: : : : (02)27372181-8443 : 252 58 / / Keto analogues of amino acid (Ketosteril ) / 101 7-101 9 (aortic dissection) Population-based studies 1987 2002 (aneurysm) 50% ( ) 30% ( ) 20% 30% 20% 10?
( 80%) ( Marfan s syndrome) : Golledge J, Eagle KA. Acute aortic dissection Lancet. 2008 Jul 5;372(9632):55-66. Review. 80% (false lumen) ( ) : Golledge J, Eagle KA. Acute aortic dissection Lancet. 2008 Jul 5;372(9632):55-66. Review.
Stanford Type A Type B Type A (ascending aorta) Type B ( ) : Golledge J, Eagle KA. Acute aortic dissection Lancet. 2008 Jul 5;372(9632):55-66. Review. ( ) ( ) ( 90% 10% ) (60% )
X Type A Type B (blood assays) (electrocardiogram ECG) (chest radiography) (CT) (echocardiogram) (MRI) (chronic dissection) 2001 (the European Society of Cardiology) : Golledge J, Eagle KA. Acute aortic dissection Lancet. 2008 Jul 5;372(9632):55-66. Review.
Type B 100-120 mmhg β (β blockers) propranolol metoprolol labetolol esmolol (calcium channel blockers) verapamil diltiazem sodium nitroprusside Type A (ascending aorta) (true lumen) β (β blockers) 130/80 mmhg (angiotensin II blockers) (systemic reviews) Type B 5% 2% (stroke) 1% 20 12% 2% 90% (ascending aorta)
(descending aorta) (International Registry of Acute Aortic Dissection) 40% (ascending aorta) 1. Golledge J, Eagle KA. Acute aortic dissection Lancet. 2008 Jul 5;372(9632):55-66. Review. 2. Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJ, Thompson MM. The diagnosis and management of aortic dissection. BMJ. 2011 Jan 11;344:d8290.doi: 10.1136/bmj.d8290. Review. 3... 2009. Sep 18-20.
12 (Primary infertility) (Secondary infertility) Clomiphene citrate (Clomiphene 50mg) (1) (2) GnRH FSH LH (3) 50-250 mg/day 3-5 5 5 (4) 50 mg (5) Clomiphene
Tamoxifen (Nolvadex 10mg) (1) Tamoxifen Clomiphene Clomiphene (2) (3) 8 mm Aspirin (Tapal 100 mg Bokey 100 mg) (1) (acetylation) COX-1 thromboxane A2 (2) 100 mg/day (3) (4) Aspirin G6PD ( ) Sildenafil (Viagra 100 mg) Tadalafil(Cialis 20 mg) (1) Sildenafil Tadalafil phosphodiesterase-5 inhibitors (PDE- 5 inhibitors) cyclic GMP Nitric oxide(no)
(2) 0.5 ~1 (3) (4) PDE-5 inhibitors (nitrates) (1) (2) A. (Progesterone 25 mg) B. (Utrogestan 100 mg) C. (Crinone 8%) (3) 14 (4)
Follitropin alfa (Gonal-F 75 IU 300 IU/0.5ml) (1) Gonal-F (FSH) FSH (2) A. 75-150 IU/day 37.5 IU 75 IU 225 IU/day 24-48 (HCG )5000-10000 IU HCG B. 150-225 IU/day 450 IU ~ 24-48 10000 IU HCG (3) (4) 2 ~ 8 Lutropin α (Luveris 75 IU) (1) Luveris (LH) LH FSH (2) FSH Luveris 75 IU/day FSH 75-150 IU/day 37.5~75 IU 24-48
(HCG)5000-10000 IU HCG (3) (4) HCG 2 ~ 8 Menotrophin (Menopur ) Menopur FSH 75 IU+LH 75 IU A. 1-2 Menopur Menopur 1-3 HCG 5000-10000 IU 7 HCG 5000IU B. 1-2 Menopur HCG 3000 IU 10-12 2-8 Follitropin beta (Puregon 300IU/0.36ml) (1) ml Puregon 833 IU FSH (2) A.
50 IU 40-100% 18mm 300-900 picograms/ml (1000-3000 pmol/l) 7-14 Puregon HCG 14 mm 14 mm HCG 100-225 IU 6 12 75-375 I.U. Puregon GnRH analogue 3 16-20mm 18 mm 300-400 picogram/ml (1000-1300 pmol/l) HCG 34-35 B. 450 IU 150 HCG 3 4 18 (3)
(4) Puregon clomiphene citrate GnRH Puregon (GnRH agonist GnRH antagonist ) (1) GnRH agonist Leuplin A. 21 3 B. 2 3 C. 3 (2) GnRH antagonist Cetrotide GnRH 5 6 1214 mm HCG Ovidrel 32 36
1. 2.. Acetylsalicylic acid (Aspirin). NO.95. http://www.taiwanpharma.org.tw/jtp/095/114-120.html. Google. 27 Sep 2012 3..http://www.bhp.doh.gov.tw/BHPnet/Portal/Default.aspx. Google. 27 Sep 2012
Keto analogues of amino acid (Ketosteril ) 40 25 ml/min 4-8 Ketosteril ( - ) Ketosteril (keto analogues) (transamination) (NH 3 ) (NH 3 ) (Urea cycle) (urea) (NH 3 ) Ketosteril (TCA cycle) (Uremic toxins) (Uremic) (Hydroxy-acid) (Keto-acid) (glomerular hyperfiltration) (renal hyperphosphatemia) secondary hyperparathyroidism (renal osteodystrophy)
Ketosteril (Uremic) Ketosteril 10 Keto-anglogues 5 20-60 90 Keto-anglogues Amino acid Keto-anglogues -Ketoacid Ketoacid Ketoacid 1. 186 90 96 22 78 52 8 36 (Chronic renal failure CRF) (Endogenous creatinine clearance) 29.4 8.2 ml/min (22-36 ml/min/1.73 m 2 ) (Serum creatinine) 2.79 0.97mg/dL (247 86 mol/l) (Renal anemia) (Hemoglobin) 10.5 g/dl (Hematocrit) 30 % 96 (Chronic tubulointerstitial nephritis) 74 (Chronic glomerulonephritis) 16 (malignant nephrosclerosis)
(low-protein diet;lpd) (Erythropoietin;EPO) - (Ketosteril;KA); (Erythropoietin;EPO) ; (low-protein diet;lpd) 0.6 1.3 4.9 35 100 mmol(2,300 mg) (Sodium) 50 mmol(1,950 mg) (Potassium) 30 mmol(930 mg) (Phosphorus) (Bicarbonate) (Iron concentration) (Transferrin) (Hypolipidemic) (Hypotensive) 135/85 mmhg (Lipid metabolism) (immunosuppressive) 2. :
0.6 0.3 Ketosteril (Oxygenation) (Metabolism) (Anaerobic glycolysis) (Pyruvate-mediated gluconeogenesis) (Branched-chain amino acid) (Hydroxy) (Keto) Ketosteril (Proteinuria) (Glomerular hemodynamics) (Membrane hemodynanics) Ketosteril (Nitrogen balance) Ketosteril Ketosteril 1. Ketosteril 2. Teschan PE, Beck GE, Dwyer JT, et al: Effect of a keto acid amino acid supplemented very low protein diet on the progression of advanced renal disease: A reanalysis of the A reanalysis of the MDRD feasibility study. Clin Nephrol 50:273-283, 1998
3. Mitch WE: Dietary therapy in uremia: The impact of nutrition on progressive renal failure. Kidney Int Suppl 75:S38-S43, 2000 4. Aparicio M, Chauvenau P, De Precigout V, Bouchet J-L, Lasseur C, Combe C: Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet. J Am Soc Nephrol 11:708-716, 2000 5. Nankivell BJ, Tay YC, Boadle RA, Harris DC: Dietaryprotein alters tubular iron accumulation after partial nephrectomy. Kidney Int 45:1006-1013, 1994 6. Mitch WE: Are supplements of keto acids and amino acids useful in treating patients with chronic renal failure?wien KlinWochenschr 112:863-864, 2000 7. Teplan V, Schu ck O, Kazdova L, et al: Metabolic effect of keto acid-amino acid supplementation in patientswith chronic renal insufficiency receiving a lowprotein diet and recombinant human erythropoietin: A randomized controlled trial.wien KlinWochenschr 113:661-669, 2001 8. Teplan V, Schu ck O, Knotek A, et al:enhanced metabolic effect of keto acidamino acid in CRF patients on low-protein diet: Czech Multicenter Study 41:26-30, 2003.
101 7-101 9 ( ) ( ) Flagyl oral tablet Frotin oral tab. 1. 250 mg (Metronidazole) (OFLAG) 250 mg (Metronidazole) (OFRO) Metronidazole 2. ( ) ( ) Tinidazole 500 mg Tinin 500 mg 1. (Tinidazole) (OTIN) (Tinidazole) (OTINI) 2. ( ) ( ) N.F.S. FC Tab 100 mg 1. (Norfloxacin) (ONFS)