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배 경 : IgA 신증 환자들에서 고용량의 스테로이드 치료가 단백뇨 감소 및 신보호 효과가 있으며, 안지오텐신 Ⅱ 수용체 차단제 (ARB) 투여도 도움이 된다는 보고들이 있다. IgA 신증 환자들에서 이 두 가지 약제를 병합 투여함으로써 단백뇨 및 신기능에 부가적 효과가 있는지를 전향적 연구로 알아보고자 하였다. 방 법 : 신생검으로 IgA 신증을 진단 받고 1일 1 g 이상의 단백뇨와 혈청 크레아티닌이 2.0 ㎎/dL 이하인 42명의 환자를 무작위로 스테로이드와 ARB의 병합 투여군과 ARB 단독 투여군 으로 나누어 추적 관찰하였다. 결 과 : 병합 투여군은 18명, ARB 단독 투여군은 20명이 추적 관찰되었으며 추적기간은 각각 15.4±3.5 및 19.8±7.4개월이었다. 24시간 단백뇨량은 병합 투여군이 치료 전 4.67±5.33 g에서 0.78±0.99 g으로, ARB 단독 투여군이 4.31±2.85 g에서 1.38±1.09 g으로 유의하게 감소하였다. 추적 후 완전 관해율은 병합 투여가 44%로서 ARB 단독 투여의 10%에 비해 유의하게 높았다. 혈청 크레아티닌은 두 군 모두 치료 시작 전과 후에 통계학적으로 유의한 변화는 없었으며 (병합 투여군: 1.33±0.38 ㎎/dL->1.33±0.46 ㎎/dL, ARB 단독 투여군 : 1.08±0.39 ㎎/dL->1.32±0.79 ㎎/dL), 두 군 사이에도 차이가 없었다. 신기능 악화 증례도 병합 투여군이 1명 (5%), ARB 단독 투여군이 5명 (25%)이었다. 부작용으로는 병합 투여군에서 1예의 당뇨병과 1예의 당불내성이 발생하였다. 결 론 : 두 치료법 모두 단백뇨 감소에 효과적이었으며, 스테로이드와 ARB의 병합요법에서 완전 관해율이 더 높았다. 두 치료법의 신기능 보존 효과의 여부는 더 장기적인 추적 관찰이 필요하다고 생각된다. Background : It has been reported that prednisolone (PDL) therapy favorably influences proteinuria and renal function in the patients with IgAN in whom ARB as well as ACE inhibitor has an anti-proteinuric effect. Therefore, we did a controlled prospective trial to test the effect of treatment with PDI, (daily high- dose for 6 months) and ARB in proteinuric adult patients with IgAN. Methods : Forty-two patients with proteinuria ≥1.0 g/day and serum Cr ≤2.0 mg/dL were randomized to treatment with PDL and ARB and to that with ARB alone. Results : The follow-up period lasted 15.4±3.5 months in combination group (n=18) and 19.8±7.4 months in ARB group (n=20). Proteinuria was significantly reduced in the both groups (ARB group: from 4.31±2.85 g to 1.38±1.09 g vs. combination group: from 4.67±5.33g to 0.78±0.99 g). The rate of complete remission was 10% in ARB group and 44% in combination group at the final follow-up (p<0.05). There were no differences of mean serum Cr between groups before and after treatment. The number of patient with aggravation in renal function was five (25%) in ARB group and one (5%) in combination group. Conclusion : This study shows that the urinary protein excretion was effectively reduced by both groups and the rate of complete remission was higher in combination group than in ARB group. Long-term follow-up may be helpful to define the effect on the renal function in IgAN patients.
Objective: To evaluate the effects of bee venom acupuncture(BVA) on the rehabilitation and quality of life in rheumatoid arthritis(RA) patients Methods: Patients with RA were treated with the BVA therapy twice a week for 3 months. Tender joint counts, swollen joint counts, morning stiffness, Erythrocyte Sedimentation Rate(ESR), C-reactive protein(CRP), patient global assessment, physician global assessment, Korean health assessment questionnaire(KHAQ) were estimated and analyzed before and after BVA therapy. Results: Tender joint counts, swollen joint counts, morning stiffness showed significant decrease after BVA therapy. But, as acute inflammatory reactants, ESR showed no significant difference and CRP showed significant increase after BVA therapy. Patient global assessment physician global assessment, and KHAQ index showed significant improvement after BVA therapy. Conclusions: BVA therapy can improve rehabilitation and health-related quality of life RA patients as well as clinical symptom and signs. Further study is required in more population with large scale including acute inflammatory reaction of BVA therapy.
Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.
담도페쇄증은 간장외 담관의 부분적이거나 완전한 파괴 또는 부재로 인한 담즙흐름의 완전한 폐쇄로 정의된다. 이 질환은대략 10,000명당 1명 정도 비율로 발생하며 여성에서 약간 높은 빈도를 보인다. 원인인자는 명확히 밝혀지지 않았으며 증상은 과빌리루빈혈증과 함께 황달, 점토색변, 지방설사, 어두운 갈색뇨, 간비대 등을 보인다. 최근의 담도폐쇄증의 치료는 간문장문합술 단독 혹은 간이식술을 병행하는 경향이다. 본 증례의 환자에서는 다양한 정도의 치아변색을 보였으며 색상은 노란색에서부터 짙은 초록색까지 다양했다. 법랑질의 저형성증이 모든 치아에 나타났고 구강위생이 좋지 않았으며 다발성 우식증을 가지고 있었다. Biliary atresia is defined as a complete obstruction of bile flow owing to destruction or absence of all or part of the extrahepatic bile ducts. This disease is occurring in approximately 1:10,000 live births and moderate pre-dominance of female is noted. The etiology of biliary atresia remained unsolved. The signs and symptoms are hyperbilirubinemia, jaundice, clay-colored stools, steatorrhea, dark yellow urine and hepatomegaly. Currently biliary atresia is best managed by hepatic portoenterostomy with or without liver transplantation. Biliary atresia patients with these cases showed staining of the teeth. The stains ranged in color from yellowish-brown to deep green. Enamel hypoplasia was all erupted teeth present. Patients had poor oral hygiene and rampant caries.
In an effort to optimize tissue culture responses of zoysiagrass (Zoysia japonica Steud.) for genetic transformation, factors affecting callus induction and plant regeneration were investigated. MS medium containing 3 ㎎/L 2,4-D was optimal for embryogenic callus induction from mature seed. The plant regeneration frequency of 73.3% was observed when embryogenic calli induced in this medium were transferred to N6 medium supplemented with 0.1 ㎎/L 2,4-D and 5 ㎎/L BA. Among several basic media, MS and N6 medium were optimal for callus induction and plant regeneration, respectively. Regenerated plants were grown normally when shoots transplanted to the soil. A rapid and efficient plant regeneration system established in this study will be useful for molecular breeding of turfgrass through genetic transformation.
아말감은 널리 사용되어 온 대표적 치과재료이지만 치질과의 접착서이 없어 와동의 형태에 의해 유지되는 단점을 가진다. 아말감 수복물은 산화물에 의한 변연봉쇄가 일어나기 전까지 초기에 큰 미세누출을 보이며 수복초기에 이를 적절하게 예방하지 않으면 타액이나 미생물이 와동 내에 침투하게 되고 이로 인해 수복 후의 과민반응, 충전물의 용해 및 파괴, 변연 변색과 2차 우식이 유발되어, 결과적으로 수복물의 수명이 단축되며 치수 병변이 발생될 수도 있다. 최근 기존 아말감 수복의 장점을 그대로 유지하면서 치질삭제를 줄이고 변연을 봉쇄하며 소와열구에 예방적 처치를 함께 할 수 있는 수복법이 제안되었는데 이를 이른바 sealed amalgam이라 한다. 이 술식은 예방적 확대 없이 병소만을 제거한 뒤 수복물 변연과 인접 소와열구에 치면열구전색재를 도포함으로서 소와열구의 예방적 충전은 물론 수복물 변연과 치질사이의 틈을 봉쇄하여 미세누출을 감소시킬 수 있다고 하였다. 이에 저자는 아말감 수복 후 수복물의 마무리 처리와 전색재 적용시점을 달리하여 sealed amalgam 수복과 기존의 아말감 수복과의 미세누출의 차이를 비교하고자 30개의 상, 하악 소구치를 준비하여 Ⅴ급 와동을 소구치의 협, 설측에 형성하고 통상적 아말감 수복을 시행한 후 다음의 각 군으로 나누어 처리하였다. 제 1군 : 24시간 후 연마 (대조군) 제 2군 : 연마하지 않음, 즉시 전색재 적용 제 3군 : 연마하지 않음, 열순환(thermocycling)500회 후 전색재 적용 위의 처리 후 각 군을 5℃와 55℃의 온도변화를 30초씩 번갈아 주며 총 500회의 열순환을 실시한 후 1% methylene blue 용액에 침윤시켜서 100% 습도가 유지된 37℃ 항온기에 24시간 보관하였다. 치아를 레진에 매몰한 후 협설측으로 치아 장축에 평행하게 절단하여 stereomicroscope를 사용해 색소침투도를 관찰하여 다음과 같은 결론을 얻었다. 1. 평균 미세누출은 연마하지 않고 바로 치면열구전색재를 도포한 2군이 가장 낮았고, 연마만 시행한 1군이 가장 높았다. 2. 실험군 간의 미세누출 비교에서 연마만 시행한 1군은 2군에 비해 미세누출이 컸으며 통계적으로 유의성있는 차이를 보였다(p<0.05). 3군은 1군보다 평균 미세누출이 작았으나 통계적으로 유의한 차이가 없었다(p>0.05). 2군은 3군보다 평균 미세누출이 작았으나 통계적으로 유의한 차이가 없었다.(p>0.05) Amalgam, though a widely used dental material, does not bond to the tooth substrate. Therefore, retentive preparation of the cavity is necessary. Such amalgam restorations, until corrosion products form and plug the margin, will show significant marginal leakage. Unless this is prevented early on, saliva and bacteria may enter the cavity, causing postoperative hypersensitivity,dissolution and collapse of the restoration, discoloration of the margin and secondary caries, leading to shortened life-span of the restoration and pulpal pathosis. Recently, a method of restoration has been introduced whereby tooth material can be preserved, cavity margin can be sealed and preventive treatment of pit and fissure can be administered while retaining all the advantages of conventional amaogam restorations. Such sealed amalgams involve removing the carious lesion without extending the cavity for prevention and using pit and fissure sealants to seal cavity margins and pit and fissures to reduce microleakage. In this study, finishing of the amalgam and sealant application were performed after different intervals following of amalgam restoration to compare the microleakage of sealed and conventional amalgam restorations. Thirty bicuspids were prepared with Class V cavity preparations on the buccal and lingual surfaces. After amalgam placement, they were divided into the following groups and treated accordingly. Group 1 : Polishing after 24 hours Group 2 : Immediate sealant application without polishing Group 3 : No polishing, but sealant applied after thermocycling 500 times After treatment, the samples were thermocycled 500 times between 5℃ and 55℃ with a dwell time of 30 seconds. After thermocycling, the snmples were dipped into 1% methylene blue kept in a 37℃ incubator at 100% humidity for 24 hours. The teeth were then embedded in resin and cut bucco-lingually along the tooth axis and observed with a stereomicroscope to determine the degree of microleakage. The following results were obtained: 1. Group 2 showed the least microleakeage, while grorp 1 showed the greatest. 2. Group 1 showed significantly greater microleakage conpared to group 2 (P<0.05). However, no significant differences were found between group 1 and 3 (p>0.05). No significant differences on microleakage were also found between group 2 and 3 (p<0.05).
Objective : This study was performed in order to evaluate the effect of bee venom therapy on rheumatoid arthritis by randomized controlled double blind method. Method : RA patients were recruited and divided into an experiment group and a control group by random selection. As a double blind test, the experiment group was treated with bee venom injection on acupoints, and the control group was treated with normal saline injection on acupoints twice a week for 8 weeks. Tender joint count, swollen joint count, morning stiffness, pain, health assessment questionnaire, ESR. and CRP were estimated and analyzed at baseline, and at 1 month and 2 months after bee venom therapy Results : Compared to the control group, the experiment group showed significant decrease in tender joint count swollen joint count, morning stiffness, and health assessment questionnaire after 2 months. Pain, ESR and CRP showed significant decrease in the experiment group after 1 & 2 months. Conclusions : These results suggests that bee venom therapy could be an effective method in the treatment of patients with rheumatoid arthritis.
This paper describes the speed control method of BLDC Motor using TDOF PI ( Tow-degree of freedom PI ). PI control method generally used has difficulty in efficient speed control because speed response and load torque response interfere each other. It can't decrease the overshoot of motor speed w rm, and shorten the response time of load torque TL, at the same time according to the step alternation of speed reference w rm. Therefore TDOF PI is applied to BLDC Motor in order to supply these weak points of PI control method in this paper. TDOF PI can get the torque characteristic of short response time as well as stable and prompt speed adjustment by separate control for speed response and load torque response. The results from the tests of C program simulation and system construction show that TDOF PI is superior to PI control system in speed adjustment and load torque response.
Object : The purpose of this study was to determine the prevalence of fungal infection and ulcer on the feet of diabetic patients and the existence of correlation between ulcer and fungal infection. Methods : A total 21,693 outpatients diagnosed as diabetes mellitus at the department of endocrinology of 32 hospitals were examined. The diabetic patients with foot problems were consulted to the department of dermatology. Physical examination and KOH preparation were performed. Results : 13,271 patients had certain kinds of foot problem, accounting for 61.2% of 21,693 diabetics examined. Of these, fungal foot disease were found in 10,403 that constituted 78.4% (48.0% of the entire diabetic population). Tinea pedis was the diagnosis in 6,496 (29.9%), onychomycosis in 7,783 (35.9%), and coexistence was in 3,883 (17.9%). Foot deformity was in 1,346 (6.2% of diabetics; 10.1% of foot disease), non-palpable pulse in 1,051 (4.8% ; 7.9%), and foot ulcer was in 425 (2.0% ; 3.2%), following in a descending order of frequency. Odds ratios for diabetic foot ulcer were 2.5 in patients with the foot deformity, 1.6 with fungal foot disease and 2.2 with non-palpable pulse. Conversely, Odds ratios for fungal foot disease were 2.5 with foot deformity, and 1.6 with foot ulcer. A total of 5,486 patients paid a visit to the department of dermatology. Of these, 4,519 patients were diagnosed with fungal infection through physical examination and KOH smear by dermatologists. The population comprised of 2,272 males and 2,247 females, showing similar prevalence between sexes. However, age did have positive correlation regarding prevalence of fungal foot disease. The number of diabetic patients with toenail problems was 3,847 patients (70%) and onychomycosis was proven mycologically in 3,276. Onychomycosis of distal subungal type was the most common clinical finding, most frequently involving the great toenails. Abnormal skin findings of the foot were seen in 3,885(70.8%) and tinea pedis was found in 3,209 (58.5%), most commonly involving the soles. Conclusion : This study showed that fungal infection might be regarded as a risk factor of foot ulcer. Treatment of fungal infection in diabetic patients might prevent diabetic foot disease such as ulcer and reduce the disability, morbidity and mortality in diabetic patients. (Korean J Dermatol 2003;41(7) : 908~915)