• 제목/요약/키워드: Cortical index

검색결과 67건 처리시간 0.03초

선천성 방광요관역류 환아의 형제자매에서 방광요관역류와 신반흔의 유병률 (Incidence of Vesicoureteral Reflux and Renal Scar in Asymptomatic Siblings of Patients with Primary Vesicoureteral Reflux)

  • 유재은;석효정;송준영;박문성;김영수;배기수
    • Childhood Kidney Diseases
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    • 제7권2호
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    • pp.181-188
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    • 2003
  • 목적 : 방광요관역류는 역류성 신병증의 주된 원인으로 작용하여 소아기 고혈압과 신부전을 유발하는 주요 원인으로 기여한다. 방광요관역류는 가족적 발생경향이 있어, 고위험군인 환자의 형제자매를 대상으로한 역류 선별검사의 시행이 국외에서는 보편적이나 국내에서는 아직 연구보고가 적어 그 시행이 제한되고 있다. 본 연구에서는 방광요관역류 환아의 형제자매에서 역류와 신손상의 유병률을 조사하여 형제자매 선별검사의 의의를 살피고자 하였다. 또한 지표환자의 임상경과를 분석하여 형제자매의 유병률에 영향을 미치는 요인이 있는지를 살펴보았다. 방법 : 1994년 6월부터 2001년 5월까지 아주대학교 병원 소아과에서 일차성 방광요관역류로 진단받은 지표환아 37명과 그들의 형제자매 50명을 대상으로 임상양상을 조사하고 배뇨 중 방광 요도조영검사, $^{99m}Tc-DMSA$ 신주사 검사, 요화학 및 요배양 검사를 시행하였다. 결과 : 지표환자 37명은 평균 $3.35{\pm}1.13$등급의 역류상태를 나타냈고 이들 중 59.5%에서는 신주사 검사상 신피질 결손을 보였다. 지표환자의 형제자매 50명 중 8명(16%)에서 방광요관역류가 있었고, 이들 중 7명(87.5%)에서는 신피질 결손을 보였으며 2명은 비가역적인 신반흔이 있었다. 역류가 없이 신피질 결손이 있는 경우도 1례 있었다. 형제자매의 방광요관역류 존재를 예측할만한 지표환자의 임상적 요인은 없었다. 결론 : 선별검사로 발견된 방광요관역류 환아의 형제자매에서 방광요관역류와 신피질손상의 유병률은 각각 16.0%, 16.0%로 형제자매가 '신손상의 고위험군'에 속함을 알 수 있었다. 따라서 방광요관역류 환아를 진료할 때, 그들의 형제자매에 대한 선별검사를 추천 시행하는 것이 가능한 신손상을 예방할 수 있는 효과적인 방법이라 판단된다. 또한 형제자매 선별검사를 할 때, 과거 시점의 역류로 인하여 형성된 신손상의 존재도 밝혀내기 위하여, 배뇨 중 방광요도조영 검사뿐만이 아니라 신주사 동위원소 검사도 포함시켜야 함을 주장하는 바이다.

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Tc-99m DMSA SPECT for Follow-Up of Non-Operative Treatments in Renal Injuries: A Prospective Single-Center Study

  • Sang-Geon Cho;Ki Seong Park;Jahae Kim;Jang Bae Moon;Ho-Chun Song;Taek Won Kang;Seong Hyeon Yu
    • Korean Journal of Radiology
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    • 제24권10호
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    • pp.1017-1027
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    • 2023
  • Objective: The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. Materials and Methods: This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had non-operatively managed renal injuries and underwent DMSA planar and SPECT imaging 3-6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. Results: SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%-36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m2). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m2 or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. Conclusion: Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.

진행성 핵상 마비에서의 국소 뇌혈류 (Regional Cerebral Perfusion in Progressive Supranuclear Palsy)

  • 이원용;이경한;이기형;윤병우;이명철;이상복;전범석
    • 대한핵의학회지
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    • 제30권1호
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    • pp.47-55
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    • 1996
  • Progressive supranuclear palsy (PSP) is a parkinson-plus syndrome characterized clinically by supranuclear ephthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormality and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using $^{99m}Tc$-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex.

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Ultrastructural Study of Germ Cells and Reproductive Cycle in Female Neptunea arthritica cumingii

  • Han, Ji-Soo;Chung, Ee-Yung;Park, Gab-Man
    • 한국발생생물학회:학술대회논문집
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    • 한국발생생물학회 2005년도 제20차 학술대회 논문집
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    • pp.52-52
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    • 2005
  • Oogenesis, the gonadosomatic index (GSI), reproductive cycle and first sexual maturation of the female Neptunea (Barbitonia) arthritica cumingii have been investigated by light and electron microscope observations. In the early vitellogenic oocyte, the Golgi complex and mitochondria were involved in the formation of glycogen, lipid droplets and yolk granules. In late vitellogenic oocytes, the rough endoplasmic reticulum and multivesicular bodies were involved in the formation of proteid yolk granules in the cytoplasm. In particular, compared with the results of other gastropods, it is a different result that appearances of cortical granules at the cortical layer and microvilli on the vitelline envelope, which is associated with heterosynthetic vitellogenesis, were not observed in vitellogenic oocytes during oogenesis. A mature yolk granule was composed of three components: main body (central core), superficial layer, and the limiting menbrane, Monthly changes in the gonadosomatic index in females were studied in 2002 and 2003 were closely associated with ovarian developmental phases. Spawning occurred between May and August in 2002 and 2003 and the main spawning occurred between June and July when the seawater temperature rose to approximately 18${\sim}$23${\circ}$C. The female reproductive cycle can be classified into five successive stages: early activestage (Septmber to October), late active stage ( November to February), ripe stage (February to June), partially spawned stage (May to Aygust), and recovery stage (June to August).

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Oogenesis and Reproductive Cycle in Neptunea (Barbitonia) arthritica cumingii on the West Coast of Korea

  • Park, Gab-Man;Kim, Yeon-Ho;Kim, Eun-Jong;Choi, Ki-Ho
    • 한국패류학회지
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    • 제22권1호
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    • pp.1-11
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    • 2006
  • The gonadosomatic index (GSI), oogenesis and reproductive cycle in female Neptunea (Barbitonia) afhritica cumingii were investigated by light and electron microscope observations. In the early vitellogenic oocyte, the Golgi complex and mitochondria were involved in the formation of glycogen, lipid droplets and yolk granules. Late in the vitellogenic oocytes, the rough endoplasmic reticulum and multivesicular bodies were involved in the formation of proteid yolk granules in cytoplasm. In particular, compared with the results of other gastropods, it showed a different result that appearances of cortical granules at the cortical layer and microvilli on the vitelline envelope, which is associated with heterosynthetic vitellogenesis, were not observed in vitellogenic oocytes during oogenesis. A mature yolk granule was composed of three components: main body (central core), superficial layer, and the limiting membrane. Monthly changes in the gonadosomatic index in females studied in 2004 and 2005 were closely associated with ovarian developmental phases. Spawning occurred between May and August in 2004 and 2005 and the main spawning occurred between June and July when the seawater temperature rose to approximately $18-23^{\circ}C$. The female reproductive cycle can be classified into five successive stages: early active stage (September to October), late active stage (November to February), ripe stage (February to June), partially spawned stage (May to August), and recovery stage (June to August).

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골다공증의 파노라마방사선사진상 진단학적 매개변수에 관한 연구 (THE STUDY ABOUT THE DIAGNOSTIC PARAMETERS OF OPSTEOPOROSIS ON PANORAMIC RADIOGRAPH)

  • 이용규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제20권4호
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    • pp.279-283
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    • 1998
  • The osteoporosis is a disease that represents a reduction in the volume of bony tissue relative to whole bone volume. And mandible also may be affected. Such porotic mandible may influence the result of the surgery like dental implant surgery relating mandible. So, the author examed the panoramic view of 89 persons for finding the possibility of useful diagnostic parameters of osteoporosis. To know the correlationship between the condition of vertebra and mandible, bone marrow density of lumbar spine from 2nd to 4th, and the number of residual tooth, panoramic mandibular index (PMI), angular cortical bone thickness (ACT) and ramus cortical bone thickness (RCT) were compared. The result is that PMI and ACT have similar relative weak linear correlationship, RCT have very weak linear correlationship, the number of residual tooth have not linear correlationship.

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기능적 자기공명영상을 이용한 구심성 및 원심성 근 수축에 따른 뇌 활성도 분석 (Comparison of Cortical Activation between Concentric and Eccentric Exercise: A Pilot fMRI Study)

  • 김중선;김중휘;박민규;박지원
    • The Journal of Korean Physical Therapy
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    • 제22권2호
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    • pp.25-30
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    • 2010
  • Purpose: Behavior and movement are accomplished by voluntary contractions of skeletal muscles. There are three types of muscle contractions: concentric, isometric and eccentric. The aim of our study was to determine whether there is a difference in the cortical activation pattern between concentric contraction and eccentric contraction of the wrist extensor muscle. Methods: Four healthy right-handed volunteers without any previous history of physical or neurological illness were recruited. fMRI scanning was done during 4 repeated blocks of concentric and eccentric exercise of the wrist joint. Subjects exercised for 12 seconds and then rested for 12 seconds before beginning the second set of exercises. To determine the excitability of cortical neurons during exercise, voxel count and intensity index were analyzed. Results: For right hand movements, when concentric contractions of the right wrist were done, only the left primary motor area was activated. In contrast, during eccentric contraction, both the primary motor area and secondary motor area were activated. For left hand movements, both concentric and eccentric contractions induced only the supplementary motor cortex and the contralateral primary motor cortex. Conclusion: During eccentric contractions, both the primary motor area and secondary motor area are activated in ipsilateral and contralateral brain areas. Thus, eccentric contractions require more complex and difficult movements than concentric contractions do.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • 제23권1호
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder

  • Lee, Jeonghwan;Son, Jung-Woo;Kim, Siekyeong;Kim, Ji-eun;Chung, Seungwon;Ghim, Hei-Rhee;Lee, Sang-Ick;Shin, Chul-Jin;Ju, Gawon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제32권4호
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    • pp.129-136
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    • 2021
  • Objectives: To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer. Results: Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group. Conclusion: The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.

골밀도를 이용한 대퇴근위부 형태 변화의 상관관계 평가 (Assessment of the Correlation for Geometry Transition using Bone Mineral Density in Proximal Femur)

  • 김다혜;고성진;강세식;김정훈;김동현;예수영;김창수
    • 한국콘텐츠학회논문지
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    • 제12권12호
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    • pp.335-344
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    • 2012
  • 우리나라는 급격한 경제성장과 의료기술의 발달로 고령화 사회가 되면서 골다공증 발병이 증가하고 있다. 또한 서구화된 식생활로 암질환이 증가하였고 항암치료과 방사선 치료 등으로 인해 골다공증이 발생하게 된다. 골다공증은 골밀도의 감소로 인한 것으로 대퇴근위부의 형태학적 구조 변화와도 밀접한 관계를 가지고 있으며, 대퇴 근위부의 형태학적 구조 변화는 고관절 골절의 위험을 나타내는 요인이다. 본 연구는 T-score변화에 따라 정상, 골감소증, 골다공증으로 분류하여 각 군별로 대퇴 근위부의 형태학적 변화를 관찰하고 상관관계를 분석하였다. 조사대상은 부산지역의 D종합병원의 남녀 350명을 대상으로 연령, 성별, T-score변화로 질환을 구분하여 분석하였다. 결과는 연령, 성별에 따라 골다공증의 발병빈도는 유의한 차이를 보였고, T-score변화에 따른 질환 분류와 대퇴근위부 형태학적 특성의 7가지 파라미터로서 Cortical ratio calcar, Cortical ratio shaft, Hip/shaft Angle, Strength index, Section modulus, CSMI, CSA는 유의한 차이를 보였으며 골다공증과 높은 상관관계가 있었다. 그러므로 연구 결과는 T-score변화에 따른 대퇴근위부의 형태학적 변화를 상관관계 분석함으로써 골다공증을 진단하는데 대퇴 근위부의 형태학적 변화가 지표로서 활용가능하리라 사료되며, 향후에 대퇴근위부의 형태학적 파라미터가 골다공증 진단의 정확성을 높이고 예측인자로서 임상활용이 가능하리라 판단된다.