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Therapeutic Efficacy of Alendronate for Glucocorticoid Induced Metabolic Bone Disease in Children with Nephrotic Syndrome (신증후군 환아에서 스테로이드 유발 대사성 골질환에 대한 Alendronate의 치료 효과)

  • Lee Ji-Eun;Lee Hyun-Ok;Paik Kyung-Hoon;Lee Suk-Hyang;Jin Dong-Kyu
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.33-42
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    • 2004
  • Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.

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Characteristics and Clinical Course of Ovarian Hernias in Infants (1세 미만 여아 난소 탈장의 특성과 임상 경과)

  • Choi, Kyoung-Eun;An, So-Yoon;Kim, Kyung-Ah;Ko, Sun-Young;Lee, Yeon-Kyung;Shin, Son-Moon;Han, Byung-Hee
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.80-83
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    • 2008
  • Purpose : Inguinal hernias are common in children and sometimes are associated with dangerous complications, such as incarceration. There are no established management guidelines for ovarian hernias. We have reviewed the clinical course of ovarian hernias in infants. Methods : We reviewed the medical records of female infants diagnosed with ovarian hernias by ultrasonogram at Kwandong University College of Medicine, Cheil General Hospital, and the Women's Healthcare Center between March 2001 and August 2007. We analyzed the patients gestational age, birth weight, age at the time of detection of the inguinal mass, the patients chief complaints, operative time, post-operative complications, and ultrasonographic findings. Results : Eight female infants had ovarian hernias, four of whom were born prematurely. Seven infants had left-sided ovarian hernias, and one infant had a right-sided ovarian hernia. Five infants underwent surgery and there were no postoperative complications or recurrences. Three girls did not have surgery, and the ovarian hernias regressed spontaneously, with no recurrences or complications. The regression time of inguinal masses ranged from 70-161 days after birth. Conclusion : Physical examination to detect movable masses within the labium major in premature female infants is important because the incidence of premature inguinal hernias is much higher than in term infants. No rational medical treatment plans for female ovarian hernias have been published to date. We cared for three girls with spontaneous regression of ovarian hernias. Pediatricians should be aware whether emergent surgery for ovarian hernias is indicated.

The reliability of dual rehabilitative ultrasound imaging measurements for muscle co-activation

  • Hahn, Joohee;Ha, Hyun-Geun;Lee, Hwang-Jae;Lim, Seungyeop;Lee, Wan-hee
    • Physical Therapy Rehabilitation Science
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    • v.6 no.3
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    • pp.152-157
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    • 2017
  • Objective: The aim of this study was to determine the intra-rater and inter-rater reliability of the dual rehabilitative ultrasound imaging (D-RUSI) when simultaneously measuring muscle thickness changes at rest and during co-contraction of the biceps brachii (BB) and triceps brachii (TB). Design: Cross-sectional study. Methods: This study included 36 healthy participants (23 men, 13 women). The participants sat on a chair in a comfortable position with a cushion placed under their elbow to maintain a 90-degree elbow flexion angle. The muscle thickness of the biceps brachii and triceps brachii was measured twice using the D-RUSI by two examiners during resting and co-contraction states. One week later, the same procedure was performed once again. Results: The intra-class correlation coefficients (ICCs) for intra-rater reliability ranged from 0.887 to 0.989 and the confidence interval was within an acceptable range of 0.778 to 0.994. The standard error of measurement (SEM) values ranged from 0.303 to 0.866 and the minimal detectable change (MDC) values ranged from 0.84 to 2.40. The ICCs for inter-rater reliability ranged from 0.758 to 0.925. The SEM values ranged from 0.702 to 1.486 and the MDC values ranged from 1.95 to 4.12. Conclusions: The use of the D-RUSI of the BB muscle had a very good intra-rater reliability and very good inter-rater reliability at the resting state, and a, good inter-rater reliability at the co-activation state. ICC values showed very good intra-reliability and inter-reliability for the TB muscle. the D-RUSI is a useful tool for simultaneously measuring the thickness of two muscles when the BB is an agonist and the TB is an antagonist during co-activation of the upper arm.

The Role of Genetic Polymorphisms in Nrf2 and P73 in Egyptian Women with Breast Cancer

  • Azhary, Nevin M Al;Kamel, Mahmoud M;Ismail, Yahia M;Mahmoud, Amal A;Radwan, Enas M
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4945-4949
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    • 2016
  • Background: Breast cancer is the commonest cancer in Egyptian females. Nrf2 is involved in oxidative stress while P73 functions in response to DNA damage. This study aimed to assess the role of Nrf2 promoter and P73 G4C14 to A4T14 SNPs in breast cancer in Egypt. Patients: Eighty-five female patients with breast tumours (41 malignant, 44 benign) were included. Nrf2 (rs6721961) and p73 (G4A) SNPs were determined by PCR- CTPP assay. Results: Genotype frequencies of the Nrf2 promoter SNP were 34.2% and 37.9% for AA in benign and malignant groups respectively, and 43.9% and 40.5% for CC and, 21.9 % and 21.6% for CA. Genotype frequencies for the P73 G4A SNP were 52.9% and 44.7% for GA in benign and malignant groups respectively, and 47.1% and 55.3% for GG. Discussion: Nrf2 genotypes in pre - and post-menopausal patients, showed significantly different distributions in the 2 patient groups, the AA genotype being significantly more common in pre-menopausal patients. The P73 G4A SNP showed no relation to age of disease onset. Conclusion: The Nrf2 (rs6721961) AA genotype might be related to early breast cancer onset. In contrast the P73 G4A polymorphism showed no relation to either disease risk or age at presentation.

The Effectiveness of Non-pharmacologic Interventions for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-analysis (국내 비특이적 만성 요통 환자에게 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Mijung;Lee, Haein
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.1-16
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effectiveness of non-pharmacologic interventions for chronic nonspecific low back pain (CLBP) in adults aged 18-64 years. Methods: We searched for potentially relevant randomized controlled trials and non-randomized controlled trials through five Korean electronic databases (i.e., Korean Studies Information Service System, Research Information Sharing Service, Korean Medical Database, KoreaMed, and National Assembly Library) published from January 2010 to May 2019. Two investigators independently selected the studies based on the criteria and assessed risk of bias in the included studies. We estimated the effect size of interventions using Comprehensive Meta Analysis 3.3. Results: Of 10,151 studies, 26 studies met the inclusion criteria and 15 studies were included in the meta-analysis. Exercise reduced low back pain (Hedges's g=-1.53, 95% CI: -2.22 to -0.85) and pain-related disabilities (Hedges's g=-0.92, 95% CI: -1.40 to -0.45). We found that taping was effective in decreasing low back pain (Hedges's g=-1.12, 95% CI: -1.51 to -0.73) and pain-related disabilities (Hedges's g=-0.50, 95% CI: -0.93 to -0.07). Manual therapy yielded a marginally significant reduction in low back pain (Hedges's g=-2.32, 95% CI: -4.64 to 0.00), the therapy was not effective in decreasing pain-related disabilities. Conclusion: Although there was little evidence for the effectiveness of manual therapy in adults with CLBP, exercise and taping were effective to relieve pain and pain-related disabilities. Based on these findings, we suggest the development of non-pharmacologic interventions or a nursing intervention protocol for the CLBP management. Also, nurses should consider implementation of effective non-pharmacologic interventions for CLBP.

Development of Home Visiting Nursing Standards Base on a Long-Term Care Insurance for the Elderly Program (노인장기요양보험제도에 의한 방문간호 표준개발)

  • Kim, Myung-Hee
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.285-301
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    • 2010
  • Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.

Investigation on the Main Exposure Sources of Nanomaterials for Nanohazards Assessment (나노위해성 관리를 위한 나노물질 주요 배출원 파악)

  • Kim, Young-Hun;Park, Jun-Su;Kim, He-Ro;Lee, Jeong-Jin;Bae, Eun-Joo;Lee, Su-Seung;Kwak, Byoung-Kyu;Choi, Kyung-Hee;Park, Kwang-Sik;Yi, Jong-Heop
    • Environmental Analysis Health and Toxicology
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    • v.23 no.4
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    • pp.257-265
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    • 2008
  • Nanotechnology is emerging as one of the key technologies of the 21 st century and is expected to enable one to broaden the applicability across a wide range of sectors that can benefit public and improve industrial competitiveness. Already, consumer products containing nanomaterials are available in markets including coatings, computers, clothing, cosmetics, sports equipment and medical devices. Recently, Institute of Occupational Medicine in UK reported an occupational hygiene review for nanoparticles in the viewpoint of nanotoxicity. They reported that the exposure control is very important issues in workplace for exposure assessment, but no proper methods are available to measure the extent of exposures to nanoparticles in the workplace. Therefore, for the estimation of exposure of nanomaterials, we have to approach the material-balance methodology, which similarly carried out in TRI (toxic release inventory) for hazardous chemicals. In order to use this methodology, the exposure source of nanomaterials should be determined firstly. Therefore, herein we investigated the main sources and processes for the exposure to nanomaterals by conducting the survey. The results could be used to define and assess nanohazard sources.

The Relationship between Hardiness.Self Efficacy and Compliance in Coronary Artery Disease Patients (관상동맥질환자의 강인성, 자기효능과 건강행위 이행과의 관계)

  • Kim, Sook-Young
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.83-95
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    • 1998
  • The purpose of this study was to investigate the relationship between hardiness-self efficacy and compliance in coronary artery disease patients. The subjects for the study were 106 patients who admitted to S medical center or visited to outpatient clinic. The instruments used for this study included a questionnaire of general characteristics, compliance, health related hardiness and self efficacy. The data were analyzed by using mean, t -test, ANOVA, Scheffe test, Pearson correlation. The results of this study were as follows: 1. The average score for compliance was 70.75, for the hardiness was 87.35, for the self efficacy was 59.04. 2. The relationship between the variables of compliance and hardiness self efficacy was significant. Compliance was significantly related to hardiness(r=.47, p<.01), suggesting that the person with high hardiness got higher compliance scores. The three dimensions of health related hardiness were control, commitment, challenge. Control(r=.513, p<.01), commitment(r=.258, p<.05), challenge(r=.419, p<.01), were significantly related to compliance. A slight but significant correlation was also found between compliance and self efficacy(r=.21, p<.05). 3. In the relationship between general characteristics variables and compliance there were significant differences in marital status(t =3.43, p<.01), duration of illness(F=4.98, p<.01), hospitalized experience(t=2.04, p<.05), educational experience(t=2.66, p<.01). From the above results, it can be concluded that ; Hardiness and self efficacy were found as important factors of the compliance in coronary artery disease patients. These results suggest that nursing intervention to increase the level of hardiness and self efficacy should be developed.

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A study of the payment of nutrition counseling services (영양상담료의 의료보험화를 위한 연구)

  • Kim, Yeong-Hye;Kim, Hwa-Yeong;Jo, Mi-Suk;Lee, Yeong-Hui;Lee, Hyeon-Suk
    • Journal of the Korean Dietetic Association
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    • v.4 no.1
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    • pp.53-64
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    • 1998
  • This study was performed to investigate the cost of nutrition counseling service at present and to suggest the guideline for the payment. Data were collected using questionnaires and the cost of counseling was expected by analyzing the time consumed and needed for nutrition counseling. The results were as follows; In the case of diabetes, mean time of nutrition counseling was 69.7$\pm$35.3min/case, but the dietitian asked 82.7$\pm$44.6min/case for counseling and in the cases of renal diseases, mean time of counseling was 64.3$\pm$24.1min/case and the time asked was 84.8$\pm$34.5min/case (P<001) It was found that time was not enough to educate or counsel the clients. The cost of counseling was not counted in 20.3% of the respondants and the mean nutrition counseling fee was 5,460.6$\pm$3,547.7won/case in in-patient. The group education fee was 6,168$\pm$2,813won/case. The estimations of the cost for nutrition counseling services using labor cost were 18,463.5won in case of diabetes and 18,463.5won/case for patients of renal disease and in group education 8,111.5won and 7,404.3won respectively.

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Characteristics of Muscle Strength and Posture among Automobile Parts Manufacturing Workers and the Necessity of the Musculoskeletal Injury Prevention Program (근골격계질환 예방프로그램의 필요성과 자동차 부품 제조업 근로자들의 근력과 자세의 특성 연구)

  • Kwon, Il-Ho;Shin, Won-Seob
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.4
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    • pp.173-181
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    • 2019
  • PURPOSE: This study examined the necessity of a musculoskeletal injury-prevention program for automobile parts manufacturing workers by assessing the body composition, muscle strength, and posture according to sex and age. METHODS: Two hundred eighty-two workers (men, 218; women, 64; mean age, 38.97 years; and mean work tenure, 10.29 years) participated in this study. They completed a questionnaire on their general characteristics, excluding personal identification codes. The participants were evaluated for body composition, muscle strength, and posture using InBody, a hand dynamometer, and the Image J program through photography, respectively. An independent t-test and one-way analysis of the variance were used for the comparisons according to sex and age, respectively. RESULTS: Significant sex-related differences in muscle strength and grip force were observed (p<.05). In addition, the left-side pelvic inclination was significantly higher in the female participants than in the male participants (p<.05). Significant age-related differences in the skeletal muscle mass and muscle strength were observed around 40 years (p<.05). Significant correlations were observed among the body composition (skeletal muscle and body fat masses), muscle strength, and posture (pelvic inclination; p<.01). CONCLUSION: Significant differences in pelvic inclination by sex and muscle strength by age were found, even in healthy workers. Additional posture and muscle strength measurements will be needed for workers who participate in the musculoskeletal injury prevention program because they are exposed to an incorrect posture for many hours or in many repetitive tasks.