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Seven-Year Follow Up of Microscopic Polyangiitis Presenting with Rapidly Progressive Glomerulonephritis (급속 진행성 사구체신염으로 시작된 현미경적 다발성 동맥염(Microscopic Polyangiitis) 환자의 7년간의 장기 추적관찰 1례)

  • Oh, Jin-Won;Kim, Pyung-Kil;Lee, Jae-Seung;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.99-104
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    • 2008
  • Microscopic polyangiitis(MPA) is a systemic necrotizing vasculitis that involves many organ systems including the skin, joint, kidneys, and lungs. In spite of early diagnosis and intensive care, the five-year actuarial patient and kidney survival rates are 65% and 55%. We experienced a case in 7-year-old girl of microscopic polyangiitis presenting with rapidly progressive glomerulonephritis which was confirmed by renal biopsy and positive serum perinuclear antineutrophil cytoplasmic autoantibodies(p-ANCA). The diagnosis of patients first renal biopsy was MPA, p-ANCA-associated crescentic glomerulonephritis. The patients second renal biopsy was done 5 years 6 months later since first renal biopsy, and pathologic diagnosis was chronic sclerosing glomerulonephritis, advanced, due to MPA. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor, angiotensin II receptor blocker, and cyclophosphamide were used until now and the patients current age is 14 years old. On admission, the patients laboratory findings showed BUN 117 mg/dL and Cr 2.3 mg/dL, while on the hospital day BUN and Cr values fell to 20.8 mg/dL and 1.6 mg/dL. But renal function was progressed to chronic failure with latest laboratory data BUN 51.7 mg/dL and Cr 3.2 mg/dL. ACE inhibitor, angiotensin II receptor blocker and small dose of immunosuppressant with close observation is the key to maintain the patient survival.

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The Clinical Analysis of Modified B-T Shunt Using 3 mm and 3.5 mm PTFE graft (3mm와 3.5mm PTFF graft를 이용한 변형 B-T 단락술의 임상적 분석)

  • 정성호;윤태진;임한중;민경석;서동만;윤소영;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.716-722
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    • 2000
  • Background: Modified Blalock-Taussig shunt using 3mm or 3.5mm PTFE graft has been performed in patients with small body weight or in candidates for single ventricle palliation. However, there are few reports concerning clinical outcomes in terms of pulmonary artery growth and shunt patency rate after shunt operations using such a small graft. Material and Method: Twenty-five patients rate after shunt operations using 3 or 3.5 mm sized grafts from September 1996 to August 1999. We retrospectively assessed the pulmonary artery growth and the shunt patency rate by reviewing the pre-and post-operative pulmonary angiograms. The risk factors for late death and second shunt operations were also analyzed. To assess the presence of any correlation between body weight and selection of the graft size, regression analysis was done in 81 cases of shunt operations performed during the same period. Result: There were 1(4%) early death and 5(20%) late deaths. The survivors were followed up for an average of 7.34 months. The pulmonary artery index increased significantly from 129$\pm$66$\textrm{mm}^2$/$m^2$ to 213$\pm$114 $\textrm{mm}^2$/$m^2$(p=0.002). The shunt patency rate assessed at postoperative 2, 4, 6 and 8 months were 82.5%, 77%, 73% and 42% respectively with a marked decline between 6 and 8 months. Asplenia was a frequent finding for the patients with late death although the incidence failed to reach statistical significance(p=0.078). Pre-operative diagnosis of PA with VSD was found to be a statistically significant risk factor for a second shunt operation(p=0.01). Body weight(a) at operation and graft size(b) used in the shunt operations revealed strong correlation and could be expressed by the following formula; b=0.128a + 3.233. Conclusion: Adequate growth of pulmonary artery and satisfactory early patency rate could be obtained by modified Blalock-Taussing shunt using 3mm or 3.5mm graft. However, during 6 to 8 months after shunt operations, the patency rate fell sharply, which implicates that close observation and early intervention are mandatory in this period.

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Clinical Manifestation and Treatment Results of the Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Arising in the Head and Neck Region (두경부의 점막연관 림프조직에서 발생한 림프절외 변연부 B세포 림프종의 임상 양상 및 치료 결과에 대한 고찰)

  • Rah, Yoon-Chan;Han, Kyu-Hee;An, Soo-Youn;Kwon, Tack-Kyun;Sung, Myung-Whun;Kim, Kwang-Hyun;Hah, J.-Hun
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.128-131
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    • 2009
  • Objectives : Mucosa-associated lymphoid tissue(MALT) lymphoma of the head and neck region is relatively rare, but it has variable clinical and biological characteristics. Although there were few studies on this topic, there is still controversy regarding the best treatment. The authors retrospectively investigated the clinical courses and treatment results in 10 patients presenting with MALT-lymphoma in head and neck region except ocular adnexa. Material and Methods : Ten patients with a histologically verified diagnosis of the extranodal marginal zone B cell lymphoma arising in thyroid glands(3), larynx(3), oral cavity(2), oropharynx(1), salivary glands(1) were analyzed. Results : Four patients were allocated to stage IE and another six patients to stage IIE according to the Ann Arbor staging system. Treatment consisted of local therapy(surgical resection and/or radiotherapy) in four patients and systemic chemotherapy with/without local therapy in six patients. Complete remission and partial remission were achieved in seven patients(70%) and two patients(20%), respectively. No recurrence or mortality was observed with a mean follow-up of 40.5 months. Conclusion : Patients with MALT-lymphomas of the head and neck region were potentially treated by local modality in localized disease state. However systemic chemotherapy was also effective even in localized disease state and was well tolerated by patients. And strict staging and close long-term monitoring were recommended considering its indolent progression.

Noodle Characteristics of Jerusalem Artichoke Added Wheat Flour and Improving Effect of Texture Modifying Agents (돼지감자가루 복합분 국수의 제조와 품질개량제의 첨가효과)

  • Shin, Ji-Young;Byun, Myung-Woo;Noh, Bong-Soo;Choi, Eon-Ho
    • Korean Journal of Food Science and Technology
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    • v.23 no.5
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    • pp.538-545
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    • 1991
  • In order to develop low calorie noodles, flours of Jerusalem artichoke and strong wheat were mixed with ratios of 25 : 75, 30 : 70 and 35 : 65. The substitution of wheat flour with Jerusalem artichoke powder up to 25% showed good formation of noodle stripes similar to that of wheat flour alone. The formation was effectively improved by addition of $0.5{\sim}1.0%$ solution alginate, 1.0% Fremol or mixure of 0.5% ${\alpha}-Polygel$, 0.5% Alcalin and 1.5% fremol for $25{\sim}30%$ substitution with Jerusalem articoke powder. Also addition of sodium alginate to the 30% substitution with Jerusalem artichoke powder showed the high Hunter value of Lightness and good cooking quality of noodle, relatively close to those of noodle of wheat flour alone. The dough prepared with mixed flours showed increase in cohesiveness and resilience and decrease in hardness and adhesiveness, compared to those of wheat flour. The addition of sodium alginate was very effective for increase in adhesiveness and cohesiveness. The cohesiveness of cooked noodles was increased with substitution with Jerusalem artichoke powder while sodium alginate influenced little. There is no significant difference of taste, odor, color and texture of cooked noodles between wheat flour alone and composite flours with $25{\sim}30%$ of Jerusalem artichoke and texture modifying agents. The results suggested that good quality noodles could be produced using Jerusalem artichoke powder.

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Effect of engineered barriers on the leach rate of cesium from spent PWR fuel (가압경수로 사용후핵연료 중 세슘의 침출에 미치는 공학적 방벽 영향)

  • Chun Kwan Sik;Kim Seung-Soo;Choi Jong-Won
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.3 no.4
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    • pp.329-333
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    • 2005
  • To identify the effect of engineered barriers on the leach rate of cesium from spent PWR fuel under a synthetic granitic groundwater, the related leach tests with and without bentonite or metals have been performed up to about 6 years. The leach rates were decreased as a function of leaching time and then became a constant after a certain period. The period in a bare spent fuel was much longer than that with bentonite or metal sheets. The cumulative fraction of cesium released from the spent fuel with bentonite or with copper and stainless steel sheets was steadily increased, but the fraction from bare fuel was rapidly and then sluggishly increased. However, the values deducted its gap inventory from the cumulative fraction of cesium released from the bare fuel was almost very close to the others. These suggest that the initial release of cesium from bare fuel might be dependant on its gap inventory and the effect of engineered barriers on the long-term leach rate of cesium would be insignificant but the rate with engineered barriers could be reduced in the initial transient period due to their retardation effect. And the long-term leach rate of cesium from spent fuel in a repository would be approached to a constant rate of $2\times10^{-2}g/m^2-day$.

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A Study of sea Dike meterials loss due to Scouring and Consolidation Settlement During the Periond of Construction on Construction on the West Cost of Korea (서해암 방조제 공사 기간중 유실토량 측정시험)

  • 안재숙
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.14 no.1
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    • pp.2503-2519
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    • 1972
  • The studies were carried out to find the cause and the quantitative evaluation of sea dike materials loss which is occured during the period of construction works for the tideland reclamation projects on the west coast of Korea. Major subjects to studies were to establish the typical relationships between the tidal flow and the movement of dike materials, the tidal-flow and the erosion, the dike materials and the ratio of material movement(losses), construction methods and the ratio of materials movement (losses). Based on the above subjects, the studies were made for the purpose of obtain the following informations; (1) Collecting and evaluaing the data of dike material losses due to foundation settlement, from designed existing dikes on the west coast. (2) By the field investigation at A-San Sea Dike, Pyong Taek Project, the Comparison would be made by the relationships between the tide velocity and the movement of dike foundation under the natural conditions and the period of construction so that find out the relationship between the dike materials of foundation situation and settlements. With regard to the dike construction works, it is so difficult to calculate the exact quantity of material losses due to the foundation settlements. The major factors that affect the settlement losses of the dike materials are: (1) Topographical variation (2) Swepting the sectional area of dike by the tide velocity. (3) Dumping riprap to the outerside of dike during the period of construction works. (4) Sectional area losses by the cause of occurence of the new tide channels. (5) material losses by the heavy storms. (6) Consolidation settlement by the foundation weakness. (7) Material losses by the earth materials by tide flow. Most hi호 material losses were occured by the Consolidation settlement due to the foundation weakness, the maximum tide velocities due to decrease the cross sectional area of the gaps and erosion of foundation due to the range of tide, Inner and outerside of dike, or dike material loses due to the tide flow. Final conclusion would be obtained by the continuous measurement of consolidation settlement at the stage of final clusure of the dike. (It is scheduled to close on the end of 1972) However, intermediate conclusion can be introduced as follows: (1) The estimation of material(losses) during the period of construction works for the existing sea-dikes up to date were only empirical. The material losses at the general closure for design was estimated at 10% of the riprap, 20% of the earth materials, and 20% of the riprap, 40% of the earth materials at the final closure of the dike. The final closure estimated double quantity to the general closure, but it is still doubt. (2) The ratio of consolidation settlements was found smaller than the calculated quantity. It can be foreseen that settlement speeds is higher thom the calculated speeds. (3) The movement of dike foundation under the natural conditions were not so depends on the geological conditions of the foundation. (4) When the tide velocities was estimated 100 at the normal tide, it was estimated 125 at the high tide and 55 at the low tide. The tide velocities at the low tide shows apparently lower than the high tide and the higher velocities at the deep water depth.

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Evaluation of Alginate Microspheres Prepared by Emulsion and Spray Method for Oral Vaccine Delivery System (유화법과 분무법에 의해 제조된 경구백신용 알긴산 마이크로스피어의 평가)

  • Jiang, Ge;Jee, Ung-Kil;Maeng, Pil-Jae;Hwang, Sung-Joo
    • Journal of Pharmaceutical Investigation
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    • v.31 no.4
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    • pp.241-256
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    • 2001
  • Alginate microspheres, containing fluorescein isothiocyanate-bovine serum albumin (FITC-BSA) or green fluorescent protein (GFP) were prepared and used as a model drug to develop the oral vaccine delivery system. The alginate microspheres were coated with poly-L-lysine or chitosan. Two methods, w/o-emulsion and spray, were used to prepare alginate microspheres. To optimize preparation conditions, effects of several factors on the particle size and particle morphology of microsphere, and loading efficiency of model antigen were investigated. In both preparation methods, the particle size and the loading efficiency were enhanced when the concentration of sodium alginate increased. In the w/o-emulsion preparation method, as the concentration of Span 80 was increased from 0.5% to 2%, the particle size was decreased, but the loading efficiency was increased. The higher the emulsification speed was, the smaller the particle size and loading efficiency were. The concentration of calcium chloride did not show any effect on the particle size and loading efficiency. In the spray preparation method, the particle size was increased as the nozzle pressure $(from\;1\;kgf/m^2\;to\;3\;kgf/m^2)$ and spray rate was raised. Increasing calcium chloride concentration (<7%) decreased the particle size, in contrast to no effect of calcium chloride concentration on the w/o-emulsion preparation method. Alginate microspheres prepared by two methods were different in the particle size and loading efficiency, the particle size of microspheres prepared by the spray method was about $2-6\;{\mu}m$, larger than that prepared by the w/o emulsion method $(about\;2{\mu}m)$, and the loading efficiency was also higher with spray method. Furthermore, drying process for the microspheres prepared by the spray was simpler and easier, compared with the w/o emulsion preparation. Therefore, the spray method was chosen to prepare alginate microspheres for further experiments. Release pattern of FITC-BSA in alginate microspheres was evaluated in simulated intestinal fluid and PBS (phosphate buffered saline). Dissolution rate of FITC-BSA from alginate/chitosan microsphere was lower than that from alginate microsphere and alginate/poly-L-lysine microsphere. By confocal laser scanning microscope, it was revealed that alginate/FITC-poly-L-lysine microspheres were present in close apposition epithelium of the Peyer's patches of rabbits following inoculation into lumen of intestine, which proved that microspheres could be taken up by Peyer's patch. In conclusion, it is suggested that alginate microsphere prepared by spray method, showing a particle size of & $10\;{\mu}m$ and a high loading efficiency, can be used as a model drug for the development of oral vaccine delivery system.

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An Analysis of Interaction Patterns by Teacher's Role in Mathematics Classrooms (수학교실에서 교사의 역할에 따른 상호작용 패턴 분석)

  • Cho, Woo-Gi;Oh, Young-Youl
    • Journal of Elementary Mathematics Education in Korea
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    • v.14 no.1
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    • pp.1-22
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    • 2010
  • The purpose of this study was to examine the relationship between teacher's role and interaction patterns in mathematics classrooms. Teacher's role was divided into usual practices with students, usual practices with content and usual practices with students and contents, and interaction patterns were classified into report, inquiry and discussion. The subjects in this study were teachers and students in three fourth- grade classes in T elementary school located in Seoul. After the classes of every math teacher were observed, three teachers who played distinctively unique roles were selected in accordance with the results of the first-semester autonomous supervision, of open class for parents and of the instructional observation. Thus, there was a close relationship between the teacher roles and interaction patterns. And it's concluded that students are able to have a more discussion on each other's ideas in the student-centered classroom, and that teachers should perform active roles in that process. Given the findings of the study, there are some suggestions: First, the teachers appeared to fulfill consistent roles when their videotaped classes, study aids and performance assessment materials were analyzed, and they should play more active roles in mathematics class. Second, they should try to create the kinds of climate that encourages students to come up with ideas in an active manner. Third, earlier studies had focused on student-teacher interaction patterns, but this study found that the roles of the teachers depended on interaction with not only students but study aids and performance assessment materials, and that the interaction patterns hinged on their roles as well. Therefore more profound research efforts should be directed into this issue.

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Study of the Dormitory Architecture of Governmental Secondary Schools in the Japanese Colonial Era (일제 강점기 관립 중등학교 기숙사 건축에 관한 연구)

  • Lee, Jeong-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5355-5362
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    • 2014
  • This study reviewed the planning characteristics of dormitories for secondary schools in the Japanese Colonial Era by analyzing the architectural drawings collected by the National Archives of Korea. The dormitory was one of the essential facilities in secondary schools but there have been few studies in this area. The analysis items were the site plan and the planning characteristics of student bedrooms, dining hall, and supervisor's area, which were the main elements of the dormitory. The results of this study were summarized as follows. 1) Generally, the dormitory area was placed in the rear of buildings for teaching with a close connection. 2) The student bedroom wings were laid out in parallel to the south as a rule making the typical site plan pattern for a dormitory, whereas the other parts of dormitory, such as the dining hall and supervisor's area were placed in the site conditions. 3) Generally, the unit plans of bedrooms for Korean schools were the ondol type and were small in size, whereas those for Japanese were the tatami type and large in size with separate study and sleeping areas. 4) The dining hall annex was made up of a dining hall and kitchen-bathroom area in general. For Japanese schools, the school store area was added to these areas. The typical shapes of dining hall plans were narrow and long with an adjacent corridor, so the overall plan of the dining hall annex was like that of a single-corridor type block plan. 5) The supervisor's area was a smaller part of the dormitory but it was considered to be a symbolic part of the whole dormitory in site planning and design.

In Teaching Method of Home Economics of Using a V.T.R. Making Skirt Instruction (가정과 교수방법에 있어서 V.T.R을 이용한 스커트 만들기 지도)

  • 신상옥;김인애
    • Journal of Korean Home Economics Education Association
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    • v.1 no.1
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    • pp.1-17
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    • 1989
  • Present, we cannot expect the maximum studying effect in a home economics and the drill unit of secondary schools because of several problems. Such problems can be enumerated as follows. 1. The explaination of a making process in texts would be difficult for the students who have a poor understanding to grasp. 2. The much effort would be made due to teacher’s repeated exhibition, by which the progress of a text might be unreasonable. 3. The teachers unaccustomed to the drill might treat it carelessly and become to avoid it. 4. The skill to grasp a general work flow might be lack. Baseing on such problems, this researcher did using a medium of Video in teaching method of home economics. For this purpose, the quality of Video Tape would be important. Above all, we made out the script of Video Tape through advices of specialists in Video medium, majors in home economics, and the students teaching of home economics and the concerned persons, by which we recorded a gather skirt, as a finished goods, especially of the characteristics of each kind of a skirt. Next, we recorded and produced the total steps from a preparation of skirt-making to a finishing as using a V.T.R. shot technique. The Video would be screened and the supplemented explaination of a teacher would be added in a step of instruction. In the development of instruction, students would begin the making. The expected effects according to using Video Tape are as follows. 1. The making order of text would be exhibited by a model directly and the explaination of a narrator would be added concurrently, by which students would understand it easily as confirming each step. 2. All students can watch these steps owing to a close up, one of the V.T.R Techniques. Accordingly, the teacher’s efforts would be decreased and the proper progress of a text could be maintained because of no repeated exhibition of a teacher. 3. To the teachers unaccustomed to and interested in a drill, the medium would become a subsidiary means. 4. Study all steps of a making, students would become to understand the general flow of a work. Therefore, it might be possible to generalize another units of a making. However though this study was designed don a basis of such effects, the using effects based on only the existing study results, and was focused on the production of a medium. Because this research would be a teacher and there was noncooperation of secondary schools, it was impossible to experiment in schools, which was the prime limitation of this study. Therefore we should be experiment further for the continuous studying.

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