• Title/Summary/Keyword: clinical studies

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Complications of transcatheter closure of atrial septal defects using the amplatzer septal occluder (심방 중격 결손의 경피적 폐쇄술 후 발생한 합병증에 관한 연구)

  • Jea, Seo Jin;Kwon, Hyo Jin;Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Son, Chang Sung;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.401-408
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    • 2008
  • Purpose : Transcatheter closure of atrial septal defects (ASD) is currently established therapy as an alternative to surgery. But rarely, complications are reported in some studies. We report early and intermediate term complications associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder (ASO). Methods : From June 2003 to May 2006, 64 patients underwent transcatheter closure of secundum ASD or patent foramen ovale using the ASO. The ratio of male to female was 1:2.4, the median age was 17 years (range: 2.6-64 years) and their median weight was 47.5 kg (range: 2.6-64 kg). Results : The median diameter of ASD measured with transthoracic or transesophageal echocardiography was 15 mm (range: 6-28 mm), the median balloon stretched diameter was 18 mm (range: 6.5-34 mm), and the median size of device was 19.5 mm (range: 6-36 mm), was little difference with balloon stretched diameter. There were 10 cases of complications: arrhythmia (2), device malformation (2), aorta to right atrial fistula (1), hemolytic anemia (1), mitral valve encroachment (1), malposition (1), residual shunt (1), and inferior vena cava perforation (1). Conclusion : Transcatheter closure of ASD using ASO is effective and safe therapy. However, significant complications such as aorta to atrial fistula, atrial erosion, or device embolization can happen, so an appropriate selection of patient and device in relevance to size and anatomy of ASD is important for successful closure.

Use of herbal medicine in epileptic children (소아 간질 환자에서 한약 복용 실태)

  • Lee, Jee Yeon;Choi, Wook Sun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.415-419
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    • 2008
  • Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

Patients Setup Verification Tool for RT (PSVTS) : DRR, Simulation, Portal and Digital images (방사선치료 시 환자자세 검증을 위한 분석용 도구 개발)

  • Lee Suk;Seong Jinsil;Kwon Soo I1;Chu Sung Sil;Lee Chang Geol;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.100-106
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    • 2003
  • Purpose : To develop a patients' setup verification tool (PSVT) to verify the alignment of the machine and the target isocenters, and the reproduclbility of patients' setup for three dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT). The utilization of this system is evaluated through phantom and patient case studies. Materials and methods : We developed and clinically tested a new method for patients' setup verification, using digitally reconstructed radiography (DRR), simulation, porial and digital images. The PSVT system was networked to a Pentium PC for the transmission of the acquired images to the PC for analysis. To verify the alignment of the machine and target isocenters, orthogonal pairs of simulation images were used as verification images. Errors in the isocenter alignment were measured by comparing the verification images with DRR of CT Images. Orthogonal films were taken of all the patients once a week. These verification films were compared with the DRR were used for the treatment setup. By performing this procedure every treatment, using humanoid phantom and patient cases, the errors of localization can be analyzed, with adjustments made from the translation. The reproducibility of the patients' setup was verified using portal and digital images. Results : The PSVT system was developed to verify the alignment of the machine and the target isocenters, and the reproducibility of the patients' setup for 3DCRT and IMRT. The results show that the localization errors are 0.8$\pm$0.2 mm (AP) and 1.0$\pm$0.3 mm (Lateral) in the cases relating to the brain and 1.1$\pm$0.5 mm (AP) and 1.0$\pm$0.6 mm (Lateral) in the cases relating to the pelvis. The reproducibility of the patients' setup was verified by visualization, using real-time image acquisition, leading to the practical utilization of our software Conclusions : A PSVT system was developed for the verification of the alignment between machine and the target isocenters, and the reproduclbility of the patients' setup in 3DCRT and IMRT. With adjustment of the completed GUI-based algorithm, and a good quality DRR image, our software may be used for clinical applications.

A Comparative Study on the Curriculum of Nursing Education in America and Korea (한.미 간호 교육과정의 비교 연구 -간호대학과정을 중심으로-)

  • 김정자
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.60-82
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    • 1977
  • The purpose of this study is first, to analyse the present nursing education and the curriculum in Korea in view of the changes and the new tendency of nursing education and second, to compare our curriculum with that of America, where nursing activities are actively earring on and, third, to try to find out what we should reconsider and improve in our nursing education. The object of this study is the educational program and the curriculum from 1973 to 1976 by selecting each five from colleges and department of nursing in Korea and America. The results of the study were as fellows : . 1. The aim of nursing education puts impassion the role of leader, knowledge and technology of nursing, welfare of society and service of community in both the America and Korea. In Korea nursing is mainly restricted to the treatment of diseases, while in the America the items of the aim of nursing are mainly extended to the capacity for Self- realization of nurse, in Korea they are restricted to the treatment of diseases. 2. In Korea the rate of credit of the curriculum of nursing education is the highest in professional education, next in general education, next in supporting science and educational subject, while in America the rate of the credit is the highest in general education, next professional education and then supporting Science and educational subject isn′t included in the curriculum. 3. In both Korea and America the role of the animal credit allotment in general education, is the highest in the first year and the rate in supporting science is the highest in the second year. In Korea professional subjects are concentrated in the third year while in America there is a tendency that they are increasing in number in the grade order. 4. There is a tendency that the rate of the credit allotment of the main professional subjects in curriculum is higher in Korea than in America : that is, in Korea the rate of the allotment of the credit is the highest in medical - surgical nursing, next maternal - child nursing, next community - health nursing and the psychiatric nursing and there in a great difference in the rate of the allotment of each credit. While in America the rate of the allotment of the credit is the highest in community - health nursing, next in medical- surgical nursing, next in maternal - child nursing, and then in psychiatric nursing and there is little difference in the rate of tile allotment of each credit. 5. From general education, supporting science and professional education, they have considered the continuity and sequence in the structure of nursing curriculum of Korea and America. While in Korea we have partly made integration in tile content of the subjects. Most of the school in America, they have made integration in the content of subjects especially in all subjects, but in Korea we haven't made it in all subjects. 6. In the system and form of nursing education Problem solving method, Dialectical method and operational method are introduced in some America schools and in others there is a tendency that the whole nursing education has the system based on Preventive frame - work or Health -illness frame work ; while only one college has an attempt for Health - Illness continue in Korea. 7. In Korea nursing education, as the importance of health- nursing and team nursing, the aim which is also comparatively emphasized is about health management and service of collective community. The subject pertaining to the aim is the studies of community health nursing, which are more in number in America. 8. When we consider the association between the social, general aims ?f the nursing education and the formation of the curriculum in Korean nursing school the courses of study concerning "the role of leadership and cooperative personal relation": "nursing care for the group": dynamic nursing care": and "the system of the public health nursing associated with the understanding of the regional community" are insufficient as compared with those of America. Especially, the lack of the behavioral science including the nursing care connected with the care for the group, the basic science on the clinical and developmental psychology, anthropology in known to be a prominent issue.

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Effects of Stressful Life Events on Patients with Recurrent Ahthous Ulcer. (SRRS를 이용한 재발성 아프타성 구내궤양 환자의 생활변화에 관한 연구)

  • Ko, Myung-Yun;Kim, Young-Ae;Ok, Soo-Min;Heo, Jun-Young;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.195-203
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    • 2012
  • Recurrent aphthous ulcer(RAU) is the most frequent form of oral ulceration with a prevalence in the general population ranging between 5% and 60%. The peak age of onset is between 10 and 19 years of age, and it can persist into adulthood and throughout the patient's lifespan, with no gender predilection. The disease is characterized clinically into three types: minor aphthous ulcer, major aphthous ulcer and herpeticform ulcers. The cause of RAU is unknown and thought to be multifactorial with many triggers or precipitating factors that include familial tendency or genetic predisposition, allergy, medications, hormones, stress or anxiety, and immunologic abnormalities. The need for consideration of psychological factors in the pathogenesis of oral disease has been increasingly acknowledged over the last decades and many studies have highlighted the psycho-social impact of oral conditions. In this study, we tried to evaluate the influence of emotional stress in RAU. There were thirty patients with a clinical diagnosis of RAU and other subjects who did not show any signs of systemic disorders include RAU. They are evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the RAU patients than the control group. Therefore it can be concluded that psychological stressors play an important role in the RAU.

PSYCHIATRIC CHARACTERISTICS OF CHILD PATIENTS WITH INVERSION OF CHROMOSOME 9 - A PRELIMINARY STUDY - (9번 염색체 전위를 지닌 환아들의 정신과적 특성 - 예비적 연구 -)

  • Lee, Jun-Young;Hwang, Jun-Won;Hong, Kang-E;Kim, Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.71-78
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    • 2001
  • Objectives:Few studies have examined the psychiatric properties or child developmental problems associated with inversion of chromosome 9. The purpose of this study is to examine the psychiatric properties of child patients who have inversion of chromosome 9, focused on behavioral problems and child developmental problems like motor or language developmental delay, intellectual impairment, and growth retardation. Methods:1) The authors examined the cases referred for cytogenetic examination from 1984 to 2000 at Seoul National University Hospital in Korea. The cases with the examination result of inversion of chromosome 9 were collected and informations about the departments which referred and the main reasons for referral were also checked. 2) 12 child subjects with inversion of chromosome 9 and their parents underwent psychiatric interview and parent questionnaire(child and adolescent past history questionnare, CBCL). 45 normal students whose sex and age were matched to patients were selected as a control group. Results:1) There were 165 cases of inversion of chromosome 9. The major departments which referred were Obstetrics and Gynecology(47.3%), Pediatrics(23.6%) and Child and Adolescent Psychiatry(17.0%). The major reasons for referral from the Pediatrics and the Child and Adolescent Psychiatry department (67 cases total) were intellectual impairment(35.8%), language or motor developmental delay(31.3%), suspected Fragile X syndrome(23.9%), and growth retardation(20.9%). 2) Compared to normal control group, the rate to be included in the clinical range with regard to the social problems profile was higher in patient group according to the CBCL results. The patient group had language and motor developmental delay. Conclusion:There is a possibility of inversion of chromosome 9 to be associated with child developmental problems or behavioral problems. This study is the first approach to evaluate the developmental aspects associated with inversion of chromosome 9.

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MOLECULAR BIOLOGIC ANALYSIS OF FMR-1 GENE TRINUCLEOTIDE REPEATS IN AUTISTIC PATIENTS (자폐장애 환자에서 FMR-1 유전 삼염기 반복의 분자생물학적 분석)

  • Kwak, Ho-Soon;Chun, Hyo-Jin;Chang, Eun-Jin;Kim, Hee-Cheol;Kim, Jung-Bun;Park, Young-Nam;Jung, Chul-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.3-15
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    • 2000
  • Objectives:There has been a rapid expansion of studies aimed at elucidating the genetic basis of autistic disorder, especially it’ relationship to fragile-X syndrome. The detection of fragile X chromosome(Xq27.3) by cytogenetic analysis has revealed many difficulties in testing. Therefore, to explore the relationship between autistic disorder and fragile X syndrome, this study administered molecular biologic methods which examined an unstable CGG repeat within the fragile X mental retardation-1(FMR-1) gene. Methods:Ninety nine autistic children and eight normal control children were tested. The number of CGG repeats within FMR-1 gene was measured after amplification by PCR, and cytogenetic analysis was also carried out to detect fragile site Xq27.3. Southern blot hybridization, using StB12.3 and/or Pfxa3 probe, was done for the patients showing expansion of more than 50 CGG repeats (premutation). Results:All but two autistic patients had no expansion in CGG repeats by PCR and there was no significant statistical difference in number of CGG repeat in comparison with normal control. Two autistic patients, considered as premutation by PCR analysis, had no full mutation or premutation by Southern blot hybridization. All autistic children tested did not have any abnormal karyotype or fragile site Xq27.3. Conclusions:These results suggest that autistic patients may not have abnormality in FMR-1 gene or abnormal expansion in CGG repeat. In conclusion, fragile X syndrome may not be antecedent of autistic disorder.

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The Correlation Between Early Clinical State and Functional Outcome in Acute Stroke Patients (급성기 뇌졸증 환자의 상태와 기능회복도와의 상관관계)

  • Choi, Eun-Jung;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.2
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    • pp.167-190
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    • 1998
  • Nowadays there were two tendencies of studies about prognostic factors in stroke. One way was to define prognostic factors according to the radiological features. And the other way was to define according to the mental state, recognition, perception, motors, language, urinary&bowel incontinence etc.. The former could be objectively investigated, while the latter was difficult. The purpose of this study was to determine which variables would be predictors of stroke and which factors would be affect predictions most. The subjects of this study were 32 patients who were admitted to the Dept. of Internal Medicine, Dongguk Univ. College of Oriental Medicine whthin 48 hours from attack, Medical records were reviewed FIM, CNS, NIH stroke scale. We compared each sub-items of FIM, CNS, NIH stroke scale about mental state, recognition, perception, motors, language, urinary&bowel incontinence with MBI score at 4 weeks from admission. Also, we analyzed the correlations of sub-items and groups which devided into 5 according to independence of MBI score. And we found out the most influent factors with multiple regression analysis. The major results were as follows; 1. In mean of MBI score at 4 weeks of each groups devided low, middle, high score at mental state, recognition, perception, motors, language, urinary&bowel incontinence items, there were statistical differences in all items. 2. The mental state and lim ataxia sub-items had no significant correlations with groups divided according to independence of MBI score. All the other items were significantly correlated. 3. The most influent factors was recognition. The second was sensory and the third was bowel incontinence. 4. The most influent scales was FIM, and the second was CNS, and NlH had no statistical significancy.

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Imaging Characteristics of Computed Radiography Systems (CR 시스템의 종류와 I.P 크기에 따른 정량적 영상특성평가)

  • Jung, Ji-Young;Park, Hye-Suk;Cho, Hyo-Min;Lee, Chang-Lae;Nam, So-Ra;Lee, Young-Jin;Kim, Hee-Joung
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.63-72
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    • 2008
  • With recent advancement of the medical imaging systems and picture archiving and communication system (PACS), installation of digital radiography has been accelerated over past few years. Moreover, Computed Radiography (CR) which was well established for the foundation of digital x-ray imaging systems at low cost was widely used for clinical applications. This study analyzes imaging characteristics for two systems with different pixel sizes through the Modulation Transfer Function (MTF), Noise Power Spectrum (NPS) and Detective Quantum Efficiency (DQE). In addition, influence of radiation dose to the imaging characteristics was also measured by quantitative assessment. A standard beam quality RQA5 based on an international electro-technical commission (IEC) standard was used to perform the x-ray imaging studies. For the results, the spatial resolution based on MTF at 10% for Agfa CR system with I.P size of $8{\times}10$ inches and $14{\times}17$ inches was measured as 3.9 cycles/mm and 2.8 cycles/mm, respectively. The spatial resolution based on MTF at 10% for Fuji CR system with I.P size of $8{\times}10$ inches and $14{\times}17$ inches was measured as 3.4 cycles/mm and 3.2 cycles/mm, respectively. There was difference in the spatial resolution for $14{\times}17$ inches, although radiation dose does not effect to the MTF. The NPS of the Agfa CR system shows similar results for different pixel size between $100{\mu}m$ for $8{\times}10$ inch I.P and $150{\mu}m$ for $14{\times}17$ inch I.P. For both systems, the results show better NPS for increased radiation dose due to increasing number of photons. DQE of the Agfa CR system for $8{\times}10$ inch I.P and $14{\times}17$ inch I.P resulted in 11% and 8.8% at 1.5 cycles/mm, respectively. Both systems show that the higher level of radiation dose would lead to the worse DQE efficiency. Measuring DQE for multiple factors of imaging characteristics plays very important role in determining efficiency of equipment and reducing radiation dose for the patients. In conclusion, the results of this study could be used as a baseline to optimize imaging systems and their imaging characteristics by measuring MTF, NPS, and DQE for different level of radiation dose.

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THE FISSURE PENETRATION AND MICROLEAKAGE OF PIT AND FISSURE SEALANT WITH MECHANICAL PREPARATION (기계적 삭제방법을 이용한 치면열구전색제의 열구 침투도 및 미세누출)

  • Kim, Ji-Yeon;Lee, Jae-Ho;Park, Ki-Tae;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.164-173
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    • 2005
  • Mechanical preparation has been introduced to provide the sealant retention. The objective of this study was to compare the fissure penetration and the microleakage of pit and fissure sealant using mechanical preparation(mechanical preparation + acid etching) and acid etching only. An additional objective of this study was to compare the fissure penetration and the microleakage of unfilled and filled sealant in both methods. Sixty human premolars extracted for orthodontic purpose were selected. Thirty teeth were acid etched alone and remaining thirty teeth were prepared with a $\frac{1}{4}$ round bur and then acid etched. One-half of teeth in each surface treatment method were sealed with unfilled sealant and the other half were sealed with filled sealant. All of the teeth were thermocycled for 1200 cycles at $5^{\circ}C\;and\;55^{\circ}C$ and immersed in 5% methylene blue for 24 hours. Each tooth was sectioned bucco-lingually at mesial pit and distal pit and examined under a Measurescope. In the case of mechanical preparation, fissure penetration of sealant was significantly increased compared with the case of acid etching only(P < 0.05). The filled and unfilled sealant using mechanical preparation showed significantly decreased microleakage when compared with the unfilled sealant using acid etching only(P < 0.05). No differences were found in fissure penetration and microleakage between unfilled and filled sealant in both methods. Taken together, the results of this study suggest that mechanical preparation and filled sealant are recommended when placing pit and fissure sealant. However, further clinical studies should be performed in regard to microleakage.

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