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Craniofacial morphologic alteration induced by bone-targeted mutants of FGFR2 causing Apert and Crouzon syndrome (어퍼트 및 크루즌 증후군을 유발하는 골조직 특이성 FGFR2 돌연변이에 의한 두개안면 형태의 변화)

  • Lee, Kee-Joon;Nah, Hyun-Duck;Tjoa, Stephen T. J.;Park, Young-Chel;Baik, Hyoung-Seon;Yun, Tae-Min;Song, Jin-Wook
    • The korean journal of orthodontics
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    • v.36 no.4
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    • pp.284-294
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    • 2006
  • Objective: Activating mutations in the fibroblast growth factor receptor-2 (FGFR2) have been shown to cause syndromic craniosynostosis such as Apert and Crouzon syndromes. The purpose of this pilot study was to investigate the resultant phenotypes induced by the two distinctive bone-targeted gene constructs of FGFR2, Pro253Arg and Cys278Phe, corresponding to human Apert and Crouzon syndromes respectively. Methods: Wild type and a transgenic mouse model with normal FGFR2 were used as controls to examine the validity of the microinjection. Micro-CT and morphometric analysis on the skull revealed the following results. Results: Both Apert and Crouzon mutants of FGFR2 induced fusion of calvarial sutures and anteroposteriorly constricted facial dimension, with anterior crossbite present only in Apert mice. Apert mice differed from Crouzon mice and transgenic mice with normal FGFR2 in the anterior cranial base flexure and calvarial flexure angle which implies a possible difference in the pathogenesis of the two mutations. In contrast, the transgenic mice with normal FGFR2 displayed normal craniofacial phenotype. Conclusion: Apert and Crouzon mutations appear to lead to genotype-specific phenotypes, possibly causing the distinctive sites and sequence of synostosis in the calvaria and cranial base. The exact function of the altered FGFR2 at each suture needs further investigation.

A Study on Subjective Symptoms of a Oral Malodor in Korean Adults (한국 성인의 주관적 구취 자각증상에 대한 연구)

  • Yoon, Mi-Sook;Youn, Hye-Jeong
    • Journal of dental hygiene science
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    • v.8 no.3
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    • pp.123-129
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    • 2008
  • The purpose of this study was to investigate the actual conditions of the subjective oral malodor perception of the survey subjects. Through the subjective questionnaire method over about 3 months from June to August in 2007, the data was collected targeting 275 adults. Statistical methods used were Chi-square test, Fisher's exact test and One-way ANOVA. And, the following results were obtained. 1. When having seen the ratio of those who were conscious of oral malodor, the adults, who responded with saying of feeling oral malodor at present and at ordinary times, accounted for 68.4% and 79.3%, respectively. And, the adults, who responded with saying of not feeling, were indicated to be 31.6%(at present) and 20.7%(at ordinary times), respectively. 2. Almost 83.5% of total people answered that they had most severe oral malodor at the time of awakening and 51.9% of subjects answered tongue contributed to the their oral malodor. 3. About the type of oral malodor, although 37.2% of the group thought the type of oral malodor was a food smell and fetid smell was second general burning smell occurred the time of hunger(22.5%). 4. In the answers of hoping for treatment of oral malodor, 66.9% of the people showed positive response to dental treatment for controlling their oral malodor. Especially 7.3% of subjects showed very big desire for treatment. 5. In the level of oral malodor that is felt now according to the time of a meal, the case of within 1 hour after having a meal was responded to be not felt the oral malodor with 44.7%. And, there was response with saying of not feeling oral malodor in 37.6% as for 1-2 hours, 16.3% as for 2-3 hours, 14.8% as for 3-4 hours, and 23.7% as for more than 4 hours. Thus, the level of oral malodor according to the time of a meal showed the statistically significant difference(p<0.01). Through the results of this study, it could be known about whether or not being conscious of oral malodor in general people, the main cause and region for oral malodor, the importance and practicing method of tongue brush through literature. Accordingly, there is necessity of further researching and comparing whether or not being conscious of oral malodor by diversely surveying relevancy with factors of causing oral malodor based on the objective oral malodor measurement value. The future diverse researches are thought to be necessarily performed in order to prevent or reduce oral malodor.

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Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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Development and Performance Evaluation of an Animal SPECT System Using Philips ARGUS Gamma Camera and Pinhole Collimator (Philips ARGUS 감마카메라와 바늘구멍조준기를 이용한 소동물 SPECT 시스템의 개발 및 성능 평가)

  • Kim, Joong-Hyun;Lee, Jae-Sung;Kim, Jin-Su;Lee, Byeong-Il;Kim, Soo-Mee;Choung, In-Soon;Kim, Yu-Kyeong;Lee, Won-Woo;Kim, Sang-Eun;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.445-455
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    • 2005
  • Purpose: We developed an animal SPECT system using clinical Philips ARGUS scintillation camera and pinhole collimator with specially manufactured small apertures. In this study, we evaluated the physical characteristics of this system and biological feasibility for animal experiments. Materials and Methods: Rotating station for small animals using a step motor and operating software were developed. Pinhole inserts with small apertures (diameter of 0.5, 1.0, and 2.0 mm) were manufactured and physical parameters including planar spatial resolution and sensitivity and reconstructed resolution were measured for some apertures. In order to measure the size of the usable field of view according to the distance from the focal point, manufactured multiple line sources separated with the same distance were scanned and numbers of lines within the field of view were counted. Using a Tc-99m line source with 0.5 mm diameter and 12 mm length placed in the exact center of field of view, planar spatial resolution according to the distance was measured. Calibration factor to obtain FWHM values in 'mm' unit was calculated from the planar image of two separated line sources. Te-99m point source with i mm diameter was used for the measurement of system sensitivity. In addition, SPECT data of micro phantom with cold and hot line inserts and rat brain after intravenous injection of [I-123]FP-CIT were acquired and reconstructed using filtered back protection reconstruction algorithm for pinhole collimator. Results: Size of usable field of view was proportional to the distance from the focal point and their relationship could be fitted into a linear equation (y=1.4x+0.5, x: distance). System sensitivity and planar spatial resolution at 3 cm measured using 1.0 mm aperture was 71 cps/MBq and 1.24 mm, respectively. In the SPECT image of rat brain with [I-123]FP-CIT acquired using 1.0 mm aperture, the distribution of dopamine transporter in the striatum was well identified in each hemisphere. Conclusion: We verified that this new animal SPECT system with the Phlilps ARGUS scanner and small apertures had sufficient performance for small animal imaging.

Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease (관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성)

  • Lee, Duk-Young;Bae, Jin-Ho;Lee, Sang-Woo;Chun, Kyung-Ah;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Ha, Jeoung-Hee;Chae, Shung-Chull;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.6
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    • pp.473-480
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    • 2005
  • Purpose: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. Methods: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into na segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. Results: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade storing system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studios. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p<0.001) Conclusion: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.

Examination about Utility of Prone Position in PET/CT of Stomach Cancer Patient (위암 환자의 양전자 방출 컴퓨터 단층 검사에서 복와위(伏臥位) 촬영의 유용성에 대한 연구)

  • NamKoong, Hyuk;Park, Hoon-Hee;Oh, Shin-Hyun;Bahn, Yung-Kag;Kim, Jung-Yul;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.93-99
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    • 2010
  • Purpose: Currently, PET/CT scan has been known to provide useful information to both preoperative and postoperative examination of cancer patients. Contracted stomach by the long fasting could cause difficulties of interpretation because of its size on reconstructed image data. To solve this problem, after the whole body PET/CT scan, patients were administrated in drinking 300 mL of water to expand stomach and performed additional scan on stomach region. Not only PET/CT scan but also CT performs this water-administration, and patients were take oral solution to make stomach expand for stomach cancer. When this scan performed, patients lay supine position. In this study, we evaluated the capacity of stomach through PET/CT scan with drinking water performed in supine and prone position so that we can distinguish exact location of cancer around pylorus and inferior wall of stomach. Furthermore, image data from supine and prone positions were analyzed the difference of volume of stomach through the change of standardized uptake values. Materials and Methods: From July 2009 to January 2010 in severance hospital, 30 patients who were diagnosed as early gastric cancer or advanced gastric cancer were chosen. All patients had PET/CT scan before the operation and have had follow-up PET/CT. The patients fast for at least 8 hours, and had an injection intravenously with $^{18}F$-FDG, 7.4 MBq (0.2 mCi/kg) per kilogram. They were rested for 60 minutes. Before the examination, all patients were administrated to drink water for 300 mL Patients had PET/CT scan with supine position around the region of stomach, whole body, and around the region of stomach with prone position after drinking another 300 mL of water respectively. Results: As a results of comparison between stomach capacity of 30 patients in supine and prone position, the study draw results that average capacity of stomach body was 460.29 $mm^2$ in supine position, and 641.39 $mm^2$ in prone position for 30 patients. The change of capacity shows 41.3% expanded in prone position. And there was no noticeable difference at maximum standardized uptake values in supine position and prone position. Conclusion: As results, stomach would have more expanded capacity in prone position than supine position. For patients who have physical disabilities to move freely, additional scan in prone position will be obstacle to perform. However, if additional scan in supine position add with the scan in prone position, it will be easier to diagnose stomach cancer. Moreover, we believe that this study will help the research for inventing support tools for patients who have physical disabilities in prone position.

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The Analysis of Blood Glucose Level Difference According to the Exact Use of Blood Glucose Measurement Test Strips in $^{18}F$-FDG Wholebody PET ($^{18}F$-FDG를 이용한 전신 PET 검사에서 혈당 측정 검사지의 정확한 사용에 따른 혈당 수치의 차이 분석)

  • Park, Soon-Ki;Lee, Nam-Ki;NamGung, Chang-Kyung;Jung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.100-103
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    • 2010
  • Purpose: $^{18}F$-FDG wholebody PET is to evaluate the tumor using glucose metabolism. The blood glucose level is important factor that affects on a result of examination. High glucose levels may interfere with tumor targeting due to competitive inhibition of FDG uptake by D-glucose. The blood glucose level measurement test strips used in the blood glucose measurement are classified into the capillary blood measurement test strips and general purpose measurement test strips that can measure the venous blood and capillary blood altogether depends on cases. The purpose of the study was to compare the blood glucose measurements between simultaneously obtained capillary and venous blood samples using the capillary blood measurement test strips, general purpose measurement test strips. Materials and Methods: A total of 46 subjects (32 males, 14 females) with a mean age of $57.3{\pm}12.3$ years were enrolled. The blood glucose estimation was performed with a Optium Xceed Glucometer (Abbott). Simultaneous capillary and venous blood samples were obtained from each subject. The blood glucose levels were measured using the capillary blood measurement test strips and general purpose measurement test strips. The capillary and venous measurements were compared using a pared t-test. Results: The mean capillary and venous glucose values using the general purpose measurement test strips were $95.2{\pm}12.4$ mg/dL and $104.1{\pm}14.4$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (9.0 mg/dL; 95% confidence interval (CI) -11.2 to -6.7). The mean capillary and venous glucose values using the capillary blood measurement test strips were $91.5{\pm}13.6$ mg/dL and $108.6{\pm}16.2$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (16.6 mg/dL; 95% CI -20.2 to -13.0). Conclusion: When measuring the blood glucose level before $^{18}F$-FDG PET examination, since the incorrect blood glucose level can be measured, it should note to measure the blood glucose level of the venous blood by the capillary blood measurement test strips. Therefore the measurement variation can be reduced to fulfill the standardized measurement procedure with the suitable measurement test strips, the preparation of the PET examination will be able to be clearly confirmed. In addition, the standardized procedure of the following measurement on the area which is same at all times the blood area in the blood glucose measurement among a capillary or a vein will be needed.

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The Role of Initial Relative Renal Function in Unilateral Hydronephrosis (일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미)

  • Han Sang-Won;Kang Seon-Jung;Kwon Min-Jung;Kim Dae-Joong;Choi Seung-Kang;Lee Tack
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.203-208
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    • 1999
  • Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

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Clinical Observations on 12 Children with Alport Syndrome (Alport 증후군 환아 12명의 임상적 고찰)

  • Bae Young-Min;Kim Seoung-Do;Kang Hyeon-Ho;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.48-56
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    • 2000
  • Purpose: Alport SD., the most common herectitary rephriris, is a renal disease with rapid progression. Deafness, ocular abnormalities and a specific EM finding may be associated in addition to a family history. We have aralyged retrospectively. Methods: We observed 12 children with Alport syndrome who were diagnosed at Dept. of pediatrics in Kyunghee Univ., College of Medicine, from Apr. 1991 until Jun. 1999. We used four criteria for diagnosis: renal disease, family history, deafness or eye abnormalities, and a specific finding in electron microscopy Results: 2 of 12 patients had all features of the four diagnostic criteria. We could not trace an exact family history in 3 patients, and 6 patients did not exhibit deafness or eye abnormality. One could not have renal biopsy because offer chronic renal failure. Other three criteria were observed in her. The ratio of male to female observed was 1:2 respectively and the mean age of initial renal symptom was 5.6 years. 9 of 12 patients had a family history of renal disease. In the audiogram and ocular examination for 11 of 12 cases, sensorineural hearing loss was observed in 6 and ocular abnormality in 2 cases. In electron microscopic finding, irregular thickness of the capillary basement membranes with lamination of lamina densa and foot process obliteration was noted in 9 of 11 and thin basement membrane with splitting and foot process obliteration was noted in the other 2. The mean period of follow-up was 3 6/12 years. And one patient developed the chronic renal failure until now and had kidney transplantation. Conclusion: For the diagnosis of Alport syndrome, the following four diagnostic criteria are very important : renal disease, family history, deafness or eye abnormalities, and a specific finding on electron microscopy. We expect that more patients can be detected through the analysis of these characteristics.

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Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit (신생아중환자실에 입원한 미숙아에서 영양지원팀 활동의 임상적 의의)

  • Yang, Hye-Ran;Choi, Chang-Won;Kim, Beyong-Il;Seo, Jeong-Kee;Choi, Su-Ahn;Kim, So-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.39-45
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    • 2009
  • Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M:F=27:21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

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