• Title/Summary/Keyword: 간이 진단

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Diffusion-Weighted MR Imaging of the Brain Tumors: The Clinical Usefulness (두개강내 종양의 확산강조자기공명영상: 임상적 유용성)

  • 이영철;서정진;정광우;강형근;김윤현
    • Investigative Magnetic Resonance Imaging
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    • v.4 no.1
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    • pp.34-41
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    • 2000
  • Purpose: To evaluate the clinical usefulness of diffusion weighted MR imaging(DWI) in the differential diagnosis of brain tumors. Materials and methods: DWI and conventional MR images of nineteen patients with brain tumors(10 metastatic tumors, 4 high grade gliomas, 4 low grade astrocytomas, one oligodendroglioma)were obtained on 1.5T unit. DWI was obtained using single shot spin echo planar imaging with b-value near 1000. We analyzed the signal intensities of lesions including solid portion, necrotic or cystic portion and peritumoral edema of brain tumors (classified five grades comparison with the signal intensities of brain parenchyma and CSF)and calculate the SIR(signal intensity ratio)of lesions to the contralateral normal brain parenchyma. We analyzed statistically the signal intensities and SIR of tumors using independence T test. Results: In solid portions of tumors, all the metastatic tumors and high grade gliomas showed high signal intensities, but low grade astrocytomas and oligodendroglioma showed iso or slight high signal intensities to the normal brain parenchyma. The SIR of solid portion has positive correlation with malignant pot ential(metastatic tumors 1.52, high grade gliomas 1.38, low grade astrocytomas 1.16, oligodendroglioma 1.31)(p < 0.05). In peritumoral edema where seen in 14 tumors, seven of 10 metastatic tumors and two of 4 high grade gliomas showed iso signal intensities, whereas edemas in other 5 brain tumors showed hyperintense to the normal brain parenchyma. The SIRs of peritumoral edemas in metastatic tumors (1.14) was lower than high grade gliomas(1.31),but statistically insignificant. The SIR of cystic or necrotic portion of brain tumors was 0.63. In non enhancing solid portions, three of six cases showed hyperintense to the adjacent peritumoral edema. Conclusion: On DWI, the signal intensities of solid portion has positive correlation with malignant potential, and perilesional edema of brain tumors appear various signal intensities owing to "T2 shine through effect" and the extensiveness of vasogenic edema. Another merit using DWI on the evaluation of brain tumors is to improved better delineation of tumor margins from the adjacent edemas, especially at the non enhancing solid portion of the tumors.

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Helicobacter pylori reinfection rate by a 13C-urea breath test and endoscopic biopsy tests in Korean children (한국 소아에서 Helicobacter pylori 박멸 후 13C-요소 호기 검사와 내시경적 생검을 이용한 재감염률 연구)

  • Shim, Jeong Ok;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.268-272
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    • 2006
  • Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

Effects of X-ray Irradiation on the Survival Rate and Weight of the Rhinoceros Beetle Larvae (X선 이 장수풍뎅이 유충의 체중과 생존율에 미치는 영향)

  • Lee, Won-Jeong;Lim, Dong-Hwan;Park, Jeong-Soon;Sim, Yeung-Eun;Jeong, Yoo-Jin;Kim, Jeong Ho;Yoo, Se Jong
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.271-277
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    • 2020
  • The Purpose of this study was to examine the survival rate and weight of rhinoceros beetle larvae by irradiating X-rays which are most commonly used in diagnosing and treating for diseases. Subjectts and Methods: In early April 2019, the rhinoceros beetle larvae 41 were classified into two groups as control group (11 larvae) and irradiated group (10 Gy, 20 Gy, 30 Gy, each 10 larvae). The irradiated group was exposed by 6 MV X-ray using linear accelerators (Clinac IS, VERIAN, USA) at the University Hospital in Daejeon (Source-surface distance 96 cm, field size 18 × 10 cm, dose rate 600 MU/min), after environmental adaptation for 3 days (temperature 20.6℃, humidity 64.3%). The survival rate and weight were measured weekly after irradiating X-ray. All statistical analyses were performed using the SPSS ver. 22.0 (Chicago, IL, USA). The weight was analysed by Independent T-test, by cross-sectional analysis for survival rates between control and X-ray irradiated groups. Also, the correlation between dose and weight was analyzed by Spearman test. In 3-week after irradiating X-ray, weight was significant difference between control group and irradiated group (10 Gy or 20 Gy, p < 0.05; and 30 Gy, p < 0.01) with increasing weight in all experimental groups. In 14-week, weight was increased in the control group, but decreased in irradiated group. weight was significant difference between control group and irradiated group. The survival rate in 3-week was decreased rapidly in all experimental group except 10 Gy, to 4-week in irradiated group. The control group had no change in survival rate 54.5% from 3-week to 14-week. From the 3-week, it showed lower survival rate with increasing radiation dose in irradiated group. In 19-week, survival rate of control group and 10 Gy was 45.4% and 30.0% respectively, all died in 20 Gy and 30 Gy. Weight was significantly negative correlated with radiation dose as longer time after irradiating X-ray. The weight and survival rate of rhino beetle larvae is affected by irradiating X-rays, weight and survival rate decreased more in higher dose.

The Study of Influence on Reducing Exposure Dose According to the Applied Flat-panel CT in Extremity Bone SPECT/CT (상·하지 뼈 SEPCT/CT 검사에서 평판형 CT의 피폭저감 영향에 관한 고찰)

  • Kim, Ji-Hyeon;Park, Hoon-Hee;Lee, Juyoung;Nam-Kung, Sik;Son, Hyeon-Soo;Park, Sang-Ryoon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.15-24
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    • 2013
  • Purpose: With the demand of SPECT/CT increasing, the interest in complex diagnostic information of CT is rising along with the expansion of various studies on potential performance value. But the study on reduction of exposure dose generated by CT is not being conducted enough. Therefore, in this study, the goal is to identify how much dose reduction exists when performing the extremity bone SPECT/CT using the flat-panel CT. Materials and Methods: The extremity bone SPECT/CT was performed with two equipments -BrightView XCT (Philips Healthcare, Cleveland, USA) and Brilliance 16 CT (Philips Healthcare, Cleveland, USA)-to identify the exposed dose and image quality resulted by changing scan parameter (mAs) applying for both equipment respectively. The noise value of image and spatial resolution were measured with AAPM CT phantom. Tube voltage (kVp) was fixed to 120 kVp, tube current (mAs) calculated at different mA (20, 30, 40, 50, 60, 70, 80) was applied to both equipments respectively. DLP (dose length product) were calculated at the same distance at respective mAs. Also, we acquired images and % contrast with NEMA IEC body phantom to confirm the effect on image. The output of statistics was analyzed by SPSS ver.18. Results: Regarding AAPM phantom, the noise decreased as the tube current (mAs) increased and flat-panel had less noise than Helical CT. This difference increased at lower dose exposure. As to the evaluation of spatial resolution, we can differentiate the space up to 0.75 mm with both equipments. With scan parameter (mA) growing, the value of DLP increased up to 54-216 mGy cm at flat-panel CT and up to 177-709 mGy cm at Helical CT. Regarding NEMA IEC body phantom, same sphere with varied parameter (mA) shows that similar results. Conclusion: There is no significant differences of image quality in both flat-panel and Helical CT when the scan parameter (mA) is changed respectively. Moreover, we can identify the reduction of exposure dose and confirm %contrast analysis value with maintaining image quality. Therefore, at the extremity bone SPECT/CT requiring high spital resolution without the wide ROI, the flat-panel CT is considered to be more useful and it expected to result in the similar image quality with lower exposure dose compared to Helical CT. Additionally, through this study, we expect to help the reduction of the unnecessary exposure dose.

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A COMPARATIVE STUDY ON AUDITORY ATTENTION AND PHONEME DIFFERENTIAL ABILITY AMONG CHILDREN WITH READING DISABILITY AND WITH ATTENTION DEFICIT/HYPERACTIVITY (읽기 장애와 주의력 결핍/과잉 운동 장애아동의 주의력 과제와 음소 변별 과제 수행 비교 - 청각 과제를 중심으로 -)

  • Lee, Kyung-Hee;Shin, Min-Sup;Kim, Boong-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.197-208
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    • 2003
  • Objective:In this study, we hypothesized that deficit in processing rapid linguistic stimuli is at the heart of Reading Disability(RD) and deficit in response inhibition is at the heart of Attention Deficit/Hyperactivity(ADHD). We conducted experiments to identify the core cognitive characteristics of children either with RD or with ADHD or with both, using attentional tasks and phoneme differential tests. Method:In the study 1, 28 children with ADHD, 16 children with RD+ADHD were individually administered visual/auditory performance tests. Then, the differences of performance on attentional tasks between two groups were compared while IQs of two groups were controlled. In the study 2, 13 children with RD+ADHD/RD, 13 children with ADHD, and 13 normal children were administered computerized phoneme differential tests. Result:Visual attentional tasks did not distinguish an ADHD group from a RD+ADHD group. With auditory attentional tasks, however, the comorbid group showed significantly more difficulties, causing a large variance in reaction time. RD, RD+ADHD, and ADHD groups showed more errors in phoneme differential tests than a normal control group, and each group showed distinctive performance patterns. Discussion:An ADHD group had difficulty in response inhibition and sustained attention, and children who also had RD along with ADHD magnified the auditory attentional difficulties. Even though children with RD had more trouble with responding correctly to target stimuli, their responses were not significantly different from those of children with ADHD.

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Evaluation of Average CT to Reduce the Artifact in PET/CT (PET/CT 검사에서 호흡에 따른 인공산물을 줄이기 위한 Average CT의 유용성)

  • Kim, Jung-Sun;Nam, Ki-Pyo;Park, Seung-Yong;Ryu, Jae-Kwang;Cha, Min-Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.3-7
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    • 2010
  • Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

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STS and the Innovation of Sociology: Focusing on Actor-Network Theory (STS(과학기술학)와 사회학의 혁신: 행위자-연결망이론(ANT)을 중심으로)

  • Kim Hwan-Suk
    • Journal of Science and Technology Studies
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    • v.1 no.1 s.1
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    • pp.201-234
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    • 2001
  • Sociology(or social science in general) is often diagnosed as in the state of 'crisis' after the collapse of socialism and the erosion of national societies because of rapid globalization. This paper introduces some recent work within science and technology studies(STS) and discusses its potentials to reinvigorate sociology. Although sociologists have rarely regarded STS as contributing to 'mainstream' issues in sociology, an increasing number of STS writers and sociologists have recently started to notice such possibilities. One main reason of this recent change is that STS is no longer merely concerned to convey substantive findings about science and technology, but instead attempts to reconstruct key notions of sociology such as 'social', 'society' and 'agency'. It is in this respect that the discussion below aims to introduce, discuss, and assess the potential contribution of some recent work of STS to sociology. In particular, it is 'actor-network theory'(ANT) that explicitly attempts to examine and suggest the ways in which STS ran help innovate sociology. One major characteristics of ANT is to impute 'agency' to things(nonhumans) unlike traditional sociology. ANT argues that if sociology studies heterogeneous relationships between humans and nonhumans instead of human relations only, it can become once again a vigorous discipline which is able to provide alternative worlds central to the basis of sociology. So this paper focuses on, not the diverse approaches of STS, the characteristics of ANT and its potential contribution to sociology. The author concludes that ANT can not only rejuvenate sociology by implicating new forms of alternative worlds but also open the possibility to contribute to the democratic reformulation of human-nonhuman relationships.

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Comparison of the Medication Effects between Milnacipran and Pregabalin in Fibromyalgia Syndrome Using a Functional MRI: a Follow-up Study (섬유근통 환자에 대한 Milnacipran과 Pregabalin 약물치료에 대한 기능적 자기공명영상에서의 후속 영향 비교)

  • Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.341-351
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    • 2014
  • Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

Psychosocial Factors Related with the Intake of Vegetables and Fruits by Stage of Change of Elementary School Children in Chungnam Province (행동변화 단계에 따른 충남지역 초등학생의 채소와 과일 섭취 관련 사회 심리적 요인)

  • Suh, Yoon-Suk;Choi, Ae-Sook;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.42 no.7
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    • pp.639-649
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    • 2009
  • This study aims at investigating the psychosocial factors that influence on the intake of fruits and vegetables according to stage of change in rural children. Total 256 elementary school children, located in Yeongi-Gun, Chungnam-Do were surveyed from May 14 2007 to May 30 2007. Stage of change on the intake of fruits and vegetables of the students was categorized into three stages: precontemplation (PC), contemplation & preparation (CO&PR) and action (AC). Psychosocial factors consist of decisional balance based on pros and cons, process of change of cognitive and behavioral processes, and self-efficacy. The recognition of cons out of decisional balance showed the highest score in the subjects at the stage of PC and lowest score in those action stage. While, no difference was shown in the score of recognition of pros among the stages. Both levels of cognitive and behavioral process of change showed no difference between two pre-action stages, PC and CO&PR. However, the subjects of action stages got higher scores in more number of the variables in both of cognitive and behavioral process of change compared to those of pre-action stages with more remarkable in results vegetables than in fruits. The results of self-efficacy on fruits and vegetables intake showed that the higher stages of change, the higher the self-efficacy score. From the result, it is suggested that the items and level of psychosocial factors are different according to the stage of change and between fruits and vegetables in rural children.

Clinical Features of and Antibiotic Resistance in Recurrent Urinary Tract Infection in Children with Vesicoureteral Reflux

  • Eun, So Hyun;Kang, Ji-Man;Kim, Ji Hong;Kim, Sang Woon;Lee, Yong Seung;Han, Sang Won;Ahn, Jong Gyun
    • Pediatric Infection and Vaccine
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    • v.27 no.1
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    • pp.35-44
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    • 2020
  • Purpose: This study aimed to investigate the clinical features of recurrent urinary tract infection (UTI) in children with vesicoureteral reflux (VUR) and to compare the causative uropathogen and antibiotic susceptibility between the first and recurrent UTI episodes. Methods: We retrospectively reviewed the medical records of children with VUR who had recurrent UTI. Group 1 included patients in whom the same pathogen caused the first and recurrent UTI episodes. Group 2 included patients in whom different pathogens caused the first and recurrent UTI episodes. Results: During a 13-year study period (2005-2018), 77 children with VUR experienced at least one episode of UTI. Among these, 47 patients (61.0%) had recurrent UTI. Of the children with recurrent UTI, 19 (40.4%) were in group 1 and 28 (59.6%) were in group 2. Escherichia coli was the most commonly isolated uropathogen (n=37; 39.4%) in both episodes of recurrent UTIs, followed by Klebsiella pneumoniae (n=18; 19.1%), Enterococcus faecalis (n=14; 14.9%), and Enterobacter aerogenes (n=7; 7.4%). Although the difference was not significant, the rate of resistance to the antibiotics ceftazidime, piperacillin/tazobactam, and trimethoprim-sulfamethoxazole increased in patients with the second episode of E. coli recurrence in group 1, and that to cefotaxime, ceftazidime, piperacillin/tazobactam, and meropenem increased in children with the second episode of E. aerogenes recurrence in group 1. Conclusions: When selecting empirical antibiotics for recurrent UTI in children with VUR, it is important to consider that the pathogen and antimicrobial susceptibility of the previous UTI are not always the same in recurrent UTIs.