• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.343-350
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• 2008

Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.415-419
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• 2008

Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1109-1118
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• 2009

Purpose : Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. Methods : In all, 684 adolescents were included in the study. Blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. Results : MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. Conclusion : Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

• The Korean Journal of Pharmacology
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• v.24 no.1
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• pp.71-81
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• 1988

Glutamate and aspartate may evoke an increase in membrane permeability to monovalent cations and $Ca^{++}$. However, it is uncertain whether $Ca^{++}$ influx is mediated by voltage dependent $Ca^{++}$ channels or by excitatory amino acid activated channels. In addition, the influences of excitatory amino acids on $Ca^{++}$ uptake by neuronal tissues as well as the responses of their actions to extracellular $Mg^{++}$ concentration are different. $K^{+}$ induced $Ca^{++}$ uptake by synaptosomes was dependent on extracellular $Mg^{++}$ up to 5 mM and at concentration of 10 mM, $Ca^{++}$ influx was rather reduced. In $Na^{+}$ rich media, glutamate-and aspartate-induced $Ca^{++}$ uptake was increased by $Mg^{++}$ in a dose independent manner. However, the response for NMDA was inhibited by $Mg^{++}$ at concentrations above 2 mM. $K^+$-and glutamate-induced $Ca^{++}$ influx s were inhibited by 2,4-dinitrophenol, chlorprom-azine and verapamil but not by tetraethylammonium chloride. Tetrodotoxin effectively inhibited the action of glutamate but did not affect that of $K^+$. The response for MNDA was inhibited by 2, 4-dinitrophenol and tetrodotoxin, slightly inhibited by verapamil, and not affected by tetraethylammonium chloride. In $Na^{++}$ rich medium, depolarizing action of glutamate, aspartate and MNDA on synaptosomes was not demonstrated, whereas these agents stimulated $Ca^{++}$ uptake and caused $Ca^{++}$ influx induced depolarization at mitochondria. On the other hand, the activities of synaptosomal ATPases were not affected by excitatory amino acids at 5 mM. The results suggest that glutamate or NMDA induced $Ca^{++}$ influx at synaptosomes exhibits different responses for extracellular $Mg^{++}$ Ex citatory amino acids induced $Ca^{++}$ influx at synaptosomes may be associated with increased permeability of membrane for $Na^{++}$ and $Ca^{++}$ except $K^{++}$ and membrane depolarization due to increased ionic permeability.

• The Korean Journal of Pharmacology
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• v.18 no.2
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• pp.33-44
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• 1982

The binding in vitro of an opiate agonist, $(^3H)-morphine$, was studied using rat brain slices which were incubated in the modified Krebs-Henseleit bicarbonate buffer solution containing various concentrations of electrolytes with or without morphine, naloxone or morphine+naloxone at $4^{\circ}C$ for 24 hours. The binding of $(^3H)-morphine$ may be seperated into two component; one a saturable binding and the other nonsaturable. The saturable binding may be calculated from the differences in binding observed in the absence and presence of high concentration of morphine. The maximal saturable binding and $K_D$ value in the naive preparations were $0.32{\pm}0.02\;pmole/mg$ protein and $0.75{\pm}0.07\;nM$ respectively. The saturable binding of $(^3H)-morphine$ was significantly increased by low temperature-treatment, while $K_D$ value was not changed. Morphine in the incubation media significantly increased the saturable binding of $(^3H)-morphine$ and $K_D$ value. Naloxone also increased the maximal saturable binding of $(^3H)-morphine$ and $K_D$ value of the drug. Decrease of $K^+\;and\;Mg^{++}$, and addition of $Mn^{++}$ in the incubation media significantly increased the saturable binding of $(^3H)-morphine$, but decrease of $Na^+$and increase of $Ca^{++}$ in the incubation media did not influence the binding. The increment of the saturable binding of $(^3H)-morphine$ by nonlabeled morphine in the incubation media was notaffected by decrease of $Na^+,\;K^+\;or\;Mg^{++}$, or addition of $Mn^{++}$ into the incubation media, but was inhibited by increase of $Ca^{++}$ in the incubation media, while the increment of the saturable binding of $(^3H)-morphine$ was net observed by decrease of $Na^+,\;K^+\;or\;Mg^{++}$, or increase of $Ca^{++}$ in the incubation media. The above results indicate that change of opiate binding sites in quality, i.e. affinity, and quantity, i.e. number of binding sites, may occur by low temperature-treatment in the absence and presence of morphine or naloxone and that electrolytes play role of the changes of opiate binding sites.

• The Korean Journal of Pesticide Science
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• v.7 no.1
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• pp.32-37
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• 2003

Bacterial soft rot by Erwinia carotovora subsp. carotovora is one of the diseases causing the biggest problem in Chinese cabbage. Chemical screening was conducted to select effective agents for controlling bacterial soft rot. Control effect of antibiotics, plant activator, and Biokeeper (avirulent Erwinia) to soft rot were tested by in vitro assay, nursery test, and field experiment. The in vitro assay was done by paper disc method and potato slice method. The nursery test was performed by using mineral oil inoculation method with consistent disease induction. The in vitro assay showed that streptomycin, oxolinic acid, bronopol, and copper hydroxide significantly suppressed the growth of pathogenic bacterium and the decomposition of potato slice. However, plant activators including acibenzolar-S-methyl did not show the suppressive effect on the growth of pathogenic bacterium and the decomposition of potato slice. When applied by the nursery test condition using mineral oil inoculation method with Chinese cabbage 'Kangruckyeurum', Biokeeper, oxolinic acid, antibiotics streptomycin, validamycin, and copper compound provided 83.5%, 95.2%, 91.2%, 57.5% and 79.9% in control efficacy, respectively. However, the control effect of acibenzolar-S-methyl showed to be low to cause phytotoxicity. Also acibenzolar-S-methyl showed a significant control effect in the field experiment with Chinese cabbage 'Sanchon' in 2000, but the field experiment with Chinese cabbage 'Kangruckyeurum' in 2001 revealed it had phytotoxicity to Chinese cabbage. Such a difference was considered to be caused by differences in phytotoxic reaction of Chinese cabbage cultivars to the chemical. Streptomycin+copper, copper hydroxide and Biokeeper showed 79.7%, 71.9% and 60.9% in control efficacy, respectively, in the field experiment with Chinese cabbage 'Sanchon' in 2002.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.51-58
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• 2011

Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.31-37
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• 2012

Purpose: This study evaluated the usefulness of Helmet bolus device using Bolx-II, paraffin wax, solid thermoplastic material in total scalp irradiation. Materials and Methods: Using Rando phantom, we applied Bolx-II (Action Products, USA), paraffin wax (Densply, USA), solid thermoplastic material (Med-Tec, USA) on the whole scalp to make helmet bolus device. Computed tomography (GE, Ultra Light Speed16) images were acquired at 5 mm thickness. Then, we set up the optimum treatment plan and analyzed the variation in density of each bolus (Philips, Pinnacle). To evaluate the dose distribution, Dose-homogeneity index (DHI, $D_{90}/D_{10}$) and Conformity index (CI, $V_{95}/TV$) of Clinical Target Volume (CTV) using Dose-Volume Histogram (DVH) and $V_{20}$, $V_{30}$ of normal brain tissues. we assessed the efficiency of production process by measuring total time taken to produce. Thermoluminescent dosimeters (TLD) were used to verify the accuracy. Results: Density variation value of Bolx-II, paraffin wax, solid thermoplastic material turned out to be $0.952{\pm}0.13g/cm^3$, $0.842{\pm}0.17g/cm^3$, $0.908{\pm}0.24g/cm^3$, respectively. The DHI and CI of each helmet bolus device which used Bolx-II, paraffin wax, solid thermoplastic material were 0.89, 0.85, 0.77 and 0.86, 0.78, 0.74, respectively. The result of Bolx-II was the best. $V_{20}$ and $V_{30}$ of brain tissues were 11.50%, 10.80%, 10.07% and 7.62%, 7.40%, 7.31%, respectively. It took 30, 120, 90 minutes to produce. The measured TLD results were within ${\pm}7%$ of the planned values. Conclusion: The application of helmet bolus which used Bolx-II during total scalp irradiation not only improves homogeneity and conformity of Clinical Target Volume but also takes short time and the production method is simple. Thus, the helmet bolus which used Bolx-II is considered to be useful for the clinical trials.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.11-14
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• 2012

Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.1
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• pp.27-33
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• 2007

Purpose: We have performed SRS (stereotactic radiosurgery) for avm (arterry vein malformation) and brain cancer. In order to verify dose and localization of SRS, dose distributions from TPS ($X-Knife^{(R)}$ 3.0, Radionics, USA) and GafChromic $EBT^{(R)}$ film in a head phantom were compared. Materials and Methods: In this study, head and neck region of conventional humanoid phantom was modified by substituting one of 2.5 cm slap with five 0.5 cm acrylic plates to stack the GafChromic $EBT^{(R)}$ film slice by slice with 5 mm intervals. Four films and five acrylic plates were cut along the contour of head phantom in axial plane. The head phantom was fixed with SRS head ring and adapted SRS localizer as same as real SRS procedure. CT images of the head phantom were acquired in 5 mm slice intervals as film interval. Five arc 6 MV photon beams using the SRS cone with 2 cm diameter were delivered 300 cGy to the target in the phantom. Ten small pieces of the film were exposed to 0, 50, 100, 200, 300, 400, 500, 600, 700, 800, 900 cGy, respectively to calibrate the GafChromic $EBT^{(R)}$ film. The films in the phantom were digitized after 24 hours and its linearity was calibrated. The pixel values of the film were converted to the dose and compared with the dose distribution from the TPS calculation. Results: Calibration curve for the GafChromic $EBT^{(R)}$ film was linear up to 900 cGy. The R2 value was better than 0.992. Discrepancy between calculated from $X-Knife^{(R)}$ 3.0 and measured dose distributions with the film was less than 5% through all slices. Conclusion: It was possible to evaluate every slice of humanoid phantom by stacking the GafChromic EBT film which is suitable for 2 dimensional dosimetry, It was found that film dosimetry using the GafChromic $EBT^{(R)}$ film is feasible for routine dosimetric QA of stereotactic radiosurgery.