Purpose This article studies the relationship between the length of a kidney measured by two scanning methods: Kidney Computed Tomography (CT) and 99mTc-Dimercaptosuccinic acid (DMSA) renal scan. Kidney CT provides a better anatomic assessment, while 99mTc-DMSA renal scan is superior in the kidney function test. Materials and Methods From January to December of 2019, two hundred patients who had Kidney CT and Tc99m-DMSA renal scan were chosen for this study. SPSS17.0 was selected for statistical analysis. Results Due to the effect of the breathing and resolution of 99mTc-DMSA renal scan, it showed the kidney's relatively longer length than the length of Kidney CT. For the same kidney, the length comparison among different brands' Gamma cameras was negligible. The length difference within the same age group did not show a noticeable discrepancy. However, there was a length difference between the radio technologists. Kidney CT and 99mTc-DMSA renal scan indicated a strong positive correlation between the length of the left and right kidney. Conclusion It is necessary to establish a standardized measurement method for measuring kidney length using 99mTc-DMSA renal scan. The kidney's functional changes and length changes are indications of Kidney diseases. Especially, pediatric patients tend to use 99mTc-DMSA renal scan for assessing the kidney's shape and the function to avoid potential radiation exposure during the Kidney CT. Therefore, it is significant to provide not only the kidney's functional information but also an anatomic analysis, including the kidney's size, length, and location through the 99mTc-DMSA renal scan.
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation that is able to alter neuronal activity in particular brain regions. Many studies have researched how tDCS modulates neuronal activity and reorganizes neural networks. However it is difficult to conclude the effect of brain stimulation because the studies are heterogeneous with respect to the stimulation parameter as well as individual difference. It is not fully in agreement with the effects of brain stimulation. In particular few studies have researched the reason of variability of brain stimulation in response to time so far. The study investigated individual variability of brain stimulation based on circadian rhythm and chronotype. Participants were divided into two groups which are morning type and evening type. The experiment was conducted by Zoom meeting which is video meeting programs. Participants were sent experiment tool which are Muse(EEG device), tdcs device, cell phone and cell phone holder after manuals for experimental equipment were explained. Participants were required to make a phone in frount of a camera so that experimenter can monitor online EEG data. Two participants who was difficult to use experimental devices experimented in a laboratory setting where experimenter set up devices. For all participants the accuracy of 98% was achieved by SVM using leave one out cross validation in classification in the the effects of morning stimulation and the evening stimulation. For morning type, the accuracy of 92% and 96% was achieved in classification in the morning stimulation and the evening stimulation. For evening type, it was 94% accuracy in classification for the effect of brain stimulation in the morning and the evening. Feature importance was different both in classification in the morning stimulation and the evening stimulation for morning type and evening type. Results indicated that the effect of brain stimulation can be explained with brain state and trait. Our study results noted that the tDCS protocol for target state is manipulated by individual differences as well as target state.
Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.
'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.
Medical practice with medical adaptability is not illegal. Consent to medical practice is also not intended to exclude causes of Illegality. The patient's consent to medical practice is the exercise of the right to self-determination, and the patient's right to self-determination is take shape through the doctor's information. If a doctor violates his duty to inform, failure to inform or lack of inform constitutes an act of illegality of omission in itself. As a result, the legal interest of self-determination is violated. The patient has the right to know and make decisions on his or her own, even when it is not connected to the benefit of life and body as the subject of the body. If that infringed and lost, the non-property damage shall be recognized and the immaterial damage must be compensated. On the other hand, the violation of the duty of information does not belong to deny the compensation for physical damage. Which the legal interest violated by violation of the obligation to inform is the self-determination, and loss of opportunity of choice is recognized as ordinary damage. However, if the opportunity of choice was lost because of the infringement of the right to self-determination and the patient could not choice the better way, that dose not occur plainly bad results, under the prove of these causal relationship, that bad results could be compensated. But the unexpectable damage could not be compensated, because the physical damage is considered as the special damage due to the violation of the right of the self-determination.
Yawut, Natpaphan;Kim, Namuk;Budluang, Phatcharaporn;Cho, Il-Rae;Kaowinn, Sirichat;Koh, Sang Seok;Kang, Ho Young;Chung, Young-Hwa
Journal of Life Science
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v.32
no.4
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pp.271-278
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2022
The detailed mechanism by which cancer upregulated gene 2 (CUG2) overexpression induces cancer stem cell-like phenotypes is not fully understood. The downregulation of FBXW7 E3 ligase, a tumor suppressor known for its proteolytic regulation of oncogenic proteins such as cyclin E, c-Myc, Notch, and Yap1, has been frequently reported in several types of tumor tissues, including those in the large intestine, cervix, and stomach. Therefore, we investigated whether FBXW7 is involved in CUG2-induced oncogenesis. In this study, the decreased expression of FBXW7 was examined in human lung adenocarcinoma A549 (A549-CUG2) and human bronchial BEAS-2B cells (BEAS-CUG2) overexpressing CUG2 and compared with control cells stably expressing an empty vector (A549-Vec or BEAS-Vec). Treatment with MG132 (a proteosome inhibitor) prevented the degradation of FBXW7 and Yap1 proteins, which are substrates of the FBXW7 E3 ligase. To address the role of Fbxw7 in the development of cancer stem cell (CSC) phenotypes, we suppressed Fbxw7 protein levels using its siRNA. We observed that decreased levels of FBXW7 enhanced cell migration, invasion, and spheroid size and number in A549-Vec and BEAS-Vec cells. The enforced expression of FBXW7 produced the opposite results in A549-CUG2 and BEAS-CUG2 cells. Furthermore, the downregulation of FBXW7 elevated the activities of EGFR, Akt, and ERK1/2 and upregulated β-catenin, Yap1, and NEK2, while the enforced expression of FBXW7 generated the opposite results. We thus propose that FBXW7 downregulation induced by CUG2 confers CSC-like phenotypes through the upregulation of both the EGFR-ERK1/2 and β-catenin-Yap1-NEK2 signaling pathways.
Hwang, Jun Ho;Kim, Su Yeong;Lee, Na Mi;Yi, Dae Yong;Yun, Sin Weon;Chae, Soo Ahn;Lim, In Seok;Park, Ji Young
Pediatric Infection and Vaccine
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v.29
no.2
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pp.84-95
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2022
Purpose: Urinary tract infections (UTIs) are the most common serious bacterial infections in young infants. Lumbar puncture (LP) has been used to diagnose coexisting meningitis in infants under 90 days of age with suspected UTI in many hospitals. However, the incidence of bacterial meningitis associated with UTIs is low. We aimed to describe the prevalence of concomitant bacterial meningitis in young infants with UTIs. Methods: The medical records of infants with the first episode of UTI admitted to the Chung-Ang University Hospital from January 2010 to December 2019 were retrospectively reviewed. Infants aged < 90 days who underwent LP with initial evaluation were included. Demographic and clinical features, laboratory findings, and imaging findings were collected and analyzed. Results: Eighty-six infants with UTIs were enrolled in the study. The median age was 61.5 days (interquartile range, 42.3-73.8 days) and boys (90.7%) were predominant. Escherichia coli was the most common pathogen (n=80, 93.0%) and followed by Klebsiella species (n=5, 5.8%). Fifteen (18.1%) specimens produced extended spectrum β-lactamase (ESBL). Five (5.8%) infants had positive blood culture results. Seven (8.1%) infants showed pleocytosis in the cerebrospinal fluid, but none had coexisting bacterial meningitis. Twenty-four (30.8%) infants showed renal dilatation or hydronephrosis on ultrasonography. Dimercaptosuccinic acid (DMSA) scans revealed cortical defects in 17 (21.3%) infants while voiding cystourethrography revealed vesicoureteral reflux in 6 (46.2%) infants. Conclusion: Co-existing bacterial meningitis was not observed in young infants with UTIs. LP could not be routinely performed considering the clinical condition of <90 days old UTI patients.
Kyeong-Tae Kim;Hyun-Jung Lee;Whee-Moon Kim;Won-Kyong Song
Korean Journal of Environment and Ecology
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v.36
no.6
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pp.566-574
/
2022
Heavy metals are one of the dangerous pollutants that threaten urban biodiversity due to their accumulation over a long period without being decomposed in vivo. Accordingly, there is a need for biological monitoring to compare accumulation concentrations in living organisms according to the degree of heavy metal exposure to evaluate heavy metal contamination in the air in urban areas. This study aims to examine the possibility of using nesting materials as heavy metal monitoring samples and determine the effects of heavy metals on Paridae. We installed 54 artificial nest boxes in the research areas that included campus green spaces (14), urban forests (11), and urban parks (29) on a university campus in Cheonan City, Chungcheongnam Province. The birds' use rate of artificial nest boxes was 11/14 (78.57%) in campus green spaces, 8/11 (72.72%) in urban forests, and 6/29 (20.68%) in urban parks. Moss materials were collected from collected nests, and the heavy metal accumulation characteristics of each type of urban green space and the effects of heavy metals on the success of fledging of Paridae were compared through heavy metal analysis. The analysis showed that the average concentrations of zinc and lead were 228.08±209.62 ㎍/dry g and 17.67 ± 6.72 ㎍/dry g, respectively. There was no significant difference in zinc concentration for each type of urban green space (Kruskal-Wallis test, p-value=0.28), but lead concentration showed a significant difference (Kruskal-Wallis test, p<0.05*). Of the 21 Paridae, nests analyzed for heavy metals, fledging of birds was observed in 11 nests (52.38%). Fledging of birds observed in each urban green space type was 7 campus green spaces (77.78%), 6 in urban forests (85.71%), and 1 in urban park (20%), mainly in urban forests and green spaces on campus. Heavy metal concentrations were compared to check the effect of heavy metal accumulation on the successful fledging of Paridae, but there was no statistically significant difference (Zn: W=44, p-value=0.74, Pb: t=0.64676, df =7.2422, p-value=0.54). This study is a basic study using the nesting materials of Paridae as heavy metal monitoring samples, and it is determined that it can be used as basic data for non-invasive biological monitoring.
Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.
In terms of understanding the water cycle and efficient water resource management, the importance of soil moisture has been highlighted. However, in Korea, the lack of qualified in-situ soil moisture data results in very limited utility. Even if satellite-based data are applied, the absence of ground reference data makes objective evaluation and correction difficult. The cosmic-ray neutron probe (CRNP) can play a key role in producing data for satellite data calibration. The installation of CRNP is non-invasive, minimizing damage to the soil and vegetation environment, and has the advantage of having a spatial representative for the intermediate scale. These characteristics are advantageous to establish an observation network in Korea which has lots of mountainous areas with dense vegetation. Therefore, this study was conducted to evaluate the applicability of the CRNP soil moisture observatory in Korea as part of the establishment of a Korean cOsmic-ray Soil Moisture Observing System (KOSMOS). The CRNP observation station was installed with the Gunup-ri observation station, considering the ease of securing power and installation sites and the efficient use of other hydro-meteorological factors. In order to evaluate the CRNP soil moisture data, 12 additional in-situ soil moisture sensors were installed, and spatial representativeness was evaluated through a temporal stability analysis. The neutrons generated by CRNP were found to be about 1,087 counts per hour on average, which was lower than that of the Solmacheon observation station, indicating that the Hongcheon observation station has a more humid environment. Soil moisture was estimated through neutron correction and early-stage calibration of the observed neutron data. The CRNP soil moisture data showed a high correlation with r=0.82 and high accuracy with root mean square error=0.02 m3/m3 in validation with in-situ data, even in a short calibration period. It is expected that higher quality soil moisture data production with greater accuracy will be possible after recalibration with the accumulation of annual data reflecting seasonal patterns. These results, together with previous studies that verified the excellence of CRNP soil moisture data, suggest that high-quality soil moisture data can be produced when constructing KOSMOS.
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