• Title/Summary/Keyword: 임상 결과 예측

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A Change of Adrenal Androgen and Cortisol in Kawasaki Disease (가와사끼병에서 부신 안드로겐과 코티솔의 변화)

  • Lee, Sun-Hee;Yu, Jae-Hong;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.654-658
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    • 2002
  • Purpose : Endocrine and immune systems are connected and interdependent. Adrenal glands play an important role in this network and control the balance between serum levels of dehydroepiandrosterone sulfate(DHEAS) and cortisol. These steroids have an antagonistic effect on the T cell progression into Th1 and Th2 cells and on the induction of correlated interleukins. Therefore we evaluated the role of adrenal androgen and cortisol as immune modulators in Kawasaki disease( KD) with changes of T cell immunity. Methods : From April to August in 2001, we examined serum DHEAS and 24 hour urine free cortisol(F) before administration of immunoglobulin and steroids by radioimmunoassay in 14 KD patients. It's clinical severity was determined by Harada score and coronary lesion. Results : The age of the patient group ranged from 4 months to 4 years; its average age was 2.3 years. Three patients(21.4%) were below 1 year, 2(14.3%) between 1 and 2 years, 5(35.7%) between 2 and 3 years, 4(28.6%) between 3 and 4 years of age. Male to female ratio was 1:1.3. DHEAS was significantly decreased in patients($11.1{\pm}6.0{\mu}g/dL$) more than controls($81.6{\pm}13.3{\mu}g/dL$)(P<0.05). Twenty-four hour urine free cortisol was significantly increased in patients($36.9{\pm}21.9{\mu}g/dL$) more than controls($13.6{\pm}5.5{\mu}g/dL$)(P<0.05). Ratio of DHEAS/F was decreased remarkably in patients($0.33{\pm}0.20$) more than controls($6.65{\pm}2.56$)(P=0.016). There was no difference between ratio of DHEAS/F and Harada score, but its ratio was very low in patients with coronary aneurysm. Conclusion : These data demonstrate that there are changes of DHEAS and cortisol in acute stage of KD and the dis-equilibrium between two steroids may be relevant in the T cell immune response induction of Kawasaki disease. These changes support the use of DHEAS/F ratio as one of the predictive factors of coronary arteries complication.

The Utility of Measurement of Plasma N-terminal Pro-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension (폐동맥고혈압 진단에 있어 N-terminal Pro-brain Natriuretic Peptide 측정의 유용성)

  • Hahn, Chang Hoon;Kang, Seok Min;Moon, Jin Wook;Cho, Jae Hee;Hwang, Sang Yon;Lee, Jung Min;Park, Moo Suk;Chung, Jae Ho;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Shim, Won Heum;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.67-76
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    • 2004
  • Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

Effect of Different CT Scanner Types and Beam Collimations on Measurements of Three-Dimensional Volume and Hounsfield Units of Artificial Calculus Phantom (인공결석모형물의 부피와 하운스필드값 측정에 대한 전산화단층촬영기기의 타입과 빔 콜리메이션의 영향)

  • Wang, Jihwan;Lee, Heechun
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.495-501
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    • 2014
  • The objective of this study was to evaluate the differences and reproducibility of Hounsfield unit (HU) value and volume measurements on different computed tomography (CT) scanner types and different collimations by using a gelatin phantom. The phantom consisting of five synthetic simulated calculus spanning diameters from 3.0 mm to 12.0 mm with 100 HU was scanned using a two-channel multi-detector row CT (MDCT) scanner, a four-channel MDCT scanner, and two 64-channel MDCT scanners. For all different scanner types, the thinnest possible collimation and the second thinnest collimation was used. The HU values and volumes of the synthetic simulated calculus were independently measured three times with minimum intervals of 2 weeks and by three experienced veterinary radiologists. ANOVA and Scheff$\acute{e}$ test for the multiple comparison were performed for statistical comparison of the HU values and volumes of the synthetic simulated calculus according to different CT scanner types and different collimations. The reproducibility of the HU value and volume measurements was determined by calculating Cohen's k. The reproducibility of HU value and volume measurements was very good. HU value varied between different CT scanner types, among different beam collimations. However, there was not statistically significant difference. The percent error (PE) decreased as the collimation thickness decreased, but the decrease was statistically insignificant. In addition, no statistically significant difference in the PEs of the different CT scanner types was found. It can be concluded that the CT scanner type insignificantly affects HU value and the volumetric measurement, but that a thinner collimation tends to be more useful for accurate volumetric measurement.

Radiation Absorbed Dose Measurement after I-131 Metaiodobenzylguanidine Treatment in a patient with Pheochromycytoma (갈색세포종 환자에서 Medical Internal Radiation Dose법을 이용한 I-131 Metaiodobenzylguanidine 치료 후 흡수선량 평가)

  • Yang, Weon-Il;Kim, Byeung-Il;Lee, Jae-Sung;Lee, Jung-Rim;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.422-429
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    • 1999
  • Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

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Clinical Characteristics and Prognosis of Fuchs Dystrophy According to COL8A2 Gene Mutation Status (COL8A2 유전자 돌연변이 유무에 따른 푹스이상증의 임상적 특징 및 예후)

  • Kim, Hyun-Ah;Whang, Woong-Joo;Lee, Jee Hye;Chae, Hyojin;Kim, Myungshin;Kim, Man Soo
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.4
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    • pp.380-386
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    • 2017
  • Purpose: To compare the clinical characteristics and prognosis of Fuchs dystrophy patients according to COL8A2 gene mutation status. Methods: Eighty-one patients (162 eyes) initially diagnosed with Fuchs dystrophy from 1996 to 2015 were divided into two groups according to COL8A2 gene mutation status. Retrospective analysis was performed comparing gender, age at diagnosis, presence of family history, diabetes mellitus, symptoms of blurred vision in the morning, changes in central corneal thickness and endothelial cell density with time, need for corneal transplantation, and pre-operative corneal status in the two groups. Results: Of the 81 patients, 12 were shown to harbor a COL8A2 gene mutation. Individuals with mutation were significantly associated with presence of family history, diabetes mellitus, and blurred vision in the morning (p = 0.021, p = 0.024, p = 0.044, respectively). They also had significantly thicker central cornea and lower endothelial cell density at the time of diagnosis (p = 0.020, p = 0.005, respectively). The differences in central corneal thickness and endothelial cell density between the two eyes in one patient were significantly smaller in patients with gene mutation (p = 0.043, p = 0.022, respectively). Over a 5-year follow-up period, 60.0% of eyes in patients with gene mutation and 19.2% of eyes in patients without gene mutation underwent corneal transplantation, a significant difference between the two groups (p = 0.014). Conclusions: By testing for COL8A2 gene mutation, early binocular disease progression and the possible need for corneal transplantation in the future can be predicted among patients diagnosed with Fuchs dystrophy.

The Prognostic Factors Affecting the Occurrence of Subsequent Unprovoked Seizure in Patients Who Present with Febrile Seizure after 6 Years of Age (6세 이후 열경련 환자의 비열성발작으로 진행되는 위험 인자)

  • Lee, Hyeon Ju;Kim, Seung Hyo
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.215-220
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    • 2018
  • Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

A Comprehensive Analysis of HLA-A and HLA-DR Allele Frequencies and Haplotype Associations in a Korean Population of 790 Individuals (한국인 790명을 대상으로 한 HLA-A 및 HLA-DR 대립유전자 빈도 및 일배체형 연관성에 대한 종합적 분석)

  • Hee-Kyung HAN;Mi Hyun KIM;Seong Su JEONG;Dong Kwon KIM;Youngtaek KIM;Joon Yeon HWANG;Seong-san KANG;Seung Min YANG;Seul LEE;Sujeong BAEK;Kwangmin NA;Chai Young LEE;Yu Jin HAN;So Young PARK;Min Hee HONG;Jii Bum LEE;Sun Min LIM;Jae-Hwan KIM;Kyoung-Ho PYO;Byoung Chul CHO
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.236-247
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    • 2024
  • The human leukocyte antigen (HLA) system, which is part of the major histocompatibility complex (MHC) plays a vital role in immune responses by differentiating between itself and foreign cells and antigens. The significant diversity of alleles affects disease susceptibility and immune responses within different populations. Specifically, the HLA-A and HLA-DRB1 alleles are associated with various immune-related diseases, and understanding the frequency and haplotype associations of these alleles is vital for genetic and immunological research. To investigate the distribution of these characteristics in Koreans, we isolated peripheral blood mononuclear cells (PBMCs) from blood samples donated by volunteers at the Seoul Central Blood Bank and performed HLA typing on 790 samples. Our study found that the HLA-A and HLA-DRB1 alleles are widely distributed within the Korean population, with HLA-A*24:02 (21.7%) and HLA-DRB1*09:01 (9.9%) being the most frequent. Significant haplotype associations between specific HLA-A and HLA-DRB1 alleles were identified using the Chi-square test, suggesting that certain genetic combinations may influence disease onset. This insight could contribute to the development of predictive and preventative strategies for various diseases. The unique genetic characteristics of the Korean population highlight the importance of studying the HLA allele and the haplotype distributions in this group as key indicators for understanding disease susceptibility.

Analysis of Expression Types of Character Animation TV Advertisements (캐릭터애니메이션 TV광고의 표현유형 분석 연구)

  • Lee, Yong-Woo
    • Archives of design research
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    • v.19 no.5 s.67
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    • pp.85-94
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    • 2006
  • In the 2000s, character animation technique is used at domestic TV character animation ads of diverse items displaying new character patterns and expression techniques of a high level. This study intends to identify the characteristics of TV character animation ads based ell character aesthetic theory and advertising rhetoric theory, and based on these findings, analyze trend and stream of expression in TV character animation ads by examining and classifying advertisements released in the past four years by items, character patterns and expression techniques. The results showed that TV character animation ads have been concentrated on confectionery, beverages and foods in the past, but the items have been diversified through the years. With reference to character patterns, personal and animal characters had made the main pattern, but recently product, virtual and composite characters are on the increase. In expression techniques, cell animation technique was found to be the most frequently used technique, which was followed by full-3D, cell and live action, cell and 3D and the clay animation technique. A trend like this suggests that TV character animation advertising items will continue to increase in line with the participation level of targets. In the meantime, personal and animal characters will continue to make the leading character pattern, while virtual and composite character patterns emerge in new forms. In expression techniques, live action combined with 30 technique and techniques using new expression materials will appear with cell animation technique as a central figure. As a whole, Korean character animation advertisement is expected to keep on growing to a new dimension in the aspect of items, character patterns and expression technique.

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Establishment of Reference Value of Insulin Using the Statistical Analysis (통계적 분석을 통한 Insulin의 정상 참고치 설정)

  • Kim, Whe-Jung;Yoon, Pil-Young;Shin, Young-Goon;Yoo, Seon-Hee;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.143-146
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    • 2010
  • Purpose: Insulin is involved in carbohydrate metabolism and also it's very important because it increases storage of glycogen, synthesis of fatty acids, absorption of amino acid, synthesis of protein. Insulin is clinically useful when we evaluate fasting patients in hypoglycemia, classify and predict diabetes, assess the activity of ${\beta}$-cell, research insulin resistance. We are going to increase usability of insulin assay by establishing normal reference value according to statistical analysis. Material & Method: We selected 6,648 patients who visited asan health medical center from May to August in 2008. We set exclusion criteria as family of diabetes, diabetes medication, the past history of blood glucose rise, more than 100 mg/dL in normal fasting blood glucose, outside the scope of BMI 18.5~22.9 $kg/m^2$, and more than HbA1c 6.5%. We determine whether the subgroup is portioned as sex and age or not and establish normal reference value by conducting statistical analysis as Bayesian's method and Hoffman's method. Result: Portioning of subgroup as sex and age is not needed. By statistical analysis of Bayesian method, results 1.5-11.0 uIU/mL. By statistical analysis of Hoffman method, results 1.8~12.8 uIU/mL. Conclusion: We established 1.8~12.8 uIU/mL as Insulin normal reference value by Hoffman method. This is a similar value with reporting reference value 1.7~11.8 uIU/mL in kit. This will enhance the usability of insulin assay by establishing normal reference value.

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Diagnostic limitation and usefulness of 99mTc-DISIDA hepatobiliary scanning on neonatal cholestasis (신생아 담즙정체성 간 질환에서 담도 폐쇄증 감별을 위한 DISIDA 스캔의 진단적 한계성과 유용성)

  • Kim, Jung Mi;Choe, Byung-Ho;Jang, You Cheol;Oh, Ki Won;Cho, Min Hyun;Lee, Kyung Hee;Park, Jin-Young;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.737-744
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    • 2006
  • Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.