• Title/Summary/Keyword: 치료 저항성

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Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction (외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험)

  • Kim, Dae Jin;Cho, Jae Wook;Kim, Hyun Woo;Choi, Jeong Su;Mun, Sue Jean
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.278-283
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    • 2020
  • Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.

Comparison of the Effects of Cyclodextrin-Naringin Inclusion Complex with Naringin on Lipid Metabolism in Mice Fed a High-Fat Diet (고지방식이를 섭취한 마우스에서 나린진과 나린진-사이클로텍스트린 포접화합물의 지질대사에 대한 영향 비교)

  • Jeon, Seon-Min;Choi, Myung-Sook
    • Journal of the East Asian Society of Dietary Life
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    • v.20 no.1
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    • pp.20-29
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    • 2010
  • Naringin has antioxidant and antihyperlipidemic properties, however, phenolic compounds including naringin are unstable in the presence of light, heat and oxygen. Beta-cyclodextrin ($\beta$-CD) is a cyclic heptamer composed of seven glucose units that enhances the stability and solubility of molecules through the formation of inclusion complexes. This study was conducted out to compare the effects of CD-naringin (CD-N) inclusion complexes with naringin on lipid metabolism in high fat-fed animals. Male C57BL/6 mice were fed either CD-N (0.048%, w/w) or naringin (N, 0.02%, w/w) in a 20% high-fat (HFC, 15% lard, 5% corn oil, w/w) diet for 10 weeks. Orlistat (Xenical, 0.01%, w/w) was used as a positive control (PC). There were no differences in body weight, food intake, liver and heart weights, plasma triglyceride(TG), leptin, adiponectin, resistin, IL-$1{\beta}$ and IL-6 concentrations, and hepatic $\beta$-oxidation, carnitine palmitoyl transferase(CPT), glucose-6-phosphate dehydrogenase (G6PD) and malic enzyme activities between the HFC and CD-N groups or between the HFC and N groups. However, both CD-naringin and naringin supplementation les to a significant reduction in the epididymal and perirenal white adipose tissue weights, plasma free fatty acid, insulin and blood glucose concentrations, hepatic cholesterol and TG contents and hepatic fatty acid synthase (FAS), phosphatidate phosphohydrolase (PAP) and HMG-CoA reductase activities compared to the HFC group. The plasma HDL-cholesterol concentration was significantly higher in CD-N and N groups than in HF and PC groups. These results indicate that both CD-naringin and naringin supplementation effectively improved plasma and hepatic lipid metabolism without differences between CD-N and naringin groups.

Effects of Elastic Band-Resistive Exercise using Audio-visual Medium on Pain, Proprioceptive Sense, and Motor Function in Adult Females with Chronic Neck and Shoulder Pain (만성 목-어깨 통증이 있는 여성 성인에게 시청각 매체를 활용한 탄력밴드 저항운동이 통증, 고유수용성 감각과 운동기능에 미치는 영향)

  • Nam Gi Lee;Jeong-Woo Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.33-45
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    • 2024
  • Background: This study aimed to investigate the effect of elastic band-resistive exercise using audio-visual medium on pain, proprioception, and motor function in adults with chronic neck and shoulder pain. Design: One group pretest-posttest follow-up experimental design. Method: Twenty adult women with neck and shoulder pain voluntarily participated in this study. Elastic band-resistive exercise using audio-visual medium including cervical flexion and extension, shoulder external rotation, and scapular retraction-protraction motions was conducted 5 times a week for 3 weeks. The Numerical Rating Scale, pressure threshold tool, CROM goniometer, and Image J software were used to assess subjective pain level, tenderness threshold (pain), joint position sense error (proprioception), joint range of motion, and postural alignment (motor function), respectively. Result:: The pain intensity and threshold and joint position sense error showed significant decreases after the intervention, whereas the joint range of motion angle revealed significant increases. The postural alignment including forward head posture and rounded shoulder revealed significant improvements after the intervention. Conclusions: Therefore, we suggest that elastic band-resistive exercise through audio-visual medium would be helpful in preventing and managing pain and physical dysfunction in individuals with chronic neck and shoulder pain, and then it would support the development of health management-related online education content.

Effects of Resistance Exercise with Elasticity of Tubes on the Gait, Balance and Strength in the Elderly of the Daycare center (고무로프의 탄성을 이용한 저항성운동이 노인의 보행능력, 균형능력 및 근력 향상에 미치는 영향 -주간보호센터 노인을 대상으로)

  • Um, Hyemi;Si, Joo Wun;Lee, Hyun Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.102-110
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    • 2019
  • This study is for the elderly with mental and physical dysfunction, developing resistance exercise program using tube elasticity, and analysing the effects of this movement on the improvement of gait ability, balance ability and muscle strength of the elderly. After a 12-week program for 58 participants of the daycare center, dependent t-test was performed. As a result, the total participants showed average improvement in gait, balancing and hand grip strength. This means a lot in terms of improving one's ability of ADL(Activities of daily living) and reducing the risk of falling. Therefore, if the program expands and activates the target as an entire elderly, it is expected to be a preventative way to prevent healthy elderly people from moving to the frailty who need treatment and to delay the deterioration of the frailty with disabilities.

Case of a Change in the Polysomnograpy Results after Using Continuous Positive Airway Pressure in a Patient with Obstructive Sleep Apnea (폐쇄성 수면 무호흡 환자의 지속적 양압기 사용 후 재검사시 수면다원검사 결과의 변화)

  • Kim, Dae Jin;Mun, Sue Jean;Choi, Jeong Su;Lee, Min Woo;Cho, Jae Wook
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.119-123
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    • 2019
  • Obstructive sleep apnea (OSA) is a sleep disorder with no breathing symptoms due to repetitive upper airway resistance. OSA is a disease that can have significant effects on the cerebral cardiovascular system. Active treatment is needed to prevent these complications. The use of continuous positive airway pressure (CPAP), the standard therapy of OSA, has comparative therapeutic effects. On the other hand, there is no comparison report of the polysomnography (PSG) results before and after CPAP therapy without using a mask. This paper reports a patient who was diagnosed as OSA and used CPAP every night for more than 2 years. The patient showed a decrease in the apnea-hypopnea index from 64.7/h to 12.9/h. In addition, other sleep-related indicators improved significantly. The daily use of CPAP as a treatment for OSA for more than 2 years may improve the PSG results. Constant follow up of PSG will be needed to adjust the appropriate CPAP pressure to patients because there might be a change in the Apnea-Hypopnea Index and other sleep-related indicators for constant CPAP users for at least 2 years.

Phenotype Changes in Immune Cell Activation in Obesity (비만 환경 내 면역세포 활성화 표현형의 변화)

  • Ju-Hwi Park;Ju-Ock Nam
    • Journal of Life Science
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    • v.33 no.3
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    • pp.295-303
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    • 2023
  • Immune and metabolic systems are important factors in maintaining homeostasis. Immune response and metabolic regulation are highly associated, so, when the normal metabolism is disturbed, the immune response changed followed the metabolic diseases occur. Likewise, obesity is highly related to immune response. Obesity, which is caused by an imbalance in energy metabolism, is associated with metabolic diseases, such as insulin resistance, type 2 diabetes, fatty liver diseases, atherosclerosis and hypertension. As known, obesity is characterized in chronic low-grade inflammation. In obesity, the microenvironment of immune cells became inflammatory by the unique activation phenotypes of immune cells such as macrophage, natural killer cell, T cell. Also, the immune cells interact each other in cellular or cytokine mechanisms, which intensify the obesity-induced inflammatory response. This phenomenon suggests the possibility of regulating the activation of immune cells as a pharmacological therapeutic strategy for obesity in addition to the common pharmacological treatment of obesity which is aimed at inhibiting enzymes such as pancreatic lipase and α-amylase or inhibiting differentiation of preadipocytes. In this review, we summarize the activation phenotypes of macrophage, natural killer cell and T cell, and their aspects in obesity. We also summarize the pharmacological substances that alleviates obesity by regulating the activation of immune cells.

Etiologies of Bacterial Pneumonia with Implications for Therapy (세균성 폐렴의 원인균과 그 치료)

  • Woo, Jun-Hee;Lee, Jae-Seok;Kwon, Kwang-Ho;Kim, Kyung-Ho;Choi, Chang-Hyun;Park, Choon-Sik;Lee, Wee-Gyo;Choi, Tae-Youn
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.67-75
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    • 1995
  • Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

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New Technique for the Reconstruction of Both Anteromedial & Posterolateral Bundles of ACL (전방십자인대의 전내측 다발 및 후외측 다발을 각각 재건하는 새로운 수술 수기)

  • Ha Chul-Won;Awe Soo-Ik
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.195-199
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    • 2002
  • This article is to report a new technique for reconstruction of the anteromedial and posterolateral bundles of anterior cruciate ligament by separate tensioning and fixation of the each bundle. Method : Tibial and femoral tunnels were made with conventional technique of anterior cruciate ligament reconstruction. Tibial tunnel was enlarged $5\~7$ mm in anterior-posterior direction to make oval it in cross section. When preparing the Achilles tendon allograft, bone plug portion was trimmed as the conventional technique. The tendinous portion was trimmed as two separate bundles by dividing the tendinous portion longitudinally, so the graft is shaped like 'Y'. The bone plug portion of allograft was inserted into the femoral tunnel and fixed with absorbable cross pins. Two ligamentous portionss of the distal part of the grafts were tensioned separately at the external orifice. Anteromedial bundle was fastened under maximum tension with the knee flexed 90 degrees by post-tie method. The posterolateral bundle was fixed by the same technique with the knee in full extension. Then, an absorbable interference screw was inserted between the two bundles upto the upper end of the tibial tunnel, to get more initial rigidity of the reconstructed graft as well as to locate the two bundles in more anatomic position.

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Inhibitory Effects on the Enzymes Involved in the Inflammation by the Ethanol Extracts of Plant Foodstuffs (식물성 일반식품 자원의 에탄올 추출물이 염증 효소계에 미치는 영향)

  • Kwon, Eun-Sook;Kim, Il-Rang;Kwon, Hoon-Jeong
    • Korean Journal of Food Science and Technology
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    • v.39 no.3
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    • pp.348-352
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    • 2007
  • Inflammation is a complex process resulting from a variety of mechanisms. Combined inhibition of the activities of enzymes involved in the process may therefore be considered more important in anti-inflammatory property of plant extracts than any single contribution. In this study, the inhibitory effects of the ethanol extracts of thirty plant foods on the activities of secretory phospholipase $A_{2}$ ($sPLA_{2}$), cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and 12-lipoxygenase (12-LOX) were examined. Several legumes, mungbean sprout and some leaf vegetables inhibited the activity of $sPLA_2$, upstream enzyme of inflammation pathway. Only soybean sprout and mungbean sprout significantly inhibited 12-LOX activity. Although most of extracts inhibited the activities of both COX-1 and COX-2, water dropwort and amaranth showed selectivity for the inhibition of COX-2 over COX-1. Especially, mungbean showed anti-inflammatory property at both upstream and downstream of inflammation pathway with relatively low $IC_{50}$ values for $sPLA_{2}$ and COX-2 enzymes. Mungbean sprout exhibited inhibitory effects on all enzymes related to early and late inflammation and soybean sprout suppressed 12-LOX and COX-2 simultaneously, although the activities of these plants were showed at relatively high concentration. Therefore, mungbean, mungbean sprout, and soybean sprout appear to exhibit anti-inflammatory effects by combined inhibition of inflammatory enzymes.

Influence Factors for Duration of Vancomycin Resistant Enterococci's Spontaneous Decolonization (반코마이신 저항 장구균의 자발적 집락 소실 기간에 대한 영향 인자)

  • Lee, Jae Sun;Kim, Dong Soo;Kim, Ki Hwan
    • Pediatric Infection and Vaccine
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    • v.22 no.1
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    • pp.16-22
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    • 2015
  • Purpose: The aim of this study was to identify the factors influencing the spontaneous decolonization period of vancomycin resistant enterococcus (VRE) species in pediatric patients. Methods: The medical records of patients presenting positive VRE cultures between January 2005 and November 2010 at a tertiary hospital in Seoul, Korea, were reviewed retrospectively. The subjects were divided into two groups according to the average number of days for decolonization (325 days). Clinical characteristics were compared between shorter VRE colonization patients (<325 days, n=41) and prolonged VRE colonization patients (>325 days, n=110). Results: There were 151 patients who had more than 1 year of follow up period or confirmed of VRE decolonization among patients who were identified with VRE. The average age at the time of initial VRE colonization was significantly younger in shorter decolonization group than in prolonged decolonization group (44.9 months vs 40.9 months, P =0.040). The prolonged decolonization group received more vancomycin treatments after VRE colonization in comparison with patients in shorter decolonization group (7.0% vs 27.2%, P =0.008). Conclusion: For the duration of VRE colonization, it was found that the initial age of acquiring VRE and use of antibiotics were important factors. Antibiotics should be used properly and precisely in order to treat infectious diseases and to control the colonization of antibiotic resistant bacteria.