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Utility Evaluation on Application of Geometric Mean Depending on Depth of Kidney in Split Renal Function Test Using 99mTc-MAG3 (99mTc-MAG3를 이용한 상대적 신장 기능 평가 시 신장 깊이에 따른 기하평균 적용의 유용성 평가)

  • Lee, Eun-Byeul;Lee, Wang-Hui;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.199-208
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    • 2016
  • $^{99}mTc-MAG_3$ Renal scan is a method that acquires dynamic renal scan image by using $^{99}mTc-MAG_3$ and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1~2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook $^{99}mTc-MAG_3$ Renal scan(13 male, 20 female, average age of 44.66 with range of 5~70, average height of 160.40cm, average weight of 55.40kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting).

AN IMMUNOHISTOLOGIC STUDY ON THE ACTIVITY OF MACROPHAGE AND T-CELL IN THE PERIODONTIUM DURING TOOTH MOVEMENT OF DOG (성견의 실험적 치아이동시 치주조직내 대식세포와 T-림파구의 활성에 관한 면역조직화학적 연구)

  • Park, Eui-Woong;Kim, Sang-Cheol;Kook, Yoon-A
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.433-445
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    • 1995
  • Tooth movement, the phenomena and mechanisms of which are still controversial, can be considered as part of the result of the inflammatory processes. The purpose of this study was to examine the activity of macrophage and T-cell, playing important roles in the immune reaction, in the periodontal ligament of dog, in which experimental tooth movement was performed. Six one and half year-old dogs, a control and 5 experimentals, were studied. Light force (50-75g) was applied by placing open-coil spring between left mandibular premolars ; heavy force (250-300g), between right mandibular premolars. Experimental dogs were sacrificed at 12 hours, 1, 3, 7 and 14 days since force application, respectively. And the histologic and the immunohistochemical evaluation on the obtained tissue were performed, using $\alpha$-1-antichymotrypsin and CD3 antibodies. The results were as follows : 1. There were more inflammatory cell infiltrations in heavy force group than in light force group until 3 days. But from 7 dsays on, no difference was not observed between groups ; Such an infiltration was more evident at pressure side than at tension side. 2. Osteoclastic activity at pressure side began to be seen in 12 hours, increasing until 7 days. After then it decreased ; Such an activity was more evident in heavy force group than in light force group. 3. Tearing of periodontal ligament and vascular dilatation at tension side began to be seen in 12 hours, increasing until 3 days. After then it decreased ; Such an observation was more evident in heavy force group than in light force group, but there was no difference between groups in 14 days. 4. $\alpha$-1-antichymotrypsin expression in control group was positive, mainly in sulcular epithelium, but negative in periodontal membrane, pulp, bone cells. 5. $\alpha$-1-antichymotrypsin expression in experimental group was more positive in pressure side than in tension side ; The expression was a little more positive in cervical area of tooth until 3 days, but after 7days, it was more positive in apical area. 6. $\alpha$-1-antichymotrypsin expression in light force group began to be observed in 12 hours and reached to the greatest level in 7 days, after which it decreased ; In heavy force group, it was the greatest in 3 days, after which it decreased. 3 Expression in the periodontium was almost negative.

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Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

Comparison for Glomerular Filtration Rate in Gamma Camera Systems Using Dynamic Renal Phantom System (동적신장팬텀시스템 개발에 따른 장비별 사구체여과율의 비교)

  • Kang, Chun Goo;Park, Hoon-Hee;Oh, Shin Hyun;Lee, Han Wool;Kim, Jung Yul;Oh, Joo Yung;Lee, Ju Young;Kim, Jae Sam;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.3-9
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    • 2013
  • Purpose: Currently commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desire to evaluate the usefulness of nuclear medicine imaging. Materials and Methods: The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc-pertechnate$. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn ten times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Results: Under the same conditions infusion rate 40 mL/min fixed to adjust the pressure of the pump when the radiopharmaceuticals between 2-3 minutes in the most integrated in the kidney phantom was excreted inthe bladder. Glomerular filtration rate (GFR), respectively, by each device SYMBIA 1,091 mL/min, FORTE 1,232 mL/min, ARGUS 1,264 mL/min, INFINIA 1,302 mL/min in that there isno statistically significant difference was found, Tmax values and T1/2 values stars from all equipment with no statistically significant difference was found. CV values of the coefficient of variation less than 5% was found to be repeatable, and to 2.67% of the lowest SYMBIA appeared, INFINIA was the highest in the 4.86%. Conclusion: Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

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Effects of Selective Obstruction of Intracranial Venous Sinuses on Systemic Arterial Pressure, Cerebral Perfusion Pressure, Intracranial Pressure and Intrasinal Pressure in Cats (실험동물에서 두개강내 정맥동의 부위별 폐쇄가 두개강내에 미치는 영향)

  • Doh, Eun-Sig;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.475-484
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    • 1993
  • In order to evaluate the safe ligation time and sites of dural venous sinuses during neurosurgical operation, systemic arterial pressure(SAP), cerebral perfusion perssure(CPP), intracranial pressure (ICP) and intrasinal pressure(ISP) were measured in cats through neuromonitor before and after obstruction of anterior 1/3, middle 1/3, posterior 1/3 of the superior sagittal sinus and the results were as follows. There were no significant increases of pressures after obstruction of anterior 1/3 of the superior sagittal sinus. In the obstructed middle 1/3 of the superior sagittal sinus group, significant increases were seen un the m-SAP within 2, 4 and 6 minutes, the m-ICP within 2-7 minutes, the m-ISP within 1-4 minutes after obstruction. In the obstructed posterior 1/3 of the superior sagittal sinus group, there were significant increases of m-SAP within 2, 4 and 6 minutes, the m-ICP within 2-7 minutes, the m-ISP within 1-3 minutes. In the obstructed Torcular Herophili group, there were significant increases of the m-SAP within 1-2 and 4-7 minutes, the m-ICP within 3-6 minutes and the m-ISP within 1-7 minutes and less significant dercreases of the m-CPP within 5-7 minutes after obstruction. In the obstructed right transverse sinus group, significant increases of the m-ICP and the m-ISP were seen within 1-7 minutes after obstruction, there were no remarkable changes in the obstructed left transverse sinus group.

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Contralateral Vesicoureteral Reflux in Children with Abnormal Unilateral Renal Development (일측성 신발생이상 환아에 동반된 반대측 방광요관역류)

  • Oh Sung-Wook;Lee Jae-Seung;Kim Myoung-Jun;Han Sang-Won;Bae Ki-Soo
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.53-59
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    • 1997
  • There have been many recent reports that unilateral renal agenesis and multicystic dysplastic kidneys are accompanied by contralateral vesicoureteral reflux leading to its injury. We grouped the children with unilateral renal agenesis, renal hypoplasia, multicystic dysplastic kidney into abnormal unilateral renal development and investigated whether it was accompanied with contralateral vesicoureteral reflux. We retrospectively reviewed 96 pediatric cases of unilateral renal agenesis, hypoplasia, multicystic dysplastic kidney diagnosed at Shinchon Severance Hospital, Yongdong Severance Hospital from 1987 to 1996 and Ajou University Hospital from 1994 to 1996. Diagnosis was based on radiological findings, renal hypoplasia being defined as small renal size with no apparent renal scarring and no irregularity of the calyceopelvic system on abdominal sonography or intravenous pyelography. Among the 96 cases,48 cases carried out voiding cystourethrography. 58 cases were male(60%) and 38 cases were female(40%). The cases of abnormal unilateral development on the left side were 45(47%) and that on the right side were 51(53%). Although there were diverse reasons leading to diagnosis, the major ones included were prenatal sonography, urinary tract infection, and other congenital anomalies. In cases of unilateral renal agenesis & hypoplasia the leading factors were urinary tract infection & other congenital anomalies and in cases of multicystic dysplastic kidney that was prenatal sonography. There was a chronological gap between the mean age of diagnosis(1.8 year) and voiding cystouerthrography(2.5 year, P < 0.01). 9 of the 18 unilateral renal agenesis cases, 5 of the 11 unilateral renal hypoplasia cases, and 3 of the 19 unilateral multicystic dysplastic kidney cases showed contralateral vesicoureteral reflux. Average reflux grade was above G III.Among the 17 children who had contralateral vesicoureteral reflux, 3 children had chronic renal failure and ureteroneocystostomy was carried out in 6 children. From the above results we conclude that screening voiding cystourethrography should be performed in children with abnormal unilateral renal development for early detection of vesicoureteral reflux in the contralateral kidney.

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Should Voiding Cystourethrography be Performed for Infants with Urinary Tract Infection? (요로감염 영아에서 배뇨성방광요도조영술이 필요한가?)

  • Woo, Mi-Kyeong;Kim, Mun-Sub;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.54-61
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    • 2008
  • Purpose: This study was performed to assess necessity of voiding cystourethrography (VCUG) for infants with urinary tract infection (UTI) who had both normal renal sonography and normal DMSA renal scans. Methods: We reviewed 117 infants hospitalized for UTI between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture(n=57), catheterization(n=58), or collection bag method (n=2, twice positive culture of the same organism). All patients had undergone renal sonography, DMSA renal scan and VCUG. Children with both normal renal sonography and normal DMSA renal scans were evaluated for the presence or severity of vesicoureteral reflux (VUR). Results: Of the 117 patients, 96 were boys and 21 were girls. 28 patients(23.9%) had VUR. 59(50.4%) showed both normal renal sonography and normal DMSA renal scans. Among these 59 patients, 7(11.9%) showed VUR. Three of them had grade I-II reflux, two grade III reflux, and the other two grade IV reflux. One of them showed bilateral VUR, grade IV reflux on the right and grade III on the left. Conclusion: Although the negative predictive value of both normal renal sonography and normal DMSA renal scan for VUR was 88.1%, 7 patients had VUR and two of them had high grade reflux(grade IV). So, we suggest that VCUG should be performed in infants with UTI despite both normal renal sonography and normal DMSA renal scans.

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A Clinical Study on Nodular Thyroid Disease (결절성 갑상선 질환에 대한 임상적 고찰)

  • Lee Gyu-Joon;Park Soon-Tae;Ha Woo-Song;Kwon Soo-In;Choi Sang-Kyeon;Hong Soon-Chan;Lee Young-Joon;Lee Young-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.244-252
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    • 1998
  • The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

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Stress and Coping for Patients with Hemiplegia during the Rehabilitation Process (편마비 환자의 재활과정에 따른 스트레스와 대처의 변화양상)

  • 강현숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.18-32
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    • 1994
  • It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2%). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

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Intracerebral Regional and Vasculature-Specific Distributions of Ischemic Cerebrovascular Diseases: Using MRI and MRA (MRI와 MRA를 이용한 허혈성 뇌혈관 질환의 뇌혈관별 분포에 대한 연구)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.223-230
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    • 2010
  • The purpose of this study was to utilize Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) to analyze intracerebral regional distributions (hot spot) of ischemic cerebrovascular diseases which were characterized by stenosis and occlusion cerebral vasculature, except for cerebrovascular diseases induced by rupture of cerebral vasculature in terms of Korean people's cerebrovascular diseases, so that it could apply the findings of analysis to clinical practices. This study focused only on analyzing intracerebral regional distributions of ischemic cerebrovascular diseases that are characterized by stenosis and occlusion cerebral vasculature, because there are different etiologic mechanisms of ischemic cerebrovascular diseases like hemorrhagic cerebrovascular diseases (caused by rupture of cerebral vasculature) and cerebral infarction (induced by atheromatous arteriosclerosis). As a result, this study could come to the following findings of analysis: 1. According to sex ratio analysis, it was found that male group comprised larger portion of total 626 subjects in this study than female one (55.0% > 45.0%). 2. According to analysis on actual intracerebral regional distributions of ischemic cerebrovascular diseases, it was found that most subjects (37.5 %) were attacked by such diseases on the right side of cerebral vasculature, which was followed by left side of cerebral vasculature (35.1%) and bilateral cerebral vasculature (27.3%) respectively. 3. According to analysis on actual intracerebral regional distributions of ischemic cerebrovascular diseases, it was found that internal carotid artery (ICA) comprised the largest portion (38.9%) of those distributions, which was followed by middle cerebral artery (MCA, 35.7%), posterior cerebral artery (PCA, 13.4%), anterior cerebral artery (ACA, 6.0%) and vertebral artery (VA, 3.3%) respectively. 4. It was found that there was no subject attacked by any disease on A-com region, and there was only one male subject attacked by cerebrovascular diseases on P-com region. 5. It was found that female group was more susceptible to the attack of cerebrovascular diseases on MCA region than male one (54.6% > 42.2%), which means significant differences depending upon sex on statistical basis ($x^2$ = 9.64, p < .01). 6. It was found that male group was more susceptible to the attack of cerebrovascular diseases on ICA region (56.4% > 46.8%), which means significant differences depending upon sex on statistical basis ($x^2$ = 5.71, p < .05). 7. Moreover, it was also found that male group was more susceptible to the attack of cerebrovascular diseases on BA region (2.3% > 0.4%), which means significant differences depending upon sex on statistical basis ($x^2$ = 4.25, p < .05). 8. However, it was found that there was not any significant difference in intracerebral vasculature-specific distributions of cerebrovascular diseases depending on age of subjects, and stenosis comprised larger portion of cerebrovascular diseases than occlusion.