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Analysis of Effect and Prognostic Factors Associated with Catheter Intervention on Ascites in Terminal Cancer Patient (복수가 있는 말기 암환자에서 복수 배액관 시술의 효과와 예후요인 분석)

  • Jang, Mungsun;Kim, Chul-Min;Yoon, Johi;Nah, Jung-Ran;Chang, Seung-Nam;Kim, Myung Ok;Lee, Ja Young
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.303-309
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    • 2016
  • Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

Bacterial Infections after Liver Transplantation in Children: Single Center Study for 16 Years (16년간 단일기관에서 시행된 소아 간이식 후 세균 감염 합병증의 특징)

  • Kim, Jae Choon;Kim, Su Ji;Yun, Ki Wook;Choi, Eun Hwa;Yi, Nam Joon;Suh, Kyung Suk;Lee, Kwang-Woong;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.82-90
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    • 2018
  • Purpose: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients. Methods: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1-5 months, and between 6-12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded. Results: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1). Conclusions: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.

Analysis of Linear Growth in Children after Living-related Liver Transplantation (소아 생체 부분 간이식 후의 성장 분석)

  • Rim, Sun-Hee;Yun, Hye-Jin;Suh, Young-Mee;Choi, Bo-Hwa;Kim, Kyung-Mo;Lee, Young-Joo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.63-70
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    • 2001
  • Purpose: The aim of this study is to evaluate the effective role of living-related liver transplantation (LRLT) on posttransplant linear growth in children. Methods: Thirty six children were enrolled who received LRLT at Asan Medical Center from December, 1994 to February, 1999 and showed more than one-year postoperative survival. Mean height standard deviation score (zH) was analyzed according to medical records including heights during pretransplant and posttransplant follow-up periods. Results: zH of total children showed significant linear growth after LRLT from -1.58 to 0.33 at 24 posttransplant month (p<0.05). zH in children under 6 years of age, to exclude the effect of adolescent linear growth spurt, showed increment in height (p<0.05). Linear growth of children with liver cirrhosis improved and that with fulminant hepatitis was matained same. While stunted children (mean zH=-2.30) achieved good catch-up growth after transplantation, children with normal growth remained same. Children with significant hepatic dysfunction after LRLT such as chronic rejection or posttransplant lymphoproliferative disorder showed retarded posttrasplant linear growth. There was no statistical difference according to the type of immunosuppressants. Conclusion: LRLT resulted in adequate or catch-up linear growth in children with acute, chronic and metabolic liver disease. Successful LRLT suggested to be a promising option not only in long term survival but also in normal linear growth.

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MicroRNA-23b is a Potential Tumor Suppressor in Diffuse Large B-cell Lymphoma (미만성 거대 B 세포 림프종(DLBCL)에서 microRNA-23b의 잠재적 종양 억제자로서의 효과)

  • Nam, Jehyun;Kim, Eunkyung;Kim, Jinyoung;Jeong, Dawoom;Kim, Donguk;Kwak, Bomi;Kim, Sang-Woo
    • Journal of Life Science
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    • v.27 no.2
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    • pp.149-154
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    • 2017
  • Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-hodgkin lymphoma. Advances in the chemotherapeutic treatment of this disease have improved the outcomes of DLBCL; nonetheless, many patients still die of DLBCL, and therefore, a better understanding of this disease and identification of novel therapeutic targets are urgently required. In a recent gene expression profiling study, PDE (phosphodiesterase) 4B was found to be overexpressed in chemotherapy-resistant tumors. The major function of PDE4B is to inactivate the second messenger cyclic 3',5' monophosphate (cAMP) by catalyzing the hydrolysis of cAMP to 5'AMP. It is known that cAMP induces cell cycle arrest and/or apoptosis in B cells, and PDE4B abolishes cAMP's effect on B cells. However, the mechanism by which PDE4B is overexpressed remains unclear. Here, we show that the aberrant expression of miRNA may be associated with the overexpression of this gene. The PDE4B 3' untranslated region (UTR) has three functional binding sites of miR-23b, as confirmed by luciferase reporter assays. Interestingly, miR-23b-binding sites were evolutionarily conserved from humans to lizards, implying the critical role of PDE4B-miR-23b interaction in cellular physiology. The ectopic expression of miR-2 3b repressed PDE4B mRNA levels and enhanced intracellular cAMP concentrations. Additionally, miR-23b expression inhibited cell proliferation and survival of DLBCL cells only in the presence of forskolin, an activator of adenylyl cyclase, suggesting that miR-23b's effect is via the downregulation of PDE4B. These results together suggest that miR-23b could be a therapeutic target for overcoming drug resistance by repressing PDE4B in DLBCL.

Processing and Taste Compounds of the Fish Sauce from Skipjack Scrap (가다랑어잔사를 이용한 어간장 제조 및 대미성분)

  • LEE Eung-Ho;LEE Tae-Hun;KIM Jin-Soo;AHN Chang-Bum
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.22 no.1
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    • pp.25-35
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    • 1989
  • To prepare a new type of fish sauce from skipjack scrap, it was examined the effect of koji on the sauce flavor, conditions of low salt fish sauce processing and the changes of taste com-pounds during its fermentation. To prepare the skipjack scrap sauce, chopped skipjack head paste was mixed with $6.6\%$ skipjack viscera, $26.9\%$ koji, $71\%$ of $25\%$ brine, $13.3\%$ salt and $7.6\%$ glucose, and fermented at $25\pm4^{\circ}C$ for 90 days. The same process was also carried out to prepare the low salt skipjack scrap sauce adding $7.6\%$ sorbitol, $0.3\%$ lactic acid and $9.8\%$ ethyl alcohol instead of $13.3\%$ salt. The major free amino acids in the products were glutamic acid, Iysine, valine, phenylalanine, alanine, leucine and isoleucine at 90 days of fermentation. And the contents of total free amino acids in both products were 3,307mg/00m1, 3,637.1mg/100m1 at 90 days of fermentation. The predominating non-volatile organic acids showed in the products were lactic acid, succinic acid, pyroglutamic acid, which were $90\%$ over contents of the total non-volatile organic acids. Total non-volatile organic acid contents in both products were 1,002.1mg/100ml, 1,312.9mg/100m1 at 90 days of fermentation. During fermentation of sauce, ADP, AMP and IMP were decreased, while inosine and hypoxanthine were increased. The major taste compounds of the products were rove진ed free amino acids and non-volatile organic acids. The nucleotides and their related compounds, total creatinine, betaine, TAMO and sugar were seemed to be having an auxiliary role in taste of those products. Fishy odor in skipjack scrap sauce can be improved by adding koji. And the low salt skipjack scrap sauce ($9.12\%$ of salt contents) can be prepared by the replacement of a part of salt with sorbitol, lactic acid and ethyl alcohol. From the results of sensory evaluation and chemical experiments, the skipjack scrap sauce products supposed to be at least equal to the sold soy sauce on the market in quality.

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ULTRA-STRUCTURE AND ACID ETCHING CHARACTERISTICS OF OCCLUSAL FISSURE ENAMEL (교합면 열구 법랑질의 미세구조 및 산부식 형태)

  • Cho, Tae-Sik;Yoon, Jeong-Hoon;Kim, Su-Gwan;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.321-331
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    • 2005
  • The purpose of this study was to compare the effectiveness of mechanical and acid treatment on enamel surfaces for the retention of pit and fissure sealants and evaluate the presence of a prismless layer. The etch pattern produced on enamel from immature and mature premolar teeth extracted with varying period of acid etching using 37% phosphoric acid was examined using a scanning electron microscope(SEM). The composition of each groups was evaluated using an energy dispersive x-ray(EDX) spectroscopy. The result of present study can be summarized as follows: 1. Prismless layer was commonly observed on the fissure enamel in young and mature premolar. 2. There were no differences in micro-structure and etching pattern on fissure enamel between the young and the mature premolar. 3. The most effective etching pattern for retention of pit and fissure sealant was observed in 60 seconds of etching time and no apparent difference of etching pattern was found among 15, 30, and 45 seconds of etching time which showed non-retentive etching patterns. 4. The etching pattern obtained by grinding enamel surface with bur followed by 60 seconds of etching was similar to that of 60 seconds of etching without any pretreatment of fissure surface. 5. Type 2 etching pattern was commonly found on fissure enamel in both young and mature premolar. 6. The calcium content and P/Ca ratio in fissure enamel between the young and the mature premolar were significantly different(P<0.05). But content of calcium, phosphate and P/Ca ratio on various regions of fissure enamel in both young and mature premolar did not showed any difference. Based on these results, prismless layer may negatively influence the retention of pit and fissure sealants. Therefore, the mechanical removal of the prismless layer by grinding prior to etching or by prolonged etching time of enamel within the fissure system should result in an improved bonding of a pit and fissure sealant.

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The Therapeutic Effect of Angiotensin II Receptor Antagonist in Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증 환자의 치료에서 Angiotensin II Receptor Antagonist의 치료효과)

  • Woo, Duck Soo;Seol, Won Jong;Kyung, Sun Young;Lim, Young Hee;An, Chang Hyeok;Park, Jeong Woong;Jeong, Sung Hwan;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.478-487
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    • 2003
  • Background : There have been several studies showing that the angiotensin II and angiotensin converting enzyme(ACE) contributes to the apoptosis of alveolar epithelial cells in idiopathic interstitial pneumonia and the activation of fibroblasts during the process of pulmonary fibrosis. These results suggest that the pulmonary fibrosis can be inhibited by the angiotensin II receptor antagonist(AGIIRA). This study was performed to identify the therapeutic effect of AGIIRA in idiopathic pulmonary fibrosis(IPF). Method : Thirteen patients with IPF, who were diagnosed with an open lung biopsy(6 patients) and furfilling the ATS criteria(7 patients) between March 1999 and October 2001 at the Gachon medical center, were enrolled in this study. Of these patients, eight patients were treated with a regimen including AGIIRA(AT group), and five were treated without AGIIRA(NT group). The pulmonary function tests and dyspnea(ATS scale) were measured at diagnosis and 1 year after treatment. All the data was collected to analyze the therapeutic effect of AGIIRA on the patients with IPF. Results : The AT group contained 8 patients(M:F=4:4) and the NT group contained 5 patients(M:F=3:2). There was no significant difference in the serum angiotensin II level between the two groups($202.5{\pm}58.5$ vs $163.7{\pm}47.3pg/ml$, p>0.05). The AT group showed an upward trend in TLC(+3%), FVC(+4%), FEV1(+3%) and DLco(+2%) compared to the NT group(TLC(-14%), FVC(-3%), FEV1(-4%) except for DLco(+5%)). The dyspnea score in the AT group improved significantly but not in the NT group. Conclusion : These results suggest that the angiotensin II receptor antagonist may have an effect on stabilizing IPF.

CEO's Political Independence, Board Chair Separation, Executive's Expertise, and Performance in State-Owned Enterprises (공기업 CEO의 정치적 독립성, 이사회 의장 분리, 임원의 전문성과 성과)

  • Yu, Seungwon
    • KDI Journal of Economic Policy
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    • v.35 no.2
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    • pp.1-39
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    • 2013
  • Considering the relationship between state-owned enterprise (SOE) CEOs and political circles, this study examines the performance impacts of CEO's succession type, board chair separation, and industry expertise and finance expertise of CEOs and outside directors. I propose the definition of political independence in SOE CEOs based on the independence in appearance that might affect general people's perception. It means that there are no relationships or circumstances that might affect SOE CEO's judgment, activity, and report. The definition is able to overcome the limitations of the prior research that could not discover the CEOs who were affiliated to political circles because the research just distinguished the CEOs following their pre-jobs. This study focused on the performance impacts of political independence impaired CEO as well as the CEO's impacts on the relationship between the performance and other corporate governance variables. I selected as dependent variables the average return on asset as operating income divided by total assets and the average customer satisfaction rate evaluated by Korean government during the first three years following the year of the events of explanatory variables. My theory and evidence from the various CEO's personal background and financial information from SOEs in Lee Myung-bak Administration and Rho Moo-hyun Administration suggest the following important things. First, the analysis based on whether or not a SOE CEO keeps political independence shows that a political independence impaired CEO made a significantly negative impact on customer satisfaction rate. Second, the separation between a board chair and a CEO in SOEs introduced by Korean Act on Management of Public Institutions made a significantly positive impact on customer satisfaction rate. However, the positive impact of the board chair separation was removed in a political independence impaired CEO's SOE. Third, outside director's industry expertise made a significantly positive impact on return on asset. However, the positive impact of the outside director's industry expertise was removed in a political independence impaired CEO's SOE. Fourth, the comparison between Lee Myung-bak Administration and Roh Moo-hyun Administration on the corporate governance and performance of SOEs shows that the ratio of political independence impaired CEO was significantly higher in Lee Administration and the ratio of outside director's industry expertise and finance expertise were respectively significantly higher in Roh Administration. Based on these results, I suggested a few policy alternatives for CEO's improved political independence and requirements for executive's expertise in SOEs.

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Use of Microwave Range and Oven, and Change on Dietary Type (전자렌지, 오븐의 이용과 식생활의 변화)

  • 김명애
    • Korean journal of food and cookery science
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    • v.9 no.1
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    • pp.1-6
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    • 1993
  • The possession of microwave range, oven and oven-microwave range has been greatly increased with 88 Seoul Olympic Game as a momentum, and the possession rate was by 68%. The respondent answered the function of microwave range to be more necessary than that of oven, and the two household commodities have been mostly used to reheat and heat simply prepared frozen foods. The 35% among total respondent wished to cook the prepared frozen foods like pizza, but the 87% prefered to cook bakery. The frequencies of the use of oven were 35%, 35% for cooking premix and raw materials, and 20%, 20% for cooking half-prepared and prepared foods, respectively. The respondent of 39% was interested in premix foods as a future preference for food forms, and the respondent with interest in half-prepared food was 30%, but the preference for raw materials and prepared foods showed a trend to be decreased. The respondent of 60ft had eaten out six times week, and 50% had eaten instant and fast foods 1~3 times week. As the results of this survey, most of consumers prefer to more convenient foods. Therefore, it is expected that the function of oven and microwave range would be widely useful if various foods are improved with regards to convenience for use and preference.

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A Study on the Moisturizing Effect and Preparation of Liquid Crystal Structures Using Sucrose Distearate Emulsifier (슈크로오스디스테아레이트를 사용한 액정구조의 생성과 보습효과에 관한 연구)

  • Kwak, Myeong-Heon;Kim, In-Young;Lee, Hwan-Myung;Park, Joo-Hoon
    • Journal of the Korean Applied Science and Technology
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    • v.33 no.1
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    • pp.1-12
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    • 2016
  • This study is to make the liquid crystalline structure using sucrose distearate (Sucro-DS) emulsifier to create the hydrophilic type oil-in-water (O/W) emulsion, the droplets of the emulsion having a structure of a multi-lamellar structure. We have studied the physicochemical properties of Sucro-DS using those techniques. And it has been studied in the emulsion performance. In order to form the liquid crystalline structure applying 3 wt% of Sucro-DS, 5 wt% of glycerin, 5 wt% of squalane, 5 wt% of capric/caprylic triglyceride, 3wt% of cetostearyl alcohol, 1wt% of glyceryl mono-stearate, 78 wt% of pure water in mixture having the lamellar structure of stable multi-layer system was found to formed. By applying them, they were described how to create an unstable active material encapsulated cream. Further, the moisturizing cream was studied using this technique. It reported the results to the skin improvement effect by the human clinical trials. The pH range to produce a stable liquid crystal phase using a Sucro-DS was maintained in 5.2~7.5. In order to increase the stability of the liquid crystal, it was when behenyl alcohol containing 3 wt%, the hardness at this time was 13 kg/mm,min. Viscosity of the same amount was 25,000mPas/min. After a test for the effects of the emulsions, the concentration of 6 wt% Sucro-DS is that was appropriate, the particle size of the liquid crystal was 4~6mm. It was observed through a microscope analysis, reliability of the liquid crystal changes for 3 months was found to get stable at each $4^{\circ}C$, $25^{\circ}C$ and $45^{\circ}C$. In clinical trial test, before applying a moisturizing effect it was $13.4{\pm}7%$. Moisturizing cream liquid crystal was not formed in $14.5{\pm}5%$. Therefore, applying than ever before could see the moisture about 8.2% was improved. On the other hand, it was the moisturizing effect of the liquid cream is $19.2{\pm}7%$. The results showed that 43.3% improvement than that previously used. Applications fields, Sucro-DS emulsifier used liquid cream, lotion, eye cream and a variety of formulations can be developed, as well as the cosmetics industry is expected to be wide fields in the application of the external preparation for skin emulsion technology in the pharmaceutical industry and pharmaceutical industry.