$^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) causes a significant amount of radioactivity retention in kidneys and urinary tract and degrades image quality and diagnostic performance. Diuretics are used to perform tests and prevent the urinary tract retention of $^{18}F$-FDG. The purpose of the study is to investigate how the diuretics affect images and excretion rates of $^{18}F$-FDG. The study consists of a group using diuretics for patients with no primary tumors or transfer lesions in kidneys according to PET/CT images, a group using physiological saline and the control group injecting only $^{18}F$-FDG and SUVs are measured by configuring interested areas for each group. Also, SUVs are compared and evaluated depending on the lasix injection after basic inspection and injecting $^{18}F$-FDG for quantitative analysis. The study shows that images with decreased background radioactivity and increased urine excretion due to using diuretics. However, an opposite result that there is no change in the amount of radioactivity in urine appears. The study concludes that the diuretics may decrease background radioactivity in the images but may not affect the $^{18}F$-FDG excretion.
Objective : To estimate the prevalence of congenital heart disease from the 1990 student heart disease screening program. Methods : The heart disease screening program for elementary students was conducted in Kyonggi-do, in 1998. The subjects of the present study comprised the 40,402 students who attended the schools in the catchment area of a collaborative university hospital and who participated in the primary examination. The congenital heart disease (CHD) patients were initially identified through a questionnaire about prior medical history, and further through diagnostic tests & medical examinations in the secondary & the tertiary examinations. Certain assumptions were used in the estimation of the number of CHD cases among non-participants of the secondary & tertiary examinations. The overall prevalence of CHD was estimated by adding the CHD detection rates of the participants and the estimated prevalence of the non-participants. Results : Among the 40,402 primary participants, 1,655 were referred further, of whom 79.1% (1,309) participated in the secondary examination. Of these, 121 were referred to the tertiary examination, with a participation rate at this last stage of 80.2%. The positive predictive value (PPV) of the screening tools was the highest when the results of both EKG and the questionnaire were positive. Because 85.9% of the detected cases had a past history of CHD, PPV was higher when the selection criteria in the questionnaire included past CHD history than when it didnt. The CHD defection rate among the participants was 1.76 cases/1,000 and the presumed number of cases among the non-participants was 31; giving an estimated final CHD prevalence of 2.52 cases/1,000 (95% CI : 2.06-3.06). Among the identified cases of CHD, VSD (52.8%) was the most common, followed by PDA (9.7%), TOF (9.7%) & PS (9.7%). Conclusion : Because the characteristics of the non-participants differed from those of the participants, the estimation of prevalence was influenced by the participation rate. Of the detected cases, 85.9% had a past history of diagnosis or operation for CMD. These findings suggested that the prevalence estimated in this study may be an underestimation of the actual condition. Therefore, a birth cohort study is required in order to more accurately estimate the prevalence and the effects of the program.
The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of $^{131}I$-rose bengal and of $^{198}Au$ colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of $^{131}I$-rose bengal was $6.6{\pm}0.63$ minutes in normal control, $17.7{\pm}6.93$ in cirrhosis of the liver, $16.6{\pm}4.80$ in acute hepatitis, and $14.7{\pm}3.46$ in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2. The mean blood disappearance half time of $^{198}Au$ colloid was $4.0{\pm}0.66$ minutes in normal control, $9.8{\pm}3.42$ in cirrhosis of the liver, $4.4{\pm}0.82$ in acute hepatitis, and $5.0{\pm}1.42$ in obstructive jaundice. The difference between cirrhosis of the liver and normal control Was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was $0.177{\pm}0.028/minute$ in normal control. In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of $^{131}I$-rose bengal blood disappearance half time to $^{198}Au$ colloid disappearance half time was $1.68{\pm}0.20$ in normal control, $1.82{\pm}0.31$ in cirrhosis of the liver, $3.80{\pm}0.82$ in acute hepatitis, and $3.01{\pm}0.54$ in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of $^{131}I$-rose bengal and that of $^{198}Au$ colloid in cirrhosis of the liver. 5. In cirrhosis of the liver, the blood disappearance half times of $^{131}I$-rose bengal and of $^{198}Au$ colloid were inversely correlated to the serum albumin level. In acute hepatitis, there was a good positive correlation between the blood disappearance half time of $^{131}I$-rose bengal and the serum transaminase activities. In obstructive jaundice, the blood disappearance half time of $^{131}I$-rose bengal was correlated to the serum bilirubin level.
Background: China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. Materials and Methods: A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. Results: The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. Conclusions: The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are needed to improve the knowledge of health care workers, especially in less developed regions.
Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.
Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.
Kim, So Eun;Lee, Jae Baek;Jin, Young Ho;Yoon, Jae Chol;Jo, Si On;Jeong, Tae Oh
Journal of The Korean Society of Clinical Toxicology
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v.17
no.1
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pp.38-41
/
2019
Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.
The purpose of this study was to observe auditory processing skills in school-age children using Fisher's Auditory Problem Checklist(FAPC; Fisher, 1976) and Scales of Auditory Behaviors(SAB; Shiffman, 1999) in order to provide a basis for clinical application in screening central auditory processing disorders(CAPD) in Korea. Korean translated version of FAPC and SAB were given to the parents or care givers of 233 students from grades 1~6. As a result of testing FAPC, the average score for all grades showed 91.87(${\pm}7.93$) points, with grade point average score falling in 90.13~93.67 range and no significant differences among grades. For SAB, the average score for all grades showed 53.44(${\pm}5.09$), with grade point average score falling in 51.78~55.44 range and also no significant differences among grades. Significant correlations between FAPC and SAB were shown in all and within grade levels. There showed to be 22 children(9.9%) in -1 SD at risk criteria, with 13 male students(12%) and 9 female students(7.8%) for both FAPC and SAB. In applying FAPC and SAB clinically to school-age children, these two tests showed to have a significant correlation, but because of different characteristics due to the small number of children in the common risk range, diagnostic testing/rehabilitation plan based on screening and auditory behavior characteristics is recommended to be conducted complementarily to one another.
Recently, the rapid growth of the companion animal market has led to the development of animal disease diagnosis kits. Therefore, the utility of the introduction of biomarkers for the development of animal molecular diagnostics is being reevaluated. A good biomarker should be precise and reliable, distinguish between normal and diseased states, and differentiate between different diseases. Recently reported genetic markers, tumor markers (cell free DNA, circulating tumor cells, granzyme, and skin tumors), and others (brucellosis, programmed death recovery-1, symmetric dimethylarginine, periostin, and cysteinyl leukotrien) have been developed. The biomarkers are used for risk prediction or for the screening, diagnosis, and monitoring of disease progression. The most important criteria for related biomarkers are disease specificity. Many potential biomarkers have emerged from laboratory and test studies, but they have not been validated in independent or large-scale clinical studies. Candidate biomarkers evaluate disease associations, verify the effectiveness of biomarkers for early detection and disease progression, and incorporate them into humans and animals. In the future, it will be necessary to reevaluate the utility of well-structured biomarker-based research and study the development of kits that can be used in on-site tests in accordance with the trends introduced in the diagnosis of animal diseases.
Leem, Cho Sun;Choi, Su Jung;Lim, Kyung-Choon;Yi, Young Hee;Jeong, Jae Sim;Shin, Yong Ae;Kang, Young-ah;Park, Hayoung;Kim, Eun Mi
Journal of Korean Critical Care Nursing
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v.12
no.3
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pp.35-49
/
2019
Purpose : This study aimed to propose a common scope of practice (SOP) for 13 specialties of Advanced Practice Nurses (APNs) in Korea. Methods : The first draft of a common SOP was extracted from domestic and international laws with a literature review by 17 experts from the Korean Association of Advanced Practice Nurses (KAAPN). Then, the common SOP was finalized after comparing the activities of APNs in clinical settings. Results : A total of 70 duties were identified and six categories were suggested for the common SOP. The SOP proposed by the KAAPN featured the following: 1) identification of and discrimination between health problems; 2) prescription and implementation of diagnostic tests; 3) treatment of injuries and diseases while implementing measures to prevent exacerbation; 4) prescription of medicinal products in line with 1) to 3); 5) referral and consultation; and 6) education and counseling. It was then confirmed that the proposed six categories in the common SOP reflected all the duties performed by APNs in clinical practice, including all 40 activities. Conclusion : The results of this study can be used as evidence for the legalization of a common SOP for APNs. Given the increasing multidisciplinary team approach adopted in Korean hospitals, it may be desirable to establish a broader SOP to reflect the diverse duties of APNs.
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