• Title/Summary/Keyword: 예측 인자

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Change of hemostatic markers according to the clinical state in Kawasaki disease (가와사끼병의 임상경과에 따른 지혈성 표지의 변화와 임상적 의의)

  • Kim, Yong Beom;Yoon, You Sook;Lee, Sang Yun;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1247-1251
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    • 2007
  • Purpose : Pathologically, Kawasaki disease (KD) is associated with widespread vascular endothelial damage in the acute phase. The vasculitis induced endothelial injury leads to coagulation abnormalities. Abnormalities of endothelial function, platelet activation, and fibrinolysis are present during acute phase and long after the onset of KD. The aim of study is to evaluate the change of hemostatic markers in the clinical stages of KD and to assess the hemostatic markers to be a useful indicator of the development of coronary artery lesion (CAL). Methods : Seventy four KD patients diagnosed in Chungnam National University Hospital from November 2004 to June 2007. Eleven febrile control and eleven healthy children were selected for healthy control. All blood samples were collected before and after Intravenous gammaglobulin (IVGG), $2^{nd}$ week, and $4^{th}-8^{th}$ week of illness of KD. Results : Initial D-dimer level of Kawasaki disease showed meaningful difference compared to control group (P<0.05). D-dimer and fibrinogen degradation products (FDP) before IVGG increased compared with normal control group and decreased after IVGG administration. It is normalized until 2 weeks later, and continue to decreasing. D-dimer and FDP were significantly different according to the CAL before IVGG. Conclusion : The hemostatic markers may change to the clinical stage of KD, which may suggest the degree of endothelial injury. Increased some hemostatic markers may be the predictors for development of CAL.

Leptin, adiponectin, interleukin-6 and tumor necrosis factor-α in obese adolescents (비만아에서의 leptin, adiponectin, interleukin-6, tumor necrosis factor-α에 대한 연구)

  • Gil, Joo Hyun;Lee, Jung Ah;Kim, Ji Young;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.597-603
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    • 2008
  • Purpose : Obesity is associated with insulin resistance. Insulin resistance and the presence of pro-inflammatory mediators are thought to cause a state of vascular endothelial dysfunction, an abnormal lipid profile, hypertension, and vascular inflammation. These chronic inflammatory responses, which are characterized by abnormal cytokine production, lead to activation of a pro-inflammatory signaling pathway. Leptin is an important mediator of inflammatory processes and immune-mediated diseases. The purpose of this study was to investigate the relationship between leptin and various cytokines associated with obesity in adolescents. Methods : Sixty-six obese adolescents (between 16-17 years of age, obesity index >130%) and 26 normal controls were included in this study. Obesity index and body mass index (BMI) were calculated. Serum lipid profile, AST and ALT were tested after 10 hours of fasting. Tumor necrosis factor alpha (TNF-${\alpha}$) and Interleukin-6 (IL-6) levels were measured by ELISA. Insulin, adiponectin, and leptin levels were estimated by radioimmunoassay. Results : Leptin was significantly higher in the obese adolescents compared to the control adolescents ($12.0{\pm}6.8ng/mL$ vs $6.3{\pm}1.0ng/mL$). TNF-${\alpha}$, IL-6, and insulin were significantly higher in the obese adolescents. Adiponectin was significantly lower in the obese group than the control group ($3.3{\pm}1.9{\mu}g/mL$ vs $5.0{\pm}1.4{\mu}g/mL$). Leptin had positive correlations with obesity index, BMI, and IL-6. Conclusion : In obese adolescents, leptin, TNF-${\alpha}$, IL-6, and insulin might be important mediators of obesity. Further clinical research is necessary to ascertain leptin as a predictor of cardiovascular diseases and to develop a guideline for clinical intervention.

A Study on the Hydrocarbon Dew Point Prediction by the Compositions of the Fuel Gas Mixtures (연료용 혼합가스 조성에 따른 탄화수소 이슬점 예측)

  • Kim, Young-Gu;Choi, Seul-Gi;Ahn, Jung-Jin;Lee, Chang-Eon
    • Journal of the Korean Institute of Gas
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    • v.19 no.3
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    • pp.44-48
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    • 2015
  • The equations of hydrocarbon dew points(DT) of the fuel gas mixtures have been derived using the multiple regression analysis. In QSDR(Quantitative Structure Dew-point Relationship), the principal descriptors are CN(average carbon number) and BI(the ratio of the branched isomers). QSDRs studied by changing the pressures of the fuel gas mixtures in the range of 100 kPa ~ 500 kPa are as follows; $$DT(^{\circ}C)=-683.1+1224.98CN-898.01CN^2+308.58CN^3-49.56CN^4+3.02CN^5-12.42BI$$ (at 100 kPa, $$R_{adj}{^2}=0.99$$) (1) $$DT(^{\circ}C)=-745.2+1351.66CN-978.1CN^2+332.7CN^3-52.96CN^4+3.20CN^5-12.84BI$$ (at 200 kPa, $$R_{adj}{^2}=0.99$$) (2) $$DT(^{\circ}C)=-795.4+1457.1CN-1051.1CN^2+357.53CN^3-57.07CN^4+3.46CN^5-13.10BI$$ (at 300 kPa, $$R_{adj}{^2}=0.99$$) (3) $$DT(^{\circ}C)=-868.1+1608.4CN-1156.0CN^2+393.38CN^3-63.06CN^4+3.85CN^5-13.39BI$$ (at 500 kPa, $$R_{adj}{^2}=0.99$$) (4) As the average carbon numbers in the mixed fuel being reduced or the ratio of the branched isomers having a boiling point lower increase, The hydrocarbon dew point becomes lower, The differences between the hydrocarbon-dew points determined by the multiple regression and those calculated by the commercial program, VMGSim are negligible.

Clinical Significance of Electrolyte Imbalance in Pediatric Urinary Tract Infection (요로감염과 동반된 전해질 불균형의 임상적 의의)

  • Cho, Sea-Eun;Choi, Lim;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.58-65
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    • 2011
  • Purpose: Some hormonal and electrolyte abnormalities have been reported in pediatric patients with urinary tract infection (UTI). This study aimed to investigate the relationships between the imbalance of electrolytes and the severity of infection and associated urologic anomalies in children with febrile UTI. Methods: We retrospectively reviewed 267 patients with febrile UTI who were admitted to Korea University Guro Hospital during the period from January, 2007 until February, 2010. According to the presence of hyponatremia or hyperkalemia, clinical parameters and associated renal anomalies, such as hydronephrosis, cortical defects and vesicoureteral reflux, were compared. Results: 42.7% of all patients had decreased concentration of serum sodium. In patients with decreased concentration of serum sodium, cortical defects were significantly increased compared to normal patients (40.4% vs. 14.4%, P <0.05). White blood cell (WBC) counts ($15,721{\pm}6,553/uL$ vs. $12,885{\pm}5,367/uL$, P <0.05), C-reactive protein (CRP) ($61.8{\pm}56.1$ mg/L, vs. $29.9{\pm}39.8$ mg/L, P <0.05), and erythrocyte sedimentation rate (ESR) ($43.9{\pm}34.3$ mm/hr vs. $27.4{\pm}26.8$ mm/hr, P <0.05) in peripheral blood showed significant increases in the group with decreased concentration of serum sodium. Duration of fever, presence of gastrointestinal symptom, the incidence of hydronephrosis and vesicoureteral reflux did not differ between the two groups. None of the patients had significant hyperkalemia. Conclusion : We suggest that decreased concentration of serum sodium in febrile UTI might be a helpful marker for leukocytosis and increased CRP and ESR in peripheral blood, and acute pyelonephritis.

Climate Change Impact on Nonpoint Source Pollution in a Rural Small Watershed (기후변화에 따른 농촌 소유역에서의 비점오염 영향 분석)

  • Hwang, Sye-Woon;Jang, Tae-Il;Park, Seung-Woo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.8 no.4
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    • pp.209-221
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    • 2006
  • The purpose of this study is to analyze the effects of climate change on the nonpoint source pollution in a small watershed using a mid-range model. The study area is a basin in a rural area that covers 384 ha with a composition of 50% forest and 19% paddy. The hydrologic and water quality data were monitored from 1996 to 2004, and the feasibility of the GWLF (Generalized Watershed Loading function) model was examined in the agricultural small watershed using the data obtained from the study area. As one of the studies on climate change, KEI (Korea Environment Institute) has presented the monthly variation ratio of rainfall in Korea based on the climate change scenario for rainfall and temperature. These values and observed daily rainfall data of forty-one years from 1964 to 2004 in Suwon were used to generate daily weather data using the stochastic weather generator model (WGEN). Stream runoff was calibrated by the data of $1996{\sim}1999$ and was verified in $2002{\sim}2004$. The results were determination coeff, ($R^2$) of $0.70{\sim}0.91$ and root mean square error (RMSE) of $2.11{\sim}5.71$. Water quality simulation for SS, TN and TP showed $R^2$ values of 0.58, 0.47 and 0.62, respectively, The results for the impact of climate change on nonpoint source pollution show that if the factors of watershed are maintained as in the present circumstances, pollutant TN loads and TP would be expected to increase remarkably for the rainy season in the next fifty years.

Changes of C-Reactive Protein and Erythrocyte Sedimentation Rate Level from Infection and Non-Infection after the Artificial Joint Surgery (인공관절 수술 후 감염과 비 감염에 따른 C-반응성단백과 적혈구침강속도의 변화 추이)

  • Kim, Min-Ju;Kim, Hye-Jeong
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.321-326
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    • 2016
  • This study aimed to analyze the changes of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measured in acute infection within four weeks post artificial joint surgery to predict potential infection in early stages, provide rapid treatment, and prevent the abuse of antibiotics. This study included 50 patients with acute infection and 50 patients without any symptoms of infection, among patients who received artificial joint replacement surgery on the lower limbs in a four-week period. CRP was the highest two-to-three days after surgery. with $5.77{\pm}3.69$ and $5.17{\pm}3.48$, respectively, in those with infection and without infection. Thereafter, the value rapidly reduced in those without infection. However, it increased again to $3.16{\pm}2.87$ in the group with infection according to the bimodal curve (p<0.001). ESR was the highest two-to-three days after surgery, with $58.8{\pm}24.63$ and $44.08{\pm}21.48$, respectively. Thereafter, the value slowly reduced in those without infection. However, it was increased again to $47.62{\pm}26.26$ in those with infection according to the bimodal curve p<0.001). As this study shows, if there is an increasing trend for CRP and ESR after artificial joint replacement surgery, it may be possible to question whether patients are acutely infected post surgery. In particular, this result is expected and regarded as a useful factor for diagnosing infection due to the high level of sensitivity and uniqueness for CRP.

Serum Adiponectin Levels and Insulin Resistance in Obese Children (비만 소아의 혈중 아디포넥틴과 인슐린저항성에 관한 연구)

  • Lee, Hee-Sun;Lee, Jin;Kang, Min-Joo;Choi, Byung-Min;Lee, Kee-Hyoung
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.481-487
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    • 2005
  • Purpose : Adiponectin, adipose tissue-specific protein, has anti-inflammatory and anti-atherogenic properties. It has been found to have a negative correlation with obesity and to play a role in modulating glucose tolerance and insulin sensitivity. Serum adiponectin concentrations are decreased in adults with obesity and type 2 diabetes. We investigated the difference in adiponectin levels between obese and non-obese children, and evaluated the relationship of serum adiponectin with body mass index(BMI), serum fasting insulin, lipid profiles and homeostasis model assessment(HOMA) in children. Methods : We measured serum adiponectin levels by radioimmunoassay in 113 children(82 obese children and 31 non-obese controls) from 8 to 15 years of age, and also checked BMI, fasting serum glucose, insulin and lipid profiles. Fasting and postprandial serum adiponectin concentrations were compared by oral glucose tolerance tests in 27 obese children. The correlations of adiponectin with BMI, insulin, low density lipoprotein(LDL)-cholesterol and HOMA were analyzed by Pearson's correlation. Results : The serum adiponectin levels were significantly lower in the obese group(19.7 mg/mL) than in the non-obese group(27.5 mg/mL)(P<0.01). Serum adiponectin concentrations were negatively correlated with BMI(r=-0.39, P<0.01), serum insulin(r=-0.28, P<0.01), LDL-C(r=-0.20, P<0.01) and HOMA(r=-0.22, P<0.01). At oral glucose tolerance tests in obese children, postprandial 2 hours adiponectin level(19.8 mg/mL) was decreased compared to fasting level(25.8 mg/mL)(P<0.01). Conclusion : Serum adiponectin concentrations were inversely related to adiposity and insulin resistance in children. We suggest the serum adiponectin level could be used as an early marker of insulin resistance in obese children.

Effects of Growth Hormone Therapy in Children with Idiopathic Short Stature (특발성 저신장증 소아에서 성장호르몬의 치료효과)

  • Lee, Kyong A;Han, Heon Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.865-870
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    • 2005
  • Purpose : The use of growth hormone(GH) to promote growth in normal short children without classical GH deficiency is controversial. Numerous foreign studies have shown the effects of GH therapy in children with idiopathic short stature(ISS) whereas few has been interested in Korea. Therefore, this study is designed to investigate the effects of GH therapy on ISS by observing correlations and changes among various growth parameters such as, insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3). Methods : This study was conducted retrospectively with 15 children with ISS in Chungbuk National University Hospital in Korea. Mean age was $11.44{\pm}2.81$ and the children were treated with 0.66 IU/kg/wk dosage of GH for 1 or 2 years. Also, the growth parameters before and after the GH therapy were observed. Results : Height standard deviation score(HT-SDS) was increased from $-1.85{\pm}0.70$ to $-1.58{\pm}0.56$ at 1 year and to $-1.21{\pm}0.37$ at 2 years after GH therapy. Predicted adult height standard deviation score(PAH-SDS) was also increased from $-2.10{\pm}0.52$ to $-1.67{\pm}0.59$ at 1 year, and to $-0.96{\pm}0.60$ at 2 years. Serum IGF-I and IGFBP-3 levels were significantly increased after 1 year and marginally increased after 2 years of GH therapy. Conclusion : It is concluded that GH therapy has growth promoting effect. The significant increase in IGF-I and IGFBP-3 levels during the GH therapy suggests that IGF-I and IGFBP-3 are useful predictors of response to the use of GH therapy. It is expected that larger patient samples would provide more reliable information about the effect of GH therapy.

Association of Leukotriene C4 Synthase Gene Polymorphism with Clinical Response to Montelukast in Childhood Asthma (소아 천식환자에서 Leukotriene C4 Synthase 유전자 다형태와 Montelukast의 임상적 효과와의 연관성)

  • Shin, Kyung Sue;Kim, Youn Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.766-771
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    • 2005
  • Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.

Serum Vascular Endothelial Growth Factor as a Predictive Risk Factor for the Occurrence of Coronary Artery Lesions in Kawasaki Disease (가와사끼병에서 관상동맥류 발생에 관한 혈청 Vascular Endothelial Growth Factor의 임상적 의의)

  • Park, Min Hyuk;Jung, Hye Lim;Yang, Ju Hee;Shim, Jung-Yeon;Kim, Deok Soo;Shim, Jae Won;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.811-816
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    • 2003
  • Purpose : Kawasaki disease is an acute systemic vasculitis of unknown etiology with a predilection for the coronary arteries. Vascular endothelial growth factor(VEGF) is a cytokine which promotes vascular permeability and angiogenesis. We investigated serum VEGF(sVEGF) levels in Kawasaki disease to determine whether sVEGF level can be used as a risk factor to predict the occurrence of coronary artery lesions(CAL) in Kawasaki disease. Methods : We measured sVEGF levels in 11 patients with Kawasaki disease in acute phase(patient group)and 11 normal children(control group) by enzyme-linked immunosorbent assay(ELISA) method. We investigated the relationship between sVEGF levels and the lumen diameters of coronary artery and other potential CAL risk factors; duration of fever, hemoglobin, WBC counts, platelet counts, ESR, CRP and LDH levels. Results : SVEGF levels of patients in the acute phase of Kawasaki disease(mean $847.9{\pm}495.7pg/mL$) were significantly higher than that of normal controls(mean $279.9{\pm}150.6pg/mL$; P<0.05). SVEGF levels showed significant positive correlation with the lumen diameters of the coronary artery(P<0.05, $r_s=0.75$) in the patient group. There was no significant correlation between sVEGF levels and duration of fever or other laboratory measurements. Conclusion : Our results support the notion that sVEGF level may be considered as a predictive indicator for the occurrence of coronary artery lesions in Kawasaki disease.