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The Central Venous Catheter-related Infection of Chlorhexidine-silver Sulfadiazine Coated Catheters in Medical ICU (내과계 중환자실 환자에서 Chlorhexidine-silver Sulfadiazine Coated Catheter의 중심정맥관 감염에 대한 연구)

  • Jung, Young Ju;Koh, Younsuck;Lim, Chae-Man;Lee, Jae Seung;Yu, Mi Hyun;Oh, Yeon Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.389-396
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    • 2005
  • Background : Central venous catheters(CVCs) area major source of nosocomial infection. Chlorhexidine-silver sulfadiazine coated catheters (CHSS) were developed to reduce the rate of CVC infection. However, the clinical effectiveness of CHSS in comparison wth non-coated catheter (NCC) remains to be evaluated. Methods : From January 2004 to December 2004 in medical intensive care unit (ICU) of Asan Medical Center, CVCs were inserted in 446 cases. We retrospectively analyzed characteristics of patients and catheterization,the catheter-related infection rate and colonization, microbiologic findings, and insertion sites (subclavian, jugular, femoral) according to the type of inserted CVCs (NCC: 187 cases, CHSS: 259 cases). Catheter related infection is defined as catheter related bacteremia and catheter related non-bacteremic sepsis. Results : 1) The mean age of the patients in each group was $62{\pm}16$ years, $63{\pm}15$ years (p=0.42), and sex ratio 94:50, 141:69 (p=0.9) in NCC and CHSS. Duration of ICU admission ($29{\pm}37$, $26{\pm}44$ p=0.42), duration of mechanical ventilation ($17{\pm}22$, $15{\pm}19$ p=0.17), and APACHE III score at the time of CVC insertion ($81{\pm}34$, $82{\pm}37$ p=0.61) were not different between both groups. 2) Mean duration of catheterization was 118 in NCC and 119 in CHSS (p=0.98). Number of catheter-days was 2176 days in NCC and 3035 days in CHSS. Catheter-related infection occurred in 9 (4.8%) cases receiving NCC and 4 cases (1.5%) receiving CHSS. Catheterrelated infection incidence per 1000 catheter-days was 4.1 and 1.3, respectively (p=0.04). CHSS was associated with a significant reduction of infection in jugular catheters regarding to insertion sites (p=0.01). 3) Microorganisms causing infection were Staphylococcus aureus (n=3), Candida (n=3), coagulase-negative Staphylococci (n=2), and Klebsiella (n=1) in NCC, and Candida species (n=2), coagulase-negative Staphylococci (n=2), Proteus (n=1) in CHSS. Conclusion : CHSS has significantly reduced the episodes of infection compared to NCC in jugular catheterization in medical ICU.

The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

Evaluation of Xerostomia Following Intensity Modulated Radiotherapy (IMRT) for Head and Neck Cancer Patients (세기조절방사선치료를 시행받은 두경부암 환자군에서 구강건조증지표 분석)

  • Lee, Seok-Ho;Kim, Tae-Hyun;Chie, Eui-Kyu;Im, Hyun-Shun;Im, En-Shil;Ryu, Jun-Sun;Jung, Yoo-Seok;Park, Sung-Yong;Kim, Joo-Young;Pyo, Hong-Ryull;Shin, Kyung-Hwan;Kim, Dae-Yong;Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.106-114
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    • 2004
  • Purpose : This study was done to evaluate xerostomia fellowing intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. Materials and Methods : From February till October 2003, 13 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years(range: 43$\~$77). Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated). The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at 1 and, 3 months after radiation therapy (RT). We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Resrlts : All 13 patients showed no significant changes in XQS, LSC and Salivary Flow rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients (<3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates However, in 5 Patients ($\geq$3,500 cOGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at 1 and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in ail patients (13) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR in proportion to the increase of XQS and, LSC. Conclusion : Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

Effects of Hysteroscopic Septotomy on Pregnancy in Patients with History of Infertility or Recurrent Spontaneous Abortion (불임 또는 습관성 유산 환자에서 중격자궁의 치료가 임신에 미치는 영향)

  • Koo, Hwa-Seon;Cha, Sun-Hwa;Yang, Kwang-Moon;Bae, Ju-Youn;Ahn, Hyun-Suk;Han, Ae-Ra;Park, Chan-Woo;Kang, Inn-Soo;Koong, Mi-Kyoung;Lee, Kyung-Sang
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.361-368
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    • 2010
  • Objective: The aim of this study was to evaluate the influences of uterine septum and their elimination on the reproductive outcomes in women who have history of recurrent spontaneous abortion (RSA) and/or infertility. Methods: The medical records of reproductive outcomes in patients who have had history of RSA and infertility who were diagnosed with uterine septum only by hysterosalpingogram (HSG) between January 2008 and December 2009 were retrospectively analyzed. The subjects who have had severe male factor, tubal factors, other uterine factors, endocrine abnormalities, peritoneal factors, and abnormal karyotyping among both partners were excluded. In 27 patients, confirmation of diagnosis by laparoscopy and elimination of uterine septum by trans-vaginal hysteroscopy was done. Seventeen patients were strongly suspected to uterine septum on HSG but tried to get pregnancy without any other procedure for evaluation and management of uterine anomaly. Age matched 42 patients who have history of RSA and/or infertility and diagnosed to normal HSG finding at same period were randomly selected as control. The medical records of reproductive outcomes were analyzed and compared between groups. Results: The mean time of observation after diagnosis was 21.8 months (10 to 32). 55.6% (15/27) of patients in patients who received trans-vaginal hysteroscopic uterine septotomy were success to get pregnancies and was significantly higher than that of 17 patients who did not receive proper management (23.5%, 4/17, p<0.05). In control population, 40.5% (17/42) were success to pregnancies and the differences were not statistically significant compared to both two study groups. The live birth rate which was excluded pregnancy loss by abnormal fetal karyotyping and congenital anomaly were 75% (9/12) in treated septated uterus group and 84.6% (11/13) in control group each which have no statistically significant different. In patients with septated uterus who did not receive proper management showed lower delivery rate (50%, 2/4) than that of other groups but was not statistically significant. Conclusion: According to present data, women with a uterine septum have an increased chance of successful pregnancy with improved obstetric outcome after proper management of the uterine cavity. And these results were showed in patients with no regard to their reproductive history. But, in case of failed to receive proper management, uterine septum can affect not only pregnancy ongoing but successful pregnancy too.

Effects of Size and Environmental Condition on Burrowing of Artificial Seedling of Ark Shell, Scapharca broughtonii (Schrenck) (피조개, Scapharca broughtonii (Schrenck) 인공치패의 크기 및 환경조건이 잠입에 미치는 영향)

  • Kim, Byeong-Hak;Shin, Yun-Kyung;Choi, Nack-Joong;Oh, Bong-Se;Sohn, Sang-Gyu;Jung, Choon-Goo;Son, Tai-Sun;Kang, Kyoung-Ho
    • The Korean Journal of Malacology
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    • v.23 no.1
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    • pp.1-8
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    • 2007
  • The influence of individual size, sediment, gain size, water temperature, salinity and air exposure on burrowing rate was investigated in order to obtain the basic biological data on applying shellfish farm for a sustainable production of ark shell, Scapharca broughtonii (Schrenk). The burrowing rate on individual size 300 minutes after starting the experiment was the highest in the shell length $16.3\;{\pm}\;1.2\;mm$, 97.7%. The highest burrowing rates were 97.0% in $12.8\;{\pm}\;0.8\;mm$, 96.7% in $9.2\;{\pm}\;1.0\;mm$, and 96.3% in $5.9\;{\pm}\;0.7\;mm$. The clams over 6 mm of shell length had burrowing ability and the burrowing rate was not related to the shell size. The burrowing rate depending on the kind of grain at the bottom after 300 minutes was the highest, 98.3%, in the mixture of sand and silt with a ratio of 75:25. The rates were 98% in silt (100%), 97.3% in mixture sand and silt with a ratio of 50:50, 97.3% in sand and silt ratio of 25:75, and 86.3% in sand (100%) in this specific order. On grain size of the soil in the seafloor, the burrowing rates after 300 minutes was at its highest in the group of sand in pore size 1 mm with 85.0%, and the $12\;{\mu}m$ to 1 mm in the grain size was fitted to burrowing of artificial seed. In the case of water temperature, the burrowing rates were at its highest after 300 minutes. In $30^{\circ}C$ group, the rate was 96.7% and in $25^{\circ}C$ and $20^{\circ}C$, 90.0%. The rates decreased as the water temperature decreased below $15^{\circ}C$. The burrowing rates on salinity were the highest in 30 psu with 93.3% and at 15 psu and below, there was no noticeable change in the burrowing rate. On air exposure, the burrowing rates after 300 minutes were the highest in 1 hour with 93.3%, and remarkably decreased as air exposure time is longer after 12 hours of air exposure.

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Suggestion of Learning Objectives in Social Dental Hygiene: Oral Health Administration Area (사회치위생학의 학습목표 제안: 구강보건행정 영역)

  • Park, Su-Kyung;Lee, Ga-Yeong;Jang, Young-Eun;Yoo, Sang-Hee;Kim, Yeun-Ju;Lee, Sue-Hyang;Kim, Han-Nah;Jo, Hye-Won;Kim, Myoung-Hee;Kim, Hee-Kyoung;Ryu, Da-Young;Kim, Min-Ji;Shin, Sun-Jung;Kim, Nam-Hee;Yoon, Mi-Sook
    • Journal of dental hygiene science
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    • v.18 no.2
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    • pp.85-96
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    • 2018
  • The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into 'dental hygiene job relevance', 'dental hygiene competency relevance', 'timeliness', and 'value discrimination of educational goal setting' to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.

The influence of the four noted physicians of Geum-Won era on the completion of the medicine in the Chosun dynasty (금원사대가의학(金元四大家醫學)이 조선조의학(朝鮮朝醫學) 형성(形成)에 미친 영향(影響))

  • Cheong, Myeon;Hong, Won Sik
    • Journal of Korean Medical classics
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    • v.9
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    • pp.432-552
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    • 1996
  • The influence of the four noted physicians of Geum-Won era(金元代) on the completion of the medicine in the Chosun dynasty(朝鮮朝) can be summarized as follows. 1. The four noted physicians of Geum-Won era were Yoo-Wan-So(劉完素), Jang-Jong-Jung(張從正), Lee-Go(李杲), Ju-Jin-Heung(朱震亨). 2. Yoo-Wan-So(劉完索) made his theory on the basic of Nae-Kyung("內經") and Sane-Han-Lon("傷寒論"), his idea of medicine was characterized in his books, for exemple, application of O-Oon-Yuk-Ki(五運六氣), Ju-Wha theory(主火論) and hang-hae-seng-je theory(亢害承制論). from his theory and method of study, many deviations of oriental medicine occurred. He made an effort for study of Nae-Kyung, which had been depressed for many years, on the contrary of the way old study that Nae-Kyung had been only explained or revised, he applied the theory of Nae-Kyung to clinical care. The theory of Yuk-Gi-Byung-Gi(六氣病機) and On-Yeul-Byung(溫熱病) had much influenced on his students and posterities, not to mention Jang-Ja-Wha and Ju-Jin-Heung, who were among the four noted physicians therefore he became the father of Yuk-Gi(六氣) and On-Yeul(溫熱) schools. 3. Jang-Jong-Jung(張從正) emulated Yoo-Wan-So as a model, and followed his Yuk-Gi-Chi-Byung(六氣致病) theory, but he insisted on the use of the chiaphoretic, the emetic and the paregoric to get rid of the causes, specially he insisted on the use of the paregoric, so they called him Gong-Ha-Pa(攻下派). He insisted on the theory that if we would strenthen ourselves we should use food, id get rid of cause, should use the paregoric, emetic and diaphoretic. Jang-Jong-Jung'S Gang-Sim-Wha(降心火) theory, which he improved Yoo-Wan-So's Han-Ryang(寒凉) theory influenced to originate Ju-Jin-Heung'S Ja-Eum-Gang-Wha(滋陰降火) theory. 4. Lee-Go(李杲) insisted on the theory that Bi-Wi(脾胃) played a loading role in the physiological function and pathological change, and that the internal disease was originated by the need of Gi(氣) came from the disorder of digestive organs, and that the causes of internal disease were the irregular meal, the overwork, and mental shock. Lee-Go made an effort for study about the struggle of Jung-Sa(正邪) and in the theory of the prescription he asserted the method of Seung-Yang-Bo-Gi(升陽補氣), but he also used the method of Go-Han-Gang-Wha(苦寒降火). 5. The authors of Eui-Hak-Jung-Jun("醫學正傳"), Eui-Hak-Ib-Moon("醫學入門"), and Man-Byung-Whoi-Choon("萬病回春") analyzed the medical theory of the four noted physicians and added their own experiences. They helped organizing existing complicated theories of the four noted physicians imported in our country, and affected the formation of medical science in the Choson dynasty largely. Eui-Hak-Jung-Jun("醫學正傳") was written by Woo-Dan(虞槫), in this book, he quoted the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, especially, Ju-Jin-Heung was respected by him, it affected the writing of Eui-Lim-Choal-Yo("醫林撮要"). Eui-Hak-ib-Moon("醫學入門"), written by Lee-Chun(李杲), followed the medical science of Lee-Go and ju-jin-heung from the four noted physicians of Geum-Won era. Its characteristics of Taoism, idea of caring of health, and organization affected Dong-Eui-Bo-Kham("東醫寶鑑"). Gong-Jung-Hyun(龔延賢) wrote Man-Byung-Whoi-Choon("萬病回春") using the best part of the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, this book affected Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") partly. 6. our medical science was developed from the experience of the treatment of disease obtained from human life, these medical knowledge was arranged and organized in Hyang-Yak-Jib-Sung-Bang("鄕藥集成方"), medical books imported from China was organized in Eui-Bang-Yoo-Chwi("醫方類聚"), which formed the base of medical development in the Chosun dynasty. 7. Eui-Lim-Choal-Yo("醫林撮要") was written by Jung-Kyung-Sun(鄭敬先) and revised by Yang-Yui-Soo(楊禮壽). It was written on the base of Woo-Dan's Eui-Jung-Jun, which compiled the medical science of the four noted physicians of Geum-Won era. It contained confusing theories of the four noted physicians of Geum-Won era and organized medical books of Myung era, therefore it completed the basic form of Byun-Geung-Non-Chi (辨證論治) influenced the writing of Dong-Eui-Bo-Kham("東醫寶鑑"). 8. Dong-Eui-Bo-Kham("東醫寶鑑") was written on the base of basic theory of Eum-Yang-O-Haeng(陰陽五行) and the theory of respondence of heaven and man(天人相應說) in Nae-Kyung. It contained several theories and knowledge, such as the theory of Essence(精), vitalforce(氣), and spirit(神) of Taoism, medical science of geum-won era, our original medical knowledge and experience. It had established the basic organization of our medical science and completed the Byun-Geung-Non-Chi (辨證論治). Dong-Eui-Bo-Kham developed medical science from simple medical treatment to protective medical science by caring of health. And it also discussed human cultivation and Huh-Joon's(許浚) own view of human life through the book. Dong-Eui-Bo-Kham adopted most part of Lee-Go(李杲) and Ju-Jin-Heung's(朱震亨) theory and new theory of "The kidney is the basis of apriority. The spleen is the basis of posterior", so it emphasized the role of spleen and kidney(脾腎) for Jang-Boo-Byung-Gi(臟腑病機). It contained Ju-Jin-Heung's theory of the cause and treatment of disease by colour or fatness of man(black or white, fat or thin). It also contained Ju-Jin-Heung's theory of "phlegm break out fever, fever break out palsy"(痰生熱 熱生風) and the theory of Sang-Wha(相火論). Dong-Eui-Bo-Kham contained Lee-Go's theory of Wha-Yu-Won-Bool-Yang-Lib (火與元氣不兩立論) quoted the theory of Bi-Wi(脾胃論) and the theory of Nae-Oi-Sang-Byun(內外傷辨). For the use of medicine, it followed the theory by Lee-Go. lt used Yoo-Wan-So'S theory of Oh-Gi-Kwa-Keug-Gae-Wi-Yul-Byung(五志過極皆爲熱病) for the treatment of hurt-spirit(傷神) because fever was considered as the cause of disease. It also used Jang-Jons-Jung's theory of Saeng-Keug-Je-Seung(生克制勝) for the treatment of mental disease. 9. Lee-je-ma's Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") adopted medical theories of Song-Won-Myung era and analyzed these theories using the physical constitutional theory of Sa-Sang-In(四象人). It added Dong-Mu's main idea to complete the theory and clinics of Sa-Sang-Eui-Hak(四象醫學). Lee-Je-Ma didn't quote the four noted physicians of Geum-Won era to discuss that the physical constitutional theory of disease and medicine from Tae-Eum-In(太陰人), So-Yang-In(少陽人), So-Eum-In(少陰人), and Tae-Yang-In(太陽人) was invented from their theories.

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Effect of Geijibokryunghwan and each constituent herb on inhibition of platelet aggregation (계지복령환(桂枝茯笭丸) 및 그 구성약물(構成藥物)의 혈소판응집억제(血小板凝集抑制)에 관(關)한 연구(硏究))

  • Kim, Jong-Goo;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.115-129
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    • 2000
  • The cause that the increase of animality fat intakes, under exercise, fatness, adding the stress, advanced age etc., the occurrence rate of the circulation system disease has been increased. And the thrombosis importantly came to the front as the risk factor of these circulation system's disease. Nowadays, the ischemic disease has especially discussed, for example the angina or myocardial infarction, originated in thrombosis that came from the platelet aggregation. In the western medicine, as the cure and prevention, using the aspirin or ticlopidine for platelet aggregation suppressant. But in the , the curing method must be used properly according to the pectoralgia or heartache's kind, state, grade. The platelet do not attache to the normal hemangioendothelial cell. But when it stimulated by endothelium peronia and so on, it attache to the injury endothelium or rise aggregation between the platelet. On this time, it secrete the platelet aggregation inducer as like ADP, thromboxane A2 from the inside of platelet. So it has first defensive function through the aggregation augment that prevent the celerity consumption of blood. But the activation of abnormal platelet occur the platelet grume and thrombogenesis. So it bring up the occlusive angiosis, so to speak, cardiovascular disease, cerebrovascular disease, arterial sclerosis. In oriental medicine, the thrombosis in the category of blood stasis and this blood stasis present the generalise or local blood circulation disturbance that generated by all kinds of pathological fact or blood stream retention accompanying with a series of syndrome. As the syndrome, stabbing pain fixed at certain region, squamous and dry skin, fullness and pain of the chest and hypochondrium, firmness and fullness of the lower abdomen, black stool, dark purple tongue or with ecchymoses and petechiae etc.. has been created. And it becomes the pathopoiesis cause that the convulsion and palpitation, severe palpitatiion, tympanites, the symtom complex with a mass or swelling in the abdomen, insanity, stricken by wind etc.. Moreover, it used the drugs for invigorating blood circulation and eliminating blood stasis or drugs for removing blood stasis for all kinds of syndrome through the blood stasis. And the drugs for activating the blood circulation, such as Salviae Radix, Angelicae Sinensis Radix, Persicae Semen, Achyranthis Radix, Cnidii Rhizoma, Carthami Flos are used for that. And it is used to the herbs of insects that has strong effect about the disintergrating blood stasis such as Hirudo, Scolopendrae Corpus, Buthus, Lumbricus etc.. On this study, It used Geijibokryunghwan(GBH) and the consisting herbs to investigate the influence of platelet aggregation about drugs that used to improvement various symptoms created by the thrombosis in oriental medicine. GBH formula has as formula recorded in the , action of 'eleminating the evil and not impairment of healthy energy' and 'promoting the flow of QI and cold and heat, so used for the expel blood stasis herbs from the ancient. Therefore we investigated the restraint effect of GBH and the consisting herbs about the platelet agregation induced to the ADP, AA or collagen. The conclusion is following. 1. When it added the aggregation inducer after that it added GBH and individual consisting herbs in the PRP, GBH showed the (+) inhibition effect on the platelet aggregation and it showed the (+) inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis. 2. It showed the (+), (+,++) inhibition effect on the platelet aggregation in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc. 3. In the aggregation inhibition activating on the difference of density, GBH showed strong inhibition effect to the aggregation state induced to collagen, and it showed the inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis about the aggregation induced by the collagen. 4. It showed the strong inhibition effect about the aggregation induced by the collagen in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc Like this, as confirm GBH and the individual consisting herb's inhibition effect of platelet aggregation, We considerated that GBH and the individual consisting herbs have practical applicational value of clinical trial in the thrombosis caused by platelet aggregation.

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A Natural L-Arginine Analog, L-Canavanine-Induced Apoptosis is Suppressed by Protein Tyrosine Kinase p56lck in Human Acute Leukemia Jurkat T Cells (인체 급성백혈병 Jurkat T 세포에 있어서 L-canavanine에 의해 유도되는 세포자살기전에 미치는 단백질 티로신 키나아제 p56lck의 저해 효과)

  • Park, Hae-Sun;Jun, Do-Youn;Woo, Hyun-Ju;Rue, Seok-Woo;Kim, Sang-Kook;Kim, Kyung-Min;Park, Wan;Moon, Byung-Jo;Kim, Young-Ho
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1529-1537
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    • 2009
  • To elucidate further the antitumor effects of a natural L-arginine analogue, L-canavanine, the mechanism underlying apoptogenic activity of L-canavanine and its modulation by protein tyrosine kinase $p56^{lck}$ was investigated in human Jurkat T cells. When the cells were treated with 1.25 to 2.5 mM L-canavanine for 36 h, several apoptotic events including mitochondrial membrane potential (${\Delta\Psi}m$) loss, activation of caspase-9, -3, -8, and -7, poly (ADP-ribose) polymerase (PARP) degradation, and DNA fragmentation were induced without alteration in the levels of Fas or FasL. These apoptotic changes were more significant in $p56^{lck}$-deficient Jurkat clone JCaM1.6 than in $p56^{lck}$-positive Jurkat clone E6.1. The L-canavanine-induced apoptosis observed in $p56^{lck}$-deficient JCaM1.6 cells was significantly reduced by introducing $p56^{lck}$ gene into JCaM1.6 cells by stable transfection. Treatment of JCaM1.6/lck cells with L-canavanine caused a transient 1.6-fold increase in the kinase activity of $p56^{lck}$. Both FADD-positive wild-type Jurkat T cell clone A3 and FADD-deficient Jurkat T cell clone I2.1 exhibited a similar susceptibility to the cytotoxicity of L-canavanine, excluding involvement of Fas/FasL system in triggering L-canavanine-induced apoptosis. The L-canavanine-induced apoptotic sub-$G_1$ peak and activation of caspase-3, -8, and -7 were abrogated by pan-caspase inhibitor (z-VAD-fmk), whereas L-canavanine-induced activation of caspase-9 was not affected. These results demonstrated that L-canavanine caused apoptosis of Jurkat T cells via the loss of ${\Delta\Psi}m$, and the activation of caspase-9, -3, -8, and -7, leading to PARP degradation, and that the $p56^{lck}$ kinase attenuated the ${\Delta\Psi}m$ loss and activation of caspases, and thus contributed as a negative regulator to L-canavanine-induced apoptosis.

Peripheral Neutrophil Count and Respiratory Failure in Preterm Infant (조산아에서 말초혈액 중성구수와 호흡 부전증과의 연관성)

  • Lee, Kum Joo;Yun, Soo Young;Lee, Ran;Hean, Jae Ho;Jung, Ghee Young;Park, Jin Hee;Park, Young Sun
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.596-602
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    • 2002
  • Purpose : The purpose of this study was to analyze the association of peripheral neutrophil count with the development of respiratory failure in preterm infants. Methods : A retrospective study was conducted from January 1993 to December 1999 on 44 preterm infants, who were admitted to the neonatal intensive care unit of St. Francisco hospital. Preterm infants(birth weight 500 to 1,350 gm) who had a complete blood count obtained within 2 hours after delivery. Patients in the lowest of neutrophil count(early neutropenia, < $1.0{\times}10^9/L$) were compared with patients in the remaining group. Results : Low neutrophil count were transient in early neutropenia group. The concentration the circulating neutrophil count rose from $0.85{\pm}0.11{\times}10^9/L$ at average of 2 hours after delivery to $5.3{\pm}2.7{\times}10^9/L$ at 24 hours after delivery in the early neutropenia group and from $3.6{\pm}1.6{\times}10^9/L$ to $5.8{\pm}3.2{\times}10^9/L$ in the non-neutropenia group during the same time period. Compare to the non-neutropenia group, the neutropenia group had a lower birth weight($1,046.50{\pm}180.76gm$ Vs $1,156.70{\pm}124.99gm$), a lower Apgar score(1 min : $3.41{\pm}1.18$ Vs $4.30{\pm}1.46$, 5 min : $5.41{\pm}0.87$ Vs $6.15{\pm}0.95$), and a higher incidence of bronchopulmonary dysplasia(27.27% Vs 7.0%). Patients who had early neutropenia were more likely to require mechanical ventilation, supplemental oxygen and hospital stay. Also, main effect factors for the two groups were birth weight(Odds ratio=5.457, 95% CI=1.551-27.525), initial peripheral blood white cells(odds ratio=8.308, 95% CI=2.054-52.699), and bronchopulmonary dysplasia(odds ratio=0.099, 95% CI=0.017-0.397). Conclusion : A low count of neutrophil in the systemic circulation of premature infants within 2 hours of birth is associated with more severe respiratory distress.