• Title/Summary/Keyword: 위험도 판단

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The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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Cultural Practices for Reducing Cold Wind Damage of Rice Plant in Eastern Coastal Area of Korea (동해안지대 도작의 냉조풍피해와 피해경감대책)

  • 이승필;김칠용
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.5
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    • pp.407-428
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    • 1991
  • The eastern coastal area having variability of climate is located within Taebaek mountain range and the east coast of Korea. It is therefore ease to cause the wind damages in paddy field during rice growing season. The wind damages to rice plant in this area were mainly caused by the Fohn wind (dry and hot wind) blowing over the Taebaek mountain range and the cold humid wind from the coast. The dry wind cause such as the white head, broken leaves, cut-leaves, dried leaves, shattering of grain, glume discolouration and lodging, On the other hand the cold humid wind derived from Ootsuku air mass in summer cause such symptom as the poor rice growth, degeneration of rachis brenches and poor ripening. To minimize the wind damages and utilize as a preparatory data for wind injury of rice in future, several experiments such as the selection of wind resistant variety to wind damage, determination of optimum transplanting date, improvement of fertilizer application methods, improvement of soils and effect of wind break net were carried out for 8 years from 1982 to 1989 in the eastern coastal area. The results obtained are summarized as follows. 1. According to available statisical data from Korean meteorological services (1954-1989) it is apperent that cold humid winds frequently cause damage to rice fields from August 10th to September 10th, it is therefore advisable to plan rice cultivation in such a way that the heading date should not be later than August 10th. 2. During the rice production season, two winds cause severe damage to the rice fields in eastern coastal area of Korea. One is the Fohn winds blowing over the Taebaek mountain range and the other is the cold humid wind form the coast. The frequency of occurrence of each wind was 25%. 3. To avoid damage caused by typhoon winds three different varieties of rice were planted at various areas. 4. In the eastern coastal area of Korea, the optimum ripening temperature for rice was about 22.2$^{\circ}C$ and the optimum heading date wad August 10th. The optimum transplanting time for the earily maturity variety was June 10th., medium maturity variety was May 20th and that of late maturity was May 10th by means of growing days degree (GDD) from transplanting date to heading date. 5.38% of this coastal area is sandy loamy soil while 28% is high humus soil. These soil types are very poor for rice cultivation. In this coastal area, the water table is high, the drainage is poor and the water temperature is low. The low water temperature makes it difficult for urea to dissolve, as a result rice growth was delayed, and the rice plant became sterile. But over application of urea resulted in blast disease in rice plants. It is therefore advise that Ammonium sulphate is used in this area instead of urea. 6. The low temperature of the soil inhibits activities of microorganism for phosphorus utilization so the rice plant could not easily absorb the phosphorus in the soil. Therefore phosphorus should be applied in splits from transplanting to panicle initiation rather than based application. 7. Wind damage was severe in the sandy loamy soil as compared to clay soils. With the application of silicate. compost and soil from mointain area. the sand loamy soil was improved for rice grain colour and ripening. 8. The use of wind break nets created a mocro-climate such as increased air. soil and water temperature as well as the reduction of wind velocity by 30%. This hastened rice growth, reduced white head and glume discolouration. improved rice quality and increased yield. 9. Two meter high wind break net was used around the rice experimental fields and the top of it. The material was polyethylene sheets. The optimum spacing was 0.5Cm x 0.5Cm. and that of setting up the wind break net was before panicle initiation. With this set up, the field was avoided off th cold humid wind and the Fohn. The yield in the treatment was 20% higher than the control. 10. After typhoon, paddy field was irrigated deeply and water was sprayed to reduce white head, glume discolouration, so rice yield was increased because of increasing ripening ratio and 1, 000 grain weight.

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