• Title/Summary/Keyword: 진단 지연

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Diagnosis and management of the early defoliation of Korean flowering cherry in Gurye (구례 왕벚나무 가로수의 조기낙엽 진단 및 친환경적 관리 방법)

  • Han, Areum;Jin, Seon-deok;Jeong, Gilsang;Won, Ho-yeon;Lee, Young-sang;Son, Se Hwan;Choi, Sunghoon;Kang, Hyejin;Lee, ll Hwan;Han, Ah Reum
    • Korean Journal of Environmental Biology
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    • v.37 no.4
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    • pp.682-689
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    • 2019
  • The Korean flowering cherry is a popular tree. However, the trees have started to defoliate early, including those in Gurye. Thus, it is necessary to identify the causes of the early defoliation and how to manage them. Therefore, the purpose of this study was threefold: 1) to investigate the early defoliation of flowering cherry trees, 2) to identify the differences in growth and flowering of the trees in response to treatment, and 3) to suggest an optimal treatment for the trees. The experiment was conducted in Gurye at a site 3km long with 102 flowering cherry trees along a street. There were three treatments: control, an environmentally friendly insecticide and a disinfectant(treatment 1), and an environmentally friendly insecticide, a disinfectant, and irrigation (treatment 2). The trees in Gurye were compared to trees on Jeju Island. The defoliation rates of the flowering cherry in Gurye were significantly higher than those on Jeju Island at each measurement time. Within Gurye, the defoliation rate was significantly higher in the trees of the control than in the two treatments and only the trees in the control from Gurye had shot-hole disease. Post-treatment, twigs collected from the control during April showed significantly poorer growth, lower numbers of flowering buds per twig, and lower numbers of foliar buds. The trees given treatment 1 showed significantly greater growth, number of total buds, flowering buds per twig, and density of buds than the trees given treatment 2. After analyzing the correlations, it was established that early defoliation led to poorer growth, affecting the flowering of the trees.

Clinical Study of the Patients, in Whom Pulmonary Embolism was Suspected by Lung Perfusion Scan (폐 관류주사검사상 폐동맥 색전증 소견을 보인 환자의 임상적 고찰)

  • Lee, Gwi-Lae;Kim, Jae-Yeol;Park, Jae-Suk;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.889-898
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    • 1997
  • Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

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Clinical Study of Hypophosphatemic Rickets (저인산혈성 구루병에 대한 임상적 고찰)

  • Lee Chang-Jin;Cho Hee-Yeon;Kang Ju- Hyung;Shin Choong-Ho;Ha Il-Soo;Cheong Hae-Il;Yang Sei-Won;Choe Yong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.195-204
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    • 2004
  • Purpose: Hypophosphatemic rickets is a hereditary disease, characterized by hypophosphatemia due to renal phosphate wasting, impaired renal production of 1,25-dihydroxyvitamin $D_3$, rachitic bone deformities and impaired growth. The purpose of this study is to provide clinical profiles of patients with hypophosphatemic rickets in our hospital. Methods: Between July 1983 and February 2004, 56 patients were diagnosed as having hypophosphatemic rickets. The medical records of these patients were reviewed retrospectively. Clinical manifestations, family histories, laboratory data, treatment outcomes were described. Results: Fifty six patients were enrolled in this study. The average age at symptom onset and diagnosis were 20 months and 5 years respectively. Fourteen patients had family histories. The main clinical manifestations were bow legs and short stature. There was a significant negative correlation between the ages and the height z-scores at the time of diagnosis(r=-0.47, P=0.005). Initial laboratory data showed normocalcemia, hypophosphatemia, elevated serum alkaline phosphatase, decreased tubular reabsorption of phosphate and a normal range of 1,25-dihydroxyvitamin $D_3$ Radiographic examinations of bone revealed fraying, widening and cupping of the metaphyseal ends. Treatment consisted of Joulie solution and vitamin D metabolites, and resulted in improved biochemical and radiographic findings. However, height z-scores remained essentially unchanged(P=0.224). Complications of treatment were frequently observed, including hyperparathyroidism, nephrocalcinosis, and hypercalciuria. Sixteen patients had corrective osteotomy and 4 of them underwent leg lengthening together. Conclusion: There was a gap of several years between the onset of symptoms and the diagnosis. Early treatment seems to be essential to growth. For the earlier treatment, the offsprings of affected parents should be followed up closely.

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Molecular Genetic Analysis in Dystroglycanopathy with the Fukuyama Congenital Muscular Dystrophy Phenotype (Fukuyama 선천성 근이영양증에서의 분자유전학적 분석)

  • Cha, Lily Myung-Jin;Shin, Jae Eun;Kim, Se Hoon;Lee, Min Jung;Lee, Chul Ho;Lee, Young-Mock
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.2
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    • pp.48-54
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    • 2017
  • Purpose: Fukuyama congenital muscular dystrophy (FCMD) is a rare, autosomal-recessive disorder characterized by early-onset hypotonia associated with brain malformations in dystroglycanopathy. Although the wide spectrum of congenital muscular dystrophies causes difficulty in diagnosis, correlating the genotype with the clinical phenotype can help diagnose FCMD. Here, we evaluated the correlation of targeted molecular genetic analysis of FKTN gene mutation with the FCMD phenotype. Methods: This study was conducted retrospectively with 9 subjects. Inclusion criteria included clinical symptoms characterized by early-onset hypotonia with magnetic resonance imaging (MRI) featuring brain malformations. FKTN gene-alteration analysis was performed using various FKTN gene-analysis methods, including sequencing. Results: Among the 9 subjects studied, 4 (44.4%) were male and 5 (55.6%) were female. The median age of onset of the first symptom was 3.1 months. The first symptom was a delayed milestone in 6 cases (66.7%). All 9 subjects (100%) presented with early-onset hypotonia and global delayed development. All subjects presented with cortical malformation in their brain MRIs. Of the 9 subjects, 6 subjects had previously undergone muscle biopsy and 4 cases (4/6; 66.7%) showed dystrophic or myopathic features. Pathogenic mutations causing FCMD were identified in 3 cases. Conclusions: In this study, all 3 subjects with FKTN mutations showed important MRI findings (pachygyria and cerebellar dysplasia). These data suggest that patients with characteristic phenotypes who show pachygyria and cerebellar abnormalities in brain MRIs may have a high probability of being diagnosed with FCMD.

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A Study on Achiles Tendon Reflex in Normal Korean Persons and Various Thyroid Diseases (정상한국인(正常韓國人) 및 각종갑상선질환(各種甲狀腺疾患)에서의 아킬레스건반사시간(腱反射時間)에 관(關)한 연구(硏究))

  • Kang, Jin-Yung;Kim, Myung-Duk;Lee, Hong-Kyu;Lee, Jung-Sang;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.12 no.1
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    • pp.17-28
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    • 1978
  • A simplified photoelectric apparatus producing graphic records of the free Achilles tendon reflex allowed us to study the reflex quantitatively in subjects with normal and abnormal thyroid function. In this study Achilles tendon reflex times were tested in 340 normal Korean persons, 89 hyperthyroid patients, 19 hypothyroid patients and 85 other thyroid disease patients who were euthyroid in thyroid function tests. In normal Korean persons, the Achilles tendon reflex time was delayed with increasing age and slower in female than in male. They showed good correlationship with various thyroid function tests which included ETR, $T_3RU,\;^{131}I$ thyroid uptake and serum TSH. Diagnostic accuracy of them was 71% in hyperthyroidism and 90% in hypothyroidism. Finally the serial measurements of them were very useful tests in evaluating the clinical coures of hyperthyroidism and hypothyroidism once treatment was begun.

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Bilateral retinoblastoma: Long-term follow-up results from a single institution (단일기관의 장기추적 결과)

  • Choi, Sang Yul;Kim, Dong Hwan;Lee, Kang Min;Lee, Hyun Jae;Kim, Mi-Sook;Lee, Tai-Won;Choi, Sang Wook;Kim, Dong Ho;Park, Kyung Duk;Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.674-679
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    • 2009
  • Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.

Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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Analysis of Vasopressin Receptor Type 2(AVPR2) Gene in a Pedigree with Congenital Nehrogenic Diabetes Insipidus : Identification of a Family with R202C Mutation in AVPR2 Gene (신성요붕증 가계에서 바소프레신 V2 수용체(AVPR2) 유전자 분석 : AVPR2 유전자 R202C 돌연변이의 발견)

  • Park June-Dong;Kim Ho-Sung;Kim Hee-Joo;Lee Yoon-Kyung;Kwak Young-Ho;Ha Il-Soo;Cheong Hae-Il;Choi Yong;Park Hye-Won
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.209-216
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    • 1999
  • Purpose : Nephrogenic diabetes insipidus (NDI) is a rare X-linked disorder associated with renal tubule resistance to arginine vasopressin (AVP). The hypothesis that the defect underlying NDI might be a dysfunctional renal AVPR2 has recently been proven by the identification of mutations in the AVPR2 gene in NDT patients. To investigate the association of mutations in th AVPR2 gene with NDI, we analyzed the AVPR2 gene located on the X chromosome. Methods : We have analyzed the AVPR2 gene in a kindred with X-linked NDI. The proband and proband's mother were analyzed by polymerase chain reaction-single strand conformational polymorphism(PCR-SSCP) and DNA sequencing of the AVPR2 gene. We also have used restriction enzyme analysis of genomic PCR product to evaluate the AVPR2 gene. Results : C to T transition at codon 202, predictive of an exchange of tryptophan 202 by cysteine(R202C) in the third extracellular domain was identified. This mutation causes a loss of Hae III site within the gene. Conclusion : We found a R202C missense mutation in the AVPR2 gene causing X-linked NDI, and now direct mutational analysis is available for carrier screening and early diagnosis.

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The Clinical Aspects of Acute Septic Arthritis and Acute Osteomyelitis in Children (소아기 급성 화농성 관절염과 급성 골수염의 임상적 고찰)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.149-156
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    • 2005
  • Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

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Risk Factors for the Early Recognition of Cow's Milk Protein-induced Enterocolitis (우유 단백질 유발성 장염의 조기진단을 위한 위험인자)

  • Lee, Sung Hyuk;Choi, Seon Yun;Lee, Byung Cheol;Choi, Won Joung;Choe, Byung Kyu;Kim, Yeo Hyang;Kang, Una;Kam, Sin;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.991-997
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    • 2005
  • Purpose : Cow's milk protein-induced enterocolitis(CMPIE) is a symptom complex of vomiting and/or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. Methods : We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. Results : CMPIE was diagnosed in 11 patients(12.8%). On admission, failure to gain weight(P=0.003), hypoalbuminemia(P=0.003), peripheral leukocytosis(P=0.015), and metabolic acidosis(P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight <10 g/day(OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia <3.5 g/dL(OR, 9.18[95% CI, 1.69-49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting(81.8%), abnormal stool test(80.0%), peripheral leukocyte count and absolute neutrophil count(ANC) increase(100.0%) (P<0.05), and enteropathy(100.0%). Conclusion : CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow : failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.