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Comparison of Urine Iodine/Creatinine ratio between Patients following Stringent and Less Stringent Low Iodine Diet for Radioiodine Remnant Ablation of Thyroid Cancer (갑상선암의 방사성요오드치료를 위한 저요오드식이 방법 차이에 따른 소변 중 요오드/크레아티닌 비의 비교)

  • Roh, Jee-Ho;Kim, Byung-Il;Ha, Ji-Su;Chang, Sei-Joong;Shin, Hye-Young;Choi, Joon-Hyuk;Kim, Do-Min;Kim, Chong-Soon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.322-326
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    • 2006
  • A low iodine diet (LID) for $1{\sim}2$ weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine ratio (urine I/Cr). Methods: From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Results: Total 27 patients were included in this investigation (M:F=1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID. Average of urine I/Cr ratio was $127.87{\pm}78.52{\mu}g/g$ in stringent LID for 1 week, and $289.75{\pm}188.24{\mu}g/g$ in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (p=0.008). The number of patients whose urine I/Cr ratios were below $100{\mu}g/g$ was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Conclusion: Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable.

Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy (스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료)

  • Yang, Hye Ran;Choi, Won Jung;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.784-789
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    • 2006
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

Nationwide surveillance of acute interstitial pneumonia in Korea (급성 간질성 폐렴의 전국적 현황 조사)

  • Kim, Byoung-Ju;Kim, Han-A;Song, Young-Hwa;Yu, Jinho;Kim, Seonguk;Park, Seong Jong;Kim, Kyung Won;Kim, Kyu-Earn;Kim, Dong Soo;Park, June Dong;Ahn, Kang Mo;Kim, Hyo-Bin;Jung, Hyang-Min;Kang, Chun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.324-329
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    • 2009
  • Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.

Incidence of congenital heart disease in the western part of Gyeongnam Province in Korea (서부경남 지역의 선천성 심질환의 발생 빈도)

  • Jang, Sun Hwa;Kim, Jae Hui;Yeom, Jung Sook;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.848-855
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    • 2008
  • Purpose : The objective of this study was to ascertain the incidence of congenital heart disease in the western part of Gyeongnam Province in Korea. Methods : We enrolled 849 children (M:F=390:459) who were diagnosed with congenital heart disease (CHD) and received echocardiography during January 1997 to December 2005 in Gyeongsang National University Hospital. The subjects were limited to patients born from 1997 to 2004. The CHDs were classified into acyanotic types and cyanotic type. Further, acyanotic type CHDs were divided into shunt type and valvular types. Results : Numbers of initially diagnosed patients from 1997 to 2004 were as follows: 113, 128, 116, 104, 129, 97, 84, and 78. The median age of initially diagnosed CHD patients was 1 month in the acyanotic type and 0.5 months in cyanotic type. Also, an annual frequency among CHD types and gender ratio were no significant difference in every year. Incidences of CHD from 2000 to 2004 in the western part of Gyeongnam Province were 8.9, 12.7, 10.9, 10.0, and 9.7 per 1,000 live births, respectively. Conclusion : From 1997 to 2001, 100-130, and from 2002 to 2004, less than 100 patients were diagnosed with CHD. This showed a decrease in the numbers of CHD patients in the last three years. However, the Incidence of CHD was 0.89-1.24% during the last five years. Therefore, the decrease in the annual frequency of CHD was due to the recent decline in birth rate in Korea.

Usefulness of MRCP in the Diagnosis of Common Bile Duct Dilatation caused by Non-stone or Non-tumorous Conditions (비결석, 비종양성 총담관 확장의 진단에 있어서 자기공명담췌관조영술(MRCP)의 유용성)

  • 정재준;양희철;김명진;김주희;이종태;유형식
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.129-136
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    • 2002
  • Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

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A Study of Removal Property of Harmful Algal Blooms by Hwangto and Oriental Mineral Medicines (황토와 광물성 한약재의 적조구제 특성에 관한 연구)

  • Kim, Pil-Geun;Sung, Kyu-Youl;Jang, Young-Nam;Park, Maeng-Eon
    • Journal of the Mineralogical Society of Korea
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    • v.19 no.4 s.50
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    • pp.277-289
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    • 2006
  • This study was carried out to find a new material having high removal efficiency for the harmful red tide. C. polykrikoides grow very fast and accumulate into dense and visible patches near the surface of the seawater ('Water bloom'). Some mineral medicines and Hwangto (reddish soil consist of clay minerals and Fe-oxides) were used in this study to remove C. polykrikoides. The pre-determined sprinkling ratio of mineral vs. seawater which contains approximately 5,000 cells/mL of C. polykrikoides was 10 g/L. In order to quantify the removal efficiency, the density of living cells was measured by counting with the Intervals of 0, 10, 30, and 60 minutes after sprinkling. Five Hwangtos feom different localities were examined in this study. It is found that a material with a high concentration of Fe and Al was the most effective to remove C. polykrikoides. After the sprinkling of the Hwangto showing the best removal efficiency in the test, 99% of total algaes were found to be eliminated within 60 minutes. Jeokeokji showed the highest removal efficiency among clay mineral medicines(92% removal efficiency after 60 minutes), and the rests in decreasing order are as follows: Gamto (91%) > Baekseokji (89%) > Hydromica (81%). In addition, Fe-oxide mineral medicine similarly looking as fine-grained earthy Daejaseok showed 100% removal efficiencyafter 30 minutes, and Wooyoeryang, 95% after 60 minutes. It is noted that even little addition (1 g/L) of Daejaseok, 10% of Hwangto concentration into seawater showed the removal efficiency of 100% after 60 minutes. From the results, it could be concluded that the fine-grained earthy Daejaseok was the most effective natural mineral medicine to remove the C. polykrikoides from seawater. Under the microscope the removal mechanism was found to be activated in the following order: adsorption, swelling of chain colony, chain colony crisis and algaecide.

Epidemiology and clinical characteristics of headache comorbidity with epilepsy in children and adolescents (소아청소년 간질 환자에서 동반된 두통의 역학과 임상적 특징)

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.672-677
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    • 2007
  • Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

Clinical features of congenital muscular torticollis (선천성 근성 사경의 임상적 특징)

  • Jun, Ji Eun;Ryu, Hye Kyeong;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.241-247
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    • 2007
  • Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

Petrography and Geochemistry of the Ultramafic Rocks from the Hongseong and Kwangcheon areas, Chungcheongnam-Do. (충남 홍성 및 광천 지역 초염기성암의 암석 및 지구화학)

  • Song Suckhwan;Choi Seon Gyu;Oh Chang Hwan;Seo Ji Eun;Choi Seongho
    • Economic and Environmental Geology
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    • v.37 no.5
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    • pp.477-497
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    • 2004
  • In the Hongseong and Kwangcheon areas, two ultramafic rocks are exposed as isolated bodies in the Precambrian Kyeonggi gneiss complex. The ultramafic rocks extend for several hundred meters to NNE direction and are contact with adjacent metasediments by steeply dipping faults. The rocks are dunite or harzburgite showing dominantly equigranular-mosaic and protogranular textures with a minor amount of porphyroclastic textures. They contain varying amounts of fosteritic olivine (F$o_{0.91-0.93}$), magnesian pyroxene (E$n_{0.89-0.93}$) and tremolitic to magnesian hornblende with minor amounts of spinel, serpentine, chlorite, magnetite, phlogopite and talc. The rocks are in contrast with adjacent gneiss complex or metabasite (amphibole, biotite, plagioclase, alkali-feldspar and quartz). Geochemically, these ultramafic rocks are characterized by high magnesium number (M$g_#$> 0.88) and transitional element (mainly, Ni>1716 ppm, Cr>1789 ppm), low alkali element (e.g. $K_2$O<0.09 wt.%, Na$_2$O<0.19 wt.%) and depletion of incompatible elements. The calculated correlation coefficients showed good positive correlations among the ferrous (e.g. Sc, V, Zn) elements, incompatible elements (e.g. REE), and among SiO$_2$ or $Al_2$O$_3$ with ferrous elements, whereas negative correlations are appeared between Ni and major elements. These results involve increasing of the ferrous- and $Al_2$O$_3$-bearing minerals(e.g. amphibole and mica) with decreasing of Mg-bearing minerals (e.g. olivine) depending on the degree of alteration. Calculated geothermometries and mineral assemblages suggest that the ultramafic rocks have been metamorphosed through the condition from the greenschist to amphibolite facies. Compared with ultramafic rocks elsewhere, it is thought that those of the Hongseong and Kwangcheon areas are derivatives of the depleted sources since they are depleted in incompatible elements including REE abundances. Moreover overall characteristics of the ultramafic rocks are similar to the those of orogenic related Alpine type ultramafic rocks, especially, shallow mantle slab varieties.

Renovascular Hypertension in Children (소아의 신혈관성 고혈압)

  • Kang Byoung-Chul;Ha Il-Soo;Kim In-One;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.101-108
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    • 1997
  • Purpose : The clinical characteristics of renovascular hypertension (RVHT) in children were analyzed. Methods : Medical records of 16 children diagnosed as RVHT on the basis of angiography during Jan. '86 to Jun. 94 in our hospital were reviewed retrospectively. Results : The mean age at the onset was 8.5 yrs and the sex ratio(M:F) was 7:9. The causes of RVHT were Takayasu arteritis in 6, Moyamoya disease in 5, and fibromuscular dysplasia in 3 patients. Abdominal bruit was noted in 6 patients (38%). Peripheral renin activity was raised in all tested patients. Bilateral renal arterial involvemnent was found in 9 patients (56%). Captopril renal scans showed good correlation with angiographic findings. Five patients were treated with antihypertensives only, and blood pressure was controlled completely in 2 and incompletely in 3. Percutaneous transluminal angioplasty was performed in 10 patients with 50% of success rate. However, hypertension was recurred due to restenosis or accompaning aortic stenosis in 3 patients. Surgical treatment was performed in 4 patients, and the blood pressure was controlled partially in 1 and poorly in the remaining 3. Conclusions : Takayasu arteritis, Moyamoya disease and fibromuscular dysplasia are the major causes of childhood RVHT in our country. The diagnosis of RVHT in children should be based on a set of tests individually selected for case by case. For the low curability of the current treatment modalities available, RVHT in children should not be regarded as 'curable' so far. We expect, however, that the outcome will be improved by more extensive application of the newly developed surgical technique.

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