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Voiding cystourethrography in children with an initial episode of febrile urinary tract infection (생후 처음으로 발생한 발열성 요로감염 환자의 배뇨성 방광 요도 조영술)

  • Lee, Hae Jeong;Lee, Won Deok;Kim, Hyun Seok;Kim, Tae Hong;Lee, Joo Seok;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.653-658
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    • 2006
  • Purpose : Because voiding cystourethrography(VCUG) is an invasive method, we studied whether VCUG could be postponed through evaluation of alternative non-invasive tests including renal ultrasonography and $^{99m}Tc$-DMSA renal scan. Methods : We reviewed the medical records of 175 patients initially diagnosed with febrile urinary tract infection during the one year period of 1999, and compared 3-tests : renal ultrasongraphy, $^{99m}Tc$-DMSA renal scan, and VCUG. Results : Renal ultrasonography didn't contribute to the prognostication of pyelonephritis(photopenic areas) or vesicoureteral reflux(VUR). Presentation of photopenic areas in $^{99m}Tc$-DMSA renal scan was related to VUR. If both findings of renal ultrasonography and $^{99m}Tc$-DMSA renal scans were normal, this condition was closely related to normal results in VCUG. And if both examinations were abnormal, the condition was closely related to VUR. But this state could not always guarantee the normal result from VCUG because of low sensitivity in finding VUR. Conclusion : In cases in which acute phyelonephritis is demonstrated by $^{99m}Tc$-DMSA renal scan, VCUG is required. In addition to this, if the conditions of hydronephrosis, vesicoureteral dilatation, increases of renal volume, and changes of echogenesity are shown by renal ultrasonography, VCUG should be performed. If a patient has difficulty undergoing VCUG, temporary postponement of VCUG can be taken into consideration, but only in cases where both examinations of renal ultrasonography and $^{99m}Tc$-DMSA renal scan are normal. Nevertheless, close observation is be advised even in this case.

The Study for Results of Complex Cystic Breast Masses by Biopsy on Ultrasound (초음파상 복합성 낭성 유방 종괴의 조직 검사 결과에 관한 연구)

  • Kang, Hye-Kyoung;Dong, Kyung-Rae
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.129-134
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    • 2008
  • Purpose: We examined the roles of Ultrasonography conductors by analyzing the results of tissue biopsy of complex cystic masse under the guidance of breast US. Objects and methods: This study was performed to a group of 178 who showed breast US indicating complex cystic masses among 342 patients who were definitely diagnosed by tissue biopsies and operations in our hospital from June 30th, 2003 to June 30th, 2007. The evaluation of tissues around, calcification, the distribution state of blood flow were excluded from the analysis subjects and logic 200 made by GE corporation and gun for core biopsy(Kimal corp., K7/MBD23) were used in this study. Results: The biopsy results of 178 subjects showed FCC (fibrocystic change)(n=56 : 31.4%), Fibrosis (n=41 : 23.0%), Fibroadenoma (n=20 : 11.2%), Epithelial hyperplasia (n=17 : 9.6%), Carcinoma (n=15 : 8.4%), Fibroadipose (n=8 : 4.5%), Sclerosing adenosis (n=7 : 3.9%), Duct ectasia (n=5 : 2.8%), Papiloma (n=5 : 2.8%), and Fat necrosis (n=1 : 0.6%), Hemangioma (n=1 : 0.6%), Abscess (n=1 : 0.6%), Dystrophic calcification(n=1 : 0.6%). Conclusion: The US showed that the results of the tissue biopsy of complex cystic masses were mostly carcinoma(8.4%). Most of them were benign and only 9.6% of epithelial hyperplasia which has high progression rate into malignant tumors epidemically showed malignancy. Most of them were included in the spectrum of fibrous cystic nodule. Even though these results are confirmed, further studies are required. As a result, a nodule which is not certified by US should be right to take the tissue biopsy, but if it's difficult due to patients or another reasons, re-check tests in three months are required. And systemic ultrasonography evaluation should be well recognized to conduct more careful and specific tests.

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Application of Ultrasonic Nano Crystal Surface Modification into Nitinol Stent Wire to Improve Mechanical Characteristics (나이티놀 스텐트 와이어의 기계적 특성 향상을 위한 초음파 나노표면 개질 처리에 대한 연구)

  • Kim, Sang-Ho;Suh, Tae-Suk;Lee, Chang-Soon;Park, In-Gyu;Cho, In-Sik;Pyoun, Young-Shik;Kim, Seong-Hyeon
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.80-87
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    • 2009
  • Phase transformation, superelastic characteristics and variation of surface residual stress were studied for Nitinol shape memory alloy through application of UNSM technology, and life extension methods of stent were also studied by using elastic resilience and corrosion resistance. Nitinol wire of ${\phi}1.778$ mm showed similar surface roughness before and after UNSM treatment, but drawing traces and micro defects were all removed by UNSM treatment. It also changed the surface residual stress from tensile to compressive values, and XRD result showed less intensive austenite peak and clear martensite and additional R-phase peaks after UNSM treatment. Fatigue resistance could be greatly improved through removal of surface defects and rearrangement of surface residual stress from tensile to compressive state, and development of surface modification system to improve not only bio-compatability but also resistance to corrosion and wear will make it possible to develop vascular stent which can be used for circulating system diseases which run first cause of death of recent Koreans.

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Histopathologic Diagnosis and Outcome of Renal Biopsied Pediatric Nephrotic Syndrome (신생검을 받은 소아 신증후군에서 조직병리 소견과 치료 성과)

  • Chung Hye-Jeon;Youn Suk;Kim Sung-Do;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.149-158
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    • 2005
  • Purpose : To determine the histological findings and treatment outcome in cases of child hood nephrotic syndrome which required renal biopsy. Methods : We retrospectively reviewed the clinical, laboratory, pathologic findings and therapeutic outcomes of 159 nephrotic children who received a renal biopsy at the Department of Pediatrics, Kyunghee Medical University Hospital, Seoul from 1984 to 2004 over a period of 21 years. The renal biopsy was performed in nephrotic children who showed atypical features at presentation, or needed cytotoxic therapy because of frequent-relapsing, steroid-dependent, or steroid-resistant nephrotic syndrome(SRNS). Results : Minimal change disease(MCD) was found in 52.1$\%$ of the patients, followed by diffuse mesangial proliferation(33.1$\%$), focal segmental gomerulosclerosis(5.3$\%$), membranoproliferative glomerulonephritis(2.4$\%$), membranous nephropathy(2.4$\%$), and IgA nephropathy(1.8$\%$). In MCD children, 14.8$\%$ had hematuria, 22.7$\%$ had hypertension, 5.7$\%$ showed decreased renal function, and no patient was found to have an abnormal complement level. Among patients diagnosed with diseases other than MCD, 43.2$\%$ had hematuria, 21.0$\%$ was found to be hypertensive, 7.4$\%$ of children showed decreased renal function and only 3(3.7$\%$) had decreased complement level; the rates of hematuria and SRNS were found to be significantly higher than MCD patients. Among 37 SRNS patients, 30(81.0$\%$) showed a final remission state with long-term steroid therapy, including methylprednisolone pulse therapy, over 4 months, with or without cytotoxic therapy. Conclusion : Almost half of the cases of childhood nephrotic syndrome requiring renal biopsy were not diagnosed with MCD. Among atypical features, hematuria and steroid-resistance would be the most probable indicators for a diagnosis other than MCD. Even in patients with SRNS, long-term methylprednisolone pulse therapy may result in a good remission rate. (J Korean Soc Pediatr Nephrol 2005;9:149-158)

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Estimation of POC Export Fluxes Using 234Th/238U Disequilibria in the Amundsen Sea, Antarctica; Preliminary Result (남극 아문젠해에서 234Th/238U 비평형법을 사용한 유광대에서 심층으로의 입자상 유기탄소 침강플럭스 추정; 예비결과)

  • Kim, Mi Seon;Choi, Man Sik;Lee, Sang Heon;Lee, Sang Hoon;Rhee, Tae Siek;Hahm, Doshik
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.2
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    • pp.109-124
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    • 2014
  • In order to understand the carbon cycle in the Amundsen Sea of the Southern Ocean, the export fluxes of particulate organic carbon from the euphotic zone to deep water estimated using ${\psi}$/${\psi}$ disequilibrium method. Seawaters in 14 water columns were collected during February and March 2012, and analyzed for total and dissolved ${\psi}$, and particulate organic carbon. Total ${\psi}$ activities in the water column showed deficiency and excess relative to those of ${\psi}$ depending on the water depth. Deficiency of total ${\psi}$ in the euphotic zone showed mirror images both with chlorophyll-a and fluorescence, and was consistent with the loss of nitrate, which indicated the effect of biological activity. In addition, deficiency of total ${\psi}$ from deep water was associated with the increase of total dissolvable Fe/Mn concentration. Excess total ${\psi}$ activity presented below the euphotic zone might be related to particulate ${\psi}$ concentrated in this water depth. Mean export flux of ${\psi}$ estimated using the steady state model was $867{\pm}246dpmm^{-2}day^{-1}$. Mean export flux of particulate organic carbon, which were estimated by the product of total ${\psi}$ flux and ratio of POC/${\psi}$ ($7.08{\pm}4.27{\mu}molCdpm^{-1}$) in the sinking particles, was $5.9{\pm}3.9mmolCm^{-2}day^{-1}$. These fluxes were similar levels to those in the Weddell Sea during February and March 2008. Export ratios (ThE) relative to the primary production in the euphotic zone were in the range of 3-54% (av. 28%).

Differentiation between Morgagni Hernia and Pleuropericardial Fat with Using CT Findings (CT 소견을 이용한 Morgagni 탈장과 심막주위지방의 감별)

  • Kim Sung-Jin;Cho Beum-Sang;Lee Seung-Young;Bae Il-Hun;Han Ki-Seok;Lee Ki-Man;Hong Jong-Myeon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.573-578
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    • 2006
  • Background: Generally hernia is diagnosed with simple chest or gastrointestinal x-ray. Sometimes CT or MRI can give lots of information for the diagnosis. However, there was no study for the differentiation with using CT findings between Morgagni hernia and pleuropericardial fat. The aim of this study was to evaluate the useful CT findings for differentiating Morgagni hernia from pleuropericardial fat. Material and Method: We retrospectively analyzed CT scans of eight patients with Morgagni hernia and 20 patients with abundant pleuropericardial fat without peridiaphragmatic lesions. All CT scans were performed with coverage of the whole diaphragm in the inspiration state. We evaluated 1) the presence of the defect of the anterior diaphragm, 2) the interface between the lung and fat, 3) the angle between the chest wall and fat, 4) the continuity between the extrapleural fat and fat, 5) the presence of the vessels within fat, and 6) the presence of a thin line surrounding fat. Result: In all cases with Morgagni hernia, the defect of the anterior diaphragm was seen. The interface was well-defined, smooth, and convex to the lung. The angle with the chest wall was acute. The continuity with the extrapleural fat was not seen. In the cases with abundant pleuropericardial fat, the defect of the anterior diaphragm was seen in three (15%). The interface was usually irregular (n=10) and flat (n=17). The angle with the chest wall was variable. The continuity with the extrapleural fat, that was markedly increased in amount, was usually seen (n=16). The thin line surrounding fat was seen in four cases with Morgagni hernia, however, not seen in all cases with pleuropericardial fat. All of the above findings were statistically significant, however, vessels within fat was not significant to differentiate Morgagni hernia (n=8/8) from pleuropericardial fat (n=14/20). Conclusion: The useful CT findings of Morgagni hernia were fatty mass with sharp margin, convexity toward lung, acute angle with chest wall, and thin line surrounding hernia. Branching structure within fatty mass representing omental vessels that has been known as a characteristic finding of Morgagni hernia was not useful for differentiating Morgagni hernia from pleuropericardial fat.

The Heart Rate and ECG Changes after Endoscopic Thoracic Sympathectomy in Patients with Primary Hyperhidrosis (원발성 다한증 환자에서 흉부 교감 신경 차단술 후의 심박동수 및 심전도 변화)

  • Kim, Jae-Jun;Kim, Young-Du;Park, Chan-Beom;Moon, Seok-Whan;Cho, Deog-Gon;Sa, Young-Jo;Seo, Jong-Hee;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.214-219
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    • 2009
  • Background: Primary focal hyperhidrosis is characterized by overactivity of the sympathetic nervous function, and this has been effectively treated with endoscopic thoracic sympathetic denervation (ESD). The imbalance of sympathetic and parasympathetic nervous system that's created by ESD may affect the heart, lung and other thoracic organs. We analyzed the heart rate and ECG changes after performing ESD at our hospital, and this is the first such study that has been conducted on this. Material and Method: Of the 263 patients who underwent ESD between October 1996 and October 2006, 130 had ECG before and after ESD, and they were classified into 3 groups according to the level of ESD: Group I (n=40) patients underwent ESD at the 2nd rib (T2ESD), Group II (n=80) at the 3rd rib (T3ESD) and Group III (n=10) at the 4th rib (T4ESD). Result: There was no mortality or major morbidity. Heart rate (HR) was significantly decreased from $71.6{\pm}10.6/min\;to\;66.8{\pm}10.2/min$ after ESD (p<0.01); however, the PR (from $148.6{\pm}21.2$ msec to $152.8{\pm}20.5$ msec) and QTc (from $399.2{\pm}15.4$ msec to $404.0{\pm}15.1$ msec) intervals were significantly increased after ESD in the patients who suffered with primary hyperhidrosis (p<0.01). According to the level of ESD, there were significant changes in the HR and QTc interval in group I (T2ESD), the HR and PR interval in group II and the QTc interval in Group III. Conclusion: There were significant changes in the heart rate and ECG findings after ESD. The thoracic sympathetic denervation of T2, T3 and T4 affected the electrical activity of the heart at the resting state.

Effect of $PGE_2$ and $PGF_{2{\alpha}}$ on the Osmotic Fragility and Membrane $Ca^{++}$ Binding in Human Erythrocytes ($PGE_2$$PGF_{2{\alpha}}$가 삼투성 용혈 및 적혈구막 $Ca^{++}$결합에 미치는 영향)

  • Yeoun, Dong-Soo;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.135-142
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    • 1983
  • $PGE_2$ and $PGF_{2{\alpha}}$ are known to act similarly in a number of animal tissues. They both facilitate regression of corpus luteum(Poyser, 1972; Fuch et al, 1974; Coudert et at, 1974) and stimulate contraction of uterine muscle (Laudanski et al, 1977; Porter et al, 1979; Hollingsworth et al, 1980). It is, however, not known whether these two prostaglandins exert similar actions in osmotic fragility of erythrocytes (Rasmussen et al, 1975) and $PGF_{2{\alpha}}$ alters conformation of membrane proteins (Meyers aud Swislocki, 1974). The former effect may not be mediated through changes in c- AMP concentration in the cell, since the adenylate cyclase activity in human erythrocyte is extremely low (Rodan et al, 1976; Sutherland et al, 1962) and the latter effect implies that physical state (or fluidity) of the membrane is altered by $PGF_{2{\alpha}}$. The present study was undertaken to elucidate mechanisms of action of $PGE_2$ and $PGF_{2{\alpha}}$ on the human erythocyte membrane by examining their effects on osmotic fragility and $Ca^{++}$ binding to the membrane fragments. The results are summarized as follows: 1) $PGE_2$ and $PGF_{2{\alpha}}$ increased osmotic fragility at concentrations above $10^{11}\;M$, the effect being similar for both hormones. The concentration of NaCl for 100% hemolysis was $1/16{\sim}1/17\;M$ in the presence of $10^{11}\;M\;PGE_2$ or $PGF_{2{\alpha}}$ and 1/18 M in the absence of the hormone (control). 2) When erythrocytes were suspended in 1/15 M NaCl solution, $44.2{\pm}4.3%$ of cells were hemolyzed. Addition of $10^{12}\;M\;PGE_2$ or $PGF_{2{\alpha}}$ did not increase hemolysis. When the concentration of the hormones was increased to $10^{11}\;M$, however the degree of hemolysis increased markealy to about 80%. No further increase in hemolysis was observed at concentration of the hormones above $10^{11}\;M$. 3) The additional hemolysis due to $10^{11}\;M\;PGE_2$ and $PGF_{2{\alpha}}$ appeared to he identical regardless of absence or presence of $Ca^{++}\;(0.5{\sim}10\;mM)$ in the suspending medium. 4) In the absence of prostaglandin, the binding of $Ca^{++}$ to the erythrocyte membrane increased curvilinearly as the $Ca^{++}$ concentration increased up to 5 mM above which it leveled off. A similar dependence of $Ca^{++}$ binding on the $Ca^{++}$ concentration was observed in the presence of $10^{11}\;M\;PGE_2$ or $PGF_{2{\alpha}}$, however, the amount of $Ca^{++}$ bound at a given $Ca^{++}$ concentration was significantly higher than in the absence of the hormones. 5) As in the hemolysis, $PGE_2$ and $PGF_{2{\alpha}}$ did not affect the $Ca^{++}$ binding at a concentration of $10^{12}\;M$, but increased it by about 100% at concentration above $10^{11}\;M$. These result indicate that both tile osmotic fragility of erythrocyte and the $Ca^{++}$ binding to the erythrocyte membrane are similarly enhanced by $PGE_2$ and $PGF_{2{\alpha}}$, but these two effects are not causally related. It is, therefore, concluded that the prostaglandin-induced hemolysis is not directly associated with alterations of the $Ca^{++}$ content in the membrane.

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Evaluation on Usefulness of Abdomen and Chest Motion Control Device (ABCHES) for the Tumor with a Large Respiratory Motion in Radiotherapy (호흡으로 인한 움직임이 큰 종양의 방사선치료 시 Abdomen and Chest Motion Control Device (ABCHES)의 유용성 평가)

  • Cho, Yoon-Jin;Jeon, Mi-Jin;Shin, Dong-Bong;Kim, Jong-Dae;Kim, Sei-Joon;Ha, Jin-Sook;Im, Jung-Ho;Lee, Ik-Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.85-93
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    • 2012
  • Purpose: It is essential to minimize the respiratory-induced motion of involved organs in the Tomotherapy for tumor located in the chest and abdominal region. However, the application of breathing control system to Tomotherapy is limited. This study was aimed to investigate the possible application of the ABCHES system and its efficacy as a means of breathing control in the tomotherapy treatment. Materials and Methods: Five subjects who were treated with a Hi-Art Tomotherapy system for lung, liver, gallbladder and pancreatic tumors. All patients undertook trained on two breathing methodes using an ABCHES, free breathing methode and shallow breathing methode. When the patients could carry out the breathing control, 4D-CT scan was a total of 10 4D tomographic images were acquired. A radiologist resident manually drew the tumor region, including surrounding nomal organs, on each of CT images at the inhalation phase, the exhalation phase and the 40% phase (mid-inhalation) and average CT image. Those CT images were then exported to the Tomotherapy planning station. Data exported from the Tomotherapy planning station was analyzed to quantify characteristics of dose-volume histograms and motion of tumors. Organ motions under free breathing and shallow breathing were examined six directions, respectively. Radiation exposure to the surrounding organs were also measured and compared. Results: Organ motion is in the six directions with more than a 5 mm displacement. A total of 12 Organ motions occurred during free breathing while organ motions decreased to 2 times during shallow breathing under the use of Abches. Based on the quantitative analysis of the dose-volume histograms shallow breathing showed lower resulting values, compared to free breathing, in every measure. That is, treatment volume, the dose of radiation to the tumor and two surrounding normal organs (mean doses), the volume of healthy tissue exposed to radiation were lower at the shallow breathing state. Conclusion: This study proposes that the use of ABCHES is effective for the Tomotherapy treatment as it makes shortness of breathing easy for patients. Respiratory-induced tumor motion is minimized, and radiation exposure to surrounding normal tissues is also reduced as a result.

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A Study on Measures to Create Local Webtoon Ecosystem (지역웹툰 생태계 조성을 위한 방안 연구)

  • Choi, Sung-chun;Yoon, Ki-heon
    • Cartoon and Animation Studies
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    • s.51
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    • pp.181-201
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    • 2018
  • The cartoon industry in Korea has continued to decline due to the contraction of published comics market and decrease in the number of comic books rental stores until the 2000s when it rapidly started to experience qualitative changes and quantitative growth due to the emergence of webtoon. The market size of webtoon industry, valued at 420 billion won in 2015, is expected to grow to 880.5 billion won by 2018. Notably, most cartoonists who draw cartoon strips are using digital devices and producing scripts in data, thereby overcoming the geographical, spatial and physical limitation of contents. As a result, a favorable environment for the creation of local ecosystems is generated. While the infrastructures of human resources are steadily growing by region, cartoon industries that are supported by the government policy have shown good performance combined with factors of creative infrastructures in local areas such as webtoon experience centers, webtoon campuses and webtoon creation centers, etc. Nevertheless, it is true that cartoon infrastructures are substantially based on a capital area which leads to an imbalanced structure of cartoon industry. To see the statistics, companies of offline cartoon business in Seoul and Gyeonggi Province make up 87%, except for distribution industry. In addition, companies of online cartoon business which are situated outside of Seoul and Gyeonggi Province form merely 7.5%. Studies and research on local webtoon are inadequate. The existing studies on local webtoon usually focus on its industrial and economic values, mentioning the word "local" only sometimes. Therefore, this study looked into the current status of local webtoon of the present time for the current state of local cartoon ecosystem, middle and long-term support from the government, and an alternative in the future. Main challenges include the expansion of opportunities to enjoy cartoon cultures, the independence of cartoon infrastructure, and the settlement of regionally specialized cartoon cultures. It means that, in order to enable the cartoon ecosystem to settle down in local areas, it is vital to utilize and link basic infrastructures. Furthermore, it is necessary to consider independence and autonomy beyond the limited support by the government. Finally, webtoon should be designated as a culture, which can be a new direction of the development of local webtoon. Furthermore, desirable models should be continuously researched and studied, which are suitable for each region and connect them with regional tourism, culture and art industry. It will allow the webtoon industry to soft land in the industry. Local webtoon, which is a growth engine of regions and main contents of the fourth industrial revolution, is expected to be a momentum for the decentralization of power and reindustrialization of regions.