• Title/Summary/Keyword: 예견

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The Significance of the Early Electroencephalographic Findings in Severely Asphyxiated Newborn Infants (중증 주산기 가사 환아에서 시행한 초기 뇌파 검사의 임상적 의의)

  • Lee, Jong Uk;Choi, Won Joung;Kim, Chun Soo;Lee, Sang Lak;Kim, Jun Sik
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.784-788
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    • 2003
  • Purpose : Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. Methods : Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of ${\leq}3$ and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. Results : Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst-suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). Conclusion : Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.

Clinical characteristics of congenital myotonic dystrophy diagnosed by molecular genetic method (분자 유전학적 방법으로 진단된 선천성 근육긴장성 이영양증 환자의 임상 양상)

  • Nam, Sook Hyun;Son, Young Bae;Lee, Bo Lyun;Lee, Jeehun;Ki, Chang-seok;Lee, Munhyang
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.868-874
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    • 2007
  • Purpose : We performed this study to investigate the perinatal and developmental features of the patients with congenital myotonic dystrophy (CDM) confirmed by the molecular genetic method and the clinical characteristics of their mother, and to identify the relation between the number of CTG repeats and the clinical severity.Methods : A retrospective review of the medical records and the results of the dystrophia myotonica protein kinase (DMPK) gene test was done for the patients who were confirmed as CDM through gene analysis from January 2001 to September 2006. Results : All of the eight patients (male 2, female 6) showed moderate to severe degree of perinatal distress and feeding difficulty associated with profound hypotonia. Three patients had the history of polyhydramnios and two patients had equinovarus deformity. The developmental milestones were delayed in all patients, which improved gradually with age. All of their mothers demonstrated myotonic symptoms and typical myopathic face. The number of CTG repeats in DMPK gene analysis ranged 1,000-2,083, and there was no significant correlation between the number of CTG repeats and the time of walking alone. Conclusion : All patients with CDM presented with severe hypotonia in perinatal period, and developmental delay thereafter, which were improved with age. All of their mothers manifested myotonic symptoms with typical myopathic face, and the identification of such features greatly contributed to the diagnosis of the patients. The number of CTG repeats had no significant influence on the motor development.

Tissue Failure of the Low-Profile lonescu-Shiley Pericardial Valve in Mitral Position (승모판에서의 단고형 이오네스큐판막의 조직실패)

  • 김종환
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.670-676
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    • 1997
  • The structural failure of the glutaraldehyde-treated xenograft valves has been the primary concern about the limited durability as predicted from the begimling of clinical use, and long-term follow-up has shown a significant incidence of primary tissue failure(PTF) from both biological and mechanical reasons. Twenty-seven patients with the low-profile lonescu-Shiley valves explanted from mitral position for PTF(Group III) were studied on the patient characteristics and valve pathology, and the results were compared with the matched observations of the Haycock(Group I) and of the standard-profile lonesiu-Shiley valves(Group II). Patients were aged 16 to 56 years(mean, 38.0$\pm$ 11.0 years), and the size of the failed mitral bioprosthesis was 30.8$\pm$ 1.3 mm. The hemodynamic consequences were stenosis in 29.6%, insufficiency in 44.4%, mixed steno-insufficiency in 14.8%, together with normal function for the rest of patients of prophylactic re-replacement. Pathology revealed calcification with or without tissue damage in 63.0% and tissue damage with or without calcification in 58.l%, in contrast with the observations of predominant tissue damage(76.8%) over calcification in Group I and of calcification(76.1%) over tissue damage in group II. Although dystrophic calcification has long and repeatedly dealt with patient's young age as a determinant of valve durability, such a characteristic evidence was not reached even in patients with calcified valves. Moreover, the prolonged explantation p riods from the studied on the previous report suggested strongly yet possibly evolving destructive processes among the valves in the remaining patients, and awaits further follow-up. In conclusion, PTF of the xenograft valves seems to result from more complicated biologic and metabolic reasons as well as more complex mecharical factors than the reported, and newer generation prostheses, with tissue preservation with glutaraldehyde, do not likely to provide decisive improvement in the occurrence of structural failurebioprostheses is generally limited to the highly aged.

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Long Term Follow Up Results of Serum Squamous Cell Carcinoma Antigen Level in Uterine Cervix Cancer Treated by Radiotherapy (자궁경부암 방사선치료 후 혈중 Squamous Cell Carcinoma 항원치의 장기추적 결과)

  • Yun, Hyong-Geun
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.283-290
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    • 2003
  • Purpose: To evaluate the long term significance of the squamous cell carcinoma (SCC) antigen (Ag) as a tumor marker in uterine cervix carcinoma. Materials and Methods: The SCC antigen levels of pre-radiotherapy and serial post-radiotherapy serum were analyzed in 48 patients who received radiotherapy with histologically proven primary SCC of the uterine cervix. Results: Pre-radiotherapy SCC Ag level was high ($\geq$2 ng/ml) at 79.2$\%$. After the treatment, the SCC Ag level was significantly decreased. The SCC Ag level measured at about 3 months after radiotherapy was high at 23.0$\%$. In further follow up measurements, a rise of the SCC Ag to a high level was well associated with clinical relapse. The specificity of the elevated SCC Ag level in association with recurrent or persistent disease was 100$\%$, and the sensitivity was 85.7$\%$. In 3 of 4 lung metastasis cases, lung lesions were detected in chest PA before elevation of the SCC Ag level. The median lead time of the high SCC Ag level to clinical recurrence was 4 months. Conclusion: SCC Ag was a good tumor marker for monitoring treatment effect in patients with increased pre-treatment levels except in case of early lung metastasis. Elevation of the SCC Ag level after radiotherapy accurately predicted the treatment failure with lead time of 4 months. But, in early lung metastasis cases, the SCC level may be normal temporarily. Thus, chest PA should be checked to evaluate the presence of lung metastasis.

Biotechnology and Women's Agency: Between IVF and Therapeutic Cloning Research (생명공학과 여성의 행위성: 시험관아기 시술과 배아복제 연구 사이에서)

  • Cho Joo-Hyun
    • Journal of Science and Technology Studies
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    • v.5 no.1 s.9
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    • pp.93-123
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    • 2005
  • This work has following two research goals. First, IVF treatments that have been recently going on in Korea are reexamined from the perspective of women's reproductive rights. Second, the intimate connection between IVF and therapeutic cloning research, in that remnant embryos and eggs that have been secured through IVF treatments have served as a main source of supply for therapeutic cloning research, has been emphasized. The fact that the influencing power of tradition on Korean families and women and IVF techniques eventually joined their hands in support of therapeutic cloning research is noted. Analysis of experiences of infertility by women in the realms of family, medical care during IVF treatment, and therapeutic cloning research that requires continuous supply of eggs leads to following conclusions. First, in the realm of family, infertile women were not only relegated to the status of abnormality but pressured to question their own womanhood. Under this circumstance, IVF treatment helped to reinforce the traditional concept of biological motherhood, thus categorizing married women giving birth to babies and married women who can't or refuses to do so to 'normal ones' and 'abnormal ones' respectively. Second, in the realm of medical care an infertile woman could rediscover her own body during the process of IVF treatment. By going through the processes of hormone treatment, implantation, conception, miscarriage, and so on, she could realize that her own body is understood in diverse ways to her, her family, and the medical profession. Third, in the realm of the state, IVF treatment that was serving as the main supplier of research materials for therapeutic cloning research has been able to avoid controversy in public discourses since the latter has emerged as a signifier of new national economic workhorse for the 21st century. As therapeutic cloning research went into high gear, the status of women as egg providers began to assume a political dimension. Women as egg providers are called upon to take on a paradoxical role as patriotic contributors to national economy on the one hand and as guardians of sacred 'life' on the other hand. The direction and progress of the research will depend on the ways that women comply, compromise, and/or resist the contradiction brought about by being assigned to assume these two identities: the one as a member of the nation requested to serve as a part of national economic development project, even though considered ineligible for financial recompense, and the other one as a guardian of sacred 'life,' even though she have to serve the research that is allowed to create a 'life' to destroy a 'life.'

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Effects of β3-Adrenergic Receptor Polymorphism on the Hyperglycemia in Korean Subjects (베타 3-아드레날린 수용체의 유전자형이 고혈당증 유발에 미치는 영향)

  • 오현희;최선미;양현성;김길수;윤유식
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.1
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    • pp.83-90
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    • 2004
  • This study was conducted to examine the effects of $\beta$3-adrenergic receptor polymorphism on the blood glucose level and obesity in 530 volunteers, who attended a weight loss program in a local obesity clinic. The age differences in total subjects and the distribution of male and female were 26.55$\pm$0.31 yr, 9.1% (n=48), 90.9% (n=492). The genotype distribution of $\beta$3-AR gene polymorphism were WW type 75%, WR type 22% and RR type 3%. Among many parameters, fasting blood glucose was significantly higher in WR+RR type (p=0.001) compared with WW type. When the subjects were divided into two groups by 6.105 mmol/L of the fasting blood glucose level, the frequency of hyperglycemia was 23.3% in WW type subjects, while there was a increase to 35.6% in WR+RR type subjects (p=0.011, $\chi$$^2$-analysis). When hyperglycemia group was compared with normoglycemia group, obesity index (p=0.044), %body fat (p=0.046) and TG (p=0.000) were significantly higher, and HDL (p=0.006) was significantly lower in the hyperglycemia. When all of the above factors were included in stepwise logistic regression analysis to find risk factors of hyperglycemia, the results were that the odds ratio for hyperglycemia were 2.015 (p=0.011) for WR+RR type of $\beta$3-AR gene, 2.165 (p=0.000) for TG and 0.419 (p=0.059) for HDL cholesterol. There was a significantly positive correlation between the blood glucose vs BMI, WHR, body fat in the WW type (r=0.099, 0.119, 0.082) However, in the WR and RR type there were no significance between the blood glucose vs BMI, WHR, body fat. These data suggest that the WR+RR genotype of $\beta$3-AR has a very strong association with increased blood glucose level and might be a significant risk factor for hyperglycemia among Korean subjects.

A Comparative Study of Relationships among Eating Behavior, Intake Frequency of Food Group and Cardiovascular disease Related Factors in Vegetariand and Non-Vegetarians (채식인과 비채식인의 식습관, 식품군별 섭취빈도와 심혈과 질환관련인자와의 관련성에 관한 비교 연구)

  • 차복경
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.1
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    • pp.183-192
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    • 2001
  • The purpose of this study is to verify the relation between vegetarian diet and the risk factors of cardiovascular disease. To do the present study the vegetarians were selected; 127 Buddhist nuns (age : 23 ~ 79 yrs) from Oonmoon Temple in Choungdo District, Gyeongsang Book-do. For control subjects, 235 healthy female adults (age : 23~79yrs) were selected. They were the teachers, the nurses of the hospital of Gyeongsang National University and the housekeepers living in Chinju Gyeongsang Nam-do. This study was conducted from October 1996 to February 1997. The contents are consisted of anthropometric measurement, questionnaries about eating behavior and intake frequency of food group and clinical examination. The results were summarized as follows. The average ages of vegetarians and non-vegetarians were 44.2 yrs and 40.5 yrs respectively. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.4 and 21.0, WHR were 0.8 and 0.8, percentage of body fat were 28.7 and 26.5 and the average duration of vegetarian diet of the vegetarians was 13.1 years. Eating behavior score of vegetarian was significantly higher than those of non-vegetarians. Eating behavior score was negatively of correlated with levels of serum total-cholesterol, LDL-cholesterol and atherogenic index (AI). In intake frequency of green vegetable, lemon-yellow vegetable, bumb and seaweeds of the vegetarians more than those of non-vegetarians. Levels of total cholesterol, LDL-cholesterol, AI, diastolic blood pressure, blood sugar and HDL cholesterol of non-vegetarians were significantly higher (p<0.01) than those of vegetarians, but ratio of HDL cholesterol/total-cholesterol was lower in non-vegetarians. Consequently, vegetable diet can be considerably diet help to decrease the risk of cardiovascular disease.

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A FEM comparison study about the force, displacement and initial stress distribution on the maxillary first molars by the application of Asymmetric Head-Gears with the different traction forces (Asymmetric Head-Gear의 견인력의 차이에 따른 상악 제 1 대구치에 나타나는 힘과 변위 및 초기 응력분포에 관한 유한요소법적 비교 연구)

  • Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.31 no.3 s.86
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    • pp.311-323
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    • 2001
  • One of the various mechanics used to treat unilateral Class II malocclusion is head gear with asymmetric face bow. We made the finite element models of unilateral Class II maxillary dental arch and power arm asymmetric face bow. We designed this experiment to observe stress distribution of periodontal ligament, reaction force, and displacement and to understand force system, so to predict the therapeutic effect. On the basis of computerized tomograph of maxillary dental arch of 25 years old male with normal occlusion without extraction and orthodontic treatment history, we made finite element models of maxillary dental arch and periodontal ligament. Then we modified that model to unilateral maxillary Class II malocclusion model of which maxillary left molar displaced mesially. Also, We made finite element model of asymmetric face bow of which right outer bow shorter than left by 25mm(RMO, Penta-FormTM/Medium size, 0.045 inch iner bow, 0.072 inch outer bow). After that, retraction force of 250g, 300b, 350g were applied to maxillary first molar. We concluded as follow. 1. The Net force that both maxillary first molars were received increased as the retraction force increased. Mesially positioned tooth received more force than normally positioned tooth. But, both tooth were received distal force, so distal movement occured. 2. Both tooth received buccal lateral force. In analysis of force element, as the retraction force were increased, force of X-axis at mesially positioned tooth decreased, and force of X-axis at normally positioned tooth increased. so lateral force component moved to the side received less force from more force. 3. There were rotation, tipping with distal movement in maxillary first molar. As retraction force were increased, rotation and tipping also increased. More tipping and rotation occured at the side received more force, that is, mesially positioned tooth. Though it Is small change, displacement of same pattern occur in normally positioned tooth

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Monte Carlo Simulations of Detection Efficiency and Position Resolution of NaI(TI)-PMT Detector used in Small Gamma Camera (소형 감마카메라 제작에 사용되는 NaI(TI)- 광전자증배관 검출기의 민감도와 위치 분해능 특성 연구를 위한 몬테카를로 시뮬레이션)

  • Kim, Jong-Ho;Choi, Yong;Kim, Jun-Young;Im, Ki-Chun;Kim, Sang-Eun;Choi, Yeon-Sung;Joo, Kwan-Sik;Kim, Young-Jin;Kim, Byung-Tae
    • Progress in Medical Physics
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    • v.8 no.2
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    • pp.67-76
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    • 1997
  • We studied optical behavior of scintillation light generated in NaI(TI) crystal using Monte Carlo simulation method. The simulation was performed for the model of NaI(TI) scintillator (size: 60 mm ${\times}$ 60 mm ${\times}$ 6 mm) using an optical tracking code. The sensitivity as a function of surface treatment (Ground, Polished, Metal-0.95RC, Polished-0.98RC, Painted- 0.98RC) of the incident surface of the scintillator was compared. The effects of NaI(TI) scintillator thickness and the refractive index of light guide optically coupling between the NaI(TI) scintillator and photomultiplier tube (PMT) were simulated. We also evaluated intrinsic position resolution of the system by calculating the spread of scintillation light generated. The sensitivities of the system having the surface treatment of Ground, Polished, Metal-0.95RC, Polished-0.98RC and Painted-0.98RC were 70.9%, 73.9%, 78.6%, 80.1% and 85.2%, respectively, and the surface treatment of Painted-0.98RC allowed the highest sensitivity. As increasing the thickness of scintillation crystal and light guide, the sensitivity of the system was decreased. As the refractive index of light guide increases, the sensitivity was increased. The intrinsic position resolution of the system was estimated to be 1.2 mm in horizontal and vertical directions. In this study, the performance of NaI(TI)-PMT detector system was evaluated using Monte Carlo simulation. Based on the results, we concluded that the NaI(TI)-PMT detector array is a favorable configuration for small gamma camera imaging breast tumor using Tc-99m labeled radiopharmaceuticals.

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Prenatally Diagnosed Uncommon Mosaic Autosomal Trisomy

  • Lee, Bom-Yi;Park, So-Yeon;Lee, Moon-Hee;Kim, Jin-Woo;Park, Ju-Yeon;Choi, Eun-Young;Lee, Yeon-Woo;Oh, Ah-Rum;Lee, Shin-Young;Kim, Min-Hyung;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.95-99
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    • 2009
  • Prenatal diagnosis of rare autosome mosaicism involvingchromosomes other than chromosome 13, 18, 21 or the sex chromosome is encountered prognostic dilemma during genetic counseling. We report four cases of level III uncommon mosaicism of trisomy 5, 16 and 20,diagnosed prenatally. In case 1 with mosaic trisomy 20, there was a higher mosaic ratio of trisomy 20 in the repeat amniocentesis (62.1%) than in the first (36.6%) with normal fetal ultrasound finding except for a relatively small aorta on a 3-vessel view of the fetal heart. Case 2 showed a low rate of mosaic trisomy 20 (5.25%) in cultured amniocytes but normal karyotype in the repeat amniocentesis, who delivered a normal healthy baby. Case 3 showed a 13.6% of trisomy 16 mosaicism in the 30 cells of cultured amniocytes. Sixty cells from a fetal blood sample at termination showed non-mosaic 46,XX normal karyotype, while skin fibroblasts had 22.5% trisomy 16 in 40 metaphases. The autopsy showed ventricular septal defect (VSD). Case 4 with low grade mosaicism (10.5%) of trisomy 5 resulted in elective termination, though the ultrasoumd showed growsly normal fetus. Although level III mosaicism is regarded as true mosaicism, it is difficult to predict the outcome of the fetus with rare mosaic autosome trisomy. Therefore mosaic autosome trisomy of fetus should be carefully interpreted with more various approaches including repeat sampling and targeted fetal ultrasound.

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