• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.110-114
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• 2007

Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.175-181
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• 1989

Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.40-48
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• 1999

Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.164-169
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• 2008

Purpose : There have been some reports on the prevalence of positive antineutrophil cytoplasmic antibody(ANCA) in Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the results were conflicting. We performed this study to evaluate the clinical significance of ANCA(c-ANCA and p-ANCA) in Korean children with HSP. Methods : The medical records of 30 patients(13 boys and 17 girls) aged 6.0$\pm$1.9(5-12) years with a clinical diagnosis of HSP based on the EULAR/PReS criteria were reviewed retrospectively. From the years 2007 to 2008, the sera from children with acute HSP were tested for antineutrophil cytoplasmic antibodies(ANCA). The target antigens of these autoantibodies are proteinase 3(c-ANCA) or myeloperoxidase(p-ANCA). Results : Palpable purpura was seen in all 30 patients(100%), abdominal pain in 20(67%), arthralgia in 17(57%), and renal involvement in 11(37%). Laboratory findings showed leukocytosis in 4 patients(13%), thrombocytosis 18 in(60%), and elevated erythrocyte sedimentation rate in 18(60%). Anti-streptolysin O titers were elevated in 7% of the patients and no patient showed elevation of serum IgA level. The sera from 29 patients were negative for c-ANCA and p-ANCA by indirect immunofluorescence, but only one patient had weakly positive results, which became negative at follow-up. Conclusions : We conclude that c-ANCA or p-ANCA is not an important serologic marker in children with HSP, because it was neither diagnostically nor immunologically specific in children with HSP. These results suggest that ANCA are not involved in the pathogenesis of HSP in children.

• Korean Journal of Soil Science and Fertilizer
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• v.34 no.5
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• pp.316-325
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• 2001

To develope a technique for efficiently managing fertilizer for cucumber, a quick test method to quantify nitrate content in soil solution and leaf petiole juice using a simple instrument was investigated. Among the nitrate analyzing instruments such as compact ion meter, nitrate ion meter, and test strip with reflectometer, the paper test-strip used in conjunction with a hand-held reflectometer was most closely correlated with ion chromatography method in nitrate content, and then it would be suggested with a tool that a farmer can use rapidly, conveniently and accurately for nitrate analysis in a field. Nitrate content in soil solution collected by porous cup was very variable on the lapsed time after drip irrigation and the sampling positions such as soil depth and the distance from dripper. As a result, a significant correlation between nitrate contents of soil solutions and 2M KCl soil extract was not found. However, nitrate content in soil solution extracted with a volume basis (soil:water=1:2) showed the highly significant correlation with that in 2M KCl extract. Nitrate contents of cucumber leaf petiole juices was greatly different between upper and lower leaves. Eleven to sixteen positioned-leaf would be a proper sampling position to determine nitrate content in leaf petiole for evaluating nutrient state by plant tissue analysis. From the secondary regression equations between nitrate contents of soil and petiole juice and the yield of cucumber, nitrate levels for real time diagnosis were estimated as $400mg\;l^{-1}$ soil solution by porous cup. $300mg\;l^{-1}$ in a soil volume extraction, and $1400mg\;l^{-1}$ in petiole juice from spring to summer season. In addition, the maximum yield of cucumber fruit in pot test was obtained in nitrate $1500mg\;l^{-1}$ level of petiole juice, which was similar to nitrate $1400mg\;l^{-1}$ in greenhouse trial.

• Journal of the Korean Society of Radiology
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• v.6 no.6
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• pp.447-454
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• 2012

To examine the performance of a diagnostic X-ray system, we tested a linearity, reproducibility, and Half Value Layer(HVL). The linearity was examined 4 times of irradiation with a given condition, and we recorded a level of radiation. We then calculated the mR/mAs. And the measured value should not be more than 0.1. If the measured value was more than 0.1, we could know that the linearity was decreased. The reproducibility was analyzed 10 times of irradiations at 80kVp, 200mA, 20mAs and 120kVp, 300mA, 8mAs. The values from these analyses were integrated into CV equation, and we could get outputs. The reproducibility was good if the output was lower than 0.05. HVL was measured 3 times of irradiation without a filter, and we inserted additional HLV filters with 0, 1, 2, 4 mm of thickness. We tested the values until we get the measured value less than a half of the value measured without additional filter. We tested the linearity, the reproducibility, and HVL of 5 diagnostic X-ray generators in this facilities. The linearity of No. 1 and No. 5 generator didn't satisfy the standard for radiation safety around 300mA~400mA and 100mA~200mA, respectively. HVL of No.1 generator was not satisfied at 80kVp. The outputs were higher in the three-phase equipment than the single-phase equipment. The old generators need to maintain and exchange of components based on the these results. Then, we could contribute to getting more exact diagnosis increasing a quality of the image and decreasing an expose dose of radiation.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.130-138
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• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.214-221
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• 2008

Purpose: We make a qualitative analysis of whether Fusion SPECT/CT can find lesion's anatomical sites better than existing SPECT or not, and we want to show the usefulness of SPECT/CT through finding out effects of CT attenuation correction on SPECT images. Materials and Method: 1. The evaluation of fusion images: This study comprised patients who was tested $^{131}I$-MIBG, Bone, $^{111}In$-Octreotide, Meckel's diverticulum, Parathyroid MIBI with Precedence 16 or Symbia T2 from 2008 Jan to Aug. We compared SPECT/CT image with non fusion image and make a qualitative analysis. 2. The evaluation of attenuation correction: We classified 38 patients who was tested 201Tl myocardial exam with Symbia T2 into 5 sections by using Cedars Sinai' QPS program - Ant, Inf, Lat, Septum, Apex. And we showed each section's perfusion states by percentage. We compared the each section's perfusion-states differences between CT AC and Non AC by average${\pm}$standard deviation. Results: 1. The evaluation of fusion images : In high energy $^{131}I$ cases, it was hard to grasp exact anatomical lesions due to difference between regions and surrounding lesions' uptake level. After combining with CT, we could grabs anatomical lesion more exactly. And in meckel's diverticulum case or to find lesions around bowels or organs with $^{111}In$ cases, it demonstrates its superiority. Bone SPECT/CT images help to distinguish between disk spaces certainly and give correct results. 2. The evaluation of attenuation correction: There is no significant difference statistically in Ant and Lat (p>0.05), but there is a meaningful difference in Inferior, Apex and Septum (p<0.05). AC perfusion at inferior wall in the 5 sections of myocardium: The perfusion difference between Non AC perfusion image ($68.58{\pm}7.55$) and CT corrected perfusion image ($76.84{\pm}6.52$) was the largest by $8.26{\pm}4.95$ (p<0.01, t=10.29). Conclusion: Nuclear medicine physicians can identify not only molecular image which shows functional activity of lesions but also anatomical location information of lesions with more accuracy using the combination of SPECT and CT systems. Of course this combination helps nuclear medicine physician find out the abnormal parts. Moreover combined data sets help separate between normal group and abnormal group in complicated body part. So clinicians can carry out diagnosis and treatment planning at the same time with a single test image. In addition, when we examine a myocardium in thorax where attenuation can occur easily, we can trust perfusion more in a certain region in SPECT test because CT provides the capability for accurate attenuation correction. In these reasons, we think we can prove the justice after treatment fusion image.

• Journal of Science Education
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• v.34 no.2
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• pp.225-236
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• 2010

The purpose of this study is to analyze and evaluate the Cyber Home Learning contents of Earth science area in the basic course of the $10^{th}$ grade. For this purpose, we applied the 'Cyber Home Study Content Quality Control Tool' presented in Elementary Secondary Education e-Learning Quality Management Guidelines (Ver.2.0)' of Korea Education & Research Information Service(2008). The results of Cyber home learning contents analysis are as follow: First, it was presented that the study guide introduced the contents which should be studied for one class, properly. And it was not analyzed that the diagnosis assesment was not completed in the initiative study; Second, it was possible to study choosing the contents fitting the learner's level of learning in the main study, it was comprised of about 10 minutes. Third, it was performed without feedback for incorrect answers in the learning assessment, just the number of wrong questions. And the learning arrangement present the important contents learned in that class, summarizing and arranging again. The results of evaluating the contents in Cyber Home Learning are as follows: First, in evaluation section of instructional design, many text materials which were so difficult for learners to read were explained, being provided. Besides, the systematic structures leaves much to be desired, in view of learners' learning experience, contents, and environment. And in evaluation section of learning contents, the error of contents caused the learning contents not to appear, the amount of learning in each section was found too much. Second, in evaluation section of the strategy for Teaching and Learning, when we mention the strategy of Self Directed Learning, the environment to make learners search for information free and self-study possible was not possessed well. And in evaluation section of interaction, it was found that a simple click caused the learning to go on. Third, in evaluation section of evaluating, it was evaluated that there was wanting in consistency in learning aims, contents, evaluation contents.

• The Journal of the Korean Society for Microbiology
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• v.18 no.1
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• pp.73-85
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• 1983

The advantages of the enzyme-linked immunosorbent assay(ELISA) are its sensitivity and its simplicity in detecting IgM and IgG antibodies. For applying the ELISA to the diagnosis of typhoid fever, first of all, experiments were performed to determine which concentration of killed whole cell antigens and lipopolysaccharide(LPS) antigens of S. typhi(0.901 w) were optimally coated to the wells of the polystyrene and polyvinylchloride microplate, using the hyperimmune sera from rabbits against S. typhi. By using both kinds of antigens of S. typhi adsorbed to the ELISA microplate, the changing patterns of IgG and IgM antibodies in the sera from rabbits responding to the killed whole cell antigens of S. typhi(0901 w) during the prolonged immunization were serially traced by the ELISA. At the same time, the level of antibodies against S. typhi in sera fron patients with typhoid fever and from normal healthy persons were measured by the ELISA employing the killed whole cell antigens and LPS antigens as the coating antigens. The results obtained were summerized as follow: 1. The optimal concentration of the killed whole cell antigens, which were more easily adsorbed to the polystyrene plate than the polyvinylchloride plate, was $10^8cells/ml$ of carbonate buffer(pH. 9.6) on the wells of the polystyrene plate when treated at $37^{\circ}C$ for 4 hours. On the other hand, the optimal concentration of lipopolysaccharide antigens, which were adsorbed only to the polyvinylchloride plate, was $100{\mu}g/ml$ of carbonate buffer(pH. 9.6) on the wells of the polyvinylchloride plate when treated at $37^{\circ}C$ for 4 hours. 2. IgM antibody response were dominating in rabbits responding to the killed whole cell antigens of S. typhi(0.901 w), and were more specific to the LPS antigens than to the killed whole cell antigens in the ELISA. Good correlations were made between the IgM titers by the ELISA and the aggglutinating titers of sera from the immunized rabbits. 3. Both IgG and IgM agglutination titers by the ELISA in sera from most of patients with typhoid fever were above 1:320 but those in sera from most of normal, healthy persons were below 1:80. 4. There were close correlations between the antibody titers by the ELISA and the agglutinating titers to the killed whole cell antigens in the tested human sera, IgM titers being more correlated with the agglutinating titers than IgG titers. But a little correlations were made between the antibody titers by the ELISA and the agglutinating titers to the LPS antigens. 5. IgM titers in the tested human sera were similar to IgG titers detected by the ELISA employing the killd whole cells antigens and the LPS antigens. 6. Good correlations were made between the antibody titers demonstrated by the ELISA performed on the killed whole cell antigens and the LPS antigens as the different, coating antigens on the ELISA microplates.