• Title, Summary, Keyword: 10-day sequential therapy

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Therapeutic Effect of Cyclosporine A on Severe Henoch-$Sch{\ddot{o}}nlein$ Purpura Nephritis (중증 Henoch-$Sch{\ddot{o}}nlein$ Purpura Nephritis 환아에서 Cyclosporine A의 치료효과)

  • Chin Hyun Jong;Kim Ji Hong;Kim Pyung Kil;Jeong Hyeon Joo
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.110-117
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    • 1998
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis(HSPN) accompanied by nephrotic syndrome(NS) is known to have a poor prognosis and effective treatment is still controversial, even though both corticosteroids and immunosuppresant have been used for therapy. Cyclosporine A(CsA) is a well known immunosuppresant and widely used in renal transplantation and glomerular diseases especially steroid resistant. The aims of this study was to evaluate the therapeutic effect of CsA and to compare CsA with previously reported our data of rifampin(RFP) and azathioprine(AZA) in children with HSPN accompanied by NS. Methods : 37 HSPN patients with NS confirmed by renal biopsy were selected. Of these, 17 patients were treated with CsA(5 mg/kg/day) fur 6-8 months, 7 children were treated with RFP(10-20 mg/kg/day) for 9-12 months and 13 patients were treated with AZA(2 mg/kg/day) fur 8 months. Along with these regimens, low dose oral prednisolone(0.5-1 mg/kg, qod) was also used. Sequential renal biopsy was done in all patients 1 month after termination of treatment. Results : Complete remission rate of nephrotic syndrome was $58.8\%$ in CsA, $57.1\%$ in RFP and $38.4\%$ in AZA group after 17, 22, 11 months of mean follow-up period. Overall remission rate including partial remission was $88.2\%$ in CsA, $85.7\%$ in RFP and $84.6\%$ in AZA group. Disappearance rate of hematuria was $58.8\%$ in CsA, $57.1\%$ in RFP and $46.2\%$ in AZA group. Improvement of grade of clinical status was observed in 17 out of 17 CsA, 7 out of 7 RFP and 10 out of 13 AZA group. Improvement of pathologic class on sequencial renal biopsy was shown in 5 CsA($29.4\%$), none RFP($0\%$) and 2 AZA group($12.4\%$). Improvement on histologic immune-deposition was seen in 15 CsA($88.2\%$), 6 RFP($85.9\%$) and 4 AZA group($30.8\%$). Conclusion : In conclusion, Both CsA and RFP treated groups showed better result in complete remission rate of nephrotic syndrome and significant improvement of histologic immune-deposition compared with AZA treated group(p=0.004). So, we recommend CsA and REP rather than AZA for immunosuppresant treatment in HSPN with nephrotic syndrome.

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The Effects of Orofacial Training Video Program using Smart Device on Oral Cavity Structure and Function, Diadochokinetic Rate in Acute Stroke Patients with Dysarthria (스마트 기기를 활용한 구강안면 훈련 영상 프로그램이 마비말장애가 있는 급성 뇌졸중 환자의 구강 구조 및 기능과 조음교대운동속도에 미치는 효과)

  • Moon, Jong-Hoon;Won, Young-Sik
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.2
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    • pp.391-400
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    • 2017
  • The purpose of this study was investigated the effect of orofacial training video program using smart device on oral cavity structure and function, diadochokinetic rate in acute stroke patients with dysarthria. Present study participated in fourteen acute stroke patients with dysarthria. All subjects assigned that randomized each seven patients in experimental and control group. Subjects of two groups received conventional rehabilitation therapy for 4 weeks. Experimental group performed additionally that orofacial training video program using smart device, supervised under caregivers, during 30 min/day. The outcome measures were the oral cavity structure and function of subscale for KOMSE(: Korean Oro-motor Mechanism Screening Examination), AMR(: Alternating Motion Rate), SMR(: Sequential Motion Rate). In results, Both group showed significant improvements after intervention in all assessments(p<.05). In comparison of change between two groups, experimental group showed significant improvements than control group in oral cavity function, /p ə/ and /tə/ of AMR(p<.05). We suggested that orofacial training video program using smart device expected to positive effects the improvements of oral cavity and articulator function in acute stroke patients with dysarthria.

Azathioprine Therapy in $Henoch-Sch\"{o}nlein$ Purpura Nephritis Accompanied by Nephrotic syndrome (신증후군을 동반한 HSP 신염에서 Azathioprine의 치료 효과)

  • Son Jin-Tae;Kim Ji-Hong;Kim Pyung-Kil;Chung Hyeun-Joo
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.41-49
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    • 1998
  • Treatment of $Henoch-Sch\"{o}nlein$ purpura nephritis(HSPN) accomanied by nephrotic syndrome is still controversal, even though both corticosteroids and immunosuppressants have been used for therapy. Azathioprine(AZA) is a chemical analog of the physiologic purines-adenine, guanine, and hyoxanthine and an antagonist to purine metabolism which may inhibit RNA and DNA synthesis and is mainly used for immunosuppressive agent. We studied the effects of AZA in HSPN accompanied by nephrotic syndrome and evaluating the clinical status and histopathologic changes by sequential biopsies following the treatment. Fifteen patients with nehprotic syndrome either initially or during the course of HSPN confirmed by renal biopsies were treated with AZA(2 mg/kg/day) and prednisolone (0.5-1 mg/kg/day qod) for 8months. Folow up renal biopsy was done after treatment in 11 patients. The clinical status of the patients on admission were C(12 cases) and B(3 cases). Improvement of clinical status were showed in 12 cases, but 3 cases were not improved and 1 case was aggrevated after AZA treatment. Complete remission of proteinuria were in 8 cases(53.3%), partial remission were in 4 cases(26.7%) and persistence of proteinuria and hematuria were in 3 cases(20.0%). The loss of hematuria were in 10 cases(66.7%). Histopathologically and immunopathologically, 4 cases were improved. This study suggests that, although control studies are needed, AZA could be used in the treatment of HSPN accompanied by nephrotic syndrome.

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