• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1061-1068
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• 2009

The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth and development. In addition, fluid, electrolyte, and acid-base status must be regularly monitored and should be well maintained. Serum calcium, phosphorus, and parathyroid hormone levels must be maintained at their target range, which are determined on the basis of the glomerular filtration rate, to avoid the development of mineral bone disease. This can be achieved by using phosphorus binders and vitamin D analogues. An erythropoiesis-stimulating agent must be administered along with iron supplementation to maintain the hemoglobin level of the patients between 11-12 g/dL. Hypertension must be controlled with adequate water and sodium balance and appropriate antihypertensive agents. Administration of recombinant human growth hormone is recommended to improve the final adult heights.

• The Journal of Internal Korean Medicine
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• v.20 no.1
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• pp.274-279
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• 1999

In order to look about the effect and possibility of oriental medical diagnosis and treatment of pancytopenia of myelodysplastic syndrome. For a patient who has pancytopenia. we diagnose him as myelodysplastic syndrome by CBC, LFT, Ultrasonic wave, Vitamin B12 test, Bone marrow test, Folic acid test and doing Herb-medication, Moxa-Tx continually, we observed the change of WBC, RBC. HGB. MCV, Platelet. ESR with following up CBC test ten times Finally, WBC increased by 900, RBC increased by 400000, MCV was reduced by 7fl. HGB increased by 1.3g/dl. Hct increased by 3.2%, ESR was reduced from 127 to 35mm/h. We diagnosed myelodysplastic syndrome as 'CONSUMPTIVE DISEASE' in oreintal medicine. The treatment effect of pancytopenia was achieved by Herb-medication and Moxa-Tx for invigorating qi, enriching the blood, invigorating the spleen and the kidney-yang, Now we need the study of oriental medical treatment for Aplastic Anemia and AML which is similar this.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1833-1835
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• 2016

Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.187-201
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• 2024

Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

• Journal of the Korean Dietetic Association
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• v.16 no.2
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.880-890
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• 2020

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (D_Thorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. D_Thorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between D_Thorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV₁) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DL_CO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower D_Thorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

• Nuclear Engineering and Technology
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• v.55 no.8
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• pp.2854-2863
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• 2023

Objective: To present a hybrid approach that incorporates a constrained beam-hardening estimator (CBHE) and deep learning (DL)-based post-refinement for metal artifact reduction in dental cone-beam computed tomography (CBCT). Methods: Constrained beam-hardening estimator (CBHE) is derived from a polychromatic X-ray attenuation model with respect to X-ray transmission length, which calculates associated parameters numerically. Deep-learning-based post-refinement with an artifact disentanglement network (ADN) is performed to mitigate the remaining dark shading regions around a metal. Artifact disentanglement network (ADN) supports an unsupervised learning approach, in which no paired CBCT images are required. The network consists of an encoder that separates artifacts and content and a decoder for the content. Additionally, ADN with data normalization replaces metal regions with values from bone or soft tissue regions. Finally, the metal regions obtained from the CBHE are blended into reconstructed images. The proposed approach is systematically assessed using a dental phantom with two types of metal objects for qualitative and quantitative comparisons. Results: The proposed hybrid scheme provides improved image quality in areas surrounding the metal while preserving native structures. Conclusion: This study may significantly improve the detection of areas of interest in many dentomaxillofacial applications.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.167-189
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• 2008

This study was conducted to investigate the factors which are related to Bone Mineral Density(BMD) of female for prevention of osteoporosis. We measured the BMD of lumbar spine(L2-L4) and femoral neck in 4802 female, using dual energy X-ray absorptionmetry(DEXA; DPX-alpha. Lunar, U.S.A.). and then analysed the 9 factors-age group, body mass index(BMI), amount of smoking, drinking, exercise, sleep, and fast blood sugar-which are related to BMD of female. The following results were obtained : 1. In age group, T-score was the highest at 36－42(六七) years group in lumbar spine(L2-L4) and at 15－21(三七) years group in femoral neck. and then it was decreased rapidly after 43－49(七七) years group in both lumbar spine(L2-L4) and femoral neck. Therefore we concluded that T-score of female in lumbar spine(L2-L4) and femoral neck change according to age group in $\ll$Hwangjaenaekyong Somun; 黃帝內經 素問$\gg$. 2. In BMI, T-score of lumbar spine(L2-L4) and femoral neck were increased according to BMI increase. 3. In amount of drinking and smoking, T-score was highest in heavy groups(women who have drunk soju more than 4 bottles for a week) in both lumbar spine(L2-L4) and femoral neck. But there t was no significant difference in comparison according to age group. 4. In exercise, T-score was higher in exercising group than non exercising group. And it appeared that women who have taken proper exercise had higher T-score than women who have taken exercise daily. 5. T-score was higher in women who ordinarily sleep well in both lumbar spine(L2-L4) and femoral neck than sleep badly. And there was significant difference in 43-56 years group. 6. T-score was low in the group that exceed 110mg/dl in fast blood sugar. Conclusions : The age group in $\ll$Hwangjaenaekyong Somun; 黃帝內經 素問$\gg$ is related to BMD of women. And risk factors-BMI, exercise, sleep, fast blood sugar, thyroid disease-are related to BMD of women. Therefore we expect that this study will help for prevention of osteoporosis of women, and further study will be achieved.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.29-38
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• 1989

5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were in defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M : E ratio was 0.7 : 1. The lead concentration in serum was in creased in 4 cases (80%) of patients. Lead concentration, deltaaminolevulinic acid concentration in 24 hours collected urine were in creased in 5 patients (100%). Qualitative test of coproporphyrin of urine was positive in all 5 cases. 3 patients treated with Ca-EDTA, abdominal pain was improved rapidly and hemoglobin level was in creased slowly.