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A Clinicopathologipal Study on the Prognosis of IgA Nephropathy in Children (소아 IgA 신병증의 예후와 관련한 임상병리학적 고찰)

  • Kwon Jae-Hun;Choi Eun-Na;Park Jee-Min;Jeung Hyeun-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.23-29
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    • 2003
  • Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

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Comparison of the mental health, metabolic syndrome and nutrient intake by Gender in Problem drinkers ; Based on The Fifth(2010-2012) Korean National Health and Nutrition Examination Survey (성별에 따른 문제음주자의 정신건강, 대사증후군과 영양소 섭취; 제 5기(2010-2012) 국민건강 영양조사를 중심으로)

  • Choi, Young -Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5159-5168
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    • 2014
  • The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.

Flexural Properties according to Change of Polymerization Temperature of Autopolymerized Resin for Orthodontic (치과 교정용 자가중합형 Resin의 중합 온도 변화에 따른 굽힘 특성)

  • Lee, Gyu Sun
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.259-264
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    • 2015
  • For this experiment, specimen was manufactured by injecting polymer and monomer into silicon mold with volume ratio of 2.5:1 based on ISO 20795-2 so that average thickness, width and length of specimen would be maintained as 3.3 mm, 10.0 mm and 65.0 mm, respectively depending on spray on technique. Specimen was divided into 3 groups ($25^{\circ}C$, $40^{\circ}C$, $70^{\circ}C$) depending on polymerization temperature and 10 specimen was manufactured for each group and it was polymerized in water tank of ${\pm}1^{\circ}C$ under the setting condition of polymerization time of 15 minutes and pressure of 3 bar. After keeping specimen in distilled water of $37^{\circ}C$ for over 48 hours before experiment, flexural strength (FS) and elasticity modulus (EM) of specimen being tested by using Intron (3344; Instron; Instron). SPSS ver. 16.0 was used for analysis and post-hoc test of Scheffe was performed after using one-way ANOVA. When comparing mean value of FS of resin for orthodontics, it was represented in the range of 71.500 MPa for $25^{\circ}C$ group, 74.920 MPa for $40^{\circ}C$ group and 76.880 MPa for $70^{\circ}C$ group and difference was shown in the order of $25^{\circ}C$ group <$40^{\circ}C$ group <$70^{\circ}C$ group but such difference was not significant statistically (p=0.052). Result of EM mean value of resin for orthodontics was more polymerization temperature was high, the more was significant difference represented in the order of $25^{\circ}C$ group <$40^{\circ}C$ group <$70^{\circ}C$ group (p<0.039).

The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.597-607
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    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

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Clinical Investigation of Cervical Tuberculous Lymphadenitis (결핵성 경부 임파선염의 임상적 고찰)

  • Park, Mi-Ran;Kim, Chang-Sun;Seo, Jee-Young;Son, Hyung-Dae;Rheu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1225-1233
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    • 1997
  • Background : Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. Method : All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL. Results : 1) CTL is most prevalent in young women between the age of 20~30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6%(p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%), other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most Common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%), fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). Conclusion : CTL is prevalent in women between the age of 20~40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.

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The Comorbidity of Periodic Limb Movements Disorder in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자에서의 수면중 주기성 사지운동장애의 동반이환율)

  • Yang, Chang-Kook;Son, Choon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1039-1046
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    • 1998
  • Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

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Development of a TBM Advance Rate Model and Its Field Application Based on Full-Scale Shield TBM Tunneling Tests in 70 MPa of Artificial Rock Mass (70 MPa급 인공암반 내 실대형 쉴드TBM 굴진실험을 통한 굴진율 모델 및 활용방안 제안)

  • Kim, Jungjoo;Kim, Kyoungyul;Ryu, Heehwan;Hwan, Jung Ju;Hong, Sungyun;Jo, Seonah;Bae, Dusan
    • KEPCO Journal on Electric Power and Energy
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    • v.6 no.3
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    • pp.305-313
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    • 2020
  • The use of cable tunnels for electric power transmission as well as their construction in difficult conditions such as in subsea terrains and large overburden areas has increased. So, in order to efficiently operate the small diameter shield TBM (Tunnel Boring Machine), the estimation of advance rate and development of a design model is necessary. However, due to limited scope of survey and face mapping, it is very difficult to match the rock mass characteristics and TBM operational data in order to achieve their mutual relationships and to develop an advance rate model. Also, the working mechanism of previously utilized linear cutting machine is slightly different than the real excavation mechanism owing to the penetration of a number of disc cutters taking place at the same time in the rock mass in conjunction with rotation of the cutterhead. So, in order to suggest the advance rate and machine design models for small diameter TBMs, an EPB (Earth Pressure Balance) shield TBM having 3.54 m diameter cutterhead was manufactured and 19 cases of full-scale tunneling tests were performed each in 87.5 ㎥ volume of artificial rock mass. The relationships between advance rate and machine data were effectively analyzed by performing the tests in homogeneous rock mass with 70 MPa uniaxial compressive strength according to the TBM operational parameters such as thrust force and RPM of cutterhead. The utilization of the recorded penetration depth and torque values in the development of models is more accurate and realistic since they were derived through real excavation mechanism. The relationships between normal force on single disc cutter and penetration depth as well as between normal force and rolling force were suggested in this study. The prediction of advance rate and design of TBM can be performed in rock mass having 70 MPa strength using these relationships. An effort was made to improve the application of the developed model by applying the FPI (Field Penetration Index) concept which can overcome the limitation of 100% RQD (Rock Quality Designation) in artificial rock mass.

Study on the channel of bipolar plate for PEM fuel cell (고분자 전해질 연료전지용 바이폴라 플레이트의 유로 연구)

  • Ahn Bum Jong;Ko Jae-Churl;Jo Young-Do
    • Journal of the Korean Institute of Gas
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    • v.8 no.2 s.23
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    • pp.15-27
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    • 2004
  • The purpose of this paper is to improve the performance of Polymer electrolyte fuel cell(PEMFC) by studying the channel dimension of bipolar plates using commercial CFD program 'Fluent'. Simulations are done ranging from 0.5 to 3.0mm for different size in order to find the channel size which shoves the highst hydrogen consumption. The results showed that the smaller channel width, land width, channel depth, the higher hydrogen consumption in anode. When channel width is increased, the pressure drop in channel is decreased because total channel length Is decreased, and when land width is increased, the net hydrogen consumption is decreased because hydrogen is diffused under the land width. It is also found that the influence of hydrogen consumption is larger at different channel width than it at different land width. The change of hydrogen consumption with different channel depth isn't as large as it with different channel width, but channel depth has to be small as can as it does because it has influence on the volume of bipolar plates. however the hydrogen utilization among the channel sizes more than 1.0mm which can be machined in reality is the most at channel width 1.0, land width 1.0, channel depth 0.5mm and considered as optimum channel size. The fuel cell combined with 2cm${\times}$2cm diagonal or serpentine type flow field and MEA(Membrane Electrode Assembly) is tested using 100W PEMFC test station to confirm that the channel size studied in simulation. The results showed that diagonal and serpentine flow field have similarly high OCV and current density of diagonal (low field is higher($2-40mA/m^2$) than that of serpentine flow field under 0.6 voltage, but the current density of serpentine type has higher performance($5-10mA/m^2$) than that of diagonal flow field under 0.7-0.8 voltage.

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Mechanical Property Evaluation of Dielectric Thin Films for Flexible Displays using Organic Nano-Support-Layer (유기 나노 보강층을 활용한 유연 디스플레이용 절연막의 기계적 물성 평가)

  • Oh, Seung Jin;Ma, Boo Soo;Yang, Chanhee;Song, Myoung;Kim, Taek-Soo
    • Journal of the Microelectronics and Packaging Society
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    • v.28 no.3
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    • pp.33-38
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    • 2021
  • Recently, rollable and foldable displays are attracting great attention in the flexible display market due to their excellent form factor. To predict and prevent the mechanical failure of the display panels, it is essential to accurately understand the mechanical properties of brittle SiNx thin films, which have been used as an insulating film in flexible displays. In this study, tensile properties of the ~130 nm- and ~320 nm-thick SiNx thin films were successfully measured by coating a ~190 nm-thick organic nano-support-layer (PMMA, PS, P3HT) on the fragile SiNx thin films and stretching the films as a bilayer state. Young's modulus values of the ~130 nm and ~320 nm SiNx thin films fabricated through the controlled chamber pressure and deposition power (A: 1250 mTorr, 450 W/B: 1000 mTorr, 600 W/C: 750 mTorr, 700 W) were calculated as A: 76.6±3.5, B: 85.8±4.6, C: 117.4±6.5 GPa and A: 100.1±12.9, B: 117.9±9.7, C: 159.6 GPa, respectively. As a result, Young's modulus of ~320 nm SiNx thin films fabricated through the same deposition condition increased compared to the ~130 nm SiNx thin films. The tensile testing method using the organic nano-support-layer was effective in the precise measurement of the mechanical properties of the brittle thin films. The method developed in this study can contribute to the robust design of the rollable and foldable displays by enabling quantitative measurement of mechanical properties of fragile thin films for flexible displays.

Correlation between Carotid Intima-media Thickness and Risk Factors for Atherosclerosis (경동맥 내중막 두께에 따른 죽상경화반의 위험요인과의 상관관계)

  • An, Hyun;Lee, Hyo Yeong
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.339-348
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    • 2019
  • The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.