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Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria (단백뇨를 동반한 IgA 신병증 및 HSP 신염을 가진 소아에서 메틸프레드니솔론 충격요법과 경구 스테로이드 요법의 비교)

  • Ahn, Ji Young;Moon, Jung Eun;Hwang, Young Ju;Choi, Bong Seok;Ko, Cheol Woo;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

Surgical Outcome of Biventricular Repair for Double-outlet Right Ventricle: A 18-Year Experience (양대혈관우심실기시증에 대한 양심실 교정의 수술 성적: 18년 치험)

  • 이정렬;황호영;임홍국;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.566-575
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    • 2003
  • We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.

Effect of Film Layers and Storing Period on the Fermentation Quality of Whole Crop Barley Silage (청보리 사일리지의 비닐겹수 및 저장기간에 따른 발효품질)

  • Song, Tae-Hwa;Park, Tae-Il;Park, Hyong-Ho;Yoon, Chang;Kim, Yang-Kil;Park, Jong-Chul;Kang, Chon-Sik;Son, Jae-Han;Kim, Kyong-Ho;Cheong, Young-Keun;Oh, Young-Jin
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.35 no.1
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    • pp.6-11
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    • 2015
  • This study was undertaken to characterize feed value and silage quality according to storage period and film layers for whole-crop barley silage. The crude protein (CP) content increased in all silage during the storage periods compared to those before silage, this content slightly increased over the prolonged storage period but it was not significant (p>0.05). Depending on the film layers of silage, 6 layers were higher than 4 layers. The neutral detergent fiber (NDF) and acid detergent fiber (ADF) contents also increased in all silage during storage periods compared to those before silage (P<0.05), but they were maintained at similar levels during the storage period. Depending on the film layers of silage, 6 layers were higher than 4 layers. The total digestible nutrients (TDN) content decreased in all silage during the storage periods. However, it was maintained at a similar level for the duration of each storage period. Depending on the film layers of silage, 6 layers were lower than 4 layers. The pH value was decreased during the prolonged storage period and depending on the film layers, 6 layers were lower than 4 layers. In the organic acid contents during the prolonged storage period, lactic acid increased, acetic acid was lower, and butyric acid was significantly higher (p<0.05). Depending on the film layers, 6 layers showed higher levels of lactic acid and lower levels of butyric acid (p<0.05). Therefore, these results showed that 6 layer wrapping was advantageous for long term storage of whole crop barley silage, while also indicating that it is desirable to use 4 layer wrapping within a six month period.

Establishment of Safe Management Guideline Based on Uptake Pattern of Pesticide Residue from Soil by Radish (토양잔류 농약의 무 흡수양상 및 토양 안전관리기준 설정)

  • Hwang, Jeong-In;Kwak, Se-Yeon;Lee, Sang-Hyeob;Kang, Min-Su;Ryu, Jun-Sang;Kang, Ja-Gun;Jung, Hye-Hyeon;Hong, Sung-Hyeon;Kim, Jang-Eok
    • Korean Journal of Environmental Agriculture
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    • v.35 no.4
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    • pp.278-285
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    • 2016
  • BACKGROUND: Uptake patterns of ${\alpha}$-, ${\beta}$-isomers and sulfate metabolite of endosulfan (ED) by radishes grown in treated soils with ED concentrations of 2 and 10 mg/kg were investigated to establish soil management guidelines for ensuring the safety of radishes from ED residues. METHODS AND RESULTS: All samples of soils and radish plants separated into shoot and root parts were analyzed for ED residues using a gas-chromatography mass spectrophotometer, and the results were used to calculate the bioconcentration factor (BCF), indicating the ratio of ED concentrations between radishes and soils. During the experimental period, uptake and distribution rates of ED-sulfate in radishes were the highest, followed by ${\alpha}$- and ${\beta}$-ED. The BCF values to initial ED concentrations in soils were greater for root parts (0.0077 to 0.2345) than for shoot parts (0.0002 to 0.0429) and used to obtain regression equations by time. Long-term BCFs estimated by the obtained equations ($R^2$ of 0.86 to 1.00) were evaluated with the maximum residue limit (0.1 mg/kg) of ED for radishes, in order to suggest safe management guidelines of ED for radish-cultivating soils. CONCLUSION: Suggested guidelines showed the significant dependency on duration for radish cultivation and exposed concentration of ED in soil.

Clinical Report of 46 Intracranial Tumors with LINAC Based Stereotactic Radiosurgery (선형가속기를 이용한 뇌종양 46예의 뇌정위다방향방사선치료 성적)

  • Yoon Sei C;Suh Tge S;Kim Sung W;Kang Ki M;Kim Yun S;Choi Byung O;Jang Hong S;Choi Kyo H;Kim Moon C;Shinn Kyung S
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.241-247
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    • 1993
  • Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

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Effect of High Temperature, Daylength, and Reduced Solar Radiation on Potato Growth and Yield (고온, 일장 및 저일사 조건이 감자 생육 및 수량에 미치는 영향)

  • Kim, Yean-Uk;Lee, Byun-Woo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.18 no.2
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    • pp.74-87
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    • 2016
  • Potato phenology, growth, and yield are projected to be highly affected by global warming in the future. The objective of this study was to examine the responses of potato growth and yield to environmental elements like temperature, solar radiation, and daylength. Planting date experiments under open field condition were conducted using three cultivars differing in maturity group (Irish Cobbler and Superior as early; Atlantic as mid-late maturing) at eight different planting dates. In addition, elevated temperature experiment was conducted in four plastic houses controlled to target temperatures of ambient temperature (AT), $AT+1.5^{\circ}C$, $AT+3^{\circ}C$, and $AT+5^{\circ}C$ using cv. Superior. Tuber initiation onset was found to be hastened curve-linearly with increasing temperature, showing optimum temperature around $22-24^{\circ}C$, while delayed by longer photoperiod and lower solar radiation in Superior and Atlantic. In the planting date experiments where the average temperature is near optimal and solar radiation, rainfall, pest, and disease are not limiting factor for tuber yield, the most important determinant was growth duration, which is limited by the beginning of rainy season in summer and frost in the late fall. Yield tended to increase along with delayed tuber initiation. Within the optimum temperature range ($17^{\circ}-22^{\circ}C$), larger diurnal range of temperature increased the tuber yield. In an elevated temperature treatment of $AT+5.0^{\circ}C$, plants failed to form tubers as affected by high temperature, low irradiance, and long daylength. Tuber number at early growth stage was reduced by higher temperature, resulting in the decrease of assimilates allocated to tuber and the reduction of average tuber weight. Stem growth was enhanced by elevated temperature at the expense of tuber growth. Consequently, tuber yield decreased with elevated temperature above ambient and drop to almost nil at $AT+5.0^{\circ}C$.

3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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Marine Environmental and Phytoplankton Monitoring in Wando Coastal Waters in August during the Period of 2009-2010 (2009-2010년 8월 완도근해 해역의 해양환경 및 식물플랑크톤 모니터링)

  • Cho, Eun-Seob;Youn, Seok-Hyun
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.18 no.2
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    • pp.95-100
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    • 2012
  • This study was determined to analysis marine environmental and phytoplankton monitoring in Wando coastal waters in August during the period of 2009-2010 and provided the basic environmental data against Southwest Sea of Korea. In August, 2009, the distribution of water temperature and salinity showed an unique characteristics for all of stations, which was associated with a long duration of rainfall after July, 2009 and a lack of sunshine. In the lower of August, 2010, the stratification of water temperature and salinity was shown, which was caused by an intensive sunshine after the middle of August, 2010. Gangjin Bay and Gogeundo waters showed a highly different water temperature and transparency. It is thought that two regions have a distinct water mass and characteristics. In dissolved oxygen and oxygen saturation were higher according to higher water depth regardless of stations. In August, 2009, different dominant species occurred that Gangjin Bay showed a higher cell density of diatom, but Gonyaulax polygramma played an important role in dominant species in Gogeundo waters. It is associated with the introduction red tide water of G. polygramma occurring to southern coastal water in August, 2009. In August, 2010, diatom was extremely higher cell density compared with that of dinoflagellate that regarded as adaptive microrganism against higher quantity of suspended solid in Wando waters. Although Wando has a record of Cochlodinium red tide, this species may be difficult to grow and persist. Dominant species, diatom, play an important role in food organism for shellfish and forming a ecological lineage.

Comparison of Tiletamine/Zolanzepam, Xylazine - Tiletamine/Zolazepam and Medetomidine-Tiletamine/Zolazepam Anesthesia in Dogs (개에서 Tiletamine/Zolazepam, Xylazine-Tiletamine/Zolazepam과 Medetomidine-Tiletamine/Zolazepam의 마취효과)

  • Kwon, Young-Sam;Jeong, Jae-Hoon;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.33-41
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    • 2003
  • The cardiopulmonary and anesthetic effects of tiletamine/zolazepam(TZ, 10 mg/kg IV), xylazine-tiletamine /zolazepam(XTZ, X: 1.1 mg/kg IM, TZ: 10 mg/kg IV) and medetomid-ine-tiletamine/zolazepam(MTZ, M: 30$\mu\textrm{g}$/kg IM, TZ: 10 mg/kg IV) were evaluated to 15 healthy mongrel dogs (4.16$\pm$0.65 kg). These dogs were randomly assigned to the three treatment groups(Control, XTZ, MTZ) with 5 dogs in each group. All experimental animals were premedicated with atropine(0.03 mg/kg, IM). Xylazine or medetomidine were administered to dogs in XTZ group and MTZ group 10 minutes after atropine injection. TZ was administered 20 minutes after atropine injection in all groups. The loss of pain response at pedal reflex and ear pinching tests in XTZ and MTZ groups were much longer compared with those of Control group(P < 0.01). All dogs in this study showed head rocking and hypersalivation during recovery time. Body temperature decreased progressively during experimental period in all groups, but it was not significant. After TZ injection, heart beat rate significantly increased 10 and 20 minutes in Control group, and 20 and 40 minutes in XTZ group(P < 0.05). Respiratory rate significantly decreased 0,10,20 and 40 minutes after 72 injection in XTZ and MTZ groups. In Control group, systolic arterial pressure (SAP) 20 minutes. diastolic arterial pressure(DAP) 10 minutes and mean arterial pressures (MAP) 10 and 20 minutes after 72 injection significantly decreased(P < 0.05). In XTZ group, SAP, DAP and MAP significantly decreased 20 and 40 minutes after 72 injection(P < 0.05). Thus, it was considered that XTZ and MTZ were useful in a canine surgical treatment that requires long anesthetic duration and deep analgesia.

The Spatio-Temporal Progress of Cochlodinium polykrikoides Blooms in the Coastal Waters of Korea (한국연안의 Cochlodinium polykrikoides 적조 발생과 변천)

  • KIM Hak Gyoon;JUNG Chang-Su;LIM Wol-Ae;LEE Chang-Kyu;KIM Sook-Yang;YOUN Sung-Hwa;CHO Yong-Chul;LEE Sam-Geun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.6
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    • pp.691-696
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    • 2001
  • The first bloom of Cochlodinium polykrikoides was observed in the estuary of Nak-dong river near Pusan in Korea in 1982. Since then, there have been irregular blooms, sometimes spread over the adjoining .to Jinhae Bay even though it was confined to the bay and its vicinites until 1988. It had been outbroken frequently in the adjacent to Tongyeong, Geoje, Namhae and Yeosu coast since 1989. It became widespread along the coast of the South Sea to the East Sea of Korea in 1995. And in October in 1998 and 1999, the bloom had been taken place in Kunsan coast of Yellow Sea. According to the observations in situ, the frequency of occurrence has been increased year by year. The prevailing bloom season was from July to October with peak in September. The duration of the bloom became longer with the year, and sometimes lasted more than one month. The density of the bloom did not exceed 5,000 cells $mL^{-1}$until 1991, but it increased year by year to the highest of 43,000 cells $mL^{-1}$ in 1999. With respect to the assembleges of species in dinoflagellate blooms, C. polykrikoides was one of the important species with diatoms and the other dinoflagellates in 1980s. But since then, C. polykrikoides made an almost monospecific bloom. Based on two decadal observations of C. polykrikoides blooms, it became widespread throughout whole coast of the Korea, persistent for about one or two month long in some year, and monospecisc high density blooms. It was reported that significant fish mortalities were caused by this harmful dinoflagellate blooms especially in the fishfarms accomodating intensive fish cages such as Tongyeong, Namhae-do, Geoje, Yeosu and Geomun-do fishfarming yards. This widespread and persistent harmful algal blooms impede the development of marine aquaculture industries.

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