• Title/Summary/Keyword: Acute effects

검색결과 2,279건 처리시간 0.032초

Changing Gadolinium-Based Contrast Agents to Prevent Recurrent Acute Adverse Drug Reactions: 6-Year Cohort Study Using Propensity Score Matching

  • Min Woo Han;Chong Hyun Suh;Pyeong Hwa Kim;Seonok Kim;Ah Young Kim;Kyung-Hyun Do;Jeong Hyun Lee;Dong-Il Gwon;Ah Young Jung;Choong Wook Lee
    • Korean Journal of Radiology
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    • 제25권9호
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    • pp.824-832
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    • 2024
  • Objective: To determine the preventive effect of changing gadolinium-based contrast agents (GBCAs) to reduce the recurrence of GBCA-associated acute adverse drug reactions (ADRs). Materials and Methods: This retrospective, observational, single-center study-conducted between January 2016 and December 2021-included 238743 consecutive GBCA-enhanced MRI examinations. We focused on a subgroup of patients who experienced acute GBCA-associated ADRs during any of these examinations and subsequently underwent follow-up GBCA-enhanced MRI examinations up until July 2023. The follow-up examinations involved either the same (non-change group) or different (change group) GBCAs compared to the ones that initially caused the acute ADR. Baseline participant characteristics, generic profile of the GBCAs, administration of premedication, history of prior ADR to iodinated contrast media, and symptoms of GBCA-associated acute ADRs were retrospectively analyzed. Multivariable logistic regression with generalized estimating equations and propensity score matching were used. Results: A total of 1042 instances of acute ADRs (0.44%; 95% confidence interval [CI]: 0.41%-0.46%) were reported. Three-hundred and seventy-three patients underwent GBCA-enhanced MRI examinations after experiencing GBCA-associated acute ADRs within the study period; 31.9% (119/373) reexperienced acute ADRs at any of the follow-up examinations. The ADR recurrence was significantly lower in the GBCA change group than in the non-change group according to multivariable logistic regression (adjusted odds ratio [OR]: 0.35; 95% CI: 0.13-0.90; P = 0.03) and analysis with propensity score matching (14.3% [6/42] vs. 36.9% [31/84], respectively; OR: 0.32, 95% CI: 0.11-0.94; P = 0.04). A history of an ADR to iodinated contrast media (OR: 1.14, 95% CI: 0.68-1.90; P = 0.62) and premedication (adjusted OR: 2.09, 95% CI: 0.93-4.68; P = 0.07) were not significantly associated with GBCA-associated acute ADR recurrence. A separate analysis for recurrent allergic-like hypersensitivity reactions demonstrated similar results (adjusted OR: 0.20, 95% CI: 0.06-0.65; P < 0.01). Conclusion: Changing GBCAs may reduce the risk of GBCA-associated acute ADR recurrence.

Glycerol-유도 급성신부전에서 표피성장인자 발현 및 조직학적 변화에 관한 스쿠알렌의 효과 (Effects of Squalene on The Epidermal Growth Factor (EGF) Expression and Histological Changes by Glycerol-Induced Acute Renal Failure in Mice)

  • 최영복;김영호;이준행;김종세
    • Applied Microscopy
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    • 제34권4호
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    • pp.241-254
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    • 2004
  • 신장은 독성물질, 빈혈, 재관류-유도 상해, 급성신부전에 회복 기능을 가지고 있다. 뇨 표피성장인자(EGF)는 신장 사구체연접장치에서 생산된다. 신장은 EGF를 축적하거나 배설한다. 신장 질환의 경우에는 EGF 배설이 감소한다. 본 연구에서는 glycerol-유도 급성신부전에서 스쿠알렌의 효과를 연구하였다. In vitro에서 RT-PCR를 통해 EGF 발현을 관찰하였다. 근위세뇨관 세포를 분리한 후, glycerol (1, 2, 4 mM) 혹은 스쿠알렌(0.1, 0.05 or 0.1%)을 첨가하였다. In vivo에서 BUN, creatine, 조직학적 변화를 관찰하였다. 실험군은 다음과 같다. 실험군 1은 정상군, 실험군 2는 glycerol (50%, 8 ml/kg) 처치 후, 스쿠알렌을 처치하지 않은 군, 실험군 3은 glycerol (50%, 8 ml/kg) 처치 후, 스쿠알렌(180 mg/kg)을 함께 처치한 군으로 각 실험군 당 생쥐 7마리를 사용하였다. 실험 결과, glycerol이 신장에 손상을 주어 EGF mRNA 발현이 감소됨을 확인할 수 있었다. 그러나, 스쿠알렌을 처치한 군에서는 EGF mRNA 발현이 증가함을 관찰할 수 있었다. 또한, BUN과 creatine 수치의 빠른 회복이 관찰되었다(P<0.01). 조직학적 관찰에서도 실험군 2는 사립체의 심한 손상이 관찰되었는데, 실험군 3의 경우 사립체의 빠른 회복이 관찰되었다. 결론적으로, 스쿠알렌이 glycerol-유도 급성신부전에 회복 효과가 있을 것으로 사료된다.

방사선피폭 후 급성조혈계증후군에 대한 Melatonin과 Ge-132의 효과 (The Effects of Melatonin and Ge-132 on Acute Hematopoietic Syndrome following Radiation Exposure)

  • 장성순
    • Journal of Radiation Protection and Research
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    • 제29권4호
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    • pp.237-242
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    • 2004
  • 방사선피폭 후 급성조혈계 손상에 대한 Melatonin과 Ge-132의 방어효과를 8 Gy의 선량으로 급성, 전신피폭 된 마우스에서 연구하였다. Melatonin은 피폭 1시간 전에 200 mg/kg의 용량으로 복강 내 주사하였고, Ge-132는 130 - 150 mg/kg/d의 용량으로 피폭 후 5일째부터 20일째까지 경구복용 시켰다. 방사선방어 효과를 평가하기 위해 비장에서 TUNEL assay를 실시하였고 혈액 내 림프구와 총 백혈구 수치를 측정하였다. 피폭 후 30일째까지의 생존분석을 위해 4 실험군들 (피폭단독군, melatonin 전처치군, Ge-132 후처치군, melatonin 전처치 및 Ge-132 후처치군)에서 날짜경과에 따른 사망을 측정하였다. 피폭단독군과 melatonin 전처치군 간에 세포고사지수 (47.8% vs 45.9%, p=0.385)와 림프구 수치 ($97/{\mu}{\ell}\;vs\;101/{\mu}{\ell}$, p=0.898)에서 차이가 없었으나, 총 백혈구 수치는 melatonin 전처치군에서 유의하게 높은 수치 ($147/{\mu}{\ell}\;vs\;306/{\mu}{\ell}$, p=0.010)를 보였다. 피폭 후 30일째의 생존율은 피폭단독군, melatonin 전처치군, Ge-132 후처치군, 그리고 melatonin 전처치 및 Ge-132 후처치군에서 각각 21.4%, 100%, 35.7%, 그리고 85.7%였다. 실험군들 간의 생존분석에서 melatonin 전처치 군은 피폭단독군(p=0.000)이나 Ge-132 후처치군(p=0.0003)에 유의하게 높은 생존을 보였다. 본 연구결과는 방사선피폭 후 급성조혈계증후군에 대하여 melatonin이 방사선방어제로서 효능을 지님을 보여주고 있다.

내관혈(內關穴) 자침(刺鍼)이 급성 역류성 식도염 백서(白鼠)에 미치는 영향 (Inhibitory Effects of Naegwan-acupuncture($PC_6$) on Acute Reflux Esophagitis Rat)

  • 최이정;정태영;임성철
    • Journal of Acupuncture Research
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    • 제30권2호
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    • pp.31-41
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    • 2013
  • Objectives : This study was to evaluate inhibitory effects of Naegwan-acupuncture($PC_6$) on acute RE(reflux esophigitis) rat induced by pylorus and forestomach ligation operation. Methods : Twenty seven SD rats were divided three groups (intact normal rat; RE control rat; RE control rat respectively stimulated by Naegwan point($PC_6$)). All rats was fasted for 18 h but free water, we induced RE by pylorus and forestomach ligation operation. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, dissected a esophagus and stomach. The stomach was washed a 1 ml PBS to research gastric volume, pH, acidity and mucin release of gastric juice, esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. The proinflammatory cytokine and chemokine including IFN-${\gamma}$, TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 were analyzed by ELISA kit. Results : 1. Significantly, death rate of $PC_6$ acupuncture rat group was decreased compared to that of RE control group. 2. Gastric Volume, gastric injury and esophageal mucosa demage were decreased significantly, too. 3. Compared with RE, all of the proinflammatory cytokine and chemokine analyzed in serum of $PC_6$ were decreased remarkably. Especially, there were significant meanings TNF-${\alpha}$, IL-6 and MCP-1 in serum of $PC_6$ were decreased. Conclusion : The results suggest that antiinflammatory and protecting effects of PC6 could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

서울지역 미세먼지 농도가 호흡기계 및 심혈관계의 외래 방문 및 입원과 진료비에 미치는 영향 (Hospital Visits, Admissions and Hospital Costs among Patients with Respiratory and Cardiovascular Diseases according to Particulate Matter in Seoul)

  • 이형숙
    • 한국환경보건학회지
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    • 제42권5호
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    • pp.324-332
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    • 2016
  • Objectives: The annual average of PM10 in Seoul was $45{\mu}/m^3$, which surpasses the WHO annual guidelines ($20{\mu}/m^3$). Most previous analyses of the effects of PM exposure have been retrospective studies using single hospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This study was conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospital costs in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 from National Institute of Environmental Research were used to identify the effects of PM10 on hospital visits, admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per $10{\mu}/m^3$ increase in PM10 were 23.11%, 10.2% and 6.9% increases for acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per $10{\mu}/m^3$ increase in PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis, respectively. For cardiovascular disease, the relative risk for admissions per $10{\mu}/m^3$ increase in PM10 were 2.2% and 2.1% increases in angina and acute myocardial infarction, respectively. A $10{\mu}/m^3$ increase in the monthly average of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won (95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increases in hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.

화학사고 후 주민복귀 및 피해복구 시점 결정을 위한 인체지표 개발 (Development of Human Indices to Determine Both Returning Point of Residents and Damage Restoration after the Chemical Accident)

  • 양준용;허정무;이현석;이준상;조용성;김호현;박상희
    • 한국환경보건학회지
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    • 제46권5호
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    • pp.588-598
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    • 2020
  • Objectives: Human indices were developed to determine returning point of residents and damage restoration after the chemical accident Methods: To determine the returning point of residents after the chemical accident, a new concept, the standard man model was introduced as a human index, in which both H-code and its acute effects were main idea. To evaluate the applicability, a hydrogen fluoride leakage accident in Gumi was applied. The returning point were suggested as the conservative remission period of acute effects among relevant hazard effects and compared with actual returning point. The coverage of each age group were considered with reflecting average daily dose expected for actual residents. In addition, a relief-index as a social-scientific approach was reflected as well to apply the damage restoration Results: Actual returning point of residents in Gumi was 88 days; and that of standard man model suggested was 84 days. The expected amount of exposure at aged 12 or under was at least 2.35 times greater than that of this model, 40s, theoretically. However, their population ratio was less than 1%, so 99% of residents could be applied when the standard man model was applied. The relief-index was as an objective and quantitative methodology to apply the qualitative aspect. Conclusions: Although evaluated as a relatively positive result, there was a limitation such as the number of accident applied to the verification of standard man model. The relief index was also considered, but further research should be carried out to find threshold level for the relief.

모니터기반 가상현실게임을 이용한 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대한 사전연구: 이중 맹검 무작위 대조 시험 연구 (A Preliminary Study of the Effects of Monitor-Based Virtual Reality Games on the Cognition & Activities of Daily Living for Acute Stroke : A Double-blind Randomized Controled Trial)

  • 최봉근;권재성
    • 한국콘텐츠학회논문지
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    • 제20권9호
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    • pp.531-540
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    • 2020
  • 본 연구의 목적은 4주 동안 모니터기반 가상현실게임 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대해 알아보기 위함이었다. 본 연구는 급성기 뇌졸중 환자 19명이 참여하였다. 모니터기반 가상현실 게임중재와 전산화 인지중재의 효과성을 비교하기 위하여, 두 집단에 1일 30분, 주 5회, 총 4주 중재하였고, 효과에 대한 측정은 TMT A & B, DST, RKMT, K-MBI를 중재 전과 후에 실시하였다. 실험군에서는 모든 변수에 대해 유의미한 향상을 보였으나, 대조군에서는 TMT A와 DST을 제외한 항목에서만 유의미한 향상을 보였다. 본 연구를 통하여, 가상현실게임 중재가 뇌졸중 환자의 인지 기능과 일상생활활동에 효과적인 치료로 적용될 가능성을 확인하였다. 또한 모니터기반 가상현실게임 중재가 인지중재를 필요로 하는 환자들에게 임상에 있는 작업치료사들이 유용하게 사용될 수 있을 것이라 사료된다.