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Renal Manifestations and Imaging Studies of Kawasaki Disease (가와사키 질환에서의 신증상과 영상 검사 소견)

  • Oh, Ji Young;Park, Se Jin;Kim, Sun Jung;Jang, Gwang-Cheon;Kim, Uria;Shin, Jae Il;Kim, Kee Hyuck
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.86-91
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    • 2013
  • Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.

Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density (골다공증 진단을 위한 초음파 변수의 골밀도에 대한 의존성)

  • Hwang, Kyo Seung;Kim, Yoon Mi;Park, Jong Chan;Choi, Min Joo;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.502-508
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    • 2012
  • Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

Acute toxicity effets of formaline to flounder, Paralichthys olivaceus (넙치 (Paralichthys olivaceus)에 대한 포르말린의 급성독성 효과)

  • Park, In-Seok;Kim, Hyung-Bae;Kim, Min-Suk;Park, Chul-Won
    • Journal of fish pathology
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    • v.8 no.1
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    • pp.57-67
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    • 1995
  • Twenty-four hours, acute toxicity and the histopathological effect of formaline to flounder, Paralichthys olivaceus larvae were examined. The $LC_{50}$ values obtained to farmaline were 2,520 ppm in 1 hour treatment. 1.610 ppm in 2 hours treatment, 868 ppm in 4 hours treatment and 141 ppm in 24 hours treatment. Many pathological features such as hypertrophy of mucous and epithelial cells in secondary gill lamella, hyaline droplet degeneration of tubular epithelial cells in the proximal convoluted segment of renal tubules, focal or massive necrosis in liver cells and pycnotic nucleus in heart cells were recognized. The above results were discussed in relation to the application of formaline as therapeutic agent in flounder disease.

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Effect of Titanium Prosthesis on Computed Tomography Measurements of Bone Mineral Density

  • Han, S.M.;Zude Feng
    • Journal of Biomedical Engineering Research
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    • v.19 no.2
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    • pp.177-182
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    • 1998
  • This study investigated the effects of a titanium prosthesis, malalignment, field of view, and distal flare of titanium prosthesis on computed tomography( CT) measurements of home mineral density. Eight femora and eight tibiae from fresh male cadavers were used. Fifteen pieces of cancellous bone from the proximal tibiae were milled into rectangular parallelepipeds. Parallelepipeds and femors were scanned with and without titanium prosthesis when centered in the gantry of the CT scanner and malaligned, respectively. Image data were then reconstructed with field of view of 10 and 30 cm. Bone mineral density(BMD) values were obtained from CT images using C-MED software. The effects of titanium prosthesis, malalignmetn, and field of view were investigated. When bone was centered in the gantry of the CT scanner, the mean relative difference of BMD measurements caused by a titanium prosthesis was less than 1% for both cortical and cancellous bone. Field of view had negligible effect on BMD measurements as well. Malalignment and distal flare of prosthesis, however, caused a significant difference in BMD measurements(p<0.0001). The titanium prosthesis did not interfere with malalignment combining the existence of a titnium prosthesis on BMD measurements was significant.

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A Finite Element Simulation of Cancellous Bone Remodeling Based on Volumetric Strain (스폰지 뼈의 Remodeling 예측을 위한 체적 변형률을 이용한 유한요소 알고리즘)

  • Kim, Young;Vanderby, Ray
    • Journal of Biomedical Engineering Research
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    • v.21 no.4
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    • pp.373-384
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    • 2000
  • The goal of this paper is to develop a computational method to predict cancellous bone density distributions based upon continuum levels of volumetric strain. Volumetric strain is defined as the summation of normal strains, excluding shear strains, within an elastic range of loadings. Volumetric strain at a particular location in a cancellous structure changes with changes of the boundary conditions (prescribed displacements, tractions, and pressure). This change in the volumetric strain is postulated to predict the adaptive change in the bone apparent density. This bone remodeling theory based on volumetric strain is then used with the finite element method to compute the apparent density distribution for cancellous bone in both lumbar spine and proximal femur using an iterative algorithm, considering the dead zone of strain stimuli. The apparent density distribution of cancellous bone predicted by this method has the same pattern as experimental data reported in the literature (Wolff 1892, Keller et al. 1989, Cody et al. 1992). The resulting bone apparent density distributions predict Young's modulus and strength distributions throughout cancellous bone in agreement with the literature (Keller et al. 1989, Carter and Hayes 1977). The method was convergent and sensitive to changes in boundary conditions. Therefore, the computational algorithm of the present study appears to be a useful approach to predict the apparent density distribution of cancellous bone (i.e. a numerical approximation for Wolff's Law)

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Comparison of Intraoperative Somatosensory Evoked Potential(SSEP) Monitoring During Aneurysm Surgery : ACA Aneurysms vs MCA Aneurysms (전대뇌동맥과 중대뇌동맥 동맥류 수술시 체성감각유발전위의 모니터링의 비교, 분석)

  • Choi, Kwang Yeong;Kim, Gook Ki;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.281-288
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    • 2001
  • Objectives : The purpose of this study is to evaluate the usefulness of SSEP monitoring during intracranial aneurysm surgery and compare the characteristics of wave change in relation to neurologic changes between ACA aneurysms and MCA aneurysms. Methods : During recent three years(between January 1997 and November 1999), intraoperative SSEP monitoring had been done in 63 operations for intracranial aneurysms. We had monitored the median nerve SSEP during surgery for aneurysms of MCA and the posterior tibial nerve SSEP for aneurysms of ACoA or ACA. A more than 50% reduction of any cortical SEP response was considered to be a significant SEP change, compared to its baseline value before the start of surgery. Changes in the SEPs were categorized as follows : Type IA, no significant amplitude changes without temporary clipping ; Type IB, no significant amplitude changes with temporary clipping ; Type II, significant changes with temporary clipping and complete return to control amplitude ; Type III, significant changes with temporary clipping and incomplete return to control amplitude ; Type IV, significant changes with temporary clipping and more decreased amplitude changes. Results : Among the 63 intraoperative monitoring, there were 37 cases of ACA aneurysms(An), and 26 of MCA An. The temporary proximal arterial occlusion during surgery were performed in 31(83.8%)cases of ACA An, 22(84.6%) of MCA An. Seven of the 31 ACA An(22.6%) and ten of the 22 MCA An(45.5%) had significant changes. The type were as follows : 4 patients with type II and 3 with type III in the ACA An ; 3 patients with type II and 3 with type III and 4 with type IV in the MCA An. In both group type II changes had no new postoperative neurological deficit. All 6 patients with type III had new neurological deficits ; However, One case in the ACA An and two cases in the MCA An. had transient neurologic deficit and improved markedly over the next two months. All 4 type IV changes in the MCA An. had permanant neurologic deficits. Two out of 30 cases(6.7%) in the ACA An. and one out of 16 cases(6.3%) in the MCA An. without significant amplitude change had new neurologic deficit postoperatively. Conclusion : Based on this study, Intraoperative SSEP monitoring during aneurysm surgery would provide useful information for detecting cerebral ischemia. SSEP response during surgery for MCA An. is more sensitive than ACA An. Otherwise, there were no meaningful difference in rate of false negativity.

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Cerebrospinal Fluid Lumbar Tapping Utilization for Suspected Ventriculoperitoneal Shunt Under-Drainage Malfunctions

  • Lee, Jong-Beom;Ahn, Ho-Young;Lee, Hong-Jae;Yang, Ji-Ho;Yi, Jin-Seok;Lee, Il-Woo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.1-7
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    • 2017
  • Objective : The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. Methods : We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. Results : The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were $2.21{\pm}24.57mmH_2O$. The frequency of CSF lumbar tapping was $2.06{\pm}1.26times$. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was $-3.69{\pm}19.20mmH_2O$. The mean frequency of CSF lumbar tapping was $2.07{\pm}1.25times$. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was $38.07{\pm}23.58mmH_2O$. The mean frequency of CSF lumbar tapping was $1.44{\pm}1.01times$. Pressure difference greater than $35mmH_2O$ was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. Conclusion : Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is $35mmH_2O$ higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

Tuberous Sclerosis Complex with Crohn's Disease (크론병과 병발한 결절성경화증 1예)

  • Kim, Min Hee;Lee, Yoon Jin;Kim, Jae Young;Yi, Yoon Young;Kang, Joon Won
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.284-287
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    • 2018
  • Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutation of one of two genes, TSC1 (encoding hamartin, 9q34) and TSC2 (encoding tuberin, 16p13). It invades the central nervous system and various parts of the body, causing various symptoms. Crohn's disease (CD) is a chronic immune-mediated disease that has not been clearly elucidated. It is thought to be caused by an excessive immune response of the body to bacteria that normally exist in the digestive tract with genetic factors. No cases have been reported in which both of the above-mentioned diseases occurred simultaneously. We report a case of CD in a patient with TSC. A 12-year-old boy was brought to our hospital because of abdominal pain. Skin lesions were observed in the TSC. Fundus examination revealed a hamartoma in the right retina. Brain magnetic resonance imaging revealed a subendothelial giant cell astrocytoma (SEGA). On the basis of these findings, he was diagnosed as having TSC. Blood test results showed increased levels of inflammatory markers. On abdominal ultrasonography, his colon walls were observed to be thickened with increased vascularity of the proximal ascending colon, ileocecal valve, and terminal ileum. Colonoscopy revealed discontinuous ulcerations and inflammations of the ileum, IC valve, and cecum, similar to those found in CD. Everolimus was administered orally for the SEGA but was discontinued frequently owing to the exacerbation of CD. The possibility of CD should be kept in mind in patients with TSC considering to undergo treatment for SEGA.

Development of Social Work Strategies for School-linked services - Based on Latent Class Growth Analysis of Delinquent Behaviors in adolescence - (학교연계 서비스를 위한 사회복지실천 전략 개발 - 청소년기 경비행행동의 차별적 발달궤적에 대한 잠재계층성장분석 -)

  • Lee, Sang-Gyun
    • Korean Journal of Social Welfare Studies
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    • v.40 no.3
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    • pp.377-406
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    • 2009
  • This study used laten class growth analysis to identify discrete developmental patterns of delinquent behaviors in adolescence. This present article also examined associations among these trajectories to determine how the development of delinquent behaviors relates to protective and risk factors, which include parental monitoring, attachment with parent, association with deviant peers, self-control, and negative stigma from others. Four-wave panel data from a Korea Youth Panel Study were used for the latent class growth model analysis. The sample consisted of 3,446 adolescents who were assessed at 4 measurement waves with approximately 1-year interval. Four trajectories of delinquent behaviors emerged: delinquency persistence, delinquency increaser, delinquency decreaser, normative group(almost no delinquent behaviors). Association with deviant peers had the most proximal strong influence on the probability of being in the delinquency increaser and delinquency persistence group compared, noed to the normative group. Parental monitoring, self-efficacy and negative stigma also differentiated the four delinquent behavior trajectories from one another after controllig for socio-demographic variables. The study suggested that there is a significant heterogeneity in the timing and change rate of delinquency progression. Adolescent delinquency prevention and intervention programs will need to consider this heterogeneity and enhance attention to protective and risk factors depending on the subpopulation.

A Study on the Relationship of Climacteric Women's Vasomotor Symptoms and Body Temperature, Kidney Deficiency Pattern (腎虛證) (폐경기 여성의 혈관운동성 증상과 체열분포, 신허증 변증유형의 상관성 연구)

  • Kim, Min-Young;Ahn, Ji-Yoon;Hwang, Deok-Sang;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Kyung-Sub;Lee, Chang-Hoon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.3
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    • pp.66-78
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    • 2014
  • Objectives: The purpose of this study is to investigate the relationship between vasomotor symptoms with upper-lower body temperature differences, and to identify Kidney Deficiency pattern (腎虛證) in menopausal women. Methods: 51 women who visited Kangnam Kyung-Hee Oriental Hospital from July to December, 2013 were analyzed. The experimental group consisted of 30 patients reported with vasomotor symptoms (Vasomotor symptom group, VG), while the control group consisted of 21 patients without vasomotor symptoms (Control group, CG). According to their chief complaints, VG was further divided into VHG (vasomotor-hot flash group) and VCG (vasomotor-cold hypersensitivity group). The temperature differences between upper and lower body part (CV17-CV4), proximal and distal extremity part (LU4-HT8, ST32-LR3) were checked. All patients reported other complaints such as headache, sweating, anxiety, dyspepsia, leukorrhea, which belong to Kidney Yang Deficiency pattern (腎陽虛證) or Kidney Yin Deficiency pattern (腎陰虛證). The relationship between vasomotor symptom and repetition rate of additional complaints were analyzed. Results: Statistical analysis showed that lower abdomen temperature of experimental group was lower than the control group. Temperature differences of upper and lower body (CV17-CV4) was significantly larger in vasomotor symptom group. VHG had more symptoms of sweating, chest discomfort, constipation, which belong to Kidney Yang Deficiency pattern group. VCG had more symptoms of leukorrhea, diarrhea, and dyspepsia, which belong to Kidney Yin Deficiency pattern group. Conclusions: Climacteric women who suffered from vasomotor symptoms showed lower temperature tendency in [CV4], larger temperature differences in [CV17-CV4] compared to the control group. Among them, VHG showed more symptoms of Kidney Yin Deficiency pattern, whereas VCG showed more symptoms of Kidney Yang Deficiency pattern.