Yang, Woo Seok;Yoo, Jae Ho;Cheon, Sang-Myung;Kim, Seong Hwan;Choe, Byeong Moo;Kim, Woo Jin;Bang, Young Rong;Park, Jae Hong
Sleep Medicine and Psychophysiology
/
v.22
no.1
/
pp.20-24
/
2015
Objectives: Restless legs syndrome (RLS) is a common sleep disorder in adults with diabetes. This study investigated the frequency of RLS and clinical correlations in children and adolescents with type 1 diabetes. Methods: This study included 55 consecutive patients (21 males, age $12.6{\pm}3.4years$) with type I diabetes that were regularly treated at the Department of Pediatric Endocrinology. RLS was diagnosed by intensive interviews which also included the Epworth Sleepiness Scale (ESS) and International RLS Rating Scale (IRLSRS). Patients also received neurological examinations and laboratory tests for diabetes, iron metabolism and renal function. Results: Thirteen patients (23.6%, 6 males) were compatible for the diagnostic criteria of RLS. None of the RLS patients showed abnormal findings in neurological evaluations and 7 patients had familial history of RLS. Demographic and laboratory findings were not different between the patients with or without RLS. The RLS group showed significantly increased ESS and IRLSRS scores. Conclusion: RLS was prevalent in children and adolescents with type 1 diabetes. The association between RLS and diabetes-related laboratory findings requires further investigation.
Biliary atresia (BA) is very difficult to distinguish from neonatal hepatitis (NH) and its prognosis depends on the age at the time of Kasai operation. Therefore early differentiation between these two conditions is very important. Although various clinical and laboratory tests have been reported to differentiate between them, they are still of limited value. From 1980 to 1999, forty-five infants were referred to our pediatric surgical unit for operation for suspected BA. Eight patients underwent Kasai operation immediately because of late diagnosis. These were excluded from the study. The clinical history, physical findings. radiologic and laboratory examinations of 37 cases were analyzed retrospectively. The average age of BA (n=20) was $55.1{\pm}16.7$ days, and that of NH (n=17) was $55.8{\pm}15.6$ days. The sex ratio of BA was 13:7, and that of NH was 14:3. All the patients had obstructive jaundice and acholic stool except 4 BA and 6 NH patients. Acholic stool with yellow component was more frequent in NH. Onset of jaundice was within 2 weeks after birth in 85 % of BA, and in 65% of NH. The onset of acholic stool was within 2 weeks after birth in 60 % of BA, and in 23.5 % of NH. The duration of jaundice and acholic stool of BA were $50.9{\pm}16.6$ days and $41.3{\pm}18.4$ days and those of NH were $40.1{\pm}23.1$ days and $26.6{\pm}25.4$ days respectively. The ultrasonogram and hepatobiliary scan were useful, but not a definitively reliable method for the differentiation of these two diseases. There was no difference in laboratory data. Seventeen cases had NH among 45 referred cases for Kasai operation with the clinical impression of BA, and 4 cases of 17 NH cases needed to be explored to rule out BA. In conclusion. false positive rate of clinical impression of BA was 37.8 %. and negative exploration rate was 8.9 %, Therefore. careful clinical observation for 1-2 weeks by an experienced pediatric surgeon was very important to avoid unnecessary operation to rule out NH up to the age of 8 - 10 weeks. so long as the stool had yellow component.
The LAP (lipid accumulation product) index is an indicator of excessive fat accumulation in combination with the fasting triglyceride concentration and waist circumference. This study examined the relationship between the LAP index and ALT (alanine aminotransferase) level and the effect of the LAP index on the ALT level. Cross-sectional studies were conducted on healthy adult males without a history of liver disease. From January 2015 to June 2017, 13,854 adults between 20 and 70 years of age, who underwent health screening at a general hospital in Gyeonggi-do, were enrolled in this study. The LAP index was calculated as [waist circumference (cm)-65]${\times}$[triglyceride (mmol/L)] for males. Serum ALT abnormalities were set at 40 IU/L or more in males. All subjects underwent measurements of the anthropometric indicators and physiological examinations. A significant increase in ALT with increasing LAP quintiles was observed (p<0.001). The LAP index correlated with ALT (r=0.238, p<0.001). Insulin (r=0.449, p<0.001) and HDL-cholesterol (r=-0.369, p<0.001) were strongly correlated with LAP. In addition, the LAP index is a factor affecting the ALT level (p<0.001). As the LAP index increased, the risk of an elevated ALT was higher (p<0.001). In conclusion, the LAP index was a predictor of an ALT elevation in Korean men.
The prevalence of Enterobius vermicularis infection among preschool children was reported to be low based on a 5-year screening program in Taipei City, Taiwan. The Taipei City government intended to terminate the E. vermicularis screening program among preschool children. Thus, we were entrusted with confirming whether pinworm infections among preschool children in Taipei City had truly declined. From each of 12 administrative districts 2-3 kindergartens were randomly selected for investigation. In total, 4,349 children were examined, of which 2,537 were boys and 1,812 were girls. The cellophane tape adhered to a glass slide was used, and all examinations were done by certified medical technologists. Results indicated that the overall prevalence rate of pinworm infections was 0.62% (27/4,349). Although the infection rate was higher among boys (0.67%, 17/2,537) than in girls (0.55%, 10/1,812), no significant difference was found ($X^2$=0.399, P=0.62). According to the administrative district, the infection rate ranged from no positive cases of E. vermicularis infection in the Xinyi, Zhongzhen, and Wanhua Districts (0%; 0/299, 0/165, and 0/358, respectively), to 0.26% (1/131) in Songshan District, with the highest rate of 1.88% (7/373) in Wenshan District. Because the overall infection rate (0.62%, 27/4,349) in the present study was unchanged compared to that (0.40%, 197/49,541) previously reported in 2005, we propose that regular pinworm screening and treatment programs should be continued in some parts of Taipei City.
Park, Ji-Hye;Kim, Nyeon-Ok;Seo, Mi-Hye;Yoo, Soh-Yeon;Park, Hye-Mi
The Korean Journal of Nuclear Medicine Technology
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v.21
no.1
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pp.23-28
/
2017
Purpose Recently, there has been increasing demands for clinical departments at Asan Medical center in Seoul. They want to see the results of lab tests about blood samples as soon as possible and to be reported to them on the day. As the main contents of the survey, we explained the goodness of Asan medical center's in vitro and the points to be improved. Based on this, it became an opportunity to create a positive image of In vitro laboratory. In addition, we could identify their specific requirements through the surveys. Materials and Methods In September 2016, a total of 14 questionnaire surveys were conducted for 49 clinical departments and outpatient nurses at Asan Medical center in Seoul. The survey consists of description questions to be able to express the intention of the individual and the questions made on the Likert 4 point scale. The main contents of 14 questions are composed of goodness of In Vitro laboratory and points to be improved. Results 62% answered that the best service in In Vitro laboratory was "good accuracy and reproducibility". On the other hand, as an inconvenience when requesting blood tests, 73% pointed out that "the result report time was long", which was recognized as a part to be improved. There are many contents that "The result of all tests is reported within 2 hours" on the day of the examination. In the question - 'Are there some examination results which do not coincide well with clinical observations?', 55 of 56 people answered "no". Above all, the majority answered that waiting for re-examination results is too long. This problem must be causing discomfort to the patients. Conclusion In order to improve these problems, the first thing is to increase the number of blood tests by using the current personnel, equipments and reagents to the fullest by item in Asan Medical Center's Nuclear medicine in vitro part. Secondly, in case of re-examinations, we use the "AMIS message" to show other clinical departments the reporting time. This methode improves the efficiency of work with nurses and increases satisfaction of custom service. Thirdly, the correlation was evaluated by selecting the test species that can be carried out by the shortening method. Currently, C-peptide and insulin are implemented in the reaction process to shorten 2 hours into 1 hour. Finally, we are considering purchasing new equipments for quick test results.
An inverse correlation between obesity and arterial stiffness has been reported, but there are no consistent results in elderly subjects. This study examined the relationship between the arterial stiffness measured by the CAVI (cardio-ankle vascular index) and BMI (body mass index) in healthy elderly people. This study included 629 healthy elderly people aged 65 and over who underwent health examinations at a general hospital in Gyeonggi from July 2018 to June 2019. Metabolic syndrome was diagnosed using the criteria of the Adult Treatment Panel (ATP) III of the US National Cholesterol Education Program (NCEP). Among the criteria of NCEP-ATP III, the waist circumference and obesity criteria were based on the WHO criteria. All subjects underwent a biochemical blood test and an assessment of the CAVI. In both men and women, the CAVI was lower in the obese group than in the normal weight group. Gender (P=0.047), age (P<0.001), BMI (P<0.001), and waist circumference (P=0.008) were factors affecting the CAVI. Gender, high blood pressure, and hyperglycemia were independent positive predictors of the CAVI levels, while obesity was a negative predictor. Therefore, the CAVI and BMI showed an inverse correlation. In conclusion, there was an inverse correlation between the CAVI and BMI in the elderly, and obesity was a negative predictor of the CAVI.
Gorantla, Vasavi R.;Bond, Vernon Jr.;Dorsey, James;Tedesco, Sarah;Kaur, Tanisha;Simpson, Matthew;Pemminati, Sudhakar;Millis, Richard M.
Journal of Pharmacopuncture
/
v.22
no.3
/
pp.166-170
/
2019
Objectives: Attentional and memory functions are important aspects of neural plasticity that, theoretically, should be amenable to pharmacopuncture treatments. A previous study from our laboratory suggested that quantitative electroencephalographic (qEEG) measurements of theta/beta ratio (TBR), an index of attentional control, may be indicative of academic performance in a first-semester medical school course. The present study expands our prior report by extracting and analyzing data on frontal theta and beta asymmetries. We test the hypothesis that the amount of frontal theta and beta asymmetries (fTA, fBA), are correlated with TBR and academic performance, thereby providing novel targets for pharmacopuncture treatments to improve cognitive performance. Methods: Ten healthy male volunteers were subjected to 5-10 min of qEEG measurements under eyes-closed conditions. The qEEG measurements were performed 3 days before each of first two block examinations in anatomy-physiology, separated by five weeks. Amplitudes of the theta and beta waveforms, expressed in ${\mu}V$, were used to compute TBR, fTA and fBA. Significance of changes in theta and beta EEG wave amplitude was assessed by ANOVA with post-hoc t-testing. Correlations between TBR, fTA, fBA and the raw examination scores were evaluated by Pearson's product-moment coefficients and linear regression analysis. Results: fTA and fBA were found to be negatively correlated with TBR (P<0.03, P<0.05, respectively) and were positively correlated with the second examination score (P<0.03, P=0.1, respectively). Conclusion: Smaller fTA and fBA were associated with lower academic performance in the second of two first-semester medical school anatomy-physiology block examination. Future studies should determine whether these qEEG metrics are useful for monitoring changes associated with the brain's cognitive adaptations to academic challenges, for predicting academic performance and for targeting phamacopuncture treatments to improve cognitive performance.
Osman Kula;Burak Gunay;Merve Yaren Kayabas;Yener Akturk;Ezgi Kula;Banu Tutunculer;Necdet Sut;Serdar Solak
Journal of Korean Neurosurgical Society
/
v.66
no.6
/
pp.681-689
/
2023
Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.
Kim, Kyung Chan;Seo, Chang Gyun;Park, Sun Hyo;Choi, Won-Il;Han, Seung Beom;Jeon, Young June;Park, Jong-Wook;Jeon, Chang-Ho
Tuberculosis and Respiratory Diseases
/
v.56
no.2
/
pp.159-168
/
2004
Background : In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the results were compared with those of cytologic examinations. Methods : Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity. Results : There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy. Conclusion : MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.
Experts of Sasang Constitution Medicine of Traditional Korean Medicine have classified stroke patients with four types of Sasang constitutions in their clinical practice and some types of Sasang constitutions have been regarded as risk factors of stroke, but this is uncertain because there were no evidences by large scale of prospective studies. The purpose of this was to study the association between strokes and Sasang constitutions. Case-control study has been conducted to the patients admitted to the research hospitals. The patients were confirmed stroke by brain MRI or CT scans and recruited from May 2003 to August 2005. The subjects who met the requirement of inclusion and exclusion criteria were 108 patients as the cases and 107 as healthy controls. Data collection has been performed by the trained specialists majoring neurologists through interviews, physical examinations, and laboratory testes. No statistical significance was obtained between the strokes and Sasang constitutions, yet Taeumin, and Soyangin types showed a trend of increase in the incidence of strokes as compared with Soeumin. To acquire more concrete data on this theme, we need further and large scale of prospective researches.
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