• Title/Summary/Keyword: 고려의학

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Studies on the Comparative Analysis Between GE Prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool (골절의 절대위험도 평가방법에서 GE Prodigy와 FRAX Tool의 비교분석에 관한 고찰)

  • Lee, Hwa-Jin;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.137-142
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    • 2009
  • Purpose: World Health Organization (WHO) have suggested that an individual's 10-year absolute fracture risk is more reliable than Bone Mineral Density (BMD) measurement as the predictor of osteoporotic fracture. In 2008, Fracture Risk Assessment Tool ($FRAX^{TM}$) was developed by WHO to evaluate fracture risk of patients based on individual's clinical risk factors. The purpose of this study is to offer the comparative analysis of the existing GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Materials and Methods: 201 women ($55{\pm}3.5$ years) underwent femoral neck BMD measurement using GE Prodigy. The 10-year probability (%) of hip fracture (or a major osteoporosis-related fracture) was estimated using T-scores of GE prodigy and $FRAX^{TM}$. We made a comparative analysis of these data using SPSS (Ver.12). Results: There was a significant difference statistically between T-score ($-0.52{\pm}0.97$) of GE prodigy and T-score ($-1.45{\pm}0.81$) of $FRAX^{TM}$ (r=0.977, p=0.000). Also, there was a significant difference statistically between a major osteoporosis- related fracture ($9.15{\pm}3.71$) of GE prodigy and a major osteoporosis-related fracture ($4.87{\pm}1.51$) of $FRAX^{TM}$ (r=0.909, p=0.000). Moreover, a statistically significant difference was found in the 10-year probability of hip fracture of GE prodigy ($1.56{\pm}1.48$) and of hip fracture ($0.53{\pm}0.61$) of $FRAX^{TM}$ (r=0.905, p=0.000). Conclusions: There was a significant difference statistically between GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Especially, T-score, a major osteoporosis-related fracture and the 10-year probability of hip fracture that were estimated using GE prodigy tended to show the higher results than one evaluated by $FRAX^{TM}$ Tool. In conclusion, $FRAX^{TM}$ Tool may provide a better tool. The application of $FRAX^{TM}$ Tool as a fracture predictor remains to be clarified.

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Research on the Reduction of Exposure Dose of a Patient Having a PET/CT Exam (PET/CT 검사 환자의 피폭선량 경감을 위한 연구)

  • Kim, Bong-Su;Pyo, Sung-Jai;Cho, Yong-Gyi;Shin, Chai-Ho;Cho, Jin-Woo;Kim, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.10-16
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    • 2009
  • Purpose: As the number of patients has increased since the installation of a PET/CT, we are now examining about 2500-3000 annually. We have realized that if we properly adjust a pitch under the same condition of a CT during a PET/CT exam, radiation quantity that reaches the patient can change. In order to reduce the exposure dose of a patient, the research examines a method of reducing the exposure dose of a patient by controlling the pitch during a PET/CT exam, viewing whether the adjustment of the pitch influences CT image and PET SUV. Methods: The equipment used is a Biograph Positron Emission Tomography (PET) Scanner (CT type: TRCT-240-130 (WCT-240-130)) of Siemens company. For the evaluation of exposure dose of a patient, we measured radiation quantities using a PTW-DIADOS 11003/1383, which is a CT radiation measurement instrument used by Siemens. We measured and analyzed the space resolutions of CT images caused by the change of pitches using an AAPM Standard Phantom in order to see how the adjustment of pitches influenced the CT images. In addition, in order to obtain SUVs caused by each change of pitches using a PET source made with a solid radioactive cylinder phantom, we confirmed whether the SUVs changed in the PET/CT images by calculating the SUVs of the fusion images caused by the change of pitches after obtaining CT and PET images and finishing the test. Results: 2slice CT scanner showed that radiation quantities largely dropped when pitches ranged from 0.7 to 1.3 and that the reduction of radiation quantities were smaller when pitches ranged from 1.5 to 1.9. That is, we found that the bigger pitch values are the smaller the radiation quantities of a patient are. Moreover, we realized that there is no change of SUVs caused by the increase of pitches and that pitch values do not influence PET SUVs and the quality of CT images. It is judged that using 1.5 as a pitch value contributes to the reduction of exposure dose of a patient as long as there is no problem in the quality of an image. Conclusions: When seeing the result of the research, hospital using a PET/CT should make an effort to reduce the exposure dose of a patient seeking pitch values appropriate for their hospital within the range in which there is no image distortion and PET SUVs are not influenced from pitches. We think that the research can apply to all multi-detectors having a CT scanner and that such a research will be needed for other equipments in the future.

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The Correlation Analysis of Stress/Rest Ejection Fraction of $^{201}Tl$ Gated Myocardial Perfusion SPECT ($^{201}Tl$ 게이트 심근관류 스펙트에서의 휴식기와 부하기 좌심실 구혈률 상관관계 분석)

  • Kim, Dong-Seok;Yoo, Hee-Jae;Shim, Dong-Oh
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.3-9
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    • 2009
  • Purpose: It is well-known that stress-induced stunning and reversible perfusion defect have impact on ejection fraction (EF) when performing myocardial perfusion SPECT. Due to these reasons, gated SPECT is recommended at stress and rest studies. And there was many experiments to analyze between Stress and Rest EF by using $^{99m}Tc$-MIBI. The aim of this study is to analyze between stress EF and rest EF at myocardial perfusion SPECT by using $^{201}Tl$ and define possible predictors of EF variability. Materials and Methods: From 2008 June to 2009 February, we analyzed 144 patients undergoing $^{201}Tl$ gated myocardial perfusion SPECT in ASAN medical center. To analyze the data, we use QGS (Quantitative gated SPECT) software, and derived End-systolic volume (ESV), End-diastolic volume (EDV), EF from the result. In this study, we comparatively analyzed stress/rest EF correlation based on stress/rest EF, EDV, ESV and reversibility of myocardial perfusion defect by using paired t-test, Bland-Altman analysis. Results: Mached pairs of stress EF and rest EF demonstrated excellent correlation (r=0.92) with no statistically significant difference (p=0.11). Bland-Altman analysis demonstrated a mean ${\Delta}EF$ was 0.52% (95% confidential interval[CI], -1.17~0.12%). No statistically significant difference between a mean ${\Delta}EF$ and hypothetic mean of 0 (${\Delta}EF$=0) (p=0.10). In the correlation of ${\Delta}EF$ according to stress/rest EDV and ESV, except rest ESV of <28mL (p<0.05), there was no statistically significant difference. In the correlation of ${\Delta}EF$ according to reversibility of perfusion defect, patients with reversible perfusion defect has statistically significant difference of ${\Delta}EF$ (p<0.05). ${\Delta}EF$ of stress/rest EF showed no statistically significant difference except 55% of rest EF (p<0.05). Conclusion: Like studies with $^{99m}Tc$-MIBI, there was generally no statistically significant difference between stress and rest EF in this study results. However a stress EF of <55%, a rest ESV of <28mL and patients with reversible perfusion defect showed statistically significant difference in ${\Delta}EF$. If performing $^{201}T$ myocardial perfusion SPECT to patients with abnormal cardiac function or reversible perfusion defect, consider this study results and apply it. We expect this study results could be useful predictors of ${\Delta}EF$ variability.

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A survey of infant sleep positions associated with sudden infant death syndrome (영아 돌연사 증후군과 연관하여 아기를 재우는 방법에 대한 인식 연구)

  • Lee, Dong Jun;Jang, So Ick;Shim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.602-609
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    • 2006
  • Purpose : As the prone position is thought to be an important factor in sudden infant death syndrome(SIDS), this study was conducted to contribute to reducing SIDS by analyzing sleeping positions of infants. Methods : A face-to-face questionnaire was carried out with a total of 170 parents with a baby aged less than 6 months. Results : A total of 170 infants included 95 males(55.9 percent) and 75 females(44.1 percent); their average age was 2.8 months. 45.3 percent slept in a supine position; 34.7 percent in a side or supine position; 7.1 percent in a side position; 4.7 percent in a prone position; 4.1 percent in a non-specific position. Among those in a side position, 59.7 percent were in a supine position in the morning; 19.5 percent were in the side position; 13.4 percent were in a non-specific position; and 4.1 percent were in a prone position. To the question why they slept in a specific position, 34.9 percent answered their baby slept comfortably, and particularly, 42.9 percent in the prone position group answered so. In the supine position group, 21.6 percent answered they had no reason. Both in the prone position and side position groups, 21 percent each answered they were worried about the shape of their baby's head. In the side position group, 22 percent answered that they had a fear of choking due to vomiting. In all sleeping position groups, 8.2 percent and 7.4 percent answered it was because they had a fear of suffocation and they wanted to avoid SIDS, respectively. Conclusion : Many of the parents preferred unstable positions, e.g. the side position and the prone position, which could cause SIDS. Their decision on their baby's sleeping position was not based on exact medical knowledge, but on convenience in taking care of their baby. As it was found that only 6 percent of the subjects were advised from their pediatrist about their baby's sleeping position, moreover, it is necessary to carry out more studies and activities for preventing SIDS caused by improper sleeping positions and educating patents about recommended sleeping positions for their baby.

Development trend of the mushroom industry (버섯 산업의 발달 동향)

  • Yoo, Young Bok;Oh, Min Ji;Oh, Youn Lee;Shin, Pyung Gyun;Jang, Kab Yeul;Kong, Won Sik
    • Journal of Mushroom
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    • v.14 no.4
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    • pp.142-154
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    • 2016
  • Worldwide production of mushrooms has been increasing by 10-20% every year. Recently, Pleurotus eryngii and P. nebrodensis have become popular mushroom species for cultivation. In particular, China exceeded 8.7 million tons in 2002, which accounted for 71.5% of total world output. A similar trend was also observed in Korea. Two kinds of mushrooms-Gumji (金芝; Ganoderma) and Seoji-are described in the ancient book 'Samguksagi' (History of the three kingdoms; B.C 57~A.D 668; written by Bu Sik Kim in 1145) during the Korea-dynasty. Many kinds of mushrooms are also described in more than 17 ancient books during the Chosun-dynasty (1392~1910) in Korea. Approximately 200 commercial strains of 38 species of mushrooms were developed and distributed to cultivators. The somatic hybrid variety of oyster mushroom, 'Wonhyeong-neutari,' was developed by protoplast fusion, and distributed to growers in 1989. Further, the production of mushrooms as food was 199,829 metric tons, valued at 850 billion Korean Won (one trillion won if mushroom factory products are included) in 2015. In Korea, the major cultivated species are P. ostreatus, P. eryngii, Flammulina velutipes, Lentinula edodes, Agaricus bisporus, and Ganoderma lucidum, which account for 90% of the total production. Since mushroom export was initiated in 1960, the export and import of mushrooms have increased in Korea. Technology was developed for liquid spawn production, and automatic cultivation systems led to the reduction of production cost, resulting in the increase in mushroom export. However, some species were imported owing to high production costs for effective cultivation methods. In academia, RDA scientists have conducted mushroom genome projects since 1997. One of the main outcomes is the whole genome sequencing of Flammulina velutipes for molecular breeding. With regard to medicinal mushrooms, we have been conducting genome research on Cordyceps and its related species for developing functional foods. There are various kinds of beneficial substances in mushrooms; mushroom products, including pharmaceuticals, tonics, healthy beverages, functional biotransformants, and processed foods have also became available on the market. In addition, compost and feed can likewise be made from mushroom substrates after harvest.

Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection (요로감염과 동반된 전해질 불균형의 임상적 의의)

  • Cho, Sea-Eun;Choi, Lim;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.58-65
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    • 2011
  • Purpose: Some hormonal and electrolyte abnormalities have been reported in pediatric patients with urinary tract infection (UTI). This study aimed to investigate the relationships between the imbalance of electrolytes and the severity of infection and associated urologic anomalies in children with febrile UTI. Methods: We retrospectively reviewed 267 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from January, 2007 until February, 2010. According to the presence of hyponatremia or hyperkalemia, clinical parameters and associated renal anomalies, such as hydronephrosis, cortical defects and vesicoureteral reflux, were compared. Results: 42.7% of all patients had decreased concentration of serum sodium. In patients with decreased concentration of serum sodium, cortical defects were significantly increased compared to normal patients (40.4% vs. 14.4%, P <0.05). White blood cell (WBC) counts ($15,721{\pm}6,553/uL$ vs. $12,885{\pm}5,367/uL$, P <0.05), C-reactive protein (CRP) ($61.8{\pm}56.1$ mg/L, vs. $29.9{\pm}39.8$ mg/L, P <0.05), and erythrocyte sedimentation rate (ESR) ($43.9{\pm}34.3$ mm/hr vs. $27.4{\pm}26.8$ mm/hr, P <0.05) in peripheral blood showed significant increases in the group with decreased concentration of serum sodium. Duration of fever, presence of gastrointestinal symptom, the incidence of hydronephrosis and vesicoureteral reflux did not differ between the two groups. None of the patients had significant hyperkalemia. Conclusion : We suggest that decreased concentration of serum sodium in febrile UTI might be a helpful marker for leukocytosis and increased CRP and ESR in peripheral blood, and acute pyelonephritis.

Emotional State and Personality Characteristics in Patient with Panic Disorder (공황장애 환자의 정서상태와 성격특성)

  • Lee, Kyung-Kyu;Choi, Eun-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.76-85
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    • 2004
  • Objectives: The purpose of the present study was to investigate the emotional state and personality characteristics of patient with panic disorder. Methods: Twenty patients with panic disorder, 21 patients with somatoform disorder, and 20 normal healthy controls were studied. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, One-way ANOVA with Scheffe test were used by SPSS/PC for windows. Results: 1) Total score of BDI was higher in the panic group than the somatoform group and normal control group(p<0.001). 2) Total score of state anxiety and trait anxiety in the panic group was higher than the somatoform group and normal control group(p<0.001). 3) In 16 PF, there were no definitely abnormal range of scores. But in first-stratum source traits of 16PF, the panic group was higher than the somatoform group and normal healthy group in O-factor (p<0.01) and Q4-factor(p<0.001). In second-stratum source traits of 16PF, the panic group was higher than the somatoform group in ANX-factor(p<0.05), but lower than normal control group in TOUfactor(p<0.05). 4) There were no differences in the panic subgroup according to sex and cutoff points of BDI score 16 and STAI-T score 54. 5) According to cutoff point of STAI-S score 52, the panic subgroup above 52 was higher than the panic subgroup under 52 in G-factor(p<0.001), Q3-factor(p<0.05) and SUP-factor(p<0.001), but lower in L-factor(p<0.05). Conclusion: These results suggest that emotional state of patients with panic disorder are depressive and anxious as compared with patients with somatoform disorder and normal controls. Patients with panic disorder did not show any abnormal personality characteristics but were more guilt-prone, anxious, emotionally sensitive. We propose that the understanding of panic patients' emotional state and personality characteristics will helpful to treat and manage in patient with panic disorder.

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A Study on Psychological Factors and Gastric Physiological Activity in the Functional Dyspepsia -Using Gastric Emptying Test- (가능성 소화장애증 환자의 정신사회적 요인과 위장 생리활동성의 연관성에 관한 연구 -위 배출능 검사를 이용하여-)

  • Kim, Jin-A;Lim, Seung-Han;Moon, Seong-Keun;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.49-57
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    • 2001
  • Objectives : This study was designed to investigate the relationship between gastric emptying, psychopathology(especially anxiety and depression), and various factors that can mediate stress and response, such as coping style, social support and level of perceived stress. Methods : A total 30 patients who complained of the non-ulcer dyspepsia and did not have any abnormal finding on the gastroduodenal endoscopic examination, 24 hour ambulatory esophageal manometry and conventional gastroesophageal manometry were tested with gastric emptying that would be a functional examination of stomach. The correlations between the gastric emptying and psychological vaiable such as quantity of perceived stress, Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), Spielberger Stait-Trait Anxiety Inventory(STAI), Ways of Coping Checklist and Interpersonal Support Evaluation List were evaluated. Results : 1) The mean and standard deviation of the time for half of the meal to empty(T50%) was $118.50{\pm}23.64$ minute which showed no gastric stasis in terms of gastric emptying test. 2) There were significant positive correlations between T50% and the state anxiety, T50% and thedepression. 3) There was no significant correlation between T50% and the quantity of perceived stress, T50% and mediating factors(coping style and social support). Conclusion : These results suggested that psychopathology, especially emotional components such as depression and anxiety, could affect on the current physiological functional gastric activity(gastric emptying), but quantity of perceive stress and mediating factors of stress and response such as coping style and social support could not affected on the functional gastric activity. These results showed that psychological interventions should considered in management of the patients with functional dyspepia.

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Dissociative Symptoms in Patients with Somatization Disorder (신체화 장애 환자의 해리 증상)

  • Kim, Seong-Hwan;Choe, Byeong-Moo;Kim, Yoon-Won;Hahn, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.116-123
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    • 1999
  • Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

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Factors Affecting Sleep Quality of Firefighters (소방공무원의 수면의 질에 대한 영향요인)

  • Oh, Jinuk;Ko, Miae;Song, Hoo Rim;Hong, Min Ha;Kim, Hyun Soo;Kim, Woo Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.19-25
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    • 2018
  • Objectives : Firefighters frequently experience traumatic events, high-tension situations and shift work. Therefore, the prevalence of insomnia of firefighters is higher than one of general population. Not only does the quality of sleep affect the satisfaction of personal life, but it also influences their performance for the public's safety. We investigated which factors affect the quality of sleep of firefighters. Methods : After personally delivering 120 questionnaires to 3 fire stations, the survey was conducted when the consents were signed. It inquired about alcohol use, smoking, shift work, sleep quality, depression, anxiety, and experience of traumatic events. We then divided the firefighting officers in two groups according to the quality of sleep and compared the variables examined to conduct the logistic regression analyses according to the results. Results : The poor sleeper group reported a higher level of current alcohol consumption, depression, anxiety and experience of traumatic events. Logistic regression analyses showed that the current alcohol intake (Crude odds ratio=3.707, 95% confidence interval=1.288-10.672, p=0.015 ; Adjusted odds ratio=3.288, 95% confidence interval=1.011-10.694, p=0.048) has a significant effect on sleep quality. Conclusions : Current alcohol consumption, depression, anxiety and experience of traumatic events were respectively associated with sleep quality of firefighters. When all significant factors considered, the current alcohol use was the only statistically significant. To improve the quality of sleep for firefighters, it will be necessary to evaluate alcohol intake, educate the poor sleep quality caused by alcohol, and provide specific interventions to reduce consumption.