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Diagnostic Efficacy of Anorectal Manometry for the Diagnosis of Hirschsprung's Disease (Hirschsprung병에서 항문직장 내압검사의 진단적 유용성)

  • Chang, Soo-Hee;Min, Uoo-Gyung;Choi, Ok-Ja;Kim, Dae-Yeon;Kim, Seong-Chul;Yu, Chang-Sik;Kim, Jin-Cheon;Kim, In-Koo;Yoon, Jong-Hyun;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.1
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    • pp.24-31
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    • 2003
  • Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

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Comparison between 24 hr pH Monitoring and Esophageal Scintigrapy in Children Presenting with Gastroesophageal Reflux Symptoms (식도 동위 원소 검사와 24시간 식도 pH 검사와의 비교 연구)

  • Wi, Ho Sung;Kim, Yong Joo;Seol, In Joon;Choi, Yun Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.163-169
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    • 2004
  • Purpose: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. Methods: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. Results: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). Conclusion: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.

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A STUDY ABOUT ALVEOLAR CREST BONE HEIGHT BEFORE AND AFTER ORTHODONTIC TREATMENT BY USING BITEWING FILM (교익사진을 이용한 교정치료 전후의 치조골 높이 변화에 관한 연구)

  • Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.421-430
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    • 1997
  • Alveolar bone grows with development of tooth germs and roots; bone deposition occurs with tooth eruption. Bone components undergoes processes of resorption and deposition, and when the balance between them is disrupted, decrease in alveolar bone height or excessive bone deposition result. It has been hon that repositioning of teeth through orthodontic treatment can cause alveolar bone resorption which result in decreased alveolar bone height, and there have been many studies to evaluate such effects. X-ray films that could be replicated and standardized were chosen in clinical studies, and among them, bitewing films were used for objective evaluation of changes in alveolar bone level. Twenty subjects, 10 to 13-year- old (average 12.2) children with Cl I molar key, healthy oral condition, no congenital missing, no periodontal disease, and pre-and post-orthodontic bitewing films, were randomly selected for comparison of alveolar bone heights. Amounts of tooth and changes in alveolar bone heights were analyzed. The following results were obtained: 1. Amount of tooth movement in canine, premolar, and molar regions, changes in tooth axis, and changes in alveolar bone heights were measured, and the mean and median values were obtained. 2. When pre-and post-orthodontic alveolar bone levels were compared, larger changes were noticed in maxilla than mandible. 3. When mesio-distally compared, larger changes were observed in the distal sides of 3D3 and 4M3, mesial sides of 4M3 and 4D3, distal sides of 4D3 and 5M3, mesial sides of 5M3 and 5D3, md distal sides of 5D3 and 6M3. 4. When the amounts of tooth movements(TX, TY)and changes in tooth axis(A) were compared,34TX, 34TY, 34A of both sides in maxilla were greater, iud changes in alveolar bone level were greater than any other region.

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Impacts of Depression, Somatization, and Jaw Disability on Graded Chronic Pain in TMD Patients (우울, 신체화, 턱기능장애가 측두하악장애 환자의 만성통증척도에 미치는 영향)

  • Kim, Cheul;Shin, Eun-Seop;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.353-360
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    • 2005
  • The aim of this study was to investigate the impact of depression, somatization, and jaw disability on graded chronic pain of TMD using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Ninety-three patients (17 men and 76 women, mean$\pm$SD age of 30.1$\pm$12.5 years) diagnosed with TMD based on RDC/TMD axis I criteria were administered RDC/TMD axis II history questionnaire. The relationships between depression, somatization, jaw disability, and each parameters of graded chronic pain (e.g. pain intensity, pain days, disability score, disability days, graded chronic pain scale) were analyzed by multiple regression analysis. The obtained results were as follows: 1. Among 93 TMD patients, the prevalence of low disability group of graded chronic pain scale was 42.0% and high disability group of graded chronic pain scale was 51.5%. 2. Depression did not show any significant influences on pain intensity, pain days, disability score, disability days, and graded chronic pain scale. 3. Somatization showed a significant effect on pain intensity (p<0.01), disability days (p<0.01), and graded chronic pain scale (p<0.01) except for both pain days and disability score. 4. Jaw disability also showed a significant effect on pain intensity (P<0.001), disability days (p<0.01), and graded chronic pain scale (P<0.001) except for both pain days and disability score. Somatization and jaw disability may closely relate to the pain intensity and degree of disability that TMD patients perceive. Therefore, comprehensive understanding of psychological profile and improvement of functional limitation of jaw movements in the patient should be considered to obtain an excellent outcome of chronic TMD management.

Antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol (자몽종자추출물과 자일리톨이 배합된 껌의 치은염 예방 및 항균효과)

  • Jin, Mi-Sung;Yoo, Yun-Jung;Choi, Bong-Kyu;Lee, Hee-Young;Kim, Mi-Jung;Roh, Hoe-Jin;Park, Jong-Sub;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.33 no.3
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    • pp.485-497
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    • 2003
  • Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.

Effect of Radiation Dose for Radiotherapy on Ovarian Follicle Atresia in Rat (치료 방사선량이 쥐의 난포 퇴축에 미치는 영향)

  • Lee, Won-Jeong;Seon, Jong-Ryul;Yoo, Se-Jong;Ahn, Bong-Seon
    • Journal of Radiation Protection and Research
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    • v.37 no.4
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    • pp.208-212
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    • 2012
  • In previous studies, ovarian follicle in rat has been used a higher radiation dose than that for cancer radiotherapy in clinical practice. The aim of this study was to evaluate the effect of radiation dose used for cancer radiotherapy on ovarian follicle atresia in rat. Mice of 4-week-old female were whole body irradiated with 2 cGy or 2 Gy (Mevatron 67, Siemens, Germany) and sacrificed by cervical dislocation. Ovaries were collected at 24 hours after irradiation to observe the degree of follicular atresia. Ovaries were fixed in neutral formaldehyde solution for 24 hours and embedded with paraffin. Cutted in $5{\mu}m$ thickness with microtome and stained with hematoxylin and eosin (H&E) and TUNEL immunohistochemical stain, and examined histologically under a light microscope. All data were presented as mean ${\pm}SD$, calculating the ratio of normal or atretic follicles to total ovarian follicles. Statistical analysis was performed by the Mann Whitney test using the SPSS ver 19.0. Ratio of atretic to total follicles of 2 Gy group was significantly higher than control or 2 cGy groups (p<0.05). Ratio of normal to total follicles of 2 Gy group was significantly lower than control group in preantral follicle (64.0 vs. 87.7, p=0.027). Ratio of normal to total follicles of 2 cGy group was significantly increased more than control or 2 Gy groups in antral follicle, and there were no significant difference between control and 2 Gy groups (p=0.522). Radiation dose of 2 Gy for cancer radiotherapy have a significant effect on ovarian follicle atresia in rat.

Clinical Evaluation of Coronary Artery Fistula (관상동맥루의 임상적 고찰)

  • Lee Sak;Park Han-Ki;Lim Sang-Hyun;Hong You-Sun;Chang Byung-Chul;Kang Meyun-Shick;Cho Bum-Koo;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.699-704
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    • 2005
  • Background: Coronary artery fistula is rare congenital anomaly, which account for $0.27\~0.40\%$ of all congenital heart diseases. We report the clinical observations of 45 patients with coronary artery fistula. Material and Method: We reviewed all patients presented with or without symptoms of coronary artery fistula between 1987 and 2004. Age ranged from 1 to 83 years. Twenty-six patients were female. The patients were divided into 2 groups according to the presenting symptoms. Twelve patients were in group A (asymptomatic) and 33 patients in group B (symptomatic). The most common clinical presentation in group B was angina (18) followed by dyspnea (7), atypical chest pain (5), syncope (1), fatigue (1), and palpitation (1). Twenty-five patients were associated with other cardiac diseases, which were atrial septal defect (4), coronary artery occlusive disease (6), hypertension (12), and valvular heart disease (2). Result: Patients were followed-up for a mean period of $64.8\pm62.7$ months. There was no complication related to coronary artery fistula during the follow-up period in both group. There was no mortality related to coronary artery fistula. Conclusion: In symptomatic patients, early surgical treatment is recommended considering the low perioperative morbidity. In asymptomatic patients receiving medical treatment, close follow up may be necessary.

Reproducibility of the Assessment of Myocardial Function Using Gated Tc-99m-MIBI SPECT and Quantitative Software (게이트 Tc-99m-MIBI SPECT와 Cedars 소프트웨어를 이용한 심근 기능 측정의 재현성)

  • Lee, Dong-Soo;Cheon, Gi-Jeong;Ahn, Ji-Young;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.5
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    • pp.403-413
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    • 1998
  • Purpose: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. Materials and Methods: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT We used 16 frames per cycle for the gating of sequential Tc-99m-MIBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF). Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. Results: Enddiastolic volumes (EDV) ranged from 58 ml to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 ml to 174 ml (65 ml +/- 39 ml), and EF from 20% to 65% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval: 0.83-0.90) for assessment of wall thickening. Conclusion: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.

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Effects of Dietary ${\beta}-1,3$ Glucan on Growth and Immune Responses in Juvenile Olive Flounder, Paralichthys olivaceus (치어기 넙치 사료내 ${\beta}-1,3$ 글루칸의 첨가가 성장 및 비특이적 면역반응에 미치는 영향)

  • Kim, Young-Chul;Kim, Kang-Woong;Lee, Seung-Hyung;Park, Gun-Jun;Okorie, Okorie Eme;Kang, Yong-Jin;Bai, Sung-Chul C.
    • Journal of Aquaculture
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    • v.19 no.4
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    • pp.247-253
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    • 2006
  • This study was conducted to investigate the effects of dietary supplementation of ${\beta}-1,3$ glucan on growth and immune responses in juvenile olive flounder, Paralichthys olivaceus fed the white fish meal based diets for 6 weeks. Five experimental diets supplemented with ${\beta}-1,3$ glucan at 0, 0.01, 0.025, 0.05, 0.1 % (Control, $G_{0.01},\;G_{0.025},\;G_{0.05}\;and\;G_{0.1}$, respectively) of diet on a dry-matter basis. Five experimental diets were formulated to be isonitrogenous and isocaloric to contain 50.0% crude protein and 16.7 kJ available energy $g^{-1}$. Fish averaging $3.2{\pm}0.1\;g\;(mean{\pm}SD)$ were randomly distributed in each aquarium as triplicate groups of 15 fish. Weight gain (WG, %), specific growth rate (SGR, %), and feed efficiency (FE, %) of fish fed $G_{0.1}$ diet were found significantly higher than those of fish fed Control, $G_{0.01},\;G_{0.025}\;and\;G_{0.05}$ diets (P<0.05). However, there was no significant difference among the fish fed control, $G_{0.01},\;G_{0.025}$. Chemiluminescent responses (CL) of fish fed $G_{0.1}$ diet were significantly higher than those of fish fed the other diets. Serum lysozyme activities of fish fed $G_{0.05}$ and $G_{0.1}$ diets were higher than those of fish fed control, $G_{0.025}$ and $G_{0.05}$ diets. Fish fed $G_{0.1}$ diet showed a significantly lower cumulative mortality than did fish fed control diet throughout the challenge test (P<0.05). These results suggested that based on growth rate, feed efficiency, non-specific immunity and protection against microbial infections the optimum dietary ${\beta}-1,3$ gulcan could be greater than 0.05% but less than 1.0% in juvenile olive flounder, Paralichthys oilvaceus.

Prediction Equations of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Adults over 50 years old in rural area (농촌지역 50세 이상 인구의 노력성호기곡선을 이용한 폐활량측정법 검사지표의 추정정상치)

  • Kim, Won-Young;Kim, Kwang-Hyun;Youn, Boung-Han;Lee, Seung-Uk;Cho, Chul-Hyun;Choi, Jin-Su;Kim, Hun-Nam
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.536-545
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    • 1998
  • Background: The studies on prediction equations of pulmonary function parameters for adults in Korea have been performed in a reference population mainly consisted of young and middle ages. So they included a relatively few elderly who conducted pulmonary function test frequently in clinic. We established prediction equations of pulmonary function parameters for healthy adults over 50 years old in rural area and compared this results with those of other studies. Therefore we attempted to consider normative values of pulmonary function tests for elderly in Korea. Method: Five hundred thirty-three women and men over 50 years old in rural area were participated. A "healthy" subgroup of 110 women and 32 men were identified by excluding those who had conditions that negatively influenced pulmonary function. We derived prediction equations for FVC, $FEV_1$ and $FEV_1%$ by multiple linear regression method from their age, heights and weights in each sex. Results: Prediction equations for FVC and $FEV_1$ in each sex were derived as follows Male; FVC (L)=0.02488Height(cm)-0.0269Age(years)+0.493 $FEV_1(L)$=0.01874Weight(kg)-0.0282Age(years)+2.906 Female; FVC(L)=0.02160Height(cm)-0.0192Age(years)-0.0125 $FEV_1(L)$=0.01720Height(cm)-0.0194Age(years)+0.3890 Prediction equations for $FEV_1%$ were not derived because $FEV_1%$ didn't have statistically significant terms. Comparing Predicted values that were calculated by substitution into the equations of various studies of mean values of age, heights and weights from this study, FVC and $FEV_1$ values in men of this study were lower than those of other studies. In women, FVC and $FEV_1$ values of this study were as similar as or lower than those of the study conducted for healthy elderly blacks in U.S.A respectively. Conclusion: We have got prediction equations of pulmonary function parameters which were driven from forced expiratory spirogram in adults over 50 years old in rural area. Predicted values of this study were lower than those of other studies which were conducted in Korea. So we consider that the study for spirometry reference values for elderly Korean using the method compatible with ATS recommendation need to be conducted more frequently forward.

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