• Title/Summary/Keyword: 이형도

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Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index (만성 폐쇄성 폐질환 환자에서 Tei 지수를 이용한 우심실기능 평가)

  • Oh, Yoon-Jung;Shin, Joon-Han;Kim, Deog-Ki;Choi, Young-Hwa;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.343-352
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    • 2001
  • Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

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Comparison of Perception Differences About Nuclear Energy in 4 East Asian Country Students: Aiming at $10^{th}$ Grade Students who Participated in Scientific Camps, from Four East Asian Countries: Korea, Japan, Taiwan, and Singapore (동아시아 4개국 학생들의 핵에너지에 대한 인식 비교: 과학캠프에 참가한 한국, 일본, 대만, 싱가포르 10학년 학생들을 대상으로)

  • Lee, Hyeong-Jae;Park, Sang-Tae
    • Journal of The Korean Association For Science Education
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    • v.32 no.4
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    • pp.775-788
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    • 2012
  • This study was done at a scientific camp sponsored by Nara Women's University Secondary School, Japan. In this school, $10^{th}$ grade students from 4 East Asian countries: Korea, Japan, Taiwan, and Singapore, participated. We made a research on students' perceptions about nuclear energy. Sample populations include 77 students in total, with 12 Korean, 46 Japanese, 9 Taiwanese and 10 Singaporean students. Overall perceptions comparison about nuclear energy shows average values from the order of highest Korea, Taiwan, Singapore, and to lowest, Japan. We implemented a T-test to identify perception differences about nuclear energy, with one group that include 3 countries (Korea, Taiwan and Singapore) and another group that includes all the Japanese students. T-test results of perceptions about nuclear energy shows students from the 3 countries of Korea, Taiwan and Singapore having higher average than Japanese students. (p<.05). Korean average scores regarding overall perceptions about nuclear energy show as the highest in all 4 East Asian countries and also highest in all subcategories. On the contrary in Japan, they have lower and negative perceptions of nuclear energy. In spite of these facts, perceptions of Japanese students about nuclear energy seem lowest and negative mainly because of the recent Fukushima nuclear power plant disaster, caused by the tsunami and its subsequent damages and fears of radiation leaks, etc. This shows that negative information about future disasters and its resulting damages like the Chernobyl nuclear accident could influence more on people's risk perception than general information like nuclear energy-related technologies or the news that the plant is operating normally, etc. Even if the possibility of this kind of accident is very low, just one accident could bring abnormal risks to technology itself. This strong signal makes negative image and strengthens its perceptions to the people. This could bring a stigma about nuclear energy. This study shows that Government's policy about the highest priority for nuclear energy safety is most important. As long as such perception and decision are fixed, we found that it might not be easy to get changed again because they were already fortified and maintained.

Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis (성인 말성 부비동염에서 내시경적 부비동 수술 전.후의 증상 호전도와 음향비강통기도 검사 결과)

  • Kim, Yong-Dae;Kim, Jae-Yeul;Chang, Keun-Young;Lee, Hyung-Joong;Song, Si-Youn;Yoon, Seok-Keun
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.28-38
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    • 2002
  • Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusions: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

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Estimation of Glomerular Filtration Rate(GFR) Using $^{99m}Tc$-DTPA Renal Scan and the Parameters for Renal Function ($^{99m}Tc$-DTPA를 이용한 신장스캔에서 사구체 여과율의 측정방법과 영상분석에서 구한 지표들에 의한 신장기능의 평가)

  • Cho, Ihn-Ho;Yoon, Hyun-Dae;Won, Kyu-Chang;Lee, Chan-Woo;Lee, Hyoung-Woo;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.101-108
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    • 1994
  • Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of $^{99m}Tc$-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using $^{99m}Tc$-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GFR calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of $^{99m}Tc$-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GFR. In conclusion, the determination of GFR according to the Gates' formula shows good and reproducible of GFR with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

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Effects of Early Parenteral Nutrition for Extremely Low Birth Weight Infants (초극소 저출생 체중아(${\leq}$1,000 g)에서 조기에 시작하는 정맥 영양공급의 효과)

  • Ahn, So-Yoon;Shin, Ji-Hun;Shin, Jung-Hee;Sung, Se-In;Jung, Ji-Mi;Kim, Jin-Kyu;Chang, Yun-Sil;Jang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.76-81
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    • 2011
  • Purpose: The object of this study was to evaluate the efficacy of early total parenteral nutrition with early amino acid in extremely low birth weight infant (ELBWI). Methods: We retrospectively analyzed the medical records of all ELBWIs who were born and admitted to Samsung Medical Center from January 2003 to December 2003 and January 2009 to December 2009 and alive at the time of discharge. Data for nutritional status and morbidities were compared between period 1 (2003, n=22), in which parenteral nutritional support was started gradually over several days and period 2 (2009, n=38), in which parenteral nutrition with amino acid was started as soon as possible after birth. Results: Compared to period 1, birth weight and Apgar score were lower in period 2. The intake amount of glucose, amino acid and total calorie was higher and the level of blood urea nitrogen was increased more from 7th day to 14th day after birth in period 2 when compared than period 1. The weight gain velocity was faster at 7th and 14th postnatal day in period 2. There were no differences in the incidence of necrotizing enterocolitis, moderate to severe bronchopulmonary dysplasia, and severe intraventricular hemorrhage (${\geq}$ Gr III) between two periods but, the incidence of periventricular leukomalacia(PVL) was significantly lower in period 2. Conclusion: Early initiation of total parenteral nutrition with early amino acid in ELBWIs was beneficial at weight gain with lowering catabolism and increasing anabolism. And it could be related with reducing the incidence of PVL.

Quantitative Evaluation of Regional Cerebral Blood Flow by Visual Stimulation in $^{99m}Tc-HMPAO$ Brain SPECT ($^{99m}Tc-HMPAO$ 뇌 SPECT에서 시각자극에 의한 국소 뇌 혈류변화의 정량적 검증)

  • Juh, Ra-Hyeong;Suh, Tae-Suk;Kwark, Chul-Eun;Choe, Bo-Young;Lee, Hyoung-Koo;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.166-176
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    • 2002
  • Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of $^{99m}Tc-HMPAO$ (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Methods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and $^{99m}Tc-HMPAO$ SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the legion of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was $32.50{\pm}5.67%$. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

Evaluation of Perinatal and Management Factors Associated with Improved Survival in Extremely Low Birth Weight Infants (출생 체중 1,000 g 미만의 초극소 미숙아의 생존율 향상과 연관된 산과 및 치료인자)

  • Park, Sung Eun;Jeon, Ga Won;Choi, Chang Won;Hwang, Jong Hee;Koo, Soo Hyun;Kim, Yu Jin;Lee, Chang Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1324-1329
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    • 2005
  • Purpose : The aim of this study was to evaluate recent improvements in the survival rate of extremely low birth weight (ELBW) infants and to identify perinatal and management factors that are associated with improved survival. Methods : Two groups of ELBW infants who were admitted to our neonatal intensive care unit (NICU) during two distinct eras : November 1994-December 1999 (Period 1 : n=100) and January 2000-April 2004 (Period 2 : n=166) were retrospectively reviewed. Results : Despite the younger gestational age and smaller birth weight of the ELBW infants in period 2, not only did their survival rate increased to 75 percent from 60 percent in period 1, but their incidence of morbidities such as bronchopulmonary dysplasia, confimed sepsis and intraventricular hemorrhage (${\geq}$Grade III) also declined. Factors significantly associated with improved survival included the use of antenatal steroids, a longer duration of nasal continuous positive airway pressure and the absence of intraventricular hemorrhage (${\geq}$Grade III). Conclusion : We believe that optimized clinical practice, that emphasized less invasive care, contributed to the recent improvements in the survival rate of ELBW infants.

A Comparative Study of Measles According to Age (홍역에서 연령별 임상상 비교)

  • Eun, Eun-Sung;Choi, Sang-Lim;Lee, Kyung-Yil;Lee, Hyung-Shin;Hong, Ja-Hyun;Kang, Jin-Han;Whang, Kyung-Tai
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.33-36
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    • 2003
  • Purpose : We evaluated clinical manifestations and laboratory findings in patients with measles according to age distribution. Methods : Retrospective analyses were performed using medical records of patients with measles admitted to The Catholic University of Korea, Daejon St. Mary's Hospital from October 2000 to May 2001. We divided the patients with measles into three age groups, i.e., those who were under two years of age(159 patients), those between 9-11 years of age(39 patients), and those older than 16 years of age who were hospitalized in the department of internal medicine(young adult group; 23 patients). We compared clinical and laboratory characteristics among these three groups. Results : Almost all patients with measles were presented with fever, skin rash and cough. No statistical differences were present between the three groups in total fever duration, number of hospitalization days, complications determined with longer hospitalization for more than eight days, and positive values of anti-measles IgM. Patients under 2 years of age showed statistically higher levels of white bood cell and lymphocyte counts. However, neutropenia and lymphopenia were observed in all age groups compared with age-matched standard values. Campared with the other two age groups, the young adult group showed a higher mean level of liver enzymes(AST/ALT) and more patients with a level twice as high as the normal values. Conclusion : Clinical manifestations including complications according to age groups showed no significant differences in patients with measles. Hepatic involvement was more prevalent in the young adult group.

Gastrointestinal surgery in very low birth weight infants: Clinical characteristics (극소 저체중 출생아에서 시행한 소화기계 수술의 임상적 특성)

  • Kim, Ji Eun;Yoo, Hye Soo;Kim, Hea Eun;Park, Soo Kyoung;Jeong, Yoo Jin;Choi, Seo Heui;Seo, Hyun Joo;Chang, Yun Sil;Seo, Jeong Meen;Park, Won Soon;Lee, Suk Koo
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.295-302
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    • 2009
  • Purpose : To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. Methods : Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed. Results : The mean gestational age ($27^{+6}2^{+3}$ vs. $28^{+5}{\pm}$2^{+6}$) and birth weight (979${\pm}$241 g vs. 1,071${\pm}$271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period. Conclusion : GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.

The usefulness of diagnostic tests in children with language delay (언어 발달지연 환아에서 진단적 검사의 유용성)

  • Oh, Seung Taek;Lee, Eun Sil;Moon, Han Ku
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.289-294
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    • 2009
  • Purpose : To assess the usefulness of magnetic resonance imaging (MRI), karyotyping, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG), tandem mass screening test, and newborn metabolic screening test in children with language delay for diagnosing underlying diseases. Methods : From January 2000 to June 2007, a retrospective chart review was performed for 122 children with language delay who visited the Child Neurology Clinic at Yeungnam University Hospital and who underwent neuropsychologic tests and other diagnostic evaluations for underlying diseases. They were grouped into phenomenological diagnostic categories, and test results were analyzed according to the underlying diseases. Results : Of 122 patients, 47 (38.5%) had mental retardation, 40 (32.8%) had developmental language disorders, 23 (18.9 %) had borderline IQ, and 12 (9.8%) had autism spectrum disorder. In 26 (21.3%) cases, the causes or relevant clinical findings to explain language delay were found. Eight (10.4%) of 77 MRIs, 6 (8.0%) of 75 EEGs, and 4 (5%) of 80 BAEPs showed abnormal results. Results directly attributed to diagnosing underlying diseases were 2 hearing defects in BAEPs and 1 bilateral perisylvian cortical dysplasia in MRIs. No abnormal results were found in karyotyping, tandem mass screening tests, and new-born screening tests. Conclusion : Commonly used tests to diagnose the cause of language delay are not very effective and should only be used selectively, according to patient characteristics. However, despite the low diagnostic yields from these tests, because many patients show abnormal results, these tests are useful when conducted in complete evaluation.