• Title/Summary/Keyword: 복부 비만도

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Endovascular Repair of Acute Type B Aortic Dissection: The Early Results and Aortic Wall Changes (급성 B형 대동맥 박리의 혈관내 스텐트-그라프트 삽입이 초기성적 및 대동맥 벽의 변화)

  • Her, Keun;Won, Yong-Soon;Shin, Hwa-Kyun;Yang, Jin-Sung;Baek, Kang-Seok
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.648-654
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    • 2010
  • Background: This study assessed the early results of endovascular repair of acute type B aortic dissection and the aortic wall changes following endovascular repair. Material and Method: From July 2008 to May 2009, the preoperative and follow-up computed tomography (CT) scans of 5 patients with acute type B aortic dissection were evaluated, and these patients had underwent stent graft implantation within 13 days of the onset of dissection (mean: 7 days; range: 3~13). The whole lumen (WL), true lumen (TL) and false lumen (FL) diameters were measured at the proximal (p), middle (m) and distal (d) third of the descending thoracic aorta. Result: The study included four men and one woman with an average age of $59.4{\pm}20.1$ years (age range: 37~79 years). The follow-up CT was performed and evaluated at 7 days and 6 months. The primary tear was completely sealed in all the patients. No paraplegia, paresis or peripheral ischemia occurred and none of the patients died. No endoleaks developed in any of the patients during follow-up. The TL diameters increased from 20.4 to 33.5 mm in the proximal third (p/3), from 19.5 to 29.8 mm in the middle third (m/3) and from 15.2 to 23.5 mm in the distal third (d/3). The FL diameters decreased from 18.7 to 0 mm in the p/3, from 15.4 to 0 mm in the m/3 and from 21.4 to 8.7 mm in the d/3. The changes in the TL diameter were statistically significant in the middle and distal aorta, and those changes in the FL diameter were not statistically significant. There was a decrease in the WL after repair, but this was not statistically Significant. In three patients, the false lumen disappeared completely on follow-up CT at 6 months. Two patients had patent false lumens and no thrombosis. Conclusion: The early results showed that endovascular repair was effective in treating acute type B aortic dissection, and endovascular repair promoted positive aortic wall changes.

An Empirical Study on the Changes in Tax Payments under Consolidated Tax Return (연결납세와 개별납세간의 법인세부담액 차이에 대한 실증연구)

  • Jeong, Jae-Yeon;Shin, Hyun-Geol
    • 한국산학경영학회:학술대회논문집
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    • 2004.11a
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    • pp.101-123
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    • 2004
  • This study examines empirically the significant changes in tax payments when the consolidated tax return is introduced in the future. We estimate the consolidated tax payments under the eight cases which are classified as such : whether only 100% ownership subsidiaries should be included or 80% and over, whether all subsidiaries should be included or only subsidiaries with loss, and whether unrealized profits from intercompany transactions should be excluded or not. After estimating the consolidated tax payments, we test the difference between the consolidated tax payments and the sum of the individual tax payments of the subsidiaries. The results of the test show that the consolidated tax payments are significantly less than the sum of the individual tax payments of the subsidiaries. We interpret that the inclusion of the losses of the subsidiaries in the consolidated tax base makes the tax payment decrease. Based on our analysis about 3.8 billion Won per each parent company would decrease due to the introduction of the consolidated tax return. And we find that under the mandatory consolidated tax return system the significant difference between the consolidated and individual tax payment exists except that the only 100% ownership subsidiaries are included and unrealized profits from intercompany transactions are not excluded. However, when the parent companies have the discretion to select the consolidated subsidiaries, the consolidated tax payments are significantly less than the sum of the individual tax payments of the subsidiaries regardless of the ownership percentage, inclusion of the loss of the subsidiaries and exclusion of the unrealized profits.

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Renal Anomalies in Children with Turner Syndrome (Turner 증후군 환자에서 신기형에 관한 연구)

  • Kim, Ji Young;Hong, Sun Young;Park, Young Mi;Park, Yong Hoon;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.891-895
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    • 2002
  • Purpose : The prevalence of renal anomalies in Turner syndrome(TS) has been reported to vary from 33% to 60%. The purpose of this study was to clarify the true incidence of renal malformations in Korean TS. Methods : We evaluated 33 patients with Turner syndrome diagnosed by karyotype in Inje University Busan Paik hospital and Youngnam University from January 1995. Intravenous pyelography(IVP) was performed on all patients; abdominal ultrasonography and 99mTc-DMSA renal scan were performed on some. Cytogenetic analysis was performed on all patients with peripheral blood lymphocytes. Results : Of the total 33 patients, the karyotype showed 45, X in 18(54.5%) patients, mosaicism in 11(33.3%) patients and structural aberration in 4(12.2%) patients. The overall incidence of renal anomalies was 36.4%. The renal anomalies included four cases of horeshoe kidney, six cases of abnormal renal collecting system one case of single kidney and one case of malrotation. The incidence of renal anomalies in 45, X karotype(44.4%) showed a higher rate than that of mosaicism and structural aberration(26.7%), but there is no statistical significance. Conclusion : The incidence of renal anomalies in Korean TS reveals 36.4%. This rate is similar to other foreign TS studies. We recommend that renal ultrasonography or IVP for investigation of renal anomalies should be done as a screening procedure for the better quality of life in patients with TS.

The Effect of Nutrition Education on Visceral Fat Reduction and Diet Quality in Postmenopausal Women (폐경 여성의 내장지방 및 식사의 질에 미치는 영양 교육의 효과)

  • Baek, Young-Ah;Kim, Ki-Nam;Lee, Yo-A;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.41 no.7
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    • pp.634-664
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    • 2008
  • This study investigated the effects of the nutrition education on body weight, visceral fat and diet quality in the postmenopausal women. The subjects (n = 101) were randomly divided into two groups: Nutrition education + Exercise (NEE) group (n = 51) and Exercise only (EO) group (n = 50). Nutrition education was consisted of counseling in portion control, food selection for low carbohydrate, high fiber food items and for the improvement in micronutrient intakes and diet quality. After 6 months, the reduction in the body weight and visceral fat area was significantly greater in the NEE than in the EO group. The NEE subjects were further divided into two groups according to the amount of visceral fat area reduction; high visceral fat area loss (HVL) group with a visceral fat area reduction 2.35% or greater and low visceral fat area loss (LVL) group with a reduction less than 2.35%. In the HVL group, the reduction in body weight, BMI, percent body fat, waist to hip ratio and visceral fat area was significantly greater than that in the LVL group. We observed a significant increase in the serum HDL-cholesterol level and a decrease in systolic blood pressure, fasting blood sucrose, total and LDL-cholesterol levels in the HVL group compared to the LVL group. The energyadjusted protein, fiber, calcium, vitamin $B_6$, vitamin C, vitamin E intakes were significantly increased in the HVL compared to LVL group. The index of nutritional quality (INQ) and mean adequacy ratio (MAR) were also increased in the HVL group compared to the LVL group. These results show that our nutrition education program was an effective intervention measure for the reduction of body weight and visceral fat, blood pressure, glucose and lipid levels in the blood and also for the improvement of nutrient intake and diet quality in postmenopausal women who are overweight.

Study on Glomerular Filtration Rate comparison according to renal depth measurement of kidney donors (신 공여자에서 신장 깊이 측정에 따른 사구체여과율의 비교에 관한 고찰)

  • Lee, Han Wool;Park, Min Soo;Kang, Chun Goo;Cho, Seok Won;Kim, Joo Yeon;Kwon, O Jun;Lim, Han Sang;Kim, Jae Sam;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.48-56
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    • 2014
  • Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

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Usefulness of Hepatocellular Carcinoma by Hepatic Arterial Perfusion Scintigraphy with $^{99m}Tc$-MAA ($^{99m}Tc$-MAA를 이용한 간세포암의 간동맥 관류 스캔의 유용성)

  • Jeong, Ji-Uk;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Lee, Moo-Seok;Song, Hyeon-Seok;Park, Se-Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.155-158
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    • 2010
  • Purpose: $^{99m}Tc$-macroaggregated albumin (MAA) hepatic arterial perfusion scintigraphy was known for useful method to evaluate patients receiving intraarterial chemotherapy for liver cancer. This study evaluate about usefulness of normal liver on hepatocellular carcinoma (HCC) from HCC patients. This study is to see the usefullness of Hepatic Arterial Perfusion Scintigraphy (HAPS) by measuring mass size, shape, lung shunting and tumor to normal ratio (T/N ratio) in relative blood stream of HCC patients compared with HCC on normal liver. Materials and Methods: From June 2009 to September 2009, HAPS studies were performed on 7 patients (men 6, women 1, mean 64) who were diagnosed HCC. HAPS was performed after proper hepatic artery $^{99m}Tc$-MAA of 5 mCi (185 MBq) injection by catheter. We performed anterior, posterior, both lateral view, SPECT of chest and abdomen. Then we set up ROI and calculated lung shunting, T/N ratio for each count, count/pixel (mean value). Results: Tumor and liver size analyzed by ROI of anterior, posterior view are 2.0-10.8 cm (mean 3.75 cm), 8.8-18.5 cm (mean 14.6 cm). T/N ratio analyzed by total tumor and total normal mean value are 2.41-5.76 (mean 3.8). lung shunting analyzed by total liver count is 3.14-13.92% (mean 6.77%). Conclusion: HAPS with $^{99m}Tc$-MAA can evaluate mass size, location, quantitative analysis through T/N ratio. also HAPS can evaluate detection of arteriovenous shunt through lung uptake before radioisotope therapy. Therefore HAPS with $^{99m}Tc$-MAA can be useful method in aspect of evaluation and treatment of HCC.

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Human Lung Cancer Cell Xenografts Implanted under the Capsule of Kidney, Spleen and Liver (폐암 세포주를 사용한 신, 비장 및 간 피막하 분식법의 비교)

  • 김수현;김종인;이해영;조봉균;박성달;김송명
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.711-720
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    • 2003
  • Bakground : Complete resection by the surgery has been selected as the treatment of choice in lung cancer patients, but in cases of recurrence after excision or inoperable cases, the importance of anticancer chemotherapy has been emphasized. If one can select a set of the sensitive chemotherapeutic agents before anticancer chemotherapy, it will give more favourable results. Subrenal capsular assay has been recognized as a useful in-vivo chemosensitivity test of thoracic and abdominal tumors and it can be done in a short time for a rapid interpretation of tumor responsiveness to anticancer chemotherapeutic drugs. It has been reported that various kinds of cancer cells can be implantable to the kidney, but so far there is no comparative study of xenogeneic cell implantation on liver, spleen and kidney. The author implanted the human lung cancer cells under the capsule of S.D rat's liver, spleen and kidney respectively and compared the pattern of growth and histology. Material and Method: After incubation of human lung cancer cell line (SW-900 G IV) in RPMI 1640 (Leibovitz L-15 medium) culture media, 3${\times}$3${\times}$3 mm size fibrin clots which contain 108 cancer cells were made. Thereafter the fibrin clots were implanted at subcapsule area of liver, spleen and kidney of S.D. female rat. For immune suppression, cyclosporin-A (80 mg/Kg) was injected subcutaneously daily from post-implantation first day to sixth day. The body weight was measured at pre and post implantation periods. The growth pattern and the size of tumor mass were observed and the pathologic examination and serum tumor marker tests were performed. Result: Body weight increased in both of control and experimental groups. Serum Cyfra 21-1 was not detected. Serum levels of CEA and NSE revealed no significant change. The SCC-Ag increased significantly in implanted group. The growth rate of human lung cancer cells which was implanted on spleen was higher than on liver or kidney. The surface area, thickness, and volume of tumor mass were predominant at spleen. The success rates of implantation were 80% on kidney, 76.7% on spleen and 43.3% on liver. Pathologic examination of implanted tumors showed characteristic findings according to different organs. Tumors that were implanted on kidney grew in a round shape, small and regular pattern. In the spleen, tumors grew well and microscopic neovascularization and tumor thrombi were also found, but the growth pattern was irregular representing frequent daughter mass. Human lung cancer cells that were implanted in the liver, invaded to the liver parenchyme, and had low success rate of implantation. Microscopically, coagulation necrosis and myxoid fibrous lesion were observed. Conclusion: The success rate of implantation was highest in the kidney. And the mass revealed regular growth that could be measured easily. The SCC-Ag was presented earlier than CEA or Cyfra21-1. The Cyfra21-1 was not detected at early time after implantation. The best model for tumor implantation experiment for chemosensitivity test was subrenal capsular analysis than liver and spleen and the useful serum tumor marker in early period of implantation was the SCC-Ag.

A case of simultaneously identified glycogen storage disease and mucopolysaccharidosis (당원병과 뮤코다당체침착증이 동시에 발견된 증례 1예)

  • Lee, Ju Young;Shim, Jeong Ok;Yang, Hye Ran;Chang, Ju Young;Shin, Choong Ho;Ko, Jae Sung;Seo, Jeong Kee;Kim, Woo Sun;Kang, Gyeong Hoon;Song, Jeong Han;Kim, Jong Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.650-654
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    • 2008
  • Glycogen storage disease (GSD) and mucopolysaccharidosis (MPS) are both independently inherited disorders. GSD is a member of a group of genetic disorders involving enzymes responsible for the synthesis and degradation of glycogen. GSD leads to abnormal tissue concentrations of glycogen, primarily in the liver, muscle, or both. MPS is a member of a group of inherited lysosomal storage diseases, which result from a deficiency in specific enzymatic activities and the accumulation of partially degraded acid mucopolysaccharides. A case of a 16-month-old boy who presented with hepatomegaly is reported. The liver was four finger-breadth-palpable. A laboratory study showed slightly increased serum AST and ALT levels. The liver biopsy showed microscopic features compatible with GSD. The liver glycogen content was 9.3% which was increased in comparison with the reference limit, but the glucose-6-phosphatase activity was within the normal limit. These findings suggested GSD other than type I. Bony abnormalities on skeletal radiographs, including an anterior beak and hook-shaped vertebrae, were seen. The mucopolysaccharide concentration in the urine was increased and the plasma iduronate sulfatase activity was low, which fulfilled the diagnosis criteria for Hunter syndrome (MPS type II). To the best of the authors' knowledge, this is the first case of GSD and Hunter syndrome being identified at the same time.

Clinical Significance of Pyuria in Pediatric Patients with Febrile Urinary Tract Infection (발열성 소아 요로감염에서 농뇨의 임상적 의의)

  • Choi, Lim;Cho, Sea-Eun;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.66-75
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    • 2011
  • Purpose: Early diagnosis and treatment of febrile urinary tract infection (UTI) in children is important to prevent kidney damage. This study aims to evaluate the relationship between the presence of pyuria, the severity, and underlying genitourinary anomalies in patients with UTI. Methods: We retrospectively reviewed 293 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from June, 2007 until January, 2010. We divided the patients into two groups, one with the finding of pyuria at admission, and the other without, and compared the fever duration, white blood cell counts (WBC) and C-reactive protein (CRP) in peripheral bloods, hydronephrosis, cortical defects, vesicoureteral reflux and admission period. Results: Among the 293 patients with febrile UTI, 189 patients showed findings of pyuria whereas 104 patients did not. Patients with pyuria showed an increment of WBC ($14,694{\pm}485.2$ vs. $11,374{\pm}451.2/uL$, P <0.05) and CRP ($46.9{\pm}3.9$ vs $17.1{\pm}3.6$ mg/L, P <0.05) in peripheral blood sample. The presence of cortical defects (21.7 Vs 5.8%, P <0.05) and vesicoureteral reflux (15.9 Vs 6.7%, P <0.05) was also increased in patients with pyuria compared to patients without pyuria. There were no specific differences in fever duration, admission period, and hydronephrosis. Within the group with pyuria, CRP in peripheral blood sample increased proportionally with the increment of pyuria (P <0.05). Conclusion: In patients with febrile UTI, the increment of WBC in the urine sample can be a helpful predictor for increased CRP in peripheral blood and acute pyelonephritis.

Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection (요로감염과 동반된 전해질 불균형의 임상적 의의)

  • Cho, Sea-Eun;Choi, Lim;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.58-65
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    • 2011
  • Purpose: Some hormonal and electrolyte abnormalities have been reported in pediatric patients with urinary tract infection (UTI). This study aimed to investigate the relationships between the imbalance of electrolytes and the severity of infection and associated urologic anomalies in children with febrile UTI. Methods: We retrospectively reviewed 267 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from January, 2007 until February, 2010. According to the presence of hyponatremia or hyperkalemia, clinical parameters and associated renal anomalies, such as hydronephrosis, cortical defects and vesicoureteral reflux, were compared. Results: 42.7% of all patients had decreased concentration of serum sodium. In patients with decreased concentration of serum sodium, cortical defects were significantly increased compared to normal patients (40.4% vs. 14.4%, P <0.05). White blood cell (WBC) counts ($15,721{\pm}6,553/uL$ vs. $12,885{\pm}5,367/uL$, P <0.05), C-reactive protein (CRP) ($61.8{\pm}56.1$ mg/L, vs. $29.9{\pm}39.8$ mg/L, P <0.05), and erythrocyte sedimentation rate (ESR) ($43.9{\pm}34.3$ mm/hr vs. $27.4{\pm}26.8$ mm/hr, P <0.05) in peripheral blood showed significant increases in the group with decreased concentration of serum sodium. Duration of fever, presence of gastrointestinal symptom, the incidence of hydronephrosis and vesicoureteral reflux did not differ between the two groups. None of the patients had significant hyperkalemia. Conclusion : We suggest that decreased concentration of serum sodium in febrile UTI might be a helpful marker for leukocytosis and increased CRP and ESR in peripheral blood, and acute pyelonephritis.