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Leukoencephalopathy after CNS Prophylactic Therapy in Pediatric Hematologic Malignancy (소아 혈액종양 환자에서 중추신경계 예방적 치료 후 발생한 백질뇌병증)

  • Lee, Jun Hwa;Lee, Sun Min;Choi, Eun Jin;Lee, Kun Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.566-571
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    • 2003
  • Purpose : Leukoencephalopathy(LE) is one of the most serious complications in children with hematologic malignancies during the course of treatment. Early recognition is important to reduce the impact and sequelae from LE. We therefore investigated the clinical features of LE following central nervous system(CNS) prophylaxis in children with hematologic malignancies and evaluated the significance of regular check-ups of brain MRI. Methods : We retrospectively reviewed children with hematologic malignancies who had CNS prophylaxis including intrathecal(IT) methotrexate(MTX) and/or cranial irradiation at the Department of Pediatrics, Kyungpook National University Hospital from Oct. 1995 to May 2002. Fifteen cases of acute leukemia and one case of lymphoma who experienced LE following CNS prophylaxis were included in the study. Clinical data were analyzed from the medical records and brain MRIs were reviewed by neuroradiologists. Results : The ages ranged from 1 to 13 years(median age=5.2 years), and the male to female ratio was 3 : 1. The time interval from the beginning of chemotherapy to the time of diagnosis of LE ranged from 2 to 17 months. They all had IT MTX two to 15 times and ten underwent cranial irradiation(1,800 rads). At the time of diagnosis, ten of them had neuropsychiatric symptoms including seizures, personality changes, headache, etc. After the change of treatment modality, four cases showed significant improvement on follow-up MRIs, six cases had no significant changes and two had worsening of LE. Four patients died of infection and bone marrow relapse. Conclusion : CNS prophylaxis with IT therapy and cranial irradiation may cause leukoencephalopathy during the course of treatment. As a result, regular brain MRI check-up is recommended for the early detection and reducing the incidence of LE, along with changes in the treatment modality.

The association between serum IGF-1 and neonatal growth and disease in a NICU (신생아집중치료실 입원아의 혈청 IGF-1과 성장 및 질병 사이의 관련성)

  • Kim, Jung Ok;Lim, Hae Ri;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.176-180
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    • 2009
  • Purpose : The objective of this study was to establish the serum IGF-1 level in newborn infants, and investigate its association with growth and diseases. Methods : In a retrospective study, serum IGF-1 levels were measured for newborn infants admitted to NICU at Kyungpook University Hospital from March 2007 to July 2007. Birth data, disease history, and hospital course were obtained from medical records. Results : Of 52 blood samples obtained at birth, serum IGF-l levels in 30 preterm infants ($31.6{\pm}27.3$ ng/mL) were lower than in 22 full-term infants ($53.4{\pm}40.0$ ng/mL; P<0.05). In sick full-term infants, serum IGF-1 levels ($46.0{\pm}40.2$ ng/mL) were lower than in healthy full-term infants ($64.1{\pm}39.5$ ng/mL; P<0.05). In preterm infants, there were no differences in IGF-1 levels between healthy ($33.2{\pm}23.3$ ng/mL) and sick infants ($30.6{\pm}30.4$ ng/mL); however, IGF-1 levels in both sick and healthy preterm infants were lower than in healthy full-term infants. Among infants admitted after 8 days of life, serum IGF-1 levels were higher in infants who gained weight ($70.8{\pm}36.2$ ng/mL) than in infants who lost weight ($13.3{\pm}19.9$ ng/mL; P<0.01); however IGF-1 levels showed no difference between gender or method of delivery. Conclusion : The study showed lower IGF-l levels in preterm infants than in full-term infants. Additionally, the IGF-l level in infants with weight loss was lower than in infants with weight gain. These results indicate that serum IGF-1 is associated with gestational age and postnatal growth.

Effect of surfactant lavage in severe meconium aspiration syndrome (중증 태변 흡인 증후군에서 인공 폐표면활성제 세정요법의 효과에 관한 비교 연구)

  • Lee, Soon Min;Kim, He Min;Jeon, Ji Hyun;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.367-371
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    • 2008
  • Purpose : The surfactant dysfunction may play an important role in meconium aspiration syndrome (MAS). We aim to evaluate the effect of surfactant lavage in the treatment of term infants with MAS. Methods : The medical records of 15 neonates with severe MAS admitted at Yongdong Severance Hospital from 2005 to 2007 were reviewed and analyzed. Seven infants with severe MAS necessitating mechanical ventilation underwent tracheobronchial lavage with 20 mL/kg of diluted (5.3 mg phospholipid/mL) surfactant saline suspension ($Newfactan^{(R)}$). Data regarding clinical outcomes was assessed by comparison with 8 control infants with equally severe MAS retrospectively. Results : In the lavage group, radiological improvement was evident after 6 hours of treatment. The duration of artificial ventilation and duration of hospital day were also significantly shorten in the lavage group compared with the control group. The mean oxygen index, mean ventilation index improved significantly within the first 6 hours after treatment. No differences were found in the incidence of major complications and mortality between the two groups. Conclusion : The surfactant lavage seems to be an effective and safe method for treatment of severe MAS. A multicenter, large scaled randomized controlled trial is needed for further study.

The influence of wearing helmet and cervical spine injury in skiers and snowboarders (스키와 스노우 보드에서 헬멧의 착용이 경추부 손상에 미치는 영향)

  • Kim, Sung Hun;Kim, Tae Kyun;Chun, Keun Churl;Hwang, Jae Sun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.94-99
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    • 2011
  • Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

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Relationship Between Job Stress and Turnover Intention Among Nurses in University Hospitals (대학병원 간호사들의 직무스트레스와 이직의도와의 관련성)

  • Shin, Hyun-Ran;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.8
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    • pp.3958-3970
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    • 2013
  • This study was carried out to grasp the job stress and intention to change their jobs of nurses at general hospitals by their socio-demographic, job-related and health-related behavior characteristics and especially to investigate their relationship to the job stress and intention to change their jobs. The subjects were 355 nurses working at three university hospitals located in Daejeon City, and data were collected by a survey using self-administered questionnaires structured from April 1 to May 31, 2012. As a results, the average point of the nurses' intention to change jobs by the causes for job stress was significantly higher in the boss group with low support than in that with high support while it was higher in colleague group with low support than in that with high support. To look into the correlation between the points of intention to change their jobs and the causes for job stress, their intention to change their jobs showed a significant negative correlation to the boss's support and colleagues' support while there was no significant relationship with job demands and job autonomy. As a result of hierarchical multiple regression, age, drinking coffee, department, job satisfaction, the boss's support and colleagues' support were selected as significant related variables affecting the nurses' intention to change their jobs and these variables' descriptive power was 29.4%. Viewed from the above results, it is suggested that the nurses' job stress and intention to change their jobs has a significant relationship with various variables such as socio-demographic, health-related behavior and job-related characteristics. In addition, there were a significant positive correlation between the causes for the job stress cause and intention to change their jobs, and among the causes for the job stress, support by their boss or colleagues turned out to be those affecting their intention to change their jobs. Thus, it is considered that it is necessary to minimize the nurses' job stress and at the same time to seek for specific measures for preventing their turnover.

The Factors Related to Musculoskeletal Symptoms of Family Care-Givers who Have a Patient with Brain Damage (뇌손상 가족 간병인의 근골격계 자각증상과 관련요인)

  • Jeon, Eun-Mi;Lee, Seong-A;Gu, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.336-344
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    • 2017
  • This study was conducted to identify factors related to the musculoskeletal symptoms of 340 family caregivers who have a patient with brain damage based on self-administered questionnaires. The questionnaires included general characteristics, characteristics of care activities and caregivers' musculoskeletal symptoms. Data were collected from many long-term care hospitals and rehabilitation centers during March 17 to March 21, 2014. The results indicated that complaint rates of work-related musculoskeletal systems of the body sites differed. Factor analysis revealed that neck complaints were related to education (under mid), while shoulder complaints were related to sex (female), age (50-59), education (mid) and duration of care (< 2 years). Arm/elbow complaints were related to age (40-49), education (high) and duration of care (12-24). Complaints regarding the hand/wrist/finger were related to age (50-59) and duration of care (12-24), while those associated with the legs/feet were related to age (50-59) and duration of care (< 6[ED highlight - years? Please specify.]). Back problems were related to education (under mid, mid stage, high) and gait. The complaint rate regarding musculoskeletal symptoms during daily life was not statistically significant. Logistic regression analysis of significant factors related to subjective musculoskeletal symptoms identified ambulation and gait as having the greatest influence and complaint factor among family caregivers. The complaint rate of family caregivers differed among body parts. Being a caregiver for less than one year was found to have a significant impact on pain. Overall, long term family caregivers could be faced with risk factors for musculoskeletal problems, but there are many different factors that affect musculoskeletal symptoms with regards to their activities. Accordingly, comprehensive and systematic prevention plans for family caregivers who have patients with brain damage should be developed.

The effect of nutritional supply on clinical outcomes and nutritional status in critically ill patients receiving continuous renal replacement therapy (지속적 신대체요법을 받은 중환자에서 영양공급이 임상결과와 영양상태에 미치는 영향)

  • Kim, Ju Yeun;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.211-220
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    • 2015
  • Purpose: This study was designed to investigate whether nutritional supply influences biochemical markers and clinical outcomes in patients who received continuous renal replacement therapy (CRRT) by evaluating adequacy of nutritional supply for patients. Methods: From January 2012 to December 2013, 239 adult patients who received CRRT in the intensive care unit for more than 3 days were included. General information from electronic medical records and nutritional status related biochemical data and clinical outcomes on the first day of CRRT and 2 weeks after CRRT were collected. Results: The rate of delivered energy and protein was 68.06% and 43.13% which was much lower than energy and protein supply based on their requirement. When the patients were divided into two groups according to 70% of energy received rate and 50% of protein received rate, the group with more than 70% of energy received rate showed significant decrease of length of hospital stay (p = 0.007), length of stay in intensive care unit (ICU) (p = 0.008), duration of CRRT (p < 0.001), and APACHE II score (p < 0.001) compared to less than 70% of energy received rate after adjusting for age. In addition, the group with more than 50% of protein received rate showed decreased mortality (p = 0.031), length of hospital stay (p = 0.008), length of ICU stay (p = 0.035), duration of CRRT (p < 0.001), and APACHE II score (p < 0.001) after adjusting for age. We found that the level of hematocrit (p = 0.006) was significantly improved in the group with more than 70% of energy received rate, and the level of TLC (p = 0.049), hematocrit (p = 0.041) was significantly improved in the group with more than 50% of protein received rate. We also found that energy delivery was negatively correlated with length of stay in ICU (p = 0.049) and positively correlated with level of calcium (p = 0.037). In addition, protein delivery was correlated with the levels of serum total protein (p = 0.021), serum albumin (p = 0.048), hematocrit (p = 0.009), and total cholesterol (p = 0.021) when dead patients were included, but was correlated with the levels of hematocrit (p = 0.034) and calcium (p = 0.024) when dead patients were excluded. Conclusion: Proper nutritional delivery may help patients' clinical outcomes for patients receiving CRRT. However, their actual intakes of energy and protein were not adequate for their requirements. Identification of patients with malnutrition is necessary and a multidisciplinary approach for systemic management is also required.

Interpretation of Landscape Elements in Borimsa Temple after 17th Century (17세기 이후 장흥 보림사(長興 寶林寺)의 경관요소 해석)

  • Kim, Kyu-Won;Sim, Woo-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.1
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    • pp.110-118
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    • 2015
  • Borimsa Temple in Jangheung, one of the Goosanseonmoon of Shilla Dynasty, calls for a study in the field of landscape architecture because it has very significant elements in cultural and ecological landscaping aspects. This study examined the changes in landscaping elements of Borimsa Temple since the 17th century in order to newly recognize cultural landscaping value of space composition elements for traditional temple and to verify landscape architectural position. For research method, literatures such as Sajeonggi (事蹟記), Joongchanggi, a surveyed map by Fujishima Gaijiro in 1928 and Joseon Gojeogdobo (朝鮮古蹟圖譜) and modern documents including Borimsa Temple Precision Ground Survey Report and photographic records of National Archives of Korea and provincial governments were examined together with a field survey in order to trace changes in landscape elements such as buildings within the temple site, pond and temple forest. The results are as the following: First, for geographical locations of Borimsa Temple, it is located in an auspicious location and Shipyuknahansang and Cheonbul were placed in a supplementary purpose according to the contents of Bojoseonsatapbi. Compared to Namhwaseonsa Temple in China, it has a similar environmental composition but the fact that buildings were placed on platforms is a distinctive difference. Second, architectural landscape of Borimsa Temple went through the Japanese colonial era and Korean War and still going through changes today. Thus, there shall be some appropriate measures such as to establish an archive of past landscape data. Third, the contents of Borimsa Temple Sajeonggi suggests that the pond of Borimsa Temple had been in a indeterminate form with stones on the outer edge. Its name could have been Yongcheon (湧泉) according to the contents of Joongchanggi. Also, the current landscape, in comparison with past photographs, is a result of changes from surface raise occurred by ground reinforcement within the temple site. Fourth, Jangsaengpyoju (長生標柱) mentioned in Bojoseonsatapbi and Borimsa Temple Sajeonggi was thought to be the dried juniper tree in front of Daewoongbojeon, which can be found in past photographic documents but, it is now assumed to be Seokbihyeong (石碑形) considering the Gukjangsaeng and Hwangjangsaeng of Dogapsa Temple of the similar time period. Moreover, Hongsalmoon mentioned in Joongchanggi was established by King's order after the Manchu war of 1636 in praising of Buddhist monks those who had volunteered to fight for the country. Fifth, it is apparent in Borimsa Temple Joongchanggi that geomancy was a consideration in landscaping process of Borimsa Temple, and the record indicates that pine trees, bo trees and persimmon trees were planted. Sixth, tea tree forest was verified of its historical root that is Seongchailyeo from Unified Shilla through passing down of Jeong Yak-yong's Goojeunggoopo method and relevant documents of Seon Master Choui and Yi Yu-won. Seventh, nutmeg tree forest suggests that nutmegs were used in national ceremonies and for medical uses. The nutmeg tree forest was also verified of its role as Naehwasoorimdae (a forest built to prevent fire from spreading) through aerial photographs and placement of a forest reserve.

Future Development Strategies for KODISA Journals: Overview of 2016 and Strategic Plans for the Future (KODISA 학술지 성장전략: 2016 개관 및 미래 성장개요)

  • Hwang, Hee-Joong;Lee, Jung-Wan;Youn, Myoung-Kil;Kim, Dong-Ho;Lee, Jong-Ho;Shin, Dong-Jin;Kim, Byung-Goo;Kim, Tae-Joong;Lee, Yong-Ki;Kim, Wan-Ki
    • Journal of Distribution Science
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    • v.15 no.5
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    • pp.75-83
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    • 2017
  • Purpose - With the rise of the fourth industrial revolution, it has converged with the existing industrial revolution to give shape to increased accessibility of knowledge and information. As a result, it has become easier for scholars to actively persue and compile research in various fields. This current study aims to focus and assess the current standing of KODISA: the Journal of Distribution Science (JDS), International Journal of Industrial Distribution & Business(IJIDB), the East Asian Journal of Business Management (EAJBM), the Journal of Asian Finance, Economics and Business (JAFEB) in a rapidly evolving era. Novel strategies for creating the future vision of KODISA 2020 will also be examined. Research design, data, and methodology - The current research will analyze published journals of KODISA in order to offer a vision for the KODISA 2020 future. In part 1, this paper will observe the current address of the KODISA journal and its overview of past achievements. Next, part 2 will discuss the activities that will be needed for journals of KODISA, JDS, IJIDB, EAJBM, JAFEB to branch out internationally and significant journals will be statistically analyzed in part 3. The last part 4 will offer strategies for the continued growth of KODISA and visions for KODISA 2020. Results - Among the KODISA publications, IJIDB was second, JDS was 23rd (in economic publications of 54 journals), and EAJBM was 22nd (out of 79 publications in management field journals). This shows the high quality of the KODISA publication journals. According to 2016 publication analysis, JDS, IJIDB, etc. each had 157 publications, 15 publications, 16 publications, and 28 publications. In the case of JDS, it showed an increase of 14% compared to last year. Additionally, JAFEB showed a significant increase of 68%. This shows that compared to other journals, it had a higher rate of paper submission. IJIDB and EAJBM did not show any significant increases. In JDS, it showed many studies related to the distribution, management of distribution, and consumer behavior. In order to increase the status of the KODISA journal to a SCI status, many more international conferences will open to increase its international recognition levels. Second, the systematic functions of the journal will be developed further to increase its stability. Third, future graduate schools will open to foster future potential leaders in this field and build a platform for innovators and leaders. Conclusions - In KODISA, JDS was first published in 1999, and has been registered in SCOPUS February 2017. Other sister publications within the KODISA are preparing for SCOPUS registration as well. KODISA journals will prepare to be an innovative journal for 2020 and the future beyond.

Blockade of Thromboxane Influences Does Not Affect Renal Blood Flow Deficit in Anesthetized Diabetic Rats (마취된 당뇨 흰쥐의 신혈류량 감소에 관여하는 기전 : 내인성 쓰롬복산계의 무관성)

  • Ha, Hun-Joo;Dunham, Earl W.
    • The Korean Journal of Pharmacology
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    • v.24 no.2
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    • pp.221-232
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    • 1988
  • Studies were conducted to determine whether reduced renal blood flow (RBF) exhibited by rats with uncontrolled, streptozotocin (STZ)-induced diabetes is attributable to diabetes-associated, enhanced renal vasoconstrictor influence of endogenous thromboxane $(TX)A_2$. Rats which were injected with STZ after pretreatment with 3-O-methyl glucose (3OMG), an agent which prevents STZ-induced hyperglycemia, were also studied. Basal values of total RBF (RBF; ml $min^{-1}$ $gKw^{-1}$; electromagnetic flow probe), systemic arterial pressure (BP; mm Hg) and renal vascular resistance (RVR;BP $RBF^{-1})$in pentobarbital-anesthetized rats during a control period were $5.9{\pm}0.3$(P<0.1_{VS}. CR), $115{\pm}3$ and $20.3{\pm}1.0$(P<0.1_{VS}. CR) for STZR (n=15), and $8.4{\pm}0.4$, $123{\pm}3$ and $15.1{\pm}0.8$ for age-matched control rats (CR; n= 15), respectively. Basal values of RBF, BP and RVR in 3OMG pretreated STZR were identical to CR. In preparations shown capable of renal vasodilatation, OKY 1581 (1 mg/kg, i.v. followed by 0.4 mg/kg min infusion) abolished arachidonate-induced $(TX)A_2$ synthesis, but did not alter basal BP, RBF or RVR in either STZR or CR (n=4/group). Similarly, i.r.a. infusion of SQ29548 (100 ng/ml RBF) abolished renal vasoconstriction induced by a TX/prostaglandin endoperoxide mimic, U46619, but had no discern able affect on RVR in either STZR (n=8) or CR (n=8). The data indicates that $TXA_2$ does not participate in the elevated basal RVR of STZR which are associated with the diabetic state.

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