• Title/Summary/Keyword: Abdomen Area

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National Trends in Pediatric CT Scans in South Korea: A Nationwide Cohort Study (소아 전산화단층촬영의 국내 동향: 전국적 코호트 연구)

  • Nak Tscheol Kim;Soon-Sun Kwon;Moon Seok Park;Kyoung Min Lee;Ki Hyuk Sung
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.138-148
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    • 2022
  • Purpose This study evaluated the rates and annual trends of pediatric CT scans in South Korea using a nationwide population-based database. Materials and Methods Data regarding pediatric CT scan usage between 2012 and 2017 were retrieved from the health insurance review and assessment service. Data on the age, sex, diagnosis, and the anatomical area of involved patients were also extracted. Results A total of 576376 CT examinations were performed among 58527528 children aged below 18 years (9.8 scans/1000 children), and the number of CT examinations per 1000 children was noted to have increased by 23.2% from 9.0 in 2012 to 11.0 in 2017. Specifically, the number of CT examinations increased by 32.9% for the 6-12 years of age group (7.4/1000 to 9.8/1000) and by 34.0% for the 13-18 years of age group (11.4/1000 to 15.3/1000). Moreover, majority of the CT scans were limited to the head (39.1%), followed by the extremities (32.5%) and the abdomen (13.7%). Notably, the number of extremity CT scans increased by 83.6% (2.3/1000 to 4.2/1000), and its proportion as compared to other scans increased from 25.3% to 37.7%. Conclusion CT scans in the pediatric population increased continuously from 2012 to 2017 at an annual rate of 4.4%. Therefore, physicians should balance the benefits of CT with its potential harms from associated radiation exposure in pediatric patients.

A Study on Epidemiologic Characteristics of Recurrent Abdominal Pain in Elementary School Children (반복성 복통증 환아의 역학적 특징에 관한 조사)

  • Oh, Sang-Hyun;Yang, Eun-Seok;Park, Sang-Kee;Park, Young-Bong;Park, Jong;Park, Sang-Hak;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.21-29
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    • 1999
  • Purpose: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find posssible factors influencing the onset and the course of the disorder. Method: We performed questionnaires in Kwangju on children from two primary schools from June,1 1998 to June 30 and carried out statistical analysis. Result: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02:1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor. The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as internal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. Conclusion: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.

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Changes in Psoas Major and Quadriceps Cross Sectional Area in Elderly People after 12 Weeks of Exercise (고령자를 대상으로 12주간 운동이 대요근 및 대퇴부 근황단면적에 미치는 영향)

  • Tachi, Toshiki;Oguri, Kazuo;Torii, Suguru;Kobayashi, Kando;Fujii, Katsunori;Kim, Jun-Dong;Nho, Ho-Sung
    • Journal of Life Science
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    • v.21 no.1
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    • pp.1-8
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    • 2011
  • The purpose of this study was to investigate whether 12-weeks of movement training would increase the psoas major cross-sectional area (CSA) in senior men and women. Fifty eight men and women aged 65 to 80 years old ($69.6{\pm}3.7$, 30 male, 28 female) were divided into a control (n=19) and exercise group (n=39). Subjects were assessed before and after the training program for stature, body mass, and magnetic resonance imaging of the psoas major and the quadriceps muscle. The experimental group performed exercises using machines designed to improve the movement of the hip at a frequency of twice every week, with a total of 23 trainings in 12-weeks. Magnetic resonance images of both thighs and the abdomen and psoas major were obtained, aimed at 50% of the length of the greater trochanter and the lower edge of the femur and between the fourth (L4) and fifth (L5) lumbars. A 9.4% increase in the psoas major CSA in the training group was observed. In the male and female breakdown, a 11.5% and 8.4% change was observed in males and females, respectively. In the quadriceps, there was no significant statistical improvement in either males or females. Furthermore, in the control group, there was no significant change seen in either the psoas major or the quadriceps. As a result of conducting training that enables upkeep of posture and smooth linkage of the lumbar spine, the pelvis and thighbone, the psoas major CSA of older adults were improved in a short period of time. For this reason, the possibility of improving the psoas CSA, which decreases remarkably with increased age, by improving the linkage of the body trunk is also suggested.

Epidemiologic Survey on Outbreak of Dermatosis Associated with Ants, Pachycondyla chinensis (왕침개미에 의한 피부질환 집단 발생에 관한 역학 조사)

  • Lim, Hyun-Sul;Kim, Byung-Jin;Bae, Geun-Ryang
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.421-426
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    • 1999
  • Objectives: An outbreak of dermatosis occurred at a city gas manufacturing factory in Pohang in Aug, 1998. The authors conducted a study to find the cause and prevent the dermatosis, Methods: We conducted a questionnaire survey of 73 workers in the factory twice, once or Aug. 14th and then Sept. 11th, 1998. Also, a dermatologist examined their skin lesions. We suspected ants as the cause, so we collected them for identification. Results: Twelve cases of dermatosis were identified with an attack rate of 16.4%. The attack rates were not different by age, educational level or tenures. The attack rates were 66.6% among production workers, 2.0% among clerical workers, 16.7% among tank trailer drivers and 0% among guards. The attack rate among production workers was significantly higher than that of the others (<0.01). There were no histories of the same dermatosis for the past one year. Histories of other skin diseases and allergies were very rare in both cases with skin diseases and control. Multiple, pruritic, rice-grained to bean sized erythemafous macules or papules with a central biting point could be found after initial severe itching occurred, Three cases showed signs of dermatosis with an allergic nature. The onset of dermatosis was between July 30 and Aug 12 and the durations varied from 5 days to over a month. The most frequent sites of stir lesions were the chest and abdomen (60.6%), and they were also observed on the neck (33.3%), arms (33.3%), shoulders (16.7%) and back (16.7%). Over 10 ants with their wings were collected in the work place and identified as Pachycondyla chinensis, subfamily Ponerinae. Conclusions : We thought that the outbreak of dermatosis was brought about by the ants flying into the work place through the open windows. Further studies on the factors contributing to the prosperity of the ants in this area are needed.

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Long Term Outcome of Endoscopically Clipping the Upper Part of R4 Sympathetic Block and R4 Sympathetic Block for the Treatment of Palmar Hyperhidrosis (수장부 다한증에서 Clipping에 의한 흉부4번 교감신경절 상부 차단술과 흉부4번 교감신경절 완전 차단술에 대한 장기성적 비교)

  • Choi, Bong-Chun;Kim, Yong-Han;Sa, Young-Jo;Park, Jae-Kil;Lee, Sun-Hee;Sim, Sung-Bo
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.752-758
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    • 2007
  • Background: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. Material and Method: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). Result: For group 1, 41.9% experienced no sweating and 48.4% re-plied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions, 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. Conclusion: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.

Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.55-62
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    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Epidemiologic Study of Frostbites and Its Current Managements in Community Hospital (지역 병원에서 동상 환자에 대한 역학에 관한 연구 및 최근 치료)

  • Kim, Dong Chul;Min, Byung Duk;Kim, Ji Hoon;Chung, Chang Eun;Lee, Chong Kun;Yu, Sung Hoon
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.21-29
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    • 2021
  • Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

The First North Korean Painting in the Collection of the National Museum of Korea: Myogilsang on Diamond Mountain by Seon-u Yeong (국립중앙박물관 소장 산률(山律) 선우영(鮮于英) 필(筆) <금강산 묘길상도>)

  • Yi, Song-mi
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.97
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    • pp.87-104
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    • 2020
  • Myogilsang on Diamond Mountain, signed and dated (2000) by Seon-u Yeong (1946-2009), is the first work by a North Korean artist to enter the collection of the National Museum of Korea (fig. 1a). The donor acquired the painting directly from the artist in Pyeongyang in 2006. In consequence, there are no issues with the painting's authenticity.This painting is the largest among all existing Korean paintings, whether contemporary or from the Joseon Dynasty, to depict this iconography (see chart 1. A Chronological List of Korean Myogilsang Paintings.) It is ink and color on paper, measures 130.2 × 56.2 centimeters, and is in a hanging scroll format. Since this essay is intended as a brief introduction of the painting and not in-depth research into it, I will simply examine the following four areas: 1. Seon-u Yeong's background; 2. The location and the traditional appellation of the rock-cut image known as Myogilsang; 3. The iconography of the image; and 4) A comparative analysis of Seon-u Yeong's painting in light of other paintings on the same theme. Finally, I will present two more of his works to broaden the understanding of Seon-u Yeong as a painter. 1. Seon-u Yeong: According to the donor, who met Seon-u at his workshop in the Cheollima Jejakso (Flying Horse Workshop) three years before the artist's death, he was an individual of few words but displayed a firm commitment to art. His preference for subjects such as Korean landscapes rather than motifs of socialist realism such as revolutionary leaders is demonstrated by the fact that, relative to his North Korean contemporaries, he seems to have produced more paintings of the former. In recent years, Seon-u Yeong has been well publicized in Korea through three special exhibitions (2012 through 2019). He graduated from Pyeongyang College of Fine Arts in 1969 and joined the Central Fine Arts Production Workshop focusing on oil painting. In 1973 he entered the Joseon Painting Production Workshop and began creating traditional Korean paintings in ink and color. His paintings are characterized by intense colors and fine details. The fact that his mother was an accomplished embroidery specialist may have influenced on Seon-u's choice to use intense colors in his paintings. By 1992, he had become a painter representing the Democratic People's Republic of Korea with several titles such as Artist of Merit, People's Artist, and more. About 60 of his paintings have been designated as National Treasures of the DPRK. 2. The Myogilsang rock-cut image is located in the Manpok-dong Valley in the inner Geumgangsan Mountain area. It is a high-relief image about 15 meters tall cut into a niche under 40 meters of a rock cliff. It is the largest of all the rock-cut images of the Goryeo period. This image is often known as "Mahayeon Myogilsang," Mahayeon (Mahayana) being the name of a small temple deep in the Manpokdong Valley (See fig. 3a & 3b). On the right side of the image, there is an intaglio inscription of three Chinese characters by the famous scholar-official and calligrapher Yun Sa-guk (1728-1709) reading "妙吉祥"myogilsang (fig. 4a, 4b). 3. The iconography: "Myogilsang" is another name for the Bhodhisattva Mañjuśrī. The Chinese pronunciation of Myogilsang is "miaojixiang," which is similar in pronunciation to Mañjuśrī. Therefore, we can suggest a 妙吉祥 ↔ Mañjuśrī formula for the translation and transliteration of the term. Even though the image was given a traditional name, the mudra presented by the two hands in the image calls for a closer examination. They show the making of a circle by joining the thumb with the ring finger (fig. 6). If the left land pointed downward, this mudra would conventionally be considered "lower class: lower life," one of the nine mudras of the Amitabha. However, in this image the left hand is placed across its abdomen at an almost 90-degree angle to the right hand (fig. 6). This can be interpreted as a combination of the "fear not" and the "preaching" mudras (see note 10, D. Saunders). I was also advised by the noted Buddhist art specialist Professor Kim Jeong-heui (of Won'gwang University) to presume that this is the "preaching" mudra. Therefore, I have tentatively concluded that this Myogilsang is an image of the Shakyamuni offering the preaching mudra. There is no such combination of hand gestures in any other Goryeo-period images. The closest I could identify is the Beopjusa Rock-cut Buddha (fig. 7) from around the same time. 4. Comparative analysis: As seen in , except for the two contemporary paintings, all others on this chart are in ink or ink and light color. Also, none of them included the fact that the image is under a 40-meter cliff. In addition, the Joseon-period paintings all depicted the rock-cut image as if it were a human figure, using soft brushstrokes and rounded forms. None of these paintings accurately rendered the mudra from the image as did Seon-u. Only his painting depicts the natural setting of the image under the cliff along with a realistic rendering of the image. However, by painting the tall cliff in dark green and by eliminating elements on either side of the rock-cut image, the artist was able to create an almost surreal atmosphere surrounding the image. Herein lies the uniqueness of Seon-u Yeong's version. The left side of Seon-u's 2007 work Mount Geumgang (fig. 8) lives up to his reputation as a painter who depicts forms (rocks in this case) in minute detail, but in the right half of the composition it also shows his skill at presenting a sense of space. In contrast, Wave (fig. 9), a work completed one year before his death, displays his faithfulness to the traditions of ink painting. Even based on only three paintings by Seon-u Yeong, it seems possible to assess his versatility in both traditional ink and color mediums.