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Significance of Bone Scan in Chest Trauma (흉부외상에서 골스캔의 의의)

  • Kim, Soo-Sung;Kim, Soon
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.454-459
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    • 2002
  • Clinical analysis of the relation between the clinical data of chest trauma patients and bone scan results was done to investigate the sensitivity and specificity of bone scan for the diagnosis of rib or chondral fracture. Material and Method: 445 patients treated due to chest trauma in Dongguk University Kyungju Hospital from July 1998 to December 2001 were studied. Age and sex distribution, causes of chest trauma, interval from the injury to arrival at hospital, final diagnosis, relationship between the chest pain and bone scan results, relationship between local tenderness and bone scan results, and sensitivity and specificity of bone scan were studied. Result: The male was 61.6% and the female was 38.4%. Age distribution was nearly even from the twenties to the sixties. The traffic accident was the most common cause of chest injury(60.4%). Most patients(76.6%) were arrived to the hospital within 6 hours after chest trauma. Rib fracture was the most common final diagnosis(46.5 %). The relationship between the duration of chest pain and tenderness and the bone scan results were significant, and the same in the relationship between the duration of local tenderness and the bone scan results, but the latter is more significant. The sensitivity of bone scan was 99.4% and the specificity was 90.4%. Conclusion: If the patient complains the chest pain continuously and the local tenderness around the chest is continued over 3 weeks, it is good to perform the bone scan. Further study including the MRI may be helpful for more evaluation in chest trauma patients.

A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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A Seroepidemiological Study on Hepatitis B Vaccination Program - In Elementary School Student from Kyonggi-Do Province - (B형 간염 예방 접종 실태 평가를 위한 혈청 역학적 연구 -경기도 지역 초등학생을 대상으로-)

  • Lee, Suk-Yong;Choi, Boyoul;Shin, Young-Jeon;Bang, Keum-Nie;Ki, Moran;Park, Hung-Bae;Yoon, Jae-Deuk;Lee, Kye-Chol;Youn, Bae-Joong
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.240-256
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    • 1997
  • Purpose: To evaluate the hepatitis B vaccination program which has been conducted since 1980, Korea. Methods: This study was carry out self reported questionnaire and serologic test covering 2,072 elementary school students who were born between 1980 and 1987, selected by cluster sampling. The HBV serologic markers (HBsAg, Anti-HBs and Anti-HBc) were tested by radioimmunoassay (RIA). The contents of questionnaire include demographic data of students and parents, vaccination status, vaccination frequency, vaccination age, past history of mother's HBV test. Results: 1) The HBsAg positive rates by sex showed 3.7% for male and 2.7% for female, representing an average rate of 3.4%. The HBsAg positive rates by age group showed 5.6% for 13 years and l.5% for 6 years, representing a tendency of lowering rate as ages being younger. 2) The pre-natal HBV test rate was 10.2%, while post-natal HBV test rate was 42.5%. The test showed that the parents' educational level being higher than others, the pre- and post-natal HBV test showed higher rates. In case the fathers occupation being office worker, the post-natal HBV test showed a higher rate compared with other occupation. 3) Overall vaccination rate was 82.6%, complete vaccination rate 69.8%, booster injection rate 42.8%. The vaccination rate, complete vaccination rate and booster injection rate increased as the age being younger. If the educational level of parents were higher, the vaccination rate, complete vaccination rate and booster injection rate showed higher rates. Younger students showed younger vaccination age, and higher educational background of family showed younger vaccination ages. 4. With regard to positive rate of HBV markers by vaccination age, HBsAg and Anti-HBc positive rate showed higher degrees in the following order; preschool age (1-6 years), school age (6-13 years) and infancy (0-1 year). Anti-HBs positive rate was increased as the frequency of vaccination increased. Five years after initial complete vaccination, minimum protective rate was lowest, 69.6%.

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Incidence and Risk Factors of Recurrent Urinary Tract Infections during Antibiotic Prophylaxis in Children with Primary Vesicoureteral Reflux (일차성 방광요관역류 소아에서 항생제 예방요법 중에 발생한 재발성 요로감염의 빈도와 위험인자)

  • Cho Su-Jin;Kim, Hyun-Jin;Lee Jeong-Won;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.46-55
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    • 2005
  • Purpose : Recurrent urinary tract Infection(UTI) in primary vesicoureteral reflux(VUR) may lead to serious renal scarring, a major cause of childhood hypertension and end-stage renal disease. To prevent recurrent UTI, low-dose long--term antibiotic prophylaxis has been recommended. However, recurrent UTI still develops during antibiotic prophylaxis, the efficacy of which is now being disputed. The emergence of resistant bacteria has also raised concerns. To evaluate the effect of antibiotic prophylaxis, we investigated recurrent UTI during prophylactic antibiotic use in children with primary VUR Materials : The incidence and risk factors of recurrent UTI were retrospectively evaluated in ninety-one children with primary VUR on trimethoprim- sulfamethoxazole(TMP/SMX) prophylafis during the year following their index febri]e UTI. Results : Recurrent UTI occurred in 31.9%(29/91) children and comprised 0.32 episodes/patient year. Febrile UTI was 0.26 episode/patient year and afebrile UTI was 0.07 episodes/patient year. The recurrent rate of UTI in male patients with phimosis was 37.2%(19/51), which was significantly higher than in males without phimosis 0%(0/5)(P=0.025). In the logistic regression analysis for recurrent UTI, renal scar was the significant risk factor for recurrent UTI [RR 3.8(95% CI 1.0-14.1) P=0.04]. For other well-known risk factors such as sex, age, degree of VUR, APN, and voiding dysfunction, the differences were not significant. Conclusion : TMP/SMX prophylaxis did not prevent recurrent UTI in children with primary VUR. Phimosis and renal scars were the risk factors for recurrent UTI but the grade of primary VUR was not. In VUR without phlmosis and renal scar, a randomized controlled study without antibiotic prophylaxis is required. (J Korean Soc Pediatr Nephrol 2005;9:46-55)

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Differences in the Clinical Characteristics of Children with Urinary Tract Infections Based on the Results of $^{99m}Tc$-Dimercaptosuccinic Acid Renal Scanning (요로감염 소아에서 입원 초기 시행한 DMSA 신 스캔 결과에 따른 임상양상의 차이에 대한 연구: DMSA 신 스캔의 임상적 의미)

  • Kim, Dong Ouk;Lee, Sang Min;Lee, Jeong Bong;Ko, Young Bin;Kim, Su Jin
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.110-116
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    • 2013
  • Purpose: The $^{99m}Tc$-Dimercaptosuccinic acid (DMSA) renal scan is used primarily for the diagnosis of renal scarring and acute pyelonephritis in children with urinary tract infections (UTI). This study aimed to evaluate clinical differences based on the positive or negative results of DMSA scans and kidney ultrasonography (US) in pediatric UTI. Method: We retrospectively reviewed 142 pediatric patients with UTI who were admitted to Myongji Hospital from January 2004 to December 2012. We performed a comparative analysis of clinical parameters such as age, sex, white blood cell (WBC) count, neutrophil count, blood urea nitrogen (BUN) level, creatinine (Cr) level, C-reactive protein (CRP) level, and durations of hospitalization and fever, grouped by the results of the DMSA scans and kidney US. Results: The mean age of the patients was $33.8{\pm}48.3$ months, and 78 (55%) were male. Fifty-two patients had abnormal DMSA findings, and 71 patients had abormal kidney US findings (test positive groups). In the DMSA scan positive group, there were significant differences in age, WBC counts, neutrophil counts, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on kidney US, and incidence of vesicoureteral reflux (VUR) compared with the scan negative group. The kidney US positive group had significant differences in age, neutrophil count, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on the DMSA scans, and more frequent VUR compared with the US negative group. Conclusion: Our data suggest that there were no major differences in clinical parameters based on the results of the DMSA scans compared with kidney US in pediatric UTI. However, as kidney US and DMSA scan were performed to predict VUR, the sensitivity and negative predictive value was increased.

Pediatric Urolithiasis: Our 22-year Experience at a Single Center (소아에서의 요로결석: 단일기관에서 22년간의 경험)

  • Kim, Su-Yon;Kim, Min-Jee;Lee, Joo Hoon;Kim, Kun Suk;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

Prevalence and risk factors of peri-implantitis: A retrospective study (임플란트 주위염의 유병률 및 위험요소분석에 관한 후향적 연구)

  • Lee, Sae-Eun;Kim, Dae-Yeob;Lee, Jong-Bin;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.8-17
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    • 2019
  • Purpose: The study analyzed the prevalence of peri-implantitis and factors which may have affected the disease. Materials and methods: This study based on medical records and radiographs of 422 patients (853 implant cases) who visited Ewha Womans University Mokdong Hospital Dental Center from January 1, 2012 to December 31, 2016. Generalized estimation equations (GEE) was utilized to determine the statistical relationship between peri-implantitis and each element, and the cumulative prevalence of peri-implantitis during the observation period was obtained by using the Kaplan Meier Method. Results: The prevalence rate of peri-implantitis at the patient level resulted in 7.3% (31 patients out of a total of 422 patients), and at the implant level 5.5% (47 implants out of a total of 853 implants). Sex, GBR, guided bone regeneration (GBR) and functional loading periods had statistical significance with the occurrence of peri-implantitis. Upon analysis of the cumulative prevalence of peri-implantitis in terms of implant follow-up period, the first case of peri-implantitis occurred at 9 months after the placement of an implant, and the prevalence of peri-implantitis showed a non-linear rise over time without a hint of a critical point. Conclusion: The prevalence of peri-implantitis at the patient level and the implant were 7.3% and 5.5%, respectively. Male, implant installed with GBR and longer Functional Loading Periods were related with the risk of peri-implantitis.

Tranexamic Acid Reduces Postoperative Blood Loss in Reverse Total Shoulder Arthroplasty (역행성 견관절 전치환술에서 트라넥삼산의 출혈 및 수혈 감소 효과)

  • Park, Kee Young;Kim, In Bo;Kim, Eun Yeol;Lee, Kwang Suk
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.391-397
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    • 2021
  • Purpose: Tranexamic acid (TXA) can reduce perioperative blood loss and the frequency of blood transfusions in lower extremity surgery. On the other hand, the effects of TXA on reverse total shoulder arthroplasty (rTSA) remain undetermined. This study evaluated the efficacy of TXA on perioperative blood loss, transfusion requirements, and the change in the hemotologic index. Materials and Methods: This study evaluated patients who underwent rTSA from September 2009 to July 2020. The patients were classified into two groups. The TXA group were administered TXA intravenously and topical TXA during surgery. The non-TXA group was not administered TXA. The quantity of hemovac drainage, which represented the postoperative blood loss, transfusion requirements, and postoperative change in hemoglobin and hematocrit level, were recorded. Results: The TXA and non-TXA groups consisted of 93 and 84 patients, respectively. The preoperative demographics showed no significant differences in age (72.0±7.0 vs. 71.5±5.8, p=0.656), sex (male:female, 28:65 vs. 23:61, p=0.689) and the prevalence of hypertension and diabetes (hypertension:diabetes:both, 36:3:13 vs. 32:3:8, p=0.806) between the two groups. There were significant differences in the requirements of transfusion (0 vs. 9, p=0.001), hemovac drainage at the 1st (98.8±61.2 ml vs. 162.7±98.8 ml, p<0.001), the 2nd postoperative day (73.8±48.4 ml vs. 91.5±54.5 ml, p=0.024), hemoglobin level at the 1st (11.7±1.2 g/dl vs. 11.2±1.4 g/dl, p=0.048), 3rd (10.9±1.2 g/dl vs. 10.2±1.2 g/dl, p<0.001), and 6th (11.2±1.3 g/dl vs. 10.7±1.3 g/dl, p=0.020) postoperative day, and the hematocrit level at the 1st (35.0%±3.6% vs. 32.5%±3.8%, p=0.001), 3rd (32.3%±5.0% vs. 29.8%±3.6%, p<0.001), and 6th (33.5%±3.8% vs. 31.5%±3.7%, p<0.001) postoperative day between the two groups. Conclusion: Intravenous and topical intra-articular TXA can reduce the transfusion requirement and blood loss in rTSA.

The basis of trust in relationships: Indigenous psychological analysis of adolescents and their parents (청소년과 부모의 인간관계를 통해 본 신뢰의식: 토착심리학적 접근)

  • Uichol Kim;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.10 no.2
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    • pp.103-137
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    • 2004
  • This study examines the basis of trust in relationships by adolescents and their parents using the indigenous psychological approach. Using the indigenous methodology, adolescents were asked the reasons why they trusted their mother, father, friends, and teachers. Parents were asked why they trusted their children, spouse and their children's teachers. A total of 1,737 participants completed an open-ended survey: 579 adolescents (274 middle school and 305 high school students) and their parents (579 fathers) and (579 mothers). The results indicate that adolescents trust their parents because of their sacrifice, followed by consanguinity (i.e., blood relationship), respect, their trust in me, dependability, and their advice and counseling. The reasons why adolescents trust their teachers is because of the academic guidance they provide, unconditional trust of teachers, their concern and care, respect for teachers, advice and counseling they provide, they are like parents, and because of their sacrifice for the students. The reasons for trusting their friends are as follows: Dependability, closeness, unconditional trust of friends, their understanding of me, and their emotional support. The reasons why parents trust their children are: Children's sincerity, honesty, consanguinity, parents' expectation and communication with the children, children's obedience, and since they are diligent in their schoolwork. The reasons for trusting one's spouse are reported to be sincerity, their sacrifice for the family, honesty, unconditional trust of a spouse, and because of mutual support. The reasons why parents trust their children's teachers are reported as follows: Unconditional trust of teachers, their sacrifice for the students, and their sincerity. There were no significant differences across the type of school and academic grades in terms of trust of parents. However, middle school students are more likely to trust their teachers, and high school students are more likely trust their friends. The male students rather than female students and those students with higher academic grades are more likely to trust their parents, friends, and teachers. For parents, there were no significant differences across age, sex, and educational status concerning the trust of their children, spouse, and children's teachers. There was a positive correlations between parents' trust of their spouse and children and their children's trust of their parents. There was also a positive correlations of mothers' trust of children's teachers and the children's trust of their teachers.

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