Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)
Park, Soo Kyung;Gil, Hee-Young;Kim, Hui;Chang, Chin-Sung
Journal of Korean Society of Forest Science
/
v.102
no.1
/
pp.38-58
/
2013
The existence of endemism in many parts of the world is an important factor for conservationists. Conservation can only be carried out under national legislation, and national endemics, which have very limited ranges, fully depend on the effort and success of conservation. A total of 523 vascular plant taxa were listed in the latest national checklist by Ministry of Environment in 2005, while the 'Creation and Furtherance of Arboretums Act' including a national endemic list (appendix 4-1) was established by Korea Forest Service and was legislated as a law in late 2011. This legislation by Korea Forest Service on endemism of Korean vascular plants have required much attention because of discrepancies of nomenclature, taxonomic bias and inflation. Examining data for both lists proposed by Ministry of Environment and Korea Forest Service, of the total of 360 legislated taxa, around 286 taxa are shared with the list of Ministry of Environment, of which about 80% have been found as common taxa. Around 67(18.7%) are typographic errors, and 14 taxa (3.9%) are recorded as illegitimate and invalidly published names. Through this analysis 12 taxa (3.4%) were found in China as well as in Korea and these are thought to be non Korean endemic taxa. Taken together, the legislated list displayed 1/4 (24.9%) errors out of the total list. Only 59 taxa (16.5%) are identified as national endemic species. The remainder are either unresolved candidates (73 taxa, 20.4%) or synonyms (196 taxa, 54.7%) status. It must be noted, that the concept of endemism very much depends on the knowledge of the species concept, taxonomic bias and geographical range of a species. Also, the most major nomenclatural problem tend to be more stable if the information on database about Korea Plant Name, which is managed by Korea National Arboretum are well updated year to year. These exaggerated numbers underscore the urgency for regional conservation planning and implementing effective strategies to preserve these real endemic taxa into the future.
The Ministry of Environment (ME) is planning to adopt in 2020 the IUCN regional Red List for "Guidelines for listing and delisting rare & endangered species and management of endangered Species System". The ME designated 377 species of vascular plants on the regional Red List. In a previous study it had been suggested that 103 species from this list are candidates for the regional Red List. With respect to a possible Red List, we assessed 59 species (after excluding 34 additional NA species and ten endemic species). These assessments indicated that 16 species are at the "threatened" level. Of those, one species is Critically Endangered, ten are Endangered, and five are Vulnerable. A further four species are classified as Near Threatened, 30 as Of Least Concern, and nine as Data Deficient. We found that most of the assessments proposed by the Ministry of Environment were not supported by scientific data, including quantitative geographic data (over 70%) in Criteria B. In order to determine the endangered species belonging to the orchid family, it is necessary to obtain records of illegal activities or data on overcollection. The current problem with the Ministry of Environment Red List has been the lack of management of scientific data on species showing a trend in decreasing population in the mid- to long-term; thus, there is a lack of critical resources for policy-makers. The ME legally designated categories and assessment, and the lack of expertise in failing to comply with the legal law by itself. The key to presenting an accurate overview of the state of Korean flora is to fill the information gaps with respect to significant geographical and taxonomical biases in the quality and quantity of data. By regularly updating the qualified data, we will be able to track the changes in the conservation status of the flora and inform the necessary conservation policies.
The purposes of this study were to investigate problems related to quality of life and to identify residents needs for the university educational program for the community residents. The data were analyzed by using $x^2$-test, F-test and multiple range test. Findings of this study provided some useful implications to develop educational programs for community people. These implications are as follows. In the aspect of home management, the need for education about time management was relatively high and the degree of time conflicts was varied to family size, educational level of house, housewife's employment status and outside work time. In the program area of economic life, education for enhancing ability to cope with unexpected events and impulsive consumption behavior, and education for money management technique and value clarification should be included. There were significant differences in the parents' role difficulties according to mother's age and income. Especially parents' role difficulties were children's social emotional development and educational activity. The major problems in management of clothing and textile products were the change of textile sensation, the poor quality of necessaries, and discoloration. This result suggests that education programs on management of clothing and textiles should be developed. In health and food management it showed that subjects were afraid of cancer, hypertension, cerebral vascular diseases in relation with food habits. Hence program of education for health and good food habits should be developed.
Background: Many functional molecules controlling diverse cellular function are included in low-molecular weight proteins and peptides. Materials and Methods: To identify proteins controlling function in lung adenocarcinomas (AC), we performed two-dimensional gel electrophoresis employing tricine-SDS polyacrylamide in the second dimension (tricine 2-DE). This system was able to detect proteins under 1 kDa even with post-translational modifications. To confirm the utility of detected proteins as novel tumor markers for AC, we performed immunohistochemical analysis using 170 formalin-fixed and paraffin-embedded lung AC tissues. Results: Tricine 2-DE revealed that five proteins including S100A16 were overexpressed in lung AC-derived cells compared with lung squamous cell carcinoma, small cell carcinoma, and large cell neuroendocrine carcinoma-derived cells. Immunohistochemically, S100A16 showed various subcellular localization in lung cancer tissues and a membranous staining status was correlated with the T-factor (P=0.0008), pathological stage (P=0.0015), differentiation extent (P=0.0001), lymphatic invasion (P=0.0007), vascular invasion (P=0.0001), pleural invasion (P=0.0087), and gender (P=0.039), but not with the age or smoking history. More importantly, membranous staining of S100A16 was significantly correlated with a poorer overall survival of either stage I (P=0.0088) or stage II / III (P=0.0003) lung AC patients, and multivariate analysis confirmed that membranous expression of S100A16 was an independent adverse prognostic indicator (P=0.0001). Conclusions: The present results suggest that S100A16 protein is a novel prognostic marker for lung AC.
Protamine, a polycationic peptide extracted from fish, has been widely used for the reversal of anticoagulant action of heparin. However it may cause untoward circulatory side effects including hypotension and bradyarrhythmia. Nowadays, histamine and prostacyclin are regarded as one of the causative agents in the underlying mechanism of hemodynamic changes. To certify the possible role of histamine and prostacyclin, we observed simultaneous changes of the hemodynamic status, plasma concentration of thromboxane B, and circulating platelet count before and after intravenous injection of protamine. Experimental dogs, weighing 12-14kg, were divided into 2 groups; group A animals [n=10], were pretreated with indomethacin[2.5mg/kg] and group B animals[n=10] were pretreated with chlorpheniramine[0.5mg/kg] Heparin[3mg/kg] and protamine [3mg/kg] were administered sequentially in both groups. The results were as follows ; 1. The mean systemic arterial pressure was maintained well in groups A, whereas in group B it decreased from 165\ulcorner18mmHg to 138\ulcorner30mmHg[p<0.01] and 151\ulcorner21 mmHg[p<0.05] at 1 minute and 2 minutes after protamine injection. The mean pulmonary arterial pressure was not changed significantly in group A, whereas in group B it increased from 852 mmHg to 11\ulcorner3 mmHg[p<0.05], 11\ulcorner3 mmHg[p<0.05] and 10\ulcorner3 mmHg[p<0.05] at 1 minute, 3 minutes and 5 minutes after protamine injection. 2 The thromboxane B2 was not changed significantly in group A, whereas in group B it increased from 399\ulcorner401 \ulcornerg/ml to 744\ulcorner615 \ulcornerg/ml[p<0.05] and 814\ulcorner1070 \ulcornerg/ml [p<0.0 5] at 1 minute and 3 minutes after protamine injection without concomitant changes of pulmonary vascular resistance and pulmonary capillary wedge pressure. 3. The number of circulating platelet was not changed in group A, whereas in group B it decreased from 207100\ulcorner103600/\ulcornerl to 159700\ulcorner90900/\ulcornerl [p<0.05] at 1 minute after protamine injection, Although thromboxane B2 and platelet count were changed significantly after protamine injection, they did not cause the remarkable hemodynamic changes. Considering the above results, hemodynamic changes may be caused mainly by prostacyclin rather than thromboxane or platelet. Therefore, the pretreatment with cyclooxygenase inhibitor would be beneficial to prevent circulatory adverse effects of protamine for the patients undergoing cardiac surgery.
Kim, Tackeun;Oh, Chang Wan;Park, Hyeon Seon;Lee, Kunsei;Lee, Won Kyung;Lee, Heeyoung
Journal of Korean Neurosurgical Society
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v.61
no.4
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pp.478-484
/
2018
Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.
With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.
High blood pressure is an important determinant of the incidence of coronary heart disease, stroke, congestive heart failure, renal failure, and peripheral vascular disease. Recommendations for control of high blood pressure emphasize lifestyle modification, including weight control, reduced sodium intake, increased physical activity. Subjects who were normotensive (n=19, $47.2\pm9.0$ y, BP l16/81 mmHg) ,treatment hypertensive (n=33, $54.2\pm6.9$ y, BP 132/85 mmHg) and non-treatment hypertensive (n=14, $50.1\pm11.0$ y, 149/94 mmHg) recruited. Anthropometric assessment (height weight waist circumference, hip circumference, fat$\%$, fat mass, and lean body mass) and dietary assessments (using 3-days food records, daily nutrient intakes were inuysed by CAN PRO 2.0 were carried out. Blood and 24-hour urine were collected). Test of recognition for salt taste threshold were performed. In non-treatment hypertensive male subjects, weight, $\%$IBW, BMI, and waist circumference were significantly higher than those of normotensive and treatment hypertensive subjects (p<0.05) .Food habits were not significantly different among the three groups. Intakes of vitamin A, vitamin B,, and vitamin B, were significantly higher in normotensive group (p<0.05). Intakes of sodium and salt taste recognition threshold were the highest in normotensive group and the lowest in treatment hypertensive group (p<0.05). Blood levels of lipids and minerals were not significantly different among the three groups. Urinary calcium level of normotensive group were significantly higher than that of treatment hypertensive and non-treatment hypertensive groups (p<0.05). These results indicate that continuous management of hypertension by drug and non-drug treatment affects salt taste recognition threshold and reduced the consumption of sodium. However, dietary sodium intake exceed recommended sodium intake to prevent and treat hypertension. It is necessary to develop the lifestyle modification program that may have beneficial effects on hypertension treatment.
Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.
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