• Title/Summary/Keyword: 병원 의학

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DEVELOPMENTAL AND CLINICAL CHARACTERISTICS IN CHILDREN WITH NOCTURNAL ENURESIS : RESULTS OF A MULTICENTER STUDY (야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 발달학적 및 임상적 특성을 중심으로)

  • Cho Soo-Churl;Shin Min-Sup;Hwang Jun-Won;Han Sang-Won;Park Kwan-Hyun;Lee Sang-Don;Kim Kyung-Do;Kim Kun-Suk;Suh Hong-Jin;Lee Yoo-Sik;Chung Jae-Yong;Kim Young-Kyoon;Kim Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.1
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    • pp.32-39
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    • 2006
  • Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

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Role of Actigraphy in the Estimation of Sleep Quality in Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증의 수면의 질 평가와 액티그라프의 역할)

  • Lee, Seung-Hee;Lee, Jin-Sung;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.14 no.2
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    • pp.86-91
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    • 2007
  • Background: Actigraphy is a reliable and valid method for assessing sleep in normal, healthy populations, but it may be less reliable and valid for detecting disturbed sleep in patients. In this study, we attempted to assess the utility of actigraphy in the estimation of sleep quality in patients with obstructive sleep apnea syndrome (OSAS), a major sleep disorder. Method: We analyzed the data of patients who underwent polysomnography (PSG) and actigraphy simultaneously for one night at the Center for Sleep and Chronobiology, Seoul National University Hospital from November 2004 to March 2006. Eighty-nine subjects with OSAS alone and 21 subjects with OSAS and periodic limb movement disorder (PLMD) were included for final data analyses between groups. Polysomnographic and actigraphic data were also compared. Results: In subjects with mild OSAS (RDI<15), modretae ($15{\leq}RDI$<30), and OSAS with PLMD, PSG and actigraphy did not show significant difference in total sleep time and sleep efficiency. However in severe ($30{\leq}RDI$) OSAS subjects, PSG and actigraphy showed significant difference in total sleep time and sleep efficiency. In all patients, no correlations were found between sleep parameters from PSG and from those using actigraphy. Conclusions: We suggest that in severe OSAS patients, PSG is the diagnostic tool. In mild and moderate cases, actigraphy might be used as a screening tool.

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Relationship between Depressive Symptoms and Sleep Parameters in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 환자의 우울증상 정도에 따른 수면 양상)

  • Won, Chang-Yeon;Lee, Seung-Hee;So, Min-Ah;Lee, Jin-Sung;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.14 no.2
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    • pp.92-98
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    • 2007
  • Objectives: Obstructive sleep apnea syndrome (OSAS) is the most common form of sleep-disordered breathing and often presents with comorbid depressive symptoms. In this study, we evaluated the relationship between depressive symptoms and sleep parameters as measured by nocturnal polysomnography (NPSG) and simultaneous wrist actigraphy. Methods: Two hundred sixty-four subjects with clinically suspected cases of OSAS underwent one-night polysomnography, while simultaneously wearing a wrist actigraphy device. They also completed two questionnaires;the Epworth Sleepiness Scale-Korean version (ESS-K) and the Beck Depression Inventory (BDI). Of the cases studied, 105 subjects were proven by NSPG to have OSAS without other sleep disorders. NPSG and wrist actigraphy data from the subjects were analyzed. Pearson correlation and paired t-test were used in order to evaluate the relationship between depressive symptoms and sleep-parameters. Results: Mean age of the subjects was $46.1{\pm}13.1$ years. Means of the ESS-K score and BDI scores were $10.9{\pm}4.7$ and $12.8{\pm}8.1$, respectively. NPSG sleep parameters significantly differed from those of wrist actigraphy. There was no correlation found between subjects' respiratory disturbance index (RDI) and BDI scores. When directly comparing sleep parameters between subjects who were more depressed versus subjects who were less depressed, both total sleep time and sleep efficiency were decreased in the more depressed. A correlation between RDI and ESS-K scores was also found in the more depressed group. Conclusions: Although our findings suggest that there is no relationship between RDI and depressive symptoms, there are other significant differences in the sleep parameters between subjects who are more depressed versus those without depression. We recommend that patients with depression should also be evaluated for clinical symptoms of OSAS.

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Cell-mediated immunity in mice infected with Acanthumoeba culbertsoni (Acanthamoeba culbertsoni 감염에 있어서 세포 매개성 면역)

  • Kim, Myeong-Jun;Sin, Ju-Ok;Im, Gyeong-Il
    • Parasites, Hosts and Diseases
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    • v.28 no.3
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    • pp.143-154
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    • 1990
  • Observations were made on the differences of cell-mediated responses in mice of three infectiorl groups di여erently scheduled in their severity with pathogenic Acanthamoeba culbertseni. Infections were done by dropping $5{\;}{\mu}l$ saline suspension containing $3{\times}10^3,{\;}1{\times}10^4,{\;}or{\;}1{\times}10^5$ trophosoites, respectively. Amoebae were cultured anenically in CGV medium and inoculated into the right nasal cavity of CSH/HeJ mice aging around 6∼8 weeks, under the anesthesia by intraperitoneal injection of secobarbital. Delayed type hypersensitivity (DTH) responses in footpad and blastogenlc responses of mouse spleen cells using ($^3H$)-thymidine and the serum antibody titer were measured up to day 14 after infection, and natural killer cell activities were measured up to day, i after infection. The results obtained in this study were as follows: 1. The mice infected with $3{\times}10^3$ trophosoites showed mortality rate of 17%, and 345 in the mice infected with $1{\times}10^4$ trophozoites and 65% with $1{\times}10^5$ trophozoites. 2. In regard to DTH responses in all experimental groups, the level increased on day 7 and declined on day 14 after infection, but their differences could not be noted between infected and control groups. 3. The blastogenic responses of splenocytes treated with amoeba Iysates and lipopolysaccharides (LPS) showed no difference from the control group. The blastogenic responses of splenocytes treated with concanavalin A were declined significantly in the experimental group as compared with the control group, but the blastogenic responses of splenocytes treated with polyinosinic acid were not different from the control group. There was also no difference among three infected groups. 4. The cytotoxic activity of the natural killer cells was activated on day 1 after infection and declined to the level of control group on day 2 in all experimental groups. On day 5 after infection, the natural killer cell cytotoxicity was significantly suppressed as compared with the control groups. 5. The serum antibody titers of the infected mice increased after day 7, but there was no statistical difference between the three infected groups. In summary of the results, there was no difference in cell-mediated immune responses of three experimental groups scheduled with different infection intensities. But there was a significant difference in cell$.$mediated immune responses between infected and control mice. It is considered that cell-mediated immune responses should be involved in murine model infected with A. culbertsoni.

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Immunization Effect on Naegleria fowleyi Infection in Splenectomized Mice (비장절제 마우스에서 Naegleria fowleri 감염에 대한 면역효과)

  • Han, Gwang-Hyeop;An, Myeong-Hui;Min, Deuk-Yeong
    • Parasites, Hosts and Diseases
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    • v.26 no.1
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    • pp.39-44
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    • 1988
  • A pathogenic free-living amoeba, Naegleria fowleri, is a causative protozoan parasite of primary amebic meningoencephalitis in human and experimental animals. It is known that humoral and cellular immunity contribute as the defence mechanism of host against this organism. Recently splenectomy has been argued on its effect on host defence mechanisms. The present study was aimed to observe the enact of immunization in splenectomized mice. For immunization, $5~10{\times}10^5$ trophozoites of Naegleria fewleri o 359 were intraperitoneally inoculated once a week for two weeks to BALB/c mice, and $5~10{\times}10^4$ of ameba trophozoites were intranasally inoculated for infection after splenectomy and/or immunization. ELISA technique was applied for the detection of seum IgG antibody levels. Experimental animals were divided into 4 groups; I. splenectomized and immuniEed; ll. splenectomized only; III. immunized only; IV. not splenectomized nor immunized. The results obtained were as follows: 1. Mortality rates of splenectomized and immunized mice in group I (38.1%) and immunized only in group III (25.0%) were lower than those of not immunized mice in group II (50%) and control group, IV (46.4%). 2. Survival times of mice in group I, II, III and IV were $20.1{\pm}3.6$, $17.3{\pm}4.5$, $20.4{\pm}7.0$ and $19.6{\pm}7.6$ days respectively, and there were no significant differences between them. 3. ELISA values (absorbance at 492nm) of group I (1, $10{\pm}0.29$) and group III ($1.31{\pm}0.28$) were significantly higher than that of group IV($0.24{\pm}0.37$) at day 31 of infection (p<0.05). Conclusively, it is presumed that humoral immunity against N. fowleri may operate as ever, after immunization, even though the mouse was splenectomized.

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The infestation states and changing patterns of human infecting metacercariae in freshwater fish in Kyongang-do and Kyonggi-do, Korea (식이성 윤충류질환의 관리전략수립을 위한 감염원의 역학 및 병원체의 생물학적 특성에 관한 조사연구 - 경상도내 3개 강 및 경기도내 4개 하천에서 채집한 민물어류의 인체기생 흡충류 피낭유충 감염상 및 변동)

  • 임한종;김기홍
    • Parasites, Hosts and Diseases
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    • v.34 no.2
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    • pp.95-106
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    • 1996
  • The infestation rates and abundances of human infecting metacercariae (Clonorchis sinensis, Metcgonimus spry. , Centrocestus crmatus, Echinostoma hortense, Echinochusnus japonicw, Clinostomum complanctum) in freshwater fish were investigated at the three river areas - Taewhagang (river), Hyongsangang (river), Nakdonggang (river) - in Kyongsang-do and at four streams - Yonpungchon, Munsanchon, Kyonganchon, and Konjiamchon- in Kyonggi-do, Korea in 1994-1995. The fish caught at Taewhagang were heavily infested with metacercariae of Clonorchis sinensis and Centrocestw armctus. At Hyongsangang, Zncco platypus and Z. temmincki were moderately infested with metacercariae of C. crmctus. Chomanpo, at the basin of Nakdonggang, was still endemic for C. sinensis. In the fish caught at four streams of Kyonggi-do, metacercariae of C. sinensis exhibited the highest infestation rate and intensity out of 6 species of metacercariae. The infestation intensity of C. sinensis metacercariae in fish flesh was markedly different according to each division of flesh. The cause of this difference was conjectured as a result of larval behavior. The metacercariae of C. omnt5 were found in almost all parts, except scales and fins, of fish. The infestation rates and intensities of C. sinensis and C. armntus metacercariae in Taewhagang greatly increased as compared with those of previous reports . RhinoBobius bmnneus and Aconthorhone5 macropterus are newly recorded intermediate hosts of Echinostonn hortense. The reason of large differences from previous data was discussed and the standard method of metacercaria examination was proposed.

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Clinical Analysis of Intussusception Delayed in the Final Diagnosis (발병 초기에 진단하지 못한 장중첩증에 관한 고찰)

  • Kim, Eo Jin;Lee, Min Hae;Lee, Hae Young;Kim, Jum Su;Seo, Ji Hyun;Lim, Jae Young;Choi, Myoung Bum;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.16-23
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    • 2004
  • Purpose: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. Methods: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. Results: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. Conclusion: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.

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Integrated Test for Screening in Down Syndrome as a Predictor of Adverse Pregnancy Outcomes (임신합병증 예측에 있어 다운증후군 통합 선별검사 지표의 의의)

  • Park, Sang-Won;Kang, Jin-Hee;Lee, Kyong-Jin;Jun, Hye-Sun;Kang, Myoung-Seo;Huh, Ji-Young;Cha, Dong-Hyun
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.74-80
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    • 2009
  • Purpose: To assess the value of first-trimester pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and second-trimester alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A in predicting pregnancy complications other than fetal aneuploidy. Materials and Methods: A retrospective study in 3,121 singleton pregnancies with integrated testing was performed at Kangnam CHA hospital between January 2005 and December 2006. Baseline characteristics, pregnancy outcomes, and serum marker levels were obtained by review of the medical records. We analyzed the data to identify associations between the integrated screening markers and adverse pregnancy outcomes. Statistical analyses were performed with the SPSS program. Results: In preterm labor and preeclampsia, high AFP, hCG, and inhibin-A levels and low PAPP-A and NT levels were found to be significantly correlated (P<0.05). Elevated second-trimester inhibin-A levels were associated with preeclampsia (odds ratio 2.843), low birth weight (odds ratio 1.446), and preterm labor (odds ratio 1.287), and while decreased first-trimester PAPP-A levels were associated with preeclampsia (odds ratio 0.51) and preterm labor (odds ratio 0.75). Conclusion: First- and second-trimester maternal serum markers screening can be used for predicting high-risk pregnancies.

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Biodistribution and Metabolism of I-123 Labelled Fatty Acid(I) : [I-123]15-(p-iodophenyl)pentadecanoic acid(IPPA) (I-123 표지 지방산의 체내 분포 및 대사(I) : [I-123]15-(p-iodophenyl)pentadecanoic acid(IPPA))

  • Chang, Young Soo;Lee, Dong Soo;Jeong, Jae Min;Suh, Yong-Sup;Chung, June-Key;Lee, Myung Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.50-60
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    • 1998
  • I-123 labelled fatty acids are suitable for investigation of regional myocardial metabolism, so they are on the clinical trial. However, the precise properties of these materials are not characterized yet. We have synthesized phenylpentadecanoic acid and labeled this compound with I-123. The purpose of this study was to examine the stability, biodistribution, metabolism and SPECT imaging of [I-123]15-(p-iodophenyl)pentadecanoic acid(I-123-IPPA) that we made. The stability test of I-123-IPPA in serum of rat, mouse and human showed no free I-123 after 1 hour. In biodistribution study in mice for various time intervals after injection(5, 10, 15, 30, 60 minutes), uptake in myocardium was 14.5%ID/g(5 min), and 1.9%ID/heart(5 min), while uptake in muscles was 2.6%ID/g(5 min). Myocardium to blood ratio and myocardium to lung ratio increased for 5 min after injection and then decreased rapidly. Chromatographic data of rat blood and urine showed that little PPA was found in blood and urine at 15-20 min after injection. The myocardial I-123-IPPA SPECT images of a dog with myocardial infarction showed defects similar to those of Tc-99m-MIBI and F-18-FDG. These data suggest that I-123-IPPA is quite stable in vitro and shows favorable biodistribution in mice. SPECT imaging with I-123-IPPA demonstrated infarct zone as photon defect in dog model of myocardial infarction. I-123-IPPA may be used for the evaluation of fatty acid metabolism in clinical trials in Korea.

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A Study on the Reduction of Kidney Uptake of 18F-FDG due to the Water Intake at the Time of Additional Examination in the PET/CT scan (PET/CT 검사에서 추가 검사 시 수분섭취에 따른 18F-FDG의 신장 섭취 감소에 대한 고찰)

  • Lee, Yi Lang;Kim, Sang Gyu;Ham, Jun Chul;Nam-Koong, Hyuk;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.47-51
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    • 2016
  • Purpose By ingestion of 18F-FDG of kidney of PET/CT during the inspection, if additional examination is required, depending on whether you want to water intake, we want to confirm a change in the rate of decrease of F-18 FDG of the kidney. Materials and Methods The 80 patients without kidney disease were performed PET/CT examination. Device was analyzed after setting the kidney to a three-dimensional region of interest. In patients require additional examination, and inspection after 30 minutes, a PET/CT torso examination after the water of the 500 cc ingested at a time. After the addition of both water intake group and no hydration group of kidney of SUV, it was compared with PET/CT torso scan. Results High and low of the kidney SUV did not show a significant difference in the rate of decrease. Reduction rates of background (BKG) of additional examination was 2.8% and reduction rates of SUV was 49.7% (Hydration) : -6.8% (No hydration), so did show a significant difference. In the image blind test, the average point score of hydration and no hydration was 34.25 : 17.25. Conclusion An undercurrent of 18F-FDG in the kidney at the time of torso examination, it was confirmed that the reduction rate after the addition of water intake is high. It is considered that can be expected to improve the quality of an image due to a decrease in elongation through the kidneys examination with additional fluid intake as needed intake.

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