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The Change of Immunologic Parameters in Acute Poststreptococcal Glomerulonephritis (급성 연쇄상구균 감염후 사구체신염에서 면역학적 지표의 변화)

  • Kim, Do-Hee;Lee, Seung-Woo;Lee, Kyung-Yil;Youn, You-Sook;Hwang, Ja-Young;Rhim, Jung-Woo;Koh, Dae-Kyun;Lee, Jun-Sung
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.138-145
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    • 2009
  • Purpose : This study was aimed to evaluate the changes of immunologic parameters during hospitalization, and the relationship between IgG and other laboratory or clinical indices in patients with acute poststreptococcal glomerulonephritis (APSGN). Methods : We reviewed the medical charts of 36 children with APSGN who showed ASO titer>250 Todd U/L and C3<70 mg/dL. We evaluated the levels of IgG and other laboratory parameters including C3 and ASO at admission and at discharge (14 cases). Results : The mean age of APSGN patients was $7.5{\pm}2.6$ year of age, and male-to-female ratio was 2.3:1. At presentation, hypertension (systolic blood pressure>125 mmHg), gross hematuria, and weight gain were observed in 27.8% (10/36), 80.1% (29/36), and 80% (24/30) of the patients, respectively. The mean IgG level was $1,432{\pm}322$ mg/dL ($1,025{\pm}234$ mg/dL in control group, P<0.001), and C3 and ASO levels were $26.1{\pm}16.1$ mg/dL and $1,068{\pm}730$ Todd U, respectively. There were no correlation between IgG level and the levels of any of the parameters analyzed (ASO, C3, BUN, creatinine and white blood cell count), and the severity of the disease assessed by the weight-change during admission. The patients aged<6 years of age (10 cases) had less degree of the weight-change, compared to those of the patients aged>8 years of age (15 cases) (-0.6% vs. -5.7%, P=0.01). The IgG and ASO levels did not change, but C3 (P=0.001) and IgM (P=0.02) levels increased during admission. Conclusion : Increased IgG and ASO levels in APSGN did not change, but C3 level increased during admission. IgG level was not correlated with other laboratory parameters (ASO and C3) and the severity of the disease. Younger children seem to have less severe clinical course compare to older children. With our hypothetic pathogenesis of APSGN, further studies are needed to resolve the pathogenesis of the disease including the increase of IgG.

Clinical Results of Mitral Valvular Surgery in Patients with Moderate Ischemic Mitral Regurgitation Undergoing Coronary Artery Bypass Grafting (중등도의 허혈성 승모판막 폐쇄부전 환자의 관상동맥 우회로 조성술 시 승모판막 수술의 유무에 따른 원상 결과)

  • Yu Song-Hyeon;Chang Byung-Chul;Yoo Kyung-Jong;Kang Meyun-Shick;Hong You-Sun
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.611-618
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    • 2006
  • Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.

Pulmonary Thromboendarterectomy for Pulmonary Hypertension Caused by Chronic Pulmonary Thromboembolism (만성폐색전중으로 인한 폐동맥고혈압 환자에서 시행한 폐동맥내막절제술)

  • Song Seung-Hwan;Jun Tae-Gook;Lee Young-Tak;Sung Ki-Ick;Yang Ji-Hyuk;Choi Jin-Ho;Kim Jin-Sun;Kim Ho-Joong;Park Pyo-Won
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.626-632
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    • 2006
  • Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

Clinical Results alter Pulmonary Endarterectomy as a Curative Surgical Method in Chronic Thromboembolic Pulmonary Hypertension: an Approach to Operative Classification of Thromboembolic Disease (만성 폐동맥 색전증의 치료로서 내막제거술의 임상적 결과: 색전증 분류에 따른 접근)

  • Lim, Ju-Yong;Lee, Jae-Won;Kim, Jeong-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Song, Hyun;Chung, Cheol-Hyun;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.591-597
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    • 2008
  • Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

The Effects of Aroma Self Massage in Hands on Pain, Depressive Mood and Anxiety in Breast Cancer Patients (유방암 환자의 통증, 우울 및 불안 증상 조절에 아로마 자가 치료의 효과)

  • Sohn, Keun-Joo;Kim, Myung-Ja;Lee, June-Young;Lee, Jae-Bok;Kim, Su-Hyun;Kim, Jong-A;Jung, Hoe-Hyun;Choi, Seung-Wan;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.18-29
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    • 2005
  • Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

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The Effects of Comprehensive Health Care Program for Living Alone Older People on Blood Pressure, Fasting Glucose, Body Composition, Depression at a Senior Welfare Center (일개 노인복지관 통합건강케어프로그램이 독거노인의 혈압, 혈당, 체중, 체성분, 우울감에 미치는 영향)

  • Jang, Ae Sun;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.526-535
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    • 2017
  • This study was conducted to identify the effects of a comprehensive health care program for elderly living alone on blood pressure, fasting glucose, body composition, and depression at a senior welfare center in M city. The study employed a one-group, pre-posttest design. The comprehensive health care program lasted for three months, from March to June in 2015, and consisted of open health education, exercise class, health consulting and personal education, nutritional consultation, and a self-support group. The sample elements of this study were individuals over 65-years-old with hypertension or diabetes mellitus, living near a welfare center in M city. A total of 34 participants were initially selected, but five subjects who were attended less than five times were excluded; therefore, a total of 29 individuals were included. The t-test and Pearson's correlation were used to analyze the data. The characteristics of subjects were 19 male(65.52%) and 10 female(34.48%). The most common age was 70 (16 subjects;55.17%). Additionally, 14 subjects were suffering from hypertension and diabetes mellitus (48.27%), which were occupied in the largest number in this study. The average attendance number of health programs was 10.28 times(${\pm}4.17$). In this study of subjects were significantly lower systolic blood pressure(t=3.275, p=0.004), body weight(t=3.878, p=0.001), depression(t=3.308, p=0.004) compared to pre-test. As the elderly population has increased, the number of individuals living alone has also increased. Accordingly, then need for physical and psycho-social health programs targeting the elderly is greater.

The relationship of ready-to-eat cereal consumption with nutrition and health status in the Korean population based on the Korea National Health and Nutrition Examination Survey 2012 (한국인의 시리얼 섭취실태와 영양 및 건강상태와의 관련성 연구 - 2012년도 국민건강영양조사 자료를 이용하여 -)

  • Chung, Chin-Eun
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.258-268
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    • 2015
  • Purpose: The aim of this study was to explore the relationship of ready-to-eat cereal (RTEC) consumption with nutrition and health status. Examination of health status for this project included obesity, abdominal obesity, hypertension, hypertriglyceridemia, hypercholesterolemia, low-HDL-cholesterolemia, diabetes, anemia, and metabolic syndrome. Methods: Two groups, RTEC consumers and those who did not consume RTEC, were identified using 24-hour dietary recall data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES). Nutritional intakes and risk factors of the two groups were compared using covariates-adjusted statistical procedures. Statistical analyses were performed using SAS survey procedures, and strata, cluster, and weight were considered. Subjects of analysis of nutritional intake were between the ages of 1 and 75, and those considered in the risk factor analysis were between the ages of 19 and 75. Results: Results showed that 3.8% of the Korean population was RTEC consumers. Compared to the subjects who did not intake RTEC, RTEC consumers exhibited significantly higher intakes of calcium, thiamin, riboflavin, and vitamin C. It was also discovered that the percentage of people whose intakes were less than EAR decreased with RTEC consumption. RTEC consumption showed significant association with decreased systolic blood pressure, diastolic blood pressure, serum triglyceride, and serum total cholesterol. Consequently, prevalence of hypertension among RTEC consumers was significantly lower than that among non-consumers, and the odds ratio for hypertension was 0.19 after adjusting the models for covariates. Conclusion: Results of this study clearly suggest an association of RTEC consumption with improved nutritional status and cardiometabolic risk profile in Korean adults. Conduct of additional studies will be necessary in order to determine the nature of these relationships.

경북 북부 초등학생의 비만과 심혈관계질환 위험도간의 상관성에 관한 연구

  • 김경애;권인숙;권정숙
    • Journal of Nutrition and Health
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    • v.34 no.6
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    • pp.664-670
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    • 2001
  • This study was carried out to investigate the obesity prevalence and relationship between the degree of obesity and risk for coronary heart disease in elementary school children in Kyungbuk area from 1996 to 1998. One hundred eighty obese children aged 8 yrs through 11 yrs(112 boys : 68 girls) were chosen depending on the criteria of obesity degree, and then the subjects were classified into one of three groups according to the degree of obesity; mild(20-29%), moderate(30-49%), and severe( $\geq$ 50%) obesity, fasting blood was collected in the morning, and body fat, plasma total cholesterol, HDL-cholesterol, and triglyceride were measured. LDL-cholesterol and atherogenic index were also calculated. The obesity prevalence increased from 7.1% in 1996 to 9.5% in 1998. As body fat level increased, blood triglyceride level increased(p < 0.001). As the degree of obesity increased, the level of blood triglyceride(p < 0.001) and systolic blood pressure(p < 0.05) also increased. The risk fur coronary heart disease based on criteria of the level of total-cholesterol, LDL-cholesterol and atherogenic index increased from 6.9%,1.4% and 13.9% in 1996 to 28.3%, 18.7% and 17.0% in 1998, respectively. The number of risk factors relating to coronary hero disease increased, as the degree of obesity increased, especially in girls. The results suggest that there is some potential relationship between children obesity and the incidence of coronary hero disease. Thus, this study implicates that desirable nutrition education may be needed for obese children.

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Comparison of Nutritional Status of the Daejeon Metropolitan Citizens by Frequency of Eating Out (외식 빈도에 따른 대전시민의 영양상태 비교)

  • Suh, Yoon-Suk;Kang, Ji-Hyun;Kim, Han-Sook;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.171-180
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    • 2010
  • This study aims at investigating the health and nutritional status of the adults according to frequency of eating out. One day food intake data were collected by 24 hr recall dietary survey and body size, blood pressure and some blood lipids and other constituents were measured on 137 Daejeon metropolitan citizens 20 yrs old and above who visited Chungnam National University Hospital for physical examination during the period of December 6, to December 15, 2008. The frequency of eating out were categorized into four levels: less than once a week, once a week, 2-3 times a week, 4 times a week and above. Body mass Index, waist circumference, blood pressure, blood lipid, blood glucose, GPT and GOT did not showed any significant difference according to the frequency of eating out of the subjects. Though, systolic blood pressures and serum levels of total cholesterol and LDL-cholesterol showed a little tendency to be high in the subjects eating out 2-3 times a week. In the contrary, serum triglyceride level tended to be low in the same group. The subjects eating out 4 times a week and over took more total protein, animal protein, animal fat, phosphorus and vitamin $B_2$ than any other group. Also protein energy ratio was the highest in the group eating out 4 times a week and above and they took more animal food group, other food group, beverages teas and alcohols than other groups eating out. These results showed that higher frequency of eating out leads to higher intake of protein, fat, phosphorus, animal food groups and other food groups (oils, beverages, seasonings) and to lower intake of vitamin C and plant food groups. It, thus, suggested that the strategy for restaurant business is required to provide the menu substituted animal food by more plant food.

Effect of Taeeumjoweetang on the Body Composition, Serum Lipid Level and Antioxidant Enzyme Activity of Obese Female College Students (태음조위탕의 적용이 태음인 비만여대생의 신체조성, 혈청지질농도 및 혈중 항산화 효소에 미치는 효과)

  • Kim, Hye-Ju;Ahn, Hong-Seok;Oh, Eun-Ha;Kim, Young-Locke
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.3
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    • pp.391-401
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    • 2011
  • 1. Objectives: Though the eating habits have improved and the living method has become convenient according to the economic growth thanks to the modern industrialization, because of the lack of exercise, obesity, wrong eating habits and stress etc, various symptoms of disease of adults are on the rise. This is the phenomenon that happens as the eating life has become life in the West along with the inundation of the western culture in our society. In this perspective, there has been many various clinical research that's been proceeded so far about the physical constitution and obesity, but there has been little research on the objective analysis of the clinical research about the alimentotherapy using taeeumjoweetang. 2. Methods: In this research we have checked the weights, fat rates, fat weight, abdominal fat rate, blood pressure, and BMI over the objects of the women that were diagnosed as lunisolar system as their physical constitution, and assessed the paramecium lipid, in-blood antioxidation enzyme and the damage of oxidization in the urine by physical constitution-specific of the body shapes that were determined by BMI. The statistical analysis of the current research was processed by using of SPSS 17.0 program. We have figure out statistical amounts such as the arithmetic average, average deviation rate and percentage number. Fro the verification of he significancy of each elements, we have used the paired t-test, ANOVA, Chi-square test at the level of p<0.05. 3. Results and Conclusions: Their characteristics are age $21.20{\pm}1.35$, height $160.30{\pm}6.11cm$, weight $64.66{\pm}8.72kg$, fat rates are $35.97{\pm}4.87%$, fat amount $23.40{\pm}5.48$, abdominal fat rate $0.823{\pm}0.03$, BMI $25.12{\pm}2.79kg/m^2$, and systolic blood pressure $111.60{\pm}10.28mmHg$ and diastolic blood pressure $68.60{\pm}7.43mmHg$ and we have let them take the medicine twice a day for 8 weeks. The clinical result for the Cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol, SGOT, SGPT, of the object people was that for the function of the liver, the result of the SGOT and SGPT test was $17.16{\pm}3.05$, $15.00{\pm}2.99IU/L$, which was a decrease, and had statistical meaning, but for the SGOT, though the figure reduced to $11.92{\pm}4.61$, $10.80{\pm}3.07$, it had no statistical meaning. For the whole cholesterol level, the figure reduced to $169.00{\pm}19.95$, $160.08{\pm}22.52$ mg/dL and had statistical significance(p<0.05). Neuter fat number, Triglyceride has slightly increased to $67.52{\pm}36.32$, $68.08{\pm}47.33$ mg/dL but did not have any statistical meaning. The antioxdant enzyme marker standard marker, SOD has increased to $2.52{\pm}0.73$, $2.86{\pm}0.60U/ml$, and had statistical significance(p<0.01). Catalase also increased by $0.63{\pm}0.18$, $1.07{\pm}0.25mmol/ml$ and had statistical meaning(p<0.01). GPx also increased to $204.76{\pm}32.64$ nmol/ml and had statistical meaning(p<0.01). But, for the Total antioxidant, though it has raised to $1.51{\pm}0.26$, $1.57{\pm}0.17nmol/{\mu}l$, it did not have any statistical meaning. MDA of oxidative stress marker has decreased to $1.70{\pm}0.68{\mu}g/ml$, $1.21{\pm}0.50{\mu}g/m$ and had statistical significance(p<0.01). 8-OHdG also decreased $3.35{\pm}0.95ng/ml$, $2.21{\pm}0.50ng/ml$ and had statistical meaning(p<0.01). In this research, we have analyzed the various markers relating to BFM and changes in oxidative enzyme in blood by takingtaeeumjoweetang. Taeeumjoweetang has the positive effect on inbody antioxidant system and reducing the content of cholesterol, which is proven to help losing weight and improving hyperlipidemia statistically. With this research, we hope to improve the lifestyle of those who are either obese or need to manage their dietary habits, and also to become the touchstone of integrating Oriental Medicine with the science of food & nutrition.