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Chronic Dialysis in Infants and Children Under 2 Years of Age (2세 미만 만성 신부전 환아에서의 만성 투석)

  • Sohn, Young-Bae;Nam, Sook-Hyun;Kwak, Min-Jung;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.41-50
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    • 2007
  • Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

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The Application of Dynamic Acquisition with Motion Correction for Static Image (동적 영상 획득 방식을 이용한 정적 영상의 움직임 보정)

  • Yoon, Seok-Hwan;Seung, Jong-Min;Kim, Kye-Hwan;Kim, Jae-Il;Lee, Hyung-Jin;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.46-53
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    • 2010
  • Purpose: The static image of nuclear medicine study should be acquired without a motion, however, it is difficult to acquire static image without movement for the serious patients, advanced aged patients. These movements cause decreases in reliability for quantitative and qualitative analysis, therefore re-examination was inevitable in the some cases. Consequently, in order to improve the problem of motion artifacts, the authors substituted the dynamic acquisition technique for the static acquisition, using motion correction. Materials and Methods: A capillary tube and IEC body phantom were used. First, the static image was acquired for 60 seconds while the dynamic images were acquired with a protocol, 2 sec/frame${\times}$30 frames, under the same parameter and the frames were summed up into one image afterwards. Also, minimal motion and excessive motion were applied during the another dynamic acquisition and the coordinate correction was applied towards X and Y axis on the frames where the motion artifact occurred. But the severe blurred images were deleted. Finally, the resolution and counts were compared between the static image and the summed dynamic images which before and after applying motion correction, and the signal of frequency was analysed after frequency spatial domain was transformed into 2D FFT. Supplementary examination, the blind test was performed by the nuclear medicine department staff. Results: First, the resolution in the static image and summed dynamic image without motion were 8.32 mm, 8.37 mm on X-axis and 8.30 mm, 8.42 mm on Y-axis, respectively. The counts were 484 kcounts, 485 kcounts each, so there was nearly no difference. Secondly, the resolution in the image with minimal motion applying motion correction was 8.66 mm on X-axis, 8.85 mm on Y-axis and had 469 kcounts while the image without motion correction was 21.81 mm, 24.02 mm and 469 kcounts in order. So, this shows the image with minimal motion applying motion correction has similar resolution with the static image. Lastly, the resolution in the images with excessive motion applying motion correction were 9.09 mm on X-axis, 8.83 mm on Y-axis and had 469 kcounts while the image without motion correction was 47.35 mm, 40.46 mm and 255 kcounts in order. Although there was difference in counts because of deletion of blurred frames, we could get similar resolution. And when the image was transformed into frequency, the high frequency was decreased by the movement. However, the frequency was improved again after motion correction. In the blind test, there was no difference between the image applying motion correction and the static image without motion. Conclusion: There was no significant difference between the static image and the summed dynamic image. This technique can be applied to patients who may have difficulty remaining still during the imaging process, so that the quality of image can be improved as well as the reliance for analysis of quantity. Moreover, the re-examination rate will be considerably decreased. However, there is a limit of motion correction, more time will be required to successfully image the patients applying motion correction. Also, the decrease of total counts due to deletion of the severe blurred images should be calculated and the proper number of frames should be acquired.

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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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The Clinical Usefulness of Serum Aminotransferase Activities for Predicting Fatty Liver in Obese Children (비만아에서 지방간의 예측 인자로서 혈청 Aminotransferase의 임상적 유용성)

  • Lim, Seon-Woong;Jeon, Myeong-Won;Park, Sin-Ae;Choi, Kyeong-Dan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.174-182
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    • 2003
  • Purpose: Non-alcoholic fatty liver disease (NAFLD) has been recognized as an important childhood liver disease, especially where the prevalence of childhood obesity is increasing. The purpose of this study is to clarify the usefulness of elevated serum aminotransferase activities and their ratio for predicting the presence of fatty liver and its severity in obese children. Methods: Forty-four children (M/F 29/15, age 4 to 16 years) with obesity (weight excess>20%) were analyzed retrospectively with medical records based on degree of obesity, bioelectrical impedence, serum aminotransferase activities, lipid profiles and ultrasonography. Results: 1) Ultrasonography was carried out in 34 cases. Elevated serum ALT was found in 89.7% (26/29) of the patients diagnosed as fatty liver by ultrasonography and decreased AST/ALT ratio (<1) was found in 96.6% (28/29). There was a strong correlation between elevated serum ALT (>45 IU/L) or decreased AST/ALT ratio (<1) and the fatty liver in obese children (p<0.05). 2) There was no significant correlation between the serum ALT or AST/ALT ratio and the degree of fatty liver (p>0.05). 3) There was a significant correlation between total cholesterol, triglyceride and fatty liver (p<0.05). Conclusion: Serum ALT activity and AST/ALT ratio were useful to predict the presence of fatty liver diagnosed by ultrasonography in obese children, whereas they were not useful to predict the degree of fatty liver. Therefore, to prevent fatty liver progressing to advanced liver disease, it is necessary to manage and monitor the obese children continuously, especially those who have predicting factors of fatty liver.

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Effect of Dietary Calcium, Casein, and Suet on the Accumulation of Cadmium in Mice (생쥐에 있어서 카세인, 칼슘 및 우지가 카드뮴의 조직내 축적에 미치는 영향)

  • Jung, Kyu-Sang;Kim, Doo-Hie;Jung, Kyung-Dong
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.340-350
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    • 1988
  • This study was carried out to clarify the effect of dietary calcium, casein, and suet on the accumulation of cadmium in mice. It was performed for 30 days, from April 11 to May 10 1988.90 mice were divided into 4 experimental groups and control group with 6 mice each dietary group, and measured survival rate, body weight, and weight ratio of organ to body. The contents of cadmium in liver, kidney, spleen, muscle and skin with hair, and feces were analyzed by atomic absorption spectrophotometer after sacrifice by anesthesia. After 30 days, the survival rate of control group was loot,, but 66.7% in group IV(basal diet+Cd+Ca) with single dose of $100{\mu}g$ cadmium and with free-intake of water containing 50ppm cadmium, and group V(basal diet+Cd+suet) with free-intake of water containing 50ppm cadmium. The rate of weight gain in the case of single dose of $100{\mu}g$ cadmium was highest in group IV as 42.3% and lowest in group V as 26.0%, whereas in the cases of free intake group W was highest as 24.0% and group II(basal diet+Cd) was lowest as 11.6%. The body weight, in the case of single dose of $100{\mu}g$ cadmium showed no increase until 5th day after acute poisoning. But in the case of free intake group, it showed very slight increase through all the breeding period. The weight ratio of organ to body were lowest in the liver of group II in both occasions. The most of cadmium adminstered. were excreted through feces within 2 days after single dose of $100{\mu}g$ cadmium. The contents of cadmium in each group were significantly higher than those of control group. In the liver, kidney, spleen and muscle, group II showed the highest level in both occasions of $100{\mu}g$ single dose and free intake of water containing 50ppm cadmium. In the skin with hair, group ll of the occasion with single dose of $100{\mu}g$ and group V with free intake showed the highest level. And the contents of cadmium in tissue were markedly higher in the occasion of free intake of water containing 50ppm cadmium. From the above results I would conclude that the addition of casein and calcium are effective in the inhibition of intesitnal absorption of cadmium esp. by calcium.

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Transmission Dose Estimation Algorithm for Tissue Deficit (조직 결손에 대한 투과선량 계산 알고리즘 보정)

  • Yun Hyong Geun;Chie Eui Kyu;Huh Soon Nyung;Lee Hyoung Koo;Woo Hong Gyun;Shin Kyo Chul;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.186-192
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.

Results of Radiation Alone Versus Neoadjuvant Chemotherapy and Radiation in Locally Advanced Stage of Uterine Cervical Cancer (진행된 자궁경부암에서 방사선치료 단독과 항암 화학요법 및 방사선치료 병용요법의 결과)

  • Kim, Jin-Hee;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.255-262
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    • 1997
  • Purpose : This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. Materials and Methods : Seventy-six Patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system. there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage lIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months. Results : Complete response (CR) rate were $86.1\%$ in radiation alone group and $80\%$ in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was $67.3\%$. According to stage, overall five-rear survival rates were $74\%$ in stage IIb, $66.7\%$ in stage IIIa, $49.8\%$ in stage IIb, $50\%$ in stage IVa. According to treatment modality overall five year survival rates were $74.1\%$ in radiation alone and $61.4\%$ in chemoradiation group (P=0.4) Five rear local failure free survival rates were $71.5\%$ in radiation alone group and $60\%$ in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were $80.7\%$ in radiation aione group and $89.9\%$ in chemoradiation group (P=0.42). Bone marrow suppression (more than noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients In chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. Conclusion : There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.

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Prevalence of Feline Leukemia Virus Infection in Cats in Bangladesh (방글라데시의 고양이 백혈병 바이러스의 감염율 조사)

  • Rahman, Siddiqur;Bhuiyan, Salauddin;Islam, Taohidul;Nahar, Azimun;Sarker, Roma Rani;Alam, Emtiaj;Chakrabarty, Amitavo;Sarker, Abu Sayed;Akhter, Laila;Chae, Joon-Seok
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.1-5
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    • 2014
  • Feline leukemia virus (FeLV) is a retrovirus that represents one of the most common and important infectious diseases of cats worldwide and it is responsible for more deaths among cats than any other infectious diseases. Prevalence data are necessary to define prophylactic, management and therapeutic measures for stray, feral and owned cats which are lacking in Bangladesh. The study was carried out to determine the prevalence of FeLV infection in Mymensingh district of Bangladesh using RapiGEN$^{(R)}$ FeLV Ag Test Kit (RapiGEN$^{(R)}$ Inc., Republic of Korea), a rapid one-step immunochromatographic assay. Blood samples from total 130 cats (23 owned cats and 107 unowned cats) were collected and tested following the manufacturer's instruction. An overall prevalence of FeLV infection was 1.54% (2/130). Prevalence was found 1.79% (2/112) on Day 0-up to one year aged cats (young) but no positive case was found in above 1 year (Adult) aged group. In male and female cats, the prevalence was 1.72% (1/58) and 1.39% (1/72), respectively. In un-owned cats the prevalence was 1.87%. Positive cases to FeLV were found only in clinically sick cats. No significant relationship was found according to age, sex, ownership status and health status. To the best of our knowledge this is the first report of the prevalence of FeLV infection in Bangladesh using RapiGEN$^{(R)}$ FeLV test kits which is very much effective because it is easy to apply, less expensive and quick screening of such type of infection.

Identification of the Transmissive Fractures in the Vicinity of waterway Tunnel (도수로터널 주변 지역의 지하수 유동성 단열 규명)

  • 이병대;이인호;추창오;함세영;성익환;황세호
    • Journal of Soil and Groundwater Environment
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    • v.7 no.3
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    • pp.33-44
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    • 2002
  • A field technique for assessing the transmissive fractures in an aquifer was applied to a fractured rock formation in Youngchun area Korea. Geological mapping and detailed acoustic borehole teleview(BHTV) logging were performed to obtain information about the fractures. The study area consists predominantly of two types of fractures. The fracture sets of low angle partings such as bedding and sheeting plains have strike N70-80$^{\circ}$W, 25$^{\circ}$-30$^{\circ}$SW and N3S$^{\circ}$W, 12$^{\circ}$NE, respectively. In areas of high fractures, on the other hand, the major fracture sets show strike N80$^{\circ}$W and dip 70$^{\circ}$-85$^{\circ}$SW, N10$^{\circ}$E.85$^{\circ}$SE in sedimentry rocks, N40-50$^{\circ}$E.85$^{\circ}$SE/85$^{\circ}$NE, N70$^{\circ}$E.80$^{\circ}$SE, and N7$^{\circ}$-75$^{\circ}$W.80$^{\circ}$SW in granites and volcanic rocks. Injection tests have been performed to identify discrete production zones and quantify the vertical distribution of hydraulic conductivity. The calculated hydraulic conductivities range from 3.363E-10 to 2.731E-6, showing that the difference between maximum and minimum value is four order of magnitude. Dominant section in hydraulic conductivity is extensively fractured. Geophysical logging was carried out to clarify characterization of the distribution of fracture zones. Transmissive fractures were evaluated through the comparison of the results obtained by each method. The temperature logs appeared to be a good indicator that can distinguish a high transmissive fractures from a common fractures in hydraulic conductivity. In numerous cases, evidence of fluid movement was amplified in the temperature gradient log. The fracture sets of N70-80$^{\circ}$W.60-85$^{\circ}$NE/SW N75-80$^{\circ}$W.25-30$^{\circ}$SW, N50-64$^{\circ}$W.60-85$^{\circ}$NE, N35-45$^{\circ}$E.65-75$^{\circ}$SE, and N65-72$^{\circ}$E.80$^{\circ}$SE/60$^{\circ}$NW were idenfied as a distinct transmissive fractures through the results of each tests.

Left Ventricular Systolic Function Improvement after Surgical Revascularization in Postinfarction Angina (급성 심근 경색 후 협심증 환자에서의 관상동맥 우회술 후 좌심실 수축 기능의 호전)

  • Yi Gi-Jong;Park Seong-Yong;Hong You-Sun;Yoo Kyung-Jong;Chang Byung-Chul;Lim Sang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.674-680
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    • 2006
  • Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.