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ABSTRACT: The aim of this study was to estimate the value of identifying vesicoureteral reflux (VUR) on a voiding cystourethrogram (VCUG) and the benefit of VUR management according to imaging strategies at the first febrile urinary tract infection (UTI).
Children aged 1-144 months (n = 618) with the first febrile UTI admitted at our hospital from 2000 to 2009 were enrolled. In all patients, renal sonogram (US), (99m) Tc-dimercaptosuccinic acid (DMSA) renal scanning and VCUG were performed. Retrospective analyses per patient and per renal unit were performed.
Abnormal US or DMSA scans had a sensitivity of 100% and a negative predictive value (NPV) of 100% to detect high-grade reflux. In hydronephrotic kidneys, DMSA scanning had a sensitivity of 88.2% and a NPV of 97.1% to detect high-grade reflux.
Routine VCUG is not required after the first febrile UTI in patients with normal US or normal DMSA scan. Even if the US reveals hydronephrosis, routine VCUG is not necessary if the DMSA findings are normal. It is recommended that children who did not receive both a DMSA scan and VCUG after the first febrile UTI should be followed up over the long term.
Acta Paediatrica 03/2012; 101(3):e105-9. · 2.07 Impact Factor
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ABSTRACT: Henoch-Schönlein purpura (HSP) is the most common vasculitis in children and is characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. We report a case involving a 3-year-old girl with HSP who displayed rapidly evolving haemorrhagic bullae from primary purpuric lesions during systemic corticosteroid therapy. CONCLUSION: The bullae disappeared within 7 days of systemic corticosteroid therapy, although some scarring of the skin occurred. Also, bullae should not be considered as a poor prognostic factor of renal outcome in HSP.
Acta Paediatrica 05/2011; 100(12):e283-4. · 2.07 Impact Factor
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Hye-Young Kang PhD,
Sung-Eun Park MS,
Dae Ryong Kang PhD,
Ji Yoon Kim PhD,
Young Hwa Jang MS,
Won-Jung Choi MS,
PhD Seong-Hwan Moon MD,
PhD Kyu-Hyun Yang MD,
PhD Jin-Young Park MD,
PhD Soon-Yong Kwon MD,
Hye‐Young Kang, Sung‐Eun Park,
Dae Ryong Kang,
Ji Yoon Kim,
Young Hwa Jang,
Won‐Jung Choi,
Seong‐Hwan Moon,
Kyu‐Hyun Yang,
Jin‐Young Park,
Soon‐Yong Kwon
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ABSTRACT: Objectives: To estimate the medical expenditure associated with osteoporotic hip fracture in elderly Korean women from insurer's perspective.Methods: All claim records of women aged ≥50 years and diagnosed with hip fracture from 2002 to 2004 were obtained from the Korean National Health Insurance. The first 6 months were considered a “window period” during which patients with fractures were defined as incident cases if their initial records of visit or admission were observed after June 30, 2002. We included only those with claim records showing diagnosis of osteoporosis or prescription for antiosteoporosis drugs. For each patient, we calculated the cumulative claims amount related to the initial and follow-up treatment for 2 years after fracture.Results: A total of 22,247 patients were identified during 2.5 years. During the first year of fracture, an average of 3.28 visits and 0.97 admissions were recorded; during the second year, 0.35 visits and 0.02 admissions were recorded. The 2-year cost per patient was KRW3,175,467, 97.4% of which was incurred during first year.Conclusion: Exploring the economic burden of osteoporotic hip fracture in the elderly women is expected to motivate policymakers and clinicians to adopt effective treatment options for the disease prevention and expenditure control.
Value in Health 10/2009; 12(s3):S93 - S96. · 2.19 Impact Factor
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ABSTRACT: To analyze innervated myotendinous cylinders (IMCs) in the extraocular muscles (EOMs) of normal subjects and strabismic patients.
The rectus muscles of 37 subjects were analyzed. Distal myotendinous specimens were obtained from 3 normal subjects, 20 patients with acquired strabismus, 11 with infantile strabismus, and from 3 with congenital nystagmus, and were studied by using light microscopy. Some specimens (6 rectus muscles) were also examined by transmission electron microscopy.
IMCs were found in the distal myotendinous regions of EOMs. The IMCs of patients with acquired strabismus showed no significant morphological alterations. However, significant IMCs alterations were observed at the distal myotendinous junction of patients with congenital strabismus and congenital nystagmus.
This study supports the notion that IMCs in human EOMs function mainly as proprioceptors, along with effector properties, and a disturbance of ocular proprioceptors plays an important role in the pathogenesis of oculomotor disorder. We suggest that a proprioceptive feedback system should be stimulated and calibrated early in life for the development of binocular vision.
Korean Journal of Ophthalmology 07/2009; 23(2):93-9.
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ABSTRACT: Chromatin immunoprecipitation (ChIP) is a powerful and widely applied technique for detecting association of individual proteins with specific genomic regions; the technique requires several complex steps and is tedious. In this paper, we develop a microbead-packed microfluidic chip which eliminates most of the laborious, time-consuming, and skill-dependent processes of the ChIP procedure. A computational fluid dynamics model was established to analyze fluidic behavior in a microbead-packed microchannel. With the use of the new chip, a ChIP procedure was performed to purify the GAPDH (glyceraldehyde 3-phosphate dehydrogenase) gene from human embryonic kidney cells (cell line 293). The ChIP capability of the microfluidic chip was evaluated and compared with that of a commercial assay kit; the precipitation performance of both methods was almost identical as shown by quantitative measurement of DNA. However, our chip offers the advantage of low resin volume, and the experimental time is greatly reduced. In addition, our method is less dependent on individual technical skill. Therefore, we expect that our microfluidic chip-based ChIP method will be widely used in DNA-, gene-, and protein-related research and will improve experimental efficiency.
Analytical Chemistry 04/2009; 81(8):2832-9. · 5.86 Impact Factor
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ABSTRACT: To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective.
From 2002 to 2004, we identified all National Health Insurance claims records for women >or= 50 years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," Ysuch that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with >or= one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals.
During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84 and 2,121,492 Won for those above 84.
Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.
Journal of Preventive Medicine and Public Health 10/2008; 41(5):287-94.
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ABSTRACT: To assess the usefulness of the vitrification method in clinical practice.
Clinical study of vitrification of human oocytes.
A university-affiliated hospital.
Thirty-four patients who agreed to undergo additional IVF-ET after the failed fresh cycle using the previously vitrified/thawed oocytes.
Surplus oocytes from the IVF-ET patients were vitrified for the next cycle.
Morphologic normality of post-thawed oocytes, fertilization, cleavage, pregnancy, and implantation rate.
Overall morphological survival and fertilization rates of vitrified/liquefied oocytes were 68.6% (325/474) and 71.7% (142/198), respectively. Pregnancy rate and implantation rate per embryo transfer were 21.4% (6/28) and 6.4% (8/125), respectively. All pregnancies resulted in the delivery of healthy babies (1 twin and 5 singletons/6 pregnancies).
The feasibility of the vitrification method for human oocytes was confirmed by our clinical results. Subsequent studies on vitrification and thawing procedures should be undertaken for further optimizing the vitrification method.
Fertility and Sterility 07/2003; 79(6):1323-6. · 3.56 Impact Factor
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ABSTRACT: We investigated the clinical characteristics and associated ocular and systemic anomalies in young children with congenital optic nerve abnormalities, and evaluated the therapeutic results of treatment for strabismus and amblyopia.
A retrospective study was conducted using the medical records of patients who were diagnosed with congenital optic nerve abnormalities in our hospital between 1995 and 2004.
This study involved 72 eyes of 51 young children (M : F = 25 : 26); 21 of these patients (41.2%) had bilateral abnormalities. The types and percentages of each abnormality were as follows: optic nerve hypoplasia, 47%; optic disc coloboma, 31.4%; morning glory syndrome, 11.8%; and myelinated nerve fiber, 9.8%. The first clinical manifestations noticed by parents were strabismus and decreased visual acuity. Occlusion therapy was carried out in 16 patients, and the visual acuities of two patients were improved by more than two lines of the Early Treatment Diabetic Retinopathy Study visual acuity chart. Accompanying strabismus was found in 70.6% of the patients; 14 patients underwent strabismic surgery, and 10 of these patients (41.2%) maintained a stable angle.
The most common congenital optic nerve abnormality was optic nerve hypoplasia, and the associated systemic abnormalities found were optic nerve hypoplasia and disc coloboma. Patients with congenital optic nerve abnormalities usually have a generally poor visual prognosis, but we emphasize the importance of treatment for associated strabismus and amblyopia.
Japanese Journal of Ophthalmology 50(3):250-5. · 0.92 Impact Factor
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ABSTRACT: To identify acute histologic change of extraocular muscles induced by bupivacaine or ricin mAb 35 injection.
The superior rectus and inferior rectus of white rabbits were injected with bupivacaine (0.4 mg in 0.3 ml) or ricin mAb 35 (0.2 microg/kg in 0.3 ml). After 1, 2, and 4 weeks, the rectus muscles were harvested, and postinjection changes in the muscle layers were examined histopathologically.
Bupivacaine and ricin mAb 35 induced myotoxic changes in both the orbital and the global layers. However, the inflammation and the myofiber destruction produced by bupivacaine injection was localized to the injection site, which compared with the diffuse change induced by ricin mAb 35. Inflammation reduced rapidly over 2 weeks. Regenerating myofibers with a central nucleus were found at 1 week after injecting these myotoxins. Four weeks after injection, the acute changes induced by these two toxins respectively were much recovered with prominent myofiber regeneration.
We found that extraocular muscle has a superb ability to recover from the acute injury induced by bupivacaine or ricin mAb 35, and the two myotoxins induce unique damage including the predilection of muscle layers and duration of damage persisted. Further investigation about the functional change during recovery from the myotoxin-induced injury of extraocular muscles is needed.
Current Eye Research 29(4-5):293-301. · 1.28 Impact Factor
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ABSTRACT: To estimate the medical expenditure associated with osteoporotic hip fracture in elderly Korean women from insurer's perspective.
All claim records of women aged > or =50 years and diagnosed with hip fracture from 2002 to 2004 were obtained from the Korean National Health Insurance. The first 6 months were considered a "window period" during which patients with fractures were defined as incident cases if their initial records of visit or admission were observed after June 30, 2002. We included only those with claim records showing diagnosis of osteoporosis or prescription for antiosteoporosis drugs. For each patient, we calculated the cumulative claims amount related to the initial and follow-up treatment for 2 years after fracture.
A total of 22,247 patients were identified during 2.5 years. During the first year of fracture, an average of 3.28 visits and 0.97 admissions were recorded; during the second year, 0.35 visits and 0.02 admissions were recorded. The 2-year cost per patient was KRW3,175,467, 97.4% of which was incurred during first year.
Exploring the economic burden of osteoporotic hip fracture in the elderly women is expected to motivate policymakers and clinicians to adopt effective treatment options for the disease prevention and expenditure control.
Value in Health 12 Suppl 3:S93-6. · 2.19 Impact Factor
