Lee, Kyung Yeon;Lee, Jin Young;Kim, Myoung Hyun;Lee, Jeong Eun;Kim, Yong Dae;Lee, Eun Ju;Lim, Young Su;Kim, Won Seop
Clinical and Experimental Pediatrics
/
v.51
no.5
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pp.512-517
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2008
Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.
The changes of electroencephalogram(EEG) in patients with dementia of Alzheimer's type are most commonly studied by analyzing power or magnitude in traditionally defined frequency bands. However because of the absence of an identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to the chaos theory, irregular signals of EEG can be also resulted from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the largest Lyapunov exponent($L_1$). The authors have analyzed EEG epochs from three patients with dementia of Alzheimer's type and three matched control subjects. The largest $L_1$ is calculated from EEG epochs consisting of 16,384 data points per channel in 15 channels. The results showed that patients with dementia of Alzheimer's type had significantly lower $L_1$ than non-demented controls on 8 channels. Topographic analysis showed that the $L_1$ were significantly lower in patients with Alzheimer's disease on all the frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia of Alzheimer's type have a decreased chaotic quality of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating the $L_1$ can be a promising tool for detecting relative changes in the complexity of brain dynamics.
Purpose : This study was designed to evaluate the usefulness of 3T-TOF MR angiography (3T-TOF MRA) compared with transcranial Doppler sonography (TCD) and conventional angiography (CA) in patients with suspected cerebral infarction. Materials and Methods : Fifty four patients with clinical symptoms of cerebral infarction were involved in this study, and had undergone 3T-TOF MRA and TCD, with CA in 11 patients. On the basis of divisions of the carotid artery, four groups were designated: group I, both vertebral arteries and basilar artery; group II, segment between 2 cm below bifurcation of common carotid artery and genu portion of internal carotid artery; group III, segment between petrous portion of internal carotid artery and bifurcation of anterior and middle cerebral artery; group IV, from bifurcation of anterior and middle cerebral artery to thier distal branches. Two radiologists retrospectively reviewed the vascular imaging and stenosis in 3T-TOF MRA, TCD, and CA. Results : A total of 432 arteries, 108 in each group, were available. The assessment of vascular imaging quality in 3T-TOF MRA is scored 2.98, 2.96, 2.91, 2.88 in 4 groups, respectively. Agreement among 3T-TOF MR angiography, TCD, and CA was high. Conclusion : 3T-TOF MR angiography may be useful method for the assessment of stenotic lesions of cranial vasculature in patients with cerebral infarction.
To aim of this study was to assess the full scan and half scan of imaging with half scan factor. Patients without a cerebral vascular disease (n = 30) and were subject to the full scan half scan, and set a region of interest in the cerebral artery from the three regions (C1, C2, C3) in the range of 7 to 8 mm. MIP (maximum intensity projection) to reconstruct the images in signal strength SNR (signal to noise ration), PSNR (peak signal noise to ratio), RMSE (root mean square error), MAE (mean absolute error) and calculated by paired t-test for use by statistics were analyzed. Scan time was half scan (4 minutes 53 seconds), the full scan (6 minutes 04 seconds). The mean measurement range (7.21 mm) of all the ROI in the brain blood vessel, was the SNR of the first C1 is completely scanned (58.66 dB), half-scan (62.10 dB), a positive correlation ($r^2=0.503$), for the second C2 SNR is completely scanned (70.30 dB), half-scan (74.67 dB) the amount of correlation ($r^2=0.575$), third C3 of a complete scan SNR (70.33 dB), half scan SNR (74.64 dB) in the amount of correlation between the It was analyzed with ($r^2=0.523$). Comparative full scan with half of SNR ($4.75{\pm}0.26dB$), PSNR ($21.87{\pm}0.28dB$), RMSE ($48.88{\pm}1.61$), was calculated as MAE ($25.56{\pm}2.2$). SNR is also applied to examine the half-scans are not many differences in the quality of the two scan methods were not statistically significant in the scan (p-value > .05) image takes less time than a full scan was used.
Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.
Purpose - Average using time of smart-phone for Korean people is 3 hours 39 minutes and most people who are using a computer at home and their workplace can be affected over force to neck and shoulder due to unstable body posture. musculoskeletal disorders which caused by unstable body posture can affect strongly to decrease work efficiency. So this research is designed to measure the effect of using computer & smart-phone on decreased work efficiency due to musculoskeletal disorders and mediating effect between decreased work efficiency and musculoskeletal disorders. Research Design, Data, and Methodology - The author has developed a questionnaire with 6 hypothesis on the basis of previous research result with 5 constructs. The questionnaires were also made by interview and E-mail. 300 copies of questionnaires were distributed and 282 questionnaire were used for the analysis as valid data responses. SPSS ver.21.0 were used and made Cronbach's α and reliability test, correlation, Baron & Kenny 3 step mediated regression analysis. Result - Cronbach's α shows 0.770~0.954 and C.R. is 0.963~0.997 which is higher than 0.7. and AVE was 0.867~0.933. So the data are all acceptable condition. Using for a long time of a computer & smart-phone has a positive effect on musculoskeletal disorders. This means, it can cause musculoskeletal disorders if people use a computer & smart-phone for a long time due to unstable body posture. And musculoskeletal disorders can effect strongly decrease work efficiency. This study also found out that a long time of using computer can cause musculoskeletal disorders rather than using smart-phone a long time. To check mediate effect of musculoskeletal disorders between using a computer & smart-phone and Decreased Work Efficiency, author used 3-step mediated regression analysis of Baron & Kenny (1986). Using a computer for a long time mediate partially and using a smart-phone for a long time mediate completely. This means that using a smart-phone a long time is not the actual reason to decrease work efficiency. But using level of smart-phone is increasing rapidly day by day. So we need to make additional research about this matter seriously. Conclusion - Nowadays, people can not live on without a computer & smart-phone even a moment. But, using a computer for a long time will affect to cause musculoskeletal disorders and it will effect strongly to decrease work efficiency. Before, we thought over that musculoskeletal disorders were diseases of elder people. But, we found out from this study that musculoskeletal disorders can be happen to any people, even children, or workers in heavy industry or engaged in brain work. So we need to be careful when we use a computer for a long time. People also need to be careful to keep correct body posture when using both a computer and smart-phone since a smart-phone became more popular and using time level became longer. Due to increased income and living standard of people, physical growth of young people is so rapid. But the physical environment of society is not suitable for them since it can not follow up the speed of growth. Suitable work table is very important to prevent musculoskeletal disorder which can affect decrease work efficiency. For a person, a society or country, increased productivity is very important since it can directly connected to the job satisfaction. Education and reeducation for the people is also important, but to teach them how to keep good condition of health will be more important since it can increase the quality of work efficiency and quality of life. Computer and Smart-phone is one the best invention of modern society, but it can cause mental and physical disease which can affect decrease work efficiency and productivity. So it is necessary to observe attentively for the situation continually.
Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.
Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.
Objectives : Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) is a hair care product which is composed of ten plant extracts used in oriental medicine. This study was carried out to investigate the effects of Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) on hair regrowth and cytokine changes in a shaving model of C57BL/6 mice. Materials and Methods : Five-week-old mice were acclimated for 1 week at a temperature between $21-23^{\circ}C$, 40-60% relative humidity, and 12h of a light/dark cycle before beginning of the experiment. There were three experimental groups including 50% ethanol (EtOH, control), a positive control of 3% Minoxidil, and 30% Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) in 50% ethanol in 18 female mice. The test compounds were topically treated once a day over 12 days. The hair regrowth was photographically and histologically determined during the experimental period of 12 days. Revelation of EGF, $TGF-{\beta}1$ and IL-6 in hair follicle were also determined using immunohistochemistry. In addition to that, IL-6, $TNF-{\alpha}$, and $IL-1{\beta}$ in skin tissue were determined using enzyme-linked immunosorbent assay(ELISA). Results : Hair regrowth in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups was promoted earlier and faster than the control group. Concentrations of hairs and thick-hair ratio in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups were promoted than the control group. EGF was moderately positive in hair follicle of 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups, but negative in the control group. $TGF-{\beta}1$ was not significantly difference between the groups. IL-6 in hair follicle of Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) group was negative, but weakly positive in 3% Minoxidil and control group. IL-6 and $IL-1{\beta}$ in skin tissue were significantly decreased in Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) group, but there was not significantly decreased in 3% Minoxidil and control group. $TNF-{\alpha}$ in skin tissue was significantly decreased in 3% Minoxidil and Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) groups. Conclusions : These results suggest that Saengbal-eum-II($Sh{\bar{e}}ngf{\grave{a}}-y{\breve{i}}n-ll$) has hair growth promoting activity and it can be used for treatment of alopecia. And these effects relate to EGF revelation of hair follicle and a decrease IL-6, $TNF-{\alpha}$, and $IL-1{\beta}$ in skin tissue.
The purpose of this study was to observe the effects of the feeding physiological activity substance in feral peach(Prunus Persica Batsch var. davidiana Max.) extract intake on the improvement of the lipid compositions, apolipoprotein and blood pressure level in spontaneously hypertensive rats(SHR, Wistar strain, male) fed the experimental diets for 33 days. Concentrations of total cholesterol, triglyceride(TG), LDL-cholesterol, free cholesterol and atherosclerotic index in serum were significantly lower in the feral peach extract intake groups[groups 5g% Ex.(basal diet+feral peach 5.0g% extract), 10g% Ex.(basal diet+feral peach 10.0g% extract)] than those in the group Control(basal diet+water). In the ratio of HDL-cholesterol concentration to total cholesterol and HDL-cholesterol concentration, feral peach 5.0g%, 10.0g% extract intake groups(group 5g% Ex. and 10g% Ex.) were higher percentage than in the group Control. However, concentrations of total cholesterol and TC in liver and brain were significantly lower in the groups 5g% Ex. and 10g% Ex. than those in the group Control. But the concentrations of apolipoprotein (Apo) A-I and Apo A-II in serum were significantly higher in the feral peach 5.0g% and 10.0g% extract intake groups(5g% Ex. and 10g% Ex.) than in the control group. However, concentrations of Apo C-II, Apo C-III, Apo E and ratio of Apo B to Apo A-I in serum were fairly reduced in the groups 5g% Ex. and 10g% Ex. than in the control group. The levels of systolic and diastolic blood pressure were significantly lower in feral peach 5g% Ex. and 10g% Ex. groups than control group. However, no significance was found in the effect of among the groups(groups 5g% Ex. and 10g% Ex.). From these results, physiological activity substance in feral peach(Prunus persica Batsch var. davidiana Max.) extracts were effective on the improvement of the lipid compositions and cardiovascular heart disease, hypertension in spontaneously hypertensive rats. And particularly, feral peach extracts were more effective as a therapeutic regimen for the control of blood pressure in hypertension.
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