• Title/Summary/Keyword: 3세 미만

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Usefulness of Ultrasonographic Examination by a Pediatrician in Children with Abdominal Pain (소아 복통에서 소아과 의사에 의한 초음파 검사의 유용성)

  • Park, Hyun-Seok;We, Ju-Hee;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.141-147
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    • 2011
  • Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

The Study of CYFRA 21-1 and Epidermal Growth Factor Receptor Levels in Cancer Tissue of Bronchogenic Carcinoma Patients (폐암환자의 암조직내 CYFRA 21-1과 Epidermal Growth Factor Receptor의 측정치에 대한 연구)

  • 김대연;김송명
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.854-861
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    • 1997
  • CYPRA 21-1 is known to be a cytokeratin 19 fragment, and it can be detected by using two specific monoclonal antibodies (KS 19-1 and BM 19-21) and can be clinically applied as a useful circulating tumor marker The epidermal growth factor receptor (EGF-R) expression was evaluated and characterized by its tyrosine protein kinase activity and by its ligand-stimulated autophosphorylation, a property shared with other peptide growth factor receptors. Autocrine or para'urine action was initiated by a growth factor, or by a transforming growth factor o, which had an extensive homology with EGP and which also stimulated tyrosine kinase activity on the EGF-R. The CYFRA 21-1 and the EGF-R levels in 30 patients with primary lung tumors were investigated. There were 24 patients with squamous cell carcinomas and 6 patients with adenocarcinomas. Specimen 5 mm3 in size were sampled at three different locations ; the main lesion, the boundary between the lesion and the unaffected tissue, and the unaffected tissue of the patients. The results were as follows 1. The CYPRA 21-1 concentration in the cancer boundary, the most malignant region,(348.6 : 89.9 ng/ml) was the lowest value. The CYFRA 21-1 concentration in unaffected tissue,(718.4$\pm$77.8 ng/ml) was higher than that in the main lesion. which had intact cellularity. 2. The EGF-R concentration in the main lesion was higher than that in the unaffected tissue, and the EGF-R concentration in a squamous cell cacinoma was higher than that in an adenocarcinoma. also, the EGF-R concentration in the cancer b undary was highest at stage 1, ll. The EGF-R concentration was higher in the main cancer lesion that in the unaffected tissue at stage 111, IV. 3. The CYFRA 21-1 was a cytoplasmic skeleton and the EGF-R was a cell-wall component; there was no correlation. In conclusion, CYFRA 21-1 was abundant in the cytoplasm but had a higher concentration in the unaffected tissue than in the main cancer lesion. The CYFRA 21-1 concentration of the tissue did not reflect the amount of cancer activity, the EGP-R was located in the cell membrane, the level of tissue that reflects cancer activity, so the main cancer lesion had a higher concentration than the unaffected tissue. CYFRA 21-1 is not a useful tumor maker at the tissue level. Because the EGF-R concentration re(looted the cancer activity, its a useful tumor marker for lung cancer.

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Serum high sensitivity C-reactive protein levels in obese middle school boys (남자 중학생에서 비만과 high sensitiviy C-reactive protein의 관계)

  • Jeong, Jae-Ho;Lim, Jae-Woo;Cheon, Eun-Jeong;Ko, Kyong-Og;Lee, Young-Hyuk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.617-622
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    • 2006
  • Purpose : High-Sensitivity C-reactive protein(hs-CRP) has been recognized as a very useful and sensitive predictor of the future risk of myocardial infarction. But the clinical significance of hs-CRP in children remains uncertain. To confirm the existence of obesity-induced vascular inflammation and the association between metabolic syndromes and elevation of CRP in children, we investigated the relationship among CRP, obesity, blood pressure(BP), and serum lipids in schoolboys. Methods : Twenty-eight obese(BMI $29.61{\pm}3.29kg/m^2$) and 93 non-obese(BMI $18.99{\pm}2.21kg/m^2$) boys aged 14 years were examined. Serum CRP levels was measured by the high sensitive latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dL were adopted to avoid the influence of acute infection. Results : Obese children had significantly higher hs-CRP levels than their non-obese group($0.104{\pm}0.075$ vs. $0.054{\pm}0.005mg/dL$). In the obese group, BMI, systolic blood pressure, diastolic blood pressure, apolipoprotein B, atherogenic index, and triglyceride were significantly higher than in nonobese. The BMI, diastolic blood pressure, apolipoprotein E, atherognic index, and triglyceride showed positive correlation with log CRP by simple regression. Multiple regression analysis indicated that BMI and apolipoprotein E were strongly related to CRP. Conclusion : This study revealed that obese children tended to have higher levels of serum hsCRP, BP elevation and dyslipidemia than the control group and that BMI and apolipoprotein E were strongly related to CRP. These results indicate that obesity related metabolic syndrome can be developed in children.

Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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Study on the Environmental Factors and Symptoms of VDT Syndrome (VDT 증후군의 환경적 요인과 증상에 대한 연구)

  • Jeong, Seunghui;Lee, Seon Young;Eu, Sun Mi;Kim, Douk-Hoon;Lee, Eun-Hee
    • Journal of Korean Ophthalmic Optics Society
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    • v.14 no.4
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    • pp.65-69
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    • 2009
  • Purpose: Recently incidence of VDT syndrome has gradually increased as extensive use of computers. VDT syndrome reported by VDT workers include musculoskeletal disorder, neuropsychiatric disoders and eye symptoms such as eye strain, tired eyes, irritation and blurred vision. The environmental factors of VDT syndrome include electromagnetic waves, size, brightness and lighting of computer screen, height of a monitor and a worktable, working hours, kind of task, distance between screen and workers, indoor humidity and temperature, indoor air contamination and ventilation. In this study, we investigated the environmental factors related to body symptoms and health effects included in VDT syndrome. Methods: Study subjects were total 120 persons (54 male, 66 female) with age from 19 to 28. We surveyed the body symptoms and physical discomfort when doing an activity in a short distance such as reading book or paper, computer work. The questionnaire included main body symptoms, self-consciousness symptoms of eye, satisfaction of working environment, pain of the wrist when using keyboard and mouse. Results: Most of people (70%) felt physical pain from long time work of computer, paper, electrical apparatus. They mainly complained pain of neck and low back (57.1%), eye (45.2%) and head (31%). With the environmental factors, 78.3% of the subjects complaint pain of eye from inappropriate illumination. Most of the symptoms included 'eye fatigue'(38.3%), 'dryness of eye'(31.9%) and 'blurred vision'(23.7%). Subjects in this study complained discomfort of their chairs and most of them experienced pain in the wrist when using keyboard or mouse. Conclusions: When people use electrical apparatus or work with paper, people would get their eye fatigue and feeling of physical fatigue because of not harmonizing various environmental factors such as light, space, posture, worktable with theirselves. Therefore, workers should develop preventive method such as self-control of adequate break time to avoid fatigue while VDT work. Work environment should be changed to ergonomic design for optimal visual environment to prevent musculoskeletal disorder through constant research.

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Comparison of Three Kinds of Methods on Estimation of Forest Carbon Stocks Distribution Using National Forest Inventory DB and Forest Type Map (국가산림자원조사 DB와 임상도를 이용한 산림탄소저장량 공간분포 추정방법 비교)

  • Kim, Kyoung-Min;Roh, Young-Hee;Kim, Eun-Sook
    • Journal of the Korean Association of Geographic Information Studies
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    • v.17 no.4
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    • pp.69-85
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    • 2014
  • Carbon stocks of NFI plots can be accurately estimated using field survey information. However, an accurate estimation of carbon stocks in other unsurveyed sites is very difficult. In order to fill this gap, various spatial information can be used as an ancillary data. In South Korea, there is the 1:5,000 forest type map that was produced by digital air-photo interpretation and field survey. Because this map contains very detailed forest information, it can be used as the high-quality spatial data for estimating carbon stocks. In this study, we compared three upscaling methods based on the 1:5,000 forest type map and 5th national forest inventory data. Map algebra(method 1), RK(Regression Kriging)(method 2), and GWR(Geographically Weighted Regression)(method 3) were applied to estimate forest carbon stock in Chungcheong-nam Do and Daejeon metropolitan city. The range of carbon stocks from method 2(1.39~138.80 tonC/ha) and method 3(1.28~149.98 tonC/ha) were more similar to that of previous method(1.56~156.40 tonC/ha) than that of method 1(0.00~93.37 tonC/ha). This result shows that RK and GWR considering spatial autocorrelation can show spatial heterogeneity of carbon stocks. We carried out paired t-test for carbon stock data using 186 sample points to assess estimation accuracy. As a result, the average carbon stocks of method 2 and field survey method were not significantly different at p=0.05 using paired t-test. And the result of method 2 showed the lowest RMSE. Therefore regression kriging method is useful to consider spatial variations of carbon stocks distribution in rugged terrain and complex forest stand.

A Study on Clinical Progress of the Metastatic Adenocarcinoma of Pleura (전이성 흉막선암의 임상 경과에 관한 연구)

  • Yang, Seong-Wook;Lee, Tae-Kwan;Lee, Tae-Heon;Cho, Deok-Su;Baek, Hyeon-Seon;Kim, Ji-Young;Lee, Hye-Kyung;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.156-164
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    • 1995
  • Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.

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Cause Analysis in Decrease of Body Stability According to The Induced Astigmatic Blur (유발된 난시성 흐림에 의한 신체 안정성 감소의 원인분석)

  • Kim, Sang-Yeob;Yu, Dong-Sik;Moon, Byeong-Yeon;Cho, Hyun Gug
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.259-264
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    • 2016
  • Purpose: To establish the cause of decrease in body stability and to analyze the effects on sensory organs maintaining static balance according to the induced astigmatic blur. Methods: Twenty subjects (10 males, 10 females; mean age, $23.40{\pm}2.70years$) were participated in this study. To induce myopic simple astigmatism, the axis directions of cylindrical lenses were placed $180^{\circ}$ on both eyes (with-the-rule), $90^{\circ}$ on both eyes (against-the-rule), and $45^{\circ}$ on both eyes (oblique). Cylindrical lenses of +0.50, +1.00, +1.50, +2.00, +3.00, +4.00, and +5.00 D were used to increase astigmatic blur in each astigmatism types. General stability (ST) and sway power (SP) in frequencies by each sensory organs were analyzed using the TETRAX biofeedback system. Results: ST in the all astigmatism types were raised with increase of astigmatic blur compared to full corrected condition, but a significant difference only showed in the induced oblique astigmatism. According to the results of correlation analysis between ST and SP in the each frequencies with increase of astigmatic blur, the causes of increased ST in the induced oblique astigmatism showed to have a high correlation in order of somatosensory system (high-medium frequency), central nervous system (high frequency), peripheral vestibular system (low-medium frequency), and visual system (low frequency). Conclusions: The visual information by uncorrected oblique astigmatism may disturb the normal functions of all sensory organs maintaining body balance, consequently, the body stability can be reduced. Therefore, optimal correction of astigmatism can play an important role for reducing the instability of body balance.

Disease, Accident and Health Behavior of in Farmers and Fishermen (농림어업인의 상병실태 및 건강행태 분석)

  • Kim, Kyung-Ran;Choi, Jeong-Wha
    • Journal of agricultural medicine and community health
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    • v.30 no.3
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    • pp.279-292
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    • 2005
  • Objectives: The purpose of this study is to analyze agricultural accident and disease using statistical data and materials about National Survey for Health & Nutrition in 2001 and to provide fundamental materials for studies about farmers' health and safety, decision of priority about research and policy. Results: Diagnosed chronic disease prevalence is 72.4% in farmer/fisher group, 49.8% in non farmer/fisher group. The chronic disease prevalence of musculoskeletal disease, circulatory disease, and gastroenteric disease is 46.5%, 18.2%, and 17.9% in farmer/fisher group respectively. The prevalence of musculoskeletal disease in farmer/fisher is 2.4 times higher than non farmer/fisher. This result shows that it need to evaluation for risk factors of musculoskeletal disease preferentially. Lifetime accident/poisoning rate is 18.2% In farmer/fisher group and 13.3% in non farmer/fisher group. The types of accidents were fracture>sprain>contusion and the reasons of accidents were traffic accident>falling/sliding. Conclusions: "Bad or very bad" response of farmer/fisher is almost 2 times higher than non farmer/fisher group. The rate of smoking and no exercising in farmer/fisher group is higher than non farmer/fisher group.

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Patterns of Retear After Repair of the Rotator Cuff - MRI Analysis of 109Cases - (회전근 개 봉합술 후 발생한 재파열의 양상 - 109예의 자기 공명 영상 검사 분석 -)

  • Tae, Suk-Kee;Kim, Young-Sung;Lee, Ho-Min;Park, Pan-Kun
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.16-24
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    • 2012
  • Purpose: This study was designed to investigate the rate of incidence, location and the clinical value of the rotator cuff retear by analyzing MRI scans, which was taken after an arthroscopic rotator cuff repair. Materials and Methods: This study included a total of 109 patients, who underwent a shoulder MRI scan after an average of 10.6 months later from the arthroscopic rotator cuff repair. We only defined the 'retear' when the Sugaya type IV and V was observed in the sagittal section of the MRI. The location of the retear was divided into the medial and lateral areas by the site, which was 1 cm medial to the anchor insertion. We investigated the incidence rate and the location of the retear, in terms of the age, sex, initial tear size and the suture method. Also, we compared the functional score of the retear group and the non-retear group, after an average of 13.9 months follow-up. Results: There were 38 of the 109 patients that showed the rotator cuff retear. Of these patients, 25 were male patients, and 13 were female patients. Of the 38 patients with the rotator cuff retear, 21 patients were included in the <3 cm retear group, and 17 were included in the ${\geqq}3$ cm retear group. At the end of the follow up period, all 109 patients showed a statistical significant improvement in the shoulder functional score. Conclusion: According to the follow up of the MRI scan, which was taken after the rotator cuff repair, the retear rate reached 34.9 %, and there were no significant differences on the age and the suture method. More rotator cuff retear occurred in male patients, and the initial tear size was positively correlated with the incidence rate of the rotator cuff retear. Also, the retear was more frequently observed at the medial side. That is because when the suture was performed, excessive tension was loaded on the medial side of the suture site.