• Title/Summary/Keyword: Diagnosis Area

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Scintigraphic Findings of Nineteen Cases of Ectopic Thyroid (이소갑상선 19예의 신티그라피 소견)

  • Cho, In-Ho;Yoon, Hyun-Dae;Won, Kyu-Chang;Lee, Chan-Woo;Lee, Hyoung-Woo;Lee, Hyun-Woo;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.183-190
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    • 1993
  • Abnomalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid may be asymptomatic, local obstructive, hemorrhagic or other complication may occur. Radinuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required. In order to evaluate the features of ectopic thyroid, we investigated the scintigraphic findings, thyroid function test and clinical symptoms of 19 patients with ectopic thyroid. 1) Th frequency of ectopic thyroid was about 5.3 times more common in female than in male. Then patients were mostly below 30 years old (79%). 2) The frequency of location of ectopic thyroid were as follows: 10 cases in the tongue base, 1 case in suprahyoid, 5 cases in infrahyoid and 3 cases over 2 areas. 3) The thyroid function test was done in 16 cases of the ectopic thyroid patients. The hypothyroidism was detected in 7 cases, subclinical hypothyroidism in 4 cases and normal thyroid function in 5 cases. 4) The rate of hypothyroidism is 90% in the lingual thyroid and 33% in the others. The thyroid dysfunction was related with the location of the ectopic thyroid (p < 0.05). 5) The clinical manifestations include a mass in the tongue base, the foreignbody sensation of a throat and a swallowing difficulty in lingual thyroid. The palpable mass was the chief complaint in the others. 6) We prescribed the thyroid hormone to 10 cases with hypothyroidism. The ectopic thyroid was removed in 2 cases with normal thyroid function. The rest is following up through OPD. We must consider the possibility of the ectopic thyroid and take the thyroid scan when the patient has a mass in the tongue base, the sublingual and the prelaryngeal area. Then we have to check the thyroid function and follow up when the ectopic thyroid is diagnosed, because the patient with normal thyroid function can result in the hypothyroidism. Except these, we must mind of the possibility of occurence of the cancer in the ectopic thyroid tissue.

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Review: Distribution, Lactose Malabsorption, and Alleviation Strategies of Lactose Intolerance (유당불내증(Lactose Intolerance)의 발생 원인과 경감 방안에 대한 고찰)

  • Yoon, Sung-Sik
    • Journal of Dairy Science and Biotechnology
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    • v.27 no.2
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    • pp.55-62
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    • 2009
  • Milk is called an almost complete food in terms of nutrition, especially for the younger generations because it contains a number of nutrients required for growth and development. Lactose intolerance is defined as a malabsorption of lactose in the intestine with some typical symptoms of abdominal pains and bloating, and occurred at 75% of global populations, which hampers milk consumption worldwide. Lacks of milk consumption in the underdeveloped countries frequently lead to many nutrients deficiencies, so that diseases including osteoporosis, hypertension, and colon cancer are more prevalent in the recent days. Lactose in foods needs to be hydrolyzed prior to intestinal absorption. The hydrolytic enzyme responsible for splitting lactose into its monomeric forms, glucose and galactose, is called as lactase or $\beta$-galactosidase. The former is primarily used as blood sugar and energy source and the latter used in glycolipid synthesis of brain tissues in infants. Lactose is clinically diagnosed with the breath hydrogen production test as well as intestinal biopsy. Reportedly, symptoms of lactose intolerance are widely prevalent at 25% of Europeans, 50 to 80% of Hispanics, South Indians, Africans, and Jews, almost 100% of Asians and native Americans. For the adults, phenotype of lactase persistence, which is able to hydrolyse lactose, is more common in the northern Europeans, but in the other area lactase non-persistence or adult-type hypolactasia is dominant. Genetic analysis on human lactase gene continued that lactase persistence was closely related to the err site of 1390 single nucleotide polymorphism from the 5'-end. To alleviate severity of lactose intolerance symptoms, some eating patterns including drinking milk a single cup or less, consumption along with other foods, whole milk rather than skimmed milk, and drink with live yogurt cultures, are highly recommended for the lactose maldigesters. Also, delay of gastric emptying is effective to avoid the symptoms from lactose intolerance. Frequency of lactose intolerance with conventional diagnosis is thought overestimated mainly because the subjects are exposed to too much lactose of 50 g rather than a single serving amount. Thus simple and accurate diagnostic method for lactose intolerance need to be established. It is thought that fermented milk products and low- or free lactose milks help improve currently stagnant milk consumption due to lactose intolerance which contributes to major barrier in milk marketing especially in Asian countries.

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The Usefulness of the Abdominal Computerized Tomography for the Diagnosis of Childhood Obesity and Its Correlation with Various Parameters of Obesity (소아 복부비만 진단을 위한 복부 전산화 단층 촬영의 유용성과 여러 지표와의 상관성 연구)

  • Shim, Yoon Hee;Cho, Su Jin;Rhyu, Jung Hyun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1082-1089
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    • 2005
  • Purpose : Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. Methods : Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index(BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography(US) and the total and intra-abdominal fat area by abdominal computerized tomography(CT) were measured in the obese group. Results : The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it(r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase(AST), alanine aminotransferase(ALT) and triglyceride level. Conclusion : Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.

A Clinical Study of Aseptic Meningitis in the Busan Area in 2002 (2002년 부산 지역에서 유행한 무균성 뇌막염에 대한 임상적 고찰)

  • Park, Ji Hyun;Lee, Na Young;Kim, Gil Hyun;Jung, Jin Hwa;Cho, Kyung Soon;Kim, Sung Mi
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.858-864
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    • 2003
  • Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.

Long Term Results of Radiation Therapy in Early Glottic Cancer (초기 성문암의 방사선치료: 장기 추적결과)

  • Kim, Jin-Hee;Byun, Sang-Jun
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.29-34
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    • 2009
  • Purpose: This study was designed to evaluate long-term results in terms of failure, survival and voice preservation after radiation therapy for early glottic cancer. Materials and Methods: From February 1988 to December 2003, 70 patients with early glottic cancer were treated with radiation therapy at Keimyung University Dongsan Medical Center. Patient age distribution was from 39 to 79 years, with a median age of 62 years. All patients had squamous cell carcinoma. According to the TNM stage, 58 patients had stage I disease, 12 patients had stage II disease; 67 patients were male. The laryngeal area was irradiated with the use of bilateral opposing fields with/without a wedge filter with 6 MV photons at a total dose of $54{\sim}70.2$ Gy in $1.8{\sim}2.2$ Gy fractions over $6{\sim}8$ weeks. We delivered a median radiation dose of 60 Gy for stage I patients and a median radiation dose of 66 Gy for stage II patients. Salvage surgery was performed in patients with local recurrence. The voice preservation rate was analyzed after all treatments including salvage surgery. Follow-up periods were from 13 to 180 months, with a median follow-up period of 77.5 months. The survival rate was analyzed by the use of the Kaplan Meier method and log rank test. A comparison of two groups was performed with the use of the chi-squared test. Results: The local control rate was 98.5% (69/70). The five-year-overall survival rate was 93.9%. The five-year disease free survival rate (5YDFS) was 84.1% and the 5YDFS after radiation and salvage surgery was 92.8%. According to stage, the 5YDFS was 93.1% and 91.7% for stage I and stage II respectively. Thirteen patients (18.5%) had local failure with 24 months of median time to local failure and nine patients received salvage surgery; however, four patients were lost to follow-up after a diagnosis of recurrence. Only two patients died due to a distant metastasis at 33 months and 71 months after radiation therapy, respectively. Nine patients died due to other diseases with a median time of 73 months. There were no severe acute or chronic complications after radiation therapy. Voice preservation was ultimately achieved in 88.5% (62/70) of patients. Conclusion: We considered that radiation therapy was effective and we achieved excellent survival and voice preservation in early laryngeal cancer. The use of radiation therapy should be the first choice for the treatment of early glottic cancer.

Serial Survey on Group A beta-Hemolytic Streptococcal Carrier Rate and Serotyping in Elementary School Children in 1996~1998 (3년간(1996~1998) 초등학생의 A군 연쇄구균 보균율과 혈청학적 분류에 관한 연구)

  • Kim, Ji-Hyun;Kim, Ju-Ye;Kang, Hyeon-Ho;Cha, Sung-Ho;Lee, Young-Hee
    • Pediatric Infection and Vaccine
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    • v.7 no.1
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    • pp.143-151
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    • 2000
  • Purpose : The accuracy of bacteriologic diagnosis of beta-hemolytic streptococcal pharyngotonsillitis depends on the degree of carrier rate in that area where the throat swabs are obtained and the evaluation of serological T typing as an epidemiologic marker is important to understand epidemiology of streptococcal infection. The purpose of this study is to know the carrier rates of group A streptococcus in normal children form four different areas and to find out the epidemiologic characteristic in distribution of the serotypes for 3 years. Method : Throat swabs were obtained from the tonsillar fossa of normal school children in four different areas(Uljin, Seoul, Osan, Kunsan) from March to May 1996, in Uljin in April 1997, and in Uljin in April 1998. The samples were plated on a 5% sheep blood agar plate and incubated overnight at $37^{\circ}C$ before examination for the presence of beta-hemolytic colonies. All isolated beta-hemolytic streptococcus were grouped and serotyped by T agglutination. Results : The carrier rate of beta-hemolytic streptococci and group A streptococci in 1996 were 27.6%, 18.6% at Uljin; 16.4%, 2.7% at Seoul; 33.0%, 26.0% at Osan; 20.0%, 12.3% at Kunsan, respectively. Among 1,192 normal school children from 4 different areas, we obtained 179 strains of group A streptococci. Fifty two percent of the strains were typable by T agglutination in 1996. Common T-type in 1996 were NT, T1, T3, T2 at Uljin; T12, T25 at Seoul; NT, T6, T28 at Osan; T25, T4, NT, T5 at Kunsan, in decreasing order, respectively. At Uljin, T1, T3, T25 accounted for 69% of strains in 1996, T1, T12, T25 accounted for 70% in 1997, and T12, T4 accounted for 88% in 1998. Conclusion : Higher carrier rates were found in Uljin and Osan, where there are a lower population density with scanty of medical facilities compared with another areas. We supposed that low carrier rates is likely to be related to antibiotic abuse or some epidemiologic factor. The periodic and seasonal serotyping analysis is important in monitoring and understanding the epidemiologic patterns of group A streptococci.

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A RETROSPECTIVE STUDY OF THE TRAUMATIC INJURIES IN THE PRIMARY AND PERMANENT TEETH (유치와 영구치의 외상에 관한 연구)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho;Park, Ji-il
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.642-651
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    • 2008
  • This study was carried out to give basic information of traumatic injuries of primary and permanent teeth which can be used for diagnosis and management of injured teeth. From January 2003 to July 2007, 570 children with 1394 teeth who came to pediatric dentistry and emergency center of Chonnam National University Hospital due to the traumatized teeth participated in this study. The following data were investigated. : age, sex, causes and places of trauma, position of injured teeth, types of injury, and treatment at the first visit. 1. Trauma prevailed at the age of 1, $6{\sim}8$, $17{\sim}18$ and the rate of males was more likely to be higher than the rate of females(1.9 : 1). 2. The main cause of injury is a fall-down injury for primary and mixed dentition, but is a traffic accident and fighting for permanent dentition, respectably. The place of injury for primary dentition is mainly home(45.3%), while street for mixed and permanent dentition. 3. The position of injured teeth according to the area in the mouth is mainly maxillary anterior teeth in both case of primary and permanent teeth and especially, the ratio of central incisors is high. 4. The periodontal tissue injury occurred the most frequently in the primary and the permanent teeth, but the ratio of hard tissue injury in the permanent teeth increased, compared with the primary teeth. 5. Among treatments at the first visit, observation without actual treatment comprised 75.6% in the primary teeth and 55.4% in the permanent teeth, respectably. The pulp necrosis occurred in 20.3% of the primary teeth and 26.6% of the permanent teeth in the case of the periodontal tissue injuries, respectably.

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INTRAOSSEOUS TOOTH MIGRATION OF IMPACTED MESIODENS IN THE INVERTED POSITION (상악 정중부에 역위 매복된 과잉치의 악골 내 이동)

  • Lee, Suk-Woo;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Hyung-Jun;Sohn, Hyung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.750-756
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    • 2008
  • Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until $8{\sim}10$ years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla, surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during $6{\sim}7$ years of follow-up period since the first diagnosis had been made at the $2{\sim}3$ years of age.

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A LONGITUDINAL STUDY ON THREE FACIAL GROWTH PATTERNS IN KOREANS WITH NORMAL OCCLUSION (정상교합자의 3가지 안면골 성장양상에 관한 누년적 연구)

  • Park, Krung-Duk;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.25 no.3 s.50
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    • pp.273-286
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    • 1995
  • The purpose of this study was to compare the difference of the growth aspects in three facial growth patterns. The biennial serial cephalometric radiographs of 33 samples(19males, 14females) with normal occlusion from 8.5 years to 18.5 yews of age were used in this study. The facial growth patterrn was categorized in 3 types(Drop type, Neutral type, Forward type) by the total amounts of the Y-axis which changed from 8.5 years to 18.5 years of age. The growth change of the craniofacial area during 10 years in each growth type was analyzed and was compared among the 3 growth types. The results of this study might be summarized as follows. 1. The samples that were classified by total change of the Y-axis during this study period were distributed to 52% of the neutral type, 27% of the forward type, 21% of the drop type. 2. The anterior growth of the maxilla to the cranial base(N per A) showed larger in the forward type than in other 2 types(p<0.05). 3. The palatal plane to the FH plane showed more anterior-superior inclination in the forward type with age during this study period. 4. The anterior growth of the mandible to the cranial base(N per Pog) appeared large in rank order, of largest the forward type, second the neutral type, and third the drop type(p<0.05). 5. During this study period the mandibular plane(SN/MN,FMA) showed more counterclockwise rotation in the forward type than in the drop type(p<0.05), and this tendency was stronger in males than in females(p<0.05). 6. The growth of the mandibular corpus length(Go-Me) showed smaller in the drop type than in the other 2 types(p<0.05). 7. In the forward type and the neutral type, the anterior growth of the mandible was larger than that of the maxilla(p<0.05). 8. In the craniofacial growth distances and angulations turned out to be somewhat variable, but the vertical proportion had a strong tendency whose original relation was maintained consistently during this study period. 9. Through these analyzed data, the profilograms on each growth type were constructed to evaluate individual growth pattern in the orthodontic diagnosis.

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The Nature of Patient's Disagreement with Doctors among Some Rural Residents (일부 농촌주민에서 의사에 대한 환자의 의견불일치)

  • Lee, Moo-Sik;Cho, Hyong-Won;Kim, Eun-Young;Chun, Byung-Chul;Shin, Dong-Hoon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.315-329
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    • 1999
  • Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

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