• Title/Summary/Keyword: 증상변화

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Comparison of the Medication Effects between Milnacipran and Pregabalin in Fibromyalgia Syndrome Using a Functional MRI: a Follow-up Study (섬유근통 환자에 대한 Milnacipran과 Pregabalin 약물치료에 대한 기능적 자기공명영상에서의 후속 영향 비교)

  • Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.341-351
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    • 2014
  • Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

Transient Splenial Lesions in the Splenium of Corpus Callosum in Seven Patients: MR Findings and Clinical Correlations (뇌량 팽대의 일과성 병변: 7명의 환자에서의 자기공명 영상소견과 임상 양상의 연관성)

  • Park, Ju Young;Lee, In Ho;Song, Chang June;Hwang, Hee Youn
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.1-7
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    • 2013
  • Purpose : The purpose of this study is to correlate the imaging findings and the clinical findings in patients with transient splenial lesions (TSL). Materials and Methods: Total of 7 patients (M: F = 4: 3; age range 11 - 38 years, mean age 25.5 years) were studied between November 2006 and April 2011. The MRI findings and clinical findings in all patients were retrospectively reviewed. The location, MR signal intensity, restricted diffusion, enhancement pattern and reversibility from the follow up images were reviewed. Clinical features were reviewed with respect to the presented symptoms, signs, treatment and outcome. Results: The lesions were located in the splenium of corpus callosum in all patients. All lesions showed high signal intensity on diffusion weighted imaging (DWI), and six patients showed restricted diffusion on the apparent diffusion coefficient (ADC) map. ADC map was not available in one patient. All lesions (n = 7) showed high signal intensity on the T2 weighted image (T2WI). Five of the patients (71.4%) with follow up images (range 7 - 34 days) showed complete resolution of focal high signal intensity on DWI, with recovery of ADC values as well as T2WI. After contrast media administration, none of the lesions showed any enhancements. All lesions with various etiologies including TB medication were developed in younger age patients and showed reversibility after the acceptable period of minimum 7 days with conservative treatment. Conclusion: All TSL showed nonspecific imaging findings, including restricted diffusion on DWI and ADC map on the initial images. However, reversibility of the lesions and the young age preference can be a characteristic finding of TSL with acceptable period of minimum 7 days. In addition, to keep it in mind that various etiologies including TB medication may cause TSL, is important for radiologists as well as clinicians.

Analysis of Maternal and Neonatal Transport by the 1339 Emergency Medical Information Center in Busan Area (부산 지역 응급의료정보센터를 통한 산모와 신생아 전원에 대한 연구)

  • Kim, Mi-Jin;Lee, Myung-Chul;Yoo, Jae-Ho;Kim, Myo-Jing
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.137-142
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    • 2011
  • Purpose: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. Methods: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. Results: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. Conclusion: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.

Pulse wave velocity and ankle brachial index in adolescents with essential hypertension (본태성 고혈압 청소년에서 pulse wave velocity와 ankle brachial index에 대한 연구)

  • Joo, Sun Young;Cho, Ki Young;Cho, Su Jin;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.769-776
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    • 2006
  • Purpose : Pulse wave velocity(PWV) and ankle brachial index(ABI) are not only noninvasive methods used to assess arterial stiffness in adults, but also useful, simple ways to estimate the severity of hypertension, end stage renal disease and atherosclerosis in adults. But there are few studies on PWV and ABI in adolescents and children. In this study, hypertensive adolescents were compared to normal individuals to find out the usefulness of PWV as the index of progress in the disease. Methods : 413 teenagers were divided into three groups. The first group consisted of adolescents that only had hypertension(Group 1 : 23 teenagers). The second group consisted of the adolescents who had hypertension with obesity(Group 2 : 17 teenagers), and the last group was the normal subjects(Group 3 : 328 teenagers). Weight, height and body mass index were measured. Simultaneous measurements of systolic, diastolic and average blood pressure were obtained from the four extremities. PWV, ABI, ejection time and preejection period were also measured. Results : Right brachial-ankle PWV was significantly higher in both group 1 and group 2 compared with group 3, and significantly higher in group 2 compared with group 1. Likewise, left brachial-ankle PWV also showed significantly higher values in both group 1 and group 2 compared with group 3, and also higher values in group 2 compared with group 1. Positive correlations were found between the systolic, diastolic, average blood pressure and PWV. There were also positive correlations between the blood pressure and weight, body mass index. Conclusion : Higher PWV was demonstrated in adolescents with essential hypertension compared to normal subjects. Follow-up study is needed to evaluate the progress.

Safety and efficacy of the ultra-rush immunotherapy with extracts of Dermatophagoides pteronyssinus in children (집먼지 진드기 항원을 이용한 초급속면역치료의 안전성과 효과)

  • Hyun, Sei Eun;Kim, Hyoung Yun;Kwak, Ji Hee;Shin, Youn Ho;Seo, Ji Yeong;Han, Man Yong
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.868-873
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    • 2008
  • Purpose : Immunotherapy is accepted as the only treatment of allergic disease that can modify the natural course of the disease and ameliorate symptoms. This study aimed to evaluate the safety and efficacy of ultra-rush therapy using Dermatophagoides extracts in children. Methods : Of children older than four years who had visited Bundang CHA Pediatric Allergy Clinic, those showing positive reactions only to Dermatophagoides in the skin prick test and to the nasal provocation test were included. In all, 11 and 12 patients respectively preferred conventional and ultra-rush immunotherapy. We elevated allergen concentrations diluted to 1,000:1 of the end strength by 2-3 times with 30-minute intervals and checked oxygen saturation, pulse rate, blood pressure, and systemic reactions every 15 minutes. Immunotherapy effectiveness was valued by changes in nasal provocation test scores before and after immunotherapy. Results : The average ages of patients in the conventional and ultra-rush immunotherapy groups were $8.3{\pm}2.3$ and $9.2{\pm}2.8years$, respectively. Systemic reactions were observed in six in the ultra-rush group (50%) without anaphylaxis and one (9%) in the conventional group. The average scores in the nasal provocation test before and after treatment in the conventional group were $8.2{\pm}1.5$ and $4.6{\pm}2.1$, respectively (P=0.043). In the ultra-rush immunotherapy group, the scores changed from $6.2{\pm}2.2$ to $3.7{\pm}2.5$ (P=0.017). Conclusion : Ultra-rush immunotherapy using Dermatophagoides in children is effective for treating allergic disease but can induce systemic effects rather than conventional immunotherapy.

Lowered Substrate pH Reduced the Bicarbonate Injury during Vegetative Growth of 'Ssanta' Strawberry (혼합상토의 pH 저하가 영양생장 중인 '싼타' 딸기의 중탄산 피해 경감에 미치는 영향)

  • Lee, Hee Su;Cheung, Jong Do;Choi, Jong Myung
    • Journal of Bio-Environment Control
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    • v.26 no.2
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    • pp.115-122
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    • 2017
  • Objective of this research was to investigate the influence of lowered substrate pH on the reduction of bicarbonate injury in the vegetative growth of 'Ssanta' strawberry. The acid substrate was formulated by mixing sphagnum peat moss with pine bark (5:5, v/v) and the pH, EC, and CEC of the substrate were 4.07, $0.46dS{\cdot}m^{-1}$, and $91.3cmol^+{\cdot}kg^{-1}$, respectively. To adjust the pH of acid substrate, various amount of dolomitic lime [$CaMg(CO_3)_2$] were incorporated with the rate of 0 (untreated), 1, 2, 3, and $4g{\cdot}L^{-1}$. Then, mother plants were transplanted and grown with fertilizer solution containing $240mg{\cdot}L^{-1}$ of the $HCO_3{^-}$ and equal concentrations of essential nutrients to Hoagland solution. In growth of 'Ssanta' strawberry, fresh weight of mother plants were the highest in the treatment of $2g{\cdot}L^{-1}$ dolomitic lime such as 102.1 g followed by 94.7 g in $1g{\cdot}L^{-1}$, 91.2 g in $3g{\cdot}L^{-1}$, 75.7 g in $0g{\cdot}L^{-1}$ and 72.3 g in $4g{\cdot}L^{-1}$ treatments. The dry weight showed a similar tendency to fresh weight. At 140 days after transplanting, 5.8, 9.8, 11.8, 8.8, and 5.0 daughter plants were derived from each of the mother plants in the treatments of 0, 1, 2, 3, and $4g{\cdot}L^{-1}$ dolomitic lime, respectively. The highest occurrence of daughter plants were observed in the treatments $2g{\cdot}L^{-1}$ dolomitic lime. The substrate pH and bicarbonate concentration of 'Ssanta' strawberry seedlings in the 1 and $2g{\cdot}L^{-1}$ dolomitic lime treatments were maintained at a proper range such as 5.6 to 6.2. The micro-nutrient contents of above ground tissue in mother plants were the highest in $2g{\cdot}L^{-1}$ and the lowest in $4g{\cdot}L^{-1}$ dolomitic lime treatment. The above results indicate that incorporation rate of dolomitic lime in acid substrate with the pH of around 4 is $2g{\cdot}L^{-1}$ to raise the 'Ssanta' strawberry in propagation.

Evaluation of Visual Performance for Implanted Aspheric Multifocal Intraocular Lens in the Cataract Patients (백내장 환자에서 비구면 다초점 인공수정체 삽입 후 시기능 평가)

  • Kim, Jae-Yoon;Lee, Koon-Ja
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.3
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    • pp.347-356
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    • 2013
  • Purpose: To evaluate the visual acuity and visual performance after implantation of a aspheric multifocal (ReSTOR$^{(R)}$ SN6AD3) intraocular lens (IOL). Methods: Nineteen cataract patients (30 eyes) implanted with an aspheric multifocal IOL (ReSTOR$^{(R)}$ SN6AD3) either unilaterally or bilaterally were participated. Visual acuity (VA) and objective optical performance were evaluated at the time of preoperation, 1 week, 1 month, and 3 month after operation. At 3 month of post-operation, objective visual performance were measured and compared with the 38 eyes of 20 age-matched normal control. Distance VA was measured by using the ETDRS LCD chart and intermediate and near visual acuity were measured using Jaeger chart. Objective visual performance was assessed preoperatively and 1 week, 1 month and 3 month postoperatively using a double-pass system (Optical Quality Analysis System) with a 4-mm pupil diameter, the OSI (objective scatter index), MTF (modulation transfer function) cut off and strehl ratio. At 3 month of post-operation, visual acuity and visual performance compared with age matched normal control. Results: The uncorrected distance VA, OSI, MTF cut off and strehl ratio were significantly improved (p<0.05) until 1 month postoperatively. Visual performance of MTF cut off and strehl ratio after 3 month of operation were significantly improved compared to the normal control (p=0.063, p=0.103 respectively), however, OSI was higher than normal control. Patients implanted with aspheric multifocal IOL were satisfied with distance and near VA however, were unsatisfied with intermediate VA and reported glare and halos. Conclusions: The visual performance reaches to a stable condition in 1 month of implantation of aspheric multifocal IOL and improved to the level of age-mated normal patients. Also patients were satisfied with their quality of vision, however, intermediate VA, glare and halos were reported as complications.

A review of the contents about childhood health care in middle & high school textbooks (중·고등학교 교과서에 실린 소아 관련 정보의 조사)

  • Kim, Jung Hun;Park, Sung Won;Shin, Son Moon;Sung, In Kyung;Park, Mi Jung;Chung, Yoo Mi;Ha, Jeong Hun
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.340-347
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    • 2007
  • Purpose : The purpose of this study is to investigate the material in middle school and high school textbooks covering child care and children's health for medically inaccurate content and to make sure that the correct information is given to students. Methods : We have examined 47 kinds of textbooks on the subjects 'Home economics' and 'Technology and home economics' published in 2007 to find out how much importance is placed on children's health and childcare and to search for incorrect definitions, inaccurate facts or insufficient explanations. We have also analyzed the credentials of the writers of these textbooks. Results : Textbooks of middle school cover psychological and physical changes during adolescence and nutrition, and those of high school cover marriage and childcare. These materials covering health made up 27.5%, 11.7% of middle & high school texts. Age definitions of neonate and infant were incorrect. Inaccurate facts were mostly about fontanelles, primitive reflexes, breastfeeding and weaning. There also were wrong informations on the umbilical cord care and developmental milestones during infancy. The childhood immunization schedules and the growth curves were not up to date. Most of the authors major in home economics and the others were school teachers. There was no evidence of any review by a medical society or an expert. Conclusions : When writing about children's health and childcare in textbooks, a board-certified pediatrician or The Korean Pediatric Society should be consulted to provide accurate medical information to middle and high school students.

Observation of Response to PPD Skin Test and Local Side Reactions at Multiple Inoculation Sites after Percutanous Inoculation with BCG Tokyo 172 Strain (경피용 건조 B.C.G. 백신(Tokyo 172주) 접종 후 국소 반응과 투베르쿨린 양전율에 관한 연구)

  • Lee, Jin Soo;Sohn, Young Mo
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.201-210
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    • 2000
  • Purpose : We observed response to PPD skin test and local side reactions among subjects who received inoculation with Tokyo 172 BCG strain by percutaneous method using multiple puncture device. Methods : 138 infants and young children were enrolled at Yongdong Severance Hospital and 7 private clinics. 5TU PPD skin test were performed at 4 months after inoculation. The local reactions at multiple puncture site were observed in 3 days, 4~6 weeks, 36 weeks, and 48 weeks after inoculations and physical check up was done for evaluation of lymphadenopathy. Results : During 48 weeks of observation period, 96 subjects among 138 who were enrolled were followed up completely with records of PPD skin test and observation of local side reactions, presenting with the photos. The size of the induration after 48 hours of PPD skin test, was less than 5mm in six subjects(6.3%), greater than 10mm in sixty seven subjects(70.0%) and greater than 12mm in forty six subjects(47.9%). All subjects showed inflammatory reaction and pustules at multiple puncture sites and only just small papules, ulcer and pustules remained 4-6 weeks later. Eight to twelve weeks later, all local inflammatory skin reactions disappeared with remaining crust. After 48 weeks, 4(4.2%) subjects showed no scar with only faint stain on the puncture site. More than 70% of subjects showed more than 10 faint pin-point scars on the sites. However, the size of scar was clearly smaller compared to that of intradermal inoculation. There were no cases of lymphadenopathy. Conclusion : We observed good immune response to 5TU PPD skin test among the infant and young children who were immunized with percutanous inoculation of Tokyo 172 BCG strain. We could not find any severe local scar at inoculation sites. A degree of satisfaction of the parents whose children received the percutaneous injection was very high.

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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