• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.935-942
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• 2021

Involuntary movement of internal organs by respiration is a factor that greatly affects the results of radiotherapy and diagnosis. In this study, a moving phantom was fabricated to simulate the movement of an organ or a tumor according to respiration, and ¹⁸F-FDG PET/CT scan images were acquired under various respiratory simulating conditions to analyze the movement range of the tumor movement by respiration, the level of artifacts according to the size of the tumor and the maximum standardized uptake value (SUVmax). Based on Windows CE 6.0 as the operating system, using electric actuator, electric actuator positioning driver, and programmable logic controller (PLC), the position and speed control module was operated normally at a moving distance of 0-5 cm and 10, 15, and 20 reciprocations. For sphere diameters of 10, 13, 17, 22, 28, and 37 mm at a delay time of 100 minutes, 80.4%, 99.5%, 107.9%, 113.1%, 128.0%, and 124.8%, respectively were measured. When the moving distance was the same, the difference according to the respiratory rate was insignificant. When the number of breaths is 20 and the moving distance is 1 cm, 2 cm, 3 cm, and 5 cm, as the moving distance increased at the sphere diameters of 10, 13, 17, 22, 28, and 37 mm, the ability to distinguish images from smaller spheres deteriorated. When the moving distance is 5 cm compared to the still image, the maximum values of the standard intake coefficient were 18.0%, 23.7%, 29.3%, 38.4%, 49.0%, and 67.4% for sphere diameters of 10, 13, 17, 22, 28, and 37 mm, respectively.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.2
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• pp.55-61
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• 2018

Orinithine transcarbamylase (OTC) deficiency is the most common inborn error of the urea cycle with resulting hyperammonemia, which is medical emergency in newborns.We recently had a case of a boy that presented with lethargy, seizure, hyperammonemia and hypocalcemia in neonatal period. He was diagnosed with OTC deficiency by two consequent ways which are initial biochemical phenotype including hyperammonemia and an increased orotic acid in his urine and genetic analysis of the OTC gene. The OTC gene showed a novel hemizygous mutation c.913C>T (p.Pro305Ser). He was treated by low protein intake, sodium benzoate, phenylbutyrate sodium, L-arginine, and continuous renal replacement therapy (CRRT). After discharge, he has a relatively good prognosis without notable developmental delay. For good prognosis, the duration of hyperammonemia should be shorten. And it can be reached by an early diagnosis. For early detection of OTC deficiency, targeted exome sequencing will be a important role as well as biochemical tests.

• Economic and Environmental Geology
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• v.54 no.2
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• pp.199-212
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• 2021

The Sebyeonggwan Hall (National Treasure No. 305) is located on the Naval Headquarter of Three Provinces in Tongyeong, and it has partly undergone with several rebuilding, remodeling, repairing and restorations since it's the first establishment in Joseon Dynasty (AD 1605) of ancient Korea. This study focuses on 50 foundation stones that comprise the Sebyeonggwan. These stones are made of six rock types and currently have various shapes of the surface damages. As the foundation stones, the dominant rock type was dacitic lapilli tuffs, and provenance-based interpretation was performed to supply alternative stones for conservation. Most of the provenance rocks for foundation stones showed highly homogeneity with their corresponding stones of petrography, mineralogy and magnetic susceptibility. According to surface deterioration assessments, the most serious damages of the stones were blistering and scaling. The deterioration mechanism was identified through the analysis of inorganic contaminants, and the primary reason is considered salt weathering caused by sea breeze and other combined circumstances. Based on the mechanical durability of the stones, there was no foundation stone that required the replacement of its members attributed to the degradation of the rock properties, but conservation treatment is considered necessary to delay superficial damage. The foundation stones are characterized by a combined outcome of multiple petrological factors that caused physical damage to surfaces and internal defects. Therefore, it's required to diagnosis and monitoring the Sebyeonggwan regularly for long-term preservation.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.62-70
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• 2024

Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.68-74
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• 2000

Purpose: This study was to investigate the clinical manifestations of FTT in children. Methods: From March 1997 to July 1999, clinical observations were made on patients with FTT who had visited to Samsung Medical Center. Detailed histories and through physical examinations were taken, and when suspected organic FTT, basic laboratory studies were done. Results: Upon the review of medical records, we investigated the clinical manifestations of 74 children, aged 1 month and 13 year 1 month. The causes of FTT were composed of either physiologic (47.8%) or pathologic (52.2%) ones. Among the physiologic FTT, were there familial short stature (FSS, 14.5%), intrauterine growth retardation (IUGR, 14.5%), constitutional growth delay (CGD, 11.6%), idiosyncrasy and prematurity. Among pathologic causes, neurologic disorders (20%) are the most common causes of FTT, and then follow by GI (13.4%), allergic and infectious disorders in decreasing order. The data showed that average caloric intake in patients with FTT was 76,2% of recommended amount. FTT patients with CGD, IUGR, and idiosyncrasy had tendency to take small foods. The FTT children with prematurity, IUGR and pathologic FTT, were short and thin for their ages. However FTT children with CGD and FSS had tendency to be thin with relatively normal heights for their ages, in comparison with those of the children with prematurity, IUGR and pathologic FTT. Conclusion: The diagnosis of FTT was easily obtained with simple and through medical history, physical examination, and minimal laboratory tests. In this study, organic FTT was more prevalent than physiologic one. This results indicate that early intervention is mandatory, because children may develop significant long-term sequelae from nutritional deficiency.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.3-11
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• 2015

Purpose It is hard to obtain high quality images of knee and T.M joint because of a lot of soft tissues in the knee and T.M joint area. Most conventional system for high resolution scintigraphy was used by 4 mm aperture pinhole collimator. Performance comparison of high-resolution pinhole SPECT for Micro deluxe phantom using conventional system. the aim of this study is to evaluate performance of each aperture according to the diameter size and the usefulness of 24-hour delayed bone scintigraphy. Materials and Methods In this study 6 mm, 8 mm diameter pinhole collimators were mounted on Siemens E.CAM systems. In order to evaluate performance evaluation of each aperture and Micro Deluxe phantom was used for performance comparison of conventional SPECT system, Projection data were obtained with 9 degree increment per 30 second. Transverse images were reconstructed using dedicated OSEM algorithm with recovery of detector blurring. $^{99m}Tc-HDP$ source was used for 24-hour delayed bone scintigraphy. Results The knee joint images obtained with 24-hour delay were improved more than those obtained with 3-hour delay in our study. The 6 mm and 8 mm pinhole collimators FWHM have improved by 28% SNR and Uniformity have improved by 35%, Contrast has improved by 7% in 24-hour delayed knee joint image. While in 24-hour delayed T.M joint image of the 6 mm and 8 mm pinhole collimators FWHM have decreased by 60% SNR has decreased by 20% and Uniformity has decreased by 25%, Contrast has decreased significantly. Conclusion Pinhole collimators with 6 mm and 8 mm diameter could offer a superior performance for 24-hour delayed bone scintigraphy. The use of 24-hour delayed image provides additional benefits for pinhole scintigraphy of knee joint. Therefore, we expect that it is useful for precise diagnosis of knee joint and it is applicable to others joint imaging.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.163-171
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• 2008

Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.

• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1008-1012
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• 2003

Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. Results : The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. Conclusion : The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.2
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• pp.142-149
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• 2014

Purpose: There are 15 types of Glycogen storage disease (GSD) that have been identified, and GSD type Ia is the most common type. There are several studies of Korean GSD type Ia patients' long-term complications. The aim of this study to find out clinical symptoms and prognosis of GSD type Ia patients. Methods: We performed clinical, biochemical and genetic analysis retrospectively on five patients diagnosed with GSD type Ia in a Soonchunhyang University Hospital from July 2002 to July 2014. Results: All patients had hepatomegaly at diagnosis, and they were all confirmed to have fatty liver at abdomen USG. They had no developmental delay, but two of them had growth retardation. Elevated blood lactate, triglyceride, and uric acid levels can find out all patients, but only one patient had hypoglycemia. They are diagnosed with GSD through gene analysis, and by gene analysis, they have c.648G>T (homozygote, splicing mutation), c.122G>A/c.648G>T, c.248G>A/c.648G>T mutations. Treatment with three times meals, three times snacks and four to six times use of uncooked constarch for all patients. Following the progress, one of them resulted in hypothyroidism, other one had renal stones. A patient diagnosed at 16 years old had liver cirrhosis and started having hemodialysis for ESRD. Conclusion: GSD type Ia patients had hepatomegaly, hyperlipidemia, hyperuricemia, and lactacidemia. Therefore patients who have such these symptoms are recommended gene analysis. A patient diagnosed at 16-years-old had liver cirrhosis and ESRD in progress, early diagnosis and treatment are important for GSD type Ia patients.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.85-95
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• 1996

Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.