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The Study of the Availability of Acute Reactive Markers in Children with Upper Urinary Tract Infection (소아의 상부요로감염에서 급성기 반응지표의 유용성에 관한 연구)

  • Lee, Hye Yeong;Lee, Baeck Hee
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.221-229
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    • 1998
  • Purpose : The symptom of urinary tract infection in children is non-specific and systemic compared to that of adults. So the diagnosis of UTI in children can be delayed. If UTI in children is not appropriately managed, it may he resulted in renal failure, hypertension, growth failure in adolescence because there are already documented renal scar or urinary tract abnormality in infection period. Especially upper UTI that involve renal parenchyme may be result in fatal complication. The purpose of this study is analyzing the relationship between acute reactive marker and $^{99m}TC$-DMSA renal scan in upper urinary tract infection. Methods : This study included 56 children admitted at Dankook University Hospital Pediatric Department in Jan. 1995~May. 1998. We analyzed quantatively the results of acute reactive marker(CRP, ESR, WBC), pyuria, fever and compared to those of sonographically find ing and $^{99m}TC$-DMSA renal scan. Comparison between groups were performed by the chi-square (x2) test and a p value of less than 0.05 was considered statistically significant. Results : 1) The number of boys less than 1 year of age was larger than that of girls. But the number of boys more than 1 year of age was reversed. 2) The higher me level of reactive marker (CRP, WBC), the more the probability of upper UTI. 3) The higher fever, the more the probability of upper UTI. 4) The more pyuria, the more probability of upper UTI. 5) The more higher the grade of vesicoureteral reflux, the more probability of upper UTI. 6) $^{99m}TC$-DMSA renal scan is more sensitive and more specific diagnostic tool than renal sonogram. Conclusion : The appearance of an abnormal $^{99m}TC$-DMSA renal scan is correlated with acute reactive marker (CRP, ESR, WBC), fever, pyuria. $^{99m}TC$-DMSA renal scan can be a good valuable predictor tool in upper UTI. So we can start early treatment and decrease the incidence of complication of upper urinary tract by above indicators before knowing the result of urine culture. And we can follow up the patients in more good relationships with their parents by telling them the duration of treatment and follow-up plan.

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A study on the Hematologic Effects of Radioactive Iodine($^{131}I$) Therapy on Various Thyroid Diseases (방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)의 치료량(治療量)이 갑상선종환자(甲狀腺腫患者)의 혈액상(血液像)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Myung-Jae;Kim, Noe-Kyeong;Lee, Jung-Sang;Choi, Keun-Chul;Lee, Ryong-Woo;Kim, Kee-Won;Kang, Shin-Il
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.1
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    • pp.51-58
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    • 1969
  • To clarify the hematologic effects of the radioiodine ($^{131}I$) in therapeutic doses ($5{\sim}10$ mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ($^{131}I$) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10 mCi of radioiodine ($^{131}I$) with single or fractionated administrations. The blood pictures of peripheral blood were repeated after 3 months in 40 cases of 65 cases who had been treated with $^{131}I$. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with $^{131}I$ therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter: 35.4% Nontoxic nodular goiter: 29.7% Euthyroid: 13.8% Nontoxic diffuse goiter: 12.6% Hypothyroidism: 4.3% Thyroiditis($\bar{s}$ subacute form): 1.8% Toxic nodular goiter: 1.4% Malignancy: 1.0% 2) Age incidence: The range of distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. $80.6{\sim}82.6%$ of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence: Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in. the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with $^{131}I$ toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter. One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ($^{131}I$) does not result any residual effect on the hematopoietic function. Radioiodine ($^{131}I$) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study.

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A Documentational Study on the Development of Chi-Kung-Hak (기공학(氣功學) 발달(發達)에 관한 문헌적(文獻的) 연구(硏究))

  • Kim, Woo Ho;Hong, Won Sik
    • Journal of Korean Medical classics
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    • v.4
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    • pp.19-73
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    • 1990
  • Today, many people are more interested in preventing the disease than curing it. Chi-Kung (氣功) is the way of Life-Cultivation (養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions ; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae (三皇五帝 )period to cure the abnormal circulation of the vital force and blood caused by damp (濕). 2. As the principle and the method of the Life-Cultivation of the Chun-chu-Jeon-Kook (春秋戰國) periods were recorded in Huang-Jae-Nai-Gyung (黃帝內徑) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin (導引), Haeng-Chi (行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta (華陀) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical gymnastics what is called O-Keum-Hi (五禽戱). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja' (莊子) or 'Hoy-Nam-Ja' (淮南子). 4. In Wui-Jin-Nambook Jo (魏晋南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism (佛敎) and Taoism (道敎). Galhong (葛洪), the author of 'Po-Bak-Ja' (抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung (陶宏景), the author of 'Yang-Seong-Yeun-Myung-Rok' (養性延命錄) recorded the 'Yook-Ja-Geul' (六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae (隋唐五代) pefiods, especially So-Won-Bang (巢元方), the author of 'Jey-Byung-Won-Hwu-Ron' (諸病源候論) collected aimost all of the Chi-Kung method, for curing the disease formed before soo (隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob' (小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist (道敎內丹學派) in Song-Keum-Won (宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum' (八段錦) was appeared and assignment of six-Chi (六氣) for bowel and viscera in the 'Yook-Ja-Geul' (六字訣) was decided firmly, that is to say Lung-Si (肺-呬), Heart-Kha (心-呵), Spleen-Hoa (脾-呼), Liver-Hoe (肝-噓), Kidneychui (賢-吹), Three-Burner-shi (三焦-嘻). 7. In Myung-Cheong (明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi' (辨證論治) to the Chi-Kung field, and after Myeong dynasty the style of doing 'Yook-Ja-Gyel' (六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak (氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom (氣功學教室) and Medical Chi-Kung Center (氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician (氣功師) is also needed.

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Predictive Value for Vesicoureteral Reflux in Children with Urinary Tract Infection (요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구)

  • Lee, Seung-Hyun;Noh, Sung-Hoon;Oh, Jeung-Eun;Kim, Min-Sun;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.62-69
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    • 2008
  • Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.

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Prognostic Implication of Normal Myocardial Perfusion Scintigraphy in Patients with Chest Pain (정상 심근관류신티그라피 소견을 보인 흉통환자의 예후)

  • Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.67-72
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    • 1997
  • Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age $53{\pm}12$ years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% Per Year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary artery disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of. cardiac event rates between patients with normal and abnormal coronary angiograms.

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Hair Heavy Metal Contents in Mentally Retarded Children I - In Association with Lead - (정신지체아 두발 중 중금속 함량 I - 납과의 관련성 -)

  • Kim, Doo-Hie;Kim, Ock-Bae;Chang, Bong-Ki
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.125-135
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    • 1989
  • This paper was carried out to study on correlation between mentally retardation and lead and zinc. The subjects were 297 mentally retarded children: 132 of Bomyung special school and Sunmyung, which were located in Taegu city of Korea. The former had their parents but the latter had not. The control group 63 children were randomly seleted from the Dong-in primary school near to Medical School of Kyungpook National University. Atomic absorption spectrophotometer, model IL-551 connected with CTF atomizer(IL. 655) was used for the analysis of lead and zinc. The mean value of lead in hair of mentally retarded children was $14.97{\pm}3.71ppm$ which is significantly higher than that of control group, $11.36{\pm}2.83ppm$. But the content of zinc was not significant in both groups. In the lead there was no significant correlation to age but significant negative correlation to IQ. Zinc showed significant correlation to age but not to IQ. Among the handicapped children, no signigicant correlation between orphan group and non orphan group. Handicaps of mentally-retarded children were speech impairment, emotional disturbance, double and triple handicaps, sensory impairment and abnormal dietary patterns. There were significantly higher contents of lead compared with normal group, except the latter two groups. The disease conditions of mentally retarded children were mongolism, autism, cerebral palsy, epilepsy and microcephaly. In comparing with mongolism, significant difference were existent only on the cerebral palsy and group of unknown etiology. We attempted to divide their past history into external etiology and internal etiology, but could not find significant difference. In view of the whole results, the relationship between mentally-retarded children and lead was presumed to be the early time exposure rather than long interval exposure during growth and the contact opportunity was considered important subject in maternal and child health care.

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A Study on the Dose Assessment Methodology Using the Probabilistic Characteristics of TL Element Response (확률분포 특성을 이용한 열형광선량계의 선량평가방법에 관한 연구)

  • Cho, Dae-Hyung;Oh, Jang-Jin;Han, Seung-Jae;Na, Seong-Ho;Hwang, Won-Guk;Lee, Won-Keun
    • Journal of Radiation Protection and Research
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    • v.23 no.3
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    • pp.123-138
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    • 1998
  • Characteristics of element responses of Panasonic UD802 personnel dosimeters in the X, ${\beta}$, ${\gamma}$, ${\gamma}/X$, ${\gamma}/{\beta}$ and ${\gamma}$/neutron mixed fields were assessed. A dose-response algorithm has been developed to decide the high probability of a radiation type and energy by using the distribution in all six ratios of the multi-element TLD. To calculate the 4-element response factors and ratios between the elements of the Panasonic TLDs in the X, $\beta$, and $\gamma$ radiation fields, Panasonic’s UD802 TLDs were irradiated with KINS’s reference irradiation facility. In the photon radiation field, this study confirms that element-3 (E3) and element-4 (E4) of the Panasonic TLDs show energy dependent both in low- and intermediate-energy range, while element-1 (E1) and element-2 (E2) show little energy dependency in the entire whole range. The algorithm, which was developed in this study, was applied to the Panasonic personnel dosimetry system with UD716AGL reader and UD802 TLDs. Performance tests of the algorithm developed was conducted according to the standards and criteria recommended in the ANSI N13.11. The sum of biases and standard deviations was less than 0.232. The values of biases and standard deviations are distributed within a triangle of a lateral value of 0.3 in the ordinate and abscissa, With the above algorithm, Panasonic TLDs satisfactorily perform optimum dose assessment even under an abnormal response of the TLD elements to the energy imparted. This algorithm can be applied to a more rigorous dose assessment by distinguishing an unexpected dose from the planned dose for the most practical purposes, and is useful in conducting an effective personnel dose control program.

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An Empirical Study on the Long-Run Performance of Cross-Listings by Multinational Corporations (다국적기업 해외상장의 장기적인 성과에 관한 연구)

  • Kim, Dong-Soon;Park, Sang-An
    • The Korean Journal of Financial Management
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    • v.21 no.2
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    • pp.27-63
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    • 2004
  • Since the 1980s, many multinational corporations have been issuing stocks on foreign stock exchanges, not only to enhance their investor base and liquidity, but also to diversify risks. The phenomenon has also been intensified by the rapid financial globalization and securitization trends. The main purpose of this study is to look into the long-run performance of MNCs' cross-listings of stocks on foreign stock exchanges. We use the event study and cross-sectional regression methods. We obtained some interesting empirical results about the long-run effect of cross-listings. First before the listing data the effect of cross-listing is to increase the underlying stock Vice in the local market. It may be caused by expectation of lower risk and cost of capital. However, after the listing data the stock price has been declining, even if it is not significant. Second, we examine the difference in the long-run cross-listing effect, which may be caused by the listing direction. When listing is made from a less developed market to a more developed market, the effect is better than that in the reverse direction. Furthermore, the effect is worse, when the listing company's home country is the U.S. Third, there is a negative relation between CARs and underlying stock liquidity in the local market, So it implies that a firm, whose underlying stocks are very liquid in the local market should carefully value cross-listing based upon the cost and benefit analysis. Last, but not the least we find that the long-un cross-listing effect is better, when a listing firm's ROE is higher.

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Primary Synchronous Lung Cancer Detected using Autofluorescence Bronchoscopy (자가 형광 기관지 내시경을 이용한 동시성 원발성 폐암의 진단)

  • Kwon, Sun Jung;Lee, Yun Seun;Joung, Mi Kyong;Lee, Yu Jin;Jang, Pil Soon;Lee, Jeung Eyun;Chung, Chae Uk;Park, Hee Sun;Jung, Sung Soo;Kim, Sun Young;Kim, Ju Ock
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.645-652
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    • 2006
  • Objective: Patients with lung cancer have a relative high risk of developing secondary primary lung cancers. This study examined the additional value of autofluorescence bronchoscopy (AFB) for diagnosing synchronous lung cancers and premalignant lesions. Methods: Patients diagnosed with lung cancer from January 2005 to December 2005 were enrolled in this study. The patients underwent a lung cancer evaluation, which included white light bronchoscopy (WLB), followed by AFB. In addition to the primary lesions, any abnormal or suspicious lesions detected during WLB and AFB were biopsied. Results: Seventy-six patients had non-small cell lung cancer (NSCLC) and 23 had small cell lung cancer (SCLC). In addition to the primary lesions, 84 endobronchial biopsies were performed in 46 patients. Five definite synchronous cancerous lesions were detected in three patients with initial unresectable NSCLC and in one with SCLC. The secondary malignant lesions found in two patients were considered metastatic because of the presence of mediastinal nodes or systemic involvement. One patient with an unresectable NSCLC, two with a resectable NSCLC, and one with SCLC had severe dysplasia. The detection rate for cancerous lesions by the clinician was 6.0% (6/99) including AFB compared with 3.0% (3/99) with WLB alone. The prevalence of definite synchronized cancer was 4.0% (4/99) after using AFB compared with 2.0% (2/99) before, and the staging-up effect was 1.0% (1/99) after AFB. Since the majority of patients were diagnosed with advanced disease, the subjects with newly detected cancerous lesions did not have their treatment plans altered, except for one patient with a stage-up IV NSCLC who did not undergo radiotherapy. Conclusions: Additional AFB is effective in detecting early secondary cancerous lesions and is a more precise tool in the staging workup of patients with primary lung cancer than with WLB alone.

Age-Based Characteristics of West Syndrome in Patients with Mitochondrial Disease (미토콘드리아 질환에서 웨스트 증후군 환자의 경련 발생 연령에 따른 임상 양상 비교)

  • Choi, Young Ha;Baek, Min-Seong;Na, Ji-Hoon;Kang, Hoon-Chul;Lee, Joon Soo;Kim, Heung Dong;Lee, Young-Mock
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.197-204
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    • 2018
  • Purpose: West syndrome is a severe form of age-specific epilepsy that typically affects infants younger than 2 years of age with mitochondrial disease. We aimed to examine age-specific characteristics of the syndrome in these patients. Methods: We retrospectively analyzed 54 patients with West syndrome diagnosed with mitochondrial disease between March 2006 and March 2016. We compared treatment strategies and diagnostic and clinical variables between patients with early-onset (<6 months of age) and late-onset (${\geq}6$ months of age) seizures. Results: Seizure was the first symptom in 30 (90.9%) and 13 (65%) patients of the early-onset and late-onset groups, respectively (P=0.046). Delayed development was observed in 3 (9.1%) and 7 (35%) patients of the early-onset and late-onset groups, respectively (P=0.023). Lactate levels were normal in 17 patients (55%) of the early-onset group and 5 (25%) of the late-onset group (P=0.036), while initial brain magnetic resonance imaging (MRI) findings were normal in 23 (67.6%) and 8 (40%) patients of the early-onset and late-onset groups, respectively. Final MRI findings were abnormal in 32 patients (94.1%) of the early-onset group and 18 (90%) of the late-onset group (P=0.036). Although ketogenic diets reduced seizure frequency in both groups, the difference was not significant. Conclusion: There is no significant difference in epilepsy-related variables when patients are divided based on a cut-off age of 6 months. However, differences in the first symptom at onset and MRI findings were observed. Although lactate levels were not of significant diagnostic value in the early-onset group, they may be in the late-onset group.