• Title/Summary/Keyword: 발생빈도 예측

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Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis (전두엽 간질에서 F-18-FDG PET의 간질병소 국소화 성능: 육안 판독과 SPM에 의한 분석)

  • Kim, Yu-Kyeong;Lee, Dong-Soo;Lee, Sang-Kun;Chung, Chun-Kee;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.131-141
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    • 2001
  • Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

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A Hierarchical Grid Alignment Algorithm for Microarray Image Analysis (마이크로어레이 이미지 분석을 위한 계층적 그리드 정렬 알고리즘)

  • Chun Bong-Kyung;Jin Hee-Jeong;Lee Pyung-Jun;Cho Hwan-Gue
    • Journal of KIISE:Software and Applications
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    • v.33 no.2
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    • pp.143-153
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    • 2006
  • Microarray which enables us to obtain hundreds and thousands of expression of gene or genotype at once is an epoch-making technology in comparative analysis of genes. First of all, we have to measure the intensity of each gene in an microarray image from the experiment to gain the expression level of each gene. But it is difficult to analyze the microarray image in manual because it has a lot of genes. Meta-gridding method and various auto-gridding methods have been proposed for this, but thew still have some problems. For example, meta-gridding requires manual-work due to some variations in spite of experiment in same microarray, and auto-gridding nay not carried out fully or correctly when an image has a lot of noises or is lowly expressed. In this article, we propose Hierarchical Grid Alignment algorithm for new methodology combining meta-gridding method with auto-gridding method. In our methodology, we necd a meta-grid as an input, and then align it with the microarray image automatically. Experimental results show that the proposed method serves more robust and reliable gridding result than the previous methods. It is also possible for user to do more reliable batch analysis by using our algorithm.

Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents (고혈압 청소년의 심혈관계 위험요소로서 Angiotensinogen M235T 유전자 다형)

  • Gil, Joo Hyun;Lee, Jung Ah;Park, Eun Young;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.36-43
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    • 2009
  • urpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential hypertension. This study aimed to analyze the angiotensinogen M235T polymorphism in hypertensive adolescents and investigate its relationship with cardiovascular risks. Methods : Forty Korean hypertensive adolescents (aged 16-17, systolic $BP{\geq}140 mmHg$ and/or diastolic $BP{\geq}90 mmHg$) and fifty seven normal adolescents were included. Obesity index (OI), body mass index (BMI) were calculated. BP was measured by oscillometric methods in resting state. Polymerase chain reaction (PCR) technique was performed on DNA from the hypertensives subjects to analyze the M235T polymorphism. Serum homocysteine, insulin, renin, aldosterone and angiotensin converting enzyme (ACE) were tested according to each genotype. The carotid intima-media thickness (IMT) and carotid artery diameter, Pulse wave velocity (PWV) and ankle-brachial index (ABI) were measured according to each genotype. Results : Genotype frequencies of T/T, M/T and M/M were 62.5%, 35.0%, 2.5%, respectively in hypertensive adolescents. The results were not significantly different compared to control group. Serum insulin, renin levels, BMI and OI were significantly higher in thoses with the M/M genotype as compared to those with the T/T of M/T genotype. Conclusion : This study showed that the M235T polymorphism was not associated with essential hypertension or any cardiovascular risks. Further clinical research is required to ascertain the relationship between this polymorphism and cardiovascular complications in Korean hypertensive adolescents.

Changes in platelet counts caused by valproate in children with epilepsy (소아 간질 환자에서 valproate 투여 후 혈소판 수의 변화)

  • We, Ju Hee;Kim, Young Mi;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.75-80
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    • 2009
  • Purpose : In adults, valproate (VPA) has been reported to be associated with thrombocytopenia. However, few studies have investigated this association in children, and the factors affecting platelet counts remain controversial. This study was undertaken to investigate changes in platelet counts following VPA therapy and related factors in children with epilepsy. Methods : Our subjects comprised 75 epileptic children who had received VPA monotherapy for at least 1 year between January 2000 and December 2005. We regularly examined platelet counts at intervals of 6 to 12 months after baseline platelet counts before VPA treatment. We analyzed changes in platelet counts according to several factors such as sex, seizure type, underlying causes of epilepsy, age at the start of medication as well as at the last follow up, duration of VPA administration, VPA dose, serum VPA level, and body weight at the last follow up. Results : Overall, the platelet counts decreased significantly after VPA therapy. The average baseline platelet count was $312.5{\pm}109.1{\times}10^6/mL$. At the last follow up, the average platelet count was $261.7{\pm}72.2{\times}10^6/mL$. We observed the relationship between platelet counts and serum levels of VPA; while children with serum VPA <$75{\mu}g/mL$ showed no change in platelet counts (P=0.102), children with serum VPA >$75{\mu}g/mL$ showed a significant decrease in platelet counts. Conclusion : VPA may cause a significantly decreased platelet count in children with epilepsy. High serum VPA levels were associated with development of thrombocytopenia.

Development of lumped model to analyze the hydrological effects landuse change (토지이용 변화에 따른 수문 특성의 변화를 추적하기 위한 Lumped모형의 개발)

  • Son, Ill
    • Journal of the Korean Geographical Society
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    • v.29 no.3
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    • pp.233-252
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    • 1994
  • One of major advantages of Lumped model is its ability to simulate extended flows. A further advantage is that it requires only conventional, readily available hydrological data (rainfall, evaporation and runoff). These two advantages commend the use of this type of model for the analysis of the hydrological effects of landuse change. Experimental Catchment(K11) of Kimakia site in Kenga experienced three phases of landuse change for sixteen and half years. The Institute of Hydrology offered the hydrological data from the catchment for this research. On basis of Blackie's(l972) 9-parameter model, a new model(R1131) was reorganized in consideration of the following aspects to reflect the hydrological characteristics of the catchment: 1) The evapotranspiration necessary for the landuse hydrology, 2) high permeable soils, 3) small catchment, 4) input option for initial soil moisture deficit, and 5) othel modules for water budget analysis. The new model is constructed as a 11-parameter, 3-storage, 1-input option model. Using a number of initial conditions, the model was optimized to the data of three landuse phases. The model efficiencies were 96.78%, 97.20%, 94.62% and the errors of total flow were -1.78%, -3.36%, -5.32%. The bias of the optimized models were tested by several techniques, The extended flows were simulated in the prediction mode using the optimized model and the data set of the whole series of experimental periods. They are used to analyse the change of daily high and low-flow caused by landuse change. The relative water use ratio of the clearing and seedling phase was 60.21%, but that of the next two phases were 81.23% and 83.78% respectively. The annual peak flows of second and third phase at a 1.5-year return period were decreased by 31.3% and 31.2% compared to that of the first phase. The annual peak flow at a 50-year return period in the second phase was an increase of only 4.8%, and that in the third phase was an increase of 12.9%. The annual minimum flow at a 1.5-year return period was decreased by 34.2% in the second phase, and 34.3% in the third phase. The changes in the annual minimum flows were decreased for the larger return periods; a 20.2% decrease in the second phase and 20.9% decrease in the third phase at a 50-year return period. From the results above, two aspects could be concluded. Firstly, the flow regime in Catchment K11 was changed due to the landuse conversion from the clearing and seedling phade to the intermediate stage of pine plantation. But, The flow regime was little affected after the pine trees reached a certain height. Secondly, the effects of the pine plantation on the daily high- and low-flow were reduced with the increase in flood size and the severity of drought.

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Clinical features of congenital muscular torticollis (선천성 근성 사경의 임상적 특징)

  • Jun, Ji Eun;Ryu, Hye Kyeong;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.241-247
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    • 2007
  • Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

Prognostic Factors and Clinical Characteristics of Terminally Ill Patients with Gastric Cancer (말기 위암 환자의 임상적 특성과 예후 인자)

  • Kim, Soo-Jae;Moon, Do-Ho;Lee, Choon-Sub;Lee, Jung-Ho;Kim, Tae-Gyun;Park, Jung-Chul;Lee, Ji-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.4
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    • pp.178-183
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    • 2007
  • Purpose: The prevalence and mortality of gastric lancer is high. We studied clinical characteristics and prognostic factors of the advanced gastric canter patients who had died in the hospice care unit. and our study is the basic report for efficient hospice and palliative care for the terminally ill patients with gastric cancer. Methods: We retrospectively reviewed the medical records of 99 advanced gastric cancer patients who had died in a hospice rare unit from May 2004 to August 2007. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS version 13.0. Results: There were 62 males (63%) and 37 females (37%). Median age of patients was 60.9 years and liver metastasis was as high as 38 patients (38%) of all. The most prevalent symptom of admission was general weakness (97%) and poor or intake (86%). There were also bypoalbuminemia (88%), anemia (73%), and hyponatremia (61%). Palliative procedure was performed on 17 (63%) out of 27 patients with intestinal obstruction. Of these stents were inserted to 11 patients. The stores of ECOGPS and dyspnea were significantly correlated with the length of survival. The duration of median survival and hospitalization in the hospice and palliative care was 22 days and was 20 days respectively. Conclusion: We need to study more about clinical characteristics of advanced gastric rancor patients to predict the length of survival for an effective hospice and palliative care.

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Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

Alteration of insulin resistance and serum adiponectin levels after one year follow-up of obese children and adolescents (비만 소아에서 1년 후 추적검사에 따른 인슐린 저항성 및 혈중 아디포넥틴의 변화)

  • Jeoung, Min Jee;Shin, Jung Yeon;Kim, Soo Young;Lee, Jung Hwa;Lee, Kee-Hyoung;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.767-773
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    • 2007
  • Purpose : Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. Methods : Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturityrating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. Results : BMI ($25.3{\pm}2.9kg/m^2$ vs. $26.0{\pm}2.9kg/m^2$) and HOMA-IR ($3.6{\pm}1.8$ vs. $4.7{\pm}1.9$) have increased significantly after one-year follow-up. The serum adiponectin concentration ($17.2{\pm}5.2g/mL$ vs. $12.6{\pm}5.2g/mL$) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. Conclusion : Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.

Evaluating Impact Resistance of Externally Strengthened Steel Fiber Reinforced Concrete Slab with Fiber Reinforced Polymers (섬유 보강재로 외부 보강된 강섬유 보강 콘크리트 슬래브의 충격저항성능 평가)

  • Yoo, Doo-Yeol;Min, Kyung-Hwan;Lee, Jin-Young;Yoon, Young-Soo
    • Journal of the Korea Concrete Institute
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    • v.24 no.3
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    • pp.293-303
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    • 2012
  • Recently, as construction technology improved, concrete structures not only became larger, taller and longer but were able to perform various functions. However, if extreme loads such as impact, blast, and fire are applied to those structures, it would cause severe property damages and human casualties. Especially, the structural responses from extreme loading are totally different than that from quasi-static loading, because large pressure is applied to structures from mass acceleration effect of impact and blast loads. Therefore, the strain rate effect and damage levels should be considered when concrete structure is designed. In this study, the low velocity impact loading test of steel fiber reinforced concrete (SFRC) slabs including 0%~1.5% (by volume) of steel fibers, and strengthened with two types of FRP sheets was performed to develop an impact resistant structural member. From the test results, the maximum impact load, dissipated energy and the number of drop to failure increased, whereas the maximum displacement and support rotation were reduced by strengthening SFRC slab with FRP sheets in tensile zone. The test results showed that the impact resistance of concrete slab can be substantially improved by externally strengthening using FRP sheets. This result can be used in designing of primary facilities exposed to such extreme loads. The dynamic responses of SFRC slab strengthened with FRP sheets under low velocity impact load were also analyzed using LS-DYNA, a finite element analysis program with an explicit time integration scheme. The comparison of test and analytical results showed that they were within 5% of error with respect to maximum displacements.