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Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee (급성 화농성 슬관절염에서 관절경적 치료 후 결과)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.53-57
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    • 2008
  • Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

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GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI

  • Kim, Chung-Hoon;You, Rae-Mi;Kang, Hyuk-Jae;Ahn, Jun-Woo;Jeon, Il-kyung;Lee, Ji-Won;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.4
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    • pp.228-233
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    • 2011
  • Objective: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP). Methods: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP. Results: There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups. Conclusion: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.

Effects of Acupuncture applied to Food Samli on the Rat Model of Knee Arthritic Pain (족삼리(足三里) 전침(電鍼)이 백서(白鼠)의 슬관절염(膝關節炎) 통증(痛症)에 미치는 영향(影響))

  • Park, Sung-Ik;Koo, Sung-Tae;Hwang, Jae-Ho;Shin, Jong-Keun;Sohn, In-Chul;Kim, Kyung-Sik
    • Korean Journal of Acupuncture
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    • v.21 no.1
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    • pp.113-127
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    • 2004
  • Objectives : The usage of acupuncture has gained popularity as an alternative method of treatment for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to foot samli$(ST_{36})$ on the carrageenan-induced knee arthritic pain was examined. Methods : A common source of persistent pain in humans is the knee arthritis. Knee arthritis was induced by injection of 2 % carrageenan $50\;{\mu}l$ into the knee joint cavity. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The weight bearing force of the hind limb was measured for an indicator of pain level after each manipulation. Results : The average weight borne by the hind limb during normal gait was 55% of total body weight, which was reduced to less than 10% after knee arthritis. EA improved the weight bearing of the arthritic hind limb significantly for the duration of 4 hr. EA applied to $ST_{36}$ point produced a significant improvement of stepping force of the arthritic foot lasting for at least 4 h. However, $GB_{31}$ point did not produce any significant increase of weight bearing force. The analgesic effect was specific to the acupuncture point since the analgesic effect on the knee arthritis model could not be mimicked by EA applied to a nearby point, $GB_{31}$. The relations between EA-induced analgesia and endogenous nitric oxide(NO) and inducible NO synthase(iNOS)/neuronal NOS was also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which is increased by arthritis were suppressed by EA stimulation applied to $ST_{36}$ point. Conclusions : The data suggest 1) that EA produces a potent analgesic effect on the rat model of chronic knee arthritis pain in a point specific manner and 2) that EA-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.

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Changes in Renal Function by Nebulized Colistimethate Treatment (Colistimethate 분무요법 시행 환자에서 투여 전후 신기능의 변화)

  • Ahn, Hye Jin;Jung, Yoo Jin;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.92-98
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    • 2017
  • Background: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. Methods: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. Results: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment ($SCr_0$ vs. $SCr_1$; $0.85{\pm}0.80$ vs. $1.00{\pm}0.82mg/dL$, n=48, p<0.001), but the changes were in normal range according to the standards at Yonsei university health $system^a$. Among 48 patients, 38 patients were in the non-AKI group (79.2%), and 10 patients developed AKI (20.8%). Within the AKI group, 2 patients were in the Injury group (20%) and the other 8 in the Risk group (80%). Conclusion: There was no significant difference in age, dosage and duration of treatment between AKI group and non-AKI group (p>0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. $^a$ : SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL.

Understanding Pollutant Emission in a Heavy-Duty Diesel Engine with JP-8 and Diesel (대형 디젤 엔진에서 JP-8 과 디젤 적용 시의 배기 배출물 특성에 대한 이해)

  • Lee, Jin-Woo;Bae, Choong-Sik
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.12
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    • pp.1375-1381
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    • 2011
  • Combustion processes in an optically-accessible single-cylinder heavy-duty diesel engine equipped with a highpressure common-rail injection system were investigated for JP-8 and diesel. Direct imaging and two-color thermometry were employed to verify the emission trend for both fuels. The combustion process was characterized by image analysis with focus on luminosity. The results of two-color thermometry were analyzed on the basis of the flame temperature and KL factor distribution. Analysis of the combustion process by direct imaging showed that the ignition delay was longer for JP-8 than for diesel, while the flame was extinguished rapidly. Analysis of the flame luminosity showed that the combustion intensity was higher for diesel and that the flame lasted for a longer duration in this case. Two-color thermometry results showed that the high-temperature region extended over a large area during JP-8 combustion, implying the formation of a large amount of $NO_x$. In addition, the KL factor showed low level over a large area and relatively homogeneous in the case of JP-8 combustion, which implied that less smoke was produced when using this fuel.

The effect of heterogeneous hyperimmune IgG antibody on prophylaxis and treatment of Pneumocystis carinii infection in rats (폐포자충증에 대한 이종항혈청 내 1gG 항체의 예방 및 치료효과)

  • 이미정;조상록
    • Parasites, Hosts and Diseases
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    • v.36 no.2
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    • pp.127-132
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    • 1998
  • Immunotherapy has been used in support of trimethoprim-sulfamethoxazole treatment for Pneumocvstis corinii pneumonia. The present study investigated the therapeutic or preventive effects of heterogeneous hyperimmune IgG antibody (HIA) in experimental rats. Their immunity was suppressed by steroid injection, and they were also injected peritoneally with HIA which reacted with 40-55, 92, 116, and 200 kDa bands of the crude antigen. All rats were infected by p. ccrinii and the cystic forms on lung impression smears were counted. The count was 20.5-76.5 (mean 52.5 ± 19.)1 in those which received steroid only, but decreased to 6.0-21.0 (mean 13.5 : 10.6) in those of group 3 which received HIA for the same duration. In other groups, the mean count ranged from 29.9 t 32.9 to 54.1 t 47.7, and in those which received 13.7 mg HIA the reduction effect was greater than in those which received 6.8 mg or 20.5 mg HIA. The present finding confirmed that in rats during the early stage of infection, the heterogeneous HIA to MSG antigen bands had a partial effect on p. cori,nii pneumonia, both prophylactically and therapeutically.

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Comparision of cardiovascular and analgesic effects of epidural administration of medetomidine, medetomidine-buprenorphine and medetomidine-fentanyl in dogs anesthetized with isoflurane (Isofourane으로 마취된 개에 medetomidine, medetomidine-buprenorphine, medetomidine-fentanyl의 경막외 투여 시 심혈관계 반응과 진통효과의 비교)

  • Chang, Hwa-Seok;Kim, Hye-Jin;Choi, Chi-Bong;Lee, Jung-Sun;Kim, Hwi-Yool
    • Korean Journal of Veterinary Research
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    • v.47 no.1
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    • pp.103-115
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    • 2007
  • The aim of this study was to compare the reaction of the cardiovascular system, and the anesthetic effect among 3 experimental groups, epidural administration of medetomidine as a single agent, the combination of buprenorphine and medetomidine, and the combination of fentanyl and medetomidine. Twenty one dogs were anesthetized with isoflurane and allowed to breathe spontaneously. Epidural, arterial, and venous catheters were inserted. The tip of epidural catheter was positioned at the level of the space between the sixth and seventh lumbar vertebra. After a stable plane of anesthesia was achieved, these dogs were each administered one of the following treatments epidurally : medetomidine $10{\mu}g/kg$ (Group M), a combination of medetomidine $5{\mu}g/kg$ and buprenorphine $10{\mu}g/kg$ (Group M/B), and a combination of medetomidine $5{\mu}g/kg$ and fentanyl $10{\mu}g/kg$ (Group M/F). Heart rate (HR), Respiratory rate (RR), End-tidal carbon dioxide (EtCO2), and arterial blood pressure were measured before drug administration (base line) and 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min postinjection. Blood gas analysis was performed before injection and 5, 15, 25, 35, 45, 60 min postinjection. Isoflurane was discontinued 80 min postinjection and pain/motor function were evaluated up to 260 min postinjection every 15 min. At the early stage of drug introduction (until 5 min), the HR was decreased significantly in all 3 groups compared with base line. In Group M, HR was significantly decreased compared with the other 2 groups. With time (starting 20 min after drug introduction), the HR was decreased significantly in Group M/B in respect to base line. However, no significant difference was seen number-wise in all 3 groups. During 60 min after drug introduction, the systolic, diastolic and mean arterial pressures were highest in Group M and lowest in Group M/F. Among 3 groups, drug action and motor loss duration were longest in Group M/F. Analgesic effect observed in the M/F group was the most prominent and long-lasting, compared to those seen in the other 2 groups. Given the fact that the recovery of motor function takes place in a short period of time after analgesic effects disappeared, additional use of M/F depending on the patient's condition would be a good way to achieve effective pain management. However, proper care should be taken to ensure the function of cardiovascular system in the patient because the administration of M/F under isoflurane anesthesia results in a significant decline in arterial blood pressure ($65{\pm}10mmHg$).

Effects of xylazine-ketamine combination on serum ACTH, corticosterone and glucose concentrations in rabbits (Xylazine-ketamine 병용마취가 토끼의 혈중 ACTH, corticosterone 및 glucose 농도에 미치는 영향)

  • Park, Kwon-moo;Li, Long-hua;Han, Seong-kyu;Ryu, Pan-dong
    • Korean Journal of Veterinary Research
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    • v.39 no.1
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    • pp.77-84
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    • 1999
  • Anesthetic agents are useful in inducing the anesthesia for surgical operations and various biological experiments, but they can disturb the body homeostasis and cause the stress in animals. Much efforts have been directed on reducing such side effects of anesthesia. In this work, we measured the serum ACTH, corticosterone and glucose concentration in rabbits to compare the degree of stress induced by two commonly-used anesthetics, ketamine, xylazine, and the combination of xylazine and ketamine. 1. The anesthesia was induced in about 10 min in the rabbits treated with xyalzine, ketamine and xylazine-ketamine. The duration of complete loss of righting reflex were 12, 13 and 115 min in the groups treated with xylazine, ketamine and xylazine-ketamine, respectively. 2. Serum ACTH concentrations in all treatment groups were higher than those in control group. At 30 min after the administration of the drugs, serum ACTH levels in ketamine-treated group were significantly higher than those in control, xylazine- and xylazine-ketamine-treated groups. However, at 1, 2, 5 and 9 hours after the drug administration, serum ACTH levels in xylazine-treated-group were higher than those in control. 3. Serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were lower than those in control or ketamine-treated groups at 0.5 and 1 hour after the administration. However, at 5 and 9 hours after the administration, serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were significantly higher than those in ketamine-treated group or control. 4. Serum glucose levels transiently increased to 3 times of the pre-injection levels at 0.5 and 1 hours after the administration in xylazine or xylazine-ketamine-treated groin, but were not changed in control and ketamine-treated group. These results indicate that xylazine-induced stress lasts longer than ketamine-induced, suggesting that the difference in stress-related hormone levels during anesthesia could be due to the differences in modes of actions of individual drugs used and the depth of anesthesia.

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The expression of Foxp3 protein by retroviral vector-mediated gene transfer of Foxp3 in C57BL/6 mice (C57BL/6 마우스에서 Retroviral 벡터를 이용한 Foxp3 유전자의 도입에 의한 Foxp3 단백의 발현 양상)

  • Hwang, Insun;Ha, Danbee;Bing, So Jin;Jeon, Kyong-Leek;Ahn, Ginnae;Kim, Dae Seung;Cho, Jinhee;Lim, Jaehak;Im, Sin-Hyeog;Hwang, Kyu-Kye;Jee, Youngheun
    • Korean Journal of Veterinary Research
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    • v.52 no.3
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    • pp.183-191
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    • 2012
  • The maintenance of peripheral immune tolerance and prevention of chronic inflammation and autoimmune disease require $CD4^{+}CD25^{+}$ T cells (regulatory T cells). The transcription factor Foxp3 is essential for the development of functional, regulatory T cells, which plays a prominent role in self-tolerance. Retroviral vectors can confer high level of gene transfer and transgene expression in a variety of cell types. Here we observed that following retroviral vector-mediated gene transfer of Foxp3, transductional Foxp3 expression was increased in the liver, lung, brain, heart, muscle, spinal cord, kidney and spleen. One day after vector administration, high levels of transgene and gene expression were observed in liver and lung. At 2 days after injection, transductional Foxp3 expression level was increased in brain, heart, muscle and spinal cord, but kidney and spleen exhibited a consistent low level. This finding was inconsistent with the increase in both $CD4^{+}CD25^{+}$ T cell and $CD4^{+}Foxp3^{+}$ T cell frequencies observed in peripheral immune cells by fluorescence-activated cell-sorting (FACS) analysis. Retroviral vector-mediated gene transfer of Foxp3 did not lead to increased numbers of $CD4^{+}CD25^{+}$ T cell and $CD4^{+}Foxp3^{+}$ T cell. These results demonstrate the level and duration of transductional Foxp3 gene expression in various tissues. A better understanding of Foxp3 regulation can be useful in dissecting the cause of regulatory T cells dysfunction in several autoimmune diseases and raise the possibility of enhancing suppressive functions of regulatory T cells for therapeutic purposes.

Reevaluation of $^{99m}Tc$-HSA Erection Penography in the Impotence Patients (발기부전의 선별검사로서 파파베린유도 음경발기 촬영술의 재조명)

  • Kim, Deuk-Gyu;Park, Chung-Ha;Park, Hee-Seung;Chung, Kyung-Woo;Kim, Jong-Sung
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.371-376
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    • 1994
  • To reevaluate the clinical usefulness of erection penography for diffential diagnosis of impotence, we reviewed retrospectively the data of penography in 56 patients who were diagnosed as impotence by various diagnostic workup. Twelve normal males were studied as control group. Papaverine HCl 30mg was injected into the corpus cavernosum and simultaneously $^{99m}Tc$-HSA 20mCi was injected via an antecubital vein. After injection radioactivities in the penile area were detected for 30 minutes by gamma camera and time activity curve was displayed. We defined that transit time(TT) is the time to reach peak activity and erection persistent time(EPT) is the duration of time to maintain peak activity and venous index(VI) is the ratio of radioactivity($R_{30}/R_{max}$). The results were as follows. The TT of arteriogenic group($10.7{\pm}2.8min$) was significantly increased compared with those of control and venogenic groups(P<0.05, respectively). The EPT of venogenic group ($6.2{\pm}6.8min$) is significantly decreased compared with those of control and arteriogenic groups(P<0.05, respectively). The TT of psychogenic($15.2{\pm}5.5min$) is significantly increased compared with those of control and arteriogenic groups(P<0.05, respectively). In conclusion erection penography was very useful for the diagnosis of vascular and psychogenic impotence and for differentiation between arteriogenic and venogenic but it could not differentiate mixed type or neurogenic from vascular or psychogenic.

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