• Title/Summary/Keyword: disease stage

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Study for Clinical Indicators of Prediction for Histological Finding of IgA Nephropathy (IgA 신병증의 조직소견을 예측할 수 있는 임상지표에 관한 연구)

  • Han Byong-Mu;Cho Jin-Youl;Chuon Ko-Woon;NamGoong Mee-Kyung
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.150-156
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    • 2003
  • Purpose : Efforts to predict the clinicopathological outcome of IgA nephropathy have been made but have yielded conflicting results and have not helped in deciding the appropriate timing of the renal biopsy. In this study, we reviewed the predictive factors of clinicopathological outcome for finding out the criteria of renal biopsy timing of IgA nephropathy. Methods : Forty children diagnosed with biopsy proven IgA nephropathy at Wonju Christian Hospital were studied retrospectively, based on medical records. Results : Among 39 patients, 2 children progressed to higher serum creatinine level. One of them reached to the end stage renal disease within 2 year 7 months. According to WHO histopathological classification, there were 15 cases of class I, 14 cases of class II, 7 cases of class III, and 3 cases of class IV. In the mild histological classes(class I, II), gross hematuria was shown in 23 out of 29 children(P=0.02). In the severe histological classes(class III, IV), gross hematuria was noted in 4 out of 10(P>0.05). The tubulointerstitial changes were grade 1 in 24 cases, grade 2 in 4 cases, grade 3 in 8 cases, and grade 4 in 3 cases. With an increase in the tubulointerstitial grade, the 24 hour urine protein/albumin ratio increased. Serum creatinine less than 0.79 mg/dL could predict the lower grade(grade 1 and 2) of tubulointerstitial changes. But serum creatinine greater than 1.13 mg/dL could predict the higher grade(grade 3 and 4) of tubulointerstitial changes. In children with gross hematuria(n=27), serum creatinine was lower(0.78 vs 1.09 mg/dL, P=0.027), serum IgA was higher(316.3 vs 198.8 mg/dL), and the cases of lower WHO classification(I and II) were more common(23 vs 4, P=0.029) than the children with microscopic hematuria. Conclusion : Serum creatinine less than 0.79 mg/dL, macroscopic hematuria, and higher 24 hour urine protein/albumin ratio would predict the lower grade glomerulo tubulointerstitial lesion in IgA nephropathy and could be used as the criteria delaying the renal biopsy.

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Is the Renal Uptake of $^{99m}Tc$-DMSA Decreased in Microalbuminuric Diabetic Patient? (미세 단백뇨기의 당뇨병 환자에서 $^{99m}Tc$-DMSA 신섭취율은 감소하는가?)

  • Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.398-404
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    • 1999
  • Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of $^{99m}Tc$-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of $^{99m}Tc$-DMSA in predicting early diabetic nephropathy Materials and Methods: $^{99m}Tc$-DMSA scan was performed and a total renal uptake of $^{99m}Tc$-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of $^{99m}Tc$-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of $^{99m}Tc$-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of $^{99m}Tc$-DMSA of Group II ($40.8{\pm}11.0%$) was significantly lower than that of Group I ($54.4{\pm}6.3%$, p<0.001). The uptake of Group III ($27.7{\pm}12.0%$) was significantly lower than those of both Group I and Group II (p<0.001). $^{99m}Tc$-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.102, p<0.001). Conclusion: $^{99m}Tc$-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, $^{99m}Tc$-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

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Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

A Study on the Establishment and Operation of a Regulatory Response Framework in connection with the Regulatory Strength of the Licensing Policy for New Medical Devices -Focusing on the Application of FMEA- (의료기기 신제품의 인허가정책 규제강도에 연계한 규제대응 프레임워크 수립 및 운영에 관한 연구 - FMEA 적용을 중심으로 -)

  • Kim, Gyosu;Ru, Gyuha;Kim, Yeonhee
    • Journal of Technology Innovation
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    • v.28 no.4
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    • pp.1-26
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    • 2020
  • Due to the spread of Corona 19 around the world, Infectious Disease Medicine and New Medical Devices such as Diagnostic Agent are being rapidly developed and launched, and for the fast supply and demand of these, each country has eased import regulations or has implemented policies for fast approval(NIDS, 2020). On the other hand, New Developed Medical Devices that are not related to New Infectious Diseases, they are still entering the market through strict licensing and licensing regulations, such as delay and cancellation in the test inspection process, etc. Therefore, This Study specialized in the government-managed laws encountered when New Medical Devices enter the market, derive Factors influencing the Strength of Regulations, analyzes the Strength of Regulations, and proposes a Regulatory Response Framework. The Research Method was conducted by Literature Research, was applied by Failure Mode and Effects Analysis(FMEA) Method, Expert Interview(1st): Idea Collection, Expert Interview(2nd): Validation, and Priority through the Application Process of FMEA Method. A Method of Quantifying the Intensity of Regulation was proposed by multiplying the Impact of the Influencing Factors for each stage of regulation and the Burden Impact for each type of Regulatory Affairs to find the Importance of the Regulatory Factors and multiplying the Severity of the Regulatory Impact. The Implications are that major overseas countries and the Korean government are actively responding with Special Regulatory Policies and Mitigation Policies for fast licensing of New Developed Medical Devices in accordance with Corona 19. It is expected that the direction for improvement of regulations and measures to respond to regulations will be implemented so that a more proactive and preemptive response to the regulatory process of the licensing policy for New Devices can be achieved.

A Medium-Maturing, High Non-Dietary Starch, Specialty Rice Cultivar 'Goami 3' (벼 중생 고 식이섬유 특수미 신품종 '고아미3호')

  • Lee, Sang-Bok;Lee, Jeom-Ho;Shin, Young-Seop;Lee, Kyu-Seong;Hwang, Hung-Goo;Jeong, O-Young;Yang, Chang-Ihn;Choi, Yong-Hwan;Yang, Sae-Jun;Jeon, Yong-Hee;Hong, Ha-Cheol;Kim, Hong-Yeol;Cho, Young-Chan;Lee, Jeong-Heui;Yea, Jong-Doo;Oh, Myung-Kyu;Kim, Myeong-Ki;Kim, Yeon-Gyu;Jeong, Kuk-Hyun;Lee, Young-Tae
    • Korean Journal of Breeding Science
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    • v.43 no.6
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    • pp.595-599
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    • 2011
  • 'Goami 3' is a new japonica rice cultivar developed from a cross between Suweon464 and Daeanbyeo by the rice breeding team of National Institute of Crop Science, RDA. 'Goami3' has about 130 days growth duration from transplanting to heading in central plain area of Korea. It has a good semi-erect plant type and resistance to lodging of about 79 cm in culm length. 'Goami 3' had 15 panicles per hill and 104 spikelets per panicle. 'Goami 3' has very high amylose (29.5%) and high non-dietary starch compared with Hwaseongbyeo. This rice variety has slow senescence and 47% tolerance to viviparous germination during the ripening stage. 'Goami 3' is susceptible to leaf blast, bacterial blight, virus disease and insect pest. The yield performance of this cultivar in milled rice was about 3.92MT/ha by ordinary season culture in local adaptability test from 2005 to 2007. 'Goami 3' is adaptable to central and southern plain area of Korea.

An Early-Maturing, Blast Resistant and High Quality Rice Cultivar "Pyeongwon" (벼 조생 단간 내도열병 고품질 신품종 "평원")

  • Ryu, Hae-Young;Jeon, Yong-Hee;Jung, Kuk-Hyun;Shin, Young-Seop;Hwang, Hung-Goo;Kim, Hong-Yeol;Kim, Myeong-Ki;Jung, O-Young;Won, Yong-Jae;Kim, Yeon-Gyu;Yang, Chang-In;Lee, Jeom-Ho;Lee, Jeong-Il;Lee, Jeong-Heui;Choi, Yoon-Hee;Yang, Sae-Jun;Ahn, Eok-Keun
    • Korean Journal of Breeding Science
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    • v.41 no.2
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    • pp.177-181
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    • 2009
  • 'Pyeongwon' is a new japonica rice cultivar which is developed from a cross between Jinbu19 and Samjiyeon4 from North Korea by the rice breeding team of National Institute of Crop Science, RDA. Pyeongwon has about 107 days duration from seeding to heading in mid-northen plain, alpine, north-eastern coastal and southern alpine areas. It has about 67 cm culm length and tolerance to lodging. Pyeongwon has 13 tillers per hill and 82 spikelets per panicle. It showed tolerance to heading delay and spikelet sterility due to cold treatment similar to Odaebyeo. It also showed slow leaf senescence and moderate tolerance to viviparous germination during the ripening stage. Pyeongwon has resistance to blast disease but susceptible to stripe virus and brown planthopper. Milled rice of Pyeongwon has translucent kernels, relatively clear non-glutinous endosperm and medium short grain. It is characterized as a low gelatinization temperature and slightly lower amylose content (17.1%) variety compared to Odaebyeo (19.5%) and has good palatability of cooked rice. The milled rice yield performance of this cultivar was about 5.28 MT/ha by ordinary culture in local adaptability test for three years. This cultivar may be highly adaptable to the mid-northen plain, alpine, north-eastern coastal and southern alpine areas of Korea.

'Hwawang': A Good Quality and Early-Maturing Rice Variety Adaptable for Rice-Cash Crop Rotation System (소득작물 후작용 고품질 조생 벼품종 '화왕')

  • Lee, Jong-Hee;Lee, Ji-Yoon;Yeo, Un-Sang;Song, You-Chun;Park, Dong-Soo;Hwang, Un-Hwa;Park, Soo-Gwan;Park, No-Bong;Kim, Sang-Yeol;Oh, Seong-Hwan;Han, Sang-Ik;Nam, Min-Hee;Lee, Jong-Gi;Cho, Jun-Hyeon
    • Korean Journal of Breeding Science
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    • v.50 no.4
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    • pp.534-539
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    • 2018
  • 'Hwawang' is an early maturing and short statured rice cultivar adaptable to the rice-cash crop rotation system that was developed by the rice breeding team of the Department of Southern Crop, National Institute of Crop Science (NICS), Rural Development Administration (RDA), Korea, in 2012. This cultivar was derived from the cross of YR25867 (Hitomebore//YR21247-B-B-B-49-1/Sasanishiki BL4) and YR25866 (Akidagomachi//YR21247-B-B-B-49-1/Sasanishiki BL4) during the 2005/2006 winter season and was fixed as a homozygous line by a doubled haploid breeding system. In the replicated yield trial in 2009, a promising line (YR26253Acp26-1) showed a good phenotype and high yield potential, and so it was selected and designated as 'Milyang256'. The local adaptability test of 'Milyang256' was carried out at three locations from 2010 to 2012. It was named 'Hwawang' and had a high head rice ratio and good eating quality. The culm length of 'Hwawang' averaged 62 cm during the yield trials and was 10 cm shorter than that of 'Keumo'. The number of spikelets per panicle of 'Hwawang' was significantly lower than that of 'Keumo', but the number of tillers per hill was higher. This variety showed resistance to bacterial blight disease but was moderately susceptible to both leaf and neck blast. The milled rice yield of 'Hwawang' was 452 kg/10 a at the late transplanting stage of the local adaptability test. Thus, 'Hwawang' is well adapted to the rice-cash crop rotation system in the southern plain area. (Registration No. 5106)

Quantitative Evaluation of Liver Fibrosis on T1 Relaxometry in Comparison with Fibroscan (Fibroscan과 비교를 통한 T1 MR Relaxometry를 이용한 간섬유화의 정량적 평가)

  • Byeong Hak Sim;Suk Hee Heo;Sang Soo Shin;Seong Beom Cho;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.365-378
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    • 2020
  • Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type (성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가)

  • Kim, Jung-In;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.54-61
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    • 2016
  • Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

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The Clinical Characteristics of Lung Cancer in Patients with Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증에 동반된 폐암 환자의 임상적 특정)

  • Park, Joo-Hun;Lee, Jin-Seong;Song, Koun-Sik;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.674-684
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    • 1999
  • Background : It has been generally known that the incidence of lung cancer is higher in the patients with idopathic pumonary fibrosis (IPF) than those in general population. The reported incidence was variable from 4.8 to 43.2%. There were controversies on the most frequent cell type (squamous cell carcinoma vs. adenocarcinoma) and no study was done about the real concordance of cancer and the fibrotic lesion. And the pulmonary fibrosis may influence not only the development of cancer but also the treatment and prognosis of the cancer, but there was no report on that point. Method : Total 63 patients ($66.8{\pm}7.8$ year, M : F=61 : 2) were diagnosed as IPF combined with lung cancer (IFF-CA) at Asan Medical Center. A retrospective analysis was done about the risk factors of the lung cancer, pulmonary function test, the site of cancer(especially the relationship of the cancer with the fibrotic lesion), the histologic types, and the stage of cancer. The histologic types were compared with those of 2,660 patients with lung cancer who were diagnosed at the same institute for the same period. The effect of IPF on the treatment of the cancer was evaluated with the survival time after the detection of lung cancer. Results : The lung cancer was found in 63(22.9%) out of 281 patients with IPF. But in most of them(45 patients), lung cancer was detected at the same time with IPF and only in 18 patients, the cancer was diagnosed during the follow-up($25.2{\pm}17.7$ months) of IPF. So in our study, 6.7% of patients with IPF developed lung cancer during the course of the disease. The age ($66.8{\pm}7.84$ vs. $63.4{\pm}11.1$ years), percentage of smoker (88.9 vs. 67.2%), and the male gender (96.8 vs. 67.6%) were significantly higher in IPF-CA compared with lone IPF (p<0.05). The odds ratio of smoking was 4.7 compared with non smoking IPF controls. The lung cancer was located more frequently in the upper lobe and 55.5% was in the periphery of lung. The cancer was developed in the fibrotic lesion in 23 patients (35.9%), and in the majority of the patients, the cancer was separated from the fibrosis. The cell type of the lung cancer in IPF-CA was squamous cell carcinoma 34.9%, adenocarcinoma 30.2%, small cell carcinoma 19.0%, large cell undifferenciated carcinoma 6.3%, and others 9.5%. No significant difference in the distribution of histologic type of the lung cancer was found between IPF-CA and lone lung cancer. There was no significant difference in demographic features, cell types, location and the stage of the cancer between the group with concurrent IPF-CA and the group with cancer diagnosed during the follow up of IPF. There was a tendency (but statistically not significant : p=0.081) of higher incidence of adenocarcinoma among the cancers developed in the fibrotic area(43.5%) (F-CA) than in the cancers in non-fibrotic area (22.5%) (NF-CA). The prognosis of the patients with F-CA was poor (median survival : 4 months) compared with the patients with NF-CA (7 months, p=0.013), partly because the prevalence of severe IPF (the extent of fibrosis in HRCT 50%) was higher in F-CA group. Conclusion : These data suggest that the lung cancer in the patients with IPF has similar features to the ordinary lung cancer.

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