• Title/Summary/Keyword: Diagnosis and treatment

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Platelet count and mean platelet volume in low birth weight infants (≤2,000 g) with sepsis (패혈증에 이환된 저출생체중아(≤2,000 g)에서 혈소판수치와 평균혈소판용적의 변화)

  • Lee, Wan-soo;Cho, Jin-young;Yoo, Seung-taek;Lee, Chang-woo;Choi, Doo-young;Kim, Jong-duck;Oh, Yeon-kyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.643-648
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    • 2007
  • Purpose : Sepsis is a common complication in Neonatal Intensive Care Units (NICU), seen especially in low birth weight (LBW) infants. A recent study showed that fungal or gram-negative sepsis is associated with a greater degree of thrombocytopenia than is seen with gram-positive sepsis. So, this study was undertaken to examine the platelet counts and platelet indices in LBW infants during episodes of sepsis. Methods : We analyzed 36 cases with culture-proven sepsis on chart review in LBW infants admitted to the NICU at Wonkwang University Hospital from January 2001 to June 2006. Results : Patients were grouped by organism type: gram-positive bacteria ($1,521{\pm}309g$, $31.3{\pm}2.9wk$, 15/36), gram-negative bacteria ($1,467{\pm}290g,\;30.6{\pm}3.6wk$, 17/36), and fungi ($1,287{\pm}205g,\;30.0{\pm}3.9wk$, 4/36). The most common organism was Staphylococcus epidermis and the incidence of thrombocytopenia was 88.9%. When compared with infants with gram-positive sepsis, those with gram-negative sepsis had significantly higher incidences of thrombocytopenia, lower initial platelet count, lower platelet nadir, and greater mean percentage decrease in platelet count from before the onset of sepsis. Those with fungal infections were similar to gram-negative sepsis, but they were not significant because of the small number of patients. And mean platelet volume (MPV) in sepsis was increased more significantly in time of platelet nadir than before the onset of sepsis. Conclusion : We conclude that decrease in platelet count was significantly greater in gram-negative sepsis than gram-positive sepsis, and also greater than fungal sepsis-which was insignificant because of the small number of patients-in LBW infants. And elevation in MPV will be helpful in the diagnosis and treatment of sepsis in LBW infants.

Comparison of Estradiol Results according to Manufacturer (제조회사에 따른 Estradiol 결과값의 비교)

  • Kim, Dae-Woon;Shin, Hee-Jung;You, Tae-Min;Noh, Gyeong-Woon;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.101-105
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    • 2011
  • Purpose: Estradiol in the menstrual cycle and ovulation induction as an important test of currently national nuclear medicine laboratory in the normal patients and patients with infertility tests are being performed. For the diagnosis of menopause is an important test with follicle stimulating hormone (FSH) and Luteinizing hormone (LH). Currently participating in external quality control of the nation's hospitals that is 54 percent of 37 hospitals, 20 hospitals have been using A's reagent. The kit's test results are highly different from other kit comes with the test results of specimens have been found. And for the phenomenon is to study the problem. Materials and Methods: Estraiol test were referred to our hospital which results of samples as more than 100pg/ml 75 specimens measured by radioimmunoassay(RIA) test with company A company B company C company D Kit, Chemiluminescent assay (CMIA) to examine and compare to the results from april to August in 2010. Results: Kit for each manufacturing company as measured by the results obtained using the average value of the correlation coefficient (R2) and A company 0.8906 B 0.9527 C 0.9547 and D company correlation coefficient of 0.873 showed a good correlation that measuring the results of A company high concentrations when Company B Company C Company D with CMIA test concentrations measured low results that the two cases were discovered specimens. Conclusion: Most of the test results of 75 samples came up with a similar trend, but two cases were reported in the patients very differently. A company result reported higher than 700 pg/ml, while the rest of other test results report was approximately 10 pg/ml. The common point of two samples more than 50 years patients are estimated to be diagnosed with cancer in postmenopausal patients receiving treatment and levels of FSH were found to be greater than 50 mIU/ml. Did not identify the exact cause. I suggest if you are using A company kit that need to again check when Estradiol result and follicle stimulating hormone results is higher.

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THE CALCIFICATION TIMING OF THE PERMANENT TEETH BY NOLLA STAGE (Nolla stage에 의한 영구치의 석회화 시기에 대한 연구)

  • Ahn, Sang-Hyun;Yang, Kyu-Ho;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.540-548
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    • 2000
  • The aim of this study was to evaluate the timing of sequence of tooth calcification in current Korean growing children. The Calcification stage of permanent teeth of Korean children was investigated by classifying them into 10 stages by the criteria of Nolla, using the panoramic radiographs of 258 healthy Korean children, 149 males and 109 females, between the ages of 4 years and 13 years, with normal growing tendency and no orthodontic treatment experience. The obtained results were as follows: 1. Timing of calcification of permanent teeth by Nolla stage was established with mean values. Among the mean value, results of Nolla stage 7 were as follows: Calcification timing of male in the maxilla was 6 year 9 month on central incisor, 7 year 4 month on lateral incisor,7 year 9 month on canine, 8 year 8 month on the first premolar, 9 year 4 month on the second premolar, 6 years 3 month on the first molar and 10 year 8 month on the second molar, calcification timing of male in the mandible was 5 year 11 month on central incisor, 6 year 4 month on lateral incisor, 7 year 5 month on canine, 8 year 1 month on the first premolar, 8 year 6 month on the second premolar 5 years 6 month on the first molar and 10 year 3 month on the second molar. Calcification timing of female in the maxilla was 6 year 2 month on central incisor, 6 year 7 month on lateral incisor, 6 year 11 month on canine, 8 year 1 month on the first premolar, 8 year 5 month on the second premolar, 5 years 10 month on the first molar and 9 year 10 month on the second molar, calcification timing of male in the mandible was 5 year 6 month on central incisor, 5 year 9 month on lateral incisor, 6 year 8 month on canine, 7 year 6 month on the first premolar, 8 year 4 month on the second premolar, 5 years 3 month on the first molar and 9 year 7 month on the second molar. 2. The sequence of calcification at Nolla stage 7 was in consequence to the first molar, central incisor, lateral incisor, canine, the first premolar, the second premolar and second molar. 3. While the sequence of root completion of maxilla was in consequence to the first molar, central incisor, lateral incisor, that of mandible was in order of central incisor, first molar and lateral incisor. 4 the calcification timing of permanent teeth was earlier in female than in male (p<0.05). According to above data, the result of this study is applicable for diagnosis and routine clinical practice for children.

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Primary Adenoid Cystic Carcinoma Arising in the Bronchus (기관지에 발생한 선양 낭포성 암종)

  • Kim, Young-Keun;Chung, Kyung-Young;Shin, Dong-Hwan;Kim, Hae-Jin;Kim, Chang-Nyun;Kang, Shin-Myung;Ko, Won-Ki;Kim, Young-Sam;Lee, Jun-Gu;Park, Jae-Min;Kim, Se-Kyu;Chang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.591-598
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    • 2001
  • Background : Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinical characteristics. Method : We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. Result : The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totally. There were three inoperable cases including two cases with distant metastasis to bone or cervical lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One patient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. Conclusion : It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible.

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Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients (뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구)

  • Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.44-48
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    • 2019
  • Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

Effectiveness of stages-matched educational program for cervical cancer screening among adult women in a community (일개 지역사회 여성 주민의 자궁경부암 조기검진 수검에 관한 행동변화단계별 교육 프로그램의 효과)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.23-37
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    • 2007
  • Background: Even though cervical cancer poses a significant global cancer burden, successful implementations for early detection offer an opportunity to prevent deaths and reduce the cancer burden. In Korea, cervical cancer is the most prevalent type of cancer among adult women, but it is one of the few cancers in which a consensus-approved screening test exists for early diagnosis, Pap test, that can be combined with highly efficacious treatment regimens for early-stage disease. Purpose: This study was carried out to identify the cognitive-behavioral factors associated with cervical cancer screening behavior among adult women, aged 40 to 59, and to develop tailored messages and to evaluate the effectiveness of stage-matched educational program. Method: A total of 283 women who aged 40 years or older was recruited in Seoul, from September, 1st to November, 14th, 2003. The intervention group (N=162) and the control group (N=121) were selected from five sub-districts in Seocho-gu, Seoul. Building on the TTM, a quasi-experimental study was conducted to test the effectiveness of stages-matched intervention addressed at the five stages of cervical cancer screening behavior. Women in the intervention group were randomly assigned to one of two conditions, internet or postal services. Results: In our results, 88.9% of participants had received a Pap test at least once in their life-time, and 65.4% had got it in the past two years. With regard to cognitive-behavioral factors, the stages-matched educational program increased attitude and process of change for cervical cancer screening. The percentage changed was the largest in maintenance stage. With regard to delivery methods for tailored messages, the print materials were more effective at increasing screening adherence than the e-mail. Whereas the postal service group showed remarkable the change of behavior stage, the internet service group did not. Also it was not shown any difference of the satisfaction with stages-matched educational program between internet and postal service groups. Conclusion: This study suggested that cervical cancer screening behavior could be changed by tailored messages which had developed with cognitive-behavioral factors. The stages-matched educational program was effective to promote the screening adherence for cervical cancer.

A Case of Glycogen Storage Disease Type Ia Confirmed by Biopsy and Enzyme Assay (제Ia형 당원병 1례 (Glycogen Storage Disease , Type Ia))

  • Meen Sang-Ae;Rho Kwang-Sik;Kim Pyung-Kil;Jeong Hyeon-Joo;Park Young-Nyeon;Kim Myung-Joon;Kim Ji-Hong
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.77-81
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    • 1998
  • The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

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Clinical Characteristics and Renal Outcomes of Acute Focal Bacterial Nephritis in Children (소아 급성 세균성 신엽염의 임상상 및 신장 예후)

  • Lee Dong-Ki;Kwon Duck-Geun;Lim Yun-Ju;Shin Yun-Hye;Yun Suk-Nam;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.229-238
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    • 2004
  • Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

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The Role of Colonoscopy in Children with Hematochezia (소아 선혈변에서 대장 내시경 검사의 역할)

  • We, Ju-Hee;Park, Hyun-Suk;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.155-160
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    • 2011
  • Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

Clinical Evaluation of Nephrotic Syndrome Manifesting in the First Year of Life (1세 이하의 소아에서 발병한 신증후군의 임상적 고찰)

  • Cho, Sung-Hee;Lee, Joo-Hoon;Cho, Young-Mi;Park, Young-Seo;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.161-169
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    • 2009
  • Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.