• Title/Summary/Keyword: 자가 투여

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The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

Hepatic glycogenosis in a patient with poorly controlled type 1 diabetes mellitus (혈당 조절이 불량한 제1형 당뇨병 환자에서 발생한 간의 당원축적증)

  • Jin, Hye-Young;Kang, Dae-Young;Choi, Jin-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1279-1282
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    • 2009
  • Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

Blend Films of Poly(acrylic acid-co-maleic acid) with Poly(vinyl alcohol) (I) : Thermo-mechanical Properties and Gas Permeability (폴리(비닐 알코올)과 폴리(아크릴산-말레산) 공중합체의 블렌드 필름 (I) : 열적-기계적 성질 및 가스 투과도)

  • Ham Shin-Kyun;Jung Min-Hye;Chang Jin-Hae
    • Polymer(Korea)
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    • v.30 no.4
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    • pp.298-304
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    • 2006
  • Blends of poly (acrylic acid-co-maleic acid)(PAM) with poly (vinyl alcohol)(PVA) were obtained by solution blending. The blends were solvent-on to a film to examine thermo-mechanical properties and gas permeability. The transition temperatures $(T_g\;and\;T_m)$ of the blends remained constant regardless of PAM contents. However, the values of enthalpy changes corresponding to melting transition $({\Delta}H_m)$ and initial degradation temperature $({T_D}^i)$ were decreased with increasing PAM content. The values of ultimate strength and initial modulus gave the maximum value at the 12 wt% PAM then decreased with further increase of PAM content up to 15 wt%. To measure the gas permeability of the PVA/PAM blend films, the PVA blend solutions were coated onto both biaxially oriented propylene (BOPP) and poly (ethylene terephthalate)(PET) films. The oxygen transmission rate $(O_2\;TR)$ permeability values mono- tonically decreased with increasing PAM content. However, moisture vapor transmission rate was not affected by PAM content.

Surgical Treatment of Peripheral Artery Occlusive Disease (말초동맥 폐쇄질환에 대한 외과적 고찰)

  • 김해균;윤용한;이두연;문동석;이택연;홍윤주
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.262-265
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    • 1998
  • A retrospective analysis was performed on the 72 cases of peripheral artery occlusive disease treated at Yonsei Medical School Yongdong Severance Hospital, from March 1, 1990, through July 31, 1992, focusing on the operative procedures, surgical results and perioperative complications. The etiologic causes of vascular obstruction were atherosclerosis in 28 cases, Buerger's disease in 31, traumatic orgin in 7, operative complications in 4, and malignancy and arteritis in one case each. Treatment modalities, actually performed include bypass graft.(27), infusion of PGE1 (23), Embolectomy (16), Sympathectomy (4) and end-to-end anastomosis (2). There were 21 satisfactory cases and 9 unsatisfactory cases of atherosclerotive occlusive disease, defining the operative outcome as“satisfactory”if the obstructive symptoms disappeared completely and “unsatisfactory”if they did not. The patients of TAO induced Buerger's disease with preoperative Foutain class III or IV were surgically converted to class 0 in 14 cases, class I in 12 and class II in 3.

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Effect of Cimetidine on Pharmacokinetics of Theophylline in Healthy Korean Volunteers (건강한 한국인 자원자에서 theophylline 약동학에 미치는 Cimetidine의 효과)

  • Kwon, Jun-Tack;Chai, Seok;Sohn, Dong-Ryul;Yom, Yoon-Ki;Kim, Hyung-Ki
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.13-18
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    • 2007
  • The purpose of the present study was to investigate the effect of cimetidine on theophylline pharmacokinetics in Korean healthy normal subjects. Eight subjects were enrolled and open label, two period cross-over study was conducted without significant drug related adverse reactions. Cimetidine seemed that significantly inhibited the metabolism of theophylline, oral clearance decreased significantly when cimetidine was coadministered. Coadministered cimetidine increased $AUC_t$ and $C_{max}$ of theophylline. All subjects were genotyped using PCR-RFLP methods to evaluate the differences in metabolic capacity in accordance with CYP1A2 genotypes, but no mutant genotype was found. This suggests that metabolic capacities were not significantly affected by CYP1A2 genotypes among subjects. In conclusion, disposition of theophylline was significantly affected by coadministered cimetidine. Further evaluation with well-designed drug interaction study in accordance with various genotype of CYP1A2 is needed.

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Radiographic Estimation of Colonic Transit Time with $Kolomark^{TM}$ in Normal Dogs (개에서 콜로마크를 이용한 대장통과시간의 방사선학적 평가)

  • Cho, Young-Kwon;Kim, Sun-Chil;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.237-241
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    • 2012
  • Colonic transit time plays an important role in creating a disease category and treatment plan in patients with chronic constipation or bowel movement problem. The aim of this study is to establish normal colon transit time using Kolomark, a radiopaque marker in dogs. The transit time of Kolomark in colon was measured every 2, 4, 8, 12, 24, 48 hours in 11 healthy Beagle dogs with oral administration of the marker. Kolomark began to appear in colon after 4 hours from administration and the largest number of Kolomark in colon was observed after 12 hours. Then, after 24 hours, some quantity of Kolomark was found but Kolomarks were all eliminated from the colon after 48 hours. The mean emptying time of Kolomark was 28.36 hours. Based on this study, the normal range of colon transit time in dogs was established by using the Kolomark, and it could be used as reference data for objective evaluation of constipation in canine patients.

Perfusion RRI of the Brain Using Oxygen Inhalation (산소 호흡을 이용한 뇌의 관류 자기공명영상)

  • 최순섭
    • Investigative Magnetic Resonance Imaging
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    • v.4 no.2
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    • pp.113-119
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    • 2000
  • Purpose : To know the possibility of clinical application of MRI using oxygen inhalation as a perfusion MRI Materials and methods : Two healthy volunteers and three patients of one moyamoya disease, one acute infarction and one meningioma were studied using a 1.5 Tesla MRI unit. Oxygen (15 liters/min) mixed with room air was given using face mask from 8 second to 35 second during the study. Images were acquired 25 times (scan time per study were 1.6 seconds) using susceptibility contrast EPI (echo planar image) sequence. Difference maps were acquired by early (study 12-18), and late (study 19-25) O2 inhalation image groups minus pre-O2 inhalation image group (study 3-9) with a Z-score of 0.7-1.0 using VB31C program of Magneton Vision. The resulting perfusion images were created by superimposition of difference maps on corresponding T1 weighted anatomic images. On moyamoya patient, similar perfusion images were acquired after Gd-DTPA injection, and compared with O2 inhalation perfusion images. Results ; The author can get the perfusion images of the brain by oxygen inhalation with susceptibility contrast EPI sequence at the volunteers, and the patient of moyomoya disease, acute infarction and meningioma. On moyamoya patient, perfusion images with O2 inhalation are similar with perfusion images by Gd-DTPA injection. Conclusion 1 This study has demonstrated that the susceptibility contrast EPI by oxygen inhalation can be used as the clinically useful perfusion MRI technique

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SPECT Imaging of Dopamine Transporter with $[^{123}I]{\beta}$-CIT: A Potential Clinical Tool in Parkinson's Disease (파킨슨병에서 $[^{123}I]{\beta}$-CIT SPECT를 이용한 도파민 운반체 영상)

  • Kim, Sang-Eun;Lee, Won-Yong;Chi, Dae-Yoon;Choe, Yearn-Seong;Lee, Kyung-Han;Choi, Yong;Oh, Seung-Jun;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.19-34
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    • 1996
  • [ $[^{123}I]{\beta}$ ]-CIT [$2{\beta}$-carbomethoxy-$3{\beta}$-(4-iodophenyl)tropane]는 도파민 운반체 (dopamine transporter)에 특이결합하며 $[^{123}I]{\beta}$-CIT의 도파민 운반체 결합정도는 파킨슨병에서 도파민 뉴우런의 변성정도를 반영하는 것으로 제안되어 왔다. 이 연구의 주요 목적은 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT SPECT를 이용하여 측정된 $[^{123}I]{\beta}$-CIT의 선조체 결합지표들이 질병의 임상적 진행정도를 반영하는지를 검토하고, 간편화된 조직방사능비가 $[^{123}I]{\beta}$-CIT의 결합정도를 나타내는 정량적 지표로 이용될 수 있는지를 검증하는 것이었다. 파킨슨병 환자 30명($59{\pm}9$세, 평균${\pm}$표준편차: Hoehn-Yahr stage 1-3)과 정상인 6명 ($58{\pm}5$세)을 대상으로 $[^{123}I]{\beta}$-CIT SPECT 영상을 얻었다. $[^{123}I]{\beta}$-CIT 선조체 결합의 정량적 지표로서 (선조체 방사능-소뇌방사능)/소뇌방사능 비(specific binding ratio, SBR)와 추적자역학모델을 이용하여 측정한 선조체 결합능(binding potential)($k_3/k_4$)을 구하였다. 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT의 선조체 결합역학은 정상인에 비하여 현저하게 느렸으며 그 결합지표들은 정상인에 비하여 뚜렷하게 낮았다. 한편, 편측파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT 결합은 증상 반대쪽 선조체 뿐만 아니라 같은 쪽 선조체에서도 정상인에 비해 유의하게 감소되어 있었다. 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT 투여 후 24시간의 선조체 SBR 및 최대 SBR, 선조체 결합능은 모두, 유병기간, Hoehn-Yahr stage, UPDRS(Unified Parkinson's Disease Rating Scale) 총점, UPDRS 운동점수, UPDRS 일상활동점수와 유의한 상관관계를 나타내었다. 24시간 선조체 SBR과 최대 SBR은 선조체 결합능과 우수한 상관관계를 보였다. 이상의 결과로부터 $[^{123}I]{\beta}$-CIT의 선조체 결합은 파킨슨병의 진행정도를 나타내는 지표로 이용될 수 있다. 또 $[^{123}I]{\beta}$-CIT 투여 후 24시간 영상으로부터 얻은 간편화된 조직방사능 비는 $[^{123}I]{\beta}$-CIT의 결합정도를 정량적으로 반영한다. $[^{123}I]{\beta}$-CIT SPECT는 파킨슨병의 조기진단 및 진행 추적에 임상적으로 유용할 것으로 판단된다.

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Inhibitive Effect of Mouse Sarcoma 180 by Crude Polysaccharide Extracted from Fruiting Body of Aramillaria mellea (뽕나무버섯(Armillaria mellea)의 자실체에서 추출한 조다당류가 생쥐의 Sarcoma 180에 미치는 억제효과)

  • Kim, Sang-Beom;Lee, Gun-Woo;Kim, Hye-Young;Shim, Mi-Ja;Rho, Hyun-Su;Lee, Hyun-Sook;Lee, Min-Woong;Lee, U-Youn;Lee, Tae-Soo
    • The Korean Journal of Mycology
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    • v.34 no.2
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    • pp.98-104
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    • 2006
  • Armillaria mellea, one of edible and medicinal mushroom belonging to Tricholomataceae of Basid-iomycota, has been known to have outstanding inhibitive effects on the sarcoma 180 and Erhrlich carcinoma of mice. Neutral salt soluble (0.9% NaCl), hot water soluble and methanol soluble substances (hereinafter referred to Fr. NaCl, Fr, HW and Fr. MeOH, respectively) were extracted from the mushroom. In vitro cytotoxicity tests, crude polysaccharide were not cytotoxic against cancer cell lines such as NIH3T3 and Sarcoma 180 at the concentration of $1000{\mu}g/ml$. Intraperitoneal injection with crude polysaccharides exhibited life prolongation effect of $60{\sim}67.5%$ in mice inoculated with Sarcoma 180, respectively. Fr, NaCl improved the immunopotentiation activity of B lymphocyte by increasing the alkaline phosphatase activity by $1.8{\sim}3.0$ folds, respectively. In case of Fr. NaCl, the numbers of peritoneal exudate cells and circulating leukocytes were increased by 10 and 2 folds, respectively.

Synthesis and Selective Gas Permeability of Liquid Crystalline Poly(allyl sulfone) Networks (액정폴리알릴술폰의 합성 및 기체 선택투과 특성)

  • Jo, Byung-Wook;Choi, Jae-Kon;Kim, Joon-Seop;Choi, Soo-Kyung
    • Elastomers and Composites
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    • v.40 no.2
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    • pp.136-142
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    • 2005
  • Liquid crystalline poly(allylsulfone) networks having $SO_2$ in a main chain and mesogens in a side chain were synthesized and their gas permeability and permselectivity were determined. The monomer II having two allyl groups on the each end group was able to form polymer networks by polymerization reaction, while the monomer I having only one allyl group was not. Molecular motion of the poly(allylsulfone) networks were retarded with increasing the cross-linking density, and the segmental motion of networks was developed enough to show isotropic phase transition. Gas permeabilities of poly(II-5 $01/I-OCH_3$ 99) were 2.58 baller for $O_2$ and 18.4 barrer for $H_2$. It means that hydrogen gas are 7 times more permeable than oxygen. Its permselectivities were high as 23.9 for ${\alpha}(H_2/N_2)$. The permselectivity was increased with increasing the cross-linking density. For example, ${\alpha}(H_2/N_2)$ was 36.8 in poly(II-5 $10/I-OCH_3$ 90), which was shown to be the highest value among these poly(allylsulfone) networks.