• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.158-169
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• 2004

Purpose : Although influenza is one of the most important cause of acute respiratory tract infections in children, virus isolation is not popular and there are only a few clinical studies on influenza and diagnostic methods. We evaluated the epidemiological and clinical features of influenza in children and rapid antigen detection test(QuickVue influenza test) on fist half of the year 2004 in Busan. Methods : From January 2004 to June 2004, throat swab and nasal secretion were obtained and cultured for the isolation of influenza virus and tested by rapid antigen detection test(QuickVue influenza test) in children with suspected influenza infections. The medical records of patients with influenza virus infection were reviewed retrospectively. Results : Influenza viruses were isolated in 79(17.2%) out of 621 patients examined. Influenza virus was isolated mainly from March to April 2004. The ratio of male and female with influenza virus infection was 1.2 : 1 with median age of 4 years 6month. The most common clinical diagnosis of influenza virus infection was bronchitis. There was no difference between influenza A and B infection in clinical diagnosis and symptoms. All patients recovered without severe complication. The sensitivity obtained for rapid antigen detection test (QuickVue influenza test) was 93.6% and the specificity was 80.2%, the positive predictive value 40.8%, the negative predictive value 98.8%. Conclusion : With rapid antigen detection test, it is possible early detection of influenza in children. reduction in use of antimicrobial agent and early use of antiviral agent.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.18-25
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• 2004

Purpose : Alport syndrome is clinically characterized by hereditary progressive nephritis causing ESRD with irregular thickening of the GBM and sensory neural hearing loss. The mutations of type IV collagen gene(COL4A5) located on the long arm of X chromosome is considered responsible for most of the structural abnormalities in the GBM of Alport patients. Since no definite clinical prognostic predictor has been reported in the disease yet, we designed this study to evaluate the significance of genetic polymorphism of the angiotensin converting enzyme in children with Alport syndrome as a prognostic factor for disease progression. Methods : ACE I/D genotype were examined by PCR amplification of the genomic DNA in 12 patients with Alport syndrome and 12 of their family members. Alport patients were divided into two groups; the conservative group, those who had preserved renal function for more than 10 years of age, the early CRF group, those who had progressed to CRF within 10 years of age. Results : The mean age of onset was $3.45{\pm}2.4$ years in the conservative group, $4.4{\pm}1.2$ years in the early CRF group. Sex ratios were 5:3 and 2:1 in each group. Among 12 cases of patients, 4 cases were in early CRF group and their mean duration of onset to CRF was 4.5 yews(8.9 years of age). Eight patients(67%) were in the conservative group and they had normal renal function for more than 10 years of age(mean duration of renal preservation was 10.6 years). The incidence of II type ACE gene were in 25.0%(3 cases), ID type in 41.7%(5 cases), DD type in 33.3%(4 cases). There was no significant difference between Alport patient and normal control(II type 44.3%, ID type 40.9%, DD type 14.8%). The incidence of DD type of early CRF group were higher than that of the conservative group(75% vs 12.5%)(p<0.05). There was no difference in ACE gene polymorphism between normal Alport family members and control group. Conclusion : Even though there was no significant difference of ACE polymorphism between Alport patients and the normal control group, the incidence of DD type is significantly increased in early CRF group which means DD type of ACE polymorphism has a possibility of being a predictor for early progression to CRF in Alport patients.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.200-207
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• 2004

Purpose: An analysis was to compare the results of radiation alone with those of radiation with dally low dose cisplatin as a radiation sensitizer in locally advanced cervical cancer. Materials and Methods: A retrospective analysis of 59 patients diagnosed with locally advanced uterine cervix cancer between December 1996 and March 2001 was peformed. Thirty one patients received radiation alone and 28 patients received dally low dose cisplatin, as a radiation sensitizer, and radiation therapy. The median follow-up period was 34 months, ranging from 2.5 to 73 months. The radiation therapy consisted of 4500 cGy external beam irradiation to the whole pelvis (midline block after 3060 cGy), a 900$\~$l,000 cGy boost to the involved parametrium and high dose-rate intracavitary brachytherapy (a total dose of 3,000$\~$3,500 cGy/500 cGy per fraction to point A, twice per week). In the chemoradiation group, 10 mg of daily intravenous cisplatin was given daily from the 1st day of radiation therapy to the 20th day of radiation therapy. According to the FIGO classification, the patients were subdivided into 51 (86.4$\%$) and 8 (13.6$\%$) stages IIB and stage IIIB, respectively. Results: The overall 5 year survival rate was 65.65$\%$ and according to treatment modality were 56.75$\%$ and 73.42$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.180). The 5 year disease-free survival rates were 49.39$\%$ and 63.34$\%$ in the radiation alone and chemoradiatoin groups, respectively (p=0.053), The 5 year locoregional control rates were 52.34$\%$ and 73.58$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.013). The 5 year distant disease-free survival rates were 59.29$\%$ and 81.46$\%$ in the radiation alone and chemoradiation groups, respectively (p=0.477), Treatment related hematologic toxicity were prominent in the chemoradiation group. Leukopenia $\geq$grade) occurred in 3.2$\%$and 28.5$\%$ of the radiation alone and chemoradiation groups, respectively (p=0.02). There were no statistical differences in the incidences of vesical, rectal and small bowel complications between two groups. Conclusion: Radiation therapy with low dose cisplatin did not improve the rates of survival and response rates, but did improve the rate of disease free survival and locoregional control rates In locally advanced cervical cancer. The incidence of bone marrow suppression was higher in the chemoradiation group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.21-30
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• 2005

Purpose: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. Methods: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (${\geq}60per$ 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. Results: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was $11.5{\pm}5.1$ (5~24) weeks, and mean age at diagnosis was $17.8{\pm}9.5$ (8~56) weeks. Duration from symptom onset to diagnosis was $6.3{\pm}6.7$ (0~36) weeks. Mean peripheral blood eosinophil count was $478{\pm}320$ (40~1,790)/$mm^3$ and eosinophilia (> $250/mm^3$) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at $29.4{\pm}8.7$ (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at $37.5{\pm}9.7$ (12~56) weeks of age. Conclusion: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.1-11
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• 2005

Purpose: The aim of this study was to evaluate the relationship between H. pylori infection and recurrent abdominal pain (RAP) in children and to evaluate the effects of eradication therapy on RAP. Methods: From January 1998 to January 2005, 166 children with RAP (61 male, 105 female) aged $10.0{\pm}3.3$ years were included. Upper gastrointestinal endoscopies were performed for all the patients. All H. pylori infected children (n=70) received the eradication therapy and were divided into two groups: Group Ia (n=52); eradicated, Group Ib (n=18); non-eradicated. H. pylori-negative children (n=96) were divided into three groups according to the medication: Group IIa (n=67); no medication, Group IIb (n=13); acid-suppressant, Group IIc (n=16); both acid-suppressant and antibiotics. Questionnaire for symptoms were asked at the first, 6th, 12th, 24th, and 36th months following the treatment (grade 0; completely resolved, grade 1; definitely improved, but there are occasional episodes of mild abdominal pain, grade 2; no change in the frequency and intensity of abdominal pain). Results: In about 90% of H. pylori positive children, RAP improved in the both H. pylori-eradicated and non-eradicated children in a follow-up survey. In about 75% of H. pylori-negative children, RAP also improved among in the three groups of patients regardless of medication. Conclusion: These results suggest that there was no correlations between improvement of RAP and eradication of H. pylori, and between improvement of RAP and medication. Consequently the reassurance that the children with RAP have no serious organic cause was important to improvement of RAP.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.12-20
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• 2005

Purpose: Helicobacter pylori infection is known to be associated with acute or chronic abdominal pain and upper gastrointestinal bleeding in children. This study was performed to analyze the gastroduodenoscopic findings and the efficacy of triple therapy with omeprazole, amoxicillin and clarithromycin between one and two weeks of duration in children with H. pylori infection. Methods: We have assessed retrospectively 60 patients presented with acute or chronic abdominal pain or upper gastrointestinal bleeding. H. pylori infection was confirmed by endoscopic biopsy and rapid urease test. Out of 60 patients, 30 patients were treated with a combination of omeprazole, amoxicillin, and clarithromycin for one week, and the other 30 patients were treated for two weeks with the same medication. Efficacy of treatment was assessed 4 weeks after the termination of treatment by using the $^{13}C$ urea breath test. Results: The 60 patients with the complaint of diffuse abdominal pain, epigastric pain, vomiting or hematemesis were included in this study. One-week treatment group (group I) consisted of 30 patients (14 male, 16 female) with mean age of $11.6{\pm}2.67years$. Two-week treatment group (group II) consisted of 30 patients (11 male, 19 female) with mean age of $10.7{\pm}4.17years$. In group I, H pylori were eradicated in 26 out of 30 patients (86.7%). In group II, H. pylori were eradicated in 26 out of 30 children (86.7%). Both groups did $^{13}C$ urea breath test after 4 weeks after termination of the triple therapy. The eradication rates were same in both groups as 86.7%, 26 out of 30 patients in each group. The results of endoscopy were nodular gastritis 26 (43.3%), erosive gastritis 10 (16.7%), hemorrhagic gastritis 7 (11.7%), gastric ulcer 2 (3.3%) and normal finding 15 (25.0%). Conclusion: In this study, the nodular gastritis was most common endoscopic findings with H. pylori positive patients. The eradication rate of H. pylori with omeprazole, amoxicillin and clarithromycin was 86.7% and it would be highly effective as primary treatment with no significant differences in the eradication rate between one-week and two-week treatment groups. However, we should need more long-term follow-up data.

• Journal of The Korean Society of Grassland and Forage Science
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• v.10 no.1
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• pp.27-35
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• 1990

As a part of studies on potassium(K) behavior in grassland with respect to magnesium(Mg) balance of ruminants, seasonal variation of K and Mg contents of forages including native gasses grown in grazing pasture and meadow were investigated. During an experimental period from April to October of 1984, two times of grazings were carried out in the orchardgrass (Dacfylis glomerata L.) and the tall fescue (Festuca arundinacea Schreb.)dominant grazing pastures, and forage plants (forages and native grasses) were sampled monthly and also K and Mg contents were determined without separating into individual plant species (Experiment 1). All the plant species grown in the two meadows which situated in the grazing pastures were harvested five times during the same period, separated into individual plant species, and botanical composition (SDR, ) and K and Mg contents of the plant species were determined (Experiment 2). The results obtained were as follows: 1. During the experimental period in the orchardgrass grazing pasture K contents of the forage plants were the highest in spring, and the seasonal variation of the contents in the orchardgrass pasture (1.5-5.8 % in a dry matter basis) was more significant than that of forage plants in the tall fescue grazing pasture (3.0- 3.8 %). 2. The Mg contents of forage plants in the orchardgrass grazing pasture ranged under 2.0 mg/g DW from Arpil until July, and the contents in the orchardgrass pasture (1.5-3.1 mg/g DW) was in the lower range than that of forage plants in the tall fescue pasture (2.0-3.8 mg/g DW). (Experiment I). 3. Orchardgrass was the dominant species in the orchardgrass meadow until July, but several species of native grasses were observed from summer (July) and native grasses such as Digitaria adscendens and Echinochlw crus-galli became dominant in autumn (October). 4. Seasonal variation of K contents of orchardgrass was in the range of 3.9-5.9 %, and the contents was higher in spring (May) and in autumn (October). The variation of white clover (Trifolium repens L.) was in the range of 3.6-5.0 %, that of tall fescue 3.8-4.8 %, and that of Italian ryegrass (Lolium multiflorum Lam.) 2.7-3.5 %, respectively. 5 . Seasonal variation of Mg content of white clover was in the range of 2.9-3.7 mg, that of tall fescue 2.0- 3.3 mg, and that of orchardgrass 1.6-2.8 mg/g DW, respectively. The variation of the contents of Italian ryegrass was in the range of 1.3-1.9 mg/g DW. And Mg contents of the forage plants were higher in summer(July) 6. In autumn (October and November ) native grasses such as D. adscendens and E. crus-galli contained lower K contents (1.7-3.9 %), but higher Mg contents (3.2-10.1 mg/g DW) than the forages contained. (Experiment 2) From the results above, it is known that K contents ranged higher in younger forages in viewpoint of growth stage and higher in spring and autumn, and that Mg contents ranged lower in spring. Therefore, the mineral imbalance or hypomagnesaemic (grass) tetany can be triggered in spring or autumn, and more frequently by such plant species as orchardgrass and Italian ryegrass with lower Mg and/or higher K contents than by tall fescue. And it is suggested that the dominant native grasses in autumn such as D. adscendens and E. emsgalli can contribute to the prevention of the tetany with higher Mg and lower K contents.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.40-57
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• 1997

The Background and Purpose It is done the study on the public health care of oriental medicine and improvement of its system recently, I think that these effect a good health care for a people through the public health care of oriental medicine. Since Woosuk university and Chonju-Wansan health center had taken upon the oriental medicine service in the health center in 1995, we have public favor from the local population. So in other to a study on the clinical statistics of oriental medicine service in the health center, I investigated general character, style of diseases, effect of treatments and the like for a paitents received oriental medicine treatments in there. Objective and Methods This study researched into clinical statistics for paitents received oriental medicine treatments in the Chonju-Wansan health center during one year period from January 4 1996 to December 26 1996. The number of object was 238 case of 234 persons. Results and Conclusions Analyzing these 234 persons, the proportion of males to females was 1 to 6.8. As for the distribution of age, the ages of 61 to 70 occupied 34.62 per cent in the ages of 51 to 90 occupied 88.89 per cent in the whole paitons. Therefor female was very highly more than male and paitents were for the most part, old ages(51years old and over). Musculoskeletal system and connective tissue disease of 238 case occupied 82.77 per cent. were the greatest proportion. At the duration of disease, 1 year to 5 years occupied 32.35 per cent, was the highest The grade Ⅲ was the most of the sign of paitents at first visit, it occupied 55.88 per cent. The good(++) and over effect of treatments occupied 62.18 per cent, the fair(+) and over effect of treatments occupied 78.99 per cent. As for the duration of treatment, the case of 2 times to 5 times visit occupied 34.03 per cent, was the highest. And the case of 2 times to 10 times visit was 4 times as good effect as the case of only one visit. By medication of treatment, O-Juk-San(五積散) occupied 32.21 per cent, was the greatest proportion, and Pal-Mj-Hoan(八味丸) occupied the second greatest proportion. Therefor the most of paitents had the chronic diseases and was diagnosed Sin-Yang-He(腎陽虛). The average 22.58 persons received acupuctural treatment a day, the average 0.58 persons received the moxibustion a day, the average 2.28 persons received venesection (bloodletting) a day. And others treatment performed physical therapy and the like. The case received treatment of the oriental and western medicine at the same time. marked 21 persons among 30 persons and had a good effect by 70 per cent. The average 26.95 persons received treatment of oriental medicine a day, the average 3.9 persons received the first medical examination a day.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.530-542
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• 2000

Background : Nonspecific interstitial pneumonia (NSIP) has been reported recently to have shown much better response to medical treatment and better prognosis compared with idiopathic UIP. However, clinical characteristics of idiopathic NSIP discriminating it from UIP have not been clearly defined. Method : Among 120 patients with biopsy-proven diffuse interstitial lung diseases admitted to the Samsung Medical Center between July 1996 and March 2000, 18 patients with idiopathic NSIP were included in this study. Retrospective chart review and radiographic analysis were performed. Results : 1) At diagnosis, 17 patients were female and the average age was $55.2{\pm}8.4$ years (44~73 years). The average duration from development of respiratory symptom to surgical lung biopsy was $9.9{\pm}17.1$ months. Increase in bronchoalveolar lavage fluid lymphocytes ($23.0{\pm}13.1%$) was noted. On HRCT, ground glass and irregular linear opacity were observed, but honeycombing was absent in all patients. 2) Corticosteroids were initially given to 13 patients, but the medication was stopped in 3 patients due to severe side effects. Further medical therapy was not possible in 1 patient who experienced streroid-induced psychosis. Herpes zoster (n=3), tuberculosis (n=1), avascular necrosis of the hip (n=1), cataract (n=2) and diabetes mellitus (n=1) developed during prolonged corticosteroid administration. Of the 7 patients receiving oral cyclophosphamide therapy, hemorrhagic cystitis hindered one patient from continuing with the medication. 3) After medical treatment, 14 of 17 patients improved, and 3 patients remained stable (mean follow-up ; $24.1{\pm}11.2$ months). FVC increased by $20.2{\pm}11.2%$ of predicted value and the extent of ground glass opacity on HRCT decreased significantly ($15.7{\pm}14.7%$). 4) Of the 14 patients who had stopped medication, 5 showed recurrence of NSIP and 2 became aggravated during steroid tapering. All patients with recurrence showed deterioration within one year after completion of initial treatment. Conclusion : Since idiopathic NSIP has unique clinical profiles and shows good prognosis, diagnosis different from UIP, and aggressive medical treatment are needed.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.795-802
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• 1999

Objective : Cardiopulmonary exercise test is a useful tool to evaluate the operative risk and to plan exercise treatment for the patients with chronic obstructive pulmonary disease(COPD). In cardiopulmonary exercise test, most of the measured parameters are recorded at the time of peak exercise, which are hard to attain in COPD patients. So we evaluated the usefulness of the parameter, breathing reserve index(BRI=minute ventilation [$V_E$]/maximal voluntary ventilation[MVV]) at the time of anaerobic threshold($BRI_{AT}$) for the differentiation of COPD patients with normal controls. Methods : Thirty-six COPD patients and forty-two healthy subjects underwent progressive, incremental exercise test with bicycle ergometer upto possible maximal exercise. All the parameters was measured by breath by breath method. Results : The maximal oxygen uptake in COPD patients (mean$\pm$SE) was $1061.2{\pm}65.6ml/min$ which was significantly lower than $2137.6{\pm}91.4ml/min$ of normal subjects(p<0.01). Percent predicted maximal oxygen uptake was 54.3% in COPD patients and 86.0% in normal subjects(p<0.01). Maximal exercise(respiratory quotient; $VCO_2/VO_2{\geq}1.09$) was accomplished in 7 of 36 COPD patients(19.4%) and in 18 of 42 normal subjects(42.9%). The $BRI_{AT}$ of COPD patients was higher($0.50{\pm}0.03$) than that of control subject($028{\pm}0.02$, p<0.01), reflecting early hyperventilation in COPD patient during exercise. The correlation between $BRI_{AT}$ and BRI at maximal exercise in COPD patients was good(r=0.9687, p<0.01). Conclusion : The $BRI_{AT}$ could be a useful parameter for the differentiation of COPD patients with normal controls in the submaximal cardiopulmonary exercise test.