• Title/Summary/Keyword: Diagnosis and treatment

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Pinhole Bone Scintigraphic Manifestation of Fibrous Dysplasia (섬유성 이형성증의 바늘구멍 골스캔 소견)

  • Baek, Jee-Hee;Lee, Sung-Yong;Kim, Sung-Hoon;Chung, Yong-An;Kim, Bum-Soo;Song, Ha-Hun;Chung, Soo-Kyo;Kang, Si-Won;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.4
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    • pp.452-458
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    • 1997
  • To evaluate the pinhole scintigraphic findings and its significance, authors retrospectively compared the pinhole bone scintigrams and corresponding radiograms of 16 lesions in 14 patients with fibrous dysplasia. They were diagnosed pathologically in 10 lesions and radiologically in 6 lesions. The mean age of patients was 41.1 years. The mean interval between two studies was 1.1 days. Locations were ribs 7, pelvic bone 4, clavicle 1, long bones 4(femur 2, tibia 1, humerus 1). The radiographic findings were as follows : the central portions were radiolucent(n=9), ground-glass opacities(n=5) or sclerotic(n=2) and the peripheral appearance were sclerotic rim(n=5), septation(n=7), cortical perforation (n=10) and invisible cortical thinning(n=9). Pinhole scintigraphic findings were as follows; Central portions showed normal 1+ uptake in 6 cases(radiolucent 5, ground-glass opacity 1), slightly increased 2+ upta- ke in 7 cases(radiolucent 4, ground-glass opacity 3), and marked 3+ uptake in 3 cases(ground-glass opacity 1, sclerotic 2). The 15 of 16 lesions showed more intense uptake in the peripheral portion: slightly increased 2+ uptake corresponding to the sclerotic rim(5/5) and unvisible cortical thinning(1/9), and irregular foci of marked 3 + uptake corresponding to septation(7/7), cortical perforation(10/10) and invisible cortical thinning (8/9). One of 16 lesions showed homogeneous 2+ uptake. In conclusion, pinhole scintigram provides information on regional activity of the fibrous dysplasia, which would be helpful in diagnosis, prediction of prognosis and determination of treatment plan.

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Pediatric Peritoneal Dialysis in Korea : Practical Solution to the Problems of Peritoneal Dialysis for Children (한국 소아복막투석의 현황 - 다기관 공동연구 결과보고 -)

  • Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.95-103
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    • 1998
  • Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

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A Study of Acute Gastroenteritis in Neonates Transfered from Postpartum Care Centers (산후조리원에서 전원되어 입원한 신생아 급성 장염 환자들에 대한 임상적 고찰)

  • Kim, Jong Suh;Lee, Hae Sung;Choi, Jung Hwan;Shin, Yoon Jung;Koo, Mi Lim;Kim, Sung Sin;Kim, Heui Suck;Kim, Eun Ah;Yoon, Sin Won;Kwon, Jae Hoon;Yoon, Sin Won;Kim, Jong Hoon;Sin, Sun Heui;Koo, Sung Kyung;Yang, Sung;Yoo, Sin;Ahn, Young Min;Kim, Eun Mi;Lee, Dong Hwan
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.186-192
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    • 2003
  • Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.

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Responses and Toxicities of Risk-adapted Chemotherapy in Pediatric Intracranial Germ Cell Tumors (소아 두개 내 생식 세포종에서 위험군에 따른 화학요법의 치료 반응 및 독성)

  • You, Dong Kil;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Lim, Do Hoon;Shin, Hyung Jin;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.186-190
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    • 2005
  • Purpose : The purpose of this study was to evaluate the responses and toxicities of risk-adapted chemotherapy in pediatric intracranial germ cell tumors(IC-GCT). Methods : Fourteen patients who were diagnosed as IC-GCT from October 2002 to December 2003 received chemotherapy as an initial treatment modality. The low risk(LR) group was defined as follows : Pure germinoma and normal AFP level. Beta-hCG level 50 mIU/mL or less. The others belonged to the high risk(HR) group. Chemotherapy was composed of cisplatin, cyclophosphamide, etoposide and vincristine. Double doses of cisplatin and cyclophosphamide was used in HR patients. Results : Pathologic confirmation was done in all but one. Median age at diagnosis was 11.6 yr (1.2-18.7 yr), and nine patients belonged to the HR group. Tumor markers were normalized after chemotherapy in all patients whose tumor markers had been elevated. Four LR patients(80 percent) and seven HR patients(77.8 percent) showed complete response(CR) at the end of chemotherapy. An additional two of the three patients with partial response(PR) achieved CR after radiation therapy (RT), and the remaining one relapsed before RT. Four LR and all HR patients experienced infectious episodes that required hospitalization. Four of the nine HR patients(44.4 percent) suffered from tinnitus, three of whom developed sensorineural hearing loss. All but one are surviving, event-free, with a median follow-up of 13.9 mo(8.1-22.3 mo). Conclusion : Risk-adapted cisplatin-based chemotherapy was effective even in HR patients, but regimen modification seems to be necessary to avoid an unacceptably high toxicity rate.

Platelet count and mean platelet volume in low birth weight infants (≤2,000 g) with sepsis (패혈증에 이환된 저출생체중아(≤2,000 g)에서 혈소판수치와 평균혈소판용적의 변화)

  • Lee, Wan-soo;Cho, Jin-young;Yoo, Seung-taek;Lee, Chang-woo;Choi, Doo-young;Kim, Jong-duck;Oh, Yeon-kyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.643-648
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    • 2007
  • Purpose : Sepsis is a common complication in Neonatal Intensive Care Units (NICU), seen especially in low birth weight (LBW) infants. A recent study showed that fungal or gram-negative sepsis is associated with a greater degree of thrombocytopenia than is seen with gram-positive sepsis. So, this study was undertaken to examine the platelet counts and platelet indices in LBW infants during episodes of sepsis. Methods : We analyzed 36 cases with culture-proven sepsis on chart review in LBW infants admitted to the NICU at Wonkwang University Hospital from January 2001 to June 2006. Results : Patients were grouped by organism type: gram-positive bacteria ($1,521{\pm}309g$, $31.3{\pm}2.9wk$, 15/36), gram-negative bacteria ($1,467{\pm}290g,\;30.6{\pm}3.6wk$, 17/36), and fungi ($1,287{\pm}205g,\;30.0{\pm}3.9wk$, 4/36). The most common organism was Staphylococcus epidermis and the incidence of thrombocytopenia was 88.9%. When compared with infants with gram-positive sepsis, those with gram-negative sepsis had significantly higher incidences of thrombocytopenia, lower initial platelet count, lower platelet nadir, and greater mean percentage decrease in platelet count from before the onset of sepsis. Those with fungal infections were similar to gram-negative sepsis, but they were not significant because of the small number of patients. And mean platelet volume (MPV) in sepsis was increased more significantly in time of platelet nadir than before the onset of sepsis. Conclusion : We conclude that decrease in platelet count was significantly greater in gram-negative sepsis than gram-positive sepsis, and also greater than fungal sepsis-which was insignificant because of the small number of patients-in LBW infants. And elevation in MPV will be helpful in the diagnosis and treatment of sepsis in LBW infants.

Comparison of Estradiol Results according to Manufacturer (제조회사에 따른 Estradiol 결과값의 비교)

  • Kim, Dae-Woon;Shin, Hee-Jung;You, Tae-Min;Noh, Gyeong-Woon;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.101-105
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    • 2011
  • Purpose: Estradiol in the menstrual cycle and ovulation induction as an important test of currently national nuclear medicine laboratory in the normal patients and patients with infertility tests are being performed. For the diagnosis of menopause is an important test with follicle stimulating hormone (FSH) and Luteinizing hormone (LH). Currently participating in external quality control of the nation's hospitals that is 54 percent of 37 hospitals, 20 hospitals have been using A's reagent. The kit's test results are highly different from other kit comes with the test results of specimens have been found. And for the phenomenon is to study the problem. Materials and Methods: Estraiol test were referred to our hospital which results of samples as more than 100pg/ml 75 specimens measured by radioimmunoassay(RIA) test with company A company B company C company D Kit, Chemiluminescent assay (CMIA) to examine and compare to the results from april to August in 2010. Results: Kit for each manufacturing company as measured by the results obtained using the average value of the correlation coefficient (R2) and A company 0.8906 B 0.9527 C 0.9547 and D company correlation coefficient of 0.873 showed a good correlation that measuring the results of A company high concentrations when Company B Company C Company D with CMIA test concentrations measured low results that the two cases were discovered specimens. Conclusion: Most of the test results of 75 samples came up with a similar trend, but two cases were reported in the patients very differently. A company result reported higher than 700 pg/ml, while the rest of other test results report was approximately 10 pg/ml. The common point of two samples more than 50 years patients are estimated to be diagnosed with cancer in postmenopausal patients receiving treatment and levels of FSH were found to be greater than 50 mIU/ml. Did not identify the exact cause. I suggest if you are using A company kit that need to again check when Estradiol result and follicle stimulating hormone results is higher.

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THE CALCIFICATION TIMING OF THE PERMANENT TEETH BY NOLLA STAGE (Nolla stage에 의한 영구치의 석회화 시기에 대한 연구)

  • Ahn, Sang-Hyun;Yang, Kyu-Ho;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.540-548
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    • 2000
  • The aim of this study was to evaluate the timing of sequence of tooth calcification in current Korean growing children. The Calcification stage of permanent teeth of Korean children was investigated by classifying them into 10 stages by the criteria of Nolla, using the panoramic radiographs of 258 healthy Korean children, 149 males and 109 females, between the ages of 4 years and 13 years, with normal growing tendency and no orthodontic treatment experience. The obtained results were as follows: 1. Timing of calcification of permanent teeth by Nolla stage was established with mean values. Among the mean value, results of Nolla stage 7 were as follows: Calcification timing of male in the maxilla was 6 year 9 month on central incisor, 7 year 4 month on lateral incisor,7 year 9 month on canine, 8 year 8 month on the first premolar, 9 year 4 month on the second premolar, 6 years 3 month on the first molar and 10 year 8 month on the second molar, calcification timing of male in the mandible was 5 year 11 month on central incisor, 6 year 4 month on lateral incisor, 7 year 5 month on canine, 8 year 1 month on the first premolar, 8 year 6 month on the second premolar 5 years 6 month on the first molar and 10 year 3 month on the second molar. Calcification timing of female in the maxilla was 6 year 2 month on central incisor, 6 year 7 month on lateral incisor, 6 year 11 month on canine, 8 year 1 month on the first premolar, 8 year 5 month on the second premolar, 5 years 10 month on the first molar and 9 year 10 month on the second molar, calcification timing of male in the mandible was 5 year 6 month on central incisor, 5 year 9 month on lateral incisor, 6 year 8 month on canine, 7 year 6 month on the first premolar, 8 year 4 month on the second premolar, 5 years 3 month on the first molar and 9 year 7 month on the second molar. 2. The sequence of calcification at Nolla stage 7 was in consequence to the first molar, central incisor, lateral incisor, canine, the first premolar, the second premolar and second molar. 3. While the sequence of root completion of maxilla was in consequence to the first molar, central incisor, lateral incisor, that of mandible was in order of central incisor, first molar and lateral incisor. 4 the calcification timing of permanent teeth was earlier in female than in male (p<0.05). According to above data, the result of this study is applicable for diagnosis and routine clinical practice for children.

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Primary Adenoid Cystic Carcinoma Arising in the Bronchus (기관지에 발생한 선양 낭포성 암종)

  • Kim, Young-Keun;Chung, Kyung-Young;Shin, Dong-Hwan;Kim, Hae-Jin;Kim, Chang-Nyun;Kang, Shin-Myung;Ko, Won-Ki;Kim, Young-Sam;Lee, Jun-Gu;Park, Jae-Min;Kim, Se-Kyu;Chang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.591-598
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    • 2001
  • Background : Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinical characteristics. Method : We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. Result : The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totally. There were three inoperable cases including two cases with distant metastasis to bone or cervical lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One patient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. Conclusion : It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible.

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Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients (뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구)

  • Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.44-48
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    • 2019
  • Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

Effectiveness of stages-matched educational program for cervical cancer screening among adult women in a community (일개 지역사회 여성 주민의 자궁경부암 조기검진 수검에 관한 행동변화단계별 교육 프로그램의 효과)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.23-37
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    • 2007
  • Background: Even though cervical cancer poses a significant global cancer burden, successful implementations for early detection offer an opportunity to prevent deaths and reduce the cancer burden. In Korea, cervical cancer is the most prevalent type of cancer among adult women, but it is one of the few cancers in which a consensus-approved screening test exists for early diagnosis, Pap test, that can be combined with highly efficacious treatment regimens for early-stage disease. Purpose: This study was carried out to identify the cognitive-behavioral factors associated with cervical cancer screening behavior among adult women, aged 40 to 59, and to develop tailored messages and to evaluate the effectiveness of stage-matched educational program. Method: A total of 283 women who aged 40 years or older was recruited in Seoul, from September, 1st to November, 14th, 2003. The intervention group (N=162) and the control group (N=121) were selected from five sub-districts in Seocho-gu, Seoul. Building on the TTM, a quasi-experimental study was conducted to test the effectiveness of stages-matched intervention addressed at the five stages of cervical cancer screening behavior. Women in the intervention group were randomly assigned to one of two conditions, internet or postal services. Results: In our results, 88.9% of participants had received a Pap test at least once in their life-time, and 65.4% had got it in the past two years. With regard to cognitive-behavioral factors, the stages-matched educational program increased attitude and process of change for cervical cancer screening. The percentage changed was the largest in maintenance stage. With regard to delivery methods for tailored messages, the print materials were more effective at increasing screening adherence than the e-mail. Whereas the postal service group showed remarkable the change of behavior stage, the internet service group did not. Also it was not shown any difference of the satisfaction with stages-matched educational program between internet and postal service groups. Conclusion: This study suggested that cervical cancer screening behavior could be changed by tailored messages which had developed with cognitive-behavioral factors. The stages-matched educational program was effective to promote the screening adherence for cervical cancer.