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Prenatal diagnosis and clinical course of restrictive foramen ovale in otherwise normal heart (단순 조기 난원공 협착의 산전 진단과 임상경과)

  • Lee, Ji Joung;Lee, Min A;Rhee, Yun ee;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.268-271
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    • 2007
  • Purpose : Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. Methods : The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. Results : At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. Conclusion : Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.

Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Clinical Study of Pulmonary Thromboembolism (폐혈전색전증의 임상적 연구)

  • Bak, Sang-Myeon;Lee, Sang-Hwa;Lee, Sin-Hyung;Sin, Cheol;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.106-116
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    • 2001
  • Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.

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The Utility of Measurement of Plasma N-terminal Pro-brain Natriuretic Peptide in Diagnosis of Pulmonary Hypertension (폐동맥고혈압 진단에 있어 N-terminal Pro-brain Natriuretic Peptide 측정의 유용성)

  • Hahn, Chang Hoon;Kang, Seok Min;Moon, Jin Wook;Cho, Jae Hee;Hwang, Sang Yon;Lee, Jung Min;Park, Moo Suk;Chung, Jae Ho;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Shim, Won Heum;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.67-76
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    • 2004
  • Background : Pulmonary hypertension is a poor prognostic factor in patients with chronic respiratory disease. However, diagnosing pulmonary hypertension is a difficult procedure which often requires an invasive test. Thus new alternative biochemical markers would be useful in clinical field and are in search. We sought to assess the role of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with pulmonary hypertension. Method : We measured plasma NT-proBNP level in twenty nine patients suspected for pulmonary hypertension. Pulmonary hypertension was defined as being right ventricular systolic pressure more than 35 mm Hg estimated by Doppler echocardiography. Plasma NT-proBNP level was measured by electrochemiluminescence sandwich immunoassay. Results : The log-transformed values for plasma NT-proBNP levels showed a linear correlation (correlation coefficiency: 0.783, p-value <0.001) with right ventricular systolic pressure. Plasma NT-proBNP levels closely correlated with right ventricular systolic pressure, right ventricular hypertrophy, interventricular septal flattening and right ventricular dilatation. Conclusion : Our results suggest that the measurement of plasma NT-proBNP level is an useful marker of the presence of pulmonary hypertension.

Prognostication by Cluster Analysis of COX-2, MMP-9 and P53 Expression and by Clinico-pathologic Correlation Analysis in Non-small Cell Lung Cancer (비소세포폐암에서 COX-2,MMP-9와 돌연변이형 p53 의 발현이 생존에 대한 예후 분석)

  • Shin, Jong Wook;Choi, Jae Ho;Park, In Won;Yoo, Jae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.31-41
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    • 2007
  • Background: In pathogenesis and prognosis of lung cancer, significance of enormous types of genetic expression were very compounding and undetermined. We performed this study to search association between clinical characteristics and expression of COX-2, MMP-9 and p53 in non-small cell lung cancer. Methods: Ninety-one patients with adenocarcinoma or squamous cell carcinoma were enrolled. We had searched clinical data retrospectively and performed immunohistochemical staining for COX-2, MMP-9 and p53. We had analyzed significance of these three genes in clinical features and prognosis for survival. Results: 1) In squamous cell carcinoma, male was predominant and was significantly correlated with smoking. 2) Major prognostic determinants for overall survival were curative resection. 3) Expression of COX-2 was more frequent in adenocarcinoma than in squamous cell carcinoma. 4) Negative staining of COX-2, MMP-9 and p53 was more frequent in squamous cell carcinoma than adenocarcinoma. 5) Survival duration was longer in the group with positive expression of p53 and negative for COX-2 and MMP-9 (median duration of survival = 165.6 weeks) than groups with the other expressional patterns. 6) Significant correlation was found between expression of MMP-9 and COX-2. In squamous cell carcinoma, expression of MMP-9, COX-2 and mutant p53 were mutually correlated. 7) COX-2 expression was significant prognostic factor for survival in resected cancer group. In unresected inoperable non-small cell lung cancer group, MMP-9 was statistically significant prognostic factor for overall survival. Conclusion: COX-2 and MMP-9 might have some roles for progression or prognosis in some selected patients with non-small cell lung cancer. COX-2 and MMP-9 may have some roles for disease progression or prognosis in selected patients with NSCLC.

History of Plant Protection Science since 1900 in Korea (한국(韓國)에 있어서의 식물보호(植物保護) 연구사(硏究史) -1900년대(年代)를 중심(中心)으로-)

  • Park, Jong-Seong
    • Korean Journal of Agricultural Science
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    • v.6 no.1
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    • pp.69-95
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    • 1979
  • The study was conducted to search developmental process of plant protection science from review of forty-three hundreds literatures presented since 1900 in Korea and to forecast future statues of the science to be done. About 80 percent of literatures related to plant protection science such as plant pathology, applied entomology, weed science and agricultural pharmacology were collected from publications of agricultural and forestry reseach organizations attached to Office of Rural Development and Office of Forestry. The rest of literatures were mainly collected from Korean Journal of Plant Protection Society and small number of literatures were also collected from publications of the other journals of crop science and thesis collection of agricultural colleges. In Korea, research organizations of plant protection science are divided into two main groups such as exclusive agricultural research organizations and agricultural colleges. It is pointed out that the former contributions to plant protection science are very great compared to those of the latter since 1900. From periodical consideration of developmental process of the science since 1900, the history or the science are divided into three eras such as introduction and sprout of modern plant protection science during the first forty years, distress of the science during the following twenty years including the Second World War and the Korean War and rapid growth of the science after 1961. In spite of long time distress of the science during the Second World War and the Korean War, the researches on plant protection science in post-war have been done twice as many as pre-war. From consideration of the subject plants in researches of plant protection, it is shown that a great many researches on protection of rice plant have been done and occupy 37 percent of plant protection researches since 1900. And also researches on protection of fruit-trees and cash-crops are not so many as those of rice plant but have been done in noticeable numbers. In fact, researches on protection of fruit-trees and cashcrops were the most important subjects of plant protection researches in pre-war while those of rice plant were the most important subjects after 1930, particulary in post-war. From consideration of contents of plant protection researches, it is said that more fundamental researches than applied ones such as practical control methods of diseases, insect pests and weeds were done in pre-war while more applied researches than fundamental ones were done in post-war, Among applied researches, those of chemical control were the most important subjects. Researches on disease and insect-pest resistance have been done in both pre-war and post-war while researches on forecasting of disease and insect-pest and race of plant pathogens have been done in post-war. And also researches on weed control mainly have been done after 1960. Researches on agricultural chemicals for control of diseases, insect pests and weeds still belong to a new field which must be expected in future, and there is nothing to notice with the exception of practical application of agricultural chemicals introduced from foreign countries. Some of important researches on diseases and insect pests were discussed in relation to developmental process of plant protection science in Korea since 1900. In future, researches on plant protection will be develop to the direction supporting importance of integrated control for plant protection. Therefore, it is pointed out that security of highly educated and trained scientists with enlargement of reseach fields of plant protection science are necessary and role of agricultural colleges for future development of the science must be emphasized.

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Comparison of Results According to Reaction Conditions of Thyroglobulin Test (Thyroglobulin 검사의 반응조건에 따른 결과 비교 분석)

  • Joung, Seung-Hee;Lee, Young-Ji;Moon, Hyung-Ho;Yoo, So-yoen;Kim, Nyun-Ok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.39-43
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    • 2017
  • Purpose Thyroglobulin (Tg) is a biologic marker of differentiated thyroid carcinoma (DTC), produced by normal thyroid tissue or thyroid cancer tissue. Therefore, the Tg values of DTC patients is the most specific indicator for judging whether recurrence occur or whether the remaining thyroid cancer is present. Thyroid cancer is currently the most common cancer in Korea, of which 90% is differentiated thyroid cancer. The number of patients with thyroid disease of this application also increased, and an accurate and prompt results are required. However, the incubation time of the Tg commonly takes about 24 hours in our hospital, and the result reporting time is delayed, and We could not satisfied with the requirements of clinical departments and patients. In order to fulfill these requirements, experiments were conducted by shortening the incubation time between company B's Kit currently in use and company C's Kit used in other hospitals. Through these experiments, we could perform the correlation with the original method and shortening method, and could find the optimum reaction time to satisfy the needs of the departments and the patients, and we will improve the competitiveness with the EIA examination. Materials and Methods In September 2016, we tested 65 patients company B's kit and company C's kit by three incubation ways. First method $37^{\circ}C$ shaking 2hr/2hr, Second method RT shaking 3hr/2hr, Third method 1hr/1hr shaking at $37^{\circ}C$. Fourth method RT shaking 3hr method which is the original method of Company C's Kit. Fifth method, the incubation time was shortened under room temperature shaking 2hr, Sixth method $37^{\circ}C$ shaking 2hr. And we performed and compared the correlation and coefficient of each methods. Results As a result of performing shortening method on company B currently in use, when comparing the Original method of company B kit, First method $37^{\circ}C$ shaking 2hr/2hr was less than Tg 1.0 ng/mL and the ratio of $R^2=0.5906$, above 1.0 ng/mL In the value, $R^2=0.9597$. Second method RT shaking 3hr/2hr was $R^2=0.7262$ less than value of 1.0 ng/mL, $R^2=0.9566$ above than value of 1.0 ng/mL. Third method $37^{\circ}C$ shaking 1hr/1hr was $R^2=0.7728$ less than value of 1.0 ng/mL, $R^2=0.8904$ above than value of 1.0 ng/mL. Forth, Company C's The original method, RT shaking 3hr was $R^2=0.7542$ less than value of 1.0 ng/mL, and $R^2=0.9711$ above than value of 1.0 ng/mL. Fifth method RT shaking 2hr was $R^2=0.5477$ less than value of 1.0 ng/mL, $R^2=0.9231$ above than value of 1.0 ng/mL. Sixth method $37^{\circ}C$ shaking 2hr showed $R^2=0.2848$ less than value of 1.0 ng/mL, $R^2=0.9028$ above than value of 1.0 ng/mL. Conclusion Samples with both values of 1.0 ng/mL or higher in both of the six methods showed relatively high correlation, but the correlation was relatively low less than value of 1.0 ng/mL. Especially, the $37^{\circ}C$ shaking 2hr method of company C showed a sharp fluctuation from the low concentration value of 1.0 ng/mL or less. Therefore, we are planning to continuously test the time, equipment, incubation temperature and so on for the room temperature shaking 2hr method and $37^{\circ}C$ shaking 1hr/1hr of company C which showed a relatively high correlation. After that, we can search for an appropriate shortening method through additional experiments such as recovery test, dilution test, sensitivity test, and provide more accurate and prompt results to the department of medical treatment, It is competitive with EIA test.

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Studies on Neck Blast Infection of Rice Plant (벼 이삭목도열병(病)의 감염(感染)에 관(關)한 연구(硏究))

  • Kim, Hong Gi;Park, Jong Seong
    • Korean Journal of Agricultural Science
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    • v.12 no.2
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    • pp.206-241
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    • 1985
  • Attempts to search infection period, infection speed in the tissue of neck blast of rice plant, location of inoculum source and effects of several conditions about the leaf sheath of rice plants for neck blast incidence have been made. 1. The most infectious period for neck blast incidence was the booting stage just before heading date, and most of necks have been infected during the booting stage and on heading date. But $Indica{\times}Japonica$ hybrid varieties had shown always high possibility for infection after booting stage. 2. Incubation period for neck blast of rice plants under natural conditions had rather a long period ranging from 10 to 22 days. Under artificial inoculation condition incubation period in the young panicle was shorter than in the old panicle. Panicles that emerged from the sheath of flag leaf had long incubation period, with a low infection rate and they also shown slow infection speed in the tissue. 3. Considering the incubation period of neck blast of rice plant, we assumed that the most effective application periods of chemicals are 5-10 days for immediate effective chemicals and 10-15 days for slow effective chemicals before heading. 4. Infiltration of conidia into the leaf sheath of rice plant carried out by saturation effect with water through the suture of the upper three leaves. The number of conidia observed in the leaf sheath during the booting stage were higher than those in the leaf sheath during other stages. Ligule had protected to infiltrate of conidia into the leaf sheath. 5. When conidia were infiltrated into the leaf sheath, the highest number of attached conidia was observed on the panicle base and panicle axis with hairs and degenerated panicle, which seemed to promote the infection of neck blast. 6. The lowest spore concentration for neck blast incidence was variable with rice varietal groups. $Indica{\times}Japonica$ hybrid varieties were infected easily compared to the Japonica type varieties, especially. The number of spores for neck blast incidence in $Indica{\times}Japonica$ hybrid varieties was less than 100 and disease index was higher also in $Indica{\times}Japonica$ hybrid than in Japonica type varieties. 7. Nitrogen content and silicate content were related with blast incidence in necks of rice plants in the different growing stage changed during growing period. Nitrogen content increased from booting stage to heading date and then decreased gradually as time passes. Silicate content increased from booting stage after heading with time. Change of these content promoted to increase neck blast infection. 8. Conidia moved to rice plant by ascending and desending dispersal and then attached on the rice plant. Conidia transfered horizontally was found very negligible. So we presumed that infection rate of neck blast was very low after emergence of panicle base from the leaf sheath. Also ascending air current by temperature difference between upper and lower side of rice plant seemed to increase the liberation of spores. 9. Conidial number of the blast fungus collected just before and after heading date was closely related with neck blast incidence. Lesions on three leaves from the top were closely related with neck blast incidence, because they had high potential for conidia formation of rice blast fungus and they were direct inoculum sources for neck blast. 10. The condition inside the leaf sheath was very favorable for the incidence of neck blast and the neck blast incidence in the leaf sheath increased as the level of fertilizer applied increased. Therefore, the infection rate of neck blast on the all panicle parts such as panicle base, panicle branches, spikelets, nodes, and internodes inside the leaf sheath didn't show differences due to varietal resistance or fertilizers applied. 11. Except for others among dominant species of fungi in the leaf sheath, only Gerlachia oryzae appeared to promote incidence of neck blast. It was assumed that days for heading of varieties were related with neck blast incidence.

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