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Remission rate and remission predictors of Graves disease in children and adolescents (소아 및 청소년 그레이브스병 환자에서의 관해 예측 인자와 관해율)

  • Lee, Sun Hee;Lee, Seong Yong;Chung, Hye Rim;Kim, Jae Hyun;Kim, Ji Hyun;Lee, Young Ah;Yang, Sei Won;Shin, Choong Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1021-1028
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    • 2009
  • Purpose:Medical therapy is the initial treatment for children with Graves disease to avoid complications of other treatments. However, optimal treatment for childhood Graves disease is controversial because most patients require relatively long periods of medical therapy and relapse is common after medication discontinuation. Therefore, this study aimed to search clinical or biochemical characteristics that could be used as remission predictors in Graves disease. Methods:We retrospectively studied children diagnosed with Graves disease, treated with anti-thyroid agents, and observed for at least 3 years. Patients were categorized into remission and non-remission groups, and the groups were compared to determine the variables that were predictive of achieving remission. Results:Sixty-four patients were enrolled, of which 37 (57.8%) achieved remission and 27 (42.2%) could not achieve remission until the last visit. Normalization of thyroid-stimulating hormone-binding inhibitory immunoglobulin (TBII) after treatment was faster in the remission group than in the non-remission group (remission group, $15.5{\pm}12.07$ vs. non-remission group, $41.69{\pm}35.70$ months). Thyrotropin-releasing hormone (TRH) stimulation tests were performed in 28 patients. Only 2 (8.3%) of 26 patients who showed normal or hyper-response in TRH stimulation test relapsed. Binary logistic regression analysis identified rapid achievement of TBII normalization after treatment as a significant predictor of remission. Six percent of patients achieved remission within 3 years and 55.8% achieved it within 6 years. Conclusion:Rapid achievement of TBII normalization can be a predictor of remission in childhood Graves disease. The TRH stimulation test can be a predictor of maintenance of remission.

Relationship between Water Temperature and Oxygen Consumption Rate of the Black Scraper Thamnaconus modestus (말쥐치, Thamnaconus modestus의 산소소비율과 수온의 관계)

  • Lee, Jung-Ah;Lee, Jae Seong;Kim, Ji-Hye;Myoung, Jung-Goo;Oh, Sung-Yong;Kang, Rae-Seon
    • Ocean and Polar Research
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    • v.36 no.1
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    • pp.39-47
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    • 2014
  • The black scraper Thamnaconus modestus was a commercially important fish species in the 1980s, but suddenly its commercial significance decreased in the 1990s mainly due to continuous overfishing. Recently, in order to reverse the depleted stocks of the black scraper and help the species recover, seed production technology has emerged. This has led to the farming of the black scraper in several parts of the southern coast of Korea. Since detailed research on its metabolism in relation to water temperature has been scanty, this was the investigative focus of the present study. The standard metabolism rates of the black scraper (9-10 months old, total length=$22.6{\pm}0.8cm$, wet weight=$140.3{\pm}13.9g$) were measured at seven different water temperature settings (12, 15, 17, 20, 23, 26, $28^{\circ}C$) to understand the relationship between metabolism and water temperature. Relationships between water temperature (WT) and oxygen consumption rate (OCR) were obtained as SOCR (weight-specific oxygen consumption rate) = 0.0117WT - 0.0135 ($r^2=0.9351$) and IOCR (oxygen consumption rate per individual) = 1.8160WT - 5.4007 ($r^2$ = 9428). The $Q_{10}$ (temperature sensitivity), an indicator of the sensitivity of biological function to temperature, was analyzed. In our experiment, when the water temperature increased, the $Q_{10}$ value decreased. The $Q_{10}$ value was 6.27 in waters where the temperature ranged from $12-15^{\circ}C$ and this was much higher than the values obtained in waters where temperatures ranged between (1) $15-23^{\circ}C$ and (2) $23-28^{\circ}C$. Consequently, it was shown that the black scraper is a warm water species and inhabiting waters in the temperature range from $15-28^{\circ}C$ is deemed appropriate.

Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer (유방암에서 유방보존수술 및 수술 후 방사선치료의 결과)

  • Chie, Eui-Kyu;Kim, Kyu-Bo;Choi, Jin-Hwa;Jang, Na-Young;Han, Won-Shik;Noh, Dong-Young;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.142-148
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    • 2008
  • Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

Effects of Small Colored Potato Extracts by High-Pressure Extraction on Serum Lipid Levels in High Fat Diet Fed Rats (꼬마색깔감자 초고압 추출물이 고지방식이를 섭취한 흰쥐의 혈청지질농도개선 미치는 영향)

  • Rha, Young-Ah;Choi, Mi-Sook;Kwon, Min-Soo;Hwang, Young-Jeong;Park, Sung-Jin
    • Culinary science and hospitality research
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    • v.20 no.4
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    • pp.157-168
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    • 2014
  • We investigated the anti-obesity effects of small colored potato extracts by high pressure water extraction process on body weight, plasma lipid levels in high-fat diet-induced obese mice. Experimental groups were divided into basal diet only (Normal), high fat diet control (HFD), small colored potato water extracts (CP), and high-fat diet and small colored potato water high pressure extracts (HCP) groups. The levels of hematological variables were not significantly different among the four groups. Compared with the HFD group's serum total cholesterol level of $86.01{\pm}1.16mg/dL$, the levels of the CP and HCP groups were significantly lowered to $80.29{\pm}1.28$ and $77.21{\pm}4.21mg/dL$, respectively. Compared with the HFD group's LDL-cholesterol level of $18.92{\pm}2.44mg/dL$, the LDL-cholesterol levels of the CP and HCP groups were significantly lowered to $13.52{\pm}1.26$ and $12.93{\pm}1.26mg/dL$, respectively. Also, compared to the HFD group's serum triglyceride level of $82.71{\pm}3.94mg/dL$, the level of the HCP group was significantly lowered to $63.24{\pm}6.32mg/dL$. These results suggested that dietary supplementation of small colored potato extracts using high pressure water extraction does not have any adverse effects on the hematological variables, while improving the lipid content and reducing hepatic damage of the high-fat fed rats.

Comparison of occurrence rate of the epileptiform discharge between awake EEG and sleep EEG in childhood epilepsy (소아청소년 간질 환자에서 수면 뇌파와 각성 뇌파의 간질파 발현율의 비교)

  • Jung, Yu Jin;Kwon, Kyoung Ah;Nam, Sang Ook
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.861-867
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    • 2008
  • Purpose : We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. Methods : This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. Results : Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. Conclusion : The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.

Finite-element analysis of the shift in center of resistance of the maxillary dentition in relation to alveolar bone loss (치조골 상실에 따른 상악 치아군 저항중심의 변화에 관한 유한요소해석)

  • Sung, Sang-Jin;Kim, In-Tai;Kook, Yoon-Ah;Chun, Youn-Sic;Kim, Seong-Hun;Mo, Sung-Seo
    • The korean journal of orthodontics
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    • v.39 no.5
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    • pp.278-288
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    • 2009
  • Objective: The aim of this study was to investigate the changes in the center of resistance of the maxillary teeth in relation to alveolar bone loss. Methods: A finite element model, which included the upper dentition and periodontal ligament, was designed according to the amount of bone loss (0 mm, 2 mm, 4 mm). The teeth in each group were fixed with buccal and lingual arch wires and splint wires. Retraction and intrusion forces of 200 g for 4 and 6 anterior teeth groups and 400 g for the full dentition group were applied. Results: The centers of resistance were at 13.5 mm, 14.5 mm, 15 mm apical and 12 mm, 12 mm, 12.5 mm posterior in the 4 incisor group; 13.5 mm, 14.5 mm, 15 mm apical and 14 mm, 14 mm, 14.5 mm posterior in the 6 anterior teeth group; and 11 mm, 13 mm, 14.5 mm apical and 26.5 mm, 27 mm, 25.5 mm posterior in the full dentition group respectively according to 0 mm, 2 mm, 4 mm bone loss. Conclusions: The center of resistance shifted apically and posteriorly as alveolar bone loss increased in 4 and 6 anterior teeth groups. However, in the full dentition group, the center of resistance shifted apically and anteriorly in the 4 mm bone loss model.

Effects of Iterative Reconstruction Algorithm, Automatic Exposure Control on Image Quality, and Radiation Dose: Phantom Experiments with Coronary CT Angiography Protocols (반복적 재구성 알고리즘과 관전류 자동 노출 조정 기법의 CT 영상 화질과 선량에 미치는 영향: 관상동맥 CT 조영 영상 프로토콜 기반의 팬텀 실험)

  • Ha, Seongmin;Jung, Sunghee;Chang, Hyuk-Jae;Park, Eun-Ah;Shim, Hackjoon
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.28-35
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    • 2015
  • In this study, we investigated the effects of an iterative reconstruction algorithm and an automatic exposure control (AEC) technique on image quality and radiation dose through phantom experiments with coronary computed tomography (CT) angiography protocols. We scanned the AAPM CT performance phantom using 320 multi-detector-row CT. At the tube voltages of 80, 100, and 120 kVp, the scanning was repeated with two settings of the AEC technique, i.e., with the target standard deviations (SD) values of 33 (the higher tube current) and 44 (the lower tube current). The scanned projection data were reconstructed also in two ways, with the filtered back projection (FBP) and with the iterative reconstruction technique (AIDR-3D). The image quality was evaluated quantitatively with the noise standard deviation, modulation transfer function, and the contrast to noise ratio (CNR). More specifically, we analyzed the influences of selection of a tube voltage and a reconstruction algorithm on tube current modulation and consequently on radiation dose. Reduction of image noise by the iterative reconstruction algorithm compared with the FBP was revealed eminently, especially with the lower tube current protocols, i.e., it was decreased by 46% and 38%, when the AEC was established with the lower dose (the target SD=44) and the higher dose (the target SD=33), respectively. As a side effect of iterative reconstruction, the spatial resolution was decreased by a degree that could not mar the remarkable gains in terms of noise reduction. Consequently, if coronary CT angiogprahy is scanned and reconstructed using both the automatic exposure control and iterative reconstruction techniques, it is anticipated that, in comparison with a conventional acquisition method, image noise can be reduced significantly with slight decrease in spatial resolution, implying clinical advantages of radiation dose reduction, still being faithful to the ALARA principle.

Tc-99m ECD Brain SPECT in Patients with Traumatic Brain Injury: Evaluating Distribution of Hypoperfusion and Assesment of Cognitive and Behavioral Impairment in Relation to Thalamic Hypoperfusion (뇌외상 환자의 Tc-99m ECD 뇌 SPECT에서 뇌 혈류감소의 분포 및 시상의 혈류감소에 대한 인지 및 행동장애 평가)

  • Park, Soon-Ah;Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.445-455
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    • 2000
  • Purpose: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Materials and Methods: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age $34.7{\pm}15.4$ yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. Results: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe ($24{\sim}26%$) thalami ($21{\sim}22.4%$), parietal and occipital lobe (${\leq}10%$). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former $4.7{\pm}1.5$ and the latter $3.2{\pm}1.4\;in\;G1,\;5.0{\pm}1.1\;and\;4.8{\pm}1.2\;in\;G2,\;6.8{\pm}1.8\;and\;6.3{\pm}1.1\;in\;G3$, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. Conclusion: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.

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Causative Organisms of Neonatal Sepsis (신생아 패혈증의 원인 병원체에 대한 조사)

  • Kim, Kyung-Ah;Shin, Son-Moon;Moon, Han-Ku;Park, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.60-68
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    • 1999
  • A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

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Clinical Features of Symptomatic Meckel's Diverticulum (증후성 멕켈 게실의 임상적 고찰)

  • Lee, Young Ah;Seo, Ji Hyun;Youn, Hee Sang;Lee, Gyeong Hun;Kim, Jae Young;Choi, Gwang Hae;Choi, Byung Ho;Park, Jae Hong
    • 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.

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