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Endocrine dysfunction and growth in children with medulloblastoma (소아 수모세포종 환자에서 치료 후의 내분비적 장애와 성장변화)

  • Yoon, In Suk;Seo, Ji Young;Shin, Choong Ho;Kim, Il Han;Shin, Hee Young;Yang, Sei Won;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.292-297
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    • 2006
  • Purpose : In medulloblastoma, craniospinal radiation therapy combined with chemotherapy improves the prognosis of tumors but results in significant endocrine morbidities. We studied the endocrine morbidity, especially growth pattern changes. Methods : The medical records of 37 patients with medulloblastoma were reviewed retrospectively for evaluation of endocrine function and growth. We performed the growth hormone stimulation test in 16 patients whose growth velocity was lower than 4 cm/yr. Results : The height loss was progressive in most patients. The height standard deviation score (SDS) decreased from $-0.1{\pm}1.3$ initially to $-0.6{\pm}1.0$ after 1 year(P<0.01). Growth hormone deficiency(GHD) developed in 14 patients. During the 2 years of growth hormone(GH) treatment, the improvements of height gain or progressions of height loss were not observed. Twelve patients(32.4 percent) revealed primary hypothyroidism. One of six patients diagnosed with compensated hypothyroidism progressed to primary hypothyroidism. Primary and hypergonadotropic hypogonadism were observed in two and one patients respectively. There was no proven case of central adrenal insufficiency. Conclusion : Growth impairment developed frequently, irrespective of the presence of GHD in childhood survivors of medulloblastoma. GH treatment may prevent further loss of height. The impairment of the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-thyroidal axis is less common, while central adrenal insufficiency was not observed.

Changes in platelet counts caused by valproate in children with epilepsy (소아 간질 환자에서 valproate 투여 후 혈소판 수의 변화)

  • We, Ju Hee;Kim, Young Mi;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.75-80
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    • 2009
  • Purpose : In adults, valproate (VPA) has been reported to be associated with thrombocytopenia. However, few studies have investigated this association in children, and the factors affecting platelet counts remain controversial. This study was undertaken to investigate changes in platelet counts following VPA therapy and related factors in children with epilepsy. Methods : Our subjects comprised 75 epileptic children who had received VPA monotherapy for at least 1 year between January 2000 and December 2005. We regularly examined platelet counts at intervals of 6 to 12 months after baseline platelet counts before VPA treatment. We analyzed changes in platelet counts according to several factors such as sex, seizure type, underlying causes of epilepsy, age at the start of medication as well as at the last follow up, duration of VPA administration, VPA dose, serum VPA level, and body weight at the last follow up. Results : Overall, the platelet counts decreased significantly after VPA therapy. The average baseline platelet count was $312.5{\pm}109.1{\times}10^6/mL$. At the last follow up, the average platelet count was $261.7{\pm}72.2{\times}10^6/mL$. We observed the relationship between platelet counts and serum levels of VPA; while children with serum VPA <$75{\mu}g/mL$ showed no change in platelet counts (P=0.102), children with serum VPA >$75{\mu}g/mL$ showed a significant decrease in platelet counts. Conclusion : VPA may cause a significantly decreased platelet count in children with epilepsy. High serum VPA levels were associated with development of thrombocytopenia.

Growth Performance of Pangasiid Catfish, Silver carp and Catla in Polyculture (복합양식에서 pangasiid catfish, silver carp과 catla의 성장률)

  • Sarkar, Md. Reaz Uddin;Khan, Saleha;Haque, Md. Mahfuzul;Khan, Mohammed Nurul Absar;Luyen, Quoc-Hai;Choi, Jae-Suk
    • Journal of Life Science
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    • v.18 no.9
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    • pp.1186-1193
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    • 2008
  • The growth performance of pangasiid catfish (Pangasius hypophthalmus), silver carp (Hypophthalmichthys molitrix) and catla (Catla catla) was evaluated in polyculture at varied combinations and stocking ratios in earthen pond for a period of 16 weeks. Combinations of pangasiid catfish, silver carp and catla with the total density of 30,000 fish per hectare were evaluated. A commercial pelleted feed containing 28% crude protein and 6% lipid was fed only to pangasiid catfish at the rate of 8% of body weight during the first six weeks, 6% during the second six weeks and 4% thereafter twice daily. The growth and feed utilization efficiency of pangasiid catfish were found similar in all treatments. The growth of silver carp was markedly decreased upon the increase of its own stocking density. The highest growth of silver carp achieved in polyculture of pangasiid catfish, silver carp and catla at 2:1:1 ratio where density of silver carp was lowest. The growth of catla was found to be affected by the presence of silver carp. The growth rate of catla markedly declined with the increase of silver carp density. The highest growth of catla obtained in polyculture of pangasiid catfish only with catla stocked at 1:1 ratio. The highest yield and economic return achieved in polyculture of pangasiid catfish, silver carp and catla at the ratio of 2:1:1 due to higher growth of silver carp and higher market value of catla. The water quality conditions in all different treatment ponds were within optimum ranges throughout the culture period and the values did not show any significant variation (p>0.05) among the treatments.

A Tool Box to Evaluate the Phased Array Coil Performance Using Retrospective 3D Coil Modeling (3차원 코일 모델링을 통해 위상배열코일 성능을 평가하기 위한 프로그램)

  • Perez, Marlon;Hernandez, Daniel;Michel, Eric;Cho, Min Hyoung;Lee, Soo Yeol
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.107-119
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    • 2014
  • Purpose : To efficiently evaluate phased array coil performance using a software tool box with which we can make visual comparison of the sensitivity of every coil element between the real experiment and EM simulation. Materials and Methods: We have developed a $C^{{+}{+}}$- and MATLAB-based software tool called Phased Array Coil Evaluator (PACE). PACE has the following functions: Building 3D models of the coil elements, importing the FDTD simulation results, and visualizing the coil sensitivity of each coil element on the ordinary Cartesian coordinate and the relative coil position coordinate. To build a 3D model of the phased array coil, we used an electromagnetic 3D tracker in a stylus form. After making the 3D model, we imported the 3D model into the FDTD electromagnetic field simulation tool. Results: An accurate comparison between the coil sensitivity simulation and real experiment on the tool box platform has been made through fine matching of the simulation and real experiment with aids of the 3D tracker. In the simulation and experiment, we used a 36-channel helmet-style phased array coil. At the 3D MRI data acquisition using the spoiled gradient echo sequence, we used the uniform cylindrical phantom that had the same geometry as the one in the FDTD simulation. In the tool box, we can conveniently choose the coil element of interest and we can compare the coil sensitivities element-by-element of the phased array coil. Conclusion: We expect the tool box can be greatly used for developing phased array coils of new geometry or for periodic maintenance of phased array coils in a more accurate and consistent manner.

The Clinical Characteristics According to the Risk Factors of Idiopathic Nonhemolytic Hyperbilirubinemia (신생아 특발성 비용혈성 고빌리루빈혈증의 위험 요인에 따른 임상 양상)

  • Park, Sook-Hyun;Kang, Ji-Hyun;Kwon, Soon-Hak;Kim, Heng-Mi;Kim, Yong-Sun
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.224-231
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    • 2010
  • Purpose: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. Methods: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. Results: The mean gestational age was $38^{+3}{\pm}1^{+4}$ weeks, and the mean age on admission was 8.8$\pm$4.0 days. The mean body weight (3,105$\pm$479 g) was decreased by 2.8$\pm$6.4 percent compared to the mean birth weight (3,174$\pm$406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. Conclusion: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

A Case of Kabuki Syndrome Confirmed by Genetic Analysis: A Novel Frameshift Mutation in the KMT2D Gene (분자유전학적으로 진단된 가부키 증후군 1례)

  • Park, Su Jin;Ahn, Moon Bae;Jang, Woori;Cho, Won Kyung;Chae, Hyo Jin;Kim, Myung Shin;Suh, Byung Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.103-108
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    • 2017
  • Kabuki syndrome is a rare congenital disorder that causes multiple birth defects and mental retardation. Mutation of the lysine methyltransferase 2D (KMT2D) gene is the primary cause of Kabuki syndrome. We report a 4-year-old Korean girl diagnosed with Kabuki syndrome based on distinctive facial features (eversion of the lower lateral eyelid, arched eyebrows, depressed nasal tip, prominent ears), skeletal anomalies, short stature, and molecular analysis, which revealed a novel frameshift mutation in the KMT2D gene. A 4-year-old patient had a past history of congenital cardiac malformations (coarctation of the aorta, ventricular septal defect, atrial septal defect, patent ductus arteriosus), subclinical hypothyroidism and dysmorphic features at birth including webbed neck, short fingers, high arched palate, micrognathia and horseshoe kidney. She showed unique facial features such as a long palpebral fissure, long eyelashes, arched eyebrows with sparseness of the lateral third, broad nasal root, anteverted ears, and small mouth. Her facial features suggested Kabuki syndrome, and genetic analysis discovered a novel heterozygous frameshift mutation (c.4379dup, p.Leu1461Thrfs*30) in exon 15 of the KMT2D gene. The diagnosis of our 4-year-old patient was made through thorough physical examination and history taking, and genetic testing. It is challenging to diagnose patients with Kabuki syndrome at birth, since the characteristic facial features are expressed gradually during growth. Clinical suspicion aroused by regular follow-ups may lead to earlier diagnosis and interventions.

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A Ecological Study of Phytoplankton Community in the Geum River Estuary (금강 하구 기수역 식물플랑크톤 군집의 생태학적 연구)

  • Shin, Yoon Keun
    • Korean Journal of Ecology and Environment
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    • v.46 no.4
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    • pp.524-540
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    • 2013
  • After the construction of the Geum River estuary dam, we investigated the ecological property of phytoplankton community with physicochemical property in 9 stations of Geum River estuary 4 times seasonally in 2010 about the environmental changes through the change of phytoplankton. Physicochemical property seems to show eutrophication which developed from the tendency of accruing of the nutrients (those involved in intermittency of freshwater which flows from the dike and the surrounding cities), caused by the changing of tidal flow, the decreasing of the inflow of seawater after the construction of the Geum River estuary dam (dike). A total of 233 species of species composition of phytoplankton emerged, showing a highly increased result compared to that of the former research. The reason for the increase in number is considered as a phenomenon resulting from the mix of blackish and freshwater marine species in the flow of intermittency of freshwater discharge. Also, the standing crops of phytoplankton considerably increased compared to when the dike had not yet been built. Highly affected by the discharge of occasional freshwater, the diatoms of blackish water zone dominated in spring and winter, while freshwater species appeared to dominate in summer and autumn. The species diversity showed over 2.0 except in winter season. After a cluster analysis, the result showed that the Geum River estuary was influenced by runoff from cities like Gunsan, the sewage which flows from Gyeongpo River, and the intermittency of freshwater discharge from the Geum River estuary dam.

The Effect of Creeping Bentgrass Growth on Greenspeed (그린잔디의 생육이 그린스피드에 미치는 영향)

  • Kwon, Il-Woo;Lee, Dong-Hee;Choi, Byuong-Man;Tae, Hyun-Sook;Shin, Dong-Hyun
    • Asian Journal of Turfgrass Science
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    • v.25 no.2
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    • pp.223-228
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    • 2011
  • This research was performed to investigate change of green speed according to growth of grass, for this, the method of effective green management for improvement of green speed was searched by investigating green density, soil moisture, surface hardness, and mowing height every day for 6 months. As the result of the study, reliability between, green density, soil moisture, surface hardness, mowing height and green speed were measured to be respectively 0.4742, 0.5690, 0.4632, 0.2806, i.e. soil moisture is considered as the factor which affects green speed the most. Therefore, it will be an advantageous environment to maintain soil moisture a little bit low to improve green speed within the range that does not disrupt the growth of green. In case of green density, it is considered to be effective to get a fast green speed when obtaining enough density during May~June, the most vigorous growth period and at the same time green up period. Surface hardness was confirmed that management work as rolling is a considerably effective method to increase hardness. However, rolling gives high stress to the green, combining another management work as regular hilling could be a good alternative. Reliability of green preview and green speed was 0.2806, lower than soil moisture or surface hardness. Through the results, it was confirmed that management of mowing height to be low less than 3.00 mm is helpful to improve green speed, timely, and it is advantageous to manage green speed when adjusting mowing height during the vigorous growth period of bent grass. However, considering the range of mowing height was not various, being 2.9~3.4 mm, henceforth research on investigation of green speed at more various mowing heights would be necessary. Consequently, except mowing height, other three factors, i.e. green density, soil moisture and surface hardness were investigated to have considerable level of reliability on green speed, and it is considered that each factor affects green speed respectively according to green condition and time. Accordingly, in order for the manager to maintain high speed all year round, intensive care for each factor per time unit considering green growth condition is considered to be necessary.

Cervicography as a Screening Test for Cervical Cancer (자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용)

  • Lee, Doo-Jin;Lee, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.169-180
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    • 1999
  • Background: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screening test of cervical cancer. Materials and Methods: Cervicography was taken from 482 women at department of obstetrics and gynecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999. Of the 482 women, 172 women were exc1uded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology (Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chronic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05). The sensitivity and specificity of cytology were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13. 3%) (p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%) (p<0.05). Conclusion: It seems inappropriate to use cervicography as a single screening test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

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A Study on the Precise Lineament Recovery of Alluvial Deposits Using Satellite Imagery and GIS (충적층의 정밀 선구조 추출을 위한 위성영상과 GIS 기법의 활용에 관한 연구)

  • 이수진;석동우;황종선;이동천;김정우
    • Proceedings of the Korean Association of Geographic Inforamtion Studies Conference
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    • 2003.04a
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    • pp.363-368
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    • 2003
  • We have successfully developed a more effective algorithm to extract the lineament in the area covered by wide alluvial deposits characterized by a relatively narrow range of brightness in the Landsat TM image, while the currently used algorithm is limited to the mountainous areas. In the new algorithm, flat areas mainly consisting of alluvial deposits were selected using the Local Enhancement from the Digital Elevation Model (DEM). The aspect values were obtained by 3${\times}$3 moving windowing of Zevenbergen & Thorno's Method, and then the slopes of the study area were determined using the aspect values. After the lineament factors in the alluvial deposits were revealed by comparing the threshold values, the first rank lineament under the alluvial deposits were extracted using the Hough transform In order to extract the final lineament, the lowest points under the alluvial deposits in a given topographic section perpendicular to the first rank lineament were determined through the spline interpolation, and then the final lineament were chosen through Hough transform using the lowest points. The algorithm developed in this study enables us to observe a clearer lineament in the areas covered by much larger alluvial deposits compared with the results extracted using the conventional existing algorithm. There exists, however, some differences between the first rank lineament, obtained using the aspect and the slope, and the final lineament. This study shows that the new algorithm more effectively extracts the lineament in the area covered with wide alluvlal deposits than in the areas of converging slope, areas with narrow alluvial deposits or valleys.

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