• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.5-20
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• 2002

허혈성 심질환 환자의 평가도구로서 MRI의 역할이 확대된 데에는 소위 "one-stop shop"이라는 통합적 심장검사법의 개발이 계기가 되었다. 즉 한 번의 MRI 검사로서 심실벽운동을 평가하여 심근의 기능과 예비능을 측정하여 만성 심근경색을 평가할 수 있고, 심근의 관류를 평가할 수 있고, 관동맥의 혈류 예비능과 심근의 viability를 평가하고, 관동맥 조영술을 통해, 수술 후의 우회로 평가 및 관동맥의 협착 여부의 진단이 가능한 프로토콜이 MRI장비마다 각각 개발되어 보급되고 있다. 하드웨어와 소프트웨어의 개발과 지속적인 연구를 통해서 MRI는 허혈성 심질환의 진단적 검사로서 기존의 다른 검사들과 비교하여 높은 시간적, 공간적 해상력으로 정확한 구조와 기능의 평가를 제공할 수 있는 가장 유용한 검사가 될 것으로 사료된다 특히, MR 관동맥조영술, 심근관류검사, 심근 표지법, dobutamine 부하검사, viability 평가, plaque characterization, MR spectroscopy 분야에서 현재 활발히 연구가 진행되고 있으며 향후 임상적용이 확대될 것으로 예상된다.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1158-1166
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• 2006

Purpose : The purpose of this study is to make a diagnostic classification and discuss a diagnostic strategy of floppy infants by investigating clinical, neurological, electrophysiological, and genetic analysis of infants admitted to intensive care units with the complaint of hypotonia. Methods : A retrospective study was performed from Jan. 1993 to Dec. 2005 in neonatal and pediatric intensive care units of Seoul National University Children's Hospital. Clinical features and all tests related to hypotonia were investigated. Results : There were 21 cases of floppy infants admitted to intensive care units. Final diagnosis was classified as centra (7 cases[33.3 percent]), peripheral (11 cases [52.4 percent]), and unspecified (3 cases [14.3 percent]). Among the central group, three patients were diagnosed as hypoxic ischemic encephalopathy, two patients as Prader-Willi syndrome, one patient as chromosomal disorder, and one patient as transient hypotonia. Among the peripheral group, four patients were diagnosed as myotubular myopathy, three patients as SMA type 1, two patients as congenital myotonic dystrophy, one patient as congenital muscular dystrophy, and one as unspecified motor-neuron disease. Motor power was above grade 3 on average, and deep tendon reflex was brisk in the central group. Among investigations, electromyography showed 66 percent sensitivity in the peripheral group, and muscle biopsy was all diagnostic in the peripheral group. Brain image was diagnostic in the central group, and Prader-Willi FISH or karyotyping was helpful in diagnosis in central group. Morbidity and mortality was more severe in the peripheral group Conclusion : Classification of diagnosis by clinical characteristics in this study, and application of investigations step by step, may provide an effective diagnostic strategy.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.559-564
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• 2010

The purpose of this study was to evaluate the value of dacryoscintigraphy with Tc-99 m Pertechnetate, which is useful in functional nasolacrimal duct obstruction diagnosis in human medical science, by applying it to normal dogs. Dacryoscintigraphy was performed on six clinically healthy beagle dogs to confirm normal passage of their lacrimal ducts. The scintigraphic images of both lacrimal system were obtained at 5 min, 10 min, and 20 min after Tc-99 m Pertechnetate administration, respectively. If lacrimal duct does not come into view within 20 min, delayed images at 30min, 45min and 60 min were gained. After drawing ROI of left and right canaliculus, lacrimal sac, and nasolacrimal duct acquired after dacryoscintigraphy, we measured each counting rate and developed a counting rate table for each time interval. Of the total of 12 places, 10 (83.3%) showed patency within 20 min, and 11 (91.6%) showed patency within 30 min. In one dog, a functional obstruction of right lacrimal canal was observed. Dacryoscintigraphy could provide useful information about functional and anatomical lacrimal duct obstruction in veterinary medicine as well as in clinical research.

• The KIPS Transactions:PartB
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• v.15B no.5
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• pp.397-406
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• 2008

Despite the effectiveness of oriental medical practice in the diagnosis of symptoms and providing cure to it, the preferences in western medicinal values is socially prevalent. The diagnosis of a disease using western medicinal practices provides us with an objective diagnostic result, however, decisions by oriental doctors are based on their heuristic intuitions developed by practice and experience. Objective solutions for the cure of symptoms using oriental medical therapy can have a high impact on the world market. Therefore, development of diagnostic machines based on oriental therapy can enhance the Ocular Inspection which is evaluated as one of the best diagnostic treatment among Oriental Medical Science, is not researched much compared to other diagnoses. Because there is no color diagnosis rules for digital machines to analyze the actual color, looking at the person's face color is one of the most important components to diagnose the disease or illness. The thesis proposes the implementation of absolute observing a person's face color standards of the color settings for objective diagnosis. As a results, comparative digital color analysis for observing a person's face color can be the most effective rule based Color scheme system to diagnose disease. A standard solution for the researching conditions is suggested to reduce the variable which may occur depending on the differences between the researching conditions.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.281-289
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• 2000

Background : Mycobacterial culture is a confirmatory test to detect. M. tuberculosis, but it takes at least 6 weeks to diagnose. PCR is a rapid and sensitive method, but it is known that PCR has a high false positive rate due to contamination, and a high false negative rate due to inhibitors. It is also known that LCR and PCR-Hybridization, recently developed methods, are more specific methods than PCR in terms of detecting M. tuberculosis. In this study, we estimated the clinical utility of in house PCR, LCR and PCR-Hybridization for the detection of M. tuberculosis. Methods : We evaluated 75 specimens, upon which M. tuberculosis culture based testing was requested, by PCR LCR, and PCR-Hybridization and compared results. Mycobacterial culture was performed on 3% Ogawa media for 8 weeks, and an in house PCR, LCx Mycobacterium tuberculosis assay kit (Abbott Laboratories, North Chicago, III) and the AMPLICOR M. tuberculosis test kit (Roche Molecular Systems, Inc. Branchburg, NJ. USA). Results : In the view of the culture results, the sensitivities of the three tests were 40%, 80%, and 100% and their specificities were 98.6%, 94.3%, and 94.3%. Conclusion : LCR and PCR-Hybridization are rapid and sensitive methods for detecting M. tuberculosis in clinical laboratories.

• Clinical and Experimental Pediatrics
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• v.46 no.5
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• pp.440-446
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• 2003

Purpose : The genetic disturbance of galactosemia is expressed as a cellular deficiency of either galactose-1-phosphate uridyltransferase(GALT) or galactokinase(GALK) or UDP galactose 4-epimerase(GALE). To find-out the pattern of galactosemia in Korea, we retrospectively analyzed cases of galactosemia detected by neonatal screening program. Methods : We analyzed medical records of patients who visited Soonchunhyang University Hospital at age of 1 month after showing abnormalities in neonatal screening of galactosemia. For accurate diagnosis, galactose was measured by enzyme immunoassay(EIA) and fluorophotometer, also galactose-1-phosphate by fluorophotometer. Enzyme activities of GALK, GALT and GALE in RBC and galactose-1-phosphate were measured by radioisotope assay(RIA). Beutler test were done. Patients went on a lactose-free diet and follow-up tests for galactose, galactose-1-phosphate level and enzyme activity were performed. Results : 10 patients(male : 6, female : 4) were diagnosed as galactosemia. Two patients had GALK deficiency and two had GALT deficiency. Six were GALE deficient showing the largest number. In two patients with GALK deficiency, GALT and GALE activities were normal but GALK activities showed respectively reduced activity. For GALT deficiency, two patients had low GALT activity in RBC and showed genotype of Duarte 2/G(galactosemia) in DNA analysis. In one patient, GALT activity was normal. Three patients seemed to be heterozygote state of GALE deficiency according to GALE activity levels. Four patients showed GALK hyperactivity. Conclusion : GALE deficiency provided the highest number. After lactose-free diet, galactose and galactose-1-phosphate were normaly maintained. Neonatal screening on galactosemia is essential for preventing life-threatening symptoms and an accurate diagnosis is needed for finding out the type of galactosemia which is important for prognosis.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1116-1124
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• 2007

Purpose : Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. Methods : Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. Results : Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. Conclusion : This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.193-199
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• 2006

Purpose: The proper diagnosis of Meckel's diverticulum (MD) is difficult and delayed because of the variety of clinical manifestations. We reviewed clinical characteristics of symptomatic MD to facilitate early detection. Methods: We analyzed retrospectively the clinical manifestations, diagnostic tools, histopathological findings, and operative findings in 58 patients with symptomatic MD. Results: The male to female ratio was 2.8 : 1. The most common symptom of MD was bleeding. Others symptoms included: vomiting, abdominal pain, irritability, abdominal distension and fever in the order of frequency. The clinical manifestations of symptomatic MD were lower gastrointestinal bleeding, intestinal obstruction, perforation, diverticulitis and hemoperitoneum, in the order of frequency. The causes of intestinal obstruction were intussusception, internal hernia, band, volvulus, invagination, in the order of frequency. Seventy five percent of patient with MD were diagnosed prior to 5 years of age. The most frequently used diagnostic tool was the Meckel's scan. The diverticulum was located 2 cm to 120 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 1 cm to 10 cm and 94% were less than 5 cm. The most common ectopic tissue found in the MD was gastric mucosa. Ileal resection was more frequently performed than diverticulectomy. Conclusion: In cases of unexplained gastrointestinal bleeding, obstruction and repeated intussusception, the meckel's scan, ultrasound and computed tomography shoud be considered to rule out MD, and if clinically necessary, an exploratory laparotomy when needed.

• Korean Security Journal
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• no.10
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• pp.293-322
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• 2005

The culpability of a person, as determined by due process of law, for any of his actions that are defined as criminal. Determination of such responsibility is a legal function, not a psychiatric one, although a psychiatrist may be called upon to present evidence to the court in order to aid the judge or jury in reaching a decision as to responsibility. Determination of responsibility varies with the laws of the state in which the accused is being tried, but in general all states base their laws on three famous judicial decisions concerning criminal responsibility. 1. the M'Naghten(McNaughton) rule(a. to establish such a defense the accused, at the time the act was committed, must be shown to have been laboring under such defect of reason as not to know the nature and quality of the act he was doing, b. if he did know it, he did or know that what he was doing was wrong). 2. the irresistible impulse test. 3. the Durham decision. Under the Durham test, however, the psychiatrist may give any relevant testmony concerning the mental illness at issue. The psychological and behavioral appearance of a person, in clinical psychiatry this term is commonly used to refer to the results of the mental examination of a patient. The written report of the mental status usually contains specific references to the following areas: I. Attitude and General Behavior (1)General health and appearance. (2)General habits of dress. (3)Personal habits. (4)General mood. (5)Use of leisure time. (6)Degree of sociability. (7)Speech. II. Attitude and Behavior during interview (1)Co-operativeness. (2)Poise. (3)Facial expression. (4)Motor activity. (5)Mental activity. (6)Emotional reactions. (7)Trend of thought. III. Sensorium, mental grasp, and capacity (1)Orientation. (2)Memory and retention. (3)Estimate of intelligence. (4)Abstraction ability. (5)Tests of absurdity, interpretation of proverbs. (6)Judgment.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.174-177
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• 2005

Purpose : We evaluated children with Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) in terms of epidemiology and clinical characteristics. Methods : A total of 424 medical records of children with HSP admitted to The Catholic University of Korea, Daejeon St. Mary's Hospital, from 1987 to 2003 were retrospectively analyzed. Results : The mean annual number of cases was $25.1{\pm}7.9$ and no one year showed an outbreak. There was a steady number of patients throughout the year with a decrease during the summer season. The male-to-female ratio was 1.3 : 1 with the median age of the patients being 6-years-old. The age distribution showed a peak at age 6 in a bell-shaped distribution curve. Purpura was noted in 100 percent of the patients, gastrointestinal involvement in 53.8 percent, joint involvement in 40.8 percent, and renal involvement in 18.9 percent. Nephrotic syndrome occurred in 1 percent of all patients. Conclusion : The epidemiologic and clinical features of HSP were similar to those of other regions in Korea and foreign nations, irrespective of time.