• Title/Summary/Keyword: 약물화

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Neonatal hearing screening in a neonatal intensive care unit using distortion product otoacoustic emissions (변조 이음향방사(DPOAE)를 이용한 고위험군 신생아 청각선별검사)

  • Kim, Do Young;Kim, Sung Shin;Kim, Chang Hwi;Kim, Shi Chan
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.507-512
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    • 2006
  • Purpose : Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). Methods : The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups : 'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. Results : The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (${\geq}60dB$) in this study was 2 percent(18 out of 871). Conclusion : This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.

Cell Death Study in Embryonic Stem Cell-derived Neurons and Its Applications (배아줄기세포 유래 신경계세포에서의 세포사멸 연구와 그 응용)

  • Lee, Chul-Sang
    • Development and Reproduction
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    • v.12 no.1
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    • pp.1-8
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    • 2008
  • Specific protocols to increase the differentiation of neuronal cells from embryonic stem (ES) cells have been well established, such as retinoic acid induction and lineage selection of neuronal cells. For the neuropathological studies, ES-derived neurons (ES neurons) must show normal physiological characteristics related to cell death and survival and should be maintained in vitro for a sufficient time to show insults-specific cell death without spontaneous death. When mouse ES cells were plated onto astrocytes monolayer after retinoic acid induction, most ES cells differentiated into neuronal cells, which were confirmed by the presence of specific neuronal markers, and the cultures were viable for at least four weeks. When these cultures were examined for vulnerability to glutamate excitotoxicity, ES neurons were vulnerable to excitotoxic insults mediated by agonist-specific receptors. The vulnerability to excitotoxic death increased with developmental age of ES neurons in vitro. Specific receptors for Neurotrophin and GDNF family ligands were present in ES neurons. GDNF and NT-3 could modulate the survival and excitotoxic vulnerability of ES neurons. The vulnerability and resistance to toxic insults, which are essential requirements of model culture systems for neuropathological studies, make ES neurons to a useful model culture system. Especially ES cell are highly amenable to genetic modification unlikely to primary neuronal cells, which will give us a chance to answer more complicated neurophysiological questions. Recently there was an outstanding attempt to explore the cellular toxicity using human ES cells (Schrattenholz & Klemm, 2007) and it suggested that ES cells could be a new model system for neurophysiological studies soon and go further a large-scale screening system for pharmacological compounds in the future.

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Bone Mineral Density and Bone Markers in the Children with Epilepsy Taking on Chronic Anticonvulsants (장기간 항경련제를 복용하고 있는 소아 간질 환아들의 골밀도 및 골대사 지표들)

  • Lee, Soon Bum;Kang, So Young;Yu, Jeesuk
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.527-533
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    • 2005
  • Purpose : Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants. Methods : Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[$25(OH)D_3$], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated. Results : Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01). Conclusion : This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.

Therapeutic response of cyclosporine and outcome in steroid resistant nephrotic syndrome (스테로이드 저항성 신증후군에서 cyclosporine 치료 반응 및 결과)

  • Choi, Hyung Soon;Lee, Joo Hoon;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.293-298
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    • 2008
  • Purpose : The aim of our study was to evaluate the therapeutic response to cyclosporine, time to remission and side effects in steroid resistant nephrotic syndrome (SRNS). Methods : This study included 22 children with idiopathic SRNS who were treated with cyclosporine between June 1989 and August 2006. Medical records were reviewed retrospectively. Results : The mean age of patients at diagnosis was $5.2{\pm}3.3\;years$. The male to female ratio was 1.2:1. Pre-treatment renal biopsies showed minimal change (MCD) in 12 (54.5%), focal segmental glomerulosclerosis (FSGS) in 8 (36.4%), membranous nephropathy (MGN) in one (4.5%) and mesangioproliferative glomerulonephritis in one (4.5%). 15 (68.2%) patients responded to cyclosporine, of whom 11 (91.6%) patients were MCD, 3 (37.5%) patients FSGS, and 1 patient MGN (MCD vs FSGS, P<0.05). The time to remission in patients who responded to cyclosporine was $31.5{\pm}15.2\;days$. Four of the 15 cyclosporine responders maintained complete remission even after cessation of the medication Seven still received cyclosporine, 2 were intermittently treated with steroids after discontinuation of cyclosporine, and two were treated with cyclosporine and steroids. The mean duration of cyclosporine therapy was $546.5{\pm}346.2$, $1,392.9{\pm}439.7$, $439.5{\pm}84.1$, and $433.5{\pm}74.2$ days, respectively. We performed post-treatment biopsies in 8 patients and partial interstitial fibrosis and tubular atrophy were found in two. Conclusion : The thrapeutic response of cyclosporine is good in steroid resistant nephrotic syndrome, especially in minimal change. But, there is a problem of long term cyclosporine dependency.

The Effects of Majarol on the Blood Pressure and Heart Rate in Rats and Isolated Frog Heart (Majarine 유도체인 majarol의 흰쥐에 있어서 혈압 및 심박동수에 대한 작용과 적출 개구리 심장에 대한 작용)

  • Lee Jong-Hwoa;Park Young-Hyun;Cho Byung-Heon;Kim Yu-Jae;Kim Jong-Bae;Kim Chun-Sook;Cha Young-Deog;Kim Young-Suk
    • The Korean Journal of Pharmacology
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    • v.22 no.1 s.38
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    • pp.34-44
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    • 1986
  • In our previous studies, we had clarified many pharmacological effects of majarine: the bacteriostatic effect in vitro; the potentiation of hypnotic action of alcohol; hypotensive effect in rats and hypothermic effect in mice. This study was undertaken to search for a new antihypertensive drug. Red crystalline was obtained from majarine (which was extracted from Berberis koreana Palibin) by chemical methods. And this crystalline was identified as $C_{19}H_{16}NO_4$ contained one hydroxy group instead of methoxy group of majarine in isoquinoline ring and named 'Majarol' (5,6-Dihydro-9-hydroxy, 10-methoxybenzo-[g]-1,3-benzodioxolo [5,6-a] quinolizinium). We examined the effects of majarol on blood pressure and heart rate in urethane ancsthetized rats and the rate and amplitude of contraction of isolated frog heart. Several drugs: atropine sulfate, diphenhydramine chloride, hexamethonium bromide, phentolamine, epinephrine, propranolol and isoproterenol were used to clarify the mechanism of the hypotensive action of majarol. The results of experimints were as follows; 1. In low dose (0.5-2mg/kg, i.v.), majarol showed a typical transient hypotensive effect and slight decrease in heart rate. In high dose (5-10 mg/kg, i.v.), majarol showed a typical transient and a subsequent prolonged hypotensive effect and a significant prolonged decrease in heart rate was followed. 2. The hypotensive effects of majarol was not abolished by the pretreatments with atropine sulfate, hexamethonium bromide and diphenhydramine. The pretreatment with phentolamine inhibited significantly the hypotensive effects of majarol and the pretreatment wtih majarol blocked markedly the hypertensive effect of epinephrine. The positive chronotropic effect of isoproterenol was not blocked by the pretreatment with majarol. 3. In low dose, majarol increased the amplitude and decreased rate of contraction, but in high dose, majarol inhibited the amplitude and rate of contraction of isolated frog heart.

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Effects of Amisulpride Administration on Body Weight and Metabolic Abnormalities in Mice (Amisulpride의 지속 투여가 생쥐의 성별에 따른 체중 및 대사에 미치는 영향)

  • Lee, Hyo-Jin;Shin, Yun-O;Jeon, Byeong-Wha;Piao, LongZhen;Kim, Jeong-Lan
    • Korean Journal of Biological Psychiatry
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    • v.15 no.2
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    • pp.101-109
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    • 2008
  • Objectives : This study was conducted to examine the effects on food intake, body weight, and metabolic parameters by amisulpride administration in male and female mice, comparing the effects of risperidone and vehicle administration. Methods : Female and male C57BL/6 mice were grouped into low dose amisulpride(1.5mg/kg), high dose amisulpride(15mg/kg), risperidone(0.1mg/kg) and vehicle. Drugs were administered once daily through intraperitoneal injection over 21days. Body weight was measured weekly and food intake was measured daily. Levels of triglyceride, glucose, insulin and prolactin were determined at the end of experiment(on day 22). Results : In the female mice, low and high dose amisulpride as well as risperidone caused significant weight gains. But weight gains in amisulpride groups were numerically smaller than that of risperidone group. In male mice, only high dose amisulpride caused significant weight gain. Among weight gain groups, only weight gain of male mice with high dose amisulpride was significantly associated with increased food intake. Weight gain group in female mice did not show significant correlation with food intake. In male mice, both amisulpride groups showed significantly high plasma insulin levels compared to vehicle. In female and male mice, low and high dose amiulpride groups showed significant high plasma prolactin levels compared to vehicle. Triglyceride level were not significantly changed in all groups. Glucose level was changed significantly only in male risperidone group. Conclusions : Administration of amisulpride caused more significant weight gains in female and male mice than controls but changes of metabolic parameters were different according to sex of mice. Our results suggest that different mechanisms of amisulpiride are likely to affect weight gain between male and female mice.

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Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

Neuropeptides in Clinical Psychiatric Research : Endorphins and Cholecystokinins (정신질환에 있어서의 신경펩타이드 연구 - Endorphin과 cholecystokinin을 중심으로 -)

  • Kim, Young Hoon;Shim, Joo Chul
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.34-45
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    • 1998
  • We provide the reader with a brief introduction to the neurobiology of neuropeptides. Several comprehensive reviews of the distribution and neurochemical, neurophysiological, neuropharmacological and behavioral effects of the major neuropeptides have recently appeared. In reviews of the large number of neuropeptides in brain and their occurance in brain regions thought to be involved in the pathogenesis of major psychiatric disorders, investigators have sought to determine whether alternations in neuropeptide systems are associated with schizophrenia, mood disorders, anxiety disorders, alcoholism and neurodegenerative disease. There is no longer any doubt that neuropeptide-containing neurons are altered in several neuropsychiatric disorders. One of the factors that has hindered neuropeptide research to a considerable extent is the lack of pharmacological agents that specifically alter the synaptic availability of neuropeptides. With the exception of naloxone and naltrexone, the opiate-receptor antagonists, there are few available neuropeptide- receptor antagonists. Two independent classes of neuropeptide-receptor antagonists has been expected to be clinically useful. Naltrexone, a potent ${\mu}$-receptor antagonist, has been used successfully to reduce the need for alcohol consumption. And cholecycstokinin antagonists are now in development as a new class of anxiolytics, which would be expected to be free from tolerance and physical dependence and lack of sedation. In this review, we deal with these two kinds of neuropeptide system, the opioid system and cholesystokinins in the brain. The role of opioid systems in the reinforcement after alcohol consumtion and that of cholesystokinins in the pathogenesis of anxiety will be discussed briefly. As we know, the future for neuropeptides in psychiatry remains bright indeed.

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Ex vivo Morphometric Analysis of Coronary Stent using Micro-Computed Tomography (미세단층촬영기법을 이용한 관상동맥 스텐트의 동물 모델 분석)

  • Bae, In-Ho;Koh, Jeong-Tae;Lim, Kyung-Seob;Park, Dae-Sung;Kim, Jong-Min;Jeong, Myung-Ho
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.93-98
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    • 2012
  • Micro-computed tomography (microCT) is an important tool for preclinical vascular imaging, with micron-level resolution. This non-destructive means of imaging allows for rapid collection of 2D and 3D reconstructions to visualize specimens prior to destructive analysis such as pathological analysis. Objectives. The aim of this study was to suggest a method for ex vivo, postmortem examination of stented arterial segments with microCT. And ex vivo evaluation of stents such as bare metal or drug eluting stents on in-stent restenosis (ISR) in rabbit model was performed. The bare metal stent (BMS) and drug eluting stent (DES, paclitaxel) were implanted in the left or right iliac arteries alternatively in eight New Zealand white rabbits. After 4 weeks of post-implantation, the part of iliac arteries surrounding the stent were removed carefully and processed for microCT. Prior to microCT analysis, a contrast medium was loaded to lumen of stents. All samples were subjected to an X-ray source operating at 50 kV and 200 ${\mu}A$ by using a 3D isotropic resolution. The region of interest was traced and measured by CTAN analytical software. Objects being exposed to radiation had different Hounsfield unit each other with values of approximately 1.2 at stent area, 0.12 ~ 0.17 at a contrast medium and 0 ~ 0.06 at outer area of stent. Based on above, further analyses were performed. As a result, the difference of lengths and volumes between expanded stents, which may relate to injury score in pathological analysis, was not different significantly. Moreover, ISR area of BMS was 1.6 times higher than that of DES, indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. And ISR area of BMS was higher ($1.52{\pm}0.48mm^2$) than that of DES ($0.94{\pm}0.42mm^2$), indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. Though it was not statistically significant, it showed that the extent of neointema of mid-region of stents was relatively higher than that of anterior and posterior region in parts of BMS as showing cross-sectional 2-D image. suggest that microCT can be utilized as an accessorial tool for pathological analysis.

THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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