Slide Session : OS-NEP-03 ; Nephrology : Serum Phosphorus Level and Coronary Artery Calcifi cation in Subjects without Renal Dysfunction

( Kyung Sun Park ),( Jongha Park ),( Seong Hoon Choi ),( Jongmin Lee ),( Eun Seok Shin ),( Soe Hee Ann ),( Gillian B Singh ),( Jong Soo Lee ),( Hyun Chul Chung ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Serum phosphorus (P) level is associated with coronary artery calcifi cation as well as cardiovascular events in patients with chronic kidney disease. However, this relationship has been debated in normal subjects without renal dysfunction. Methods: A cross-sectional study was undertaken in 2,503 Korean subjects who underwent coronary multi-detector computerized tomography for screening and had estimated glomerular fi ltration rate >60 ml/min/1.73m². The study subjects were divided into 3 groups according to Agatston score: 0 (n=1582), >0 to 100 (n=613), and >100 (n=308). Serum P concentration was divided to 4 categories: =3.2, >3.2 to 3.6, >3.6 to 4.0 and >4.0 mg/dL. A baseline-category (Agatston score=0) logit model was applied to estimate relative risk ratio (RRR) for each serum P category (reference: =3.2 mg/ dL) with adjustment for age, sex, body mass index, corrected serum calcium, albumin, non-high density lipoprotein (HDL) and HDL cholesterol concentration. Results: Mean (±SD) age of subjects was 53.5±9.1 years and 36.9% were females. Increase in serum P level was not associated with the risk of Agatston scores of >0 to 100. When subjects with Agatston score =0 or >100 were analyzed, higher serum P levels were associated with higher risk of having Agatston scores of >100 (Figure). Serum P level of >4.0 mg/dL was a signifi cant and independent risk factor for Agatston scores of >100 (RRR 1.78, 95% confi dence interval 1.14-2.78). Conclusions: Higher serum P level may be associated with higher coronary artery calcifi cation even in healthy subjects with normal renal function. This fi nding needs to be validated in diverse populations.

의생활을 위한 시장조사

구옥경,김복실,윤주남,호명진,김충희,서영선,서한희,이영,이혜숙,임가혜,김일수,배영순 연세대학교 생활과학대학 1972 婦學 Vol.5 No.-

Effect of 840 nm light-emitting diode(LED) Irradiation on Monosodium Iodoacetate-Induced Osteoarthritis in Rats

( Hyun-ji Lee ),( Ha-nul Soe ),( Woo-bin Soel ),( Kyung-sun Soe ),( Jong-won Ju ),( Hae-sung Lee ),( Ung-bae Park ),( Min-suk Yu ),( Ji-hyun Lee ) 대한임상병리사협회 2013 조직세포검사학회 발표자료집 Vol.2013 No.-

Background The objective of this study was to evaluate whether 840 nm light-emitting diode (LED) could be effective in a noninvasive, therapeutic device for the treatment of monosodium iodoacetate-induced osteoarthritis in rats. Method Twenty male Sprague-Dawley rats weighing approximately 200 g each were divided into four groups: control group (C); monosodium iodoacetate-treated(MIA) group; monosodium iodoacetate-treated(MIA) group with LED phototherapy(MIA-LED); indomethacin-treated group(IMT). Osteoarthritis(OA) was induced by intra-articular injection of 50 μl of 3 mg MIA through the patellar ligament of the right knee. Control rats were injected with an equivalent volume of saline. In the MIA-LED group, the animal knees were exposed to LED stimulation at intervals of 15 min/day, for 1 weeks after MIA treatment. Animals were sacrificed at 2 weeks postoperatively. Knee joints were removed and fixed overnight in 10% neutral buffered formalin and subsequently decalcified by EDTA for 2 wk before being embedded in paraffin. Frontal sections (4 μm thick) of the medial aspect of the rat knee joints were prepared every 250 μm. The OA clinical score was monitored by knee movement and by radiographic analyses. Histologic analyses were performed following staining with hematoxylin and eosin, Safranin O-fast green, or toluidine blue, and histologic changes were scored according to a modified Mankin system. Results Radiographic examination showed no differences between the MIA-treated and the MIA-LED-treated rats. Sclerotic regions adjacent to the tibioepiphyseal margin, thinning of the epiphysis, and a small exophite were evident in the MIA-treated and the MIA-LED-treated rats, whereas tibioepiphyseal margin was well preserved in the IMT-treated rats compared with the two groups. Histologically, the lesion severity of knee joint by Mankin``s scoring showed not a significant difference between the MIA-treated and the MIA-LED-treated rats, however the lesion score was significantly decreased in the IMT rats compared with the two groups. Discussion The irradiation of LED at 840 nm after monosodium idoacetate treatment was no significant difference between the respective arthritis parameters in LED-treated group compared with indomethacin-treated group. However, the total Mankin score was significantly decreased in MIA-LED-treated group compared with monosodium iodoacetate-treated group. These results indicate that LED phototherapy was some beneficial influence on the repair of chondral lesion in osteoarthritis rats.

어린이의 일차성 단일 증상성 야뇨증에서 Imipramine과 Desmopressin 복합 약물치료의 효과 및 안전성

여지현,최정연,정효석,이경수,고철우,김교순,김기혁,김정수,남궁미경,박영서,배기수,유기환,박용훈,Yeo Ji-Hyun,Choi Jung-Youn,Chung Hyo-Seok,Lee Kyung-Soo,Ko Cheol-Woo,Kim Kyo-Sun,Kim Kee-Hyuk,Kim Jung-Soe,NamGoong Mee-Kyung,Park Young-Seo,Pai Ki 대한소아신장학회 2004 Childhood kidney diseases Vol.8 No.2

목적: 일차성 야뇨증에 여러 가지 치료법이 시도되고 있는데 이 중 일반적으로 사용되는 imipramine와 desmopressin 등의 약물요법은 치료효과가 빠르고 비교적 양호하기 때문에 선호하는 치료 방법이다. 그러나 효과가 매우 다양하고 때로는 약물에 의한 부작용으로 인해 사용이 어렵게 되는 경우도 있다. 본 연구에서는 이들 약물을 단독으로 투여한 경우에 비하여 복합투여 할 경우에 치료 효과와 안정성을 비교 평가하여 보다 나은 야뇨증 치료 방법을 제시하고자 하였다. 방법: 2002년 4월부터 2002년 12월까지 내원한 5-l5세 사이의 환자로서 1) 일차성 단일성 야뇨증, 2) 주 2회 이상의 야뇨증, 3) 5세 이상의 연령, 4) 비뇨기과적 이상이 없고, 5) 정신적 또는 신경학적인 증상이 없으며, 6) 내분비 질환이 없고, 7) 최근 2개월 동안 야뇨증 약물치료를 받지 않은 환아로서, 8) 부모의 동의를 받은 경우를 대상으로 하였으며 조건을 만족하는 환자들을 무작위로 선택하여 imipramine 단독투여군, desmopressin 단독투여군과 imipramine과 desmopressin 복합투여군의 3군으로 나누어 야뇨횟수, 부작용과 약물 중단 후 1개월 후 야뇨증 빈도를 확인하였다. 결과: 대상 환아들은 남, 녀 각각 78명과 90명이며, 5-10세가 119명이었고 11-16세는 49명이었다. 치료 시작 4주 이후에서부터 모든 군에서 유의하게 야뇨 횟수가 감소하였다. 치료 종료 시의 imipramine 단독투여군, desmopressin 단독투여군과 imipramine과 desmopressin 복합투여군의 치료율은 각각 68.6%, 74.4%와 86.1%로서 imipramine와 desmopressin 복합투여군의 치료율이 가장 높았으나 통계학적인 차이는 없었다. 치료 종료 후 4주의 야뇨 빈도는 imipramine 단독투여군은 주당 1.9회, desmopressin 단독투여군은 1.3회이고 imipramine와 desmopressin 복합투여군은 1.0회로 세군 사이에는 유의한 차이가 없었다. 약물에 의한 부작용은 imipramine 단독투여군은 20명, desmopressin 단독투여군은 12명, imipramine와 desmopressin 복합투여군13명에서 총 45례에서 나타났는데 이중 imipramine 투여로 인한 식욕 감퇴가 가장 많았다. 결론: 일차성 단일 증상성 야뇨증 치료를 위한 imipramine 단독용법, desmopressin 단독요법, imipramine과 desmopressin 복합요법의 치료효과와 단기간 동안 관찰한 재발 빈도에서는 의미있는 차이는 없어서, 두 약제의 복합요법이 desmopressin 단독 요법에 비해 치료효과, 재발정도와 부작용 빈도에서 차이가 없어 치료 효율성의 우월성을 발견하지 못하였다. 다만 약물 부작용 발생은 imipramine 단독요법이 다른 치료 방법에 비해 발생 빈도가 유의하게 높은 것으로 나타나서 imipramine 단독요법을 할 때에는 부작용 발생유무를 유의해서 관찰하여야 할 것으로 생각된다. Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.