• Title/Summary/Keyword: 신경학적 검사

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Statistical Analysis of 1,000 Cases of Kawasaki Disease Patients Diagnosed at a Single Institute (단일 기관에서 진단받은 가와사끼병 환아 1,000례의 통계학적 분석)

  • Hwang, Dae Hwan;Sin, Kyoung Mi;Choi, Kyong Min;Choi, Jae Young;Sul, Jun Hee;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.416-424
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    • 2005
  • Purpose : To find the risk factors associated with coronory artery lesions, non-responsiveness to intravenous immunoglobulin(IVIG) treatment, and recurrences in Kawasaki disease patients. Methods : We retrospectively analyzed 1,000 Kawasaki disease patients who were admitted to Yonsei University Medical Center from September 1990 to December 2003. We compared between responder and non-responder groups to IVIG treatment as well as between relapsed and non-relapsed groups, and as to the relapsed group, we also compared variables between patients in their first and second attack states. Finally, factors associated with longer-fever duration from disease onset were evaluated. Results : Longer fever durations before and after IVIG treatment, male sex, lower Hgb and Hct level, higher WBC count and segmented WBC proportion, and higher CRP and Harada's score were related with coronary artery lesions. Non-responsiveness was related to higher WBC count, segmented WBC proportion, CRP, SGPT, Harada's score, and pyuria. Moderate-to-severe coronary artery dilatations and recurrences were more commonly seen among the non-responder group. No significant predictive factors for recurrence were found. In the relapsed group, lower WBC count, CRP, and shorter fever duration from disease onset were observed in their second attack state. Fever duration from disease onset showed positive correlation with WBC count, CRP, and Harada's score and negative correlation with Hgb levels. Conclusion : Higher WBC count, CRP, and higher Harada's score were related to both higher incidences of coronary artery lesions and non-responsiveness to IVIG treatment, and these factors were also related with longer fever duration. Non-responders to IVIG treatment showed higher recurrence rate and more moderate-to-severe coronary artery dilatations than responders.

Depressive Symptoms in Patients with Parkinson's Disease (파킨슨병 환자에서의 우울증상)

  • Lee, Moon-Sook;Yang, Chang-Kook;Hah, Hong-Moo;Kim, Jae-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.25-35
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    • 2003
  • Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

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Risk Factor's Affecting long-term Outcome of Alport syndrome (Alport 증후군의 예후와 관련된 위험요인 분석)

  • Byun Ji-Yoon;Baek Seoung-Yon;Lee Young-Mock;Kim Ji-Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo;Kim Soon-Il;Kim Yu-Seun;Park Ki-Il
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.164-175
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    • 2001
  • Purpose : Alport syndrome is a hereditary nephrotic disease characterized by progressive nephrotic symptom, sensorineural hearing loss, ophthalmic abnormality, typical microscopic findings, and familial occurrence. In this study, we tried to find the risk factors related with its prognosis by taking a close observation on clinical symptoms of children with Alport syndrome reviewing retrospectively. Materials & methods : We chose children diagnosed as Alport syndrome in renal biopsy during 20 years(from 1980, Jan. until 1999, Dec.) who could receive follow up studies in tile department of pediatrics. They were divided into two groups by comparing renal function at the time of diagnosis and at current status. We compared several clinical aspects in them, and applied nonparametric test for statistical analysis. Results : The sex ratio(male:female) of 24 children was 3:1. The most common clinical symptom presented at their first visit was gross hematuria. Among those 24 children, 11 cases($46\%$) of progressing into chronic renal failure(Group II) were observed. Hypertension, proteinuria and edema were seen much frequently in group II. The level of serum protein, albumin, and creatinine clearance were decreased while BUN, creatinine were relatively increased. All the results were statistically significant. Conclusion Clinically significant risk factors related to prognosis in Alport syndrome were the presence of hypertension, edema, and proteinuria at the time of diagnosis. Also, the level of serum protein, albumin, BUN, creatinine, and glomerular filtration rate were proved to be important factors in predicting prognosis. We believe that studies on these possible risk factors would be of great help in treating and predicting prognosis of children suffering with Alport syndrome. (J Korean Soc Pediatr Nephrol 2001;5 : 164-75)

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Delayed Diagnosis of Primary Lung Cancer (원발성 폐암의 지연진단에 관한 임상적 고찰)

  • Kim, Sun-Young;Cho, Hae-Jeong;Kim, Geun-Hwa;Ko, Dong-Seok;Suh, Jae-Chul;Shin, Kyoung-Sang;Jeong, Seong-Su;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.754-759
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    • 1998
  • Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

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Pinhole Bone Scintigraphic Manifestation of Fibrous Dysplasia (섬유성 이형성증의 바늘구멍 골스캔 소견)

  • Baek, Jee-Hee;Lee, Sung-Yong;Kim, Sung-Hoon;Chung, Yong-An;Kim, Bum-Soo;Song, Ha-Hun;Chung, Soo-Kyo;Kang, Si-Won;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.4
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    • pp.452-458
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    • 1997
  • To evaluate the pinhole scintigraphic findings and its significance, authors retrospectively compared the pinhole bone scintigrams and corresponding radiograms of 16 lesions in 14 patients with fibrous dysplasia. They were diagnosed pathologically in 10 lesions and radiologically in 6 lesions. The mean age of patients was 41.1 years. The mean interval between two studies was 1.1 days. Locations were ribs 7, pelvic bone 4, clavicle 1, long bones 4(femur 2, tibia 1, humerus 1). The radiographic findings were as follows : the central portions were radiolucent(n=9), ground-glass opacities(n=5) or sclerotic(n=2) and the peripheral appearance were sclerotic rim(n=5), septation(n=7), cortical perforation (n=10) and invisible cortical thinning(n=9). Pinhole scintigraphic findings were as follows; Central portions showed normal 1+ uptake in 6 cases(radiolucent 5, ground-glass opacity 1), slightly increased 2+ upta- ke in 7 cases(radiolucent 4, ground-glass opacity 3), and marked 3+ uptake in 3 cases(ground-glass opacity 1, sclerotic 2). The 15 of 16 lesions showed more intense uptake in the peripheral portion: slightly increased 2+ uptake corresponding to the sclerotic rim(5/5) and unvisible cortical thinning(1/9), and irregular foci of marked 3 + uptake corresponding to septation(7/7), cortical perforation(10/10) and invisible cortical thinning (8/9). One of 16 lesions showed homogeneous 2+ uptake. In conclusion, pinhole scintigram provides information on regional activity of the fibrous dysplasia, which would be helpful in diagnosis, prediction of prognosis and determination of treatment plan.

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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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Physioanatomical studies on mechanism in the process of becoming non-spinning silkworm(Bombyx mori) (토사불능잠의 출현기구에 관한 생리해부학적 연구)

  • 윤종관
    • Journal of Sericultural and Entomological Science
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    • v.8
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    • pp.41-50
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    • 1968
  • In order to achieve efficiency of laying eggs of silkworms, it is very important to eliminate noncocooning silkworms. This study is written on the basis of observation and analysis of mechanism of silkworms physiologically and anatomically. It is hoped that given herein will contribute to the effecting elimination work. Outline of the study summarize as follows: 1. It is observed through microscope that the silkworms which are seen normal state in the silk gland but no ability of cocoon making have polyhedrosis in the nerve, trachea and muscle near the tissue of the spinneret. 2. Relatively high proportion of non-cocooning silkworms are caused by the grasserie of the silkworms. 3. As a result of inoculation with purulent discharges against silkworms from first fooding through 8th day of 5th instar, number of cocooning silkworms were increased when inoculation are applied at laterer day of the instar. In the case of non-cocooning silkworms, meanwhile, resulted not big varriation when it is apllied in the early and middle of the period, but number of non-cocooning silkworm was reduced when the inoculation are given at laterer of the instar. Number of death during rearing and mounting are increased when earliest application of inoculation are carried out. 4. Symptom of grasserie was appeared more or less three days after application of the inoculation. Some silkworms which were inoculated just before mounting has ability of cocooning making even taken grasserie, in this case the silkworm can make thin cocoon. since the silkworm fall sick during cocoon making and unable of spinning soon. when the worm was affected by grasserie slightly, it was observed that the silkworm can spinning. It is supposed to be the light paralysis of spinneret is not very much influenced to spinning. 5. As a result of observation of original stock and hybrid including other 44 kinds of silkworm, many non-cocooning silkworms were found in the original stock especially originated from japanese than in hybrid. 6. A number of undulations are found in the middle division of the silk gland of non-cocooning silkworms. 7. According to the observation of the sizes of the body and digestive organs, normal natured silkworms and non-cocooning silkworms are more or less same in length, but the width, circumference of bodies and digestive organs were more larger in the later. If silkworm which was in the period of active eating of 5th instar was given shock of dropping to the floor, the silkworm receives little more shock when hit to side of the body than to head, and concrete floor than ondol and wooden floor.

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Comparison of Antioxidant Activities of Enzymatic and Methanolic Extracts from Ecklonia cava Stem and Leave (감태(Ecklonia cava) 줄기 및 잎의 효소적 추출물과 메탄올 추출물에 의한 항산화 활성비교)

  • Lee, Seung-Hong;Kim, Kil-Nam;Cha, Seon-Heui;Ahn, Gin-Nae;Jeon, You-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.9
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    • pp.1139-1145
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    • 2006
  • In this study, antioxidant activities of enzymatic and methanolic extracts from E. cava stem and leave were evaluated by measuring the scavenging activities on 1,1 diphenyl 2 picrylhydrazyl (DPPH), hydroxyl radical, hydrogen peroxide and the inhibitory effects on DNA damage induced by oxidative stress of cells. Enzymatic extracts were prepared by enzymatic hydrolysis of both stem and leave using food grade five different carbohydrases (Viscozyme, Celluclast, AMG, Termamyl, Ultraflo) and five proteases (Protamex, Kojizyme, Neutrase, Flavourzyme, Alcalase). The enzymatic extracts were lower than methanolic extracts in polyphenol contents, but higher in extraction yield by approximately 30%. The enzymatic extracts were superior to methanolic extracts in DPPH and H2O2 scavenging activities and DNA damage protective effect. There were no significant antioxidant activity difference between stem and leave, but the extracts of leave were relatively better than those of stem. In this study it is suggested that E. cava stem as well as its leave would be a good raw materials for antioxidants compound extraction and enzymatic hydrolysis would be a good strategy to prepare antioxidant extracts from seaweeds.

Radiation Exposure of Hands and Feet from $^{18}F$-FDG in Radio-technologists (방사선 작업 종사자의 작업화 및 작업복의 방사선 오염 분석)

  • Lee, Seung-Jae;Jeong, Seok;Seo, Soo-Hyun;Park, Yong-Sung;Park, Hoon-Hee;Oh, Shin-Hyun;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.94-98
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    • 2011
  • Purpose: The radiation exposure from radioisotope at the hands and foots of radiation workers who works in PET/CT part at the department of nuclear medicine was investigated in this study. Materials and Methods: From 4th August 2010 to 14th January 2011, 6 radio-technologists' radiation on hands and feet were measured. All radio-technologist have been examined around 8; morning, 12; afternoon, and 16 o'clock; evening, respectively. SPSS version 17 was used for statistical analysis. Results: The statistical significances were calculated in several ways. The radiation from both hands and feet in the Morning was lower than Afternoon and Evening. In some cases, the detected radiation showed extremely high values in data. In order to find the effect of the ${\gamma}$-ray on the hand, the estimated doses were presumably calculated, however, the exposure dose on feet were unmeasured. Conclusion: Even if the radiation exposure from the radioisotope at the hands and feet were under the limitations, it is definitely needs to prevent the radiation-contamination. Therefore, the radio-technologists need to have a proper radiation-dealing-procedure of their own, and must try to prevent a radiation exposure by themselves.

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Characterization of B Cells of Lymph Nodes and Peripheral Blood in a Patient with Hyper IgM Syndrome (Hyper IgM Syndrome 환자에서 얻은 림프절 및 말초혈액 B세포의 특성)

  • Kim, Dong Soo;Shin, Kyuong Mi;Yang, Woo Ick;Shin, Jeon-Soo;Song, Chang Hwa;Jo, Eun Kyeong
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.128-136
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    • 2003
  • Purpose : Hyper IgM syndrome(HIGM) is characterized by severe recurrent bacterial infections with decreased serum levels of IgG, IgA, and IgE but elevated IgM levels. Recently, it has been classified into three groups; HIGM1, HIGM2 and a rare form of HIGM. HIGM1 is a X-linked form of HIGM and has now been identified as a T-cell deficiency in which mutations occur in the gene that encodes the CD40 ligand molecule. HIGM2 is an autosomal recessive form of HIGM. Molecular studies have shown that the mutation of HIGM2 is in the gene that encodes activation-induced cytidine deaminase(AID). Recently, another rare form of X-linked HIGM syndrome associated with hypohydrotic ectodermal dysplasia has been identified. We encountered a patient with a varient form of HIGM2. To clarify the cause of this form of HIGM, we evaluated the peripheral B cells of this patient. Methods : The lymphocytes of the patient were prepared from peripheral blood. B cells were immortalized with the infection of EBV. Cell cycle analysis was done with the immortalized B cells of the patient. Peripheral mononuclear cells were stained with monoclonal anti-CD40L antibody. Total RNA was extracted from the peripheral mononuclear cells. After RT-PCR, direct sequencing for CD40L gene and HuAID gene were done. Immunostainings of a lymph node for CD3, CD23, CD40, Fas-L, bcl-2, BAX were done. Results : The peripheral B cells of this patient showed normal expression of CD40L molecule and normal sequencing of CD40L gene, and also normal sequencing of AID gene. Interestingly, the peripheral B cells of this patient showed a decreased population of G2/mitosis phase in cell cycles which recovered to normal with the stimulation of IL-4. Conclusion : We suspect that the cause of increased serum IgM in this patient may be from a decrease of G2/mitosis phase of the peripheral B cells, which may be from the decreased production or secretion of IL-4. Therefore, this may be a new form of HIGM.