• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1789-1794
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• 2015

Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

• Childhood Kidney Diseases
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• 제5권1호
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• pp.15-21
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• 2001

목 적 : 요로감염은 어린이에서 중요한 신요로계 질환으로 빠르고 정확한 진단과 치료로 신장 손상의 위험을 줄이고 불필요한 검사와 치료를 피할 수 있다. 저자들은 우리나라 어린이 요로감염 치료의 개선을 도모하는 첫걸음으로 설문 조사를 통해 요로감염의 진단, 치료, 영상 검사와 예방에 관한 진료 행태를 알아보았다. 대상 및 방법 : 전국의 소아신장전문의와 비뇨기과 전문의를 대상으로 설문조사를 통하여 요로감염의 진단, 치료, 영상검사, 예방의 진료형태를 조사하였다. 결 과 : 응답자들은 대부분 신생아에서는 소변 채취용 백을, 이후에는 중간소변 채취를 이용하여 소변 배양 검사를 하였고, 소변 배양검사가 음성인 경우에는 농뇨, nitrite 양성, 세균뇨 등의 소견을 보일 때 요로감염이라고 판단하였다. 요로감염 후에는 80$\%$가 예방적 항생제를 사용하였다. 방광 요관 역류가 있는 환아에서는 1-2세 이상의 환아가 고도의 방광 요관 역류를 보이거나 예방 요법 중에도 요로감염이 발생할 때 수술로 치료하는 경우가 많았으나 그 기준에는 차이를 보였다. 대부분이 요로감염 진단시에 신장 초음파 검사를 시행하였고 과반수에서 각각 다양한 시기에 배뇨 방광 요도 조영 검사와 DMSA scintigraphy를 시행하였다. 포경 수술은 대개 권하지 않았으며 반수에서 방광 요관 역류 환아의 형제에 대한 선별 검사를 시행하였다. 결 론 : 이 보고에서 밝혀진 다양한 치료 행태로 보아, 어린이 요로감염 치료의 개선과 발전을 위해 체계적인 진료 방침의 고안이 필요할 것으로 보인다.

• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.213-218
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• 2017

최근 고위험 임신군이 증가함에 따라 과거에 비해 음향파워 세기가 높은 도플러초음파 이용이 산전 진단에서 점차 증가하고 있으며, 여러 기관에서 가이드라인을 설정하여 과도한 노출을 자제하고 있다. 따라서 본 연구에서는 장시간 초음파검사 실시에 따른 검사모드 별 체표면의 온도변화를 알아보고 열효과에 영향을 받지 않는 노출시간을 고찰해 보고자 하였다. 시간경과에 따른 B mode, C mode, PD mode 별 초음파를 조사한 부위와 조사하지 않은 부위의 온도변화를 측정하여 차이를 비교하였으며 B mode는 초음파 조사 후 10분, 50분에서, C mode는 20분부터, PD mode는 30분부터 온도변화에 유의한 차이를 나타내었다(p<0.01). 측정시점에 따라 3개의 mode에서 모두 온도상승에 차이를 보였으며(p<0.000), PD mode가 가장 온도변화에 민감한 반응을 나타내었다. 또한 초음파 노출시간이 증가함에 따라 온도상승 시간이 짧아짐을 알 수 있었다. 따라서 배아나 태아를 관찰하기 위한 초음파검사 시 과도한 검사시간을 피하여 진단목적으로만 신속하게 사용할 것을 권고한다.

• Parasites, Hosts and Diseases
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• 제55권3호
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• pp.295-304
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• 2017

Opisthorchis viverrini infection induces chronic inflammation, and a minor proportion of infected individuals develop advanced periductal fibrosis (APF) and cholangiocarcinoma (CCA). Inflammatory cytokines and/or their gene polymorphisms may link to these biliary pathologies. We therefore investigated associations among cytokine gene polymorphisms and cytokine production in 510 Thai cases infected with O. viverrini who presented with APF+ or APF-, as established by abdominal ultrasonography as well as in patients diagnosed with CCA. Levels of pro-inflammatory and anti-inflammatory cytokines were determined in culture supernatants after stimulation of peripheral blood mononuclear cells (PBMCs) with O. viverrini excretory-secretory (ES) products. Pro-inflammatory cytokines, IL-$1{\beta}$, IL-6, IFN-${\gamma}$, LT-${\alpha}$, and TNF-${\alpha}$ were significantly increased in CCA patients compared with non-CCA (APF- and APF+) cases. Polymorphisms in genes encoding IL-$1{\beta}$-511C/T, IL-6-174G/C, IFN-${\gamma}$+874T/A, LT-${\alpha}$+252A/G, and TNF-${\alpha}$-308G/A were then investigated by using PCR-RFLP or allele specific-PCR (AS-PCR) analyses. In the CCA cases, LT-${\alpha}$+252A/G and TNF-${\alpha}$-308G/A heterozygous and homozygous variants showed significantly higher levels of these cytokines than the wild type. By contrast, levels of cytokines in wild type of IFN-${\gamma}$+874T/A were significantly higher than the variants in CCA cases. IFN-${\gamma}$+874T/A polymorphisms were associated with advanced periductal fibrosis, whereas IL-6-174G/C polymorphisms were associated with CCA. To our knowledge, these findings provide the first demonstration that O. viverrini infected individuals carrying several specific cytokine gene polymorphisms are susceptible to develop fibrosis and CCA.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1097-1102
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• 2016

Background: Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand. Healthy behavior can decrease infection, therefore, the investigation of knowledge, attitude, and practice is need required in high risk areas. Objective: This study aimed to investigate the behavior and perceptions regarding liver fluke. Materials and Methods: A cross-sectional descriptive study was conducted in Chum Phuang district of Nakhon Ratchasima province, Thailand during July to November 2015. A total 80 participants who had screened with verbal screening test, stool examination, and ultrasonography, were purposive selected and completed a pre-designed questionnaire (Kruder-Richardon-20=0.80, Cronbach's alpha coefficient=0.82 and 0.79). T-test, ANOVA, and Pearson correlation test were used for analyzed data. Results: The results reveal that O. viverrini infection was 1.25%, and 3 patients had a dilated bile ducts. The participants had a high knowledge, attitude, and practice regarding liver fluke. The education, occupation, and income, were statistical significant to attitude regarding liver fluke. Nurses and television were the main sources of information regarding liver fluke, with statistical significance(p-value <0.05). Knowledge was significantly associated with attitude and practice (p-value<0.05). Conclusions: Participants had good behavior regarding liver fluke. Improvement of knowledge and attitude is influenced to practical change regarding this carcinogenic fluke. In addition, nurse and television are the main information resources for key success in increasing people perception for disease prevention and control in this area.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7079-7083
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• 2014

The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with $IPSS{\leq}7$ and those with $IPSS{\geq}8$, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with $IPSS{\leq}7$ than in those with $IPSS{\geq}8$. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.316-323
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• 2023

Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

• 한국방사선학회논문지
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• 제17권5호
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• pp.735-742
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• 2023

비알콜성 지방간은 심혈관계 질환, 당뇨병, 고혈압 및 신장질환의 발생에 있어 독립적인 위험인자에 해당하며, 최근에는 비알콜성 지방간에 대한 임상적 중요성이 증가하고 있다. 본 연구에서는 비알콜성 지방간 환자의 초음파영상에 대하여 질감분석 방법인 GLCM을 적용하여 특징값을 추출하고자 한다. 추출된 특징값들을 이용한 인공신경망 모델의 적용을 통하여 비알콜성 지방간의 지방침착 정도를 정상 간(normal), 경도 지방간(mild), 중등도 지방간(moderate), 중증 지방간(severe)으로 분류를 하고자 한다. GLCM알고리듬 적용 결과 Autocorrelation, Sum of squares, Sum average, Sum variance 파라미터 값들은 경도 지방간, 중등도 지방간을 거쳐 중증 지방간으로 갈수록 특징값의 평균값이 증가하는 경향성을 나타내었다. 인공신경망 모델의 입력은 비알콜성 지방간질환의 초음파영상에 GLCM 알고리듬을 적용하여 추출한 Autocorrelation, Sum of squares, Sum average, Sum variance의 4개의 파라미터들을 인공신경망 모델의 입력값으로 적용하였다. 비알콜성 지방간질환의 초음파영상에 GLCM 알고리듬을 적용하여 추출한 영상을 인공신경망에 적용하여 분류 정확도를 평가한 결과 92.5%의 높은 정확도를 나타내었다. 이러한 결과를 통하여 비알콜성 지방간 환자의 초음파 영상에 대한 질감 분석 GLCM 연구 시 본 연구의 결과를 기초자료로 제시를 하고자 한다.

• Korean Journal of Radiology
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• 제23권9호
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• pp.866-877
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• 2022

Objective: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. Materials and Methods: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23-75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar's test or a generalized estimating equation. Results: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). Conclusion: The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.

• 대한영상의학회지
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• 제84권3호
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• pp.676-685
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• 2023

목적 본 연구는 무증상 여성의 유방 초음파에서 발견된 군집 미세낭종의 발생률, 임상적 결과 및 영상 소견을 알아보고, 적절한 조치 가이드라인을 제시하고자 한다. 대상과 방법 2014년 8월부터 2019년 12월까지 무증상 여성에서 시행한 유방 초음파에서 발견된 군집 미세낭종 병변에 대해 분석하였다. 최종 진단은 병리학적 결과 및 12개월 이상의 추적관찰로 하였다. 결과 100명의 환자에서 117개 병변이 후향적으로 연구되었으며, 군집 미세낭종의 발생률은 1.5%였다. 총 117개의 병변 중, 3개(2.6%)는 악성, 2개(1.7%)는 고위험 병변, 112개(95.7%)는 양성이었다. 악성 병변 중 2개는 관상피내암이었고, 1개는 침윤성 유관암이었다. 이중, 유방 촬영술에서 의심스러운 미세석회화 또는 초음파에서 내부 혈류를 보인 2개의 병변은 category 4로 분류되었다. 나머지는 12개월 뒤 시행한 초음파에서 echo pattern의 변화를 보인 위 음성의 증례였다. 결론 무증상 여성에서 시행한 유방 초음파에서 군집 미세낭종의 유병률은 1.5%였으며, 악성률은 2.6%였다. 군집 미세낭종의 악성률과 양성 및 악성 영상 소견을 아는 것은 영상의학과 의사들이 병변을 분류하고 적절한 조치를 권유하는 데 도움이 될 것이다.