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Analysis of urine β2-microglobulin in pediatric renal disease (소아 신장질환에서 요 β2-microglobulin검사의 분석)

  • Kim, Dong Woon;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.369-375
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    • 2007
  • Purpose : There have been numerous researches on urine ${\beta}_2$-microglobulin (${\beta}_2$-M) concerned with primary nephrotic syndrome and other glomerular diseases, but not much has been done in relation to pediatric age groups. Thus, our hospital decided to study the relations between the analysis of the test results we have conducted on pediatric patients and renal functions. Methods : Retrospective data analysis was done to 102 patients of ages 0 to 4 with renal diseases with symptoms such as hematuria, edema, and proteinuria who were admitted to Chung-Ang Yongsan Hospital and who participated in 24-hour urine and urine ${\beta}_2$-M excretion test between January of 2003 and January of 2006. Each disease was differentiated as independent variables, and the statistical difference of the results of urine ${\beta}_2$-M excretion of several groups of renal diseases was analyzed with student T-test by using test results as dependent variables. Results : Levels of urine ${\beta}_2$-M excretion of the 102 patients were as follows : 52 had primary nephrotic syndrome [MCNS (n=45, $72{\pm}45{\mu}g/g$ creatinine, ${\mu}g/g-Cr$), MPGN (n=3, $154{\pm}415{\mu}g/g-Cr$), FSGS (n=4, $188{\pm}46{\mu}g/-Cr$], six had APSGN ($93{\pm}404{\mu}g/g-Cr$), seven had IgA nephropathy ($3,414{\pm}106{\mu}g/g-Cr$), 9 had APN ($742{\pm}160{\mu}g/g-Cr$), 16 had cystitis ($179{\pm}168{\mu}g/g-Cr$), and 12 had HSP nephritis ($109{\pm}898{\mu}g/g-Cr$). IgA nephropathy (P<0.05) and APN (P<0.05) were significantly higher than in other renal diseases. Among primary nephrotic syndrome, FSGS with higher results of ${\beta}_2$-microglobulin test had longer treatment period (P<0.01) when compared to the lower groups, but no significant differences in Ccr, BUN, or Cr were observed. Conclusion : IgA nephropathy and APN groups showed significantly higher level of ${\beta}_2$-M excretion value than other groups. Although ${\beta}_2$-microglobulin value is not appropriate as an indicator of general renal function and pathology, it seems to be sufficient in the differential diagnosis of the UTI and in the prediction of the treat-ment period of nephrotic syndrome patients.

Biological activity of shizukanols isolated from Chloranthus japonicus roots (홀아비꽃대(Chloranthus japonicus) 뿌리로부터 분리한 shizukanol들의 생물활성)

  • Park, Mi-Ran;Kim, Hae-Young;Choi, Gyung-Ja;Lee, Seon-Woo;Jang, Kyoung-Soo;Kim, Jin-Seog;Hong, Kyung-Sik;Park, No-Joong;Cho, Kwang-Yun;Kim, Jin-Cheol
    • The Korean Journal of Pesticide Science
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    • v.8 no.4
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    • pp.338-346
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    • 2004
  • The methanol extract of Chloranthus japonicus roots effectively controlled the development of rice blast(Magnaporthe grisea), rice sheath blight(Corticium sasaki), tomato pay mold(Btrytis cinerea), tomato late blight(Phytophthora infestans), and wheat leaf rust(Puccinia recondita). From the methanol extract of C. japonicus roots, three antifungal substances were isolated. Their chemical structures were determined to be shizukanols B, C, and D mainly by mass and NMR spectral data. Among the three substances, shizukanol C showed the strongest inhibitory activity against mycelial growth of the plant pathogenic fungi tested; it completely inhibited mycelial growth of M. grisea. Colletotrichum gloeosporioides, and C. acutatum at concentrations of more than $12.5{\mu}g$/ and P. infestans at concentrations of more than $3.13{\mu}g/m\ell$. They also controlled effectively the development of rice blast and wheat leaf rust. On the other hand, they caused phytotoxic symptoms on barley leaves and inhibited the growth of duckweed (Lemna paucicostata) with $EC_{50}$ values of $30.0{\mu}g/m\ell$ for shizukanol B, $49.9{\mu}g/m\ell$ for shizukanol C, and $154{\mu}g/m\ell$ for shizukanol D. In addition, shizukanol C showed an insecticidal activity against brown planthopper (Nilaparavata lugens), peen peach aphid (Myzus persicae), diamond-back moth (Plutella xylostella), and tobacco cutworm (Spodoptera litura) of the 5 arthropod pests tested with mortality values of more than 60% at a concentration of $1,000{\mu}g/m\ell$.

A Study on the Efficiency of Hand-Knee Position in GB Stone Ultrasonography (담낭결석 초음파검사에서 Hand-Knee position의 효율성에 관한 연구)

  • Park, Soung-Ock;Do, Yun-Su
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.267-274
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    • 2006
  • The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

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The Clinical Usefulness of the Minimal Invasive Ulno-humeral Arthroplasty in the Patients with Mild to Moderate Elbow Arthritis (경도 및 중등도 주관절 관절염 환자에서 최소 침습적 척골-상완 관절 성형술의 임상적 유용성)

  • Kim, Bo-Kun;Shin, Hyun-Dae;Kim, Kyung-Cheon;Cha, Soo-Min
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.73-79
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    • 2011
  • Purpose: To evaluate of the clinical usefulness of minimal invasive ulnohumeral arthroplasty in patients with mild to moderate elbow arthritis. Materials and Methods: From January 2000 to December 2008, twenty-nine patients with mild to moderate elbow arthritis underwent minimal invasive ulnohumeral arthroplasty. Among these patients, we reviewed the cases of 24 patients for whom we had follow-up data for at least 1 year. There were 20 males and 4 females with a mean age of 53 years (range: 31~69). We excluded patients with preoperative ulnar neuropathy symptoms and investigated the mean operation time, the joint range of motion, the time required until the start of joint exercise, and the Mayo elbow performance score (MEPS). Results: Passive and active joint exercises were started in an average of 1.8 days (range: 1~4) after surgery; the mean operation time was 38 minutes (range: 25~55). The elbow joint range of motion was 25-104 degrees (extension 0~70, flexion 80~130) preoperatively and was improved 40 degrees on average to 14-133 degrees (extension 0~45, flexion 90~150) after a year of follow up. The average time required until the start of joint exercise was 1.6 days (range: 1~5). MEPS were excellent in 9 cases and good in 5 cases after a year of follow up. Although there was 1 case of delayed wound healing and 7 cases of postoperative edema, they improved spontaneously. Conclusion: For patients with mild to moderate elbow arthritis, minimal invasive ulnohumeral arthroplasty is a clinically useful surgery since its operation time is short, early joint exercise is possible, and pain is mild.

Radical Radiotherapy for Carcinoma of the Prostate (전립선암의 근치적 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.40-44
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    • 2001
  • Purpose : To evaluate effect and tolerance of external beam radiotherapy for carcinoma of the prostate and define the optimal radiotherapeutic regimen. Materials and methods : We retrospectively analyzed the records of 60 patients with prostate cancer who were treated with external beam radiotherapy with curative intent in our institution between September, 1987 and March, 2000. Histologic diagnosis was established by transurethral resection or ultrasonography guided biopsy. The major presenting symptoms were a nodule at routine prostatic examination and frequency and urgency of urination, along with dysuria. The median age was 63 years with range of 51 to 87 years. There were 6 patients in Stage A, 20 in Stage 8, 26 in Stage C, and 8 in Stage Dl. All patients were treated with megavoltage equipment producing 10 MV photons. The 4 field pelvic brick technique was used to a dose of 45 Gy or 50.4 Gy at 1.8 Gy per day in 5 to 6 weeks, after which a small boost field was delivered 2.0 Gy per day to a total dose of 66 to 70 Gy. The follow-up period ranged from 1 to 8 years. Results : Actuarial 5-year and 7-year survival rates for Stage A, B, C, and D1 were $100\%\;and\;84\%$, $83\%\;and\;72\%$, $67\%\;and\;54\%$, and $v$, respectively. The corresponding 5-year and 7-year relapse free survival rates were $84\%\;and\;84\%$, $77\%\;and\;67\%$, $48\%\;and\;40\%$, and $33\%\;and\;25\%$, respectively. Relapse free 5-year survival rates for Stage B were $80\%,\;80\%,\;and\;50\%$ for well, moderately, and poorly differentiated tumors, respectively. These were $64\%,\;44\%,\;and\;33\%$ for Stage C, respectively. The local control rates at 5 years were $84\%,\;85\%,\;78\%,\;and\;60\%$ for Stage A, B, C, and D1, respectively. Mild to moderate complications were observed in $22\%$ of patients. Severe complications requiring surgical procedures were documented in only $3\%$ of patients. Conclusion : This study confirms that external beam irradiation is an effective and safe treatment for prostatic cancer, providing long-term local control and good survival with acceptable complications.

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Expression of Jun and p53 Genes from the Brain of Rats Irradiated with $^{60}Co{\gamma}$-ray (감마선 조사에 의한 뇌조직의 Jun 및 p53유전자 발현)

  • Kim Yong Seok;Woo Chong Kyu;Lee Yong Sung;Koh Jai Kyung;Chun Ha Chung;Lee Myung Za
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.265-279
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    • 1996
  • Damage produced by radiation elicits a complex response in mammalian cells, including growth rate changes and the induction of a variety of genes associated with growth control and apoptosis. At doses of 10,000 cGy or greater, the exposed individual was killed in a matter of minutes to a couple of days, with symptoms consistent with pathology of the central nervous system(CNS) including degenerative changes. The nature of the damage in irradiated cells underlies the unique hazards of ionizing radiation. Radiation injury to CNS is a rare event in clinical medicine, but it is catastrophic for the patient in whom it occurs. The incidence of cerebral necrosis has been reported as high as 16% for doses greater than 6,000 cGy. In this study, the effect of radiation on brain tissue was studied in vivo. Jun and p53 genes in the rat brain were induced by whole body irradiation of rat with 600Co in doses between 1 Gy and 100 Gy and analyzed for expression of jun and p53 genes at the postirradiation time up to 6 hours. Northern analyses were done using 1.8 Kb & 0.8 Kb-pGEM-2-JUN/Eco RI/Pst I fragments, 2.0 Kb-php53B/Bam HI fragment and ,1.1 Kb-pBluescript SK--ACTIN/Eco RI fragment as the digoxigenin or [${\alpha}^{32}P$] dCTPlabeled probes for Jun, p53 and ${\beta}$-actin genes, respectively. Jun gene seemed to be expressed near the threshold levels in 1 hour after irradiation of $^{60}$Co in dose less than 1 Gy and was expressed in maximum at 1 hour after irradiation of $^{60}$Co in dose of 30 Gy. Jun was expressed increasingly with time until 5 or 6 hours after irradiation of $^{60}$Co in doses of 1 Gy and 10 Gy. After irradiation of $^{60}$Co in dose between 20 Gr and 100 Gy, the expression of Jun was however increased to peak in 2 hours and decreased thereafter. p53 gene in this study also seemed to be expressed near the threshold levels in 1 hour after irradiation of $^{60}$Co in dose less than 1 Gy and was expressed in maximum at 6 hours after irradiation of $^{60}$Co in dose of 1 Gy, p53 was expressed increasingly with time until 5 or 6 hours after irradiation of $^{60}$Co in dose between 1 Gy and 40 Gy. After irradiation of $^{60}$Co in doses of 50 Gy and 100 Gy, the expression of p53 was however increased to peak in 2 hours and decreased thereafter. The expression of Jun and p53 genes was not correlative in the brain tissue from rats. It seemed to be very important for the establishment of the optimum conditions for the animal studies relevant to the responses of genes inducible on DNA damage to ionizing radiation in mammalian cells. But there are many limitations to the animal studies such as the ununiform patterns of gene expression from the tissue because of its complex compositions. It is necessary to overcome the limitations for development of in situ Northern analysis.

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Radiotherapy Results of Midline Malignant Reticulosis (MMR) (중심선 악성 세망증의 방사선 치료 결과)

  • Yun, Sang-Mo;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.291-297
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    • 1996
  • Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

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The Results of Radiation Therapy of Limited Stage Small Cell Lung Cancer (국한된 페소세포암의 방사선 치료성적)

  • Kim Sung Hwan;Choi Byung Ok;Gil Hak Joon;Yoon Sei Chul;Bahk Yong Whee;Shinn Kyung Sub;Kim Hoon Kyo;Lee Kyung Sik
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.97-102
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    • 1993
  • A retrospective analysis of various characteristics in 32 limited stage small cell lung cancer patients treated at the Department of Therapeutic Radiology in Kangnam St. Mary's Hospital, Catholic University Medical College from April 1983 to September 1991, was carried out to identify factors which had prognostic significance for survival from initiation of radiation therapy. There were 26 men and 6 women. Median age was 63 years (range: 24-78 years). The follow up duration was 1.5 to 44 months (median: 9 months). External radiation therapy was done with daily 160-180 cGy,5 fraction/week, total of 1000-6660 cGy (median: 4500 cGy) to the mediastinum by 6 MV linear accelerator. Of 32 Patients, 27 ($84.4{\%}$) patients were treated with combined modality (chemotherapy plus radiation therapy), and 5 ($15.6{\%}$) patients were treated with radiation therapy only. Complete responders were 12 patients ($37.5{\%}$), partial responders were 11 ($34.4{\%}$), and no responders were 9($28.1{\%}$). Karnofsky performance status over 70 (p<0.04), chemotherapy regimen (CAV, PV, and CAV+PV) (p<0.04),6 or more cycles of chemotherapy (p<0.007), radiation therapy over 4500 cGy (p<0.03), and radiation therapy responder (CR+PR) (p<0.003) showed a significantly favorable influence on 1 year survival rate. Age (p=0.545), sex (p=0.666), presence of superior vena cava syndrome (p=0.719), prophylactic cranial irradiation (p=0.217), and radiation therapy duration (p=0.491) had no effect on survival. Radiation induced side effects were transient esophagitis in 11 ($34{\%}$), general weakness in 9($28{\%}$), gastrointestinal symptoms in terms of nausea, vomiting and indigestion in 5 ($15{\%}$) and leukopenia in 1 ($3{\%}$).

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Clinical Significance of Coagulation Screening Tests and Platelet Counts in Children Undergoing Endoscopy (소아에서 내시경 검사의 출혈 위험 예측 인자로서 혈액 응고 검사 및 혈소판 검사의 의의)

  • Lee, Eun-Hye;Yang, Hye-Ran;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.23-29
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    • 2010
  • Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.

The Study of Intravenous-gammaglobulin Therapy in Acute phase of Measles (급성기 홍역 환자의 정주용 인면역글로부린 치료 효과에 대한 연구)

  • Kim, Min Shik;Cha, Yoon Hwa
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.101-106
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    • 2001
  • Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.

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