• Title/Summary/Keyword: Renal

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Values of Alpha-fetoprotein of Maternal Serum in Normal Pregnancy (정상 임산부의 혈청 Alpha-fetoprotein치의 임상적 이용)

  • Kim, Mok-Jin;Han, Kuk-Sun;An, Jae-Hong;Suh, Jeung-Ho;Lee, Young-Gi;Park, Yoon-Kee;Lee, Tae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.168-174
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    • 1997
  • Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.

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Suicide Ideation and the Related Factors among Korean Adults by Gender (한국 성인의 성별 자살생각 관련 요인 분석)

  • Park, Eunok
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.161-175
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    • 2014
  • Objectives: This study investigates the prevalence of suicide ideation and its the related factors by gender among Korean adults. Methods: National cross-sectional data from the database of the first and second year of $5^{th}$ Korean National Health and Nutritional Examination Survey (KNHANES V-1, V-2) were used for this study. 13,165 adults (${\geq}20$ years) were included in this analysis. Results: The prevalence of suicide ideation was 9.8% for men, 18.9% for women. Renal failure, depression, melancholy, stress, perceived health status, and smoking were significant risk factors among both men and women for suicide ideation. Divorced, separated or widowed of marital status and severe physical activity were related factors of suicide ideation for men. Low educational attainment, and alcohol dependency were associated factors of suicide ideation for women. Conclusions: There was gender difference of prevalence and risk factors of suicide ideation. These gender differences should be considered for planning and implementing suicide prevention program.

Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death (앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病))

  • Lee, Cha-soo;Park, Cheong-kyu
    • Korean Journal of Veterinary Research
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    • v.27 no.2
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    • pp.277-290
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    • 1987
  • This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

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Intestinal Ultrasonographic and Endoscopic Findings in Pediatric Patients with Henoch-Sch$\"{o}$nlein Purpura and Gastrointestinal Symptoms (위장관 증상을 동반한 Henoch-Sch$\"{o}$nlein Purpura 환아의 장관 초음파 소견 및 내시경 소견)

  • Noh, Yun-Il;Ryu, Min-Hyuk;Jung, Chul-Zoo;Lee, Dong-Jin;Kwon, Jung-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.181-190
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    • 2001
  • Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

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Minor Stress, Coping Skill and Quality of Life in Patients with Hemodialysis (혈액투석 환자들의 Minor Stress, 대처방식 및 삶의 질)

  • Yang, Jae-Won;Lee, Moon-Soo;Park, Sang-Uk;Oh, So-Young;Ko, Young-Hoon;Kwan, Young-Joo;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.38-46
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    • 2008
  • Objectives : The purpose of this study is to investigate the minor stress in daily life related to undergoing hemodialysis and the relationship between minor stresses, coping skills, and subjective quality of life among the patients with end stage renal disease. Methods : Seventy seven patients on hemodialysis were enrolled in this study. Minor stress was assessed with daily stress inventory-Korean version(K-DSI), ways of coping checklist identified the use of the following coping strategies:problem-focused, seek social support, emotion-focused coping and wishful thinking. Socio-demographic data were obtained and World Health Organization-Quality of Life Scale(brief form) was also administered to subjects. Results : Participants mean age was $55.92{\pm}13.71$ years. The mean of the event, impact and impact/event (I/E) ratio scores of K-DSI were $29.06{\pm}21.57$, $88.69{\pm}75.88$ and $2.92{\pm}1.11$, respectively. These scores were much higher than normative data of K-DSI. Among the 5 categories of this inventory, the scores of cognitive stressors were highest. 5 categories of the inventory showed positive relationship with way of coping subscales, which showed coefficient of correlation between 0.259(p<.01) and 0.495(p<.001). However, no significant correlation was found between minor stress subscales and quality of life. Hemodialysis patients in our study used more emotional-focused coping methods, which was considered as passive way of cope than problem-orientated coping methods. Conclusion : The main findings of this study indicated that patients on hemodialysis showed higher level of perceived minor stress than normal population. The patients treated with hemodialysis tend to use passive way of coping primarily. For assessing the stress in patients on hemodialysis, clinician has to consider both level of perceived minor stress and the ways of coping the patients primarily use.

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Comparison of Enalapril Maleate Tablets on Bioavailability and the Time Course of Inhibition of Plasma Angiotensin-Converting Enzyme (Enalapril Maleate 정제의 동등성에 관한 연구 ; 약동학적 성상 및 혈장 ACE 활성도 억제 효과)

  • Jang, In-Jin;Jang, Byung-Soo;Shin, Sang-Goo;Shin, Jae-Gook;Rho, Il-Kun;Lee, Kyeong-Hun;Park, Chan-Woong
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.219-226
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    • 1990
  • Enalapril maleate tablets of two different producers were tested for bioequivalence. Enalapril is rapidly metabolized to an active metabolite, enalaprilat which inhibits angiotensin-converting enzyme (ACE). The pharmacokinetics of enalapril maleate and the time course of inhibition of plasma ACE activity after administration of the drugs were studied. Two single doses of 10mg each of enalapril maleate were administered orally to twelve male volunteers in a balanced, randomized, two-way crossover investigation. Plasma enalaprilat concentrations were determined over a 23-hour after the dose by enzyme inhibition assay and enalapril by the same method following in vitro hydrolysis. Urinary recoveries of enalapril and enalaprilat were determined for the calculation of renal clearance. Plasma ACE activity was determined by an enzyme assay. Peak plasma levels of enalapril were observed about 1 hour after the doses, and practically all enalapril had disappeared from plasma within 6 hour. Peak enalapril concentrations of both formulations were almost identical ($Vasotec^{\circledR}$, 61.38 ng/ml; $Beartec^{\circledR}$, 64.27 ng/ml). The values of the pharmacokinetic parameters of enalaprilat computed for $Vasotec^{\circledR}$ and $Beartec^{\circledR}$ tablets are presented in that order; area under the curve=330.63:320.96 $ng{\cdot}hr/ml$; peak concentration=38.63:39.43 ng/ml; time to peak=3.83:4.08 hour; elimination half-life=3.95:3.92 hours. No statistically significant difference was detected when area under the curve and all other parameters were compared. Using criteria of 95% confidence interval for the comparison of these parameters, only the upper limits of area under the curve and time to peak of enalapril were over 120%. All the parameters of enalaprilat were acceptable. Percent inhibition of plasma ACE to plasma enalaprilat concentration showed the sigmoid concentration-inhibition relationship. Time courses of plasma ACE inhibition after the administration of both formulations were quite similar. The formulations were found to be equivalent when compared on the premise that no significant difference was detected when pharmacokientic parameters and inhibition of ACE activity were compared, based on the confidence limits analysis.

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Survey of Caffeine levels in the Favorite Diets of Children (어린이 기호식품 중 카페인 함량에 대한 조사)

  • Lee, E-Na;Kim, Hee-Jin;Im, Ji-Young;Kim, Jeoung-A;Park, Hye-Young;Ryu, Ju-Young;Ko, Kwang-Rack;Kim, Hyung-Sik
    • Journal of Food Hygiene and Safety
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    • v.22 no.3
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    • pp.173-178
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    • 2007
  • Children may respond differently to the caffeine from adults because they have different physiologic makeup and are functionally immature in terms of hepatic and renal function; this leads to the slower clearance of caffeine in early life. Therefore, children are often assumed to be more susceptible to caffeine effects. Alarge number of food supplements may interfere with these processes, and therefore caffeine exposure may have more serious consequences for children than for adults, irrespective of sensitivity. However, there has never been a national dietary survey on caffeine intakes in children. The purpose of our study was to identify caffeine intakes and beverage sources of caffeine in a representative sample of children in Busan, Korea. Caffeine intakes were based only on beverages included in the Continuing Surveys of Food Intakes by individuals. The caffeine content of the beverages ranged from 2.8 to 65.2mg/100ml for cola, soft drinks, and teas. Caffeine was not completely absent from caffeine-free colas, juice, and milk. In this study, cola-type beverages were an important dietary source of caffeine in the children. Daily caffeine intake for children was estimated to range from 12.5 to 250 mg/day. In general, the acceptable daily intake (ADI) of caffeine should cover the entire population including children. Therefore, special considerations should be needed regarding the consumption of soft drinks containing caffeine to children below the 12 years of age.

A Clinical Effect of Ofloxacin, Prothionamide, Cycloserine Streptomycin(Kanamycin or Tuberactinomycin) in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료에서 Ofloxacin, Prothionamide, Cycloserine, Streptomycin(Kanamycin or Tuberactinomycin) 4제요법의 임상 효과)

  • Song, Ju-Young;Yoo, Min-Kyu;Hong, Jae-Rack;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.295-301
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    • 1995
  • Background: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. Method: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. Results: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. Conclusion: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.

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Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

Protective Effects of Phellinus linteus and Curry-Added Cooked Mixed Grain Rice Extracts on Oxidative Stress-Induced LLC-PK1 Cell Damage (상황버섯 및 카레를 첨가한 잡곡밥 추출물의 LLC-PK1 세포에서의 산화적 스트레스 보호 효과)

  • Lee, Jung-Sook;Song, Jia-Le;Kil, Jeung-Ha;Jeong, Byung-Jin;Jeong, Jong-Sung;Huh, Tae-Gon;Park, Kun-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.11
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    • pp.1674-1680
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    • 2014
  • The aim of this study was to investigate the protective effects of methanolic extracts of cooked mixed grain rice samples, including grain rice (sorghum, black bean, proso millet, and Job's tears) mixed with fermented brown rice (GR), GR added with 0.5% water extract of Sanghwang mushroom (GRS) or 0.1% curry (GRK), and traditional five grain mixed rice (TMR, Ohgokbap), on $H_2O_2$-induced oxidative injury in LLC-PK1 pig renal epithelial cells. White rice (WR) was used as a positive control. Cells were first exposed to $H_2O_2$ ($250{\mu}M$) for 4 hr, followed by treatment with $100{\mu}g/mL$ of different GR extracts for 24 hr. $H_2O_2$ significantly induced cell damage (P<0.05). Cellular levels of reactive oxygen species (ROS), lipid peroxidation, and antioxidant enzymes, including catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-px), were measured. In addition, mRNA levels of antioxidant enzymes were determined by RT-PCR assay. Mixed grain rice, particularly GRS and GRK, were able to reduce cellular levels of ROS, decrease lipid peroxidation, and also increase mRNA expression of antioxidant enzymes compared to other samples. These results suggest that mixed grain rice, specifically GRS and GRK, have strong protective effects against $H_2O_2$-induced oxidative injury in LLC-PK1 cells through inhibition of lipid peroxidation, reduction of ROS levels, and elevation of antioxidant enzyme activities.