• Title/Summary/Keyword: 비침습적 검사

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The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma (기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Choi, Young-Mee;Lee, Sook-Young;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.922-931
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    • 2000
  • Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

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Measurement of Space Dose Distribution during Exposure Micro Computed Tomography (μ-CT) for Scattering Rays (Micro-CT 촬영 시 발생되는 산란선에 관한 공간선량률 측정)

  • Jung, Hongmoon;Won, Doyeon;Kwon, Taegeon;Jung, Jaeeun
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.45-50
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    • 2013
  • Non-invasive technique CT, called automated computed tomography, is used to detect lesion of a patient when diagnosing human body. Information obtained from CT plays an important role in assembling 3 dimensional images. Recently, new equipment, operated by CT, is required which can be appliable to physical and biological research. In accordance to this quest, micro-CT is invented that produce more detail and concrete information. Images supplied by CT are even more detailed and concrete, so it contributes much to the development of biology and polymer material engineering field. However, there has been little reliable reports regarding measuring information of space dose distribution about exposure dose limit of users operating micro-CT. In addition, little reports regarding space dose distribution of exposure has been known about unwanted diffraction light produced by usage of micro-CT. The exterior of micro-CT is covered by lead, which is for removing exposure of diffraction light. Thus, even if it is good enough to prevent exposure of diffraction light, consistent management of equipment will be required as time goes by and equipment are getting old as well. We measured space dose distribution regarding exposure of diffraction light of users operating micro-CT directly. Therefore, we suggest that proper management should be necessary for users operating micro-CT not to be exposed by unwanted diffraction light.

Clinical Analysis of Surgical Results and Preoperative Management of Acute Aortic Dissection (급성 대동맥박리증의 수술성적 및 수술전 처치에 대한 임상적 고찰)

  • 현성열;박국양;이재웅;이창하;전양빈;박철현;염석란;신종환;민순식
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.876-881
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    • 2002
  • Acute aortic dissection associated with high mortality rate has an extremely poor prognosis if early diagnosis and treatment are not received. Recently, with advanced computed tomography and echocardiography, diagnostic rate is higher and early operation is possible. Therefore preoperative medical therapy at ER(emergency room) lowered the mortality rate. This study was done to analyze the results with preoperative management at ER and operations, retrospectively. Material and Method: A series of 42 patients treated surgically for acute aortic dissections from 1991 to 2001 were included in this study. There were 18 males and 24 females. Mean age was 51.1 years. The admission course through emergency and outpatient department(OPD) was 34 and 8 respectively. Result: 26 patients underwent ascending aorta replacement-7 combined aortic valve replacements, 7 patients underwent descending aorta replacements and 9 patients received Bentall's operation. At emergency department, 20 patients received antihypertensive drugs and $\beta$-receptor blockers and 6 patients died. 22 patients did not receive antihypertensive and $\beta$-receptor block drugs and 10 patients died. There were 16(38%) overall deaths. Conclusion: Early diagnosis at ER or OPD is essential for acute aortic dissection, and it is important to select the most appropriate noninvasive interventions as possible. Therefore, preoperative drug therapy at ER is suggested according the patient conditions.

Heart Rate Variability and Lipid Profile in Patients with Major Depressive Disorder (주요우울장애 환자에서의 심박변이도와 혈중 지질 농도와의 연관성)

  • Ahn, Eun-Jung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.27-34
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    • 2012
  • Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

Time-resolved Fluoroimmunoassay (TR-FIA) Analysis of Fecal Progesterone and Estradiol in Leopard Cats (Prionailurus bengalensis) (삵에서 TR-FIA를 이용한 분변내 Estradiol과 Progesterone의 검사)

  • Kim, Young-Seob;Kim, Ji-Yong;Jung, So-Young;Lee, Bong-Joo;Shin, Nam-Shik
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.693-697
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    • 2010
  • This study, conducted with four leopard cats (Prionailurus bengalensis), used time-resolved fluoroimmunoassay (TR-FIA) to analyze estradiol and progesterone concentrations in fecal samples. We measured fecal samples taken during estrus period, diestrus period, pregnancy and non-pregnancy period. During estrus (February), the mean minimum estradiol concentration was $4.02{\pm}1.9$ng/g, and the mean maximum was $86.01{\pm}35.2$ng/g (dry fecal weight). During diestrus (November), the mean minimum estradiol concentration was $4.42{\pm}1.32$ng/g and mean maximum was $15.62{\pm}6.48$ng/g (dry fecal weight). Midgestation (April), the mean minimum progesterone concentration was $427{\pm}24.49$ng/g and the mean maximum was $1490{\pm}265.27$ng/g. During non-pregnancy (November), the mean minimum progesterone concentration was $71.25{\pm}29.61$ng/g and the mean maximum was $291.75{\pm}90.30$ng/g. These results suggest that steroid hormone analysis of feces using TR-FIA is a valid method for noninvasively determining ovarian activity associated with estrus and pregnancy in leopard cats. This study will contribute to building breeding management and reproductive plans for endangered species.

Prognostic Value of Normal Exercise $^{99m}Tc$-MIBI Myocardial Perfusion SPECT: Comparison with Exercise Electrocardiography and Coronary Angiography ($^{99m}Tc$-MIBI 운동부하 심근관류 SPECT에서 정상소견을 보인 환자의 예후: 운동부하 심전도와 관동맥 조영소견과의 비교)

  • Lee, Sang-Woo;Lee, Jae-Tae;Chun, Kyung-Ah;Kang, Do-Young;Kim, Dong-Hwan;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.199-206
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    • 2000
  • Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

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Gastric Emptying in Patients with Diabetes: Gastric Emptying Time, Retention Rate and Effect of Cisapride (당뇨병 환자의 위배출능 : 위배출시간, 위저류율 및 Cisapride의 영향)

  • Chung, Byung-Chun;Choi, Chung-Il;Gwak, Dong-Suck;Lee, Jae-Tae;Lee, Kyu-Bo;Kim, Bo-Wan;Chung, Jun-Mo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.299-306
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    • 1992
  • Gastic emptying scan in diabetic patients is widely used to assess the degree of motility disturbance and the symtoms such as nausea, vomiting, bloating, abdominal pain and early gastric fullness which we can't find anatomic lesion by fiberoscopic or barium study In order to determine the relationship among diabetic gastropathy, neropathy, retinopathy and disease duration, gastric emptying scan using $^{99m}Tc-tin$ colloid labeled scramble egg in hamburger was performed in 10 healty male controls and 50 diabetic patients which were subdivided to no neuropathy, peripheral neuropathy and autonomic neuropathy groups according to the degree of diabetic neuropathy and no retinopathy, background retinopathy and proliferative retinopathy groups according to the degree of diabetic retinopathy. After medication of cisapride for 2 weeks, we observed the presence of improvement of gastric motility in diabetics. The results were as following: 1) In controls, gastric emptying time (GET1/2) was $75{\pm}13.6$ min and 2 hour gastric retension rate (GRR2) was $32{\pm}11.1%$. 2) In diabetics, GET/2 was prolonged more than 2 hours and GRR2 was $58{\pm}23.1%$. According to degree of neuropathy, GET1/2 was prolonged more than 2 hours in all three groups and GRR2 was $54{\pm}24.1%$ in no neuropathy group, $57{\pm}24.3%$ in peripheral neuropathy group and $69{\pm}24.6%$ in autonomic neuropathy group. According to degree of retinopathy, GET1/2 was $110{\pm}23.4$ min in no retinopathy group and prolonged more than 2 hours in other two groups and GRR2 was $45{\pm}21.6%$ in no retinopathy group, $71{\pm}19.7%$ in background retinopathy group and $73{\pm}21.5%$ in proliferative retinopathy group. 3) After cisapride medication for 2 weeks, GET1/2 and GRR2 were improved as $90{\pm}14.6$ min and $40{\pm}13.8%$ (initial GET1/2 and GRR2 were above 2 hours and $61{\pm}15.4%$). We can conclude from above findings that gastropathy in diabetic neuropathy suggesting main underlying factor in motility disorder The degree of retinopathy and disease duration were correlated with severity of gastropathy in diabetics. From the results of gastric emptying scan, we can conclude that cisapride was useful drug for improving diabetic gastropathy and gastric emptying scan was valuable for assessing severity of diabetic gastropathy as non-invasive method.

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Classification Model of Chronic Gastritis According to The Feature Extraction Method of Radial Artery Pulse Signal (맥파의 특징점 추출 방법에 따른 만성위염 판별 모형)

  • Choi, Sang-Ho;Shin, Ki-Young;Kim, Jeauk;Jin, Seung-Oh;Lee, Tea-Bum
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.1
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    • pp.185-194
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    • 2014
  • One in every 10 persons suffer from chronic gastritis in Korea. Endoscopy is most commonly used to diagnose the chronic gastritis. Endoscopic diagnosis is precise but it is accompanied with pain and high cost. According to pulse diagnosis in Traditional East Asian Medicine, health problems in stomach can be diagnosed with radial pulse signals in 'Guan' location in the right wrist, which are non-invasive and cost-effective. In this study, we developed a classification model of chronic gastritis using pulse signals in right 'Guan' location. We used both linear discrimination method and logistic regression model with respect to pulse features obtained with a peak-valley detection algorithm and a Gaussian model. As a result, we obtained sensitivity ranged between 77%~89% and specificity ranged between 72%~83% depending on classification models and feature extraction methods, and the average classification rates were approximately 80%, irrespective of the models. Specifically, the Gaussian model were featured by superior sensitivities (89.1% and 87.5%) while the peak-valley detection method showed superior specificities (82.8% and 81.3%), and the average classification rate (sensitivity + specificity) of the Gaussian model was 80.9% which was 1.2% ahead of the peak-valley method. In conclusion, we obtained a reliable classification model for the chronic gastritis based on the radial pulse feature extraction algorithms, where the Gaussian model was featured by outperformed sensitivity and the peak-valley method was featured by outperformed specificity.

Inpatient Dental Consultations to Pediatric Dentistry in the Yonsei University Severance Hospital (연세대학교 세브란스 병원 내 입원한 환자의 소아치과 의뢰 현황)

  • Joo, Kihoon;Lee, Jaeho;Song, Jeseon;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.145-151
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    • 2014
  • The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

The Role of Radiation Therapy in the Treatment of Intracranial Glioma : Retrospective Analysis of 96 Cases (뇌 교종 96예에 대한 방사선치료 성적의 후향적 분석)

  • Kim Yeon Sil;Kang Ki Mun;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Kang Jun Gi
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.249-258
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    • 1993
  • Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months (range: 31~133 months). Of the 96 patients, 60 $(63\%)$ were males and 36 $(37\%)$ were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headeche $(67\%)$ followed by cerebral motor and sensory discrepancy $(54\%),$ nausea and vomiting $(34\%),$ seizure $(19\%),$ mental change $(10\%)$ and memory and calculation impairment $(8\%).$ Eighty five $(88.5\%)$ patients all, except 11 $(11.5\%)$ brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas $(75\%),$ 4 mixed oligoastrocytomas $(5\%),$ and 17 oligodendrogliomas $(20\%).$ Fourty nine patients $(58\%$ were grade I, II histology and 36 $(42\%)$ patients were grade III, IV histology. Of the 96 patients, 64 $(67\%)$ recieved postoperative RT and 32 $(33\%)$ were treated with primary radiotherapy. Gross total resection was peformed in 14 $(16\%)$ patients, subtotal resection En 29 $(34\%),$ partial resection in 21 $(25\%),$ and biopsy only in 21 $(25\%).$ Median survival time was 53 months (range 2~ 133 months), and 2- and, 5-year survival rate were $69\%,49\%$ respectively. 5-year survival rate by histologic grade was grade I, $70\%,$ grade II, $58\%,$ grade III, $28\%,$ and grade IV, $15\%.$ Multivariated analysis demonstrate that age at diagnosis (p=0.0121), Karnofsky performance Status (KPS) (p=0.0002), histologic grade (p=0.0001), postoperative radiation therapy (p=0.0278), surgical extent (p =0.024), cerebellar location of tumor (p=0.0095) were significant prognostic factors influencing on survival.

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