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The Effect of Nuclear Overhauser Enhancement in Liver and Heart $^{31}P$ NMR Spectra Localized by 2D Chemical Shift Technique (이차원 화학변위 기법을 이용한 간 및 심장 $^{31}P$ 자기공명분광에서의 Nuclear Overhauser 효과에 대한 연구)

  • Ryeom Hun-Kyu;Lee Jongmin;Kim Yong-Sun;Lee Sang-Kwon;Suh Kyung-Jin;Bae Sung-Jin;Chang Yongmin
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.2
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    • pp.94-99
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    • 2004
  • Purpose : To investigate the signal enhancement ratio by NOE effect on in vivo $^{31}P$ MRS in human heart muscle and liver. we also evaluated the enhancement ratios of different phosphorus metabolites, which are important in 31P MRS for each organ. Materials and Methods : Ten normal subjects (M:F = 8:2, age range = 24-32 yrs) were included for in vivo $^{31}P$ MRS measurements on a 1.5 T whole-body MRI/MRS system using $^1H-^{31}P$ dual tuned surface coil. Two-dimensional Chemical Shift Imaging (2D CSI) pulse sequence for $^{31}P$ MRS was employed in all $^{31}P$ MRS measurements. First, $^{31}P$ MRS performed without NOE effect and then the same 2D CSI data acquisitions were repeated with NOE effect. After postprocessing the MRS raw data in the time domain, the signal enhancements in percent were estimated from the major metabolites. Results : The calculated NOE enhancement for liver $^{31}P$ MRS were $\alpha-ATP\;(7\%),\;\beta-ATP\;(9\%),\;\gamma-ATP\;(17\%),\;Pi\;(1\%),\;PDE\;(19\%)$ and $PME\;(31\%)$. Because there is no creatine kinase activity in liver, PCr signal is absent. For cardiac $^{31}P$ MRS, whole body coil gave better scout images and thus better localization than surface coil. In $^{31}P$cardiac multi-voxel spectra, DPG signal increased from left to right according to the amount of blood included. The calculated enhancement for cardiac $^{31}P$ MRS were : $\alpha-ATP\;(12\%),\;\beta-ATP\;(19\%),\;\gamma-ATP\;(30\%),\;PCr\;(34\%),\;Pi\;(20\%),\;(PDE)\;(51\%),\;and\;DPG\;(72\%)$. Conclusion : Our results revealed that the NOE effect was more pronounced in heart muscle than in liver with different coupling to 1H spin system and thus different heteronuclear cross-relaxation.

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Clinical, Endoscopic and Pathologic Findings of Colonic Polyposis in Korean Children (소아 대장용종증 환자의 임상양상 및 내시경적, 조직학적 소견)

  • Lim, Mi-Sun;Seo, Jeong-Kee;Ko, Jae-Sung;Yang, Hye-Ran;Kang, Gyeong-Hoon;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.154-163
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    • 2010
  • Purpose: Colonic polyposis is less common in children than in adults. The clinical data pertaining to colonic polyposis in children are limited. Children with colonic polyposis have complications associated with numerous polyps, malignant transformation of the polyps, and extraintestinal neoplasms. We studied the clinical spectrum, endoscopic characteristics, and histologic findings of colonic polyposis in Korean children. Methods: We reviewed the clinical data of 37 children with multiple colonic polyps between 1987 and 2009. The mean age at the time of diagnosis of colonic polyposis was 8.0${\pm}$3.2 years. Results: Peutz-Jeghers syndrome, juvenile polyposis syndrome, familial adenomatous polyposis (FAP), and lymphoid polyposis was diagnosed in 22, 7, 6, and 2 children, respectively. The most common clinical presentation in children with colonic polyposis was hematochezia. A family history of colonic polyposis was noted in 7 children. The colonoscopic findings of colonic polyposis varied with the size and number of polyps. The majority of polyps were multi-lobulatd and pedunculated in children with Peutz-Jeghers syndrome. The polyps in children with juvenile polyposis syndrome were primarily round and pedunculated. For the children with FAP, the colon was carpeted with small, sessile polyps. There were multiple sessile polyps in the patients with lymphoid polyposis. Surgical polypectomy was performed in 14 children (38%). Intestinal segmental resection was performed in 13 children (35%). Four patients with FAP underwent total colectomy. Four children with Peutz-Jeghers syndrome had extraintestinal neoplasms. No malignant transformation of polyp was identified. Conclusion: Children with colonic polyposis should undergo a careful initial evaluation and require periodic re-evaluation.

Accelerated Fractionation In The Treatment of Brain Metastasis From Non-Small Cell Carcinoma of The Lung (비소세포성 폐암환자의 뇌전이에 대한 급속분할조사법)

  • Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.165-173
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    • 1994
  • Purpose : Metastatic cancer to the brain is a major problem for the patients with bronchogenic carcinoma, and most of these patients have a limited survival expectancy. To increase tumor control and / or to decrease late morbidity with possible shortening in over-all treatment period, multiple daily fraction technique for brain metastasis was performed. The author reperesented the results of accelerated fractionation radiotherapy in patients with brain metastases from non-small cell lung cancer. Materals and Methods : Twenty-six patients with brain metastases from non-small cell lung cancer between 1991 and 1993 received brain radiotherapy with a total dose of 48 Gy, at 2 Gy per fraction, twice a day with a interfractional period of 6 hours, and delivered 5 days a week. The whole brain was treated to 40 Gy and boost dose escalated to 8 Gy for single metastatic lesion by reduced field. Twenty-four of the 26 patients completed the radiotherapy. Radiotherapy was interupted in two patients suggesting progressive intracerebral diseases. Results : This radiotherapy regimen appears to be comparable to the conventional scheme in relief from symptoms. Three of the 24 patients experienced nausea and or vomiting during the course of treatment because of acute irradiation toxicity. The author observed no excessive toxicity with escalating dose of irradiation. An increment in median survival, although not statistically significant(p>0.05), was noted with escalating doses(48 Gy) of accelerated fractionation(7 months) compared to conventional treatment(4.5 months). Median survival also increased in patients with brain solitary metastasis(9 months) compared to multiple extrathoracic sites(4 months), and in patients with good performance status(9 months versus 3.5 months), they were statistically significant (p<0.01). Conclusion : The increment in survival in patients with good prognostic factors such as controlled primary lesion, metastasis in brain only and good perfomance status appeared encouraging. Based on these results, a multi-institutional prospective randomized trial should be initiated to compare the twice-a-day and once-a-day radiotherapy schemes on patients with brain metastasis with careful consideration for the patients' quality of life.

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The Clinical Significance of Soluble Intercellular Adhesion Molecule-1 sICAM-1) and Soluble Vascular Cell Adhesion Molecule-1(sVCAM-1) in Kawasaki Disease (급성 발열기 및 아급성기 가와사끼병에서 세포부착분자 sICAM-1, sVCAM-1의 임상적 의의)

  • Rhee, Kang Won;Yun, Sin Weon;Lee, Dong Keun;Choi, Eung Sang;Yoo, Byeong Hoon;Lee, Mi Kyung
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.640-648
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    • 2005
  • Purpose : Kawasaki disease(KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value. Methods : A typical KD group was 32 patients who were hospitalized from Jan. 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I. Results : sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control(P=0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage(P=0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages(P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin(IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages(P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T(r=0.63, P=0.00063). Conclusion : The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.

Clinical characteristics and prognosis of acute disseminated encephalomyelitis based on the lesions on MRI (자기공명영상의 병변에 따른 급성 파종성 뇌척수염의 임상 양상과 예후)

  • Chung, Sunghoon;Park, Sungsin;Chung, Sajun
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.891-895
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    • 2007
  • Purpose : Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system and mostly develops after viral illness or vaccinations. We investigated the clinical differences and neurologic outcomes according to the distribution of the lesions on brain MRI. Methods : The study group was composed of 21 patients from January 1995 to August 2003 in Kyunghee University hospital. We grouped the patients according to the MRI findings as follows. Group I (14 cases): Multi- or unifocal lesions only in the cerebral white matter. Group II (7 cases): lesions in the gray matter with or without white matter involvement. Results : 1. Preceding events were as follows: no defined prodrome (38.1%), upper respiratory tract infection (28.6%), nonspecific febrile illness (19.0%), gastointestinal disturbance and vaccination. 2. Presenting symptoms were as follows: seizures (76.2%), headache/vomiting (47.6%), altered consciousness (38.1%), hemiparesis, cerebellar ataxia, visual disturbance and facial nerve palsy. 3. Laboratory findings were as follows: CSF pleocytosis (76.2%), leucocytosis (38.1%) and elevated CSF protein (28.6%). 4. Fifteen patients were recovered completely without neurological sequelae. Three patients in group I and 1 patient in group II had intractable seizures. Two patients in group I and 2 patients in group II had motor disturbance. Conclusion : There were no statistically significant differences in preceding events, presenting symptoms, and neurological outcomes according to the distribution of the lesions on brain MRI. However, the ADEM have quite diverse clinical manifestations and neuroimage findings. MRI plays an important role in making diagnosis of the patients who are suspected of ADEM.

A Study on the Residents' Perception about New Towns of Seoul Metropolitan Area (수도권 신도시에 대한 주민의 인식 평가 연구)

  • Yoon, Jeong-Joong;Yoon, Jeong-Ran
    • Journal of the Korean Regional Science Association
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    • v.35 no.3
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    • pp.45-58
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    • 2019
  • The government is recently pushing for five large-scale public housing sites near Seoul, the so-called third wave of new towns. In this regard, this study sought to analyze the key considerations in planning new towns from the perspective of the residents who are the consumers, using survey data. For this purpose, frequency analysis and variance analysis(ANOVA) were conducted on existing first and second era of new towns and the third era of new towns scheduled for construction. Eight indicators, such as environmental comfort, self-sufficiency such as jobs, transportation access and convenience, were set as subordinate variables, and characteristics of residents, including gender, age, number of households, household income, occupation, and residential areas, were set as explanatory variables. According to the analysis, the respondents rated the first era of new towns more positively than the second era of new towns. For self-sufficiency items such as jobs, both the first and second era of new towns showed low levels. In addition, for the eight indicators, the first era of new towns were no significant differences depending on gender, number of households, or household income, and the second era of new towns were no significant differences by the number of households, household income, occupations or place of residence. However, for new towns in the third period, the assessment of the importance of each indicator by age, number of households, household income and occupation showed significant differences. The results of the multi-comparison analysis of the third era of new towns showed that the importance of environmental comfort was highly valued by the youth, the managerial/professional/clerical position, single or five more persons of household, and the youth, high income household, the managerial/professional/clerical position when it comes to accessibility and convenience of transportation. It suggests that various personal characteristics and demands for each of the planning indicators need to be considered in planning for the third era of new towns.

A Study of Efficient Measures for Installing and Managing Traditional Market Arcades (전통시장 아케이드의 설치 및 관리 효율화 방안 연구)

  • Kim, Young-Ki;Kang, Heon-Soo;Kim, Seung-Hee
    • Journal of Distribution Science
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    • v.10 no.3
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    • pp.15-30
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    • 2012
  • It has been 10 years since the facility modernization projects of traditional markets was rigorously undertaken. Although more than 835 traditional Korean markets nationwide have already completed these projects, there does not exist a specific set of standards of installation, future maintenance, and management. As a result, the complaints made by civil stakeholders in accordance of the actual facility installation caused problems and delays of related projects. In addition, while some local governments secured and implemented their own differing standards, others have not yet established their own separate standards for maintenance and management. Specifically, 694 traditional markets nationwide were supported for the cost of installing arcades by 2010. For the short period of time after the arcade-supported projects were deployed, the number of the traditional markets had been rapidly growing as a prime example of the facility modernization projects. The arcade facilities are being planned and installed merely for screening the rain or the sun. Without fundamental data for the newly landscaped environments or information on the actual conditions of usage and assessment, there is a lack of comprehensive approaches that could possibly organize the public environments. Furthermore, the amount of support needed for repairs, maintenance, and management from the central and local governments is gradually increasing. Thus, it becomes both crucial and necessary to complement the current set of standards. The purpose of this study is to examine the actual conditions of usage, maintenance, and management among those traditional market facilities that were installed with the supports of the facility-modernization projects, especially for arcades. This will be carried out through investigating the local problems, issues, and considering international case studies. The results of this study will provide measures for effective and efficient installation and management of traditional market arcades. Improvements in the use of public resources could be directed towards transforming public business, as well as public enhancement and functional maintenance and reinforcement. Under this condition, the arcade is not a simple area to avoid rain or sunlight; it becomes a public space. It is highlighted that the arcade should establish its public business not only to activate markets but also to refine street environments and revitalize local communities. A more specific way to improve is introduced through systematic supplementation. This is needed to attract effective participation from local residents and is done so by conducting a fair procedure from the first stage of business and by providing guidelines for establishing arcades as public facilities. The study points out to the problem of merchants-centered plans and street use. It presents the need to expand to involve residents and customers. Given that the arcade is a public facility and merchants' ability to maintain it is limited, manuals and systems for its maintenance needs to be introduced through multi-party agreement of merchants, government, residents and customers.

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Status of health and nutritional intake of the elderly in long-term care facilities: focus on Gwangju Metropolitan City (노인의료복지시설 입소 노인의 건강 상태 및 영양소 섭취 현황: 광주광역시를 중심으로)

  • Han, Gyusang;Yang, Eunju
    • Journal of Nutrition and Health
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    • v.53 no.1
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    • pp.27-38
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    • 2020
  • Purpose: This study assessed the food intake and nutritional status of the elderly in long-term care facilities in order to provide adequate food services and improve the nutritional status. Methods: The survey was carried out from August 2019 to October 2019 for the elderly in long-term care facilities located in Gwangju Metropolitan City. The survey was conducted to collect data from 199 elderly persons (34 males and 165 females) aged over 65 years old. The food intake was assessed using a 1-day 24-hour recall method. Results: More than 90% of the subjects were over 75 years old. Forty five percent of the subjects were active, 44.2% of the subjects perceived themselves as not being healthy. Dementia and Parkinson's disease were the most common diseases, followed by hypertension, musculo-skeletal disease, diabetes, and stroke. Only 25.6% of the subjects had most of their teeth intact, and 44.7% of the subjects had difficulty in chewing and swallowing. The total food intake was 1,127 g in males and 1,078 g in females. The most frequently consumed foods were kimchi, cooked rice with multi-grains, soybean soup, cooked rice with white rice, yogurt, pumpkin porridge, soy milk, and duck soup. The average energy intake of the subjects was 1,564.9 kcal in males and 1,535.5 kcal in females. The overall nutritional status of the elderly in the long-term care facilities was poor. In particular, the intake of vitamin D and calcium, vitamin C, riboflavin, and potassium were very low. The intake of vitamin D was 5 ㎍, and 86.4% of the elderly were below the estimated average requirement, while the intake of sodium was high. Conclusion: The results of this study can be used to understand the health and nutritional status and to improve the food services and nutrition management for the elderly in longterm care facilities.

Evaluate the implementation of Volumetric Modulated Arc Therapy QA in the radiation therapy treatment according to Various factors by using the Portal Dosimetry (용적변조회전 방사선치료에서 Portal Dosimetry를 이용한 선량평가의 재현성 분석)

  • Kim, Se Hyeon;Bae, Sun Myung;Seo, Dong Rin;Kang, Tae Young;Baek, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.167-174
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    • 2015
  • Purpose : The pre-treatment QA using Portal dosimetry for Volumetric Arc Therapy To analyze whether maintaining the reproducibility depending on various factors. Materials and Methods : Test was used for TrueBeam STx$^{TM}$ (Ver.1.5, Varian, USA). Varian Eclipse Treatment planning system(TPS) was used for planning with total of seven patients include head and neck cancer, lung cancer, prostate cancer, and cervical cancer was established for a Portal dosimetry QA plan. In order to measure these plans, Portal Dosimetry application (Ver.10) (Varian) and Portal Vision aS1000 Imager was used. Each Points of QA was determined by dividing, before and after morning treatment, and the after afternoon treatment ended (after 4 hours). Calibration of EPID(Dark field correction, Flood field correction, Dose normalization) was implemented before Every QA measure points. MLC initialize was implemented after each QA points and QA was retried. Also before QA measurements, Beam Ouput at the each of QA points was measured using the Water Phantom and Ionization chamber(IBA dosimetry, Germany). Results : The mean values of the Gamma pass rate(GPR, 3%, 3mm) for every patients between morning, afternoon and evening was 97.3%, 96.1%, 95.4% and the patient's showing maximum difference was 95.7%, 94.2% 93.7%. The mean value of GPR before and after EPID calibration were 95.94%, 96.01%. The mean value of Beam Output were 100.45%, 100.46%, 100.59% at each QA points. The mean value of GPR before and after MLC initialization were 95.83%, 96.40%. Conclusion : Maintain the reproducibility of the Portal Dosimetry as a VMAT QA tool required management of the various factors that can affect the dosimetry.

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Evaluation of the sodium intake reduction plan for a local government and evidence-based reestablishment of objectives: Case of the Seoul Metropolitan Government (지자체의 나트륨 섭취 감소 계획 평가 및 근거 기반 목표 재설정 : 서울시 사례를 중심으로)

  • Lim, A-Hyun;Hwang, Ji-Yun;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.50 no.6
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    • pp.664-678
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    • 2017
  • Purpose: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. Methods: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. Results: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. Conclusion: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.