• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.548-553
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• 2006

Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.516-522
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• 2006

Background : In contrast to tuberculous pleurisy, tuberculous empyema is a chronic active infectious disease of the pleural cavity that is frequently accompanied by cavitary or advanced pulmonary lesions. The condition requires long-term anti-tuberculous medication with external drainage. The clinical features and treatment outcome of tuberculous empyema are unclear despite the high prevalence of tuberculosis in Korea. Methods : From January 1991 through April 2004, 17 patients diagnosed with tuberculous empyema in Kyungpook National University Hospital were enrolled in this study. Their medical records and chest radiographs were reviewed. Results : Twelve patients(71%) had a history of tuberculosis and six of the 12 patients were under current anti-tuberculous medication. Productive cough, fever, and dyspnea were the main complaints. There was no predominance between the right and left lungs. Nine patients(53%) had far-advanced pulmonary tuberculosis, two(12%) had a cavitary lesion, and seven(41%) had a pyopneumothorax on the chest radiograph. All eight cases in whom the data of pleural fluid WBC differential count was available showed polymorphonuclear leukocyte predominance. Eight patients(47%) had other bacterial infections as well. The overall rates of a positive sputum AFB smear and culture for M. tuberculosis were 71% and 64%, respectively. The positive AFB smear and culture rates for M. tuberculosis from the pleural fluid were 33% and 36%, respectively. Twelve of the 16 patients(75%) were treated successfully. Three underwent additional surgical intervention. Two patients (12%) died during treatment. Conclusion : Tuberculous empyema is frequently accompanied by advanced pulmonary lesions, and polymorphonuclear leukocytes are predominant in the pleural fluid. Other accompanying bacterial infections in the pleural cavity are also common in tuberculous empyema patients. Therefore, tuberculous empyema should be considered in differential diagnosis of patients with polymorphonuclear leukocyte-predominant pleural effusion. In addition, more active effort will be needed to achieve a bacteriological diagnosis in the pleural fluid.

• Journal of the Korean Society of Food Science and Nutrition
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• v.31 no.5
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• pp.847-885
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• 2002

The purpose of this study was to develop a web-based internet program for nutritional assessment and diet Prescription by renal diseases. Renal diseases were classified by nephrotic syndrome, renal failure, hemodialysis and peritoneal dialysis. The system consisted of five parts according to their functions and contents. The first part is to assess the general health status such as body weight, obesity index, basal metabolic rate and total energy requirement by the input of age, sex, height, weight and degree of activity. The second part was designed to investigate dietary history of patient, that is, to find out his inappropriate dietary habit and give him some suggestions for appropriate dietary behavior by investigating his dietary history. This part also offers the diet and nutrition management by personal status with renal disease, and the information for food selection, snacks, convenience foods, dine-out, behavioral modification, cooking methods, food exchange lists and terms. The third part is evaluating their energy and nutrients intake by comparing with recommended dietary allowance for Koreans or standardized data for patient with renal disease. In this part, it is also analyzing energy and nutrients of food consumed by food group and meals, and evaluating the status of nutrient intake. The fort]1 one, a major part of the system, is implementing the diet and menu planning by using food exchange lists. This Part Provides the patient with menus lists and I day menu suitable to his weight, activity and the status of renal disease. The fifth part is providing information on energy and nutrients of foods and drinks, and top 20 foods classified by nutrients. These results are finally displayed as tabular forms and graphical forms on the computer screen.

• Journal of Korean Society of Forest Science
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• v.81 no.4
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• pp.337-345
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• 1992

In this research, a kinematic wave model was applied for the runoff analysis, Regulation of streamflow was estimated by the calibration of roughness coefficient as a parameter. The data analyzed were obtained from Ananomiya and Shirasaka experimental basins at Tokyo University Forest in Aichi. Estimation methods and characteristics of roughness coefficient as a evaluation method of hydrological function of forest are summarized as follows ; 1. Roughness coefficient($N_s$) indicates the resistance of hillslope to the flowing water of surface runoff. There exists an hypothesis that resistance of hillslope to flowing water increase with the growth forest and development of the $A_o$ layer. 2. Roughness coefficient($N_s$) was estimated by the parameter when the stream direct runoff was calculated by using the kinematic wave. 3. Secular change of '$N_s$' in ananomiya has a curve which has an upper limit and increases exponentially near the limit. The curve quickly increased from 1935 to 1945 when results of afforestation for erosion control were thought to be effective. On the other hand, slight increase of '$N_s$' in Shirasaka indicates that there was not such a big change in the surface of soil layer. 4. The increase of '$N_s$' was related with decrease of direct runoff and increase of base flow. It was recognized that the rate of direct runoff decreased with the improvement of forest physiognomy and the rate of base flow was increased. But absolute value of water runoff per one storm decreased in chronological order.

• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.61-68
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• 2001

Purpose: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). Materials and methods: One hundred fifty patients (M:F=83:67, age $48.6{\pm}11.2$ yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (${\geq}200dpm$), Intermediate ($50{\sim}199dpm$) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. Results: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were $45{\pm}27$ dpm in grade 0, $707{\pm}584dpm$ in grade 1, $1558{\pm}584dpm$ in grade 2, $1851{\pm}604dpm$ in grade 3, and $2719{\pm}892dpm$ in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. Conclusion: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.

• Journal of Genetic Medicine
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• v.4 no.2
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• pp.167-178
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• 2007

Purpose : The necessity of professional non-MD genetic counselor has been recently emphasized in a medical field. By conducting a national survey on the demands for generic counseling and professional non-MD generic counselor, we can make a long-term master plan to execute the educational program for professional genetic counselors and indeed promote genetic counseling in Korean health care service in a systemic manner. Methods : The survey has been conducted from September 3rd to October 4th of 2007 in a way of e-mail, telephone interview, fax, and direct contacts. It's targets were senior researchers and professors in medical and non-medical institutions, policy makers, research institutions or foundations. The survey questions consist of 16 questionnaires. Results : As a result of survey, 102 of 650 people responded. 80% of respondents indicated that genetic counseling is needed as a health care service and 34% among them considered it as "the most needed". In addition, 77% of the respondents showed that, it is necessary to have a professional non-MD genetic counselor with a master degree or higher in the field of medical genetics and among them 29% thought it as "the most necessary". A 77% of respondents considered that the cost of genetic counseling should be covered by health insurance and among them, 29% answered "strongly agreed". A 56% of respondents chose the answer of "They have a plan to hire the professional non-MD genetic counselor" in their institution, and among them 71% selected "within 5 years" in terms of when to hire. Also, they tend to expect the role of the professional non-MD genetic counselor to be not only "genetic counselor" (60%), but also "researcher" (42%), "educator" (18%) and "clinical laboratory coordinator" (19%). Conclusion : The 102 of 650 people responded to the survey. Based upon the nationwide survey over the needs on genetic counseling in health care service and demands on the professional non-MD genetic counselor, systematic educational program for the genetic counseling, with reimbursement coverage for counseling service by health insurance should be emphasized in development of a master plan.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.17-20
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• 2010

Purpose: The hepatobiliary scan is the examination which is the possibility of knowing the function of liver, gall bladder and closing of the biliary tract. Also, after subtotal gastrectomy, the increased gastric-bile reflux is known as the primary reason of reflux gastritis. In this study, according to changing the acquisition method, we tried to prove the reflux time and reflux index in patients who underwent subtotal gastrectomy. Materials and Methods: From Oct 2008 to Jan 2009, 72 patients with subtotal gastrectomy who took the hepatobiliary scan (man: 52, woman: 20, age range: 31-77, mean age: $60.5{\pm}7$) in our department. We used the radiopharmaceutical $^{99m}Tc$-mebrofenin 185 MBq/0.5 cc. After 5 minutes, we acquired 300,000 counts anterior image on supine, and then we acquired right lateral and $45^{\circ}$ LAO position by using the time setting method. We acquired 30 min, 60 min, 90 min, 120 min and fatty meal by the same method. We painted the ROI of liver, GB and CBD on 30 min anterior image and LAO image in patients had occurred the bile juice reflux. And then we painted the ROI of stomach on others image. We calculated the reflux index from those values. Results: According to this study, we found out 40 patients (55.6%) who had occurred the gastric-bile juice reflux (1 person from 30 min, 7 persons from 60 min, 4 persons from 90 min, 28 persons from after fatty meal). Hourly, the bile reflux highest level is 6 persons from 60 min, 2 persons from 90 min, 32 persons from fatty meal among those people. The reflux index of anterior is 0.85-23.36% (mean 6.53%). The reflux index of LAO is 1-29.13% (mean 8.89%). By visual assessment, we can distinguish that there were 26 of the 40 patients (65%) had occurred the reflux on LAO image more than anterior image. Conclusion: We find out that the patients with subtotal gastrectomy had occurred gastric-bile juice reflux more than 50% from hepatobiliary scan. And after eating fatty meal, we can know that it's the most possible to occur the gastric-bile juice reflux. When it happened, we have to change the acquisition method to reduce the overlap between colon and stomach. This study will be more valuable in diagnosis.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.197-203
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• 2015

The Study on the patient is in a clinical researcher is not necessarily pose before after before after dwichim (Pronation) pose with neck-in-law (RAO, LAO) to chwalyoungbeop subjective evaluation experiment looked at objectively. Overview evaluation is a result of measuring the angle of the space between the vertebrae in PACS image $C_2{\sim}C_3$, $C_3{\sim}C_4$, $C_4{\sim}C_5$, $C_5{\sim}C_6$, $C_6{\sim}C_7$, in the angle of the $C_7{\sim}T_1$ $47.4^{\circ}{\pm}3.3$, $50.5^{\circ}{\pm}2.3$, $52.7^{\circ}{\pm}4.2$, $53.2^{\circ}{\pm}1.9$, $53.2^{\circ}{\pm}2.3$, $55.2^{\circ}{\pm}2.3$ was found to show increasing the angle between the ball and the median nerve in the lower neck sagittal grows. In a comparison of the measured angles in foraminal image was not significantly different (P>0.01). Subjective evaluation Recever Operation characteristic to the top, the upper neck hole (foramen) C2 ~ C3-up than conventional $45^{\circ}$ angle of the lower neck, $C_3{\sim}C_4$, were observed in the well $50^{\circ}$ $C_5{\sim}C_6$, $C_6{\sim}C_7$, the $C_7{\sim}T_1$ was observed at $55^{\circ}$ well observed experimental results video recession neck vertebrae son-in-law, son-in-law taken place in an objective evaluation, subjective evaluation of the upper neck after case could be observed at $50^{\circ}$, well in the lower neck $55^{\circ}$.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.149-158
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• 2004

Purpose : In order to evaluate the value of the renal expression of ICAM-1 as a marker of renal injury, we analyzed the relationship between abnormal tubular expression of ICAM-1 and histopathological features and clinical manifestations in children with IgA nephropathy (IgAN). Methods: The clinical data from 43 patients with IgAN were analyzed retrospectively and compared to the histopathologic subclassification proposed by Haas. ICAM-1 in tubular epithelium was assessed using the LSAB(Labeled streptavidine biotin) kit on the renal biopsy specimens. Results: In 43 patients with primary IgAN, 28 males and 15 females aged $12.2{\pm}2.2$ years were studied. There were no differences of renal tubular expression of ICAM-1 between patients with gross hematuria and without gross hematuria. But renal tubular expression of ICAM-1 in patients with proteinuria was significantly higher than that of in patients without proteinuria($78.2{\pm}14.19%\;vs\;55.8{\pm}32.20%,\;P<0.05$). Renal tubular expression of ICAM-1 was also associated with the severity of histopathological degree using Haas classification method. In subclass I, renal tubular expression of ICAM-1 was significantly lower than those of other subclasses. A significant correlation was found between the tubular expression of ICAM-1 and the total amount of protein in 24 hour collected urine$(r_s=0.47236,\;p<0.05)$. But there were no significant correlations between the renal tubular expression of ICAM-1 and interstitial cellular infiltration, tubular atrophy, and interstitial fibrosis respectively(F=0.89, P>0.05; F=0.31, p>0.05; F=0.21, p>0.05). Conclusion: Renal tubular expression of ICAM-1 can be a useful marker of renal injury in children with IgAN. (J Korean Soc Pediatr Nephrol 2004;8:149-158)

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.40-48
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• 2009

Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.