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진정법을 이용한 치과치료 시 편도선의 크기가 행동에 미치는 영향
김현지,백광우,마연주,정영정 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.3
본 연구에서는 진정법을 이용한 치과치료에서 소아환자의 편도선 크기가 진정법 중 환자의 행동에 미치는 영향을 평가하기 위해 진정법으로 치과치료를 받은 소아환자 35명의 진정기록지를 분석하였다. 진정법은 chloral hydrate 50 mg/kg, hydroxyzine 1 mg/kg를 경구투여하고, 치료 중 50% 아산화질소-산소 흡입 진정 및 필요에 따라 midazolam의 점막하투여(0~0.3 mg/kg)를 병행하는 방법으로 시행되었으며, 편도선의 크기는 Brodsky 분류법을 이용하여 4그룹으로 분류하였다. 환자의 진정 기록지를 분석하여 다음과 같은 결과를 얻었다. 1. 진정법 중 행동 반응은 수면, 움직임, 울음, 전반적 행동 모두에서 편도선 크기가 클수록 낮은 지수(negative behavior)를 보였다(p<0.05). 2. 편도선의 크기는 진정법 중 구호흡과 유의한 연관성을 보였으나(p<0.05), 진정법 중 코골이, 기침과는 유의한 연관성을 보이지 않았다(p>0.05). 3. 편도선의 크기가 큰 환자일수록 midazolam의 점막하투여량이 유의하게 증가하였다(p<0.05). The purpose of this study was to evaluate the effect of children's tonsil size on the behavior during pediatric dental sedation. The sedation records of thirty five children were examined in this study. All the sedations had been performed using chloral hydrate/hydroxyzine, nitrous oxide/oxygen or/and submucosal midazolam, and the subjects were divided into 4 groups according to their tonsil size using Brodsky's tonsil classification. The results were as follows: 1. The patients with enlarged tonsils showed negative behaviors in all behavior rating aspects(sleep, movement, crying, overall behavior) during sedation than those with normal tonsils(p<0.05). 2. Enlarged tonsils were correlated with mouth breathing(p<0.05) but not with snoring and coughing(p>0.05) during sedation. 3. For the patients with enlarged tonsils, significantly higher doses of midazolam were administered during sedation than for those with normal tonsils(p<0.05).
Jung Oh, Hyung,Lee, Mi Jung,Lee, Hye Sun,Park, Jung Tak,Han, Seung Hyeok,Yoo, Tae-Hyun,Kim, Yong-Lim,Kim, Yon Su,Yang, Chul Woo,Kim, Nam-Ho,Kang, Shin-Wook by Lippincott WilliamsWilkins, Inc. 2014 Medicine Vol.93 No.27
ABSTRACT: Numerous studies have demonstrated that cardiac biomarkers are significant predictors of cardiovascular (CV) and all-cause mortality in ESRD patients, but most of the studies were retrospective or included small numbers of patients, only prevalent dialysis patients, or measured 1 or 2 biomarkers. This study was to analyze the association between 3 cardiac biomarkers and mortality in incident HD patients. A prospective cohort of 864 incident HD patients was followed for 30 months. Based on the median values of baseline NT-proBNP, cTnT, and hsCRP, the patients were divided into “high” and “low” groups, and CV and all-cause mortality were compared between each group. Additionally, time-dependent ROC curves were constructed, and the NRI and IDI of the models with various biomarkers were calculated. The CV survival rates were significantly lower in the “high” NT-proBNP and cTnT groups compared to the corresponding “low” groups, while there was no significant difference in CV survival rate between the 2 hsCRP groups. However, all-cause mortality rates were significantly higher in all 3 “high” groups compared to each lower group. In multivariate analyses, only Ln NT-proBNP was found to be an independent predictor of mortality. Moreover, NT-proBNP was a more prognostic marker for mortality compared to cTnT. In conclusion, NT-proBNP is the biomarker that results in the most added prognostic value on top of traditional risk factors for CV and all-cause mortality in incident HD patients.
Pluronic-based core/shell nanoparticles for drug delivery and diagnosis.
Jung, Yon Woo,Lee, Hwanbum,Kim, Jae Yeon,Koo, Eun Jin,Oh, Keun Sang,Yuk, Soon Hong Bentham Science Publishers 2013 Current medicinal chemistry Vol.20 No.28
<P>Pluronic-based core/shell nanoparticles (NPs) were formed using various strategies such as self-assembly and temperature induced-phase transition. To improve their functionality as a nanomedicine for diagnosis and therapy, the vesicle fusion and layer by layer approach were employed. Because of the hydrophilic nature of the Pluronic shell and the relatively small size, Pluronic-based core/shell NPs were used in order to improve their pharmacokinetic behaviors in drugs and in imaging agents. This review will introduce various types of Pluronic-based core/shell NPs according to their preparation method and formation mechanism. The focus will be on the Pluronic-based core/shell NPs for tumor targeting, stimulated release of proteins, and cancer imaging capabilities.</P>
Jung, Jae-Woo,Song, Woo-Jung,Kim, Yon-Su,Joo, Kwon Wook,Lee, Kyung Wha,Kim, Sae-Hoon,Park, Heung-Woo,Chang, Yoon-Seok,Cho, Sang-Heon,Min, Kyung-Up,Kang, Hye-Ryun Springer International ; Oxford University Press 2011 Nephrology, dialysis, transplantation Vol.26 No.11
<P>Although allopurinol is a very effective urate-lowering drug for complicated hyperuricemia, in some patients, it can induce severe cutaneous adverse reactions (SCARs). Recent investigations suggest that HLA-B*5801 is a very strong marker for allopurinol-induced SCARs, especially in the population with a high frequency of HLA-B*5801. Korea is one of the countries with a high frequency of HLA-B*5801 which is the only subtype of HLA-B58 in the Korean population. Objective. This study was conducted to find out the incidence of allopurinol-induced hypersensitivity on patients with chronic renal insufficiency (CRI) according to HLA-B58 and the clinical implications of HLA-B58 as a risk marker for the development of allopurinol-induced hypersensitivity.</P>
Interdialytic Weight Gain and Cardiovascular Outcome in Incident Hemodialysis Patients
Lee, Mi Jung,Doh, Fa Mee,Kim, Chan Ho,Koo, Hyang Mo,Oh, Hyung Jung,Park, Jung Tak,Han, Seung Hyeok,Yoo, Tae-Hyun,Kim, Yong-Lim,Kim, Yon Su,Yang, Chul Woo,Kim, Nam-Ho,Kang, Shin-Wook S. Karger AG 2014 American journal of nephrology Vol.39 No.5
<P>Abstract</P><P><B><I>Background:</I></B> Interdialytic weight gain (IDWG) has been regarded as a surrogate of volume overload, but also as a marker of a better nutritional status in end-stage renal disease (ESRD) patients on hemodialysis (HD). This paradoxical meaning of IDWG requires further investigation, particularly in adverse cardiovascular outcomes. <B><I>Methods:</I></B> A prospective cohort of 1,013 incident HD patients from 36 HD centers of the Clinical Research Center for ESRD in Korea was included. Patients were categorized into five groups according to the IDWG%, a ratio of absolute IDWG to dry weight: <1.0, ≥4.0, and every 1.0 increment in between. Primary outcome was major adverse cardiac and cerebrovascular events (MACCE). <B><I>Results:</I></B> During a mean follow-up of 18.7 months, primary outcome was observed in 104 patients (10.3%). In multivariate analysis, compared to patients with IDWG% of 1.0-1.9 (reference group), the hazard ratios (HRs) for primary outcome in the IDWG% <1.0, 2.0-2.9, 3.0-3.9, and ≥4.0 groups were 1.10 [95% confidence interval (CI) 0.55-2.20, p = 0.80], 1.15 (95% CI 0.59-2.27, p = 0.68), 1.80 (95% CI 0.95-3.41, p = 0.07), and 1.93 (95% CI 1.02-3.64, p = 0.04), respectively. Furthermore, even when residual renal function and 24-hour urine volume were adjusted, IDWG% ≥4.0 remained as a significant predictor of primary outcome (HR 2.03, 95% CI 1.02-4.02, p = 0.04). <B><I>Conclusion:</I></B> Increased IDWG% is a significant independent predictor of MACCE in incident HD patients. It could be helpful to prevent excessive IDWG for improving clinical outcomes in incident HD patients.</P><P>© 2014 S. Karger AG, Basel</P>
Lee, Mi Jung,Park, Jung Tak,Park, Kyoung Sook,Kwon, Young Eun,Oh, Hyung Jung,Yoo, Tae-Hyun,Kim, Yong-Lim,Kim, Yon Su,Yang, Chul Woo,Kim, Nam-Ho,Kang, Shin-Wook,Han, Seung Hyeok American Society of Nephrology 2017 Clinical journal of the American Society of Nephro Vol.12 No.3
<P>Background and objectives Residual kidney function can be assessed by simply measuring urine volume, calculatingGFRusing 24-hour urine collection, or estimatingGFRusing the proposed equation (eGFR). Weaimed to investigate the relative prognostic value of these residual kidney function parameters in patients on dialysis. Design, setting, participants,& measurementsUsing the database froma nationwide prospective cohort study, we compared differential implications of the residual kidney functionindices in 1946 patients ondialysis at 36dialysis centers in Korea between August 1, 2008 and December 31, 2014. Residual GFR calculated using 24-hour urine collection was determined by an average of renal urea and creatinine clearance on the basis of 24-hour urine collection. eGFR-urea, creatinine andeGFR beta(2)-microglobulinwere calculatedfromthe equationsusingserumurea and creatinine and beta(2)-microglobulin, respectively. The primary outcome was all-cause death. Results During amean follow-up of 42months, 385 (19.8%) patients died. In multivariable Cox analyses, residual urine volume (hazard ratio, 0.96 per 0.1-L/d higher volume; 95% confidence interval, 0.94 to 0.98) and GFR calculated using 24-hour urine collection (hazard ratio, 0.98; 95% confidence interval, 0.95 to 0.99) were independently associated with all-cause mortality. In 1640 patients who had eGFR beta(2)-microglobulin data, eGFR beta(2)-microglobulin (hazard ratio, 0.98; 95% confidence interval, 0.96 to 0.99) was also significantly associated with all-causemortality aswell as residual urine volume (hazard ratio, 0.96 per 0.1-L/d higher volume; 95% confidence interval, 0.94 to 0.98) and GFR calculated using 24-hour urine collection (hazard ratio, 0.97; 95% confidence interval, 0.95 to 0.99). When each residual kidney function indexwas added to the basemodel, only urine volume improved the predictability for all-cause mortality (net reclassification index = 0.11, P= 0.01; integrated discrimination improvement = 0.01, P= 0.01). Conclusions Higher residual urine volumewas significantly associated with a lower risk of death and exhibited a stronger associationwithmortality thanGFRcalculated using 24-hour urine collection and eGFR-urea, creatinine. These results suggest that determining residual urine volume may be beneficial to predict patient survival in patients on dialysis.</P>
Oh, Hyung Jung,Lee, Mi Jung,Kwon, Young Eun,Park, Kyoung Sook,Park, Jung Tak,Han, Seung Hyeok,Yoo, Tae-Hyun,Kim, Yong-Lim,Kim, Yon Su,Yang, Chul Woo,Kim, Nam-Ho,Kang, Shin-Wook Williams & Wilkins Co 2015 Medicine Vol.94 No.44
<P><B>Abstract</B></P><P>Although numerous previous studies have explored various biomarkers for their ability to predict mortality in end-stage renal disease (ESRD) patients, these studies have been limited by retrospective analyses, mostly prevalent dialysis patients, and the measurement of only 1 or 2 biomarkers. This prospective study was aimed to evaluate the association between 3 biomarkers and mortality in incident 335 ESRD patients starting continuous ambulatory peritoneal dialysis (CAPD) in Korea. According to the baseline NT-proBNP, cTnT, and hsCRP levels, the patients were stratified into tertiles, and cardiovascular (CV) and all-cause mortalities were compared. Additionally, time-dependent ROC curves were constructed, and the net reclassification index (NRI) and integrated discrimination improvement (IDI) of the models with various biomarkers were calculated. We found the upper tertile of NT-proBNP was significantly associated with increased risk of both CV and all-cause mortalities. However, the upper tertile of hsCRP was significantly related only to the high risk of all-cause mortality even after adjustment for age, sex, and white blood cell counts. Moreover, NT-proBNP had the highest predictive power for CV mortality, whereas hsCRP was the best prognostic marker for all-cause mortality among these biomarkers. In conclusions, NT-proBNP is a more significant prognostic factor for CV mortality than cTnT and hsCRP, whereas hsCRP is a more significant predictor than NT-proBNP and cTnT for all-cause mortality in incident peritoneal dialysis patients.</P>