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The Efficacy of Nebulized 3 Percent Hypertonic Saline Solution and Fenoterol in Infants with Bronchiolitis (영아 세기관지염에서 3% 고장성 식염액과 Fenoterol 병용흡입 치료의 효과)

  • Park, Joon Young;Jeong, Young Mi;Jeong, Soo Jin;Seo, Son Sang
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.518-522
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    • 2005
  • Purpose : To evaluate the effect of inhaled hypertonic saline solution in hospitalized infants with bronchiolitis. Methods : A randomized double blind trial was performed from October 2003 to May 2004. A total of eighty patients <1 year of age with a clinical diagnosis of acute viral bronchiolitis were enrolled and assigned to receive either of the following : inhalation of 2 mL(0.5 mg) fenoterol added to 2 mL of 0.9 percent saline solution(group 1; n=40) or 2 mL(0.5 mg) fenoterol added to 2 mL of 3 percent saline solution(group 2; n=40). This therapy was repeated at six hours interval after admission. They were evaluated daily just before and 20 minutes after nebulization. The outcome measures included changes in clinical severity score(based on respiratory rate, presence of wheezing, retraction, and general condition) after nebulization and duration of hospitalization. Results : In the clinical severity score, a significant improvement was observed during the 72 hours of hospitalization in both groups(P<0.05). The basic clinical severity scores before inhalation were decreased significantly faster in group 2 as compared to group 1 on each day of treatment(P<0.05). The mean duration of hospital stay was significantly reduced in group 2 than group 1($5.9{\pm}1.9days$ versus $7.4{\pm}2.0days$, P<0.05). No adverse effects were associated with inhaled therapy. Conclusion : These results suggest that a nebulized 3 percent saline solution plus 0.5 mg fenoterol may be more effective than a 0.9 percent saline solution plus 0.5 mg fenoterol in accelerating the clinical recovery of infants with viral bronchiolitis.

Cause of enteroviral infection in children in chungnam area summer, 2005 (2005년 하절기에 충남지역 소아에서의 장바이러스 감염원인)

  • Jeon, Se Yun;Choi, Suk Joo;Kim, Yong Bae;Nam, Hae Seon;Park, Kwi Sung;Baek, Kyung Ah;Park, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1186-1193
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    • 2006
  • Purpose : Enterovirus infection is a type of viral infection that occurs relatively frequently in children during summer. It has clinical symptoms of non-specific fever, aseptic encephalomeningitis, gastrointestinal diseases, skin rash and, hand-foot-mouth disease. However, it can also occcaisionally, result in fatal symptoms like myocarditis, epicardial inflammation, transverse myelitis, quadriplegia and etc. There have been epidemic enterovirus studies, but not in the Chungnam area. Therefore, we undertook this study in order to comprehend the cause viruses in this area. Methods: We enlisted 157 children hospitalized with enteroviral infections at Soonchunhyang University hospital in Cheonan between May and August 2005. Cerebrospinal fluids or feces were collected during the acute phase after hospitalization, and observed the cytopathic effects caused by enterovirus and using reverse transcription polymerase chain reaction (RT-PCR). Results : The number of children hospitalized due to possible enteroviral infection during the period of study was 157. The number of children who tested positive with the reverse transcription polymerase chain reaction totalled 32 cases (20.4 percent). Among the children with entroviral diseases, 20 were male and 12 were female, thus the sex ratio of male to female was 1.67:1. Their clinical symptoms included fever most frequently (93.7 percent), was followed by headaches (90.0 percent), meningeal irritation signs (65.0 percent), and abdominal pain (30.0 percent). As for the type of isolated enterovirus, there were 17 cases of echovirus 18 and 6 cases of coxsackievirus B5. Furthermore, there were 2 cases of echovirus 9, 1 case of coxsackievirus A6 and coxsackievirus B3, respectively. But 5 cases were not determined by genotype. Conclusion : Echovirus 18 is circulating in Korea. We reported on identified enteroviruses, including echovirus 18, using RT-PCR in the Chungnam area during the summer of 2005.

High Dose Rate Interstitial Brachytherapy in Soft Tissue Sarcomas : Technical Aspect (연부조직종양에서 고선량율 조직내 방사선치료: 기술적 측면에서의 고찰)

  • Chun Mison;Kang Seunghee;Kim Byoung-Suck;Oh Young-Taek
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.43-51
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    • 1999
  • Purpose : To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy Materials and Methods : Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1 ~l.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery, Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. Results : All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOGIEORTC grade 3 or 4). Conclusion : The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.

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Treatment Outcome of Postoperative Radiotherapy in Extrahepatic Bile Duct Cancer (간외담관암의 수술 후 방사선치료 성적)

  • Choi, Young-Min;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.27-34
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    • 2003
  • Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.

A BIOCHEMICAL INVESTIGATION OF THE ROLE OF $IL-1{\beta}$ UPON INFlAMMATION IN MOUSE (마우스에서 $IL-1{\beta}$가 염증의 발현에 미치는 영향에 관한 연구)

  • Yoon, Duk-Sang;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.28 no.4 s.69
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    • pp.611-626
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    • 1998
  • Cytokines are intercellular peptide mediators that regulate homeostasis and host defense reactions in living body. Of the diversity of cytokines in terms of biological accomplishment, interleukin $1-{\beta}$($IL-1{\beta}$) and tumor necrosis factor(TNF) are the most conspicuous cytokines with a wide variety of effects on cells involved in inflammatory and immune responses, and likely to be involved in the inflammatory pathogenesis of oral tissue as well. The present study was designed to explicate the role of $IL-1{\beta}$ on inflammatory revelation of oral tissues in mice biochemically. In the Induced arthritis by injection of 10${\mu}g$ LPS shown the relaese of 0.93 ${\mu}g$ $IL-1{\beta}$/joint with a peak at at 4-5 h. and diminished at 24t and the release of $TNF_{\alpha}$ of 1.25 ${\mu}g$/joint with a peak at 2-3h and diminished at 6h. After injection of th $IL-1{\beta}$ into the joint, the mumber of leucocytes proliferated with a peak at 4-5h and diminished at 36h and the loss of proteoglycan showed with maximum at 15-30h. After injection of $IL-1{\beta}$ into the oral tissue, cycloosygenase metabolites ($PGE_2$) accumulated in the oral tissue with dose dependant. These elucidated $IL-1{\beta}$ to be inflammatory mediator in the early phase of its pathogenesis. Intraoral injection of recombinant $IL-1{\beta}$ induced the proliferation of leukocytes in situ. $IL-1{\beta}$ took an pertinent part in the development of inflammation and the succession of cellular infiltration. The results exemplify that $IL-1{\beta}$ plays a significant role in mediating inflammatory response induced by LPS in oral tissue, the inflammatory response is regulated by $IL-1{\beta}$ at an acute phase of pathogenesis.

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Combination Treatment with Arsenic Trioxide and Sulindac Induces Apoptosis of NCI-H157 Human Lung Carcinoma Cells via ROS Generation with Mitochondrial Dysfunction (NCI-H157 폐암 세포주에서 활성산소종의 생성과 미토콘드리아 기능변화를 한 Arsenic Trioxide와 Sulindac 병합요법의 세포고사효과)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.30-38
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    • 2005
  • Background : Arsenic trioxide ($As_2O_3$) has been used to treat acute promyelocytic leukemia, and it induces apoptosis in a variety of solid tumor cell lines including non-small cell lung cancer cells. However, nonsteroidal antiinflammatory drugs (NSAID) can enhance tumor response to chemotherapeutic drugs or radiation. It was previously demonstrated that a combination treatment with $As_2O_3$ and sulindac induces the apoptosis of NCI-H157 human lung carcinoma cells by activating the caspase cascade. This study aimed to determine if a combination treatment augmented its apoptotic potential through other pathways except for the activation of the caspase cascade. Material and Methods : The NCI-H157 cells were treated with $As_2O_3$, sulindac and antioxidants such as glutathione (GSH) and N-acetylcysteine (NAC). The cell viability was measured by a MTT assay, and the level of intracellular hydrogen peroxide ($H_2O_2$) generation was monitored fluorimetrically using a scopoletin-horse radish peroxidase (HRP) assay. Western blotting and mitochondrial membrane potential transition analysis were performed in order to define the mechanical basis of apoptosis. Results : The viability of the cells was decreased by a combination treatment of $As_2O_3$ and sulindac, and the cells were protected using antioxidants in a dose-dependent manner. The increased $H_2O_2$ generation by the combination treatment was inhibited by antioxidants. The combination treatment induced changes in the mitochondrial transmembrane potential as well as the expression of the Bcl-2 family proteins, and increased cytochrome c release into the cytosol. However, the antioxidants inhibited the effects of the combination treatment. Conclusion : Combination treatment with $As_2O_3$ and sulindac induces apoptosis in NCI-H157 human lung carcinoma cells via ROS generation with a mitochondrial dysfunction.

Effects of Cyclosporin A, FK506, and 3-Deazaadenosine on Acute Graft-versus-host Disease and Survival in Allogeneic Murine Hematopoietic Stem Cell Transplantation (마우스 동종 조혈모세포 이식모델에서 Cyclosporin A, FK506, 3-Deazaadenosine 등의 약제가 급성 이식편대 숙주병과 생존에 미치는 영향)

  • Jin, Jong Youl;Jeong, Dae Chul;Eom, Hyeon Seok;Chung, Nak Gyun;Park, Soo Jeong;Choi, Byung Ock;Min, Woo Sung;Kim, Hack Ki;Kim, Chun Choo;Han, Chi Wha
    • IMMUNE NETWORK
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    • v.3 no.2
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    • pp.150-155
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    • 2003
  • Background: We investigated the effect of donor marrow T cell depletion, administration of FK506, cyclosporin A (CSA), and 3-deazaadenosine (DZA) on graft versus host disease (GVHD) after allogeneic murine hematopoietic stem cell transplantation (HSCT). Methods: We used 4 to 6 week old Balb/c ($H-2^d$, recipient), and C3H/He ($H-2^k$, donor) mice. Total body irradiated recipients received $1{\times}10^7$ bone marrow cells (BM) and $0.5{\times}10^7$ splenocytes of donor under FK506 (36 mg/kg/day), CSA (5 mg/kg/day, 20 mg/kg/day), and DZA (45 mg/kg/day), which were injected intraperitoneally from day 1 to day 14 daily and then three times a week for another 2 weeks. To prevent the GVHD, irradiated Balb/c mice were transplanted with $1{\times}10^7$ rotor-off (R/O) cells of donor BM. The severity of GVHD was assessed daily by clinical scoring method. Results: All experimental groups were well grafted after HSCT. Mice in experimental group showed higher GVHD score and more rapid progression of GVHD than the mice with R/O cells (R/O group) (p<0.01). There were relatively low GVHD scores and slow progressions in FK506 and low dose CSAgroups than high dose CSA group (p<0.01). The survival was better in FK506 group than low dose CSA group. All mice treated with CSA died within 12 days after HSCT. The GVHD score in DZA group was low and slow in comparison with control group (p<0.05), but severity and progression were similar with low dose CSA group (p=0.11). All mice without immunosuppressive treatment died within 8 days, but all survived in R/O group (p<0.01). Survival in low dose CSA group was longer than in control group (p<0.05), but in high dose CSA group, survival was similar to control group. The survival benefit in DZA group was similar with low dose CSA group. FK506 group has the best survival benefit than other groups (p<0.01), comparable with R/O group (p=0.18), although probability of survival was 60%. Conclusion: We developed lethal GVHD model after allogeneic murine HSCT. In this model, immunosuppressive agents showed survival benefits in prevention of GVHD. DZA showed similar survival benefits to low dose CSA. We propose that DZA can be used as a new immunosuppressive agent to prevent GVHD after allogeneic HSCT.

Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

A Study on their Health Promotion Behavior Influenced by Primary School Students' Self-concept (초등학생의 자아개념이 건강증진행위에 미치는 영향)

  • Lee, Deog-Weon;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.1 no.2
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    • pp.29-48
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    • 2000
  • This study was designed to diagnose the correlations between health promotion behavior and primary school students' demographic characteristics and their self-concept, and also this study was aimed at representing the basic data of proper instruction method and school health program with the respective to primary school students' health promotion behavior through the above things. For this, author selected as 5th, 6th graders, 400 persons at 5 elementary schools located on Kyonggi province. This data utilized ANOVA, multiple regression analysis and correlation analysis by SPSS program. The findings of this study were as follows; First, there showed meaningful differences concerning their health promotion behavior according to students' demographic traits. There were a birth date, living standard, domestic environments etc. as a factors which influenced on their health promotion behavior. With this, from ex-past-facto verification for these variable factors, as their birth date was faster, living standard was higher, domestic environments was better, as their health promotion behavior was more promotive. Second, students' health promotion behavior marked 3.61 among total 5 paint with the respective to its fulfillment degree, their self-concept marked 3.45 among total 5 paint. Their mental health promotion behavior marked 3.71 with the respective to inferior category of health promotion behavior, which was the highest score. In the other hands, their physical health promotion behavior marked 3.71, social health promotion behavior marked 3.45. contrary the disease prevention, first-aid & safety, oral health, health & nutrition(P>.05). Third, there show meaningful difference, in the level of p-value <.001 with the respective to the correlations between primary school students' health promotion behavior and their self-concept, more their self-concept was positive, more their more their whole health promotion behavior(r=.479), the fulfillment degree of physical health promotion behavior(r=.384), mental health promotion behavior(r=.543), social health promotion behavior(r=.372) were high. Fourth, with the respective to the results of difference verification concerning their fulfillment degree of health promotion behavior according to the upper, middle, inferior group of self-concept, there showed statistically meaningful difference, in the level of p-value<.001. In the long run, more their self-concept was positive, more their whole health promotion behavior was high. With this, from the results of $Scheff\acute{e}$ verification, there showed meaning differences among the upper and middle group, upper and inferior group, middle and inferior group. Fifth, self-concept played the role as the most important prognostic factor with the respective to primary school students' health promotion behavior(23.0%), in the other hands, there showed positive weight of 24.0% concerning the fulfillment of whole health promotion behavior by domestic environments(1.0%). From the above results, primary school students' the fulfillment degree of health promotion behavior didn't reach to middle or inferior level. In the other hands, there showed positive effects in the correlations between self-concept and the fulfillment degree of health promotion behavior, and also high self-concept group was much positive considering inferior group in the fulfillment degree of health promotion behavior. Accordingly, more their self-concept was positive, more their fulfillment degree of health promotion behavior was effective. Eventually, in the future, there have to make an efforts to develope positive, substantial programs through their self-concept enhancement etc. in the adequate planning or operation for primary school students' health education and school health program.

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The Optimal Combination of Major Nutrients Computed by the Homés Systematic Variation Technique -III. Determination of the Optimal Combination of Σ Anion : Σ Cation and the Optimal Application Rate of Total Ions on the Various Grassland Soils (Homés방법(方法)에 의(依)한 다량요소(多量要素)의 적정(適正) 시비비율(施肥比率) 결정(決定)에 관한 연구 -III. 초지토양별(草地土壤別) 음(陰)이온 성분총량(成分總量) : 양(陽)이온 성분총량(成分總量) 적정(適正) 시비비율(施肥比率) 및 적정(適正) 총시비량(總施肥量))

  • Jung, Yeun-Kyu;Kim, Sang-Chul;Weinberger, P.
    • Korean Journal of Soil Science and Fertilizer
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    • v.15 no.3
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    • pp.178-187
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    • 1982
  • This pot experiment was undertaken to find out the optimum fertilization ratios of total anions to total cations, ${\Sigma}A/{\Sigma}C$, and the optimum application rates of total macro-nutrients in various soil conditions. Soil samples were collected from uncultivated mountains and hills where grassland development was under consideration. 1. The optimum application ratios of ${\Sigma}A/{\Sigma}C$ and the optimum application rates of total macro-nutrients for the high yields of mixed grass-clover sward in various grassland soils were computed by the Hom$\acute{e}$s systematic variation techniqu.e. 2. With respect to the optimum application ratios of ${\Sigma}A/{\Sigma}C$ in fertilization in a mixed grass-clover sward, the grass yield and botanical composition were distinctly proportional to ${\Sigma}A$ wheras the regume yield and botanical composition were proportional to ${\Sigma}C$. 3. The optimum fertilization rates of total macro-nutrients for the high legume yields were depended upon ${\Sigma}A/{\Sigma}C$ ratios. These optimum rates were in proportional to ${\Sigma}C$ ratios and were inversely proportional to ${\Sigma}A$ ratios. 4. The efficiencies of ${\Sigma}A$ and ${\Sigma}C$ in relation to the grass and grass plus legume yields were highest with the low ratios of each other and the low fertilization rates of total macronutrients. The ${\Sigma}A$ effieiency in the legume yield tended to be similar to that of ${\Sigma}A$ related to the grass yield noted above except Daegu soil. The ${\Sigma}C$ efficiency, however, was proportional to the ${\Sigma}C$ ratio, although that was varied with the fertilization rates of total macro-nutrients and with the kinds of soils. 5. The yield of mixed forages, yield component, and botanical composition in a mixed sward were greatly influenced by the ${\Sigma}A/{\Sigma}C$ ratios, the fertilization rates of total macronutrients, and the interactions of ratio and rate noted above. In addition, these effects were generally different and opposite according to grass and legume.

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