• 제목/요약/키워드: severity levels

검색결과 610건 처리시간 0.027초

가미강활산(加味羌活散)이 집먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향 (Effect of Kami-kanghwalsan (KKHS) on Atopic Dermatitis-like Skin Lesions Induced in NC/Nga Mouse by Mite Antigen Stimulation)

  • 김윤희;한재경;김윤희
    • 대한한방소아과학회지
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    • 제22권1호
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    • pp.69-93
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    • 2008
  • Objectives The purpose of this study is to investigate the effect of KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to this condition in humans. Methods To investigate the effect of KKHS on atopic dermatitis (AD), we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis of NC/Nga mouse in vivo. Results In vivo, clinical skin severity score was significantly lower in the KKHS group than in the control group. IgE, IL-6, TNF-${\alpha}$, IgM, IgG2a and IgG2b levels in serum decreased remarkably in the KKHS group than in the control group, and the level of IFN-${\gamma}$ production which is secreted from Th1 cell was increased by KKHS. After this experiment we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+CD69^+$, $CD4^+CD25^+$ and $CD49b^+$) by flow cytometry. It results that the total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as much as normal state, and the level of $CD3^+CD69^+$ in isolated DLN and PBMCs were significantly decreased, and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by KKHS. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E), toluidine staining (mast cells marker). KKHS were very effective to the histological symptoms which are in dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration. Ear thickness was significantly decreased compared with the control group and the size of inflammatory lymphocytes cells (ILC) and plasma cells (PC) in DLN were also decreased. Conclusions KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse was very effectiveness to the atopy dermatitis treatment.

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Therapeutic Benefits of Mesenchymal Stromal Cells in a Rat Model of Hemoglobin-Induced Hypertensive Intracerebral Hemorrhage

  • Ding, Rui;Lin, Chunnan;Wei, ShanShan;Zhang, Naichong;Tang, Liangang;Lin, Yumao;Chen, Zhijun;Xie, Teng;Chen, XiaoWei;Feng, Yu;Wu, LiHua
    • Molecules and Cells
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    • 제40권2호
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    • pp.133-142
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    • 2017
  • Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

토양개량제시용에 따른 화산회토양 감자 연작지 더뎅이병 억제 효과 (Effect of Applying Soil Amendments on Potato Scab Prevention in Volcanic Ash Soil with Continuous Cropping System)

  • 좌재호;문두경;고상욱;손다니엘
    • 한국유기농업학회지
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    • 제22권4호
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    • pp.719-730
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    • 2014
  • 화산회토양 감자 연작지 토양 pH 수준별로 고토석회, 유황, 황산칼륨, 패화석, 규산질비료, 석회질소, 유안비료를 이용하여 감자 더뎅이병 발생을 경감시키고 토양건전성을 유지하는데 적절한 대체농자재를 선발하고자 수행하였다. 토양 pH가 낮은 황산칼륨 처리구(24 kg/10a)에서는 더뎅이병 발병률이 84.4%, 발병도가 28.4%로 가장 낮았다. 방제효과는 12.3%, 상품율은 93.2%로 다른 처리구와 비교할 때 가장 높게 나타났다. 석회질소 처리구(60kg/10a)가 발병도 38.3%로 낮았고 방제효과 23.8%, 상품율 66.3%로 높았다. 토양 pH가 높은 시험구 중 더뎅이병 발병률은 석회질소 처리구(60 kg/10a)가 38.3%로 가장 낮았고 유안 처리구(48 kg/10a)는 62.6%로 높았다. 더뎅이병 방제효과는 석회질소 처리구(60 kg/10a)에서 23.8%로 유황 처리구의 6.1% 보다 4배 이상, 상품률은 66.3%로 가장 높게 나타났다. 감자더뎅이병 병원균 Streptomyces acidiscabies과 Streptomyces scabiei를 석회질소 2.5, 5 g/L, 10 g/L에 접종시 생장량은 다른 토양개량제 보다 상대적으로 억제되었다. 결론적으로 감자 파종 전에 토양 pH가 5 이하이면 황산칼륨을, 6 이상이면 석회질소를 시비하면 더뎅이병 발생을 경감시킬 수 있을 것으로 보인다.

중증 급성 중독 환자에서 급성 신장 손상과 병원 내 사망률을 예측하기 위한 강이온차(Strong Ion Gap)의 중요성 (The Significance of the Strong Ion Gap in Predicting Acute Kidney Injury and In-hospital Mortality in Critically Ill Patients with Acute Poisoning)

  • 심태진;조재완;이미진;정해원;박정배;서강석
    • 대한임상독성학회지
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    • 제19권2호
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    • pp.72-82
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    • 2021
  • Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성 (Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments)

  • 문선희;심재란
    • 한국산학기술학회논문지
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    • 제19권11호
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    • pp.626-634
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    • 2018
  • 본 연구는 한국형응급환자분류도구(Korean Triage and Acuity Scale: KTAS)를 사용한 소아 중증도 분류의 정확성을 파악하기 위한 후향적 조사연구이다. 연구자료는 2016년 10월부터 2017년 9월까지 1개 권역응급의료센터, 1개 지역응급의료센터에 방문한 소아환자의 자료 중 무작위로 추출한 250건의 간호초진기록지와 진료결과였다. 수집된 자료를 검정된 전문가가 분석하여 true-triage를 정하였다. 중증도 분류 정확도는 응급실간호사의 중증도 분류 결과와 전문가의 true-triage결과와의 일치도로 평가하였다. 전문가 의견에 따라 중증도 분류 오류의 원인이 분석되었고, KTAS 등급과 퇴원, 체류시간, 진료비와의 연관성이 비교되었다. 연구결과 전문가와 응급실 간호사의 중증도 분류 등급은 높은 일치도를 보였다(weighted kappa=.77). 중증도 분류 불일치의 원인 중 활력징후 결과를 KTAS 알고리즘 기준에 잘 못 적용한 경우가 가장 많았다(n=13). KTAS 1,2 등급과 같이 중증도가 높을수록 퇴원이 적었다(${\chi}=43.25$, p<.001). 연령을 보정했을 때 KTAS 등급에 따라 체류시간(F=12.39, p<.001)과 진료비(F=11.78, p<.001)는 차이가 있었다. 본 연구결과 KTAS는 국내 응급실에서 높은 정확도를 보였으므로, 새로 개발된 중증도 분류 도구가 국내 응급실에 잘 적용되고 있다고 할 수 있다.

파킨슨병 환자에서 한국어판 Dizziness Handicap Inventory의 라쉬 분석에 의한 임상측정 특성 평가 (Rasch Analysis of the Clinimetric Properties of the Korean Dizziness Handicap Inventory in Patients with Parkinson Disease)

  • 이다영;양희준;양동석;최진혁;박병수;박지윤
    • Research in Vestibular Science
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    • 제17권4호
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    • pp.152-159
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    • 2018
  • Objectives: The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of our study was to address the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis. Methods: The unidimensionality, scale targeting, separation reliability, item difficulty (severity), and response category utility of the KDHI were statistically assessed based on the Andrich rating scale model. The utilities of the orderedresponse categories of the 3-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability (PSR), which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits. Results: Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the 3-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (items 1 and 2) for Rasch model. Conclusions: The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified parts for possible amendments in order to further improve the linear metric scale.

Features and Outcomes of Children with Ulcerative Colitis who Undergo a Diagnostic Change: A Single-Center Experience

  • Ito, Natsuki;Takeuchi, Ichiro;Kyodo, Reiko;Hirano, Yuri;Sato, Takuro;Usami, Masaaki;Shimizu, Hirotaka;Shimizu, Toshiaki;Arai, Katsuhiro
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권4호
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    • pp.357-365
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    • 2021
  • Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

2020년 코로나바이러스감염증-19 유행 상황에서 서울시 다중이용 시설 및 실외에서의 마스크 착용 행태 (Mask-wearing Characteristics an COVID-19 in Indoor and Outdoor Environments in Seoul in 2020)

  • 강소현;곽수영;;김동현;정영덕;신지윤;이기영
    • 한국환경보건학회지
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    • 제46권6호
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    • pp.750-756
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    • 2020
  • Objectives: After coronavirus disease 2019 (COVID-19) was declared a pandemic, the South Korean government announced guidelines on wearing masks to prevent its spread. The guidelines have changed depending on the severity of the spread of COVID-19. This study aimed to identify mask-wearing behaviours to counter the spread of COVID-19 in indoor and outdoor environments. Methods: The type of mask worn and proper wearing were observed in cafés, supermarkets, underground shopping malls, and streets in Seoul. Behavioral assessment was repeated in August at social distancing levels 1 and 2, in October at social distancing level 1, and in November after the mask mandates. Results: In August, 22.1% of subjects in cafés, 90.8% in supermarkets, 91.8% in underground shopping malls, and 83.6% on outdoor streets wore masks properly. In October, the proportion of correct wearers increased in all locations. After masks became mandatory in November, about 97% of users of supermarkets, underground shopping malls, and streets wore masks properly. In cafés, the proportion of proper wearers was 61.5% with both social distancing level 2 in August and the mandate in November. The number of KF-certified mask wearers continued to increase from August to November. Conclusion: This study investigated mask-wearing behaviors to counter COVID-19 through observations in indoor and outdoor places in Seoul. Mask-wearing behavior was different depending on the place and the government guidelines in place. The results could be used for evaluation of the current guidelines for COVID-19.

근무자세가 두통/눈의 피로에 미치는 영향: 제5차 2017년 근로환경조사 (Effects of Working Postures on Headache/Eye Strain in Korean Waged Workers: The 5th Working Condition Survey(2017))

  • 김유현;고석재;조경민;채진경;오현정;장세진
    • 한국산업보건학회지
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    • 제32권2호
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    • pp.116-128
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    • 2022
  • Objectives: The aim of this study was to examine the association of working posture with headache/eye strain in Korean waged workers. Methods: Data were collected from the 5th Korean Working Condition Survey. A total of 30,955 workers participated in this study. A four-items of working postures were measured using a 7-point Likert scale, and we categorized them into three groups ('normal', 'moderate', and 'severe') each 4 items. Headache/eye strain were measured using a self-administrative questionnaire ('yes' vs. 'no'). To examine the relationship between the total working postures score and headache/eye strain, we summed a 4-items of working postures. It was categorized into five groups according to the severity of exposures('normal', 'mild', 'moderate', 'severe', and 'very severe'). The multivariate logistic regression analysis was performed using the IBM SPSS(Ver. 25), and a p<.05 was considered significant. Results: The results show that 'fatiguing and painful posture' and 'posture repetitively using hands or arms' were associated with headache/eye strain after controlling for control variables. The total working posture score was positively associated with headache/eye strain. People with higher levels of the total working posture score were more likely to increase the risk of headache/eye strain compared to those of normal(OR: 1.844, 95% CI: 1.549~2.195 for 'mild'; OR: 2.564, 95% CI: 2.152~3.503 for 'moderate'; OR: 4.140, 95% CI: 3.432~4.994 for 'severe'; OR: 7.613, 95% CI: 5.625~10.304 for 'very severe') (p<.05 for trend). Conclusions: These results indicate that inappropriate working postures might play a crucial role in developing headache/eye strain. It is needed to improve the working environment, especially focusing on reducing inappropriate working posture at the organizational level.

펜-타입 QLF 장비의 임상적 유구치 인접면 우식 탐지 성능 (Detecting of Proximal Caries in Primary Molars using Pen-type QLF Device)

  • 조혜진;김현태;송지수;신터전;김정욱;장기택;김영재
    • 대한소아치과학회지
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    • 제48권4호
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    • pp.405-413
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    • 2021
  • 이 연구의 목적은 펜-타입 quantitative light-induced fluorescence(QLF) 장비의 임상적 유구치 인접면 우식 탐지 성능을 평가하는 것이다. 이를 위해 형광 소실, 적색 자기형광 그리고 인접면 우식을 위해 간편화된 QLF 평가 기준(QS-proximal)이 사용되었으며 교익 방사선 영상과 비교, 평가되었다. 총 344개의 유구치 인접면이 분석되었으며 인접면 우식 병소는 시진과 방사선학적 검사 그리고 QLF 검진을 통하여 평가되었다. QLF 영상들을 이용하여 분석된 QLF 매개변수들과 QS-proximal을 방사선학적 평가와 비교하여 장비의 법랑질과 상아질 우식 탐지 능력에 대한 민감도, 특이도 그리고 area under receiver operating curve(AUROC)가 계산되었다. 두 QLF 매개변수 모두 준수한 상아질 우식 탐지 능력을 보였으며 AUROC은 △F = 0.794, △R = 0.750였다. QS-proximal(0.757 - 0.769)은 시진(0.653)보다 더 높은 AUROC을 나타내었다. 결론적으로 펜-타입 QLF 장비는 방사선학적 평가와 비교하여 임상적으로 적용 가능한 성능을 보였다.