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Outcome of Continuous Renal Replacement Therapy in Children (소아에서 지속적 신대체요법의 치료 결과)

  • LIm, Yeon Jung;Jin, Hyun-seung;Hahn, Hyewon;Oh, Sei Ho;Park, Seong Jong;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.68-74
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    • 2005
  • Purpose : There is growing use of continuous renal replacement therapy(CRRT) for pediatric patients, but reports about the use and outcome of CRRT in children is rare in Korea. We report our experiences of CRRT in critically ill pediatric patients. Methods : We reviewed the medical records of 23 pediatric patients who underwent CRRT at Asan Medical Center between May 2001 and May 2004. We evaluated underlying diseases, clinical features, treatment courses, CRRT modalities and outcomes. Results : Ages ranged from three days to 16 years with a median of five years. Patients weighed 2.4 to 63.9 kg(median 23.0 kg; 10 patients ${\leq}20kg$). The underlying diseases were malignancy(nine cases), multiple organ dysfunction syndrome(five cases), hyperammonemia(four cases), acute renal failure associated with liver failure(three cases), dilated cardiomyopathy(one case) and congenital nephrotic syndrome(one case). Pediatric Risk of Mortality(PRISM) III score was $17.6{\pm}7.6$ and the mean number of failing organs was $3.0{\pm}1.7$. Duration of CRRT was one to 27 days(median : nine days). Eleven patients(47.8%) survived. Chronic renal failure developed in two cases, intracranial hemorrhage in one case, and chylothorax in one case among the survivors. PRISM III score and the number of vasopressor before the start of CRRT was significantly lower in the survivors($12.7{\pm}4.2$ and $0.9{\pm}1.1$) compared with nonsurvivors($22.1{\pm}7.8$ and $2.4{\pm}1.4$)(P<0.05). Conclusion : CRRT driven in venovenous mode is an effective and safe method of renal support for critically-ill infants and children to control fluid balance and metabolic derangement. Survival is affected by PRISM III score and the number of vasopressors at the initiation of CRRT.

Differences of Garlic Powder Ingestion and Exercise Training on Blood Lipids, MDA and SOD in Rats (운동훈련과 마늘가루 섭취에 의한 흰쥐의 혈중 지질 및 MDA, SOD 활성 차이)

  • Jeon, Byung-Duk;Kim, Jin-Ha;Ryu, Sung-Pil
    • Journal of Life Science
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    • v.19 no.10
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    • pp.1337-1345
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    • 2009
  • This study investigated the effect of exercise training and garlic powder ingestion on blood lipids and antioxidants activity in rats. Twenty-eight male Sprague Dawley rats were fed a high-fat diet with or without garlic powder (500 mg/kg) for four weeks as grouped in control (CON), exercise (EXE), garlic (GAR), and garlic + exercise training (GAREXE), respectively. EXE and GAREXE were trained on the treadmill for the same periods. Weight of fats (mesentery, perirenal, and epididymal) were weighed and blood glucose, triglycerides (TG), total cholesterol (TC), and high density lipoprotein- cholesterol (HDL-C) were analyzed and low density lipoprotein-cholesterol (LDL-C) was calculated. Malondialdehyde (MDA) and superoxide dismutase (SOD) for lipid peroxidation were analyzed in liver tissue. Body weight in GAREXE was significantly lower in the statistics than that in other groups (p<0.05), and the volume of fat in GAR and GAREXE was also much lower (p<0.05). Blood glucose was significantly lower in EXE and GAR (p<0.05), however, there was no effect of exercise training. Blood TG was lower in GAR and GAREXE (p<0.05), however, there was no effect of exercise training. HDL-C was significantly improved in EXE and GAR compared to CON (p<0.05), and GAREXE was higher than EXE (p<0.05). MDA content was considerably lower in GAREXE compared to EXE (p<0.05), and SOD activity was much higher in other groups compared to CON (p<0.05). In addition, GAREXE was significantly higher than EXE and GAR, thus there was significant increase when a garlic diet was carried out together with exercise (p<0.05). These results suggested that garlic powder ingestion during the training periods had a beneficial effect of lowering glucose and enhancing blood lipids profiles. Moreover, it also has antioxidant effects, which means that it could possibly suppress aging. It is necessary to inspect various effects of garlic with a variety of research methods regarding sampling process, production process, intake method, etc.

Role of Group II Phospholipase $A_2$ in the Pulmonary Oxidative Stress of the Acute Lung Injury Induced by Gut Ischemia-Reperfusion (장의 허혈-재관류로 유도된 급성 폐손상에서 산화성 스트레스에 관여하는 group II phospholipase $A_2$의 역할)

  • Jheon, Sang-Hoon;Kim, Keun;Lee, Sang-Cheol;Kim, Seong-Eun;Lee, Young-Man;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.501-510
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    • 2002
  • Background: The various pathogeneses of acute respiratory distress syndrome have been suggested but not established yet. In the present study, the role of group II phospholipase $A_2$($PLA_2$) in the pathogenesis of gut ischemia-reperfusion(I/R) induced acute lung injury (ALI), especially in the pulmonary oxidative stress with infiltration of neutrophils was investigated. Material and Method: To induce ALI, reperfusion of mesentery was done for 120 min after clamping of superior mesenteric artery for 60 min in Sprague-Dawley rats that weighed about 300g. To exmaine the role of group II $PLA_2$ in ALI, especially endothelial injury associated with the action of neutrophils, lung myeloperoxidase activity, lung leak index, bronchoalveolar lavage fluid protein were measured, and pulmonary $PLA_2$ activity changes in gut I/R were also measured. The role of group II $PLA_2$in the neutrophilic generation of free radicals was assessed by inhibiting group II $PLA_2$ with rutin, manoalide and scalaradial. Furthermore, to verify the oxidative stress in the lung, histologic and free radical detecting cytochemical electron microscopy were done. Result: After reperfusion, ALI was developed with accumulation of neutrophils in the lung, which was confirmed by the increase of myeloperoxidase activity, lung leak index and bronchoalveolar lavage protein (p<0.001). The pulmonary and intestinal group II $PLA_2$ activities significantly increased after gut I/R which were reversed by rutin(p<0.001). In vitro, cytochrome-c reduction assay denoted the inhibitory effects of rutin, scalaradial and manoalide on the production of free radicals from isolated human neutrophils. Histologically, neutrophilic accumulation and pericapillary edema in the lung after gut I/R was detected by light microscopy which was suppressed by rutin. In $CeCl_3$ cytochemical electron microscopy, the increased production of hydrogen peroxide in the lung after gut I/R was confirmed and also the production of hydrogen peroxide was decreased by rutin. Conclusion: On the basis of these experimental results, the inhibition of group II $PLA_2$ seemed to mitigate gut I/R-induced ALI by suppressing the production of free radicals from the infiltrated neutrophils. Collectively, group II $PLA_2$ seems to play a crucial role in gut I/R-induced ALI by neutrophilic oxidative stress.

IL-1 AND TNF-α RELEASE IN HUMAN POLYMORPHONUCLEAR LEUKOCYTES AFTER EXPOSURE TO CALCIUM HYDROXIDE TREATED Porphyromonas endodontalis LIPOPOLYSACCHARIDE (수산화칼슘 처리된 Porphyromonas endodontalis Lipopolysaccharide가 다형핵백혈구의 IL-1과 TNF-α 생성에 미치는 영향에 관한 연구)

  • Park, Chan-Je;Park, Dong-Sung;Yoo, Hyeon-Mee;Oh, Tae-Seok;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.27 no.5
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    • pp.463-472
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    • 2002
  • Bacterial lipopolysaccharide (LPS) plays a major role in stimulating the synthesis and release of the principal osteoclast-activating cytokines, namely, interleukin 1 and tumor necrosis factor-$\alpha$ from immune cells. Although rnonocytes/macrophages are the main producers of these cytokines, recent evidence has indicated that polymorphonuclear leukocytes (PMN) have the ability to release IL-1 and TNF-$\alpha$. Calcium hydroxide has been shown to be an effective medicament in root canal infections, reducing the microbial titre within the canal. It has been proposed that the therapeutic effect of Ca(OH)$_2$ may also be the result of direct inactivation of LPS. The purpose of this study was to investigate whether treatment of Porphyromonas endodontalis LPS with calcium hydroxide alters its biological action as measured by human PMN secretion of IL-1 and TNF-$\alpha$, and it was compared with Escherichia coli LPS. P. endodontalis ATCC 35406 was cultured in anaerobic condition, and LPS was extracted using the hot-phenol water extraction method and purified. Purchased E. coli LPS was also purified. 100 $\mu\textrm{g}$/ml of each LPS in pyrogen free water were incubated with 25mg/ml Ca(OH)$_2$ at 37$^{\circ}C$ for 7 days. The supernatants were subjected to ultrafiltration, and the isolates were lyophilized and weighed. PMNs were obtained from peripheral blood by centrifugation layered over Lymphoprep. The cells were resuspended (4$\times$10$^6$ cells/ml) in RPMI 1640 followed by treatment with various concentrations of LPS (0, 0.1, 1, 10$\mu\textrm{g}$/ml) for 24 hours at 37$^{\circ}C$ in 5% $CO_2$ incubator. The supernatants of cells were collected and the levels of IL-1$\alpha$, IL=1$\beta$ and TNF-$\alpha$ were measured by enzyme-linked immunosorbent assay. The results were as follows ; 1. The levels of IL-1$\alpha$, IL-1$\beta$, TNF-$\alpha$ from PMN treated with each LPS were significantly higher than those released from unstimulated PMN of the control group (p<0.05). 2. The levels of all three cytokines released from PMN stimulated with each calcium hydroxide treated LPS were significantly lower than those released from PMN stimulated with each untreated LPS (p<0.05), while they were not significantly different from those released from unstimulated PMN of the control group (p>0.05) 3. The levels of secretion for all three cytokines were affected in a dose-dependent manner in PMN stimulated with each LPS (p<0.05), but not in PMN stimulated with each calcium hydroxide treated LPS (p>0.05). 4. The levels of all three cytokines released from PMN stimulated with p. endodontalis LPS were significantly lower than those released from PMN stimulated with E coli LPS (p<0.05).

Comparison of Effectiveness and Adverse Reactions between Isoniazid 300 mg and 400 mg in Korean Patients with Pulmonary Tuberculosis (한국인 폐결핵 환자의 표준치료에서 Isoniazid 300 mg 및 400 mg의 치료 효과와 부작용의 비교)

  • Park, I-Nae;Hong, Sang-Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.44-48
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    • 2006
  • Background : Isoniazid (INH) is one of the most effective anti-tuberculosis (TB) drugs. In Korea, the dose of INH normally used in patients over 50 kg is 400 mg/day, which differs from the dose recommended by other countries. Indeed, the metabolism of INH shows ethnic variations, and Koreans are predominantly rapid acetylators. However, two reports suggested 300 mg of INH might be sufficient to reach an ideal peak level in Korean patients over 50 kg. Therefore, the aim of this study was to compare the effectiveness and adverse reactions between INH 300 mg and 400 mg in Korean TB patients. Method : Patients who were culture-positive, susceptible to all 1st-line drugs, initially on HREZ, and weighed over 50 kg were selected from patients with pulmonary TB between April 2003 and March 2005. The treatment results and adverse reactions in the INH 300 mg and 400 mg group were compared. Since April 2004, most TB patients at Asan Medical Center were administered INH 300 mg irrespective of the body weight. Results : The study included 123 patients in the 300 mg INH group and 128 in the 400 mg INH group. There were no significant differences between the groups in terms of age, gender, weight, history of TB treatment, initial smear strength, and frequency of cavitary lesions. There was no difference in the treatment duration between the groups. One hundred eleven (90%) patients in the INH 300 mg group and 102 (80%) in the INH 400 mg group completed treatment (p>0.05). There were no differences in the frequency of modification of the initial regimen between groups due to any adverse reactions (300 mg : 9.0%, 400 mg : 13.7%) and hepatotoxicity (300 mg : 2.7% ; 400 mg : 7.8%). Conclusion : Considering treatment results and adverse reactions of two groups, 300mg of INH may be sufficient for treating Korean TB patients. Further studies comparing the frequency of relapse will be needed.

Efficacy of Antibacteriocidal Yeast That Producing Bacteriocin OR-7 in Chicken (박테리오신 OR-7을 생산하는 항균 효모의 양계에서의 사양시험 효과)

  • Cho, Dong-In;Kang, Sang-Mo;Lee, Jae-Hwa;Lee, Sang-Hyeon;Kim, Nam-Young;Kim, Ki-Seuk
    • Microbiology and Biotechnology Letters
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    • v.38 no.4
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    • pp.391-398
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    • 2010
  • This study was conducted to investigate the effects of feeding probiotics(gene modified yeast) on the egg quality in laying hens. The laboratory method of this study is as follow: In hens, 300, 36 weeks old ISA brown commercial layer, were employed in 13weeks feeding trial with a 7 days adjustment period. Dietary treatments are 1) control (basal diet) 2) Y0.3 (basal diet+0.3% probiotics), 3) Y0.5% (basal diet+0.5% probiotics), 4) PY0.3% (basal diet+0.3% plasmid modified probiotics), 5) PY0.5% (basal diet+0.5% plasmid modified probiotics). For overall period, hen-day egg production, egg weight (p<0.05) by dietary probiotic supplementation were recorded. Eggs were collected and weighed every day. Egg production number and egg production rate, egg weight, failure egg ratio and trouble egg ratio were recorded for 13weeks days. Diets PY0.3 and PY0.5 improved Egg production rate, egg production number and egg weight, compared to control diet (linear effect. p<0.05). And, diets PY0.3 and PY0.5 improved Egg production rate, egg production number, compared to Y0.3 and Y0.5 (linear effect. p<0.05). But, in Inferior egg and cracked egg, diets PY0.3 and PY0.5 did not tended to increase by dietary probiotic supplementation compared to control diet and Y group (0.3, 0.5) (linear effect. p<0.05). The productivity enhance on the egg quality in laying hens is considered from the effects of feeding probiotics(gene modified yeast).

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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