Kim, Ji-Young;Kim, Kyung-A;Lee, Yeon-Kyung;Ko, Sun-Young;Shin, Son-Moon;Han, Byung-Hee
Neonatal Medicine
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v.18
no.1
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pp.117-123
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2011
Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.
Purpose: We retrospectively investigated the diagnostic performance of $^{18}F$-fluorodeoxyglucose positron emission tomography (PET) and PET/CT for cancer detection in asymptomatic health-check examinees. Materials and Methods: This study consisted of 5091 PET or PET/CT conducted as part of annual health examination at one hospital from March 1998 to February 2008. To find the incidence of cancers, medical records of the subjects were thoroughly reviewed for a follow-up period of one year. The patterns of formal readings of PET and PET/CT were analyzed to assess the sensitivity and specificity for cancer detection. The histopathology and stage of the cancers were evaluated in relation to the results of PET. Results: Eighty-six cancers (1.7%) were diagnosed within one year after PET or PET/CT. When PET and PET/CT results were combined, the sensitivity was 48.8% and specificity was 81.1% for cancer detection. PET only had a sensitivity of 46.2% and a specificity of 81.4%, and PET/CT only had a sensitivity of 75.0% and a specificity of 78.5% respectively. There were no significant differences in cancer site, stage and histopathology between PET positive and PET negative cancers. In 19.3% of formal readings of PET and PET/CT, further evaluation to exclude malignancy or significant disease was recommended. Head and neck area and upper gastrointestinal tract were commonly recommended sites for further evaluation. Conclusions: PET and PET/CT showed moderate performance for detecting cancers in asymptomatic adults in this study. More experience and further investigation are needed to overcome limitations of PET and PET/CT for cancer screening.
The purpose of this study were to analyze the clinical correlation between the thyroid autoimmune antibodies (anti-TPO Ab, anti-TG Ab, and TSH) and the maximum standardized uptake value ($SUV_{max}$) base on the Hashimoto's thyroiditis and the Graves' disease in diffusely $^{18}F-FDG$ uptake of the thyroid gland to the PET/CT image. To achieve this, we was performed the PET/CT examination for the 1,097 subjects from May 2010 to April 2013 in the health screening, and was detected the diffused FDG thyroid uptake, and was additionally performed the thyroid function test (TFT) and the ultrasound (US). As a results, the autoimmune thyroid disease with the diffused FDG thyroid uptake were discovered 39 patients (3.9%), of this, the Hashimoto's thyroiditis was 43.6% and the Graves' disease was 23.1%. Hashimoto's thyroiditis was shown the positive reaction of high titer between the anti-TPO Ab and the anti-TG Ab level, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>04, p<0.05). Also, Graves' disease was shown the positive reaction of high titer most of the thyroid autoimmune antibodies, and the correlation coefficient between the $SUV_{max}$ and the anti-TPO Ab was a statistically significant (r>05, p<0.01). Therefor, when have a high standard of the $SUV_{max}$ due to the diffusely $^{18}F-FDG$ uptake of the thyroid gland, Hashimoto's thyroiditis and Graves' disease were proportionally increased the anti-TPO Ab and TSH level, respectively. The correlation coefficient between the $SUV_{max}$ and the thyroid autoimmune antibodies will be the most influential criterion that was a standard of judgment for the epihpenomenon of the autoimmune thyroid disease, and it will be available for the clinical application.
Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.
Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.
To investigate the distribution of dry eye and to accept diagnosis methods of dry eye in ophthalmic shop, this study was performed on 81 persons(male : 49, female : 32). 1. We divided two group for diagnosing dry eye by dry eye screening questionnaire : one was dry eye symptom group(49.3%) and the other was non-dry eye symptom group(50.7%). 2. Non-invasive break-up time(NIBUT) which was measured by using Tear $scope^{(R)}$ (Killer. co)was longer than invasive break-up time(IBUT). 3. A blink rate in dry eye symptom group(10%) was measured lesser than 10 cycle/min, in non-dry eye symptom group(14.9%). 4. In shirmer test there were lesser than 10mm/5min in dry eye symptom group(67.5%), in non-dry eye symptom group(39%). 5. Cornea and conjunctival staining by rose bengal represented Mild 25%, medium 36.25%, extreme 38.75% in dry eye symptom group. Non-dry eye symptom group was showed Mild 19.51%, medium 14.63%, extreme 12.19%. 6. These results showed that the patient showed dry eye symptom in 3 items of eye examination was 22.5%, 4 items 25%, 5 items 30%, 6 items 15%.
Objective : The aim of this study is to observe the effect of Herbal-acupuncture(HA) with Luffae Fructus Retinervus Herbal-Acupuncture Solution(LFR-HAS) at ST36(Joksamni) on Collagen Ⅱ -induced arthritis(CIA) in mice. Methods : DBA1/J mice were immunized with bovine type Ⅱ collagen(CⅡ) on days 0 and 21 to induce an arthritis. The mice were divided into 5 groups. They were Normal group(wild type), Control group(CIA), Saline group(CIA +saline injection), Needle Prick group(CIA +single Prick with an injection needle) and LFR-HA group(CIA +LFR-HA treatment). The saline injection, needle prick and LFR-HA were made on the right ST36(Joksamni) of mice for 5 weeks, 3 times a week beginning 4 weeks after the booster immunization. Results : 1. The highest synovial rate of lung fibroblasts was measured in the 1% LFR-HAS. 2. TNF-${\alpha}$ expression of survival cells from CIA mouse joint was significantly reduced in the 1% LFR-HAS. 3. The incidence of arthritis and the spleen weight of CIA mouse were significantly reduced by the Luffae Fructus Retinervus Herbal-Acupuncture (LFR-HA) at ST36. 4. The concentrations of IL-6, INF-${\alpha}$, INF-${\alpha}$, IgG, IgM, and anti-collagen Ⅱ in the CIA mouse serum were significantly reduced by the LFR-HA at ST36. 5. The histological examination showed that, in the LFR-HA group, the cartilage destruction and the synoviocyte proliferation in the CIA mouse joint were not significant compared to the control group, and the collagen fiber was similarly expressed as the normal group. 6. In the LFR-HA group, the ratio of CD3e+ to CD19+ cell, and the ratio of CD4+ to CD8+ cell in the lymph node were similarly maintained as those of the normal group. 7. CD69+/CD3e+ and CD11a+/CD19+ cells in the CIA mouse lymph node were significantly reduced by the LFR-HA at ST36. 8. CD11b+/Gr-1+ cells in the CIA mouse joint were significantly reduced by the LFR-HA at ST36. Conclusions : These results indicate that Luffae Fructus Retinervus Herbal-Acupuncture (LFR-HA) at ST36 may regulate the immune system and have a therapeutic effect on Collagen-induced arthritis(CIA) in mice.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.11
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pp.7978-7989
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2015
Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.
Proceedings of the Korean Vacuum Society Conference
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2013.08a
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pp.88-89
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2013
A variety of influenza A viruses from animal hosts are continuously prevalent throughout the world which cause human epidemics resulting millions of human infections and enormous industrial and economic damages. Thus, early diagnosis of such pathogen is of paramount importance for biomedical examination and public healthcare screening. To approach this issue, here we propose a fully integrated Rotary genetic analysis system, called Rotary Genetic Analyzer, for on-site detection of influenza A viruses with high speed. The Rotary Genetic Analyzer is made up of four parts including a disposable microchip, a servo motor for precise and high rate spinning of the chip, thermal blocks for temperature control, and a miniaturized optical fluorescence detector as shown Fig. 1. A thermal block made from duralumin is integrated with a film heater at the bottom and a resistance temperature detector (RTD) in the middle. For the efficient performance of RT-PCR, three thermal blocks are placed on the Rotary stage and the temperature of each block is corresponded to the thermal cycling, namely $95^{\circ}C$ (denature), $58^{\circ}C$ (annealing), and $72^{\circ}C$ (extension). Rotary RT-PCR was performed to amplify the target gene which was monitored by an optical fluorescent detector above the extension block. A disposable microdevice (10 cm diameter) consists of a solid-phase extraction based sample pretreatment unit, bead chamber, and 4 ${\mu}L$ of the PCR chamber as shown Fig. 2. The microchip is fabricated using a patterned polycarbonate (PC) sheet with 1 mm thickness and a PC film with 130 ${\mu}m$ thickness, which layers are thermally bonded at $138^{\circ}C$ using acetone vapour. Silicatreated microglass beads with 150~212 ${\mu}L$ diameter are introduced into the sample pretreatment chambers and held in place by weir structure for construction of solid-phase extraction system. Fig. 3 shows strobed images of sequential loading of three samples. Three samples were loaded into the reservoir simultaneously (Fig. 3A), then the influenza A H3N2 viral RNA sample was loaded at 5000 RPM for 10 sec (Fig. 3B). Washing buffer was followed at 5000 RPM for 5 min (Fig. 3C), and angular frequency was decreased to 100 RPM for siphon priming of PCR cocktail to the channel as shown in Figure 3D. Finally the PCR cocktail was loaded to the bead chamber at 2000 RPM for 10 sec, and then RPM was increased up to 5000 RPM for 1 min to obtain the as much as PCR cocktail containing the RNA template (Fig. 3E). In this system, the wastes from RNA samples and washing buffer were transported to the waste chamber, which is fully filled to the chamber with precise optimization. Then, the PCR cocktail was able to transport to the PCR chamber. Fig. 3F shows the final image of the sample pretreatment. PCR cocktail containing RNA template is successfully isolated from waste. To detect the influenza A H3N2 virus, the purified RNA with PCR cocktail in the PCR chamber was amplified by using performed the RNA capture on the proposed microdevice. The fluorescence images were described in Figure 4A at the 0, 40 cycles. The fluorescence signal (40 cycle) was drastically increased confirming the influenza A H3N2 virus. The real-time profiles were successfully obtained using the optical fluorescence detector as shown in Figure 4B. The Rotary PCR and off-chip PCR were compared with same amount of influenza A H3N2 virus. The Ct value of Rotary PCR was smaller than the off-chip PCR without contamination. The whole process of the sample pretreatment and RT-PCR could be accomplished in 30 min on the fully integrated Rotary Genetic Analyzer system. We have demonstrated a fully integrated and portable Rotary Genetic Analyzer for detection of the gene expression of influenza A virus, which has 'Sample-in-answer-out' capability including sample pretreatment, rotary amplification, and optical detection. Target gene amplification was real-time monitored using the integrated Rotary Genetic Analyzer system.
Screening data from preplacement and periodic examination in Gu Mi Industrial Estate from May, 1983 to June, 1983 provide an opportunity to evaluate the accuracy of self-reported height and weight. The data for men and women were analyzed separated for effects of age, marrital status, educational level, employment status, measured height, measured weight and relative weight (percent of ideal body weight). The mean percent discrepancy from self-reported and measured height was analysed by cross-tubulation, P. value for analysis of variance and multiple correlation analysis in men and women. It is clear from the data that self-reported height and weigt differ from the quantities in systemic ways. But the magnitude of misreporting is very small on average except for weight in women. Whereas height tend to be over-reported, weight is under-reported in women but over-reported in men. Weight was accuracte for age group 20-29 years in men and age group over 40 year in women and over-reporting of weight increased with age in men and under-reporting of weight decreased with age in women. Weight was accurate in 60-64kg group in men and under 50kg group in women and under-stating of weight increased with weight in men and women. Weight was the most accurate in 100-109 percent relative weight group in men and in 90-99 percent relative weight group in women and under-stating of weight increased with relative weight and over-stating decreased with relative weight and over-stating decreased with relative weight in men and women. Height was the most accurate for group of primary school and except group of primary school, accuracy of height increased with educational level in men and women. In height, the highest measured height groups (over than 175cm measured height in men and over than 165cm measured height in women) were the most accurate and of over-reporting of height decreased with measured height. Single variable regression analysis and ANOVAs showed age(P<0.003), measured weight(P<0.0001) relative weight(P<0.0001), educational level(P<0.0005) and employment status(P<0.0007) to be significantly related to ${\Delta}WT$ in women and measured height(P<0.0001), educational level(P<0.03) and marrital status (P<0.03) to be significantly related to ${\Delta}WT$ in men. The women were more sensitive about her body weight than height.
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