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Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia (소아 골반저 근실조에서 바이오피드백 치료의 유용성)

  • Park, Kie-Young;Chang, Soo-Hee;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.51-59
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    • 2007
  • Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

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Comparison of Clinical Outcome According to the Duration of Corticosteroid Therapy in Childhood Henoch-$Sch{\ddot{o}}nlein$ Purpura: a Bicentric Study (소아 Henoch-$Sch{\ddot{o}}nlein$ purpura에서 스테로이드 치료 기간에 따른 임상적 결과의 비교)

  • Lee, Su-Jin;Shin, Jae-Il;Lee, Chong-Guk;Kim, Kee-Hyuck
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.170-177
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    • 2008
  • Purpose : The aim of this study was to evaluate whether the incidence of relapse or nephritis might be influenced by the duration of corticosteroid therapy in children with Henoch-Schonlein purpura(HSP). Methods : We retrospectively analyzed 186 children with a diagnosis of HSP in two major hospitals in Ilsan, Korea from the years 2000 to 2003. To evaluate whether renal involvement or relapse might be influenced by the duration of corticosteroid therapy in children with HSP, one pediatric nephrologist from hospital A, maintained corticosteroid therapy for at least 2 weeks(Group A, n=94). The other from hospital B used only during the symptomatic period(Group B, n=92). Results : There were no significant differences in age, sex, body weight, white blood cell count, hemoglobin, hematocrit, platelet count, serum protein and albumin levels between the two groups. The incidence of abdominal pain or arthralgia also did not differ between two groups. However, the duration of steroid therapy was significantly longer in Group A than in Group B and the cumulative dose of prednisolone was also higher in Group A than in Group B. The development of nephritis was more frequent in Group A. Conclusion : The longer duration of steroid use was not associated with the decreased rate of nephritis. Therefore, corticosteroids should be used carefully in a selected group of HSP children, and be tapered rapidly after control of the acute symptoms.

Effect of Ischemic Preconditioning on Myocardial Protection - A Comparative Study between Normothermic and Moderate Hypothermic Ischemic Hearts Induced by Cardioplegia in Rats - (허혈 전처치가 심근보호에 미치는 영향 - 적출 쥐 심장에서 상온에서의 심근허혈과 중등도 저체온하에서 심근정지액 사용 시의 비교 연구 -)

  • 조성준;황재준;김학제
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.242-254
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    • 2003
  • Background: Most of the studies conducted have investigated the beneficial effects of ischemic preconditioning on normothermic myocardial ischemia. However, the effect of preconditioning could be attenuated through the use of multidose cold cardioplegia as practiced in contemporary clinical heart surgical procedures. The purpose of this study was to investigate whether preconditioning improves postischemic cardiac function in a model of $25^{\circ}C$ moderate hypothermic ischemic heart induced by cold cardioplegia in isolated rat hearts. Material and Method: The isolated Sprague-Dawley rat hearts were randomly assigned to four groups All hearts were perfused at 37$^{\circ}C$ for 20 minutes with Krebs-Henseleit solution before the baseline hemodynamic data were obtained, Group 1 consisted of preconditioned hearts that received 3 minutes of global ischemic preconditioning at 37$^{\circ}C$, followed by 5 minutes of reperfusion before 120 minutes of cardioplegic arrest (n=6). Cold (4$^{\circ}C$) St. Thomas Hospital cardioplegia solution was infused to induce cardioplegic arrest. Maintaining the heart at $25^{\circ}C$, infusion of the cardioplegia solution was repeated every 20 minutes throughout the 120 minutes of ischemic period. Group 2 consisted of control hearts that underwent no manipulations between the periods of equilibrium and 120 minutes of cardioplegic arrest (n=6). After 2 hours of cardioplegic arrest, Krebs solution was infused and hemodynamic data were obtained for 30 minuts (group 1, 2: cold cardioplegia group). Group 3 received two episodes of ischemic preconditioning before 30 min of 37$^{\circ}C$ normothermic ischemia and 30 minutes of reperfusion (n=6) Group 4 soloed as ischemic controls for group 3 (group 3, 4: warm ischemia group). Result: Preconditioning did not influence parameters such as left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), rate-pressure product (RPP) and left ventricular dp/dt (LV dp/dt) in the cold cardioplegia group. (p=NS) However, preconditioning before warm ischemia attenuated the ischemia induced cardiac dysfunction, Improving the LVSP, LVEDP, RPP, and LV dp/dt. Less leakage of CPK and LDH were observed in the ischemic preconditioning group compared to the control group (p<0.05). Conclusion: Ischemic preconditioning improved postischemic cardiac function after warm ischemia, but did not protect cold cardioplegic hearts.

Performance Evaluation of a Pinhole Collimator According to the Aperture Diameter (핀홀 콜리메이터 초점의 직경 크기 별 성능비교 및 평가)

  • Lee, Kwang Hun;An, Byung Ho;Kim, Soo Young;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.104-109
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    • 2014
  • Purpose: Conventional pinhole scintigraphy offers a high resolution and generally use for thyroid scan or bone scintigraphy. the aim of this study is to evaluate performance of each aperture according to the diameter size. Materials and Methods: In this study 2 mm, 4 mm, 6 mm, 8 mm diameter pinhole collimators were mounted on Siemens E.CAM systems. In order to evaluate performance evaluation of each aperture, we acquired projection image by using SPECT for evaluating FWHM, resolution test and static image for evaluating thyroid phantom test. Results: As a result of FWHM showed 2.2 mm FWHM, 3.2 mm FWHM, 5.4 mm FWHM, 7.5 mm FWHM per each aperture in the resolution test. SNR, uniformity, contrast were acquired result from thyroid phantom test comparing general image and delayed image. as a result of SNR showed 6.55, 8.47, 6.2, 5.23 in case of general image and 5.25, 5.01, 5.38, 5.82 in case of delayed image per each aperture. as a result of uniformity showed 0.152, 0.118, 0.161, 0.19 in case of general image and 0.19, 0.199, 0.185, 0.171 in case of delayed image per each aperture. as a result of contrast showed 1.31, 1.19, 1.15, 1.01 in case of general image and 1.09, 1.08, 1.04, 1 in case of delayed image per each aperture. Conclusion: Resolution and sensitivity were heavily influenced by aperture size. and also we found advantage of delayed image as a result of thyroid phantom test.

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Preoperative Concurrent Radiochemotherapy for Locally Advanced Esophageal Cancer: Treatment Outcome and Prognostic Factors (국소 진행된 식도암에 대한 수술 전 동시병용 방사선-항암 화학요법: 치료 성적과 예후인자에 대한 연구)

  • Kim, Hae-Young;Kim, Kwan-Min;Kim, Jhin-Gook;Shim, Young-Mog;Im, Young-Hyuck;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.25 no.3
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    • pp.160-169
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    • 2007
  • Purpose: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. Materials and Methods: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/$m^{2}$/day, days 1-4 and 29-32, Cisplatin 60 mg/$m^{2}$/day, days 1 and 29). An esophagectomy was planned in $4{\sim}6$ weeks after the completion of CRCT. Results: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1 % and 53.3%, 41.8%, respectively. By univariate analysis, achieviement of pCR and a clinically uninvolved distant lymph node (cMO) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. Conclusion: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.

A Change of Adrenal Androgen and Cortisol in Kawasaki Disease (가와사끼병에서 부신 안드로겐과 코티솔의 변화)

  • Lee, Sun-Hee;Yu, Jae-Hong;Kil, Hong-Ryang
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.654-658
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    • 2002
  • Purpose : Endocrine and immune systems are connected and interdependent. Adrenal glands play an important role in this network and control the balance between serum levels of dehydroepiandrosterone sulfate(DHEAS) and cortisol. These steroids have an antagonistic effect on the T cell progression into Th1 and Th2 cells and on the induction of correlated interleukins. Therefore we evaluated the role of adrenal androgen and cortisol as immune modulators in Kawasaki disease( KD) with changes of T cell immunity. Methods : From April to August in 2001, we examined serum DHEAS and 24 hour urine free cortisol(F) before administration of immunoglobulin and steroids by radioimmunoassay in 14 KD patients. It's clinical severity was determined by Harada score and coronary lesion. Results : The age of the patient group ranged from 4 months to 4 years; its average age was 2.3 years. Three patients(21.4%) were below 1 year, 2(14.3%) between 1 and 2 years, 5(35.7%) between 2 and 3 years, 4(28.6%) between 3 and 4 years of age. Male to female ratio was 1:1.3. DHEAS was significantly decreased in patients($11.1{\pm}6.0{\mu}g/dL$) more than controls($81.6{\pm}13.3{\mu}g/dL$)(P<0.05). Twenty-four hour urine free cortisol was significantly increased in patients($36.9{\pm}21.9{\mu}g/dL$) more than controls($13.6{\pm}5.5{\mu}g/dL$)(P<0.05). Ratio of DHEAS/F was decreased remarkably in patients($0.33{\pm}0.20$) more than controls($6.65{\pm}2.56$)(P=0.016). There was no difference between ratio of DHEAS/F and Harada score, but its ratio was very low in patients with coronary aneurysm. Conclusion : These data demonstrate that there are changes of DHEAS and cortisol in acute stage of KD and the dis-equilibrium between two steroids may be relevant in the T cell immune response induction of Kawasaki disease. These changes support the use of DHEAS/F ratio as one of the predictive factors of coronary arteries complication.

The Standard of Judgement on Plagiarism in Research Ethics and the Guideline of Global Journals for KODISA (KODISA 연구윤리의 표절 판단기준과 글로벌 학술지 가이드라인)

  • Hwang, Hee-Joong;Kim, Dong-Ho;Youn, Myoung-Kil;Lee, Jung-Wan;Lee, Jong-Ho
    • Journal of Distribution Science
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    • v.12 no.6
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    • pp.15-20
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    • 2014
  • Purpose - In general, researchers try to abide by the code of research ethics, but many of them are not fully aware of plagiarism, unintentionally committing the research misconduct when they write a research paper. This research aims to introduce researchers a clear and easy guideline at a conference, which helps researchers avoid accidental plagiarism by addressing the issue. This research is expected to contribute building a climate and encouraging creative research among scholars. Research design, data, methodology & Results - Plagiarism is considered a sort of research misconduct along with fabrication and falsification. It is defined as an improper usage of another author's ideas, language, process, or results without giving appropriate credit. Plagiarism has nothing to do with examining the truth or accessing value of research data, process, or results. Plagiarism is determined based on whether a research corresponds to widely-used research ethics, containing proper citations. Within academia, plagiarism goes beyond the legal boundary, encompassing any kind of intentional wrongful appropriation of a research, which was created by another researchers. In summary, the definition of plagiarism is to steal other people's creative idea, research model, hypotheses, methods, definition, variables, images, tables and graphs, and use them without reasonable attribution to their true sources. There are various types of plagiarism. Some people assort plagiarism into idea plagiarism, text plagiarism, mosaic plagiarism, and idea distortion. Others view that plagiarism includes uncredited usage of another person's work without appropriate citations, self-plagiarism (using a part of a researcher's own previous research without proper citations), duplicate publication (publishing a researcher's own previous work with a different title), unethical citation (using quoted parts of another person's research without proper citations as if the parts are being cited by the current author). When an author wants to cite a part that was previously drawn from another source the author is supposed to reveal that the part is re-cited. If it is hard to state all the sources the author is allowed to mention the original source only. Today, various disciplines are developing their own measures to address these plagiarism issues, especially duplicate publications, by requiring researchers to clearly reveal true sources when they refer to any other research. Conclusions - Research misconducts including plagiarism have broad and unclear boundaries which allow ambiguous definitions and diverse interpretations. It seems difficult for researchers to have clear understandings of ways to avoid plagiarism and how to cite other's works properly. However, if guidelines are developed to detect and avoid plagiarism considering characteristics of each discipline (For example, social science and natural sciences might be able to have different standards on plagiarism.) and shared among researchers they will likely have a consensus and understanding regarding the issue. Particularly, since duplicate publications has frequently appeared more than plagiarism, academic institutions will need to provide pre-warning and screening in evaluation processes in order to reduce mistakes of researchers and to prevent duplicate publications. What is critical for researchers is to clearly reveal the true sources based on the common citation rules and to only borrow necessary amounts of others' research.

HVL Measurement of the Miniature X-Ray Tube Using Diode Detector (다이오드 검출기를 이용한 초소형 X선관(Miniature X-ray Tube)의 반가층 측정)

  • Kim, Ju-Hye;An, So-Hyeon;Oh, Yoon-Jin;Ji, Yoon-Seo;Huh, Jang-Yong;Kang, Chang-Mu;Suh, Hyunsuk;Lee, Rena
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.279-284
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    • 2012
  • The X ray has been widely used in both diagnosis and treatment. Recently, a miniature X ray tube has been developed for radiotherapy. The miniature X ray tube is directly inserted into the body irradiated, so that X rays can be guided to a target at various incident angles according to collimator geometry and, thus, minimize patient dose. If such features of the miniature X ray tube can be applied to development of X ray imaging as well as radiation treatment, it is expected to open a new chapter in the field of diagnostic X ray. However, the miniature X ray tube requires an added filter and a collimator for diagnostic purpose because it was designed for radiotherapy. Therefore, a collimator and an added filter were manufactured for the miniature X ray tube, and mounted on. In this study, we evaluated beam characteristics of the miniature X ray tube for diagnostic X ray system and accuracy of measuring the HVL. We used the Si PIN Photodiode type Piranha detector (Piranha, RTI, Sweden) and estimated the HVL of the miniature X ray tube with added filter and without added filter. Through an another measurement using Al filter, we evaluated the accuracy of the HVL obtained from a direct measurement using the automatic HVL calculation function provided by the Piranha detector. As a result, the HVL of the miniature X ray tube was increased around 1.9 times with the added filter mounted on. So we demonstrated that the HVL was suitable for diagnostic X ray system. In the case that the added filter was not mounted on, the HVL obtained from use of the automatic HVL calculation function provided by Piranha detector was 50% higher than the HVL estimated using Al filter. Therefore, the HVL automatic measurement from the Piranha detector cannot be used for the HVL calculation. However, when the added filter was mounted on, the HVL automatic measurement value using the Piranha detector was approximately 15% lower than the estimated value using Al filter. It implies that the HVL automatic measurement can be used to estimate the HVL of the miniature X ray tube with the added filter mounted on without a more complicated measurement method using Al filter. It is expected that the automatic HVL measurement provided by the Piranha detector enables to make kV-X ray characterization easier.

A Study on the Influence of Finishing and Polishing Methods on the Gap between Denture Base Resin and Soft Liner (의치의 마무리와 연마법이 의치상 레진과 연성 이장재 간의 공극에 미치는 영향에 관한 연구)

  • Jung, Seung-Hwan;Lee, Joon-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.4
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    • pp.325-335
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    • 2008
  • The junction between resilient denture liner and the denture base is difficult to finish and polish due to difference of the physical property of the materials. Gaps tend to be formed during finishing and polishing procedures. The purpose of this study was measuring the width of junctional gap between $Molloplast-B^{(R)}$ and denture base material after finishing and polishing procedure, and evaluating the effect of method and direction on gap width. $Molloplast-B^{(R)}$ was processed (according to the manufacturer's instruction) against Lucitone $199^{(R)}$ acrylic resin. 50 specimens were fabricated with a raised center section. All of specimens were examined and photographed with a stereoscopic microscope(x120), and the largest gap along the junction of $Molloplast-B^{(R)}$ and acrylic resin on each specimen was measured. One-way analysis of variance(ANOVA) and independent t-test at 95% confidence level were used to analyze the data and to compare groups. The results of this study were as follows. In comparison with finishing tools, the gap width was the largest in $Molloplast^{(R)}$-Cutter and the smallest in FSQ-cross cut bur. There was statistically significant difference between FSQ-cross cut bur and $Molloplast^{(R)}$-Cutter(p<0.05). There was no significant difference in gap width between the direction of polishing. The mean value of gap width was the smallest in case of no polishing, and the largest in case of polishing with pumice & tin oxide. There was statistically significant difference between pumice and pumice & tin oxide. From the results, it is concluded that the use of $Molloplast^{(R)}$-Cutter in clinic need serious consideration even though it has good cutting ability. Further careful study is needed for finishing and polishing methods for decreasing gap width in junction of two materials.

A Study on the Development of a Microbial Insecticide -(With special emphasis on formulation)- (미생물(微生物) 살충제(殺蟲劑)의 개발(開發)에 관(關)한 연구(硏究) -(제제화(製劑化)를 중심(中心)으로)-)

  • Lee, Jae-Koo;Kim, Ki-Cheol;Kim, Do-Young
    • Applied Biological Chemistry
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    • v.22 no.2
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    • pp.123-134
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    • 1979
  • For the purpose of developing a microbial insecticide utilizing Bacillus thuringiensis Berliner, research was done and the following results were obtained. 1) As the freeze-dried matter of the cocoon-cooked water discarded from the filature contains much crude protein(51.825%) and a lot of inorganic salts, it can make a good nutrition source for the culture cf B. thuringiensis Berliner. 2) Based on the suspensibility, formula F-5 turned out to be the most suitable for insecticidal use. Its composition includes 0.2 g of the cell-spore-crystal mixture, 25 g of 200-mesh kaolin, 2.5 g of New Kalgen-NX-150, and 2.5 g of glycerine admixed with 8 ml of distilled water and granulated in 80-mesh size. 3) All the components of F-5, F-6 and F-7 are identical except that the amounts of cell-spore-crystal mixture of F-5, F-6, and F-7 are 0.2 g, 0.4 g, and 0.6 g, respectively. Accordingly, their physical properties are almost all the same. 4) Formulas F-5, F-6, and F-7 exhibited an excellent toxicity to Anomis mesogona Walker, Dendrolimus spectabilis Butler, and Margaronia perspectalis Walker at the concentration of 5%. 5) Formulas F-8 and F-9 which contain $NaHCO_3$ as one of their components showed a remarkably reduced toxicity to Anomis mesogona Walker and Dendrolimus spectabilis Butler than F-6 which does not contain $NaHCO_3$. 6) A maximum of $2.97{\times}10^9$ spores per ml was obtained by incubating B. thuringiensis in M-3 which has a pH of 7.05 and comprises 0.2% of ammonium sulphate and 0.8% of glucose dissolved in the cocoon-cooked water, with aeration for 96 hours. 7) Formula F-6 exhibited a somewhat reduced toxicity to Anomis mesogona Walker and Dendrolimus spectabilis Butler, when stored at room temperature for 70 days after formulation and it is desirable to keep it in a dark and cold place. 8) In held applications, formula F-6 showed a good activity in controlling Monema flavescens Walker. Margaronia perspectalis Walker, and Macrosiphum ibarae Matsumura.

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