된다.

The Association between Mortality and the Oxygen Saturation and Fraction of Inhaled Oxygen in Patients Requiring Oxygen Therapy due to COVID-19-Associated Pneumonia

  • Choi, Keum-Ju;Hong, Hyo-Lim;Kim, Eun Jin
    • Tuberculosis and Respiratory Diseases
    • /
    • 제84권2호
    • /
    • pp.125-133
    • /
    • 2021
  • Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO2) and the fraction of inhaled oxygen (FiO2) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO2, FiO2, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality. Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

교통사고 상해증후군 환자의 급성 스트레스 장애와 외상 후 스트레스 장애의 유병률과 한의변증유형 분석 (An Analysis of the Prevalence and Pattern Identification of Korean Medicine for Acute Stress Disorder and Post Traumatic Stress Disorder in Patients with Traffic Injuries)

  • 이유진;이성준;정문주;임정화;조희근;김보민;정선용;곽희용;박보라;박태용;신병철;강형원
    • 동의신경정신과학회지
    • /
    • 제32권1호
    • /
    • pp.1-11
    • /
    • 2021
  • Objectives: To investigate the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in patients with traffic injuries. In addition, PTSD patients was classified using 'pattern identification for jing ji and zheng chong'. Methods: Questionnaires such as the primary care PTSD screen for DSM-5(PC-PTSD-5), Korean version of PTSD checklist-5 (PCL-5-K), and the instrument of pattern identification for jing ji and zheng chong were conducted on 195 patients within 3 days to 1 year after traffic accidents. Patients were recruited from six medical institutions. Collected data were used to determine the prevalence of acute stress disorder and post-traumatic stress disorder. Results: On PC-PTSD-5, the prevalence was 39.1% for ASD and 50% for PTSD. On PCL-5-K, the prevalence was 20.4% for ASD and 29.3% for PTSD. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. As a result of pattern identification for jing ji and zheng chong, 'weakness of heart and gall bladder type' accounted for the highest proportions in both ASD and PTSD groups. Conclusions: In this study, the prevalence was 39.1% for ASD and 50% for PTSD by PC-PTSD-5. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. Further large-scale prospective studies are needed to analyze the prevalence of ASD and PTSD, the rate of progression from ASD to PTSD, and the type of pattern identification.

제2형 당뇨병 환자에서 최종당화산물과 heme oxygenase-1의 상관성 (Correlation of advanced glycation end products and heme oxygenase-1 in Korean diabetic patients)

  • 최하늘;구다혜;임정은
    • Journal of Nutrition and Health
    • /
    • 제55권3호
    • /
    • pp.348-358
    • /
    • 2022
  • 본 연구는 한국에서 최초로 시행되는 연구로서, 성인 제2형 당뇨환자에서 혈청 AGEs의 농도에 따라 두 군으로 나눈 뒤 신체계측 및 체조성, 영양소 섭취량, 생화학적 지표를 비교 분석한 연구이다. Low AGEs group과 High AGEs group의 평균 AGEs는 각각 0.4 ± 0.2, 3.4 ± 1.7 ng/mL로 나타났다. 항산화 효소인 HO-1은 High AGEs group이 Low AGEs group에 비해 유의적으로 높게 나타났다. 또한, 전체 연구참여자를 대상으로 연령과 성별을 보정한 후 상관관계를 분석한 결과, 혈청 HO-1 농도와 혈청 AGEs 농도 및 소변 8-OHdG 농도는 양의 상관관계를 가지는 것으로 나타났다. 본 연구를 통해 혈청 HO-1은 당뇨환자 특이적 지표인 AGEs와 더불어 DNA 손상 지표에도 예민하게 반응하는 것을 확인하였으며, 추후 한국 당뇨환자의 산화적 스트레스와 합병증 연구의 근거자료로 널리 사용될 수 있을 것으로 사료된다.

근골격계 질환에서 통증 조절을 위한 마약성 진통제 및 항우울제 (Opioids and Antidepressants for Pain Control in Musculoskeletal Disease)

  • 박세진;김우섭;장태동
    • 대한정형외과학회지
    • /
    • 제55권1호
    • /
    • pp.1-8
    • /
    • 2020
  • 고령화의 진행 및 근골격계 질환의 증가로 인해 여러 가지 수술적 치료 방법을 포함한 침습적인 치료 방법이 증가되고 있으나 수술적 치료 시행 전 보존적 치료는 충분히 시행되어야 한다. 보존적 치료 중에서 통증 조절을 위한 약물 치료는 오래 전부터 보존적 치료의 가장 대표적인 치료 방법으로 사용되어 왔고 여전히 가장 흔히 사용되는 방법이다. 통증 조절을 위한 약물로는 아세트아미노펜(acetaminophen), 비스테로이드성 항염증제(non-steroidal anti-inflammatory drugs), 스테로이드(steroid), 마약성 진통제(opioid), 항우울제(antidepressants) 등이 있으며 저자는 마약성 진통제 및 항우울제에 대해서 살펴보고자 한다. 통증으로 인해 말초 부위에 있는 통각 수용체에 자극이 전달되면 통증은 중추 신경계로 전달되는 상향성 경로(ascending pathway)를 거쳐 대뇌에 전달되고 대뇌는 통증을 조절하기 위해 하향성 조절 경로(descending pathway)를 통해 엔도르핀(endorphin)과 같은 내인성 마약성 진통제를 분비하게 된다. 마약성 진통제라는 것은 마약성 진통제 수용체(receptor)에 작용하는 물질을 통틀어서 일컫는 말로 마약성 진통제는 세 가지의 수용체가 존재하며 조직이나 환자의 전신 상태에 따라서 각각의 수용체에 대한 친화성이 달라진다. 이와는 달리 항우울제는 중추신경계의 시냅스에 작용하여 통증을 조절하는 상향성 경로를 조절하는 것이 주된 기전으로 만성통증과 신경병성 통증에 효과적이며 이는 마약성 진통제 계열과 효과가 유사한 것으로 알려져 있다. 본 종설에서는 이러한 마약성 진통제와 항우울제의 효과적인 사용 방법, 사용 시 유의점 및 부작용 등에 대해 다루고자 한다.

Melatonin Attenuates Mitochondrial Damage in Aristolochic Acid-Induced Acute Kidney Injury

  • Jian Sun;Jinjin Pan;Qinlong Liu;Jizhong Cheng;Qing Tang;Yuke Ji;Ke Cheng;Rui wang;Liang Liu;Dingyou Wang;Na Wu;Xu Zheng;Junxia Li;Xueyan Zhang;Zhilong Zhu;Yanchun Ding;Feng Zheng;Jia Li;Ying Zhang;Yuhui Yuan
    • Biomolecules & Therapeutics
    • /
    • 제31권1호
    • /
    • pp.97-107
    • /
    • 2023
  • Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN). AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.

유해 화학물질 처리에 의한 녹농균과 포도상구균의 성장저해최소농도 측정 (Measurement of Minimum Inhibitory Concentration of Toxic Chemicals against Pseudomonas aeruginosa and Staphylococcus aureus)

  • 안지선;김진경;김재성;이창수
    • 청정기술
    • /
    • 제29권2호
    • /
    • pp.135-144
    • /
    • 2023
  • Pseudomonas aeruginosa와 Staphylococcus aureus는 만성 창상 감염의 원인이 되는 주요 병원체이며 상처부위에서 공존한다. 이러한 감염은 단일 감염에 비해 독성이 높아 환자에게 바람직하지 않은 결과를 초래한다. 복합미생물 감염내에서 미생물 간의 상호작용은 질병 진행을 악화시키는 것으로 알려져 있다. 호흡기, 상처, 당뇨병 발과 같은 질병 내 복합 미생물 감염은 다양한 미생물들을 포함하나, 녹농균과 황색포도상구균이 가장 일반적으로 확인된다. 본 연구는 그람음성균 P. aeruginosa와 그람양성균 S. aureus를 중심으로 독성화학물질의 농도구배에 따른 성장양상을 비교하고자 하였다. 세균 성장이 억제되는 농도를 의미하는 최소 억제 농도(MIC)는 특정화학물을 함유한 배지를 연속적으로 희석하여 성장 곡선을 평가하여 결정한다. 두 균주 모두 상기 방법을 통해 성장곡선을 확인하였고, 지수성장기를 적용하여 세균의 배가시간을 계산하였다. 각 독성 물질에 대한 MIC 결과로부터 그람양성균과 그람음성균 사이의 성장 속도 차이와 각 독성 물질에 대한 내성 차이를 식별하였다. 우리는 이 접근 방식이 세균 관련 감염의 혁신적인 치료법 개발에 대한 강력한 잠재력을 가지고 있다고 기대한다.

특발성 폐섬유증의 통합의료 협진 모델 개발을 위한 의료진 및 환자 대상 설문조사 연구 (Research for the Development of an Integrated Medical System for Idiopathic Pulmonary Fibrosis: Based on an Analysis of Questionnaire Survey in Doctor and Patient Groups)

  • 박지원;이범준;신정원;진수현;양정민;김수덕;김관일;최혜숙;정희재
    • 대한한방내과학회지
    • /
    • 제44권3호
    • /
    • pp.366-386
    • /
    • 2023
  • Objective: In this study, a questionnaire survey was conducted for doctors and patients to obtain basic data necessary for the development of an integrated medical system for idiopathic pulmonary fibrosis (IPF). Methods: Questionnaires were developed separately for doctors and patients through an expert group meeting. The survey subjects were recruited online and offline, and finally, responses from 231 doctors and 59 patients were used for statistical analysis. Results: The most important parts in the treatment of IPF for both doctors and patients were the "improvement of respiratory symptoms," "improvement of quality of life," and "prevention of disease progression." Antifibrotic agents were prescribed at a high rate, and 100% of the specialists in Western medicine (WM) and 45.8% of patients reported experiencing side effects. As for the additional payment costs that patients considered as affordable for an integrated medical system, "under 50,000 won (about 38$)" was reported the most in both doctor and patient groups. With regard to the reasons for their reluctance to recommend an integrated medical system for IPF, specialists in WM responded highly to "uncertain evidence for treatment effectiveness." Regarding complementary and alternative medicine therapies that can be beneficial in patients with IPF, "lifestyle management," "diet management," "herb," "relaxation therapy," and "psychotherapy" were ranked high in both doctor and patient groups. Conclusions: In this study, a questionnaire survey on IPF was conducted to review actual treatment status, analyze shortcomings, and identify considerations for the development of an integrated medical system for IPF in the future.

사람 및 가축 유래 분변 미생물 군집과 항생제 내성 유전자 간 상관 관계에 대한 연구 (Co-occurrence Analyses of Antibiotic Resistance Genes and Microbial Community in Human and Livestock Animal Feces)

  • 정지원;반다리 아프라지타;운노 타쯔야
    • 한국환경농학회지
    • /
    • 제41권4호
    • /
    • pp.335-343
    • /
    • 2022
  • BACKGROUND: Antibiotics used in animal husbandry for disease prevention and treatment have resulted in the rapid progression of antibiotic resistant bacteria which can be introduced into the environment through livestock feces/manure, disseminating antibiotic resistant genes (ARGs). In this study, fecal samples were collected from the livestock farms located in Jeju Island to investigate the relationship between microbial communities and ARGs. METHODS AND RESULTS: Illumina MiSeq sequencing was applied to characterize microbial communities within each fecal sample. Using quantitative PCR (qPCR), ten ARGs encoding tetracycline resistance (tetB, tetM), sulfonamide resistance (sul1, sul2), fluoroquinolone resistance (qnrD, qnrS), fluoroquinolone and aminoglycoside resistance (aac(6')-Ib), beta-lactam resistance (blaTEM, blaCTX-M), macrolide resistance (ermC), a class 1 integronsintegrase gene (intI1), and a class 2 integrons-integrase gene (intI2) were quantified. The results showed that Firmicutes and Bacteroidetes were dominant in human, cow, horse, and pig groups, while Firmicutes and Actinobacteria were dominant in chicken group. Among ARGs, tetM was detected with the highest number of copies, followed by sul1 and sul2. Most of the genera belonging to Firmicutes showed positive correlations with ARGs and integron genes. There were 97, 34, 31, 25, and 22 genera in chicken, cow, pig, human, and horse respectively which showed positive correlations with ARGs and integron genes. In network analysis, we identified diversity of microbial communities which correlated with ARGs and integron genes. CONCLUSION(S): In this study, antibiotic resistance patterns in human and livestock fecal samples were identified. The abundance of ARGs and integron genes detected in the samples were associated with the amount of antibiotics commonly used for human and livestocks. We found diverse microbial communities associated with antibiotics resistance genes in different hosts, suggesting that antibiotics resistance can disseminate across environments through various routes. Identifying the routes of ARG dissemination in the environment would be the first step to overcome the challenge of antibiotic resistance in the future.

Analysis of miRNA expression in the trachea of Ri chicken infected with the highly pathogenic avian influenza H5N1 virus

  • Suyeon Kang;Thi Hao Vu;Jubi Heo;Chaeeun Kim;Hyun S. Lillehoj;Yeong Ho Hong
    • Journal of Veterinary Science
    • /
    • 제24권5호
    • /
    • pp.73.1-73.16
    • /
    • 2023
  • Background: Highly pathogenic avian influenza virus (HPAIV) is considered a global threat to both human health and the poultry industry. MicroRNAs (miRNA) can modulate the immune system by affecting gene expression patterns in HPAIV-infected chickens. Objectives: To gain further insights into the role of miRNAs in immune responses against H5N1 infection, as well as the development of strategies for breeding disease-resistant chickens, we characterized miRNA expression patterns in tracheal tissues from H5N1-infected Ri chickens. Methods: miRNAs expression was analyzed from two H5N1-infected Ri chicken lines using small RNA sequencing. The target genes of differentially expressed (DE) miRNAs were predicted using miRDB. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were then conducted. Furthermore, using quantitative real-time polymerase chain reaction, we validated the expression levels of DE miRNAs (miR-22-3p, miR-146b-3p, miR27b-3p, miR-128-3p, miR-2188-5p, miR-451, miR-205a, miR-203a, miR-21-3p, and miR-200a3p) from all comparisons and their immune-related target genes. Results: A total of 53 miRNAs were significantly expressed in the infection samples of the resistant compared to the susceptible line. Network analyses between the DE miRNAs and target genes revealed that DE miRNAs may regulate the expression of target genes involved in the transforming growth factor-beta, mitogen-activated protein kinase, and Toll-like receptor signaling pathways, all of which are related to influenza A virus progression. Conclusions: Collectively, our results provided novel insights into the miRNA expression patterns of tracheal tissues from H5N1-infected Ri chickens. More importantly, our findings offer insights into the relationship between miRNA and immune-related target genes and the role of miRNA in HPAIV infections in chickens.