• Title/Summary/Keyword: Diagnostic tools

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The Clinical Significance of Soluble Intercellular Adhesion Molecule-1 sICAM-1) and Soluble Vascular Cell Adhesion Molecule-1(sVCAM-1) in Kawasaki Disease (급성 발열기 및 아급성기 가와사끼병에서 세포부착분자 sICAM-1, sVCAM-1의 임상적 의의)

  • Rhee, Kang Won;Yun, Sin Weon;Lee, Dong Keun;Choi, Eung Sang;Yoo, Byeong Hoon;Lee, Mi Kyung
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.640-648
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    • 2005
  • Purpose : Kawasaki disease(KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value. Methods : A typical KD group was 32 patients who were hospitalized from Jan. 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I. Results : sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control(P=0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage(P=0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages(P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin(IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages(P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T(r=0.63, P=0.00063). Conclusion : The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.

The Relationship between the Salivary IgA against AgI/II of S. mutans and Dental Caries Experience among Children and Adults (소아와 성인의 타액 내 AgI/II 특이 IgA 와 우식경험도의 관계)

  • Lim, Su-Min;Kim, Jae-Gon;Baik, Byeong-Ju;Yang, Yeon-Mi;Kim, Su-Kyung;Lee, Kyung-Yol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.671-676
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    • 2008
  • AgI/II of Streptococcus mutans(S. mutans) is an important virulence factor that contributes to the pathogenesis of S. mutans-induced dental caries. In oral cavity, salivary IgA antibodies act as safeguards against enormous challenges from oral bacteria. IgA antibodies inhibit adherence of cariogenic microorganisms to hard surfaces. Analysis of salivary IgA against AgI/II can be very useful diagnostic and powerful communication tools to the dental caries The purpose of this study was to investigate correlation between salivary AgI/II specific IgA and incidence of dental caries among children and young adults. Subjects consisted of 28 children and 18 adults. They were assigned to four groups : Group I deft index $\leq$3), Group II(deft index $\geq$4), Group III(DMFT index $\leq$3), Group IV(DMFT index $\geq$4) and they was divided two groups into caries resistant group and caries susceptible group. The study group were examined caries activity and their salivary IgA was evaluated by enzyme-linked immunosorbent assay. The results are as follows : 1. There was a positive correlation between the number of S. mutans and caries activity. 2. The titer of salivary IgA against the AgI/II was significantly higher in caries resistant group than caries susceptible group(p<0.01). 3. The titer of salivary IgA against the AgI/II in Group III was significantly higher than Group II(p<0.05).

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Clinical Significance of MR Imaging for the Diagnosis and Treatment of Subungual Glomus Tumor in the Fingers (수지 조갑하 사구종의 진단 및 치료에서 자기 공명 영상의 임상적 의미)

  • Kim, Byoung-Suck;Kim, Woo-Sig;Han, Kyoung-Jin;Cho, Jae-Hyun;Lee, Kyi-Beom;Ha, Heon-Kyo;Kang, Shin-Young
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.1
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    • pp.28-35
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    • 2001
  • Purpose : Authors investigated the efficiency of preoperative MRI in suspicious glomus tumor and the clinical outcomes after marginal excision. Materials and Methods : In 10 cases of glomus tumors in the fingers, authors retrospectively analyzed the clinical data, including previous trauma, treatment history, preoperative symptoms, physical examination, plain radiography, MRI (9 cases), pathological findings and postoperative complications. Results : The patients had pain in 10 cases, tenderness in 9 cases, cold sensitivity in 3 cases and edema in one case. MRI showed low signal (3 cases) or iso-signal (5) intensity on T1 weighted image, high signal intensity (8) on T2 weighted image, and all the lesions were enhanced in gadolinium enhancement images. The exact locations of glomus tumors were median in 6 cases, lateral in 5, lateral fold in 2 and pulp in 3 in transverse section and nail bed in 5 cases and nail matrix in 5 in sagittal section. Marginal excision was performed by lateral approach in one case and transungual in 9 cases. Histologically, all 10 cases were composed of solid sheets of round cells interrupted by thin-walled blood vessels. Most of clinical symptoms were disappeared in all cases after operation. Nail deformity was found in one case, which was originated from nail matrix, however, there was no recurrence. Summary : Clinical symptom was the most impotant factor in diagnosis of glomus tumor in the fingers. However, preoperative MRIs were helpful in patients, who had obscure pain or prolonged clinical symptoms with suspicious glomus tumors. Preoperative MRI might be one of the most useful tools for establishing the exact diagnosis and detecting the location of glomus tumors, in spite of the relatively high expenses.

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Quantification of Brain Images Using Korean Standard Templates and Structural and Cytoarchitectonic Probabilistic Maps (한국인 뇌 표준판과 해부학적 및 세포구축학적 확률뇌지도를 이용한 뇌영상 정량화)

  • Lee, Jae-Sung;Lee, Dong-Soo;Kim, Yu-Kyeong;Kim, Jin-Su;Lee, Jong-Min;Koo, Bang-Bon;Kim, Jae-Jin;Kwon, Jun-Soo;Yoo, Tae-Woo;Chang, Ki-Hyun;Kim, Sun-I.;Kang, Hye-Jin;Kang, Eun-Joo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.241-252
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    • 2004
  • Purpose: Population based structural and functional maps of the brain provide effective tools for the analysis and interpretation of complex and individually variable brain data. Brain MRI and PET standard templates and statistical probabilistic maps based on image data of Korean normal volunteers have been developed and probabilistic maps based on cytoarchitectonic data have been introduced. A quantification method using these data was developed for the objective assessment of regional intensity in the brain images. Materials and Methods: Age, gender and ethnic specific anatomical and functional brain templates based on MR and PET images of Korean normal volunteers were developed. Korean structural probabilistic maps for 89 brain regions and cytoarchitectonic probabilistic maps for 13 Brodmann areas were transformed onto the standard templates. Brain FDG PET and SPGR MR images of normal volunteers were spatially normalized onto the template of each modality and gender. Regional uptake of radiotracers in PET and gray matter concentration in MR images were then quantified by averaging (or summing) regional intensities weighted using the probabilistic maps of brain regions. Regionally specific effects of aging on glucose metabolism in cingulate cortex were also examined. Results: Quantification program could generate quantification results for single spatially normalized images per 20 seconds. Glucose metabolism change in cingulate gyrus was regionally specific: ratios of glucose metabolism in the rostral anterior cingulate vs. posterior cingulate and the caudal anterior cingulate vs. posterior cingulate were significantly decreased as the age increased. 'Rostral anterior'/'posterior' was decreased by 3.1% per decade of age ($P<10^{-11}$, r=0.81) and 'caudal anterior'/'posterior' was decreased by 1.7% ($P<10^{-8}$, r=0.72). Conclusion: Ethnic specific standard templates and probabilistic maps and quantification program developed in this study will be useful for the analysis of brain image of Korean people since the difference in shape of the hemispheres and the sulcal pattern of brain relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques.

Multiplex PCR method for environmental monitoring of approved LM cotton events in Korea (국내 승인 LM면화의 자연환경 모니터링을 위한 multiplex PCR 개발)

  • Jo, Beom-Ho;Seol, Min-A;Shin, Su Young;Kim, Il Ryong;Choi, Wonkyun;Eum, Soon-Jae;Song, Hae-Ryong;Lee, Jung Ro
    • Journal of Plant Biotechnology
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    • v.43 no.1
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    • pp.91-98
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    • 2016
  • The growth area of living modified (LM) cotton has steadily increased every year, since its first commercialization in 1996. Development of environmental risk assessment tools and techniques for LM cotton is required for ecosystem safety. We therefore developed multiplex PCR assays for simultaneous detection of two (MON15985, MON531) and four (GHB614, LLCOTTON25, MON88913 and MON1445) LM cotton events approved in Korea, with event specific primer pairs. The PCR reactions were optimized by using event specific primers of six LM cottons at various concentrations. The reactions allows amplification of estimated amplicons of MON15985 (214 bp), MON531 (270 bp), GHB614 (119 bp), LLCOTTON25 (164 bp), MON88913 (276 bp), and MON1445 (389 bp) from multiplex PCR reactions. The multiplex PCR assay developed allowed that two annealing steps (15 cycles at $55^{\circ}C$ and 25 cycles at $60^{\circ}C$) were performed for amplification of distinguished two LM cottons, and only one annealing step (50 cycles at $60^{\circ}C$) was necessary for tetraplex PCR. Primer extension step of all PCR reactions was skipped for time-effective amplification. Our methods suggest that two multiplex PCR assays can be cost-effective and a rapid diagnostic tool for environmental LMO monitoring of six LM cottons.

Clinical Significance of Follow-up CT after Ultrasonography for Acute Appendicitis in Children (소아 급성 충수염에서 복부초음파 이후 전산화단층촬영 추적 검사의 임상적 의의)

  • Yu, Seong-Keun;Moon, Jin-Soo;Kim, Nam-Hee;Hwang, Jong-Hee;Nam, Seung-Yeon;Kim, Dong-Wook;Lee, Chong-Guk;Seo, Jung-Wook;Heo, Tae-Gil
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.36-43
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    • 2007
  • Purpose: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. Methods: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. Results: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. Conclusion: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.

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Regeneration of Low Heat - Treated Sciatic Nerve of Rabbit (저온 열처리한 가토 좌골 신경의 재생)

  • Kim, Jae-Do;Kim, Sang-Jin;Jung, Cheoul-Yun;Hong, Young-Gi;Kim, Ghi-Chan
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.80-88
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    • 1997
  • Malignant tumors of extremeties involving major neurovascular structures have been treated by amputation. However recent development of diagnostic tools(CT, MRI etc.), surgical techniques, anticancer chemotherapeutic agents, and radiation techniques allow surgeons to treat malignant tumors in the limb without amputation. It has been reported that a local application of low-heat to the tissue with tumor can kill tumor cells. It is, however, not known if the attendant neural and vascular injuries may be recovered. The present study was, therefore, undertakn to address this question in rabbit sciatic nerves. A low-heat injury to the sciatic nerve was induced by perfusing the nerve with $60^{\circ}C$ saline for 30 minutes and the courses of functional and morphological recovery of the nerve were evaluated for 16 weeks. The results are summerized as follows : 1. In the electromyographic nerve conduction test the average amplitude was markedly attenuated at 4 and 8 weeks after the low-heat treatment, but it progressively increased to the level 89.5% of the control at 16 week post-treatment. The average latency in the control group was 0.62 msec. The latency in the experimental group was much longer than this at 4 and 8 week post-treatment, but it progressively reverted to the control level, showing 0.622 msec at 16 weeks. 2. In the needle EMG, many fibrillation potentials and positive sharp waves were appeared until 8 weeks post-treatment. After 16 weeks, however, no fibrillation potential was observed. 3. In the early phase of post-treatment period, the myelinated nerve fibers contained many vacuoles and the number of myelinated nerve fibers appeared to be considerably reduced. However, as time goes myelinated nerve fibers were regenerated, such that after 16 weeks the histologic appearance of the nerve was similar to that of the control group.

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Acute Appendicitis -A Survey by the Korean Association of Pediatric Surgeons in 2006- (급성 충수염 - 2006년 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Chang, S.I.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Chung, U.S.;Jung, P.M.
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.203-211
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    • 2007
  • A nationwide survey on acute appendicitis (AAP) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the 6 months period from the $1^{st}$ October, 2005 to $31^{st}$ March, 2006. Questionnaires were collected from 23 members. Four hundred seventy six patients were registered from 21 hospitals where the members were working. The male to female ratio was 1.67:1. Average age was 9 years and 5 months (range 21 months-20 years). Operations were performed on average 10.4 hours (range 1-230 hours) from arrival at hospital. The average operation time was 59.1 minutes. The average admission days were 5.8 days (range 2-45 days). The most frequent symptoms were abdominal pain (95.1 %), vomiting (50.6 %) and fever (43.7%). The average duration of symptoms was 42.2 hours (range 1 hour-22 days). Leukocytosis (WBC count > 10,000) was found in 85.9%. The most popular diagnostic tools were ultrasonography and CT. Open surgery was performed in 72.1 % and laparoscopic surgery in 27.5 %. Two laparoscopic surgeries were converted to open surgery (0.4 %). Simple appendicitis was found in 54.5 % and complicated appendicitis such as abscess, gangrenous change and perforation in 45.5%. According to the questionnaires 12 hospitals were performing open surgery only in all patients. Four hospitals were performing laparoscopic surgery in all patients. Seven hospitals are performing both surgical methods according to surgeon or occasion. Regarding the use of antibiotics in acute appendicitis, three kinds of antibiotics were used in 40 % of total simple appendicitis patients. The results showed the trend of management in acute appendicitis in Korea. Especially it is necessary for the members to discuss the use of antibiotics for prophylaxis in the simple appendicitis.

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PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

A Clinical Study of Renal Abscesses in Children (소아 신농양의 임상적 고찰)

  • Hwang You-Sik;Rhie Young-Jun;Ahn Sun-Young;Han Sang-Won;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.64-68
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    • 2005
  • Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

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