• Title/Summary/Keyword: internal diseases

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A Case of Renovascular Hypertension Due to Renal Artey Stenosis Related to Moyamoya Disease (모야모야병과 동반된 신 동맥 협착에 따른 신성 고혈압을 보인 1례)

  • Kim, Joung-A;Kim, Seung;Kim, Hyo-Sun;Shin, Jae-Il;Jeong, Il-Cheon;Kim, Dong-Seok;Kim, Myung-Joon;Lee, Do-Yun;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.294-298
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    • 2007
  • Moyamoya disease is a progressive cerebrovascular disorder with stenosis or occlusion of the bilateral internal carotid arteries with abnormal vascular networks at the base of the brain. Previous reports have shown that there are extracranial vascular involvements in Moyamoya disease, especially in the renal artery. We report a 7-year-old patient with Moyamoya disease associated with renovascular hyper tension, who presented in infancy with seizures and hemiparesis. Renal angiography showed multiple stenoses of the right renal artery. Although renal artery stenosis in Moyamoya disease has been effectively treated with balloon angioplasty, stent implantation, or surgery, bat-loon angioplasty could not be done in this patient due to multiple stenoses. His blood pressure was successfully controlled with medical treatment, and remained normotensive during the follow up period of 6 months.

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Usefulness of Minimally Invasive Radio-Guided Parathyroidectomy in Patients with Prior Central Neck Exploration (중앙 경부 수술의 과거력이 있는 환자에서의 방사능 유도 최소 침습 부갑상선 절제술의 유용성)

  • Lee, Sung-Hwan;Kim, Bup-Woo;Kim, Kuk-Jin;Lee, Yong-Sang;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Chang, Hang-Seok;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.138-142
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    • 2009
  • Introduction : Although bilateral exploration has been thought to be the standard therapeutic modality for primary hyperparathyroidism(pHPT) due to the admirable cure rate, questions have remained as to whether bilateral neck exploration for all patients with pHPT is needed because 80-85% of patients with pHPT have a single parathyroid adenoma. If the diseased parathyroid can be determined preoperatively, a directed and minimal operation is appropriate using the recent innovations of preoperative diagnosis and operation techniques for parathyroid diseases, the radio-guided parathyroid surgery(RGPS) is one of the standards. In especial, RGPS has been reported beneficial in special circumstances, such as in recurrent disease, ectopic parathyroid, and in mediastinal parathyroid. It can be also useful for the parathyroid disease in previously explored or irradiated neck. Material and Methods : We experienced 2 cases of pHPT successfully treated by RGPS in who previously underwent extensive neck dissection and concomitant external or internal radiotherapy. We adopted and modified the technique described by Dr. James Norman at the University of South Florida-the minimally invasive parathyroidectomy using intraoperative nuclear mapping with 99mTc-sestamibi scanning and radioactivity detection probe. Results : We acquired the successful results for these patients. Conclusion : RGPS is thought to be the alternative technique for the patients with prior central neck exploration and irradiation.

Treatment of Patients with Cancer in a Secondary Hospital in Korea (국내 일개 2차 병원의 암환자 치료 실태)

  • Son, Myoung Kyun
    • Journal of Hospice and Palliative Care
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    • v.21 no.3
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    • pp.84-91
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    • 2018
  • Purpose: This study aims to investigate treatment of cancer patients at a secondary hospital. Methods: A retrospective analysis was performed with electronic medical records of cancer patients admitted to a secondary hospital from January 1, 2009 through September 31, 2017. Results: A total of 223 patients were studied. Sixty-nine patients were hospitalized for supportive care after receiving a surgery, chemotherapy, and radiotherapy at a tertiary hospital, 58 patients for other supportive care, 53 patients for symptom control, 16 patients with a decision not to take active cancer treatment, and 27 patients for treatment of cancer that was diagnosed during their hospital stay. Among 75 patients who were discharged to other institutions, 50 were transferred to tertiary hospitals, 10 to long-term care hospitals, eight to hospice hospitals, four to nursing homes and two to secondary hospitals. Comorbidities were found in 120 patients (53.8%). For patients who consulted with more than one department, more consultations were for non-cancer diseases than cancer. Seventy-three patients had a do-not-resuscitate order. Conclusion: For treatment of cancer patients, it is needed to establish a cooperation system among medical institutions and provide comprehensive management including treatment of comorbidities.

Successful Renal Autotransplantation for the Treatment of Severe Renovascular Hypertension in a 14-year-old Boy (신 자가이식을 통한 14세 소년에서 발생한 심한 신성 고혈압의 성공적인 치료)

  • Ji, Min-Chul;Park, Se-Jin;Choi, Jae-Young;Ko, Young-Guk;Kim, Myoung-Soo;Kim, Ji-Hong;Shin, Jae-Il
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.223-229
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    • 2010
  • Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

Development of a Quality of Life Scale For Children on Chronic Peritoneal Dialysis (만성 복막투석 아동용 삶의 질 척도 개발)

  • Shin, Min-Sup;Cho, Soo-Churl;Jang, Jae-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.202-212
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    • 2008
  • Purpose : The aim of this study was to develop a quality of life scale for children on chronic peritoneal dialysis(QOL-CPD). Methods : Thirty children on chronic PD at Seoul National University Children's Hospital participated. A healthy control group included 47 elementary school children. Other patients groups are 32 children from the department of pediatric orthopedics and 28 children from the department of child psychiatry. The age range of all children was 7 to 16 years. Preliminary items of the QOL-CPD were developed and administered along with the Korean version of the Children's Depression Inventory(CDI) to all children. Results : The final QOL-CPD was constructed by excluding those items with a factor loading of less than .20, and the principal axis factor analysis was performed again. The QOLCPD demonstrated a good internal consistency with a value of .87. The dialysis and childpsychiatric groups showed significantly lower QOL scores compared to the healthy control group. In addition, the dialysis and child-psychiatric groups showed greater difficulties on physical and academic functions. For the CDI, the PD group showed a mild level of depression. Conclusion : The results of this study demonstrate the clinical utility of a newly developed self-report QOL scale specific for children on chronic PD.

The Recovery Effects of Joojakwhan - A Traditional Korean Medical Poly-herbal Drug for the Cognitions and Motor Functions in Mild Stroke Rat Model by Using Transient Middle Cerebral Artery Occlusion (주작환(朱雀丸)이 일시적 국소 뇌허혈 유발 백서(白鼠)에 대한 인지 및 운동기능 회복에 미치는 효과)

  • Kim, Bo-Eun;Kang, Seok-Bong;Chung, Dae-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.4
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    • pp.419-434
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    • 2013
  • Objectives: The object of this study is to observe the cognition and motor function recovery effects of Joojakwhan (JJW), a traditional Korean poly-herbal formula for treating various neuropsychiatric diseases such as dementia, for the mildly stroke rats, with 60 minutes of reperfusion transient middle cerebral artery occlusion (tMCAO). Methods: In the present study, 125, 250 and 500 mg/kg of JJW were orally administered, once per day for 10 continuous days 2 hours after the tMCAO. The body weight changes, infarct sizes under 2% 2, 3, 5-triphenyl tetrazolium chloride (TTC) stain, sensorimotor functions and cognitive motor behavior tests were serially monitored with cerebral caspase-3 and cleaved poly (ADP-ribose) polymerase (PARP)-immunoreactivities and histopathological changes. The effects of tMCAO on sensorimotor functions were evaluated by using of limb placing and body-swing tests, and the cognitive motor behaviors were also observed with water maze tests. Results: From the results of tMCAO, with marked decreases of body weights, disorders of sensorimotor functions increases the limb placing test scores, and decrease the numbers and percentages of body swings to the ipsilateral sides. The cognitive motor behaviors increases the distances and time to reach the escape platform which included the inhibitions of the decreases with repeated trials that were observed with focal cerebral cortex infarct volumes. In addition, the marked increases of the atrophy, numbers of degeneration, caspase-3- and PARP-immunoreactive cells around peri-infarct ipsilateral cerebral cortex were also observed in tMCAO controls when compared with the sham control rats, respectively. Conclusions: The results obtained from this study suggest that oral administrations of JJW indicate obvious cognitions and motor function recoveries of the rats with tMCAO, mild strokes, which are mediated by neuro-protective effects through known antioxidant effects of components.

Prevalence of Canine Influenza Infection in Pet Dogs and Canine Parvovirus Infection in Street Dogs of Bangladesh

  • Hassan, Md. Kumrul;Nahat, Faizul Wasima;Bhattacharjee, Palash Kumar;Rahman, Md. Siddiqur;Rahman, A.K.M. Anisur;Islam, Md. Ariful;Akter, Mahmuda;Chae, Joon-Seok
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.165-171
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    • 2017
  • A cross-sectional study was conducted to investigate the prevalence of canine influenza (CI) infection in pet dogs and canine parvovirus (CPV) infection in street dogs of different age and sex by collecting rectal and nasal swab samples from three districts, Dhaka, Mymensingh and Sirajgonj, in Bangladesh using a RapiGEN$^{(R)}$ Canine Influenza Virus Ag Test kit and RapiGEN$^{(R)}$ Canine Parvovirus Ag Test Kit. Out of 114 rectal swabs and 115 nasal swab samples, the overall prevalence of CI and CPV was found to be 11.30% and 32.45%, respectively. The prevalence of parvovirus infection was found to be significantly higher in puppies and dogs 6 months of age (50.0%) than those > 24 months of age (p = 0.005). The prevalence was also higher in males (34.42%) than females (30.18%). The prevalence of CI was higher (30.43%) in dogs up to 6 months of age (p = 0.011) than 6-12 month (7.93%) and 12-18 month (6.66%) old dogs. Moreover, the prevalence of CI was found to be higher in males (16.10%) than females (5.66%). The prevalence of CPV infection also varied significantly in different study areas (p = 0.0029), with 12.72%, 12.5% and 7.14% of dogs found to be CI positive in Dhaka, Mymensingh and Sirajgonj, respectively. Overall, the highest prevalence of CI was found in local breeds (6.08%) followed by German shepherds and Keeshonds (1.73%), and Bloodhounds and Terriers (0.86%). Additionally, there were more positive CI found in unvaccinated dogs (14.81%) than vaccinated (2.94%) dogs. Dogs with flu-like symptoms were more positive (19.23%) for CI relative to those without flu-like symptoms (4.76%) samples. Overall, the results of this study indicate that canine vaccination should be initiated to prevent the occurrence of diseases and that regular monitoring should be continued in Bangladesh.

Food Habits, Nutrients Intake, and Disease Distribution according to Sasang Constitutions in the Elderly Aged over 65 Years(II) (65세 이상 노인에서 사상체질에 따른 식습관, 영양소 섭취상태 및 질병 양상에 관한 연구(II))

  • Kim, Youn-Kyoung;Cho, Mi-Ran;Chang, Rin;Choue, Ryo-Won
    • Korean Journal of Community Nutrition
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    • v.7 no.1
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    • pp.76-85
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    • 2002
  • Since the 1970s, the average life expectancy of Koreans has been increasing. Our concerns are not simply about longevity, but also about disability-free life. lately, Sasang constitutional medicine has attracted public attention, especially with respect to the elderly. The purpose of this study was to investigate the food habits, nutrients intake, and disease distribution among the elderly, according to their Sasang constitutions. The results are as follow : The distribution of constitutions of the subjects were Tae-eum 48.8%, So-yang 27.4%, So-eum 22.6%, and So-yang + So-eum 1.2%. In both elderly men and women, body weight, percent ideal body weight, and diastolic pressure of the Tae-eum were significantly higher than those of other constitutions. In both men and women, the level of hemoglobin in the Tae-eum was significantly higher than those of other constitutions. The level of LDL-cholesterol was higher, and the level of HDL-cholesterol was lower in the So-eum elderly women. Food habits of the So-eum were the most irregular, and nutrients intake of the So-eum was lower than that of other constitutions in both elderly men and women. In elderly men, the incidence of hypertension was the highest in the Tae-eum, and the incidence of gastritis was the highest in both So-yang and So-eum. In elderly women, the incidence of fatty liver was the highest in the Tae-eum and So-yang, and gastritis and hypertension were the highest in the So-eum. In the elderly, obese and anemic persons were significantly more in the Tae-eum and the So-eum, respectively. The results of this study showed that there were significant differences of physical, characeristics, food, habits, and distributions of disease for the subjects according to each Sasang constitutions. Intake of nutrient was poor, regardless of Sasang constitutions, in both men and women.

Establishment and Functions of World Health Organization: With a Functionalism Perspective (기능주의 관점에서 본 세계보건기구의 설립과 역할)

  • Ko, Han-Soo;Kim, Chang-Yup
    • Health Policy and Management
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    • v.22 no.1
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    • pp.1-28
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    • 2012
  • Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber's five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber's theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.

The Sanguinarine Apoptosis Induction of Hep3B Human Hepatocellular Carcinoma Cells is Dependent on the Activation of Caspase (Sanguinarine에 의한 Hep3B 인체 간암세포의 apoptosis 유도에 관한 연구)

  • Han, Min Ho;Choi, Sung Hyun;Hong, Su Hyun;Park, Dong Il;Choi, ung Hyun
    • Journal of Life Science
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    • v.27 no.11
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    • pp.1340-1348
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    • 2017
  • Sanguinarine is a benzophenanthridine alkaloid derived from the roots of Sanguinaria canadensis L., which is used for the purpose of treating various diseases. Although studies of anticancer activities have been performed using various cancer cell lines, the phenomenon of inducing apoptosis in cancer cells by using sanguinarine requires more research. Therefore, this study investigated the anti-cancer activities and related mechanisms of sanguinarine used with Hep3B human hepatocellular carcinoma cells in terms of the regulation of apoptosis. Sanguinarine inhibited the proliferation of Hep3B cells in a concentration-dependent manner, which was associated with the induction of apoptosis. Sanguinarine also increased the activity of caspase-3, which is a typical effector caspase, and the activities of caspase-8 and caspase-9, which are key when initiating extrinsic and intrinsic apoptosis pathways, respectively. In addition, sanguinarine increased the expression of death receptor-related genes and pro-apoptotic BAX, which belongs to the Bcl-2 family, while suppressing the expression of anti-apoptotic Bcl-2. Sanguinarine promoted the truncation of Bid and enhanced the release of cytochrome c from the mitochondria to the cytoplasm due to a loss of mitochondrial membrane potential. Furthermore, the reduction of a survival rate that was induced by sanguinarine and the induction of apoptosis disappeared with the inhibition of artificial caspase activity. Therefore, the results of the study indicated that sanguinarine-induced apoptosis in Hep3B cells involves both extrinsic and intrinsic pathways; such apoptosis is a caspase-dependent phenomenon.