• Childhood Kidney Diseases
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• v.11 no.1
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• pp.59-64
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• 2007

Purpose : Suprapubic aspiration(SPA) has been considered the "gold standard" for obtaining urine in non-toilet trained infants. Ultrasound(US)-guided SPA improves the success rate of the procedure and reduces the complications. However, many physicians perceive SPA as invasive and prefer the use of urethral catheterization (Ucat). We compared the success rate, complications and accuracy of US-guided SPA and Ucat. Methods : 121 infants who visited Ewha Womans University Mokdong Hospital with suspected urinary tract infection(UTI) were investigated. For the first study, the study infants were randomly assigned to either the US-guided SPA(n=32) or Ucat(n=32) groups. The success rate and complications of both procedures were compared. For the second study, US-guided SPA and Ucat were performed simultaneously(n=57). The accuracy of urethral catheterization was subsequently analyzed. The criteria for success was defined as the collection of more than 0.5 mL of urine. UTI was diagnosed by the presence of uropathogens over 105 colony-forming units (CFU)/mL. Results : The overall success rate of the US-guided SPA was 96.9%(71.9% in first attempts, 25.0% in second attempts) which was not significantly different compared to 96.9%(90.6% in first attempts, 6.3% in second attempts) in the Ucat(P>0.05) group. The aspirated urine volume was $7.4{\pm}3.7mL$ in the US-guided SPA group, which was not significantly different to $4.5{\pm}2.6mL$ in the Ucat(P>0.05) group. The accuracy of Ucat in comparison to the US guided SPA was low with sensitivity 59.5%, specificity 86.6%, false-positive rate 13.3% and false-negative rate 40.5%. Conclusion : US-guided SPA should be encouraged as the best method to collect the urine in non-toilet trained infants with UTI.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.361-370
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• 2009

The image quality management of bone mineral density is the responsibility and duty of radiologists who carry out examinations. However, inaccurate conclusions due to lack of understanding and ignorance regarding the methodology of image quality management can be a fatal error to the patient. Therefore, objective of this paper is to understand proper image quality management and enumerate methods for examiners and patients, thereby ensuring the reliability of bone mineral density exams. The accuracy and precision of bone mineral density measurements must be at the highest level so that actual biological changes can be detected with even slight changes in bone mineral density. Accuracy and precision should be continuously preserved for image quality of machines. Those factors will contribute to ensure the reliability in bone mineral density exams. Proper equipment management or control methods are set with correcting equipment each morning and after image quality management, a phantom, recommended from the manufacturer, is used for ten to twenty-five measurements in search of a mean value with a permissible range of ${\pm}1.5%$ set as standard. There needs to be daily measurement inspections on the phantom or at least inspections three times a week in order to confirm the existence or nonexistence of changes in values in actual bone mineral density. in addition, bone mineral density measurements were evaluated and recorded following the rules of Shewhart control chart. This type of management has to be conducted for the installation and movement of equipment. For the management methods of inspectors, evaluation of the measurement precision was conducted by testing the reproducibility of the exact same figures without any real biological changes occurring during reinspection. Bone mineral density inspection was applied as the measurement method for patients either taking two measurements thirty times or three measurements fifteen times. An important point when taking measurements was after a measurement whether it was the second or third examination, it was required to descend from the table and then reascend. With a 95% confidence level, the precision error produced from the measurement bone mineral figures came to 2.77 times the minimum of the biological bone mineral density change. The value produced can be stated as the least significant change (LSC) and in the case the value is greater, it can be stated as a section of genuine biological change. From the initial inspection to equipment moving and shifter, management must be carried out and continued in order to achieve the effects. The enforcement of proper quality control of radiologists performing bone mineral density inspections which brings about the durability extensions of equipment and accurate results of calculations will help the assurance of reliable inspections.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.381-391
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• 2009

Purposes : The purpose of this study was to analyze factors that could affect health of radiological technologists, which is useful for health care and development of programs for health promotion. Methods : Subjects were 234 of radiological technologists who work in general hospitals. Some questionnaires were made about perceptions of health condition and promotional behavior of health for this study. The questionnaires of health perception were 20 items that consist of the present condition of health, health concern and sensitivity. The reliability was sufficient(Cronbach's $\alpha=0.79$). The other questionnaires about health promotion behavior were 47 items that consist of self-realization, health responsibility, exercise, nutrition, personal relationships, and stress management. The results turned out to bewas sufficient (Cronbach's $\alpha=0.93$). Every data was treated statistically, comparison of average(t-test, ANOVA), correlation, and multiple regression. Results : Related factors to health promotion behavior were age, marriage, salary, class of one's position, career, employment, and religion, in general features. In health life habit, related factors were smoke and exercise. Results of health promotion behavior was 2.90 of mean score, 0.37 of standard deviation. Correlations between factors of health perception and health promotion behavior was positive(p<0.01). Health promotion behavior were affected by sensitivity, presents condition of health, exercise, smoke, career. Sensitivity was the most affectable variable, which means that promotional behavior score became higher and higher as the score of sensitivity and present condition were increased. In addition, persons who exercise regularly, had been smoked, and has higher career showed higher score of promotional behavior. Conclusion : Radiological technologists have to keep their health, trying not to infected by a disease. Most of all, no smoking and regular exercise are the most important thing to all of members.

• Toxicological Research
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• v.24 no.3
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• pp.175-182
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• 2008

DNA-dependent protein kinase(DNA-PK) is involved in joining DNA double-strand breaks induced by ionizing radiation or V(D)J recombination and is activated by DNA ends and composed of a DNA binding subunit, Ku, and a catalytic subunit, DNA-PKcs. It has been suggested that DNA-PK might be $2^{nd}$ upstream kinase for protein kinase B(PKB). In this report, we showed that Ser473 phosphorylation in the hydrophobic-motif of PKB is blocked in DNA-PK knockout mouse embryonic fibroblast cells(MEFs) following insulin stimulation, while there is no effect on Ser473 phosphorylation in DNA-PK wild type MEF cells. The observation is further confirmed in human glioblastoma cells expressing a mutant form of DNA-PK(M059J) and a wild-type of DNA-PK(M059K), indicating that DNA-PK is indeed important for PKB activation. Furthermore, the treatment of cells with doxorubicin, DNA-damage inducing agent, leads to PKB phosphorylation on Ser473 in control MEF cells while there is no response in DNA-PK knockout MEF cells. Together, these results proposed that DNA-PK has a potential role in insulin signaling as well as DNA-repair signaling pathway.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.59-66
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• 2011

Purpose: We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children. Methods: PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed. Results: Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p<0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p<0.001). Clinical parameters, such as serum protein (p<0.001) and albumin concentrations (p<0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p<0.001), and splenomegaly (p<0.001), showed significant differences. The clinical features in the reactivated sub-group >10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed. Conclusion: PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.19-24
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• 2014

The purpose of the present study was to determine the priming effects of progesterone that affect the emergence of LH surge mode secretion by three different progesterone levels. In previous studies, we have shown that LH surge occurred in follicular levels of progesterone, whereas there was no surge mode secretion of LH and FSH in either the subluteal or luteal levels of progesterone. In this study, the hypothesis was that the priming effects of progesterone on the timing of the LH surge induced by exogenous estradiol are same between subluteal and luteal levels of progesterone. Long-term ovariectomized Shiba goats that had received implants of estradiol capsules (Day 0) and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels. On Day 7, all devices of progesterone packets were removed but estradiol capsules were maintained during the experiment, and blood samples were collected at 1 hr interval for 12 h from the time of progesterone removals to determine peripheral changes of estradiol and progesterone concentration. Then all animals were infused estradiol on the Day 7 after 13 h from the removals of progesterone devices with a peristaltic pump into jugular vein at a rate of 3 ${\mu}g/h$ for 36 h. For analysis of peripheral LH and estradiol concentration, blood samples were collected via another jugular vein at 2 h intervals for 52 h (from 4 h before the start of estradiol infusion to 48 h after the start of estradiol infusion). In all animals of the three groups treated with estradiol infusion, an LH surge was expressed but the peak time of LH surge was different. This time interval from estradiol infusion until the peak of LH surge was gradually and significantly extended by the different levels of progesterone treated before estradiol infusions in the three groups.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.25-30
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• 2014

This study tested the hypothesis that the priming effects of progesterone on the timing of the LH surge induced by exogenous estradiol are more potentiated the negative feedback actions of progesterone on LH secretion by the existence of estradiol. In previous studies, the time interval from estradiol infusion until the peak of LH surge was gradually and significantly extended by the different levels of progesterone treated before estradiol infusions. Longterm ovariectomized Shiba goats that had received implants of estradiol capsules (Day 0) and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels. On Day 7, all devices of progesterone and estradiol packets were removed but estradiol capsules were maintained during the experiment, and blood samples were collected at 1 hr interval for 12 h from the time of progesterone removals to determine peripheral changes of estradiol and progesterone concentration. Then all animals were infused estradiol on the Day 7 after 13 h from the removals of progesterone devices with a peristaltic pump into jugular vein at a rate of 3-6 ${\mu}g/h$ for 36 h. For analysis of peripheral LH and estradiol concentration, blood samples were collected via another jugular vein at 2 h intervals for 52 h (from 4 h before the start of estradiol infusion to 48 h after the start of estradiol infusion). In all animals of the three groups treated with estradiol infusion, an LH surge was expressed but the peak time of LH surge was different. This time interval was not extended by the different levels of progesterone treated before estradiol infusions and the difference was not significant during this interval between the Low P and the High P groups. Progesterone pretreatment may contribute to regulating the neural system that is responded by estradiol, and estradiol existence potentiates the negative feedback effect of progesterone on GnRH/LH surge-generating system.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.335-348
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• 2005

Background: This retrospective review examines the preoperative condition, postoperative course, mortality and cause of death for the patients who underwent modified Blalock-Taussig shunt for complex congenital heart defects in early infancy. Material and Method: Fifty eight patients underwent modified Blalock-Taussig shunts from January 2000 to November 2003. The mean age at operation was $23.1\pm16.2$ days ($5\~81\;days$), and the mean body weight was $3.4\pm0.7\;kg\;(2.1\~4.3\;kg)$. Indications for surgery were pulmonary atresia with ventricular septal defect in 12 cases, pulmonary atresia with intact ventricular septum in 17, single ventricle (SV) in 18, and hypoplastic left heart syndrome (HLHS) in 11. Total anomalous pulmonary venous return (TAPVR) was associated with SV in 4 cases. Result: There were 11 ($19.0\%$) early, and 5 ($10.6\%$) late deaths. Causes of early death included low cardiac output in 9, arrhythmia in 1, and multiorgan failure in 1. Late deaths resulted from pneumonia in 2, hypoxia in 1, and sepsis in 1. Risk factors influencing mortality were preoperative pulmonary hypertension, metabolic acidosis, use of cardiopulmonary bypass, HLHS and TAPVR. Twenty four patients ($41.4\%$) had hemodynamic instability during the 48 postoperative-hours. Six patients underwent shunt revision for occlusion, and 1 shunt division for pulmonary overflow. Conclusion: Modified Blalock-Taussig shunt for complex congenital heart defects in early infancy had satisfactory results except in high risk groups. Many patients had early postoperative hemodynamic instability, which means that continuous close observation and management are mandatory in this period. Aggressive management may appear warranted based on understanding of hemodynamic changes for high risk groups.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.341-350
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• 2007

Background: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. Material and Method: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. Result: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity. Conclusion: Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.604-609
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• 2009

Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery. Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system ($EBS^{(R)}$, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients. Result: The average age of the patients was $60.2{\pm}16.5$ years (range, $19{\sim}77$ years). The mean supporting time was $48.7{\pm}64.7$ hours (range, $4{\sim}210$ hours). Of the 10 patients, 6(60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving $34{\pm}8.6$ months (range, $23{\sim}48$ months) post-operatively. Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.