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Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Feeding Preference of Foraging Ants on Insect Cadavers Killed by Entomopathogenic Nematode and Symbiotic Bacteria in Golf Courses (골프장에서 곤충병원성 선충과 공생세균 처리에 대한 개미의 섭식 선호성)

  • Lee Dong Woon;Lyu Dong Pyeo;Choo Ho Yul;Kim Hyeong Hwan;Kweon Tae Woong;Oh Byung Seog
    • Korean journal of applied entomology
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    • v.44 no.1 s.138
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    • pp.21-30
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    • 2005
  • Feeding behavior of foraging ants including visiting numbers, species, and preference on insect cadavers killed by entomopathogenic nematodes <(Heterorhabditis sp. KCTC 0991BP (He) and Steinernema carpocapsae KCTC 0981BP (Sc)> and their symbiotic bacteria was investigated in Dongrae Benest Golf Club, Anyang Benest Golf Club, Gapyung Benest Golf Club and Ulsan Golf Club. The number of ants, kinds and numbers of cadavers taken away by ants were different depending on killing method, golf club and site within the golf courses (fairway and rough). The feeding preference of ants was the lowest on cadavers killed by He. At Dongrae Benest Golf Club Lasius japonicu ($75{\pm}5\%$) and Monomorium floricola ($10\%$) took away cadavers only at the rough. The visiting rate of ants was $85{\pm}6\%$ at the rough, but none at the fairway by 16 hours. The taken rate of cadavers by ants was the lowest on He-killed cadavers representing $16.7\%$ compared with $40.0\%$ on Sc-killed cadavers, $53.3\%$ on fenitrithion-killed cadavers, and $56.7\%$ on natural dead cadavers by 12 hours. At the rough of hole 6 in Anyang Benest Golf Club, Tetramorium tsushimae ($33{\pm}12\%$), Pheidole fervida ($17{\pm}15\%$), Camponatus japonicus ($10\%$), Formica japonica ($7{\pm}6\%$), Paratrechina flavipes ($3{\pm}6\%$), and Crematogaster matsumurai ($3{\pm}6\%$) took away cadavers, but $23{\pm}15\%$ of cadavers were not visited by ants. Ants took away $40\%$ of Sc-killed cadavers, $16.7\%$ of frozen-killed cadavers, and $3.4\%$ of He-killed cadavers. The number of visiting ants was low at the hole 9 of Cherry course in Gapyung Benest Golf Club and only Tetramorium tsuhimae and Paratrechina flavipes were found from one site. The density of entomopathogenic nematodes did not influence ant visiting on cadavers, but burying affected ant visiting. Although ants took away unburied cadavers, buried cadavers were taken away at the hole 6 of Dongrae Benest Golf Club by 16 hours. Ant visiting had the same tendency on symbiotic bacterium-treated biscuit as nematode-killed cadavers. The visiting was less on biscuit inoculated by Photorhabdus sp., a symbiotic bacterium of He than on biscuit inoculated by Xenorhabdus nematophila, a symbiotic bacterium of Sc.

Effects of Size and Environmental Condition on Burrowing of Artificial Seedling of Ark Shell, Scapharca broughtonii (Schrenck) (피조개, Scapharca broughtonii (Schrenck) 인공치패의 크기 및 환경조건이 잠입에 미치는 영향)

  • Kim, Byeong-Hak;Shin, Yun-Kyung;Choi, Nack-Joong;Oh, Bong-Se;Sohn, Sang-Gyu;Jung, Choon-Goo;Son, Tai-Sun;Kang, Kyoung-Ho
    • The Korean Journal of Malacology
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    • v.23 no.1
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    • pp.1-8
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    • 2007
  • The influence of individual size, sediment, gain size, water temperature, salinity and air exposure on burrowing rate was investigated in order to obtain the basic biological data on applying shellfish farm for a sustainable production of ark shell, Scapharca broughtonii (Schrenk). The burrowing rate on individual size 300 minutes after starting the experiment was the highest in the shell length $16.3\;{\pm}\;1.2\;mm$, 97.7%. The highest burrowing rates were 97.0% in $12.8\;{\pm}\;0.8\;mm$, 96.7% in $9.2\;{\pm}\;1.0\;mm$, and 96.3% in $5.9\;{\pm}\;0.7\;mm$. The clams over 6 mm of shell length had burrowing ability and the burrowing rate was not related to the shell size. The burrowing rate depending on the kind of grain at the bottom after 300 minutes was the highest, 98.3%, in the mixture of sand and silt with a ratio of 75:25. The rates were 98% in silt (100%), 97.3% in mixture sand and silt with a ratio of 50:50, 97.3% in sand and silt ratio of 25:75, and 86.3% in sand (100%) in this specific order. On grain size of the soil in the seafloor, the burrowing rates after 300 minutes was at its highest in the group of sand in pore size 1 mm with 85.0%, and the $12\;{\mu}m$ to 1 mm in the grain size was fitted to burrowing of artificial seed. In the case of water temperature, the burrowing rates were at its highest after 300 minutes. In $30^{\circ}C$ group, the rate was 96.7% and in $25^{\circ}C$ and $20^{\circ}C$, 90.0%. The rates decreased as the water temperature decreased below $15^{\circ}C$. The burrowing rates on salinity were the highest in 30 psu with 93.3% and at 15 psu and below, there was no noticeable change in the burrowing rate. On air exposure, the burrowing rates after 300 minutes were the highest in 1 hour with 93.3%, and remarkably decreased as air exposure time is longer after 12 hours of air exposure.

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Effect of Geijibokryunghwan and each constituent herb on inhibition of platelet aggregation (계지복령환(桂枝茯笭丸) 및 그 구성약물(構成藥物)의 혈소판응집억제(血小板凝集抑制)에 관(關)한 연구(硏究))

  • Kim, Jong-Goo;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.115-129
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    • 2000
  • The cause that the increase of animality fat intakes, under exercise, fatness, adding the stress, advanced age etc., the occurrence rate of the circulation system disease has been increased. And the thrombosis importantly came to the front as the risk factor of these circulation system's disease. Nowadays, the ischemic disease has especially discussed, for example the angina or myocardial infarction, originated in thrombosis that came from the platelet aggregation. In the western medicine, as the cure and prevention, using the aspirin or ticlopidine for platelet aggregation suppressant. But in the , the curing method must be used properly according to the pectoralgia or heartache's kind, state, grade. The platelet do not attache to the normal hemangioendothelial cell. But when it stimulated by endothelium peronia and so on, it attache to the injury endothelium or rise aggregation between the platelet. On this time, it secrete the platelet aggregation inducer as like ADP, thromboxane A2 from the inside of platelet. So it has first defensive function through the aggregation augment that prevent the celerity consumption of blood. But the activation of abnormal platelet occur the platelet grume and thrombogenesis. So it bring up the occlusive angiosis, so to speak, cardiovascular disease, cerebrovascular disease, arterial sclerosis. In oriental medicine, the thrombosis in the category of blood stasis and this blood stasis present the generalise or local blood circulation disturbance that generated by all kinds of pathological fact or blood stream retention accompanying with a series of syndrome. As the syndrome, stabbing pain fixed at certain region, squamous and dry skin, fullness and pain of the chest and hypochondrium, firmness and fullness of the lower abdomen, black stool, dark purple tongue or with ecchymoses and petechiae etc.. has been created. And it becomes the pathopoiesis cause that the convulsion and palpitation, severe palpitatiion, tympanites, the symtom complex with a mass or swelling in the abdomen, insanity, stricken by wind etc.. Moreover, it used the drugs for invigorating blood circulation and eliminating blood stasis or drugs for removing blood stasis for all kinds of syndrome through the blood stasis. And the drugs for activating the blood circulation, such as Salviae Radix, Angelicae Sinensis Radix, Persicae Semen, Achyranthis Radix, Cnidii Rhizoma, Carthami Flos are used for that. And it is used to the herbs of insects that has strong effect about the disintergrating blood stasis such as Hirudo, Scolopendrae Corpus, Buthus, Lumbricus etc.. On this study, It used Geijibokryunghwan(GBH) and the consisting herbs to investigate the influence of platelet aggregation about drugs that used to improvement various symptoms created by the thrombosis in oriental medicine. GBH formula has as formula recorded in the , action of 'eleminating the evil and not impairment of healthy energy' and 'promoting the flow of QI and cold and heat, so used for the expel blood stasis herbs from the ancient. Therefore we investigated the restraint effect of GBH and the consisting herbs about the platelet agregation induced to the ADP, AA or collagen. The conclusion is following. 1. When it added the aggregation inducer after that it added GBH and individual consisting herbs in the PRP, GBH showed the (+) inhibition effect on the platelet aggregation and it showed the (+) inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis. 2. It showed the (+), (+,++) inhibition effect on the platelet aggregation in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc. 3. In the aggregation inhibition activating on the difference of density, GBH showed strong inhibition effect to the aggregation state induced to collagen, and it showed the inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis about the aggregation induced by the collagen. 4. It showed the strong inhibition effect about the aggregation induced by the collagen in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc Like this, as confirm GBH and the individual consisting herb's inhibition effect of platelet aggregation, We considerated that GBH and the individual consisting herbs have practical applicational value of clinical trial in the thrombosis caused by platelet aggregation.

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An Optimum Control Time of Alopecurus aequalis var. amurensis Ohwi in No - tillage Dry Seeded Rice (벼 무경운(無耕耘) 건답직파재배시(乾畓直播栽培時) 둑새풀 방제적기(防除適期) 구명(究明))

  • Hwang, C.D.;Park, S.T.;Kim, S.Y.;Lee, K.Y.;Kim, S.C.
    • Korean Journal of Weed Science
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    • v.17 no.4
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    • pp.362-367
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    • 1997
  • A field experiment was conducted to determine an optimum control time of water foxtail(Alopecurus aequalis var. amurensis Ohwi), a most troublesome weed, in no-tillage dry seeded rice. Paraquat, a non-selective herbicide, was applied at 1.5 days interval from March 15 to May 15 at a concentration of 3,000ml per hectar and its control efficacy to A. aequalis was recorded before and after seed sowing. In addition. other characters such as decayed injury of A. aequalis to rice seedling, and its influence of seedling stand were also investigated in relation to rice grain yield. Dry weight of A. aequalis was rapidly increased with delay in control time from 42g/$m^2$at March 15 to 237g/$m^2$ at May 15. The amount of its regrowth at seeding time was highest with 68.3g, when paraquat was applied at March 15, then decreased thereafter and it was less than 6.2g when paraquat was applied after April 15 which indicates above 98% control rate. The control rate of A. aequalis, at 30 days after paraquat application way likewise similar to that the seeding time. Rice seedling stands in the plot treated with paraquat before April 15 were not affected by decayed injury of A. aequalis while decayed injury of 3 to 4 degree for those after April 30 application was noted. Dwarf virus disease on rice seedling due to occurrence of A. aequalis was not observed when A. aequalis was controled from March 30 to May 15 while it was occurred in the plot of March 15 application and the untreated control. The control plot of A. aequalis at April 15 had the highest grain yield with 4.79ton/10a. Based on control rate of A. aequalis, seedling stands of rice, virus disease, and rice grain yield, the most suitable control time of A. aequalis in no-tillage dry seeded rice is considered to be about April 15.

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Radiotherapy in Medically Inoperable Early Stage Non-small Cell Lung Cancer (내과적 문제로 수술이 불가능한 조기 비소세포성 폐암에서의 방사선치료)

  • Kim, Bo-Kyoung;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.257-264
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    • 2000
  • Purpose: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. Materials and Method : We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wail invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included souamous (24), adenocarcinoma (6) and unclassiried squamous cell (2). The clinical stages of the patients were 71 in 5, 72 in 25, 73 in 2 patients. Initial tumor size was 3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. Ail patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 0.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. Results : The overall survival rate was 44.6$\%$ at 2 years and 24.5$\%$ at 5 years, with the median survival time of 23 months. of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0$\%$ at 2 years and 33.5$\%$ at 5 years. The disease-free survival rate was 38.9$\%$ at 2 years and 28.3$\%$ at 5 years. The local-relapse-free survival rate was 35.1$\%$, 28.1$\%$, respectively. On univariate analysis, tumor size was significant variable of overall survival (p=0.0015, 95$\%$ C.1.; 1.4814-5.2815), disease-free survival (P=0.0022, 95$\%$ C.1., 1.4707-5.7780) and local-relapse-free survival (p=0.0015, 95$\%$ C.1., 1.2910- 4.1197). 7 stage was significant variable of overall survival (p=0.0395, 95$\%$ C.1.; 1.1084-55.9112) and had borderline significance on disease-free survival (p=0.0649, 95$\%$ C.1.; 0.8888-50.7123) and local-relapse-free survival (p=0.0582, 95$\%$ C,1.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival (p=0.6919, 955 C.1., 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95$\%$ C.1.; 0.9720-4.9657). Tumor size was also significant variable of disease-free survival (p=0.0317, 95% C.1.; 1.1028-8.4968). Conclusion : Radical radiotherapy is an effective treatment for small (71 or f3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hypefractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.

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Association of Health-related Behaviors with Socio-demographic Characteristics (건강증진과 관련된 행태에 영향을 미치는 인구사회학적 특성)

  • Roh, Won-Hwan;Kim, Seok-Beom Gib;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.157-174
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    • 1998
  • A survey was conducted to study the influence of socia-demographic factors on health-related behaviors. from June 1 to July 31, 1996. The study population was 1,903 adults in Kyongju City. A questionnaire method was used to collect data. Health-related behaviors included 24 items for men and 26 items for women. The followings are summaries of findings : The compliance of health promotion activities was higher when the age was older in men, when married, when having no religion and when the education level was higher than the other groups. And it was significantly higher when the income was lower in men and higher in women, in the residents living in apartment, in white collar workers, in the chronic ill people and when the body weight was lower than the other groups. Notable differences were found in the composition of health behavior factors for socio-demographic characteristics. Men used more tobacco, coffee and tea, salt and alcohol than women. However, the practice rates of regular exercise and physical examination were higher in men than women. On the other hand, the practice rates of fruit/vegetable intake, milk drinking and regular tooth brushing were higher in women than men. When the age was old, the amount of fruit/vegetable intake, the frequency of physician visit and health check-up, and regularity of meal were increased. When the income was high, the use rate of seat-belts, the amount of coffee, milk, fruit/vegetable and red meat intake were increased. The frequency of regular exercise. tooth brushing, health check-up, pap test and breast self examination were higher in the rich than the poor. When the education level was high, the frequency of regular exercise and tooth brushing, and the use rate of seat belts were increased, and the amount of alcohol consumption and salt intake were decreased. These findings suggest that socio-demographic factors are significantly associated with the patterns of health behaviors. In conclusion public health programs and individual counseling efforts should be multifaceted and behavior-specific to encourage to practice healthy life-style.

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Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit (호흡기계 중환자실에서 치료 관리된 급성호흡곤란증후군의 임상특성)

  • Moon, Seung-Hyug;Song, Sang-Hoon;Jung, Ho-Seuk;Yeun, Dong-Jin;Uh, Su-Tack;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1252-1264
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    • 1998
  • Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

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The Influences of Maintenance Hemodialysis on Sleep Architecture and Sleep Apnea in the Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 유지요법이 수면구조 및 수면 무호흡에 미치는 영향)

  • Park, Yong-Geun;Lee, Sang-Haak;Choi, Young-Mee;Ahn, Seok-Joo;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.824-835
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    • 1999
  • Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

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Influence of Edible Oil, Casein, Calcium and Magnesium on Serum Cholesterol Level in Rabbit (식용유, 카제인 및 칼슘, 마그네슘 첨가식이가 토끼의 혈청 Cholesterol 치에 미치는 영향)

  • Nam, Hyun Keun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.2
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    • pp.122-136
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    • 1983
  • The effect of dietary casein, calcium, magnesium and some vegetable oils such as seasme, perilla and soybean oil on the serum cholesterol level in the rabbit were studied for a period of 5 weeks using isocalories and isonitrogenous as basal diets. The experimental rabbits fed the following basal diets containing crude protein 68.47%, carbohydrates 13.35%. fats 16.18% and vegetable oil 10%. casein 10%, calcium and magnesium according to experimental plan making. In order to calculate the feeding efficiency, protein efficiency and calorie efficiency during period, the body weight gains were measured at the same time using same balance, respectively. The results are summarized as follows. Body weight gains per week of the group fed perilla oil, calcium and basal diet were the higher than any other groups. And body weights gains per week of the group fed basal diet, vegetable oil were the lower than any other groups. In the case of efficiency of reed, protein and calorie, the efficiency ratios of the group fed perilla oil were the higher than any other groups. Especially, perilla oil and calcium diet effect on body weight gain in rabbit. In the case of serum protein, the total proteins in serum were almost same value for all the groups. Serum albumin of group fed basal diet. vegetable oil and casein were the higher than any other groups. The ${\alpha}$-globulin of the groups, fed basal diet and calcium was the lower than any other grosps. The ${\beta}$-globulins of the groups fed basad diet, perilla oil and casein were the highest value. In serum lipoprotein, lipalbumin was almost same value for the groups fed vegetable oil, but fed vegetable oil and calcium diet was the lowest value. The ${\beta}$-lipoprotein in high cholesterol level group was increased some degree, the group fed perilla oil added was lower. The ratio of ${\beta}$-lipoprotein per lipalbumin was from 0.11 to 0.26. The ratio of lipalbumin per total lipoprotein was high in calcium and soybean oil added diet. In serum triglyceride, the level of triglyceride of groups fed seasme oil or perilla oil was the higher than any othe groups, but in the group fed casein and calcium or magnesium, the level of triglyceride level was decreased. Calcium and magnesium effect on triglyceridge level lowering action. In serum total cholesterol, the group does fed vegetable oil with basal diet and casein added more, total cholesterol level increased as much as triglyceride level increased. But the group does fed perilla oil and magnesium shows total cholesterol level decreased remarkably. In the group fed basal diet with calium, the amount of serum calcium was increased, but of serum magnesium was decreased. In the case of blood glucose, the group fed basal diet and vegetable oil was decreased. According to the regression and correlation coefficient in blood components in rabbit, there are positive correlation $${\gamma}{\sim_=}1$$ between serum cholesterol and triglyceride, ${\beta}$-lipoprotein, ${\alpha}$-globulin, calcium and magnesium according to diet composition. From the above results, the serum cholesterol level lowering factors in rabbit, was the amount of triglyceride and ${\beta}$-lipoprotein which was decreased in perilla oil fed. It assumes that serum cholesterol and triglyceride level lowering factors are not only unsaturation degree of fatty acid but the amount of calcium and magnesium and the ratio calcium per magnesium 2:1 in the diet.

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