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The Usefulness of Visceral Fat Thickness Measured by Ultrasonography as an Abdominal Obesity Index (초음파로 측정된 내장지방두께의 복부 비만지표로서의 유용성)

  • Kim, Yong-Kyun;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.249-258
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    • 2008
  • Purpose : Abdominal obesity with visceral fat accumulation have been known to be intimately associated with the development of metabolic syndrome. Therefore, it is important to estimate the precise amount of visceral fat. Ultrasonography has been reported that it is a simple and noninvasive method for visceral fat evaluation. Purpose of this study is to evaluate the association of ultrasonographic visceral fat thickness, anthropometric indexes, and risk factor of metabolic syndrome, and to investigate the cut-off value of abdominal visceral fat thickness leading to increased risk of metabolic syndrome. Materials and methods : The subject included 200 men and 200 women who visited D healthcare center in Daejeon from January to April 2008. The subcutaneous fat thickness and visceral fat thickness were measured by ultrasonograph. As anthropometric index, we measured body mass index, waist circumference and waist/height ratio. As for the risk factor of metabolic syndrome, we measured blood pressure, high density lipoprotein cholesterol, triglyceride and fasting serum glucose. Results : VFT was significantly correlated with waist circumference, (r=0.683/M, r=0.604/F), waist to height ratio (r=0.633/M, r=0.593/F) and BMI (r=0.621/M, r=0.534/F) in both men and women. In addition it was significantly correlated with Systolic blood pressure (r=0.229/M, r=0.232/F), Diastolic blood pressure ((r=0.285/M, r=0.254/F), high density cholesterol (r=-0.254/M, r=-0.254/F), Triglyceride (r=0.475/M, r=0.411/F), and Fasting blood sugar (r=0.158/M, r=0.234/F) in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm (sensitivity89.2%, specificity 71.2%) in men and 3.50cm (sensitivity61.2% specificity 80.8%) in women respectively. The odds ratio of the risk of metabolic syndrome was dramatically increased with the abdominal visceral fat thickness level over 6cm in men and 5cm in women. Conclusion : The visceral fat thickness using ultrasonography was significantly correlated with anthropometric indexes and risk factors of metabolic syndrome in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm in men and 3.50cm in women.

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Usefulness of applying Macro for Brain SPECT Processing (Brain SPECT Processing에 있어서 Macro Program 사용의 유용성)

  • Kim, Gye-Hwan;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyeon-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.35-39
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    • 2009
  • Purpose: Diagnostic and functional imaging softwares in Nuclear Medicine have been developed significantly. But, there are some limitations which like take a lot of time. In this article, we introduced that the basic concept of macro to help understanding macro and its application to Brain SPECT processing. We adopted macro software to SPM processing and PACS verify processing of Brain SPECT processing. Materials and Methods: In Brain SPECT, we choose SPM processing and two PACS works which have large portion of a work. SPM is the software package to analyze neuroimaging data. And purpose of SPM is quantitative analysis between groups. Results are made by complicated process such as realignment, normalization, smoothing and mapping. We made this process to be more simple by using macro program. After sending image to PACS, we directly input coordinates of mouse using simple macro program for processes of color mapping, adjustment of gray scale, copy, cut and match. So we compared time for making result by hand with making result by macro program. Finally, we got results by applying times to number of studies in 2007. Results: In 2007, the number of SPM studies were 115 and the number of PACS studies were 834 according to Diamox study. It was taken 10 to 15 minutes for SPM work by hand according to expertness and 5 minutes and a half was uniformly needed using Macro. After applying needed time to the number of studies, we calculated an average time per a year. When using SPM work by hand according to expertness, 1150 to 1725 minutes (19 to 29 hours) were needed and 632 seconds (11 hours) were needed for using Macro. When using PACS work by hand, 2 to 3 minutes were needed and for using Macro, 45 seconds were needed. After applying theses time to the number of studies, when working by hand, 1668 to 2502 minutes (28 to 42 hours) were needed and for using Macro, 625 minutes (10 hours) were needed. Following by these results, it was shown that 1043 to 1877 (17 to 31 hours were saved. Therefore, we could save 45 to 63% for SPM, 62 to 75% for PACS work and 55 to 70% for total brain SPECT processing in 2007. Conclusions: On the basis of the number of studies, there was significant time saved when we applied Macro to brain SPECT processing and also it was shown that even though work is taken a little time, there is a possibility to save lots of time according to the number of studies. It gives time on technologist's side which makes radiological technologist more concentrate for patients and reduce probability of mistake. Appling Macro to brain SPECT processing helps for both of radiological technologists and patients and contribute to improve quality of hospital service.

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Management of Two Spotted Spider Mite, Tetranychus Urticae, on Organic Strawberry Field in Jeonnam Area and Toxicity of Natural Enemies Against Crude Extract of Chrysanthimum cinerariefolium and Melia azedarach (전남지역 유기 딸기재배지에서 제충국과 멀구슬 추출물을 이용한 점박이응애 방제 및 천적에 대한 독성)

  • Kim, Do-Ik;Kim, Seon-Gon;Kang, Beom-Ryong;Ko, Suk-Ju;Kim, Jin-Seob;Kim, Sang-Soo
    • Korean Journal of Organic Agriculture
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    • v.17 no.2
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    • pp.211-226
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    • 2009
  • This experiment was conducted to investigate the effect of plant extracts, Chrysanthimum cinerariefolium and Melia azedarach to natural enemies and management of two spotted spider mite, Tetranychus urticae in organic strawberry fields in Jeonnam area. Plant extracts were highly toxic against Phytoseiulus persimilis, but low against Orius laevigatus. In the residual effect against Phytoseiulus persimilis, C. cinerariefolium showed lower level than M. azedarach which safe at least 1 day after spray. Emergence rates of parasitoids were about 40% at seven days after spray. Eretmocerus eremicus has very low emergence rate in treatment of M. azedarach, so it should release after spray of M. azedarach. To control of T. urticae C. cinerariefolium (CC) sprayed first and then sprayed C. cinerariefolium or M. azedarach (MA) for two and three times at a week interval. In the treatment of CC+MA and CC+CC+MA, the density of T. urticae was inhibited by 15th day but increased afterward. In CC+MA+CC, that of T. urticae inhibit from 8 days but also increased after I5th day. In case of spray M. azedarach (MA) first, the treatment of MA+CC, MA+MA+CC, MA+CC+MA suppressed T. urticae from the first day so the densy of T. urticae maintained low level to 30 days after spray. It suggested that M. azedarach should spray first and then alternative spray. When C. cinerariefolium sprayed before and behind to release of P. persimilis, the density of P. persimilis maintained unchanged but could not suppress T. urticae after 8 days which T. urticae increase time. When M. azedarach sprayed, the density of T. urticae rapidly decreased. It was accompanied with P. persimilis so T. urticae did not occur at 8 days after treatment.

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Measurement of δ-Aminolevulinic Acid in Urine by Fluorometric HPLC and Colorimetric Methods (비색법과 HPLC 법에 의한 요중 δ-Aminolevulinic acid의 측정치 비교)

  • Ahn, Kyu-Dong;Yeon, You-Yong;Lee, Byung-Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.4 no.1
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    • pp.17-24
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    • 1994
  • The urinary excretion of ${\delta}$-aminolevulinic acid has been widely used as a measure of the biological effect of lead in lead exposed workers. It is usually measured by colorimetric method based on the color reaction of ALA-pyrrole with Ehrlich's reagent. But the results of ${\delta}$-ALA in urine by this method are somewhat artificially higher than expected due to the urinary ALA-like compound such as aminoacetone. On the other hand, the recently developed fluorometric HPLC method is very sensitive and specific for the measuring urinary ALA. In order to compare the data obtained by two methods and to investigate the interrelation between two methods, 117 lead workers with different lead exposure were checked urinary ${\delta}$-ALA, blood lead and other lead exposure related indices. The results obtained are as follows; 1. Urinary excretion of ${\delta}$-ALA by colorimetric method is 2.15 times higher than HPLC method in overall, revealing 2.47 times in workers of blood lead less than $20{\mu}g/dl$, 2.53 times in workers of blood lead $21-40{\mu}g/dl$ and 1.86 times in workers of blood lead over $41{\mu}g/dl$, respectively. 2. While the correlation coefficients of ${\delta}$-ALA measured by colorimetric method with blood lead and blood ZPP was 0.571 and 0.629, those of ${\delta}$-ALA measured by HPLC with blood lead and blood ZPP were 0.6l0 and 0.637. All the correlation coefficients were statistically significant, but there was no statistical difference of correlation coefficients between two methods. 3. The correlation coefficient of urinary excretion of ${\delta}$-ALA between two method was 0.838 without any correction, but it was 0.852 with the correction of specific gravity 1.024. 4. Simple linear regression of ${\delta}$-ALA measured by HPLC method on ${\delta}$-ALA measured by colorimetric method was (ALA-UPH)=-0.245+0.536 (ALA-UCO) without any correction and it was (SP ALA)=-0.525+0.598 (SP ALA-UCO) with the correction of specific gravity 1.024. With above results, it is recommended that the diagnostic criteria of ${\delta}$-ALA for lead poisoning needed to be revised if ${\delta}$-ALA is measured by HPLC rather than colorimetric method.

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Review of 2014 Major Medical Decisions (2014년 주요 의료판결 분석)

  • Jeong, Hye Seung;Lee, Dong Pil;Yoo, Hyun Jung;Lee, Jung Sun
    • The Korean Society of Law and Medicine
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    • v.16 no.1
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    • pp.155-190
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    • 2015
  • The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

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Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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Improvement of Patient Safety and Inspection Satisfaction by Developing Pretreatment Process System with the Patients Who Reserved CT Enhance Examination (CT 조영검사 예약환자의 전처치 프로세스 시스템 개발을 통한 환자안전 및 검사 만족도 향상)

  • Beom, Hyinam;Han, Jaebok;Song, Jongnam;Kim, Wook;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.10 no.1
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    • pp.29-37
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    • 2016
  • This study aims to improve the satisfaction level of the patient who undergoes CT contrast examination by developing and applying pretreatment process system, which not only can reduce the side effects caused by the test but also can help carry out the test smoothly. The subjects were 214 patients who booked CT contrast examination from January 2014 to February 2014 but could not carry out their test on schedule. We analyzed the reasons for the delay and conducted follow-up survey on them. We analyzed the usefulness of pretreatment process system by contemplating and developing pretreatment process system and applying it to the patients for whom follow-up survey was conducted from January 2015 to February 2015. The number of outpatients who came to the hospital form January to February 2014 was 2,846 and the number of patients who could not undergo the test was 214, accounting for 7.52% of the total. The specific reason for the delay includes 214 cases of unknown creatinine 98 with 120 minutes of average delay time, 40 cases of creatinine over 1.3(19%) with 30minutes of average delay time, 34 cases of past contrast media side effect 6% with 40 minutes of average delay time and 25 cases of lack of pretreatment such as fasting, etc. 11% with 120minutes of average delay time. The number of CT scan has been increasing ever since the development of CT and the frequency of using the contrast media is expected to increase. If we can employ pretreatment process system in order to effectively control the side effect of contrast media and help the CT contrast examination to be smoothly conducted on schedule, I'm sure we could improve the quality of our medical service and increase our patients' satisfaction who come to our CT scan room.

Qualitative and quantitative PCR detection of insect-resistant genetically modified rice Agb0101 developed in korea (해충저항성 유전자변형 벼 Agb0101에 대한 PCR 검정)

  • Shin, Kong-Sik;Lee, Jin-Hyoung;Lim, Myung-Ho;Woo, Hee-Jong;Qin, Yang;Suh, Seok-Cheol;Kweon, Soon-Jong;Cho, Hyun-Suk
    • Journal of Plant Biotechnology
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    • v.40 no.1
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    • pp.18-26
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    • 2013
  • Genetically modified (GM) rice Agb0101, which expresses the insecticidal toxin modified cry1Ac (mcry1Ac1) gene, was developed by the Rural Development Administration in Korea. To monitor the probable release of Agb0101 in the future, it is necessary to develop a reliable detection method. Here, we developed the PCR detection method for monitoring and tracing of GM rice. The primer pair (RBEgh-1/-2) from a starch branching enzyme (RBE4) gene was designed as an endogenous reference, giving rise to an expected PCR amplicon of 101 bp. For the qualitative PCR detection, construct- and event-specific primers were designed on the basis of integration sequence of T-DNA. Event-specific PCRs amplified specifically 5'- or 3'-junction region spanning the native genome DNA and the integrated gene construct, while none of amplified product was shown on crops, rice varieties, and other insect-resistant transgenic rice lines. The event-specific real-time PCR method was performed using TaqMan probe and plasmid pRBECrR containing both rice endogenous gene RBE4 sequence and 5'-junction sequence as the reference molecule. The absolute limit of quantification (LOQ) of real-time PCR was established with around 10 copies for one plasmid molecule pRBECrR. Thereafter, the different amounts of transgenic rice (1, 3, 5, and 10%, respectively) were quantified by using the established real-time PCR method, with a range below 19.55% of the accuracy expressed as bias, 0.06-0.40 of standard deviation (SD) and 3.80-7.01% of relative standard deviations (RSD), respectively. These results indicate that the qualitative and quantitative PCR methods could be used effectively to detect the event Agb0101 in monitoring and traceability.

The Effect of 2-Week Dual Therapy with Proton Pump Inhibitor and Amoxicillin in the Eradication of Helicobacter pylori Infection for Treatment of Children with Recurrent Abdominal Pain (만성 반복성 복통 환아에서 Helicobacter pylori 감염에 대한 Proton Pump Inhibitor 및 Amoxicillin 2주 치료 효과)

  • Lee, Young-Mock;Lee, Chang-Han;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.23-29
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    • 2000
  • Purpose: It has recently been recognized that Helicobacter pylori (H. pylori) is an important factor in the pathogenesis of recurrent abdominal pain (RAP) in children. But, the best treatment for H. pylori infection is still unsettled. This study was performed to evaluate the efficacy of 2 weeks dual therapy with proton pump inhibitor (PPI) and amoxicillin for children with H. pylori infection associated with RAP. Method: Our study included 24 children with RAP who were H. pylori positive assessed by CLO test and histologic examination (silver stain). We used the regimen consisted of PPI (omeprazole, 0.7 mg/kg/day) and amoxicillin (50 mg/kg/day) for 2 weeks to eradicate H. pylori. Eradication of H. pylori was determined 4 weeks after the termination of treatment using the CLO test and histologic examination. Results: The endoscopic diagnoses of patients were nodular gastritis in 11 cases, superficial gastritis in 7 cases, peptic ulcer in 4 cases and normal finding in 2 cases. H. pylori was eradicated in 12 cases by omeprazole and amoxicillin dual therapy for 2 weeks and the eradication rate was 50%. In 4 of 12 children in whom H. pylori had not been eradicated with that regimen, we successfully eradicated H. pylori with other regimens of which 2 or 3 drugs among omeprazole, amoxicillin, clarithromycin, colloidal bismuth subcitrate ($Denol^{(R)}$) and metronidazole were used. Conclusion: The dual therapy with PPI and amoxicillin for 2 weeks had no clear advantage over other regimens for the eradication of H. pylori infection in children. We concluded that the combi-nation of PPI and amoxicillin for 2 weeks is not so good for H. pylori eradication as other commonly used regimens.

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Meconium Obstruction in Very Low Birth Weight Infants (극소저출생체중아에서 태변에 의한 장폐색에 관한 연구)

  • Hong, Ki-Bae;Seong, In-Chang;Lee, Kun-Song;Chang, Young-Pyo;Song, Hee-Seung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.52-58
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    • 2011
  • Purpose: Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema. Methods: Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction. Results: 1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed. Conclusion: Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.