• Title/Summary/Keyword: Jun

Search Result 79,783, Processing Time 0.113 seconds

ERUPTION TIME AND SEQUENCE OF PERMANENT TEETH IN STUDENTS FROM E-ELEMENTARY SCHOOL (E-초등학교 어린이의 영구치 맹출시기 및 순서)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh;Son, Heung-Kyu;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.36 no.2
    • /
    • pp.253-261
    • /
    • 2009
  • The purpose of this study was to present new data on the timing and sequence of permanent teeth emergence and to compare these findings with the results of earlier studies. The dental examinations had been performed to E-elementary school students, who visited the Yonsei University Dental Hospital between 1998 and 2005; 1,307 boys and 1,312 girls with the age ranging from 6 to 12 years old. The followings were concluded. 1. Eruption time of the maxillary permanent teeth is as follows. It was 6.81 years in male and 6.73 years in female for the central incisor, 7.78 years in male and 7.65 years in female for the lateral incisor, 10.48 years in male and 9.92 years in female for the canine, 9.76 years in male and 9.63 years in female for the first premolar, 10.66 years in male and 10.49 years in female for the second premolar, 6.39 years in male and 6.26 years in female for the first permanent molar, and 12.13 years in male and 12.03 years in female for the second permanent molar. 2. Eruption time of the mandibular permanent teeth is as follows. The central incisor could not be determined in this study, but it is assumed to erupt before the age of 6.08. In the mandible, eruption time was 6.78 years in male and 6.65 years in female for the lateral incisor, 9.76 years in male and 9.05 years in female for the canine, 9.82 years in male and 9.59 years in female for the first premolar, 10.67 years in male and 10.52 years in female for the second premolar, 6.22 years in male and 6.12 years in female for the first permanent molar, and 11.58 years in male and 11.14 years in female for the second permanent molar. 3. The eruption sequence is as follows. In the maxilla, the first permanent molar erupted first, followed by the central incisor, the lateral incisor, the first premolar, the canine, the second premolar, and the second permanent molar. In the mandible, the central incisor erupted first, followed by the first permanent molar, the lateral incisor, the canine, the first premolar, the second premolar, and the second permanent molar. 4. Tooth eruption occurred earlier in female compared to male by average of 0.19 year in the maxilla and 0.29 year in the mandible. 5. In both male and female, the hiatus (interval of rest) occurred between the emergence of lateral incisor and first premolar in the maxilla while it was observed between the lateral incisor and canine in the mandible. Male had a hiatus of 1.98 years in the maxilla and 2.90 years in the mandible, while the female's were 1.98 years and 2.40 years, respectively.

  • PDF

The Long-term Follow-up Study of Therapeutic Effects of 8 French Catheter for Spontaneous Pneumothorax (자연 기흉의 치료에서 8 French 도관삽입의 치료 효과에 대한 장기적 관찰)

  • Shin, Jong-Wook;Lee, Byoung-Hoon;An, Chang-Hyeok;Choi, Jae-Sun;Yoo, Jee-Hoon;Lim, Seong-Yong;Kang, Yoon-Jung;Koh, Hyung-Ki;Kim, Jae-Yeol;Na, Moon-Jun;Park, In-Won;Sobn, Dong-Suep;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.5
    • /
    • pp.1094-1104
    • /
    • 1997
  • Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.

  • PDF

A Study of Microsatellite Instability in Primary Small Cell Lung Cancers by Microsatellite Analysis (원발성 소세포폐암에서 Microsatellite 분석을 이용한 Microsatellite 불안정화에 대한 연구)

  • Cho, Eun-Song;Chang, Joon;Park, Jae-Min;Shin, Dong-Hwan;Kim, Se-Hoon;Kim, Young-Sam;Chang, Yoon-Soo;Cho, Chul-Ho;Kwak, Seung-Min;Lee, Jun-Gu;Chung, Kyung-Young;Kim, Sung-Kyu;Lee, Won-Young;Kim, Se-Kyu
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.2
    • /
    • pp.180-190
    • /
    • 2000
  • Background: Genomic instability, which is manifested by the replication error(RER) phenotype, has been proposed for the promotion of genetic alterations necessary for carcinogenesis. Merlo et al. reported frequent microsatellite instability in primary small cell lung cancers. However, Kim et al. found that instability occurred in only 1% of the loci tested and did not resemble the replication error-positive phenotype. The significance of microsatellite instability in the tumorigenesis of small cell lung cancer as well as the relationship between microsatellite instability and its clinical prognosis was investigated in our study. Methods: Fifteen primary small cell lung cancers were chosen for this study. The DNAs extracted from paraffin-embedded tissue blocks with primary tumor and corresponding control tissue were investigated. Forty microsatellite markers on chromosome 1p, 2p, 3p, 5q, 6p, 6q, 9p, 9q, 13q, and 17p were used in the microsatellite analysis. Results: Thirteen(86.7%) of 15 tumors exhibited LOH in at least one of the tested microsatellite markers. Three of 13 tumors exhibiting LOH lost a larger area in chromosome 9p. LOH was shown in 72.7% on chromosome 2p, 40% on 3p, 50% on 5q, 46.7% on 9p, 69.2% on 13q, and 66.7% on 17p(Table 1). Nine(60%) of 15 tumors exhibited shifted bands in at least one of the tested microsatellite markers. Nine cases exhibiting shifted bands showed altered loci ranging 2.5~52.5%(mean $9.4%\pm16.19$)(Table 2). Shifted bands occurred in 5.7% (34 of 600) of the loci tested(Table 2). Nine cases with shifted bands exhibited LOH ranging between 0~83.3%, and the median survival duration of those cases was 35 weeks. Six cases without shifted bands exhibited LOH ranging between 0~83.3%, and the median survival duration of those cases was 73 weeks. There was no significant difference between median survival durations of the two groups(p=0.4712). Conclusion: Microsatellite instability as well as the inactivation of several tumor suppressor genes may play important roles in the development and progression process of tumors. However, the relationship between microsatellite instability and its clinical prognosis in primary small cell lung cancer could not be established.

  • PDF

Relationship between Systemic Inflammatory Marker, Oxidative Stress and Body Mass Index in Stable COPD Patient (안정된 만성폐쇄성폐질환 환자에서 신체질량지수와 전신 염증인자, 산화 스트레스와의 관련성)

  • Ham, Hyun Seok;Lee, Hae Young;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Young;Kim, Ho Cheol;Ham, Jong Ryeal;Park, Chan Hoo;Lee, Jong Deok;Sohn, Hyun Joon;Youn, Hee Shang;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
    • /
    • v.61 no.4
    • /
    • pp.330-338
    • /
    • 2006
  • Background: The main factors associated with weight loss in patients with COPD are not well known. Since chronic inflammation and oxidative stress play a major pathogenic role in COPD, these factors may be responsible for the patients' weight loss. Therefore, this study measured the body mass index (BMI) in COPD patients and evaluated the variables, such as systemic inflammatory marker, oxidative stress and lung function, that correlate with the BMI. Method: The stable COPD patients (M:F=49:4, mean age=$68.25{\pm}6.32$) were divided into the lower (<18.5), normal (18.5-25) and higher (>25) BMI group. The severity of the airway obstruction was evaluated by measuring the $FEV_1$. The serum IL-6 and TNF-$\alpha$ levels were measured to determine the degree of systemic inflammation, and the carbonyl protein and 8-iso-prostaglandin $F_2{\alpha}$ level was measured to determine the level of oxidative stress. Each value in the COPD patients and normal control was compared with the BMI. Results: 1) Serum 8-iso-prostaglandin $F_2{\alpha}$ in COPD patients was significantly higher ($456.08{\pm}574.12pg/ml$) than that in normal control ($264.74{\pm}143.15pg/ml$) (p<0.05). However, there were no significant differences in the serum IL-6, TNF-$\alpha$, carbonyl protein between the COPD patients and normal controls. 2). In the COPD patients, the $FEV_1$ of the lower BMI group was significantly lower ($0.93{\pm}0.25L$) than that of the normal BMI ($1.34{\pm}0.52L$) and higher BMI groups ($1.72{\pm}0.41L$) (p<0.05). The lower $FEV_1$ was significantly associated with a lower BMI in COPD patients (p=0.002, r=0.42). The BMI of very severe COPD patients was significantly lower ($19.8{\pm}2.57$) than that of the patients with moderate COPD ($22.6{\pm}3.14$) (p<0.05). 3). There were no significant differences in the serum IL-6, TNF-$\alpha$, carbonyl protein and 8-iso-prostaglandin $F_2{\alpha}$ according to the BMI in the COPD patients. Conclusion: The severity of the airway obstruction, not the systemic inflammatory markers and oxidative stress, might be associated with the BMI in stable COPD patients. Further study will be needed to determine the factors associated with the decrease in the BMI of COPD patients.

Study on Intestinal Viability and Optimum Feeding Method of Lactobacillus in Broiler Chickens (육계에 대한 유산균의 장내 생존성 및 적정 급여방법에 대한 연구)

  • Kim, Dong-Wook;Kim, Ji-Hyuk;Kang, Geun-Ho;Kang, Hwan-Ku;Lee, Sang-Jin;Lee, Won-Jun;Kim, Sang-Ho
    • Journal of Animal Science and Technology
    • /
    • v.50 no.6
    • /
    • pp.807-818
    • /
    • 2008
  • This study was conducted to prove the optimum feeding method of Lactobacillus in broiler chickens by investigating the intestinal viability of ingested Lactobacillus and the effect of feeding levels and frequency of Lactobacillus on growth performance in broiler chickens. In experiment 1, A total of one hundred, 5 weeks old male broiler chickens(Abor Acre) were fed Lactobacillus reuteri avibro2 expressed green fluorescent protein(GFP) at 104cfu/g diet to investigate the retention time of ingested Lactobacillus in the intestine for 1 day. The percentage of Lactobacillus expressed GFP in intestinal contents was 26% at 1 day after fed Lactobacillus expressed GFP. The percentage of Lactobacillus expressed GFP in intestinal contents was decreased in length of time. In experiment 2, A total of four hundred eighty, 1-d-old male broiler chicks(Abor Acre) were randomly divided into 4 groups with 4 replicates of 30 birds each to prove the optimum feeding level of Lactobacillus. The treatments were control(free antibiotics), Lactobacillus reuteri avibro2 5.0×10cfu/mL, 5.0×103cfu/mL, and 5.0×105cfu/mL. The final body weight and body wight gain of Lactobacillus reuteri avibro2 5.0×103cfu/mL were the highest in all groups(P<0.05). Feed conversion ratio was not significantly difference among the groups. The number of intestinal lactic acid bacteria in Lactobacillus treated groups tended to be improved or significantly increased as compared to that of control(P<0.05). Protein and fat digestibility in Lactobacillus 5.0×103cfu/mL and 5.0×105cfu/mL treated groups were significantly improved(P<0.05). No significant differences were observed on the availability of dry matter and crude ash in Lactobacillus treatments compared to those of control. In experiment 3, A total of six hundred 1-d-old male broiler chicks(Abor Acre) were randomly divided into 4 groups with 4 replicates of 30 birds each and were fed Lactobacillus reuteri avibro2 at intervals of 1, 2, 3, and 5 day for five weeks. Feeding level of Lactobacillus was 5.0×103cfu/mL The final body weight and body wight gain of Lactobacillus reuteri avibro2 5.0×103cfu/mL were the highest in all groups(P<0.05). The final body weight and body weight gain were significantly increased, when Lactobacillus was fed at intervals of 1 days, or 2 days. There were no significant differences in feed intake and feed conversion ratio among the all groups. The number of intestinal lactic acid bacteria in Lactobacillus treated groups tended to be improved or significantly increased as compared to that of control(P<0.05). No significant differences were observed on the number of coliform bacteria and Salmonella of ileum and cecum. Consequently, supplemental Lactobacillus influenced positive effects on the growth performance, nutrient availability and intestinal microflora. The optimum feeding level of Lactobacillus was 5.0×103cfu/mL, and the constant feeding of Lactobacillus was effective.

Effect of Mixed Sowing Ratios Between Whole Crop Barley with Hooded Type and Forage Pea on the Forage Yield and Quality (삼차망 청보리와 사료용 완두의 혼파재배가 수량 및 사료가치에 미치는 영향)

  • Ju, Jung-Il;Park, Jong-Min;Lee, Jung-Jun;Kim, Chang-Ho;Koo, Han-Mo;Oh, Tae-Seok;Lee, Hyo-Won
    • Journal of The Korean Society of Grassland and Forage Science
    • /
    • v.29 no.3
    • /
    • pp.171-178
    • /
    • 2009
  • The study was conducted to clarify the mixed seeding rate of whole crop barley with hood type and forage pea for using of forage crops and to compare the forage yield and quality. At a mixed seeding rate between the whole crop barley (WCB) and forage pea, The heading date and plant height of WCB were not a difference according to mixed seeding rate of forage pea. The tillers of the WCB were a decrease and plant of the forage pea were a increase according to increased seeding rate of forage pea. The lodging index of the WCB was a appearance with distribution of $0{\sim}3$, The lodging index of WCB with a 20kg/10a seeding rate of a only WCB without seeding of the forage pea was 3. The overwintering rate of forage pea was a appearance more than 90% at all treatment. The plant height of forage pea was a increase according to increased seeding rate of forage pea at 14 kg/10a and 20 kg/10a plots of WCB. At a mixed seeding between the WCB and forage pea, The fresh weight was a increase according to increased seeding rate of forage pea and was a appearance more than 3,000 kg at all treatment plot. But the dry matter weight was decrease according to increased seeding rates of forage pea. The dry matter weight of 20 kg/10a seeding rate of a only WCB without seeding of the forage pea showed the most amount with 1,266 kg. The crude protein (CP) content was a tendency to increase according to increased seeding rates of forage pea. But, the relative feed value (RFV) was a tendency to decrease according to increased seeding rate of forage pea. The highest RFV was 183.8 at 14 kg/10a seeding rate of a only WCB without seeding of the forage pea. The acid detergent fiber (ADF) and neutral detergent fiber (NDF) were a increase according to increased seeding rate of forage pea at 14 kg/10a and 20 kg/10a plots of WCB. The highest content of ADF and NDF were 23.9% and 46.3% at mixed seeding rate of 20 kg/10a of WCB with 10 kg/10a of forage pea, respectively. The highest sum of standardized score by fresh weight, dry matter weight, CP, ADF, NDF and RFV was 2.309 at mixed seeding rate of 20 kg/10a of WCB with 7.5 kg/10a of forage pea. The optimum mixed seeding rate was a considered judgment in the order of mixed seeding rate of 20 kg/10a of WCB with 7.5 kg/10a of forage pea, mixed seeding rate of 20 kg/10a of WCB with 5.0 kg/10a of forage pea.

The Plan of Dose Reduction by Measuring and Evaluating Occupationally Exposed Dose in vivo Tests of Nuclear Medicine (핵의학 체내검사 업무 단계 별 피폭선량 측정 및 분석을 통한 피폭선량 감소 방안)

  • Kil, Sang-Hyeong;Lim, Yeong-Hyeon;Park, Kwang-Youl;Jo, Kyung-Nam;Kim, Jung-Hun;Oh, Ji-Eun;Lee, Sang-Hyup;Lee, Su-Jung;Jun, Ji-Tak;Jung, Eui-Ho
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.14 no.2
    • /
    • pp.26-32
    • /
    • 2010
  • Purpose: It is to find the way to minimize occupationally exposed dose for workers in vivo tests in each working stage within the range of the working environment which does not ruin the examination and the performance efficiency. Materials and Methods: The process of the nuclear tests in vivo using a radioactive isotope consists of radioisotope distribution, a radioisotope injection ($^{99m}Tc$, $^{18}F$-FDG), and scanning and guiding patients. Using a measuring instrument of RadEye-G10 gamma survey meter (Thermo SCIENTIFIC), the exposure doses in each working stage are measured and evaluated. Before the radioisotope injection the patients are explained about the examination and educated about matters that require attention. It is to reduce the meeting time with the patients. In addition, workers are also educated about the outside exposure and have to put on the protected devices. When the radioisotope is injected to the patients the exposure doses are measured due to whether they are in the protected devices or not. It is also measured due to whether there are the explanation about the examination and the education about matters that require attention or not. The total exposure dose is visualized into the graph in using Microsoft office excel 2007. The difference of this doses are analyzed by wilcoxon signed ranks test in using SPSS (statistical package for the social science) program 12.0. In this case of p<0.01, this study is reliable in the statistics. Results: It was reliable in the statistics that the exposure dose of injecting $^{99m}Tc$-DPD 20 mCi in wearing the protected devices showed 88% smaller than the dose of injecting it without the protected devices. However, it was not reliable in the statistics that the exposure dose of injecting $^{18}F$-FDG 10 mCi with wearing protected devices had 26% decrease than without them. Training before injecting $^{99m}Tc$-DPD 20 mCi to patient made the exposure dose drop to 63% comparing with training after the injection. The dose of training before injecting $^{18}F$-FDG 10 mCi had 52% less then the training after the injection. Both of them were reliable in the statistics. Conclusion: In the examination of using the radioisotope $^{99m}Tc$, wearing the protected devices are more effective to reduce the exposure dose than without wearing them. In the case of using $^{18}F$-FDG, reducing meeting time with patients is more effective to drop the exposure dose. Therefore if we try to protect workers from radioactivity according to each radioisotope characteristic it could be more effective and active radiation shield from radioactivity.

  • PDF

Usefulness Evaluation of Open Mouth View when PET/CT scan In Tongue Cancer Patients (Tongue Cancer 환자에서 PET/CT 검사 시 Open Mouth 촬영법의 유용성 평가)

  • Kim, Jae Hwan;Yun, Jong Jun;Jung, Ji Wook;Kim, Jung Wook;Hwang, Ju Won;Ji, Hye In
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.20 no.2
    • /
    • pp.14-20
    • /
    • 2016
  • Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

  • PDF

Incidence of Chronic Pathologic Nephrotoxicity of Cyclosporine A in Pediatric Nephrotic Syndrome (소아 신증후군에서 Cyclosporine A에 의한 만성 조직학적 신독성의 발현빈도에 대한 연구)

  • Kim Ji-Hong;Jeong Hyun-Ju;Choi In-Jun;Kim Pyung-Kil
    • Childhood Kidney Diseases
    • /
    • v.3 no.2
    • /
    • pp.130-144
    • /
    • 1999
  • Purpose : Long-term use of Cyclosporine(CsA) reduce renal blood flow by afferent arteriolar vasoconstriction and lead to chronic pathologic changes of CsA nephrotoxicity - 1) interstitial nephritis(IN); tubular atrophy (TA) and/or interstitial fibrosis(IF),2) arteriolopathy(AP). The Object of this study is to estimate the incidence of chronic pathologic CsA nephrotoxicity by duration of treatment and type of renal disease, relationship between histologic and clinical nephrotoxicity, and optimal duration of CsA therapy. Methods : 102 children with steroid resistant or dependent nephrotic syndrome confirmed by renal biopsy and treated with CsA from 1986 to 1997 were enrolled in this study(58 MCNS, 10 FSGS, 10 MGN, 15 $Henoch-Sch\"{o}nlein$ purpura nephritis with nephrotic syndrome (HSPN) and 9 IgA nephropathy with nephrotic syndrome(IgAN)). CsA was administered for 1yr, 1.5yr, 2yr in 24, 12, 22 MCNS patients and 2, 2, 6 FSGS patients respectively, 1yr, 2yr in MGN and 1yr in HSPN and IgAN. Sequential biopsies were done in all 102 patients after CsA treatment for evaluation of pathologic nephrotoxicity. Results : Complete remission rate was 92.2% (100% in MCNS and MGN, 80% in FSGS, 86.6% in HSPN and 55.5% in IgAN). Incidence of relapse during 6months after CsA treatment was significantly decreased compaed with relapsing spisodes during 6months before CsA treatment in MCNS(P<0.0001) and FSGS(P<0.0001). According to pathologic changes, 71 patients(69.6%) showed no pathological change, 24 patients(23.5%) showed IN and 7 patients(6.8%) showed AP. IN was 16.6%, 33.3%, 27.2% in 1, 1.5, 2 year of CsA treatment group in MCNS. AP was 0%, 16.6%, 9% in 1, 1.5, 2 year of CsA treatment group in MCNS. 14 out of 58 MCNS(24.1%) showed IN and 4 out of 58 MCNS(6.8%) showed AP. Incidence of pathologic change was significantly lower in CsA therapy of <1yr than >1yr(P=0.03). There were no significant difference of incidence of pathologic change in original renal disease, age and sex. Conclusion : Duration of CsA treatment was significant risk factor for nephrotoxicity and optimal duration seemed to be 1 year. Pathologic change due to nephrotoxicity did not correlate with deterioration of renal function and only detectable by renal biopsy.

  • PDF

A Clinical Study of Tsutsugamushi Fever in Children during 1997~2000 in the Western Kyungnam Province (최근 4년간 서부 경남지역의 소아에서 발생한 쯔쯔가무시열의 임상적 고찰)

  • Ju, Hye Young;Lee, Jun Su;Kim, Jeong Hee;Yoo, Hwang Jae;Kim, Chun Soo
    • Pediatric Infection and Vaccine
    • /
    • v.8 no.2
    • /
    • pp.213-221
    • /
    • 2001
  • Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

  • PDF