• Title/Summary/Keyword: clinical index

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Preliminary analysis of metabolic syndrome components in Korean adolescents by using Korean national health and nutrition examination Survey pooling data (1998, 2001, and 2005) (한국국민건강영양조사 병합자료(1998년, 2001년, 2005년)를 이용한 소아청소년에서의 대사증후군 진단 요인의 기초 분석)

  • Huh, Kyoung;Park, Mi Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1300-1309
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    • 2008
  • Purpose :This study aimed to estimate age- and gender-specific cut points for metabolic syndrome (MS) components, including body mass index (BMI), blood pressure (BP), triglycerides, high-density lipoprotein (HDL) cholesterol, and glucose. Methods :Data from the 1998, 2001, and 2005 Korean NHANES (National Health and Nutrition Examination Survey) were analyzed (n=4164; 2,139 boys and 2,025 girls, aged 10-19 years). Height, weight, waist circumference (WC), BP, triglycerides, HDL cholesterol, and fasting glucose were measured. Results :BMI over $25kg/m^2$ represents the $85^{th}P$ (percentile) in 17-year-old boys and the $90^{th}P$ in 17-year-old girls. A level of WC higher than that of the cutoff points of Asian adults was found in the $90^{th}P$ of 17-year-old boys and girls. The $90^{th}P$ of boys aged 15 years old and the $95^{th}P$ of 13-year-old were included in the range of systolic BP over 130 mm Hg. Over the $75^{th}P$ of the group showed triglycerides greater than 110 mg/dL, (criterion of MS presented by NCEP-ATP III) and the $90^{th}P$ of the group showed triglycerides greater than 150 mg/dL by IDF. An HDL cholesterol level of 40 mg/dL represents the $25^{th}P$ in boys and the $10^{th}P$ in girls. A glucose level greater than 110 mg/dL represents the $95^{th}P$ and greater than 100 mg/dL represents the $90^{th}P$. Conclusion :Values of the $90^{th}P$ of MS components in late adolescent boys (WC, BP, and triglycerides) and girls (WC and triglycerides) were very high and in close proximity to the diagnostic criteria of adult MS.

Pattern of Decrease of Prostate Specific Antigen after Radical Radiotherapy for the Prostate Cancer (전립선암 환자에서 방사선치료 루 전립선특이항원 농도 변화 양상)

  • Kim Bo-Kyoung;Park Suk Won;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.136-140
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    • 1999
  • Purpose : Prostate specific antigen (PSA) is a useful tumor marker, which is widely used as a diagnostic index and predictor of both treatment and follow-up result in prostate cancer. A prospective analysis was carried out to obtain the period of PSA normalization and the half life of PSA and to analyze the factors influencing the period of PSA normalization. The PSA level was checked before and serially after radical radiotherapy. Materials and Method : Twen쇼 patients with clinically localized prostate cancer who underwent radical external beam radiotherapy were enrolled in this study. Accrual period was from April 1993 to May 1998. Median follow-up period was 20 months. Radiotherapy was given to whole pelvis followed by a boost to prostate. Dose range for the whole pelvis was from 45 Gy to 50 Gy and boost dose to prostate, from 14 Gy to 20 Gy. The post-irradiation PSA normal value was under 3.0 ng/ml. The physical examination and serum PSA level evaluation were performed at 3 month interval in the first one year, and then at every 4 to 6 months. Results : PSA value was normalized in nineteen patients (95%) within 12 months. The mean period of PSA normalization was 5.3 (${\pm}$2.7) months. The half life of PSA Of the nonfailing patients was 2.1 (${\pm}$0.9) month. The nadir PSA level Of the nonfailing Patients waS 0.8 (${\pm}$0.5) ng/ml. The period of PSA normalization had the positive correlation with pretreatment PSA level (R$^{2}$=0.468). The nadir PSA level had no definite positive correlation with the pretreatment PSA level (R$^{2}$=0.075). The half life of serum PSA level also had no definite correlation with pretreatment PSA level (R$^{2}$=0.029). Conclusion :The PSA level was mostly normalized within 8 months (85%). If it has not normalized within 12 months, we should consider the residual disease in prostate or distant metastasis. In 2 patients, the PSA level increased 6 months or 20 months before clinical disease was detected. So the serum PSA level can be used as early diagnostic indicator of treatment failure.

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The Study of Affecting Image Quality according to forward Scattering Dose used Additional Filter in Diagnostic Imaging System (부가필터 사용 시 전방 산란선량에 따른 화질 영향에 대한 연구)

  • Choi, Il-Hong;Kim, Kyo-Tae;Heo, Ye-Ji;Park, Hyong-Hu;Kang, Sang-Sik;Noh, Si-Cheol;Park, Ji-Koon
    • Journal of the Korean Society of Radiology
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    • v.10 no.8
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    • pp.597-602
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    • 2016
  • Recent clinical field utilizes the aluminium filter in order to reduce the low-energy photons. However, the usage of the filter can cause adverse effect on the image quality because of the scattered dose that is generated by X-ray hardening phenomenon. Further, usage of filter with improper thickness can be a reason of dose creep phenomenon where unnecessary exposure is generated towards the patient. In this study, the author evaluated the RMS and the RSD analysis in order to have a quantitative evaluation for the effect of forward scattering dose by the filter on the image. as a result of the study, the FSR and the RSD was increased together with the increasing of thickness of the filter. In this study the RSD means the standard deviation of the mean value is relatively size. It can be understood that the signal-to-noise ratio decreases when the average value is taken as a signal and the standard deviation is judged as a noise. The signal-to-noise ratio can understanding as index of resolution at image. Based on these findings, it was quantitatively verified that there is a correlation of the image quality with the FSR by using an additional filter. The results, a 2.5 mmAl which is as recommended by NCRP in the tube voltage of 70 kVp or more showed the 14.6% on the RSD when the filter was not in used. these results are considered able to be utilized as basic data for the study about the filter to improve the quality of the image.

Relationship of Hemodynamic Changes during Off-Pump Coronary Bypass Grafting and Their Effects on Postoperative Outcome (심폐바이패스 없이 시행하는 관상동맥 우회수술 중의 혈역학적 변수들의 변화양상 및 수술 후 결과에 미치는 영향)

  • 허재학;장지민;김욱성;장우익;이윤석;정철현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.576-582
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    • 2003
  • During the Off-Pump Coronary Arterial Bypass surgery (OPCAB), the manipulation of the heart can depress cardiac contractility and cause hemodynamic instability. In this study, hemodynamic parameters were measured during operation and the laboratory and clinical data were investigated to evaluate their effects on postoperative outcome. Material and Method: From March 2001 to August 2002, 50 consecutive patients who underwent OPCAB were included in this study. During the same period, total number of CABG was 71 The blood pressure, pulmonary artery pressure, mixed venous oxygen saturation, and cardiac index were measured before manipulation, after application of stabilizer, and at the end of anastomosis. Postoperatively, we measured the cardiac enzymes such as CK-MB, troponin 1 and checked the amount of inotropes required, chest tube drainage, the amount of transfusion, duration of ventilator support, and duration of ICU stay. Result: The number of mean distal anastomoses was 2.8$\pm$0.9 per patient. On elevation and stabilization of the heart, systolic blood pressure was depressed and pulmonary artery pressure was elevated significantly, but during each anastomosis no significant changes were detected. The peak level of cardiac markers was 29.2$\pm$46.7 for CK-MB, 0.69$\pm$0.86 for troponin 1 on postoperative day f. Among the intraoperative hemodynamic parameters, the ischemic change of EKG and bolus injection of inotropes significantly affected the posteroperative cardiac enzymes. But, no difference other than the level of cardiac enzymes between the two groups with or without the ischemic change of EKG and bolus injection of inotropes was noticed. Conclusion: The significant hemodynamic changes occurred when the heart was elevated and stabilized, however during anastomoses there were no significant changes. Serum cardiac enzymes rose significantly in the group that showed the ischemic charge of EKG or needed the bolus injection of inotropes for maintaining hemodynamic stability intraoperatively, but it did not affect the postoperative outcome. In conclusion, the ischemic change of EKG and the need for bolus injection of intropes during operation may be very indicative for probable ischemia.

The Clinical Usefulness Measurement of the Whole Body Percent Fat Calculated by the Part Bone Mineral Density Measurement (부분골밀도 측정을 통해 산출되는 체지방률의 임상적 유용성에 대한 평가)

  • Kang, Young-Eun;Kim, Eun-Hye;Kim, Ho-Sung;Choi, Jong-Sook;Choi, Woo-Jun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.3-9
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    • 2011
  • Purpose: Generally dual energy X-ray absorptiometry has been used for the purpose of evaluation of osteoporosis and treatment. Recently the interest of obesity came to be high and body percent fat test is increasing. Existing measure of body fat have to scan the whole body can be evaluated, but only lumbar spine and hip measurements was assumed to be whole body fat as well as improving the software. It tries to check whether the part measured value not being whole body measurement has the validity or not compared with the value calculated with the method that it is different, it forgives through a correlation with a (BIA) and (BMI). Materials and Methods: In 2010, the body percent fat was measured among the examinee coming to the Asan Medical Center public health care center from March till August against 90 females more than 40 years old through (DXA) and BIA. BMI utilized the value which wrote an hight and weight measured through the body measuring instrument in the examinee information and is automatically calculated. In addition, it classified as the low weight ($13-18.5kg/m^2$), normal ($18.5-25kg/m^2$), and corpulence ($25-30kg/m^2$) based on BMI and so that it could check whether there was the difference according to the weight or not BMI and BIA and correlation between DXA were analyzed in each group. The statistical program for the analysis used SPSS 12.0. Results: The comparison of DXA at 3 which it divides into the low weight and normal and corpulence groups and BIA did not show the difference noted statistically in all groups and the between group comparison was exposed to do not have a meaning. The body percent fat measured by the correlation analysis result DXA at the state that it doesn't divide into the group showed the high correlation (r=0.908, p0.01) noted statistically compared with BMI and showed the high correlation noted statistically in a comparison with BIA (r=0.927, p0.01). Conclusion: It confirmed that the whole body percent fat presumed from the part bone density measurement showed the excel correlation compared with BIA and BMI and information is high. There is still no clear standard about the presumed whole body percent fat and it is difficult to evaluate the fat evaluation by the bone mineral density measurement. However, it is determined that the information offering which is more objective through the comparative study with the body percent fat which is very efficient and in that it can obtain till the information about a fat as well as diagnosis of the osteoporosis through the bone density checkup is measured by the afterward telegraph bone density checkup and is clinically useful is possible.

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Morphometric Study on the Arterial Palmar Arch of the Hand (손바닥 동맥활에 관한 형태계측 연구)

  • Park, Bong Kwon;Jang, Soo Won;Choi, Seung Suk;Ahn, Hee Chang
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.691-701
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    • 2009
  • Purpose: Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study was to provide new information about palmar arches through cadaver's dissection. The values of the location and diameter in these vessels were analyzed in order to support anatomical research and clinical correlation in the hand. Methods: The present report is based on an analysis of dissections of fifty - three hands carried out in the laboratory of gross anatomy. A reference line was established on the distal wrist crease to serve as the X coordinate and a perpendicular line drawn through the midpoint between middle and ring fingers, which served as the Y coordinate. The coordinates of the x and y values were measured by a digimatic caliper, and statistically analyzed with Student's t - test. Results: Complete superficial palmar archs were seen in 96.2 % of specimens. In the most common type of males, the superficial arch was formed only by the ulnar artery. In the most common type of females, the superficial arch was formed anastomosis between the radial artery and the ulnar artery. The average length of the superficial and deep palmar arch is $110.3{\pm}33.0mm$ and $67.9{\pm}14.0mm$ respectively. Regarding the superficial palmar arch, ulnar artery starts $-16.1{\pm}5.1mm$ on X - line, and $2.5{\pm}24.5mm$ on Y - line. Radial artery appears on palmar side $7.7{\pm}3.2mm$ on X - line, and $20.9{\pm}10.9mm$ on Y - line. But radial artery starts on $6.3{\pm}3.6mm$ on X - line, and $3.4{\pm}5.1mm$ on Y - line. Digital arteries of superficial palmar arch starts on $6.1{\pm}3.7mm$, $33.9{\pm}8.8mm$ on index finger, $1.8{\pm}3.4mm$, $40.1{\pm}7.3mm$ on middle finger, $-3.2{\pm}4.9mm$, $42.6{\pm}7.0mm$ on ring finger, and $-8.9{\pm}5.1mm$, $42.5{\pm}80mm$ on little finger in respective X and Y coordinates. Radial artery of deep palmar arches measured at the palmar side perforating from the dorsum of hand. It's coordinates were $9.7{\pm}4.8mm$ on X - line, $21.7{\pm}10.2mm$ on Y - line. Ulnar artery was measured at hypothenar area, and it's coordinates were $-20.4{\pm}6.3mm$ on X - line, and $30.6{\pm}7.4mm$ on Y - line. Conclusions: Anatomically superficial palmar arch can be divided into a complete and an incomplete type. Each of them can be subdivided into 4 types. The deep palmar arch is less variable than the superficial palmar arch. We believe these values of the study will be used for the vascular surgery of the hand using the endoscope and robot in the future.

Comparison of Outcomes According to the Hospitals of Antenatal Care in Very Low Birth Weight Infants (극소 저체중 출생아에서 산전 관리 기관에 따른 임상 경과 및 예후 비교)

  • Lee, Byoung-Kook;Lee, Heun-Ji;Min, Sung-Joo;Kim, Do-Hyun;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.205-212
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    • 2009
  • Purpose: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. Methods: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. Results: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score ($\leq3$) was lower in the immediate group than the delayed group. Conclusion: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.

The Role of T1-201 Brain SPECT in the Differentiating Recurrent Tumor from Radiation Necrosis (뇌종양의 재발과 방사선 괴사의 감별을 위한 탈륨 SPECT의 역할)

  • Won, Kyoung-Sook;Ryu, Jin-Sook;Moon, Dae-Hyuk;Yang, Seoung-Oh;Lee, Hee-Kyung;Lee, Jung-Kyo;Kwun, Byung-Duk
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.476-483
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    • 1996
  • Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging rrere calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.

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Parametric Images of Standardized Uptake Values using P-18-FDG Attenuation Corrected Whole Body PET (F-18-FDG감쇠보정 전신 PET을 이용한 표준섭취계수 추정과 매개변수 영상의 구성)

  • Kim, Kyeong-Min;Kwark, Cheol-Eun;Lee, Dong-Soo;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kim, Yong-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.560-569
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    • 1996
  • Background and Purpose : Standardized uptake value(SUV) has been used as a quantitative index for differentiating benign and malignant tumors with F-18-FDG PET In this study, we produced whole body parametric images of SUV(WBPIS) by body weight normalization, and validated the values by comparison with SUV's calculated with regional scans. Subjects and Methods : Whole body scans were followed by regional scans sequentially on 23 patients. In whole body study, transmission and emission scans were acquired for 2 minutes and 6 minutes for each bed position, respectively. In regional study, transmission and emission scans were acquired for 20 minutes. Measured and segmented/ smoothed attenuation correction were applied using these 2 min transmission scans in whole body studies. The effects of attenuation correction on SUVs were evaluated quantitatively using F-18 filled cylindrical phantom. The mean and peak SUVs obtained from WBPIS were compared with SUVs of the regional scans. Results : In phantom studies, with any method of attenuation correction using regional or whole body studies of phantom, SUVs were nearly consistent. In whole body scan, SUV obtained using measured attenuation correction method was a little higher than SUV of regional scan. SUV obtained using segmented/smoothed attenuation correction method was a little lower. In patient studies, WBPIS using segmented/smoothed attenuation correction method was much smoother and more readable. SUVs of WBPIS obtained with both methods of attenuation correction were well correlated with SUVs of regional scans(r=0.9). SUVs of WBPIS with measured attenuation correction method were 5% lower than SUVs of regional scans. SUVs of WBPIS with segmented/smoothed attenuation correction method were 10% lower than SUVs of regional scans. The differences of SUVs of WBPIS by the two attenuation correction methods were relatively small compared with the possible differences derived from biological characteristics of tumors. Conclusion : We concluded that WBPIS could be useful in the quantification of tumor as well as in localization of whole body lesions, which were often outside the field of view in regional scan. WBPIS made using segmented/smoothed attenuation correction method could be used in clinical routines and SUVs from attenuation corrected F-18-FDG PET could be used interchangeably with SUVs of regional studies.

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Effect of 1 Year E-mail Nutrition Education after Face-to-Face Encounter at Worksite: Changes in Cardiovascular Risk Factors (면대면 영양교육 후 1년간의 E-mail 영양교육이 직장인 남성의 심혈관 질환 위험인자 감소에 미치는 효과)

  • Oh, Hye-Sun;Jang, Mi;Hwang, Myung-Ok;Cho, Sang-Woon;Paek, Yun-Mi;Choi, Tae-In;Park, Yoo-Kyoung
    • Journal of Nutrition and Health
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    • v.42 no.6
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    • pp.559-566
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    • 2009
  • Effective nutrition educations for prevention of chronic diseases for the general population are of great importance these days. The purpose of this study was to evaluate the feasibility of nutrition education for cardiovascular risk factor reduction by e-mail education in male workers. The participants were divided into three groups by age; 28-39 age group, 40-49 age group, and 50-59 age group who got regular checkups for anthropometry and biochemistry. The 1 year program consisted of 15 topics containing information about metabolic syndrome (MS) and healthy eating behavior (intake of salt, fat and alcohol). Seven hundred thirty nine participants volunteered for the study [28-39 age group, n = 240; body mass index (BMI) = 24.9 $\pm$ 2.7 kg/m$^2$: 40' group, n = 276; BMI = 24.8 $\pm$ 2.6 kg/m$^2$: 50' group, n = 223; BMI = 24.9 $\pm$ 2.7 kg/m$^2$]. Percentage body fat (p < 0.05) and percentage of abdominal fat (p < 0.05), total cholesterol (p < 0.05), systolic blood pressure (p < 0.05), and diastolic blood pressure (p < 0.05) were significantly decreased in all participants after the 1 year program. The total number of participants who had MS was decreased from 216 to 199 and especially the incidence of MS was decreased 27% in the group of subjects who were under the age 39. The e-mail worksite nutrition education program shows a substantial contribution to the development of effective CVD and chronic disease control and lifestyle nutrition educations that are applicable to and attractive for the large population at risk.