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Long-term Prognostic Factors in Pediatric Focal Segmental Glomerulosclerosis (소아 국소성 분절성 사구체 경화증에서의 장기예후인자 분석)

  • Kim Eun A;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Jung Hyun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.125-135
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    • 2001
  • Purpose : Efforts to predict long-term outcome of focal segmental glomerulosclerosis(FSCS) have been made but have yielded conflicting results. Reports are rare especially in Pediatric patients. In this study, we reviewed the predictable prognostic factors in patients of FSGS Method : Fifty children who diagnosed as biopsy-proven FSGS at department of pediatrics at Yonsei university were studied retrospectively. Based on medical records, response to treatment and pathologic slides, we compared normal renal function group and decreased renal function group, assessed the factors affecting renal survival and progression to renal failure. Results : The mean age at onset was 8 1/12 years, sex ratio was 2.3 : 1, and the mean duration of follow-up was 7 1/12 years. The overall renal survival rate was $34\%$ at 5 years, $8\%$ at 10 years Five-year survival rate was $74\%$ in normal renal function group and $27\%$ in decreased renal function group. Between the two groups, there were no significant differences in age at onset, sex ratio, amount of proteinuria, incidence of hematuria and hypertension, mesangial hypercellularity. Decreased renal function group showed higher serum creatinine level, poor response to treatment, higher percent of glomeruli with sclerosis, moderate to severe tubulointerstitial change and vascular change(P<0.05). The prognostic factors of renal survival rate were same as above and incidence of hypertension also affected renal survival( P<0.05). The progression rate to renal failure did not show statistically significant factor. Conclusion : We reviewed the factors affecting long-term outcome of FSGS. Serum creatinine level, steroid responsiveness, and the degree of glomerulosclerosis were significant prognostic factors. (J Korean Soc Pediatr Nephrol 2001 ;5 : 125-35)

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Association of Leukotriene C4 Synthase Gene Polymorphism with Clinical Response to Montelukast in Childhood Asthma (소아 천식환자에서 Leukotriene C4 Synthase 유전자 다형태와 Montelukast의 임상적 효과와의 연관성)

  • Shin, Kyung Sue;Kim, Youn Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.766-771
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    • 2005
  • Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.

Effect of Imipramine on the Contractility of Single Cells Isolated from Canine Detrusor (Imipramine이 배뇨근 세포의 수축성에 미치는 직접작용)

  • Huh, Chan-Wook;Lee, Kwang-Youn;Kim, Won-Joon
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.293-302
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    • 1994
  • The objective of this study was to establish a good methodology to isolate single smooth muscle cells that are alive and respond properly to pharmacological agents. Canine urinary bladders were employed as the source of single cells, and acetylcholine, atropine and imipramine were used as indicators of pharmacological responsiveness. Imipramine, an antidepressant drug exhibited the anticholinergic and calcium antagonizing properties on rat detrusor muscle. To establish a control value for a further experiment to elucidate the mechanism of action of imipramine on detrusor muscle, we measured the concentration-response of single cells to acetylcholine in the presesnce of imipramine by length of the cells and compared the result with the response in the presence of atropine. Tiny chops of smooth muscle taken from anesthetized canine urinary bladder were incubated in collagenase solution at $36^{\circ}C$ for 17-20 minutes. The collagenase solution included collagenase 1.2 mg/ml, soybean tryspin inhibitor 0.08 mg/ml, bovine serum albumin 2% in 10 ml Krebs-Henseleit buffer solution aerated with a consistent breeze of 95/5% $O_2/CO_2$, to maintain the pH at 7.4. After washing with plain K-H solution on 450 mesh, cells were dissociated from the digested tissue for 12-15 minutes. Cell suspension was transfered in 5 ml test tubes and acetylcholine was added for the final concentration to be $10^{-14}M{\sim}10^{-9}M$. To find the optimal time to fix the cells to determine the contractile responses, 1% acrolein was added 5, 10, 20, 30, 60 and 120 seconds after the administration of ACh. The length of cells fixed by acrolein were measured by microscaler via CCTV camera on phaes-contrast microscope. The average length of 50 cells from a slide glass was taken as the value of a sample at the very concentration point. Single cells were isolated from canine detrusor. The length of untreated cells varied from 82 ${\mu}m$ to 94 ${\mu}m$. The maximal response to actylcholine $10^{-9}M$ was accomplished within 5 seconds of exposure, and the shortening was $19{\pm}3$%. Atropine reduced the contraction of the cells concentration-dependently. Imipramine which exerts a cholinergic blocking action on some smooth muscles also reduced the contraction concentration-dependently and by a similar pattern as atropine. These findings document that imipramine may exerts a cholinergic blocking activity in the single smooth muscle cells isolated from canine urinary bladder.

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Methacholine and adenosine 5'-monophosphate challenge tests in children with atopic asthma and with nonatopic asthma, and their relationships to blood eosinophil markers. (아토피성 천식 환아와 비아토피성 천식 환아에서 메타콜린과 아데노신 기관지 유발 검사의 비교 및 혈중 호산구 염증 지표와의 관련성)

  • Lee, Sun Hee;Kim, Do Kyun;Choi, Sun Hee;Koh, Young Yull
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1216-1222
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    • 2006
  • Purpose : Though atopic and nonatopic asthma have different clinical manifestations, bronchial hyperresponsiveness (BHR) and airway inflammations are common characteristics of them. We investigated BHR to both methacholine and adenosine 5'-monophosphate (AMP), and their relationships with blood eosinophil markers in nonatopic asthma as well as atopic asthma. Methods : We studied 116 children (82 atopics; 34 nonatopics) with mild to moderate asthma. Methacholine and AMP challenge tests were performed and bronchial responsiveness was expressed as $PC_{20}$ (provocative concentration causing a 20 percent fall in $FEV_1$); blood eosinopil counts (ETCs) and serum eosinophil cationic protein (ECP) levels were gauged. Results : In atopics, 95.1 percent and 90.2 percent showed hyperreactivity to methacholine ($PC_{20}$<16 mg/mL) and AMP ($PC_{20}$<200 mg/mL), respectively. Meanwhile, in nonatopics, 94.1 percent and 52.9 percent displayed hyperreactivity to methacholine and AMP, respectively. The geometric mean of AMP $PC_{20}$ was lower in atopics (31.6 mg/mL) than in nonatopics (125.9 mg/mL); that of methacholine $PC_{20}$ was similar in the two groups. AMP $PC_{20}$ correlated with blood ETCs in both atopics(r=-0.30, P<0.01) and nonatopics (r=-0.57, P<0.01), and correlated with serum ECP levels (r=-0.23, P<0.01) in atopics, but not in nonatopics. Apart from AMP, methacholine $PC_{20}$ was not associated with blood eosinophil markers in either group. Conclusion : Atopics more frequently displayed BHR to AMP than nonatopics. Furthermore, BHR to AMP was associated with not only blood ETCs, but serum ECP levels in atopics but was correlated with only blood ETCs in nonatopics. Those results suggest that BHR to AMP reflects airway inflammation in asthma and is more related to atopy.

A Study 0n the Improvement of the domestic in producing area organizations According to the change retail environment: Focused on organized, scaled, Specialization. (농산물 소매유통환경 변화에 따른 국내 산지유통조직 개선방안에 관한 연구: 조직화·규모화·전문화를 중심으로)

  • Kim, Dae-Yun
    • The Journal of Industrial Distribution & Business
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    • v.2 no.2
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    • pp.5-14
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    • 2011
  • Opening agricultural market expansion, reduced purchases through wholesale markets, expanding the influence large retailers of consumer's market such as changes in the distribution system to the farmer's market conditions are changing rapidly. Because of this, retailers of the scaled and chain-store operations was centered on distribution environmental changes of the consumer market place. In producing area due to changes in market conditions in the agricultural production of in producing area distribution organization and the size distribution can not be put off no longer challenge is imminent. If it do not raise forces banded together, the producer is bound to remain as the weak. To support the distribution of this production was introduced in 2000 enable the Activation Project of in producing area distribution. Recent in producing area Changes of Agricultural conditions in order to cope with the Small-scale farmers and small individual farmers are becoming Scaled and specialized. Also, is specific to each item and regional is showing aspects. Government support for Activation Project of in producing area distribution is greatly improved, but in terms of competitiveness on the market still is showing the limitations. The most common of these problems, the market response if in producing area producer's organization and scale of the problem. Equipped for the purpose of consumer market place responsiveness unreasonable propelled outward from the Painter-sized weakens the organizational power. also, Difficult to succeed organizational size is a dissolution or anything within a few years, farmers around the best producer organizations, such as deviation occurs is exposed to a variety of issues. In this study, previous studies refer to the recent changes in agricultural retail environment, background and needs of organization·scaled, Determine the status of the domestic in producing area organizations and derived Problems, look into Domestic and overseas of in producing area organization with best practices for enhancing the competitiveness of the proposed improvement are intended to. In the future, in producing area distribution policy would like to provide direction to the development. The results of the study showed the follwing : 1) enhance utilization and orrganized through the diversification of the agricultural Collection systems. 2) Scaled to achieve through Items of specialized a wide area marketing. 3) Management operating units, such as installation and operating that overseas the best practices " Comite Economique Agricole Regional 'Fruits et Legumes' de Bretagne". 4) To establish a support system that in producing area distribution organization model development for appropriate domestic. In particular, in case of domestic in producing area distribution organization, through the analysis of various case study that a successful organization and scaled. The process of the various challenges arising in organizational scaled and generalization, and by the way he goes about trying to overcome is required. At the end of the study's limitations and future research directions suggested.

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A Comparative Study on the Electrophysiological Properties of Medial and Lateral Spinoreticular Tract Cells in Cats (고양이의 내측 및 외측 척수망상로 세포의 전기생리학적 비교연구)

  • Lee, Suk-Ho;Jun, Jae-Yeol;Park, Choon-Ok;Goo, Yong-Sook;Kim, Jun;Sung, Ho-Kyung
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.181-194
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    • 1990
  • Antidromically activated spinoreticular tract (SRT) cell units in the lumbosacral enlargement of ${\alpha}-chloralose$ anesthetized cats were classified as medial and lateral SRT units according to the location of their axonal termination. Identified SRT units were tested fer antidromic conduction velocity, laterality of their axonal projection, the location in spinal gray, peripheral receptive field, the response pattern to graded mechanichal stimulation and the responsiveness to $A{\delta}$ and C volley of the peripheral nerve. 1) The 59% of 34 medial SRT units were recorded in ipsilateral side to the antidromic stimulation site, but 60% of the 47 lateral SRT units projected to contralateral side. 2) Most of the medial SRT cells and rostral ventrolateral medulla (RVLM)-projecting lateral SRT cells were recorded in lamina VII & VIII. The LRN (lateral reticular nucleus)-projecting SRT cells, however, distributed through all the laminae except superficial ones (I & II). 3) The identified SRT units were classified as low theshold (LT), deep, high threshold (HT), wide dynamic range (WDR) cells, based on the response patterns to graded mechanical stimuli. The proportion of SRT units which receive noxious input was 37.5%, 25% and 75% in the medial, LRN-projecting and RVLM SRT group, respectively. 4) There was no significant difference in the mean conduction velocities between the 3 groups. But the deep cells had significantly higher velocity than that of the HT cells. The above results show that the peripheral inputs to the SRT units are different in the 3 groups: medial, LRN & RVLM SRT group. Especially in case of the SRT cells projecting to RVLM which is a probable candidate fur the integration center of various pressor reflexes such as somatosympathetic reflex, the noxious informations occupy higher proportion of input to them than in other groups. Therefore the noxious information transmitted through the lateral SRT destined for RVLM is expected to play a role in somatosymapthetic reflex.

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An Empirical Study on the Influencing Factors of Perceived Job Performance in the Context of Enterprise Mobile Applications (업무성과에 영향을 주는 업무용 모바일 어플리케이션의 주요 요인에 관한 연구)

  • Chung, Sunghun;Kim, Kimin
    • Asia pacific journal of information systems
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    • v.24 no.1
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    • pp.31-50
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    • 2014
  • The ubiquitous accessibility of information through mobile devices has led to an increased mobility of workers from their fixed workplaces. Market researchers estimate that by 2016, 350 million workers will be using their smartphones for business purposes, and the use of smartphones will offer new business benefits. Enterprises are now adopting mobile technologies for numerous applications to increase their operational efficiency, improve their responsiveness and competitiveness, and cultivate their innovativeness. For these reasons, various organizational aspects concerning "mobile work" have received a great deal of recent attention. Moreover, many CIOs plan to allocate a considerable amount of their budgets mobile work environments. In particular, with the consumerization of information technology, enterprise mobile applications (EMA) have played a significant role in the explosive growth of mobile computing in the workplace, and even in improving sales for firms in this field. EMA can be defined as mobile technologies and role-based applications, as companies design them for specific roles and functions in organizations. Technically, EMA can be defined as business enterprise systems, including critical business functions that enable users to access enterprise systems via wireless mobile devices, such as smartphones or tablets. Specifically, EMA enables employees to have greater access to real-time information, and provides them with simple features and functionalities that are easy for them to complete specific tasks. While the impact of EMA on organizational workers' productivity has been given considerable attention in various literatures, relatively little research effort has been made to examine how EMA actually lead to users' job performance. In particular, we have a limited understanding of what the key antecedents are of such an EMA usage outcome. In this paper, we focus on employees' perceived job performance as the outcome of EMA use, which indicates the successful role of EMA with regard to employees' tasks. Thus, to develop a deeper understanding of the relationship among EMA, its environment, and employees' perceived job performance, we develop a comprehensive model that considers the perceived-fit between EMA and employees' tasks, satisfaction on EMA, and the organizational environment. With this model, we try to examine EMA to explain how job performance through EMA is revealed from both the task-technology fit for EMA and satisfaction on EMA, while also considering the antecedent factors for these constructs. The objectives of this study are to address the following research questions: (1) How can employees successfully manage EMA in order to enhance their perceived job performance? (2) What internal and/or external factors are important antecedents in increasing EMA users' satisfaction on MES and task-technology fit for EMA? (3) What are the impacts of organizational (e.g. organizational agility), and task-related antecedents (e.g., task mobility) on task-technology fit for EMA? (4) What are the impacts of internal (e.g., self-efficacy) and external antecedents (e.g., system reputation) for the habitual use of EMA? Based on a survey from 254 actual employees who use EMA in their workplace across industries, our results indicate that task-technology fit for EMA and satisfaction on EMA are positively associated with job performance. We also identify task mobility, organizational agility, and system accessibility that are found to be positively associated with task-technology fit for EMA. Further, we find that external factor, such as the reputation of EMA, and internal factor, such as self-efficacy for EMA that are found to be positively associated with the satisfaction of EMA. The present findings enable researchers and practitioners to understand the role of EMA, which facilitates organizational workers' efficient work processes, as well as the importance of task-technology fit for EMA. Our model provides a new set of antecedents and consequence variables for a TAM involving mobile applications. The research model also provides empirical evidence that EMA are important mobile services that positively influence individuals' performance. Our findings suggest that perceived organizational agility and task mobility do have a significant influence on task-technology fit for EMA usage through positive beliefs about EMA, that self-efficacy and system reputation can also influence individuals' satisfaction on EMA, and that these factors are important contingent factors for the impact of system satisfaction and perceived job performance. Our findings can help managers gauge the impact of EMA in terms of its contribution to job performance. Our results provide an explanation as to why many firms have recently adopted EMA for efficient business processes and productivity support. Our findings additionally suggest that the cognitive fit between task and technology can be an important requirement for the productivity support of EMA. Further, our study findings can help managers in formulating their strategies and building organizational culture that can affect employees perceived job performance. Managers, thus, can tailor their dependence on EMA as high or low, depending on their task's characteristics, to maximize the job performance in the workplace. Overall, this study strengthens our knowledge regarding the impact of mobile applications in organizational contexts, technology acceptance and the role of task characteristics. To conclude, we hope that our research inspires future studies exploring digital productivity in the workplace and/or taking the role of EMA into account for employee job performance.

Long-term outcomes of infantile spasms (영아 연축 환아의 장기적 예후에 관한 고찰)

  • Oh, Seak Hee;Lee, Eun-Hye;Joung, Min-Hee;Yum, Mi-Sun;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.80-84
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    • 2010
  • Purpose : The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment. Methods : We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.Results : The mean follow-up duration for these 43 children was $7.2{\pm}1.5$ years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of $1.3{\pm}1.9$ months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR. Conclusion : Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.

Limitation of Prediction on Intravenous Immunoglobulin Responsiveness in Kawasaki Disease (가와사끼병에서 정맥용 면역글로불린 치료 반응 예측의 한계)

  • Kim, Seong-Koo;Han, Ji-Yoon;Rhim, Jung Woo;Oh, Jin Hee;Han, Ji-Whan;Lee, Kyung Yil;Kang, Jin-Han;Lee, Joon-Sung
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.169-176
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    • 2010
  • Purpose : We aimed to evaluate predictive parameters for non-response to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD) before IVIG use using two controls. Methods : We evaluated 229 consecutive KD patients who were treated with 2 g/kg of IVIG at a single center. Those who had persistent fever >24 hours after IVIG infusion made up the 23 IVIG non-responders; the first control included a total 206 defervesced cases and the second control included 46 cases that were matched for age and pre-treatment fever duration to non-responders. Results : Demographic and clinical characteristics were similar in IVIG non-responders and responders at presentation. As for laboratory findings, the neutrophil differential, CRP, AST, ALT, and LDH were higher, and lymphocyte differential, total protein, albumin, platelet count, and total cholesterol were significantly lower in IVIG non-responders compared to responders by univariate analysis in both study designs. However in multivariate analysis, non-responders showed a significantly higher neutrophil differential (cutoff value, >77%, sensitivity 68.4% and specificity 79.5%) and lower cholesterol (<124 mg/dL, sensitivity 79% and specificity 70.5%). Whereas plasma albumin (<3.6 g/dL, sensitivity 73.7% and specificity 60%) was the sole laboratory parameter of non-responders in the second study design. Conclusion : Severity of inflammation in KD was reflected by higher or lower laboratory values at presentation. Because the multivariate analysis for these indices may be influenced by some confounding factors, including the numbers of patients of different ages and fever duration, other assessment modalities are needed for KD patients with the greatest risk of coronary artery lesions.

GATA-3 is a Key Factor for Th1/Th2 Balance Regulation by Myristicin in a Murine Model of Asthma (Myristicin이 Ovalbumin으로 유도한 천식 생쥐모델에서 Th1/Th2 Balance를 조절하는 GATA-3에 미치는 효과)

  • Lee, Kyu;Lee, Chang-Min;Jung, In-Duk;Jeong, Young-Il;Chun, Sung-Hak;Park, Hee-Ju;Choi, Il-Whan;Ahn, Soon-Cheol;Shin, Yong-Kyoo;Lee, Sang-Yull;Yeom, Seok-Ran;Kim, Jong-Suk;Park, Yeong-Min
    • Journal of Life Science
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    • v.17 no.8 s.88
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    • pp.1090-1099
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    • 2007
  • Myristicin, l-allyl-3,4-methylenedioxy-5-methoxybenzene, was one of the major essential oils of nutmeg. However, its anti-allergic effect in the Th1/Th2 immune response was poorly understood. Recently, it was shown that T-bet and GATA-3 was master Th1 and Th2 regulatory transcription factors. In this study, we have attempted to determine whether myristicin regulates Th1/Th2 cytokine production, T-bet and GATA-3 gene expression in ovalbumin (OVA)-induced asthma model mice. Myristicin reduced levels of IL-4, Th2 cytokine production in OVA-sensitized and challenged mice. In the other side, it increased $IFN-{\gamma}$, Th1 cytokine production in myristicin administrated mice. We also examined to ascertain whether myristicin could influence eosinophil peroxidase (EPO) activity. After being sensitized and challenged with ovalbumin (OVA) showed typical asthmatic reactions. These reactions included an increase in the number of eosinophils in bronchoalveolar lavage fluid, an increase in inflammatory cell infiltration into the lung tissue around blood vessels and airways, and the development of airway hyper-responsiveness (AHR). The administration of myristicin before the last airway OVA challenge resulted in a significant inhibition of all asthmatic reactions. Accordingly, these findings provide new insight into the immunopharmacological role of myristicin in terms of its effects in a murine model of asthma.