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The Clinical Characteristics of Infantile Primary Vesicoureteral Reflux and Its Spontaneous Resolution Rate (영아기 일차성 방광요관역류의 임상적 특성과 자연 소실율)

  • Choi, Youn-Sung;Kim, Ji-Hye;Shim, Yoon-Hee;Lee, Seung-Joo
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.83-91
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    • 2007
  • Purpose : Childhood primary VUR is generally diagnosed after urinary tract infection, is more prevalent among girls and has a low spontaneous resolution rate in cases of severe VUR. The aim of the present study is to examine the age and gender-related characteristics and the spontaneous resolution rate of infantile primary VUR. Methods : The medical records of 96 infants with primary VUR, diagnosed after their first UTI, were retrospectively reviewed(1995-2004). The clinical characteristics including gender, the degree of VUR and presence of renal scars were evaluated. The spontaneous resolution rate and contributing factors were also analyzed Results : Infantile primary VUR was more prevalent in males than females. The percentage of atrophic scarred kidney was significantly higher in males than females(17.2% vs 3.4%) (P<0.05). The cumulative spontaneous resolution rate in 3 years was very high(89.1%), and was not significantly different between gender and among VUR grades. But in the first year, the spontaneous resolution rate of severe refluxing ureters was significantly higher in males than in females(46.2% vs 7.1%)(P<0.05) and the spontaneous resolution rate of refluxing ureters with no scarred kidneys was significantly higher than those associated with atrophic scarred kidneys(76.6% vs 20%)(P<0.05). Conclusion : Infantile Primary VUR was more prevalent among males and tends to be associated with atrophic scarred kidneys In male infants. The cumulative spontaneous resolution rate in 3 years was very high, even in high-grade VUR and associated atrophic scarred kidneys. In infantile primary VUR, surgery should be withheld even in infants with high-grade VUR with atrophic scarred kidneys.

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The Study on the Reduction of Patient Surface Dose Through the use of Copper Filter in a Digital Chest Radiography (디지털 흉부 촬영에서 구리필터사용에 따른 환자 표면선량 감소효과에 관한 연구)

  • Shin, Soo-In;Kim, Chong-Yeal;Kim, Sung-Chul
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.223-228
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    • 2008
  • The most critical point in the medical use of radiation is to minimize the patient's entrance dose while maintaining the diagnostic function. Low-energy photons (long wave X-ray) among diagnostic X-rays are unnecessary because they are mostly absorbed and contribute the increase of patient's entrance dose. The most effective method to eliminate the low-energy photons is to use the filtering plate. The experiments were performed by observing the image quality. The skin entrance dose was 0.3 mmCu (copper) filter. A total of 80 images were prepared as two sets of 40 cuts. In the first set (of 40 cuts), 20 cuts were prepared for the non-filter set and another 20 cuts for the Cu filter of signal + noise image set. In the second set of 40 cuts, 20 cuts were prepared for the non-filter set and another 20 cuts for the Cu filter of non-signal image (noisy image) with random location of diameter 4 mm and 3 mm thickness of acryl disc for ROC signal at the chest phantom. P(S/s) and P(S/n) were calculated and the ROC curve was described in terms of sensitivity and specificity. Accuracy were evaluated after reading by five radiologists. The number of optically observable lesions was counted through ANSI chest phantom and contrast-detail phantom by recommendation of AAPM when non-filter or Cu filter was used, and the skin entrance dose was also measured for both conditions. As the result of the study, when the Cu filter was applied, favorable outcomes were observed on, the ROC Curve was located on the upper left area, sensitivity, accuracy and the number of CD phantom lesions were reasonable. Furthermore, if skin entrance dose was reduced, the use of additional filtration may be required to be considered in many other cases.

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The Correlation of Sonographic Finding of Fatty Liver with Hematologic Examination and Body Fat Percentage (초음파상 지방간과 혈액학적 검사 및 체지방률과의 상관관계)

  • Cheon, Hae-Kyung;Lee, Tae-Yong;Kim, Young-Ran
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.437-444
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    • 2009
  • Ultrasonography has been used as a basic examination of a medical check up for prevention and diagnostics of diseases. Even the person who has no particular subjective symptoms can have a variety of diseases. Especially fatty liver is found in many cases. In this study, we tested 3582 persons who are in between the ages of 15 to 81 and observed that 1390 persons had fatty liver while 2192 persons are normal. We classified the grade of fatty liver and compared their life styles with the results of liver function test and BMI. The results are as follows. Ratio of the subjects who had a fatty liver is 38.8%. Male and female ratio was 46.2% and 24.2%. On the correlation among the fatty liver, the body mass index and the body fat%, the average value of body mass index and body fat% were significantly higher in the group of the fatty liver than in those of the normal liver. The influence of the related factor and the correlation on the fatty liver was shown that it was more related with the order of age, body mass index, triglyceride, ALT, body fat%, sex, HDL-Cholesterol, LDL-Cholesterol, and GGT. The result of the ultrasonography carried out for the purpose of regular health check up indicates that even the 38.8% of those who was diagnosed as normal condition could have the fatty liver and have possibility of other diseases. Therefore, if there are any troubles related to liver function and lipid through hematologic examination or when practicing follow-up study with ultrasonography concerning the correlation relation between the body fat% and dietary preference, alcohol consumption and exercise, the ultrasonography is definitely useful for prevention and treatment of diseases.

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Experimental and epidemiological studies on the life cycle of Echinostoma hortense Asada, 1926(Trematoda: Echinostomatidae) (남한강류역(南漢江流域)의 호르텐스극구흡충(棘口吸蟲) 감염실태(感染實態)와 생활사(生活史)에 관(關)한 연구(硏究))

  • Ahn, Yung-Kyum;Ryang, Yong-Suk
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.121-136
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    • 1986
  • Recently there have been some reports on human infections of Echinostoma hortense in Korea. It was found that a few species of freshwater fishes were playing the role of the second intermediate host of E. hortense. However, molluscan intermediate host has not been identified yet in Korea. The present study aimed to establish the life cycle of E. hortense in laboratory. Experimental studies such as egg production from the rat, development of the eggs in vitro, exposure of miracidia to freshwater snails, shedding pattern of cercariae from infected snails, morphology of cercariae, cercarial infection to the second intermediate host and infection of metacercariae to the definitive hosts were done. In addition, epidemiological surveys on the infection status in inhabitants and house rats, and on the natural infection of larval echinostomes in the snails and fishes were carried out along the South Hangang-river. The results obtained were as follows: 1. The eggs deposited from adults in physiological saline were cultivated at room temperature($20{\sim}24^{\circ}C$). The miracidia were firstly observed on 8 days after cultivation, and 85.5% of the eggs contained the mature miracidia on 11 days after cultivation. More than 90% formed the miracidia when cultivated at temperature $22{\sim}27^{\circ}C$. Hatching of the miracidia began on 12 days after cultivation and continued for a week. The size of the miracidia was $103.0{{\times}}51.4{\mu}m$ in average. The motility of the miracidia were active up to 8 hours after shedding, but they were all dead within 10 hours after shedding. 2. A freshwater snail, Radix auricularia coreana was cultivated in aquaria. A hatched $F_1$ snails from the egg masses were exposed to 20 miracidia respectively. Escape of cercariae started on 15 days after infecton. Radix auricularia coreana was experimentally identified as the first intermediate host of E. hortense in Korea. 3. Cercarial shedding started on $15{\sim}20$ days after infection by snail, continued for about 10 days (8.8 days in average). Infected snails were dead within 32 days after the miracidial infection. About 1,335 cercariae($328{\sim}1,994$) per snail were shed in its life, and 119 cercariae in average per snail per day were shed. The cercariae were motile for more than 24 hours, and then squirming at the bottom until death. The body and tail sizes of cercariae were $356{\times}186{\mu}m$ and $510{\times}68{\mu}m$ in average, respectively. The rediae parasitized in the snail hosts were found mainly around the pericardial regions, and their size was $1,575{\times}258{\mu}m$ in average. The numbers of developing cercariae in a mature redia were 14 in average ($7{\sim}20$ in range). The numbers of rediae in a snail were 102 in average on 15 days after miracidial infection and 221 in average on 28 days. 4. Three uninfected Misgurnus anguillicaudatus, less than 6.5cm long were used in for the cercarial infection. They were all exposed with 755 cercariae, and examined at 5-day intervals starting from 10 days after infection. All the fishes were infected with metacercariae of E. hortense and a total of 275 was found infected(36.4%). The metacercariae were fed to rats and the adult worms were obtained on 15 days after infection. 5. The infected rats began to deposit the eggs on 11 days after infection. The number of eggs deposited per day per worm (EPD/worm) was $400{\sim}500$ on 3 weeks after infection and was increased to $1,000{\sim}1,500$ on 4 to 17 weeks, then decreased to 800 on 21 weeks after infection. 6. A total of 745 stool specimens collected from 576 male and 169 female residents of 8 different villages along South Hangang basin was examined. Out of 745 specimens, the eggs of Echinostoma sp. were found in 2 cases (0.3%). Of 34 house rats one showed egg-positive (2.9%). 7. Total 971 Radix auricularia coreana collected from 7 sampling stations were examined for shedding of cercariae. Three snails (0.3%) shed the cercariae of E. hortense. A total of 119 out of 542 freshwater fishes (22.0%) had the metacercariae of E. hortense. The fishes parasitized with the metacercariae were 4 out of 14 examined species. The infection rates of 4 species were 34.1% (106 out of 311) in Misgurnus anguillicaudatus, 30.4% (7 out of 23) in Misgurnus mizolepis, 4.3% (2 out of 46) in Moroco oxycephalus and 22.2% (4 out of 18) in Odontobutis obscura interrupta. In summarizing the above results, the first intermediate host of E. hortense was found as Radix auricularia coreana in Korea. Also, it took about 46 days for the shortest completion of a life cycle of E. hortense in summer; that is, 10 days for miracidial development in eggs, 15 days for cercarial development in the snail, about 10 days for metacercarial development in the second intermediate hosts, and 11 days for the maturation as the adults in the definitive hosts. The natural infection rates of E. hortense in the intermediate hosts were relatively high but those in the definitive hosts were low in the middle areas of South Hangang basin.

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Adenovirus Pneumonia with Respiratory Failure in Pediatric Patients (소아에서 발생한 호흡부전이 동반된 아데노 바이러스 폐렴)

  • Do, Sung Suk;Ma, Sang Hyeok;Park, Jae Sun;Lee, Young Ho;Lee, Hwan Jong;Lee, Gyu Man
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.258-266
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    • 1998
  • Purpose : Cases of adenoviral penumonia with rapidly progressive clinical course were experienced. We reviewed these patients in viewpoint of clinical manifestation and adenoviral serotypes. Methods : Culture and indirect immunofluorescence for respiratory viruses including respiratory syncytial virus, influenza virus, parainfluenza virus, adenovirus was done with nasopharyngeal aspirates from patients who admitted due to respiratory infections in Fatima Hospital, Masan from Nov. 1996 to Jul. 1997. Cultured adenovirus was serotyped by both neutralization and hemagglutination inhibition test. Medical records were reviewed for 5 patients with respiratory failure from adenovirus was isolated and serotyped. Results : The total number of examined patients was 460 patients. We isolated respiratory viruses in 143(30.9%) patients. Adenovirus was isolated from 66 out of 143(46.2%) patients. During Jan 1997 to May 1997, five patients with ages of 18 days to 11 months who were infected by adenovirus and had high fever with dyspnea and required assisted mechanical ventilation. One patients discharged against doctor's advice then died. Two of four patients had complications of disseminated intravascular coagulation; two had bronchiolitis obliterans. Two isolates were serotype 7, and one was serotype 5, and two were untyped. Conclusion : Severe pneumonia caused by serotype 7 continued to occur in 1997 following the epidemic in 1996, and severe pneumonia may also be caused by serotype 5 and other serotypes.

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Maternal and Child Factors Associated with Early Detection of Cerebral Palsy (뇌성마비아 조기발견과 관련된 모자인자)

  • Bae, Sung-Soo;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.312-321
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    • 1987
  • To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitiation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over \610,000, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (p<0.05). Parents noticed the child's abnormality first in 85.1% of the cases whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education is needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.

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Optimal Time to Localize Bleeding Focus and the Usefulness of Flexible Bronchoscopy in Hemoptysis (객혈에서 굴곡성 기관지경의 출혈부위 결정을 위한 적절한 시행시기 및 그 유용성)

  • Lee, Jae-Ho;Koh, Won-Joong;Lee, Chan-Ju;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.353-364
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    • 2000
  • Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.

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Diagnostic Performance of Routine Objective Tests and Cost-Effective Approach for Chronic Cough (만성 기침의 진단 성적과 경제적 접근 모델)

  • Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.535-542
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    • 2004
  • Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

Clinical Benefits and Complications of Cryotherapy in Advanced Lung Cancer with Central Airway Obstruction (중심성 기도 폐쇄를 동반한 폐암에서 냉동치료의 임상적 유용성 및 부작용)

  • Jung, Jin Yong;Lee, Sung Yong;Kim, Dae Hyun;Lee, Kyung Joo;Lee, Eun Joo;Kang, Eun Hae;Jung, Ki Hwan;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.272-277
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    • 2008
  • Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately $-89^{\circ}C$, and the icing time was 5~20 seconds. Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications- one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.

Mineral Contents in Scalp Hair in Patients with Non-insulin Dependent Diabetes Mellitus (두발중(頭髮中) 일부(一部) 금속(金屬) 농도(濃度)와 인슐린비의존형(非依存形) 당뇨병(糖尿病)과의 관련성(關聯性))

  • Chung, Kyeong-Dong;Kwon, Sam;Kim, Doo-Hee
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.215-223
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    • 1997
  • To estimate association of minerals relating to non-insulin dependent diabetes mellitus(NIDDM) the contents of essential minerals and toxic heavy metals in the scalp hair were measured during the period from March 1993 to June 1993. The cases were selected 69 (32 male, 37 female) from the patients who visited Kyungpook University Hospital during the period from March 1993 to June 1993 and 74 controls (47 male 27 female) from normal population. zinc, copper, manganese, lead, cadmium and aluminum were analyzed by atomic absorption spectrophotometer(IL. 551). The results were summarized as follows. In NIDDM group, mean contents of zinc and copper were $132.99{\pm}19.66$ ppm, $8.58{\pm}5.07$ ppm respectively; where as $152.51{\pm}46.15$ ppm, $12.48{\pm}6.56$ ppm in control group. The mean of above two mineral content showed significant difference statistically (p<0.01). But, in manganese the content of NIDDM group; $0.44{\pm}0.27$ ppm were significantly higher than the control group; $0.34{\pm}0.18$ ppm(p<0.05). A thesis submitted to the Council of the Graduate School of Kyungpook National University in partial fulfillment of the require ements for the degree of Ph.D. in Medical Science in June 1994. The mean contents of toxic metals - lead, cadmium, aluminum - in NIDDM group were $10.04{\pm}4.60$ ppm, $0.57{\pm}0.12$ ppm, $11.31{\pm}3.98$ ppm; whereas $8.10{\pm}2.45$ ppm, $0.41{\pm}0.23$ ppm, $7.61{\pm}4.16$ ppm in control group. The mean of above three mineral showed significant difference statistically(p<0.01). Cadmium, zinc and copper were selected statistically significant variables with presence of the NIDDM by multiple logistic regression analysis; copper, zinc and cadmium may be associated with NIDDM.

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