• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.357-362
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• 2014

Purpose: The incidence of Kawasaki disease (KD) is rare in young infants (less than 3 months of age), who present with only a few symptoms that fulfill the clinical diagnostic criteria. The diagnosis for KD can therefore be delayed, leading to a high risk of cardiac complications. We examined the clinical characteristics and measured the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels of these patients for assessing its value in the early detection of KD. Methods: We retrospectively reviewed the data of young infants diagnosed with KD from 2004 to 2012. The control group included 20 hospitalized febrile patients. Laboratory data, including NT-proBNP were obtained for each patient in both groups. Results: Incomplete KD was observed in 21/24 patients (87.5%). The mean fever duration on admission was $1.36{\pm}1.0$ days in the KD group. Common symptoms included erythema at the site of Bacille Calmette-Guerin inoculation (70.8%), skin rash (50.0%), changes of oropharyngeal mucosa (29.1%), and cervical lymphadenopathy (20.8%). The mean number of major diagnostic criteria fulfilled was $2.8{\pm}1.4$. Five KD patients (20.8%) had only one symptom matching these criteria. The incidence of coronary artery complications was 12.5%. The mean serum NT-proBNP level in the acute phase, in the KD and control groups, were $4,159{\pm}3,714pg/mL$ and $957{\pm}902pg/mL$, respectively, which decreased significantly in the convalescent phase. Conclusion: Incomplete KD was observed in 87.5% patients. Serum NT- proBNP might be a valuable biomarker for the early detection of KD in febrile infants aged <3 months.

• Toxicological Research
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• 제28권2호
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• pp.81-91
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• 2012

Many risk factors exist for chemotherapy-induced nausea and vomiting (CINV). This study utilized a multivariate projection technique to identify which risk factors were predictive of CINV in clinical practice. A single-centre, prospective, observational study was conducted from January 2007~July 2010 in Singapore. Patients were on highly (HECs) and moderately emetogenic chemotherapies with/without radiotherapy. Patient demographics and CINV risk factors were documented. Daily recording of CINV events was done using a standardized diary. Principal component (PC) analysis was performed to identify which risk factors could differentiate patients with and without CINV. A total of 710 patients were recruited. Majority were females (67%) and Chinese (84%). Five risk factors were potential CINV predictors: histories of alcohol drinking, chemotherapy-induced nausea, chemotherapy-induced vomiting, fatigue and gender. Period (ex-/current drinkers) and frequency of drinking (social/chronic drinkers) differentiated the CINV endpoints in patients on HECs and anthracycline-based, and XELOX regimens, respectively. Fatigue interference and severity were predictive of CINV in anthracycline-based populations, while the former was predictive in HEC and XELOX populations. PC analysis is a potential technique in analyzing clinical population data, and can provide clinicians with an insight as to what predictors to look out for in the clinical assessment of CINV. We hope that our results will increase the awareness among clinician-scientists regarding the usefulness of this technique in the analysis of clinical data, so that appropriate preventive measures can be taken to improve patients' quality of life.

• Annals of Clinical Neurophysiology
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• 제21권1호
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• pp.36-43
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• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.

• Clinical and Experimental Vaccine Research
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• 제12권2호
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• pp.143-155
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• 2023

Purpose: An association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been reported. We aimed to summarize the clinical features of GBS associated with SARS-CoV-2 vaccination and determine the contrasting features from coronavirus disease-19 (COVID-19) associated GBS and GBS following other causes. Materials and Methods: We performed PubMed search for articles published between 1 December 2020 and 27 January 2022 using search terms related to "SARS-CoV-2 vaccination" and "GBS". Reference searching of the eligible studies was performed. Sociodemographic and vaccination data, clinical and laboratory features, and outcomes were extracted. We compared these findings with post-COVID-19 GBS and International GBS Outcome Study (IGOS) (GBS from other causes) cohorts. Results: We included 100 patients in the analysis. Mean age was 56.88 years, and 53% were males. Six-eight received non-replicating virus vector and 30 took messenger RNA (mRNA) vaccines. The median interval between the vaccination and the GBS onset was 11 days. Limb weakness, facial palsy, sensory symptoms, dysautonomia, and respiratory insufficiency were seen in 78.65%, 53.3%, 77.4%, 23.5%, and 25%, respectively. The commonest clinical and electrodiagnostic subtype were sensory-motor variant (68%) and acute inflammatory demyelinating polyneuropathy (61.4%), respectively. And 43.9% had poor outcome (GBS outcome score ≥3). Pain was common with virus vector than mRNA vaccine, and the latter had severe disease at presentation (Hughes grade ≥3). Sensory phenomenon and facial weakness were common in vaccination cohort than post-COVID-19 and IGOS. Conclusion: There are distinct differences between GBS associated with SARS-CoV-2 vaccination and GBS due to other causes. Facial weakness and sensory symptoms were commonly seen in the former and outcomes poor.

• Journal of Korean Biological Nursing Science
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• 제4권2호
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• pp.51-58
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• 2002

The purpose of this study was to identify clinical characteristics of type 2 diabetic patients with hypertension. The subjects were 209 type 2 diabetic patients who visited at the endocrine center at Kangnam St. Mary's Hospital of Catholic University in Seoul from beginning of March through the end of April in 2001. The patient's clinical laboratory data were assessed at medical record review. The data were analyzed using for t-test, $x^2$ test. The results were as follows: 1) There were no significant differences in age, body mass index, sex, family history of diabetes and oral hypoglycemic agents between hypertensive group and normotensive group, However, percentage of patients receiving insulin treatment was higher significantly in the hypertensive group. 2) Creatinine and microalbuminuria levels were higher significantly in the hypertensive group. However, fasting blood glucose levels were lower significantly in the hypertensive group. There were no significant differences in $HbA_1c$, 2-hour postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, lipoprotein(a) and blood urea nitrogen between two groups. Our present study supports that Creatinine and microalbuminuria levels were higher significantly in the hypertensive group.

• 한국보건간호학회지
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• 제16권2호
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• pp.346-353
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• 2002

The purpose of this study was to identify clinical characteristics of type 2 diabetic patients with microalbuminuria. The subjects were 390 out type 2 diabetic patients from beginning of March through the end of April in 2001, who visited at the endocrine center at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patients' clinical laboratory data were assessed at medical record review. The data were analyzed using for t-test and $\chi^2$ test. The results were as follows : 1. There were no significant differences in age, body mass index, family history of diabetes and hypoglycemic agents between normoalbuminuria group and microalbuminuria group. 2. The level of systolic blood pressure and creatinine of microalbuminuria group were higher than those of normoalbuminuria group. There were no significant differences in HbAlc, fasting blood glucose, 2-hour postprandial blood glucose, diastolic blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, lipoprotein(a) and blood urea nitrogen between normoalbuminuria group and microalbuminuria group.

• 대한임상검사과학회지
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• 제50권3호
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• pp.304-312
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• 2018

본 연구에서는 면역 억제 역할을 하는 것으로 알려져 있는 조절 T 세포 (regulatory T cell, Treg)의 새로운 생리학적 기능 대하여 확인해보고자 하였다. 시험관내나 동물실험에서 조절 T 세포가 분비하는 transforming growth factor ${\beta}1$ ($TGF-{\beta}1$)에 의하여 이식 직전까지 췌장섬세포의 생존률을 향상시키면서 동시에 혈당조절 기능이 향상될 수 있을 것이라는 가설이다. 이를 증명하기 위하여 마우스를 이용한 1형 당뇨병 모델을 제작한 뒤, 180 IEQ (islet equivalents)의 췌장섬세포를 동종간 이식하였다. 췌장섬세포는 이식 수술 시행 전까지 48시간 동안 $4{\times}10^6$의 Treg 세포와 함께 배양하여 Treg 유래 $TGF-{\beta}1$에 충분히 노출시킨 뒤 사용하였다. Treg 단독군, 췌장섬세포 단독군 및 Treg/islet 동시 배양군에서 각각 $TGF-{\beta}1$, IL-6 및 인슐린 분비 수준의 변화를 측정하였다. Treg/islet 동시 배양군에서 IL-6와 인슐린 분비는 증가하였고 (P<0.0005, P<0.005), 췌장섬세포 단독군과 비교하여 생존율이 향상되었다(P<0.005). 또한, 이식 후, 동시 배양된 췌장섬세포는 1형 당뇨병 마우스 모델에서 혈당 수치를 보다 효율적으로 조절하였다. 이러한 결과는 Treg 세포가 $TGF-{\beta}1$ 분비를 통하여 췌장섬세포의 기능과 생존력을 향상시킬 수 있음을 시사한다.

• 대한임상검사과학회지
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• 제51권3호
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• pp.379-385
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• 2019

골다공증은 호르몬의 변화와 무기질 감소에 의해 골밀도의 감소를 유발하여 골절의 위험을 높이는 질환이다. 최근 보고에 의하면, 간염바이러스 및 에이즈 치료제로 사용되고 있는 Adefovir dipivoxil (ADV)의 장기적 복용에서 골다공증 부작용이 유발할 수 있음이 보고 되고 있다. 이에 대한 연구수행을 위해 골모세포주 hFOB1.19와 혈관내피세포 HUVEC을 이용하여 ADV에 대한 생물학적 연관성을 평가하였다. 우선적으로 ADV를 농도별로 처리한 후 각 세포와 핵의 형태학적 분석을 위해 DAPI와 crystal violet 염색을 시행하였다. 또한 세포 증식에 대한 약물 효과를 평가하기 위하여 CCK-8분석과 골모세포에 대한 분화유도 및 억제 효과를 확인하기 위하여, ALP 염색을 진행하였다. 그 결과, ADV는 hFOB1.19 세포와 HUVEC 세포에서 농도 의존적으로 세포의 비대 현상을 유발하였고, 세포의 증식이 억제되었다. 이러한 원인들을 규명하기 위해 TGF-${\beta}$발현을 조사하였을 뿐만 아니라 이러한 발현 감소에 의한 생물학적 영향이 골모세포로부터 골세포로의 분화 과정에 관여하고 있음을 확인 할 수 있었다. 결론적으로, 본 연구에서는 ADV 약물이 골모세포와 혈관내피세포의 TGF-${\beta}$의 발현을 억제하여 핵의 크기 증가와 세포형태의 비대증을 유발하며, 세포의 증식억제 및 골모세포 분화능에 영향을 줌으로서 골다공증을 유발할 수 있는 가능성을 확인하였다. 이러한 결과는 ADV 복용에 따른 골다공증 발병 원인을 이해하기 위한 기초 연구 및 이를 이용한 임상영역에 활용 될 수 있을 것으로 사료된다.

• 대한임상검사과학회지
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• 제43권4호
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• pp.171-178
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• 2011

Glycated hemoglobin ($HbA_{1c}$) is a most preferably used baseline of diabetes, implicating average blood glucose levels over a 2-3 month period of time. Recently the American Diabetes Association has recommended the $HbA_{1c}$ assay as one of the criteria for diabetes. Although some studies provide data with "estimated average glucose", by converting the $HbA_{1c}$ results from simple linear regression, the results are not applicable to whole diabetes. We compared the relationship between $HbA_{1c}$ and estimated average glucose by anemia degree of diabetic patients in Korea. The data from the 2008~2009 Korean National Health and Nutrition Examination Survey were used. Analysis was done for 1,257 diabetes subjects with $HbA_{1c}$ results. The distribution of subjects was 34.1% in 60's, 25.9% in 70's, 21,6% in 50's, showing that there was more than 80% in over 50's. To take a close look of the differences depending on the anemic degree, we applied WHO criteria (hemoglobin<13.0 in men and hemoglobin<12.0 in women) and divided anemia degree. The regression equation for A1c and estimated average glucose was $eAG_{mg/dL}=24.3{\times}A1c-32.0$ ($R^2=0.54$, p<0.001) in all subjects, $eAG_{mg/dL}=33.1{\times}A1c-96.1$ ($R^2=0.52$, p<0.001) in slight anemia ($11.0{\leq}$Hb<13.0 in men, $10.0{\leq}$Hb<12.0 in women), and $eAG_{mg/dL}=13.5{\times}A1c+34.9$ ($R^2=0.12$, p =0.075) in moderate anemia (Hb<11.0 in men, Hb<10.0 in women). The regression was not significant in moderate anemia. The relationship between HbA1c and eAG was lower correlation than ADAG study, and eAG showed lower value in all ranges among $HbA_{1c}$ 5~13%. Such as a korea where, there are many diabetic patients among the old aged and higher prevalence rate of anemia, we should be extra careful when we reflect eAG using $HbA_{1c}$ and need to establish criteria which can be applicable to koreans.

• 한국임상약학회지
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• 제15권1호
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• pp.21-26
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• 2005

A bioequivalence study of CKD $Cefaclor^{(R)}$ capsule (Chong Kun Dang Pharm Co., Ltd) to $Ceclor^{(R)}$ capsule (Lilly Korea Co., Ltd.) was conducted according to the guidelines of Korea Food and Drug Administration (KFDA). Twenty four healthy male Korean volunteers received each medicine at the cefaclor dose of 250 mg in a $2{\times}2$ crossover study. There was a one-week washout period between the doses. An improved high-performance liquid chromatorgraphy (HPLC) analytical method with UV detection was used to determine plasma cefaclor concentration in human volunteers for 8 hr after oral drug administration. The area under the plasma concentration-time curve from time zero to 8 hr ($AUC_{0-8hr}$) was calculated by the linear trapezoidal rule. the $C_{max}$ (maximum plasma drug concentration) and $T_{max}$ (time to reach $C_{max}$) were compiled from the plasma concentration-time data. Analysis of variance was carried out using logarithmically transformed $AUC_{0-8hr}\;and\;C_{max}$. No significant sequence effect was found for all of the bioavailability parameters indicating that the cross-over design was properly performed. The $90{\%}$ confidence intervals of the $AUC_{0-8hr}$ ratio and the $C_{max}$ ratio for CKD $Cefaclor^{(R)}$ and $Ceclor^{(R)}$ were $0.9400{\leq}{\delta}{\leq}1.0345$ and $0.8858{\leq}{\delta}{\leq}1.1021$, respectively. These values were within the acceptable bioequivalence intervals of 0.80-1.25. Thus, our study demonstrated the of CKD $cefaclor^{(R)}$ capsule was bioequivalent to $Cefaclor^{(R)}$ capsule with respect to its bioavailability.